Immigration Battle Could Squeeze Nursing Home Finances

The long-term care industry dodged a bullet this week with a short government shutdown, but the fate of a federal budget still hinges on Congress reaching consensus over immigration — another issue that could have an outsized impact on the skilled nursing space.

Should Congressional Republicans attempt to clamp down on legal immigration and the so-called “Dreamers,” or undocumented immigrants brought to the country as children, the impact on staffing could be significant, Wall Street Journal Washington bureau chief Gerald F. Seib wrote this week.

“Failure to provide a path to legal status for ‘Dreamers’ … could compel some of them to depart from the country and the workforce,” Seib wrote.


Seib cited a June 2017 study from the Paraprofessional Healthcare Institute (PHI), which found that about a quarter of direct care workers are immigrants. In addition, non-profit provider association LeadingAge found that long-term care operators will have to increase maintenance, food preparation and nursing assistant staffing levels by almost 70% to meet demand in 2030.

“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 SNN back in August, when Senate Republicans introduced a bill that would slash the annual number of green cards issued in half.

The subject has returned to the forefront of U.S. politics amid this past week’s partial government shutdown. Democrats had initially refused to sign off on a budget plan without a comprehensive solution for residents covered by the Deferred Action for Childhood Arrivals program — an Obama-era framework that protects the “Dreamers.”


Democrats then agreed to end the standoff Monday afternoon, agreeing to a three-week extension with the promise that Senate majority leader Mitch McConnell would bring DACA reform to a vote.

“A reduction in the immigrant workforce might drive up wages as providers scramble for help, perhaps drawing in native-born Americans who aren’t currently attracted to relatively low-paying care jobs,” Seib wrote. “That, in turn, would drive up the cost of care.”

Clifton Porter, senior vice president of government relations for the American Health Care Association (AHCA), expressed his concerns to the Wall Street Journal and Seib.

“Many have lived and worked in the United States for years and deserve a chance to continue their productive lives here for the good of the U.S. economy and our aging population,” Porter told the WSJ. “Forcing dedicated, qualified people from other countries to leave will be a blow to many, including those who rely on their care.”

Read the full story — subscription required — at the WSJ.

Written by Alex Spanko

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