The Bay of Plenty risks running out of beds and care workers to look after the region's rapidly ageing population - and immigration rules are part of the problem.
Figures released by the New Zealand Aged Care Association show the region's already stretched industry will need nearly 2690 more beds in the next eight years. In that time, another 1670 caregivers will be needed - more than 200 workers a year.
Chief executive Simon Wallace said the Bay's rest home occupancy rate was above the national average at 87 to 88 per cent and "when you look at the projection to 2026, clearly, in this region, there will be a supply issue".
Wallace said New Zealanders had little interest in working in the industry despite last year's $2 billion pay equity settlement to increase pay rates by 15 to 50 per cent.
"Come 2020, we will have a real problem unless we get a surge in Kiwis wanting to work in the industry."
A foreigner can work three years but must move home afterwards, "regardless of whether we can find a Kiwi to do the job or not", and Wallace said immigration rules should be relaxed for the right aged care workers.
Radius Matua manager Craig Shipton said its occupancy rate was "very high" at 97 per cent and immigration was also a "real concern".
"We have wonderful overseas staff. We advertise in the hope of getting Kiwis that are passionate about the job. Sadly, it seems lacking, so the immigration policy directly impacts us."
Tauranga Mayor Greg Brownless said the aged care sector was a special field requiring the right temperament and disposition.
"With my own family, I've seen the difference that good care and good staff make. I would rather people - whether locals or foreigners - who have a heart for the elderly looking after them."
National's health spokesman Dr Jonathan Coleman said the Bay had a growing seniors population, so it was important the Government planned appropriately to meet the demand for workers.
Coleman said such plans were being made under the National government and its pay equity settlement included provisions for career development and pay raises while making caring a more attractive career.
Minister of Health David Clark was unable to respond to queries before publication.