The Caregiver Shortage Is Getting Worse in 2026, Here's Why That Should Change How You Choose a Home

Senior care in Texas is short-staffed. That's not new. What's new in 2026 is how many directions the pressure is coming from at once, and why that matters enormously when you're choosing where Mom or Dad will actually live.

Funding Cuts Are Squeezing Staffing

A national survey by the American Health Care Association found that if Medicaid funding is reduced, 58% of nursing home and assisted living providers say they'd be forced to reduce current staff, and 44% say they'd limit new hiring and recruitment. With Medicaid cuts from the One Big Beautiful Bill Act phasing in through 2026, that pressure is no longer hypothetical for a lot of facilities.

The Federal Push to Improve Staffing Has Been Rolled Back

A 2024 rule meant to raise the floor on nursing home staffing nationwide was rescinded by CMS effective February 2026. Without that requirement in place, there's less regulatory pressure on large facilities to maintain adequate staffing levels even as their labor costs rise and workforce gets harder to find.

The Workforce Itself Is Shrinking

Research from the University of Pennsylvania's Leonard Davis Institute has noted that a meaningful share of the home care and long-term care workforce is foreign-born, and stepped-up immigration enforcement in 2025 and 2026 has reportedly affected even lawful workers in the field, on top of undocumented workers leaving the industry. For an industry that was already short-staffed before any of this started, a shrinking labor pool makes every open caregiving shift harder to fill.

What This Looks Like in a Large Facility

When a facility with 80 or 150 residents loses even a handful of caregivers, the math gets ugly fast, more residents per remaining staff member, longer waits for help with basic needs, and rising reliance on rotating or agency staff who don't know the residents. This is exactly the kind of environment where care quality quietly slips, even when a facility isn't doing anything wrong on paper.

Why Small Homes Are More Resilient

A small personal care home with 6 to 8 residents and a handful of consistent, known caregivers isn't immune to workforce pressure, but it's structurally more resilient. Losing one staff member out of a small, tight team is a manageable disruption. Losing one staff member out of an already-stretched large facility can mean a resident goes without timely help.

At Psalm 23, our caregivers know each grandma and grandpa personally: their routines, their preferences, what makes them comfortable. That kind of continuity is harder to maintain at scale, and it's exactly what a shrinking workforce puts at risk in bigger facilities.

"He restoreth my soul: he leadeth me in the paths of righteousness for his name's sake" (Psalm 23:3). Consistent, familiar care restores something a rotating cast of strangers never can.

Frequently Asked Questions

Is the caregiver shortage a Texas-specific issue?It's a national issue, but Texas has historically ranked among the lower-staffed states for long-term care, which can make local pressure feel more acute.

How can I tell if a facility is understaffed before moving my loved one in?Ask directly about current staff-to-resident ratios, staff turnover, and how many caregivers are on-site overnight, then ask to observe it during your tour rather than take it on faith.

Does Psalm 23 Home Care struggle with staffing turnover?We're proud of the continuity and stability of our small team. We're happy to talk through exactly who cares for our residents day to day.

See a Stable, Consistent Team for Yourself

Come meet the caregivers who would actually be looking after your loved one, not just read about staffing on paper. Click the Schedule Tour button on our website to book a tour. From our family to yours.

Sources

AHCA/NCAL, "New Survey Highlights Devastating Impact of Medicaid Reductions on Nursing Homes," 2025, ahcancal.orgPenn LDI, "How Medicaid Cuts Could Force Millions Into Nursing Homes," July 2025, ldi.upenn.eduManatt, Phelps & Phillips, "Trump Administration Repeals Minimum Staffing Standards for Long-Term Care Facilities," December 2025, manatt.comHealthcare Dive, "Trump administration repeals Biden-era nursing home staffing mandate," December 2025, healthcaredive.com