Investigation · April 30, 2026

The Supreme Court is deciding who takes care of your parents

The Supreme Court heard arguments on stripping TPS from 300,000+ Haitians and Syrians. For nursing homes already struggling with 1-star staffing ratings, the stakes are concrete.

Immigrants make up roughly one in four nursing home workers nationally. More than 20,000 Haitian TPS holders alone work as nursing assistants or caregivers across the U.S. In states like Massachusetts, about 40% of front-line nursing home staff are immigrants, filling roles as nursing assistants, licensed nurses, and in housekeeping and dining.

This isn't an abstract workforce question. CMS data shows 2,636 nursing homes, nearly one in five, already carry a 1-star staffing rating. In Illinois, that's 45% of facilities. Missouri, 42.5%. Texas, 37.8%. Those numbers reflect the floor, before any workforce disruption.

TPS changes mean exclusion of workers from countries like Haiti, which have been a significant source of nursing home staff. The federal minimum staffing mandate was repealed in February. Demand for direct care workers is projected to grow 35 to 41% through 2037.

The court's decision narrows the pool further.

25 Nursing Homes with the Worst Staffing Ratings

Facilities with 1-star CMS staffing ratings, ranked by total fines

FacilityOverallStaffingFines
AUTUMN MEADOWS OF CAHOKIA
1
1
$956K
MAJESTIC GARDENS AT MEMPHIS REHAB & SNC
1
1
$810K
BRIA OF CAHOKIA
1
1
$799K
Nexus Pavilion at Belleville
1
1
$791K
Nexus at Alton
1
1
$711K
Legacy Nursing at St. Christina
1
1
$656K
Whispering Pines Lodge
1
1
$624K
BRIDGEWOOD HEALTH CARE CENTER
1
1
$611K
CHICAGO RIDGE SNF
1
1
$607K
ARCHER HEIGHTS HEALTHCARE
2
1
$597K
GREGORY RIDGE HEALTH CARE CENTER
1
1
$585K
SOUTH SHORE REHABILITATION
1
1
$557K
BOSTICK NURSING CENTER
1
1
$547K
La Bella of Woodstock
1
1
$538K
SOUTHPOINT NURSING & REHAB CENTER
1
1
$531K
ARCADIA CARE HAVANA
1
1
$521K
Avir at Rose Trail
1
1
$520K
Sunset Rehabilitation and Health Care
1
1
$518K
ARCADIA CARE ALEDO
1
1
$507K
AUSTIN OASIS, THE
1
1
$488K
Goldwater Care Danville
1
1
$462K
PLYMOUTH HARBORSIDE HEALTHCARE
1
1
$460K
ARIA OF BROOKFIELD
1
1
$454K
RYZE AT HOMEWOOD
1
1
$451K
PLEASANT MEADOWS SENIOR LIVING
1
1
$450K

Sources

  • NPR: "As Supreme Court weighs Trump's immigration policy, senior citizens join the fight" (April 29, 2026)
  • Skilled Nursing News: "'We're Not Prepared to Replace Them': Immigration Changes Hit Nursing Homes Hard" (April 2026)
  • CMS staffing ratings via CareLeaks database