As nursing homes turn abroad to fill vacancies, the diverse linguistic backgrounds of nurse hires are creating new challenges in comprehensibility between nurses, providers, and residents. Accents are a natural part of spoken language that may present difficulty even when the parties involved are speaking the same language. We surveyed 1,629 nurses working in 98 nursing homes (NHs) in five U.S. states to determine if and how language difficulties were perceived by nurses and others (e.g. physicians, residents and family members). We found that when participants were asked how often other care team members and residents/families had difficulty understanding them due to language use or accent, foreign born nurses were significantly more likely to report that they experienced difficulty at least some of the time across all groups. This study supports an assessment of nurses' language, accents, and comprehensibility in these settings.