Trump Immigration Rollback Deepens Staffing Crisis at U.S. Nursing Homes

U.S. long-term care operators say President Donald Trump’s revocation of work authorizations for several groups covered by Temporary Protected Status is aggravating a chronic staffing shortage just as demand for elder care accelerates. A.G. Rhodes, which runs three facilities in the Atlanta area, expects to lose eight employees after their TPS is cancelled, and similar reports are surfacing nationwide, according to industry group LeadingAge. Foreign-born workers account for more than a quarter of the nation’s roughly four million nursing assistants, home-health aides and related direct-care staff, making the sector especially exposed to tighter immigration rules. The timing is challenging: the Bureau of Labor Statistics projects about 820,000 additional home-care positions will be needed by 2032 as the baby-boom generation ages. Operators were already scrambling to rebuild payrolls after pandemic-era departures; federal data show annual turnover at some facilities around 50%. Front-line caregivers earned an average $16.72 an hour last year, limiting recruitment from the domestic labor pool and prompting homes to recruit abroad—a pipeline executives say is now ‘coming in dribs and drabs’. Advocates warn the clampdown could force facilities to cut admissions or shutter units, exacerbating pressure on hospitals and families. While the administration has cited national security and labor-market concerns, care-home executives argue that limiting legal pathways for workers threatens service quality and patient safety in one of the economy’s fastest-growing occupations.