Stefania Silvestri, a registered nurse at Greenville Center in Smithfield, listens to a fellow long-term care worker speak during a COVID-19 memorial event outside the Rhode Island State House on Tuesday, March 11, 2025. Silvestri spoke about her own experience working amid understaffing during the pandemic. (Photo by Alexander Castro/Rhode Island Current)
It’s been five years, but registered nurse Stefania Silvestri can still recall the smell of plastic.
“I placed body after body in a bag, day after day. That smell of plastic still paralyzes me,” Silvestri, who works at Greenville Center in Smithfield, recalled for a crowd gathered outside the Rhode Island State House Tuesday for a memorial event for the COVID-19 pandemic.
Tuesday marked the fifth anniversary of the World Health Organization’s official declaration of the pandemic. During the height of the pandemic, Silvestri said her workplace usually had four staff members on duty to care for 30 older COVID patients. That ratio made for a severe challenge in delivering care to the residents, who Silvestri said were often alone and scared, crying for help.
Silvestri recounted the powerlessness she felt back. “Nobody is coming to help them,” she said. “I can’t get to them either, and neither can anyone else. How? How can you save them all? How do you ease their pain and suffering?”
Her experience is one reason she continues to campaign alongside her fellow unionized frontline workers for Rhode Island to adopt nursing home workforce standards passed by the legislature back in 2021. Tuesday’s COVID-19 memorial also served as a protest against Gov. Dan McKee’s fiscal 2026 budget and his veto of legislation last year that would have set minimum statewide compensation and quality of care standards for nursing home workers by establishing a Nursing Home Workforce Standards Board. The General Assembly did not call a special session for a vote to override the veto.
Jesse Martin, the executive vice president of SEIU-1199, shouted into a megaphone that the governor opposes improving working conditions of resident care workers.
“What happened to the time five years ago when every house had a sign on the front lawn that said ‘Health care workers and essential workers are heroes’? Five years later, under the governor’s proposed budget, he wants to cut money off of our backs, from our units, from our supplies, from our workplaces. Is that OK?” Martin
“No!” the crowd roared back.
Nursing home advocates were livid when McKee vanquished the Nursing Home Workforce Standards Board Act last year. The bill would have established a 13-member advisory body to help the General Assembly and state labor department craft and enforce regulations in line with the 2021 legislation.
McKee wrote in his June 2024 veto memo, “Rhode Island needs comprehensive solutions to resolve its critical nursing home emergency and support residents, workers, and the long-term health of facilities. This Act does not meet that need.”
McKee added that the nursing home crisis is more than a labor issue, with closures, receiverships and Medicaid reimbursement rates unaffected by the proposed legislation.
Yet in January, McKee proposed a fiscal 2026 budget that seeks to limit the annual increase in Medicaid reimbursement rates, which states tether to federally defined reimbursement rates for providers. Rhode Island hospitals, for instance, were expecting Medicaid reimbursement rates to rise 3.4% for inpatient services and 2.9% for outpatient services in the new fiscal year that starts July 1. But McKee wants to cap the hike at 2.3%, a number more closely aligned with the state’s projected revenue growth.
About two-thirds of nursing home residents in Rhode Island have their stays paid for by Medicaid, a population of about 5,000 people overall. At a press conference last month at Bannister Center in Providence on possible federal Medicaid cuts, Martin expressed concerns about the continued underfunding of nursing homes, which have “seen a lot of hardship” in the last five years because of Medicaid’s underfunding.
Martin echoed the need for more funding to the crowd on Tuesday, dozens of whom sported the distinctive purple shirts with SEIU-1199 branding.
“We’re still dealing with poverty level wages. We’re still dealing with understaffing. We’re still dealing with for-profits or nonprofits that act like for-profits that take money away from the bedside,” Martin told the crowd at the State House Tuesday. “That is not where we should be five years after this pandemic.”
The Nursing Home Workforce Standards Board Act has been reintroduced this year in both chambers of the General Assembly. In the House, the bill is led by Rep. Scott Slater, a Providence Democrat, while Sen. Bridget Valverde, a North Kingstown Democrat, leads the charge for the senate version.
The House version has not yet been scheduled for a committee hearing, but the Senate version had its initial hearing on March 6. As is standard practice, it was held for further study. Testifying on the bill before the committee, Valverde remarked on the assertion in McKee’s veto memo that the bill was not a “comprehensive solution.”
“I don’t think that is something anybody has ever said that this bill is going to do,” Valverde said.
McKee’s office did not immediately respond to a request for comment Tuesday.
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