Washington, D.C. — The Supreme Court is scheduled to hear oral arguments this month in a case that could determine whether hundreds of thousands of Haitian immigrants lose their legal right to live and work in the United States — and senior care providers say the fallout would be felt in nursing home hallways from Boca Raton to Boston.
Nursing home operators and advocacy groups have filed an amicus brief asking the court to preserve Temporary Protected Status for Haitians, warning that ending it would deepen an already acute staffing crisis across the long-term care sector. The brief was filed by Sinai Residences, a continuing care retirement community in Boca Raton, Florida, and LeadingAge Southeast.
“Providers across the country are losing longtime, legally authorized caregivers, breaking trusted relationships and widening staffing gaps that directly threaten older adults’ access to needed care,” said Katie Smith Sloan, president and CEO of LeadingAge, which represents more than 5,300 nonprofit aging services providers.
A workforce nursing homes can’t afford to lose
The numbers tell a clear story. Nursing homes currently have roughly one in seven direct care positions unfilled nationwide. That gap has persisted despite years of recruitment efforts, wage increases, and state-level mandates. Now industry leaders say the TPS decision could remove a significant portion of the workers who actually show up every day.
In Massachusetts alone, nursing facilities employ about 4,300 Haitian workers — licensed nurses, certified nursing assistants, laundry staff, and food service employees — who collectively help care for more than 150,000 residents each year. Sinai Residences, which filed the brief, employs 26 Haitian staff members whose work permits are at risk. The facility’s workforce is 70% foreign-born.
The problem extends beyond any single state. Foreign-born workers have filled around-the-clock shifts — especially overnights and weekends — in facilities that already struggle to compete with better-paying industries for American-born workers. With staffing pressures mounting across the sector, losing legally authorized employees isn’t an abstraction. It directly affects how many residents can be admitted and how safely they can be cared for.
What’s at stake at the Supreme Court
Trump’s administration revoked Temporary Protected Status for approximately 350,000 Haitians — a designation that has been in place since Haiti’s 2010 earthquake and was later extended after political violence and gang activity worsened following the 2021 assassination of President Jovenel Moïse. A lower court placed a stay on the termination, and after the administration sought emergency relief, the Supreme Court accepted the case for argument this month.
If the court sides with the administration, the roughly 350,000 Haitians currently protected would lose work authorization and face possible deportation. For nursing homes, that means losing employees who, in many cases, have worked the same halls for years — people residents know by name and depend on for daily care.
Maryse Balthazar, a Florida elder care nurse and TPS holder who fled Haiti after the 2010 earthquake, described the threat of removal as feeling “like another earthquake.” She fears separation from her U.S. citizen daughter and the possibility that her son could be deported to a country now controlled by gang violence.
At Sinai Residences, a 92-year-old resident named Murray Rubin described the Haitian workers as “like family” — the kind of bond that forms when the same caregivers help someone eat, bathe, and move through each day for years at a time.
An industry watching closely
The TPS case is one of several immigration policy changes hitting nursing homes at once. Work authorization is expiring for workers from multiple countries, home care agencies have already reported losses, and advocates say 150,000 pending TPS applications face additional uncertainty regardless of how the court rules.
LeadingAge’s brief argues that the court should weigh not just the legal questions around TPS termination, but the practical consequences for a sector that is simultaneously facing demographic surge, chronic underfunding, and a pipeline of workers that was already too thin before this fight began.
The Supreme Court’s ruling — expected before the end of the term — will likely land in a sector that has little margin to absorb the loss.
