Filling the Care Gap: Immigration, Workforce, and the Future of Senior Living in Northern Virginia

A Northern Virginia Senior Resource Network Forum at Goodwin House Bailey's Crossroads

• 96% of senior living organizations report staffing shortages; the field remains 130,000 workers short of pre-pandemic levels, even as 10,000 Americans turn 65 every day.
• At Goodwin Living, 40% of 1,400+ team members are immigrants; among direct caregivers in some units, that figure reaches 90%.
• Current immigration policy offers virtually no visa pathway for non-degreed caregiving roles like certified nursing assistants.
• Goodwin Living's resident-driven Citizenship Program has issued 242 grants to fund the U.S. Citizenship Exam Fee and helped produce 128 new U.S. citizens.
• Practical steps any organization can take: send handwritten letters to legislators, connect employees to pro bono legal resources, and build a workforce tracker organized by immigration status and country of origin.

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The numbers alone tell a stark story. Twenty-five percent of active U.S. physicians are international medical graduates. Sixteen percent of nurses were educated abroad. Ninety-six percent of senior living organizations report staffing shortages. And the field remains 130,000 workers short of pre-pandemic levels — even as 10,000 Americans turn 65 every single day.
Those were among the statistics that opened a recent Northern Virginia Senior Resource Network forum hosted at Goodwin House Bailey's Crossroads, where senior living operators, home care providers, and community members gathered to confront one of the most pressing challenges facing the industry: how to sustain a workforce that depends heavily on immigrant labor in an era of sweeping immigration restriction.

A Wall Everywhere
Forum moderator Steve Gurney of Positive Aging walked attendees through a policy landscape that has erected barriers well beyond the southern border. The H-1B visa — the primary pathway for physicians — requires a bachelor's degree, carries a $100,000 employer sponsorship fee, is capped at 85,000 annually, and filled by lottery from a pool of roughly 400,000 applicants. For non-degreed roles like certified nursing assistants, there is effectively no temporary visa pathway unless the worker comes from Canada or Mexico. Refugee admissions have been sharply curtailed, and immigration visas have been paused for nationals of 75 countries.
"It's not just the wall in Mexico," Gurney noted. "There's a wall everywhere."
Solutions raised by policy experts included exempting healthcare workers from H-1B caps and lotteries, reinstating a temporary visa category for nurses, lifting per-country visa caps to speed green card processing, and expanding visa waivers for clinicians willing to serve underserved areas.

The Human Reality
For Brittany DiSciullo, Vice President of Human Resources at Goodwin Living, the policy environment is anything but abstract. The organization employs more than 1,400 team members from over 65 countries, about 40 percent of whom are immigrants. Among direct caregivers in some healthcare teams, that figure reaches 90 percent.
"If you remove immigrants from our workforce, you can effectively remove 90 percent of our caregivers," DiSciullo said.
Following the 2024 presidential election, Goodwin Living moved quickly. The organization hosted "Know Your Rights" seminars with immigration attorney James Montana, built a confidential workforce tracker organized by country of origin and immigration status, and began monitoring the federal E-Verify status change report — a 2025 tool that flags employees whose work authorization has been revoked even when their documents appear current. It was through that report that Goodwin Living learned it had to part ways with four Haitian team members last year.
"They weren't just losing their job at Goodwin Living. They were losing their right to work in the United States," DiSciullo said.
Jim Lindsay of ACC Family home care described a similar landscape for smaller organizations. With roughly 150 employees — 85 percent immigrants — ACC Family must rigorously verify documentation while lacking the resources to sponsor workers for citizenship. In Alexandria, where Lindsay serves on the Commission on Aging, the local response has centered on basic needs: feeding programs for families afraid to access public services, and free legal referrals.

The Mother of the Citizenship Program
One of the forum's most resonant voices belonged not to a professional, but to a resident. Rita Siebenaler, a retired clinical social worker who lives at Goodwin House Bailey's Crossroads, is credited as the driving force behind Goodwin Living's Citizenship Program.
Siebenaler recalled her outrage when the citizenship application fee jumped overnight from $325 to $725. She approached administration, was initially turned down, returned with a formal proposal arguing the program would improve recruitment and retention — and was proven right on both counts. A quiet announcement went out, and within two weeks residents raised $40,000. To date, 242 grants have been issued covering citizenship applications, green card renewals, and DACA renewals, resulting in 128 new U.S. citizens among Goodwin Living's workforce.
"This isn't a political issue, it's a human issue," she said.

Choosing to Go Public
Goodwin Living also made a deliberate decision to step into the national spotlight — appearing in major media, visiting Capitol Hill, and standing visibly alongside immigrant employees at a moment when that visibility carried real risk. Chief Strategy & Marketing Officer Lindsay Hutter described a careful vetting process for every media request, and deeply personal conversations with team members about whether they were comfortable being photographed knowing ICE could potentially come to their workplace and even go to their children's schools.
"We never had a single team member back away," Hutter said. "The heroes are the team members who said, 'I can. I've got the support, I've got the courage, I trust Goodwin Living.'"
The organization has worked closely with LeadingAge and the American Business Immigration Coalition to advocate for healthcare workforce carve-outs in immigration policy, and has organized its residents — among the most reliable voting blocs in the country — to testify before lawmakers. Siebenaler was in the House gallery when Representative Ayanna Pressley's bipartisan legislation on Temporary Protected Status for Haitians passed.
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What Any Organization Can Do
Panelists were emphatic that meaningful action isn't reserved for large organizations. Jim urged every attendee to send handwritten letters — not emails or petitions — to their congressional representatives, explaining that personal correspondence cuts through mass advocacy noise and often lands directly on a legislator's desk.
Siebenaler pointed to three Northern Virginia organizations offering pro bono immigration legal assistance: Catholic Charities, Lutheran Social Services, and Just Neighbors. Hutter highlighted a model for smaller operators: pooling modest contributions from multiple senior living businesses to fund additional nursing faculty at Northern Virginia Community College.
"Are we going to choose to meet the moment?" Hutter asked in closing. "We invite you on the journey."