Drawing on direct member feedback, LeadingAge described how TPS terminations and related policy changes are resulting in the abrupt loss of experienced certified nursing assistants, nurses, dietary aides, housekeepers, and other essential staff: “Members report that long-tenured certified nursing assistants, dietary aides, and nurses who know clients’ and residents’ clinical needs,
routines, and preferences are being lost, often abruptly.”

In addition, our members report increased reliance on overtime and agency staffing, higher labor costs, delayed admissions, and growing strain on remaining workers—many of whom are already stretched thin. Providers also emphasized the toll on continuity and quality of care, particularly in long‑term care, memory care, and home‑based settings where consistent caregiver relationships are critical. In some cases, uncertainty around immigration status has led workers to leave jobs preemptively, intensifying shortages in both urban and rural communities.

LeadingAge also highlighted that the potential end of TPS for Haiti would have an especially severe impact, given the significant role Haitian TPS holders play in direct care roles across the country.

We urged Congress to pair oversight with legislative action to advance durable, statutory solutions that provide stability for foreign-born, work-authorized employees and predictability for providers.

LeadingAge will continue to advocate for immigration policies that support workforce stability and high‑quality care across the aging services continuum.