The Biden administration’s vaccine mandate for workers at government-funded healthcare facilities, upheld on Thursday, threatens to push out workers at nursing homes already struggling to maintain employees.

“We respect the ruling of the U.S. Supreme Court but remain concerned that the repercussions of the vaccine mandate among health care workers will be devastating to an already decimated long term care workforce,” said Mark Parkinson, president and CEO of the American Health Care Association, a trade organization representing over 14,000 nursing homes.