The growing healthcare needs of baby boomers require significant increases in the number or productivity of healthcare workers. This paper explores how immigrants may fill these gaps in nursing homes. First, we show that immigrant inflows are associated with reduced wages of lower skilled nurses along with increases in their employment. We then show that more immigrant labor leads to fewer falls among residents and improvements in other measures of quality of care. We also find that only in competitive nursing home markets is there a link between immigrant inflows and the quality of care provided in nursing homes.