As the nation’s more than 160 million voters prepare to determine who will be the next president of the United States, long-term care leaders continue to hold their breath, uncertain as to who would be the better choice for the sector.

As a member of the administration that has made historically tough pronouncements about nursing homes, Vice President Kamala Harris has been treated with overt suspicion by nursing home operators. While top lobbying leaders expressed hope she would stake her own path, they also worry that she would extend President Biden’s aggressive implementation of new regulations, including the first nursing home staffing mandate.

And despite the expected pro-business leanings a Republican might bring to the White House, long-term care operators worry that another Donald Trump term could further restrict access to immigrant workers who are so sorely needed by the sector.