The needs of immigrant workers should be a top concern of nursing home operators during the coronavirus pandemic in order to prevent severe workforce shortages within the industry and protect the high-risk population from contracting the disease. 

In order to do that, researchers called on LTC operators in a blog posted in Health Affairs last week to adopt system-level changes that include COVID-19 protections and reforms against restrictive immigration policies. 

About 1 in 4 direct-care workers in LTC facilities are foreign born, and immigrant workers are more likely to fill key shortages in under-resourced nursing homes, explained authors Caroline Lee, Archana Podury, Jasmine Kaduthodil and Leigh Graham, Ph.D. The research group is a part of a collaboration at Ariadne Labs that works to address COVID-19 and structural changes in long-term care facilities. The lab is a joint center for health systems innovation at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health.

Ongoing staff shortages has been a long-time issue in nursing homes, prior to being exacerbated by the pandemic, but the problem could reach critical levels if stabilization efforts for immigrant workers aren’t adopted by operators. 

The researchers also noted that although immigrants are at an increased risk for adverse health outcomes, they are less likely to access healthcare or demand workplace safety measures because of their citizenship status. 

“Environmental, legal and financial barriers have direct implications on immigrant workers’ ability to avoid COVID-related infection and advocate for safer practices,” the research team wrote. 

“Addressing these barriers would improve immigrant worker livelihood, ameliorate outbreaks in facilities serving vulnerable neighborhoods, and improve residents’ well-being by reducing isolation during the pandemic,” they added. 

The team called for a new framework that “views immigrant workers’ livelihood as both a human rights issue and a public health good.” That framework includes efforts like categorizing LTC facility staff as “healthcare providers,” which would protect them from immigration suspension and prevent critical worker shortages, and improving workplace safety during COVID-19. 

“These are not isolated efforts, but instead exist within an ecosystem where immigrants, LTC facilities, and their communities mutually benefit from efforts to improve the well-being of one another,” they concluded.