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Workforce Retention in LTC: Navigating Immigration Uncertainty

Written by Showd.me | Nov 13, 2025 6:38:32 PM

With an aging population and growing demand for care, long-term care and home care face recruitment and retention challenges that show no sign of slowing. Now, shifts in immigration policy add another layer of uncertainty, threatening a workforce already stretched thin.

Immigrants make up about 28 percent of direct care workers, serving as the backbone of care delivery in homes, assisted living communities, and skilled nursing facilities nationwide. As the policy landscape shifts, so does the urgency for providers to strengthen what they can control: how they support, train, and retain the caregivers who make quality care possible.  

The most effective strategies combine competitive pay and benefits, supportive workplaces, and career development opportunities that help caregivers grow.

Why Workforce Retention Matters In LTC

Workforce retention isn’t just a staffing issue; it is central to quality care. When caregivers stay, they build relationships with families and residents, learn their routines and preferences, and provide more consistent care, which leads to better outcomes and higher satisfaction. 

On the other hand, high turnover weakens care continuity and morale. Each new vacancy means another recruitment cycle, more onboarding, and heavier workloads for remaining staff. 

Competitive pay and benefits will always be essential, but compensation alone can’t offset the stress of a demanding care environment or the uncertainty many immigrant workers face when policies shift. We’ll explore strategies beyond compensation that can foster stability and build a workplace culture where caregivers feel supported to stay and grow. 

Building a Supportive Workplace Culture

Many direct care workers are immigrants who’ve built their lives and livelihoods around caring for others, even as shifting regulations leave their own futures feeling less secure. In that kind of environment, workplace culture becomes a lifeline.

Direct care work is challenging on both a physical and emotional level, and workers who feel supported are more likely to remain in their role. 

Positive work relationships can make a difference to employees who care for others. Some tips for creating an organizational culture that values its employees and their contributions include:

  • Celebrate impact. Dedicate time to call out the difference staff make in residents’ and clients’ lives every day, whether that’s in daily stand-ups, department meetings, or employee newsletters
  • Build community. Foster bonds with long-tenured employees through mentorship programs. Establish peer recognition programs that allow employees to a way to share the great things their co-workers are doing for the clients and patients they care for. 
  • Encourage mentorship and peer recognition programs that build community and morale. 
  • Show appreciation. Express gratitude through thank-you notes, recognition events/awards, or small gifts, such as company swag, new shoes or scrubs, or even lunch with leadership.
  • Lead with empathy. Regularly check in with employees and respond to issues with an empathetic mindset or a “that’s just how it is” approach. Doing so will help establish clear channels of communication. But don’t just listen. Be sure to take action on feedback wherever you can to foster trust and loyalty. 
  • Acknowledge the emotional load. Compassion fatigue is real and very common among those working in long-term care. Giving access to counseling or grief resources or even checking in with a simple “how are you really doing?” can go a long way.

Investing in Training and Career Growth

We all know that effective onboarding and ongoing training are cornerstones of retention. But when immigration and labor policies fluctuate, the first weeks of employment become even more critical. New hires who feel prepared and supported are more likely to stay and grow within the organization. This is particularly important for those new to the U.S. healthcare system. 

Robust Onboarding and Training

A structured onboarding process—one that clearly explains expectations, introduces team members, and pairs new employees with mentors—helps your organization remain compliant with regulations, reduces anxiety, and improves the performance of new caregivers during those first critical weeks.

But training shouldn’t stop after orientation. Comprehensive ongoing education makes sure that workers have the skills they need and demonstrates a long-term investment in staff success. Tuition reimbursement programs, mentorship, coaching, and in-service education sessions in both clinical and soft skills all promote professional growth. 

Importantly, training should also be accessible to everyone, including a multilingual workforce. Providing education in the languages your caregivers understand best not only enhances comprehension but also builds confidence and inclusion from day one.

Opportunities for Advancement

One of the strongest remedies to workforce uncertainty is a visible path forward. Caregivers who can see what’s next for them are much more likely to stay and grow. Offering tuition reimbursement, mentorship, and transparent career ladders or “in training” programs demonstrates commitment to the people who form the backbone of care delivery. 

 A CNA who sees a pathway to a medication aide role, then to an LPN role isn’t just doing a job, they’re building a career. When people see future opportunities, they’re more likely to stay and invest in their work.

From Uncertainty to Resilience

The long term care workforce has always been incredibly diverse and dedicated, both qualities that no policy changes will likely impact. But sustaining that workforce requires intention. Each experienced caregiver who stays in your organization contributes to stronger relationships with patients and colleagues, more consistent patient outcomes, and a more resilient organization.

Showd.me helps long-term care providers strengthen what matters most: their people.

While organizations can’t control policy, they can control how supported their teams feel through change. Let’s explore strategies that build belonging, strengthen resilience, and foster a workplace culture where caregivers want to stay and grow.

Showd.me helps providers do just that. From structured onboarding and multilingual training to career advancement pathways, our platform helps organizations retain and develop the caregivers who make quality care possible. Schedule a demo to see how we can help your team stay strong through uncertainty.