Key Takeaways
• Over 500,000 caregivers from Cuba, Haiti, Nicaragua, and Venezuela lost work authorization due to Trump’s 2025 crackdown.
• Foreign-born workers form 22% of nursing assistants; shortages cause nursing homes to reduce services or close wings.
• DHS permits ICE raids in healthcare settings, increasing fear and staff departures amid slow visa processing.
Nursing homes and long-term care facilities across the United States 🇺🇸 are facing a severe staffing crisis as of July 2025, directly tied to President Trump’s recent immigration crackdown. Since January, a wave of new executive orders and enforcement actions has stripped work authorization from thousands of caregivers, leaving many facilities unable to fill critical roles and forcing some to close wings or turn away new residents.
The Impact of the Immigration Crackdown on Nursing Homes
The Trump administration’s approach to immigration since returning to office in January 2025 has been swift and far-reaching. Nursing homes, which have long depended on foreign-born workers, are among the hardest hit. In July 2025, facilities nationwide began reporting the sudden loss of employees whose legal status was revoked, especially those with Temporary Protected Status (TPS) and humanitarian parole. The Department of Homeland Security (DHS) notified over half a million parolees from Cuba 🇨🇺, Haiti 🇭🇹, Nicaragua 🇳🇮, and Venezuela 🇻🇪 that their status was ending, urging them to leave the United States 🇺🇸 voluntarily.
The administration also suspended refugee programs, further shrinking the pool of available workers. New DHS directives now allow Immigration and Customs Enforcement (ICE) agents to conduct enforcement actions in or near sensitive areas, including hospitals and medical clinics. This reverses previous restrictions and has created a climate of fear among staff and residents alike.
Who Makes Up the Nursing Home Workforce?
Foreign-born workers are the backbone of the long-term care sector. According to the latest data:
- 30% of nursing home housekeeping and maintenance staff are foreign-born, compared to 19% in the overall U.S. workforce.
- 41% of home health aides and 28% of personal care aides come from outside the United States 🇺🇸.
- 22% of nursing assistants are immigrants.
These workers often fill roles that are hard to staff with U.S.-born employees, especially given the low average wage of $16.72 per hour for front-line caregivers, a figure that has barely increased since 2023.
A Growing Demand, Shrinking Supply
The need for caregivers is only expected to grow. The Bureau of Labor Statistics projects a 21% increase in demand for home health and personal care aides by 2033. Some estimates suggest a 35–41% growth in demand for direct care workers between 2022 and 2037. With the pipeline for new foreign-born workers nearly shut off and existing staff leaving due to fear of deportation or loss of work authorization, the gap between supply and demand is widening at an alarming rate.
Policy Changes and Enforcement Actions
The Trump administration’s crackdown has included several key changes:
- Revocation of TPS and Parole: Work authorizations for hundreds of thousands of individuals, especially those from countries previously granted TPS or humanitarian parole, have been rescinded.
- Suspension of Refugee Programs: Refugee resettlement, a key source of entry-level workers for care facilities, has been halted.
- Visa Processing Delays: The process for sponsoring registered nurses and licensed practical nurses from abroad has become so slow and uncertain that many candidates are choosing to work in other countries, such as Canada 🇨🇦 or Germany 🇩🇪.
- ICE Raids in Healthcare Settings: ICE agents are now authorized to conduct enforcement actions in hospitals and clinics, including questioning and detaining staff, patients, or visitors suspected of lacking legal status.
These changes have left nursing homes scrambling to fill positions and comply with new legal risks.
Practical Effects on Nursing Homes and Residents
The consequences for nursing homes are immediate and severe:
- Staff Shortages: Many facilities are operating with empty wings—not because there aren’t enough residents, but because they can’t find enough staff to care for them.
- Service Reductions: Some homes are cutting services or halting new admissions due to a lack of workers.
- Quality of Care: Experts warn that the quality of care is under threat, with disruptions already causing anxiety among residents and their families.
- Recruitment Challenges: The flow of new foreign-born workers has slowed to a trickle, and existing staff are leaving due to fear of deportation or loss of work authorization.
- Legal and Compliance Risks: Facilities must now prepare for possible ICE enforcement actions, including developing protocols to protect patient and staff privacy under HIPAA and state laws.
Deke Cateau, CEO of A.G. Rhodes in Atlanta, describes the situation: “We’ve lost staff due to TPS revocations, and the labor pipeline is getting smaller and smaller.” Nicole Jorwic of Caring Across Generations highlights the emotional toll: “Caregivers build irreplaceable relationships with residents. Forced departures are devastating for everyone involved.”
Why Are Immigrants So Important to Care?
David Grabowski, a professor at Harvard Medical School, explains, “Immigrant workers are critical to long-term care. Areas with more immigrant labor deliver better quality care.” This is not just about filling jobs; it’s about maintaining the relationships and trust that are essential in caring for vulnerable people.
The Government’s Position
Despite warnings from industry leaders and advocates, the White House remains firm. Spokeswoman Abigail Jackson says, “There is no shortage of American minds and hands to grow our labor force.” The administration argues that these policies will open up jobs for U.S.-born workers, but so far, there is little evidence that enough Americans are stepping in to fill the gaps.
How Are Facilities Responding?
Nursing homes are taking several steps to cope with the crisis:
- Review and Update Policies: Facilities are updating their protocols for responding to ICE enforcement, including staff training and legal compliance with privacy laws.
- Legal Preparedness: Many are consulting legal counsel to understand their rights and obligations during enforcement actions, especially regarding warrants and access to non-public areas.
- Staff Communication: Employers are notifying workers about potential changes to their work authorization status and providing resources for legal assistance.
- Recruitment Adjustments: Some are trying to recruit more U.S.-born workers, but options are limited due to federal restrictions and low wages.
- Resident and Family Support: Facilities are communicating transparently with residents and families about staffing challenges and the possible impact on care.
Background: How Did We Get Here?
The long-term care sector has relied on immigrant labor for decades. Shortages became even more acute during the COVID-19 pandemic, when many workers left due to health risks and burnout. From 2021 to 2024, the Biden administration expanded TPS and parole programs, temporarily increasing the available workforce. President Trump’s return to office in 2025 marked a sharp reversal, with immediate executive actions targeting both unauthorized and legal immigration channels.
Legal and Political Challenges
There are ongoing court challenges to some of the administration’s actions, especially the termination of certain legal statuses. However, the Supreme Court has so far upheld key elements of the crackdown. Without significant policy changes or new sources of labor, experts predict that shortages will worsen and care quality will decline in the coming months and years.
What Does the Future Hold?
- Litigation: Court cases may still change the administration’s ability to end certain legal statuses, but for now, the crackdown continues.
- Workforce Crisis: Unless there are major policy changes, the staffing crisis in nursing homes is likely to get worse.
- Industry Advocacy: Nursing home associations and advocacy groups are lobbying Congress and the administration for targeted immigration relief for healthcare workers. As of July 2025, no legislative action is expected soon.
What Can Facilities Do Right Now?
Facilities facing these challenges should:
- Stay Informed: Monitor updates from the Department of Homeland Security and other official sources. The DHS website (www.dhs.gov) provides the latest information on immigration enforcement and policy changes.
- Prepare Legally: Work with legal experts to ensure compliance with federal and state laws, especially regarding ICE enforcement and privacy protections.
- Support Staff: Offer resources and support to employees affected by changes in immigration status, including referrals to legal assistance.
- Communicate Clearly: Keep residents and families informed about staffing issues and any changes to care or services.
- Advocate: Join with industry groups to push for policy changes that would allow more foreign-born workers to fill critical roles in nursing homes.
Real Stories from the Front Lines
The human cost of these policies is clear in the stories shared by facility leaders and advocates. One administrator described having to close an entire wing because there simply weren’t enough staff to keep it open. Residents who have built close relationships with their caregivers are suddenly left without familiar faces, causing distress and confusion.
Nicole Jorwic, from Caring Across Generations, says, “These are not just workers—they are trusted companions for people at the end of their lives. Losing them is a loss for the whole community.”
Why Can’t U.S.-Born Workers Fill the Gap?
Despite the administration’s claims, there is little evidence that enough U.S.-born workers are willing or able to take these jobs. The work is physically and emotionally demanding, the pay is low, and the hours are often long and unpredictable. Many facilities report that even when they advertise widely, they receive few applications from U.S.-born candidates.
The Role of Temporary Protected Status
Temporary Protected Status (TPS) has been a lifeline for many caregivers. It allows people from countries facing war, natural disasters, or other crises to live and work legally in the United States 🇺🇸. The recent revocations have left thousands of workers in limbo, unsure if they can stay or must leave. As reported by VisaVerge.com, the loss of TPS workers has had an immediate and dramatic effect on staffing levels in nursing homes.
ICE Enforcement in Healthcare Settings
The new DHS directives allowing ICE agents to conduct enforcement actions in hospitals and clinics have created additional stress. Facilities must now prepare for the possibility of agents questioning or detaining staff, patients, or visitors suspected of lacking legal status. This not only disrupts care but also raises serious privacy concerns under HIPAA and state laws.
What Are the Legal Rights of Facilities and Staff?
Facilities have the right to protect patient and staff privacy. They should:
- Require ICE agents to present a valid warrant before entering non-public areas.
- Train staff on how to respond to enforcement actions.
- Consult with legal counsel to ensure compliance with all laws.
For more detailed guidance, facilities can refer to the official DHS website.
Industry and Advocacy Group Responses
LeadingAge, a nonprofit representing aging services providers, and other advocacy groups are calling for immediate action to address the crisis. They argue that without foreign-born workers, the entire long-term care system is at risk. Some are urging Congress to create special visa programs for healthcare workers or to restore TPS and parole protections.
Conclusion: What’s at Stake?
The Trump administration’s immigration crackdown has triggered a severe staffing crisis in U.S. nursing homes. The loss of workers with Temporary Protected Status and other legal protections has left many facilities unable to provide the care that residents need. Without significant policy changes, the situation is likely to get worse, with serious consequences for the health and well-being of some of the country’s most vulnerable people.
Facilities, workers, residents, and families are all feeling the effects. While legal challenges and advocacy efforts continue, the immediate need is for clear communication, legal preparedness, and support for those affected. The future of long-term care in the United States 🇺🇸 may depend on finding solutions that recognize the essential role of immigrants in caring for the nation’s aging population.
Learn Today
Temporary Protected Status (TPS) → A temporary immigration status for citizens of designated countries affected by crisis, allowing legal work.
Humanitarian Parole → Permission for individuals to enter or stay in the U.S. temporarily for urgent humanitarian reasons.
Immigration and Customs Enforcement (ICE) → Federal agency responsible for enforcing immigration laws, including detaining unauthorized individuals.
Refugee Resettlement Program → Government initiative to admit refugees for permanent settlement in the U.S., often filling labor needs.
Health Insurance Portability and Accountability Act (HIPAA) → U.S. law protecting patient privacy and regulating medical information handling.
This Article in a Nutshell
The 2025 immigration crackdown severely disrupted U.S. nursing homes by revoking work authorizations for many foreign-born caregivers. This led to staffing shortages, service reductions, and enforcement fears. With demand rising, facilities struggle to recruit while quality of care suffers, highlighting immigrants’ crucial role in long-term care across the country.
— By VisaVerge.com
