Immigrants make up 28% of the overall direct care workforce for long-term care services (compared to 17% of all adult workers), according to KFF, the independent health policy research organization.

Using data from the 2023 American Community Survey (ACS), KFF researchers assessed the role that immigrants play in the direct care workforce for LTC services. The analysis, released in an April 2, 2025 research note,  finds there were over 820,000 immigrants working as direct care workers providing long-term care in the U.S. (including over 500,000 naturalized citizens and over 300,000 noncitizen immigrants).

Immigrants represent one in three workers (32%) in home care settings and 21% of workers in nursing homes. KFF also found that the share of direct care workers providing LTC services who are immigrants increased from 24% in 2018 to 28% in 2023.

These data come at a critical time for foreign-born workers, who some providers tell LeadingAge feel threatened by mass deportation plans even though they are working in the country legally, creating a chilling effect throughout the workplace.

Trump administration campaign promises for increased border control and deportations exist parallel to LeadingAge’s continued advocacy to reform and expand woefully outdated legal immigration pathways to increase the aging services workforce, which is desperately needed as the number of workers in the United States pales in comparison to the number needed to address the care and services needs of today’s and tomorrow’s older adults.

The research note points to existing research “that immigration increases the local supply of workers in nursing fields, with the largest effect on the number of nurse aides” and that “increased immigration significantly raises the staffing levels of nursing homes in the U.S., particularly in full time positions” while providing “culturally competent care to an increasingly diverse population of older adults.”

Read the research note here.