Nurses at Jefferson Einstein Philadelphia Hospital on Monday voted to authorize a strike if their bargaining committee calls for it as they negotiate a new union contract.
The nurses want the contract to include solutions to staffing issues, as well as assurances that the hospital will not close departments. Earlier this year, Jefferson Health announced plans to close several pediatric clinics, including the Pediatric & Adolescent Ambulatory Center at Einstein Philadelphia at the end of this month.
“Our patients deserve better than Jefferson is willing to deliver on its own. So do the nurses who care for them,” said Stephanie Stucka, a neuroscience nurse and co-president of Einstein Nurses United, in a statement.
The Logan hospital has about 1,200 unionized nurses, whose contract expired over six weeks ago. They are members of Einstein Nurses United, a local of Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP).
A little more than half the local’s members participated in the in-person vote, and 96% voted in favor of a strike, according to the union.
The union also voted to authorize a strike during their last contract negotiations in 2023, and ultimately reached an agreement on a new contract without walking off the job.
The union and hospital management continue to negotiate. Bargaining sessions are scheduled Tuesday, Wednesday and Monday, PASNAP spokesperson Megan Othersen Gorman said. If the committee does call for a strike, it must submit a 10-day notice under the National Labor Relations Act, she said.
“This action risks putting disruption ahead of patients and community members,” a Jefferson spokesperson said in an e-mailed statement Tuesday. “While a strike is not imminent, this vote sends the wrong message at a time when our community needs stability, partnership, and a shared commitment to care — especially as Philadelphia prepares to host major national and global events that will place increased demand on our healthcare system.”
The nurses’ union has proposed changes to improve staffing levels in most units, as well as contract language to protect staffing standards. It says Jefferson management has rejected these proposals.
The nurses also want management to commit to keeping hospital safety measures put in place in recent years, including increased security and weapons screenings. The union also noted nurses’ concerns that benefits like paid time off and pension may be cut, and that the cost of their healthcare plans could rise.
Half of the nonprofit health systems in Southeastern Pennsylvania had operating losses in the first nine months of fiscal 2026, the systems’ latest reports to municipal bond investors showed.
All had strong revenue growth, with the exceptions of Redeemer Health and Tower Health, the two smallest systems by revenue. The gains at Jefferson Health and Penn Medicine benefited from acquisitions in fiscal 2025.
The reports are not perfectly comparable because of variations in accounting practices.
For example, Jefferson, Main Line Health, and ChristianaCare changed their depreciation rates, which reduced their expenses relative to competitors. Jefferson includes investment income in its revenue, boosting its results.
Here’s a summary in order of revenue, from the region’slargest to smallest systems:
Jefferson Healthhad a $252.6 million operating loss, which it attributed to severe winter weather, restructuring costs related to layoffs, and shortfalls in insurance reimbursement. Total revenue was just shy of $13 billion, up from $11.6 billion last year, which included only eight months of results from Lehigh Valley Health Network.
Children’s Hospital of Philadelphia had a $271 million operating profit in the first nine months of fiscal 2026, up from $195.8 million the year before. Total revenue rose 9% to $4.1 billion from $3.7 billion, thanks to strong gains in payments for hospital patients and unspecified other operating revenue.
Temple University Health System had an operating loss of $9.9 million, recovering largely from a $50.5 million loss in the first half of fiscal 2026. In the same period a year ago, Temple had a $10.9 million operating loss. The health system’s revenue was $2.6 billion, up from $2.3 billion last year.
Main LineHealth reported a small operating profit of $214,000, following a winter quarter setback. The four-hospital nonprofit system recorded an $8.5 million loss in the three months that ended March 31. Severe winter weather reduced patient visits, and the health system increased its reserves for medical malpractice expenses.
Tower Health swung to a small operating loss of $3.6 million. During the same period a year ago, Tower had a $4.2 million operating profit. Revenue increased 1.6% to $1.6 billion.
Steep losses continued at Redeemer Health, which reported a $29 million operating loss, compared to a $33 million loss last year. Redeemer’s total revenue rose by less than 1%, to $332 million. Redeemer owns Holy Redeemer Hospital, a 239-bed facility in Abington Township, Montgomery County, not far from Jefferson Abington Hospital.
On a muggy Friday days before the World Cup began, a small team of medical emergency planners inspected the cavernous, air-conditioned tent erected for patients at Lemon Hill in Fairmount Park, not far from the enormous screen where thousands can watch matches through July 19.
Near a FIFA tent already full of merchandise, and branded “fan pavilions” in various stages of construction, Philadelphia’s host city medical lead, Patrick J. Brennan, paced what is now the medical home base for dozens of doctors, nurses, and EMTs over the next several weeks.
Brennan, who is also the chief medical officer of University of Pennsylvania Health System, pointed out where the dunk tanks for heatstroke victims would go. He walked through tents with massive fans and misters and visited a smaller first-aid tent for minor medical issues.
Philadelphia is no stranger to large events, from a papal visit to the NFL Draft to the annual Roots Picnic. But the World Cup fan festival at Lemon Hill will be open for more than a month — and is taking place in a summer of high-profile events expected to bring more than 1.5 million visitors to the city.
“That’s the difference — the duration of the event,” Brennan said.
Preparing for the full range of medical emergencies got underway nearly two years ago for Philadelphia’s public health leaders and largest health systems. They have prepared for heat-related illnesses, injuries, mass casualties, and terrorism.
Infectious diseaseis a leading public health concern among host cities and national health agencies.
Measles, a disease once considered eradicated through widespread vaccination and now on the rise across the country, is at the top of their list. An Inquirer analysis found that the Philadelphia region is pockmarked with vulnerable communities, where vaccination rates have fallen below the rate scientists say is necessary to prevent widespread illness.
Now thousands of people from all over the world will turn Philadelphia into a petri dish prime for the spread of infectious diseases. Yet another concern is an Ebola outbreak in parts of Africa, including the Democratic Republic of Congo, which has a team participating in the World Cup games in Houston.
Public health leaders say their best strategy for preventing widespread illness, especially should a case of highly infectious measles arise, is to respond as quickly and efficiently as possible.
Hospitals have added questions about measles vaccination to their routine emergency department screening, with weekend and evening contacts on call at the city lab that would test potential measles samples. Newly posted flyers in local medical buildings explain how to recognize the early signs of measles — which many doctors have never encountered.
“My main concern with measles are the pockets where people are under-vaccinated, too few people are vaccinated to really stymie an outbreak,” Brennan said. “It’s going to be hard to prevent it from coming into the country.”
The city’s health department, public safety units, and leaders from top health systems, including Temple Health, Penn Medicine, and Jefferson Health, all had seats at the table.
They hashed out responses for potential public health emergencies ranging from bioterrorism, a mass casualty, and violence to routine heat-related health issues. Experts anticipate that the ongoing heat wave, paired with high levels of alcohol consumption, will lead many to experience heat exhaustion, dehydration, and potentially heatstroke.
The prep work built on efforts for past major events, such as Pope Francis’ visit in 2015 or the 2016 Democratic National Convention. New this time around, Philadelphia and World Cup host cities across the country are paying much more attention to infectious-disease concerns.
P.J. Brennan (right), Penn Medicine’s chief medical officer and the medical team lead for FIFA’s Philadelphia events, stands with Jack Welsh, an emergency preparedness specialist and clinical nurse at Penn Medicine, outside the main medical tent at the FIFA Fan Fest in Lemon Hill Park.Jessica Griffin / Staff Photographer
Until recent years, measles was not “immediately on the radar” for public health planning, said Jessica Caum, director of disease control for the Philadelphia Department of Public Health.
“We’re in a different place now with measles,” she said. “More cases, increases in vaccine hesitancy, decreases in vaccination rates — all of these things are important to keep in mind.”
The planners looked at staffing levels at medical tents and hospitals, including where surge staffing could come from. They developed a plan for where to quarantine a large number of people, in the event of an outbreak of measles or other infectious disease, but declined to provide details.
“We want to be as prepared as possible,” Caum said.
All that preparation still may not provide a firewall against weeks of sustained sports chaos.
The city’s game-day strategy, should a suspected measles case crop up, is to react as quickly as possible.
Temple trained its emergency department staff to ask new screening questions about measles symptoms and vaccination status in an effort to quickly identify anyone who is at risk, said Daniel Feinberg, chief medical officer for Temple University Hospital Inc.
Temple has been distributing measles information in Spanish and English to providers at its hospitals. Joe Lamberti / For The Inquirer
People whose vaccination status is unclear, or who say they are unvaccinated, will immediately be whisked to an isolation room if they show symptoms associated with measles, such as fever, cough, runny nose, and red eyes.
The telltale blotchy red rash does not typically appear for up to four days, though hospital administrators distributed photos of it to help medical staff recognize it.
Once isolated, people with suspicious symptoms will be tested, with the sample rushed to a city lab on call for such emergencies.
Administrators lined up contact information to reach the lab in the evenings or weekends, when it is typically closed, and discussed the fastest way to get a sample to the lab — potentially to have someone with good sneakers run.
“We don’t want any time wasted,” said Carlene Muto, vice president of infection prevention and occupational health services at Temple Health.
The MMR vaccine can protect against the virus if given to someone within 72 hours of being exposed. Measles immunoglobulin, which contains concentrated antibodies, can provide temporary protection against the virus if given within a few days of exposure. But it is often reserved for infants and other high-risk patients.
The faster health providers identify a measles case, the faster they can work to trace who else may have been exposed.
Medical tents are prepared to handle medical emergencies during the World Cup.Jessica Griffin / Staff Photographer
The risk of exposure is high when someone with measles attends a busy outdoor event, and the challenge of locating all the people who could have come in contact with the disease is immense.
Nine out of 10 unvaccinated people who come into contact with measles will get sick, making it among the most highly contagious diseases.
Anyone who does not get treated in time and has not been vaccinated will need to quarantine for 21 days.
At Jefferson, health system screening protocols are routinely updated to address the latest health threats, said Eric Sachinwalla, Jefferson’s medical director of infection prevention. Its hospitals recently added Ebola screening questions for patients who are being admitted and have traveled to at-risk countries.
Jefferson and other health systems are more likely to see “low-impact” but predictable threats: COVID-19 and other respiratory illnesses, sexually transmitted infections, and gastrointestinal diseases. These illnesses “can spread between people pretty quickly,” he said, but health systems are generally equipped to handle them.
A case of Ebola or measles, however, requires significant resources devoted to treatment and preventing further cases — so hospitals also have to carefully prepare for that possibility, he said.
“It’s balancing those two things. We plan for the high-occurrence things but also [diseases with] high potential impact,” Sachinwalla said.
Chris Feaster sees Main Line Health clinicians for mammograms, breast MRIs, and other preventive screenings required due to her high risk of breast cancer.
The 61-year-old Montgomery County resident has been panicked in recent weeks after Main Line sent patients a letter warning that the nonprofit health system’s contract with her insurer, UnitedHealthcare, may end later this month.
Main Line is a leading provider of care across Philadelphia’s western suburbs, where it has four hospitals. Feaster has relied on its facilities for care for 40 years.
“They know me,” she said of her Main Line providers in an interview. “I have been getting monitored there since the time I was in my early 30s.”
Feaster, who lives in Trooper, has already experienced a healthcare disruption caused by another insurance dispute. Two years ago, Axia Women’s Health and United failed to reach adeal. That forced Feaster to find a new gynecologist after 40 years.
Chris Feaster is among thousands of Main Line Health patients worried about the prospect of Main Line Health going out of network with UnitedHealthcare at the end of this month.Steven M. Falk / For The Inquirer
If no deal is reached by June 30, Feaster could be facing a repeat.She is among 32,000 affected Main Line patientswho have United insurancethrough Medicare Advantage plans and commercial insurance from employers.
Main Line Health said that United had been engaging more meaningfully in negotiations in recent weeks. “We are hopeful that momentum continues. We remain committed to reaching a resolution before June 30,” itsstatement said.
For Main Line, which is far less profitable than it was before the pandemic, the dispute is not just about rate increases. The nonprofit health system also wants toreduce claim denials, prior authorization delays, and excessive audits.
“Main Line Health is seeking price hikes that would significantly increase costs for families and employers,” UnitedHealthcare said.
United added that self-insured companies would absorb the biggest hit ”impacting the money they have to grow their business and compensate their employees.”
Worries about maternity care
Jessica Geida, a Newtown Square resident and an ob/gyn who is not currently practicing, is particularly worried about access to maternity care in Delaware County, given that Axia is already out of network with United.
Main Line operates the only practice that delivers babies at Riddle Hospital for people with UnitedHealthcare (UHC), said Gaida, who has worked at Axia and Main Line. “If they drop UHC, there would be no access to care in the Delaware County,” she said.
Maternity care has been underpressure in Delaware County since the maternity unitclosed at Delaware County Memorial Hospital in early 2022, followed by the shutdown of Crozer-Chester Medical Center a year ago as part of the Prospect Medical Holdings bankruptcy.
Mercy Fitzgerald Hospital in Darby closed its labor and delivery unit more than 20 years ago.
If Main Line and United fail to reach a deal, UnitedHealthcare patients might have to go to Penn Medicine’s Chester County Hospital in West Chester, which is already busy.
Patients who get into Penn’s ob/gyn practice at Penn Medicine Radnor deliver babies at the Hospital of the University of Pennsylvania in Philadelphia, according to that group’s web site.
Feaster saida call from UnitedHealthcare Friday left her feeling very uncertain about her care.
Feaster grew up in Wayne and kept seeing Main Line doctors when she moved to Trooper, which is north of King of Prussia.
Feaster would have to specially request a continuation of care to keep seeing each of her Main Line doctors at in-network prices, the UnitedHealthcare representative told her.
The temporary stopgap is designed to help people who have significant needs — including cancer patients in the middle of treatment — avoid gaps in care while they switch to doctors who accept their insurance.
Feaster would have to fill out part of the form, and her doctors would have to complete another part. She’d also have to take the same steps for Main Line providers of her regular mammograms, breast MRIs, and DEXA bone density scans.
UnitedHealthcare would then review each request to determine whether to approve.
The new owner of the defunct Crozer-Chester Medical Center wants to restore hospital and emergency services to the 64-acre campus that straddles Chester and Upland Township in Delaware County.
Newly formed Chariot Equities completed the $10 million purchase Wednesday. The for-profit entity said it expected within six months to have an agreement with a health system that would operate a “right-sized” hospital and emergency department at the facility that had been the county’s largest provider of those services before closing last year.
The idea is then to open the first phase within two years, Chariot said in a statement.
Chariot did not say how much it would spend on refurbishing Crozer-Chester, which had suffered from years of neglect under its two previous owners.
Chariot’s partner at Crozer-Chester is Allaire Health Services, a Jackson, N.J.-based for-profit operator of nursing homes.
The partners said they are in talks with regional and national nonprofit health systems regarding an operating partnership, but provided no details. The amount of money needed for the project would likely depend on what prospective tenants would want to do at the property.
“Our belief in Delaware County’s future, and the community’s need for sustainable healthcare access, made this an effort worth committing to well before the finish line,” said Yoel Polack, Chariot’s founder and principal.
Little is known about the new owners. Polack worked in healthcare real estate in the New York City area before setting his sights on redeveloping Crozer-Chester.
Federal records list Allaire’s CEO Benjamin Kurland as an owner of 20 nursing homes, including three in the Philadelphia area. Chariot’s statement said Allaire owns a total of 29 facilities in five states.
Main Line Health has been involved in discussions about reopening emergency services at three former Crozer hospitals — Crozer-Chester Medical Center, Springfield Hospital, and Taylor Hospital — at the request of state lawmakers and the property owners, Ed Jimenez, CEO of Main Line Health, said Wednesday at a Riddle Hospital event.
Jimenez said he would “entertain the concept” of restoring emergency services at one of the hospitals as part of a partnership with other health systems, but only if it can be done on a break-even basis.
All three of the former hospital buildings visited by Main Line officials are in poor condition and were stripped of medical equipment after the closures. Main Line’s experts estimated it would cost between $15 million and $20 million just to make the emergency department at Taylor functional, Jimenez said.
ChristianaCare, Delaware’s largest health system, considered acquiring Crozer in 2022. Instead, it took a different path to expansion in Southeastern Pennsylvania. It is planning to open two micro-hospitals in Delaware County. The nonprofit system also took over five former Crozer outpatient locations. Its credit rating was recently downgraded by one notch because of lower profitability.
The importance of Crozer-Chester
Crozer-Chester closed in early May during the bankruptcy of owner Prospect Medical Holdings Inc., a for-profit company based in California, and after the failure of government-supported efforts to form a new nonprofit owner for Crozer-Chester and other Crozer Health facilities.
Crozer-Chester was particularly important as a safety-net provider for a low-income area of Delaware County that has few other nearby options. The Crozer system, which had four hospitals, was the county’s largest health system and largest employer for many years.
Two local Democratic officials, State Rep. Leanne Krueger and Delaware County Council member Monica Taylor, said they were encouraged by the approach being taken by Chariot and Allaire.
At Taylor Hospital, the other Crozer hospital that closed last year, new owners are also looking for healthcare tenants. Local investors bought the Ridley Park facility for $1 million. It is less than four miles from Crozer-Chester.
The same group agreed last week to pay $1 million for Springfield Hospital, another facility that had previously shut down under Prospect ownership.
