Immigration Bill Could Compound Skilled Nursing Workforce Woes

A new bill that would curtail immigration could cut off a key solution to the growing skilled nursing workforce crisis.

The Reforming American Immigration for a Strong Economy (RAISE) Act, co-authored by Republican Sens. Tom Cotton of Arkansas and David Perdue of Louisiana and supported by President Trump, could result in a 50% reduction in legal immigration — cutting the number of new green card holders per year from 1 million to just 500,000, according to the Washington Post.

If passed, the new bill would initiate a skills-based points system that would prioritize immigrants that have higher levels of education, better English language abilities, and high-paying job offers.


The proposed law would be detrimental to the already strained skilled nursing workforce, according to executives of the Paraprofessional Healthcare Institute (PHI), a New York City-based nonprofit organization that works to improve long-term care services for seniors.

“Legislation that curbs the number of legal immigrants in this country will have a harmful effect on the long-term care system, where one in four paid caregivers is an immigrant,” PHI vice president of policy Robert Espinoza told Skilled Nursing News.

PHI released research in June which stated that there are approximately one million immigrants in the direct-care field.


“Attacking workers who already occupy low-paying jobs with minimal protections will make it more difficult to stabilize a workforce critical to the U.S. economy,” said PHI president Jodi M. Sturgeon in the June research press release.

A recent study from LeadingAge found that long-term care (LTC) operators will need 69% more maintenance workers, 68% more nursing assistants, and 67% more food preparation workers to accommodate demand by 2030. By that same year, LeadingAge estimates that care providers will have to boost total staff by 2.5 million people.

Many senior housing businesses are limited by their inability to raise wages because two-thirds of their revenues come from fixed government payment systems, Fred Benjamin, president of Lexington Health Network’s skilled nursing division, said.

In April 2013, as the COO of SNF operator Medicalodges, Benjamin testified before a congressional subcommittee on behalf of the American Health Care Association (AHCA), expressing support for a proposed W visa program to admit low-skilled foreign workers.

These workers could fill many open positions in senior housing, such as certified nurses’ aides, licensed practical nurses, housekeepers, activity aides, and dietary and kitchen workers, Benjamin told SNN today.

“We simply cannot find enough American workers to fill these jobs, despite having good benefits and many different kinds of outreach programs,” Benjamin said. “We need more workers, and traditionally unskilled immigrant laborers are the people that end up filling many of these roles. Cutting the number of legal immigrants in half would make an already difficult situation much worse.”

Written by Elizabeth Jakaitis

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