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Immigrant workers like Jackline Conteh are the backbone of Goodwin House Alexandria, a top-rated nursing home in Virginia. Conteh, a nurse assistant from Sierra Leone, cares for 92-year-old resident Rev. Donald Goodness, who credits immigrant staff with sustaining his well-being.

Now, the long-term care sector faces serious risks from Donald Trump and GOP-backed policies. Trump has reversed protections shielding healthcare facilities from ICE raids, raising fears even among green card holders. At the same time, Republicans are proposing deep cuts to Medicaid, which funds 60% of nursing home residents’ care.

Experts warn these moves could exacerbate staffing shortages and jeopardize care quality. Foreign-born workers make up 28% of direct care staff nationally, yet fear and policy uncertainty are driving many away.

Nursing home officials say immigrants provide consistent, compassionate care and are critical to meeting rising demand from aging baby boomers. “If all these people leave… what will become of our old people?” Conteh asked.


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