Close to 1,200 nurses at Jefferson Einstein Philadelphia Hospital are currently negotiating a new contract with Jefferson Health. We are using the negotiations to push for better working conditions, safer staffing, patient care, and the resources our community desperately needs. Instead of working with us, Jefferson execs are resisting needed improvements in staffing and in the facility, and they are refusing to commit to maintaining current hospital services.
OUR PATIENTS PAY THE PRICE.
Jefferson wants to call itself a nonprofit. It wants to call itself a partner to Philadelphia. But you can’t claim to serve the public while turning your back on workers and patients, and the community. Instead of investing in patient care at Einstein, Jefferson has prioritized:
MILLIONS FOR EXECUTIVE PAY
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Jefferson gave former CEO Stephen Klasko an $8 million payout when he left.
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Current CEO Joseph Cacchione is paid more than $5.5 million annually by Jefferson.
MULTIPLE MILLIONS FOR UNION-BUSTING CONSULTANTS
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During and after COVID, Jefferson paid out-of-state anti-union consultants instead of investing those dollars into patient care.
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Jefferson has promoted Einstein leadership who spent millions trying to bust the nurses union at Einstein.
HUNDREDS OF THOUSANDS FOR ADVERTISING
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Using patient-care dollars, Jefferson is spending heavily on public sponsorships and ads, while RNs at Einstein are forced to bring in tools from home to repair patient beds.
WHILE INSIDE THE HOSPITAL, IT’S A DIFFERENT STORY.
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No investment in safe staffing levels
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No investment in resources
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Critical support positions eliminated
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Capital improvements frozen
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Legacy Einstein pediatric clinics closed or sold, leaving low-income families in the lurch
THE TRUTH ABOUT
JEFFERSON
C SUITE DECISIONS THAT DON’T SERVE THE COMMUNITY
Among the 15 largest nonprofit health systems in the U.S., Jefferson Health has taken away all decision-making power from the nursing leadership at the hospital. Executives in Center City are dictating decisions, and ENU members have serious concerns over the quality of the care they are able to provide as the suits in the Jefferson C Suite fail to address issues in their hospital.
There’s a growing disconnect between the willingness of the people in the C suites to address and fulfill the needs of Einstein’s already chronically underserved patient community:
1. A constant battle for safe staffing.
On a number of occasions the Hospital has left a single PACU RN during overnight hours to recover critically ill patients after surgery, creating a serious risk to these patients
The Hospital has increased the number of beds/patients on multiple units without talking to the nurses to ensure the number of staff are at levels that allow for the best and safest care- a violation of the nurses union contract.
Jefferson will tell nurses not to come to work, they are not needed, despite patients waiting in the emergency room to be admitted into the hospital. When those patients are admitted, it results in the units being short staffed because of the unnecessary staffing cancellation.
In bargaining, the nurses have proposed changes to the staffing grids to make improvements on most units. Additionally, the union has proposed language to prevent Jefferson from making staffing worse in the future and to protect good staffing standards and best practices. Jefferson has completely rejected the Union’s proposals – including one to increase ancillary staff. Jefferson actually threatened to file an Unfair Labor Practice against the nurses the first time the proposal was brought up, since ancillary staff are not members of the union.
2. Physical improvements to the hospital are being delayed. At a January meeting, management informed the Union that all capital improvements over $5,000 have been halted. Management was not able to tell the Union when or how approval for requests would be made by Jefferson leadership. Einstein currently has no organizational chart and reported that they do not expect to have one until 2027.
3. Access to supplies and the quality of available supplies have been a constant struggle. Emergency Department nurses bring tools from home so they can perform maintenance on patient beds while they’re in the middle of patient care. The quality of supplies has diminished as cheaper versions have replaced higher quality versions. For example, nurses are reporting lower quality IV kits which allow IVs to easily fall out of patients arms.
Less than 1% of the union nurses reported an improvement to supplies since Jefferson took over.
CLOSURE OR SALE OF LEGACY EINSTEIN PEDIATRIC CLINICS
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On March 5th, The Philadelphia Inquirer reported that Jefferson Health will shutter four legacy Einstein pediatric practices, including one located at the hospital, and move three others to for-profit True North Pediatrics – a move that could potentially force thousands of low-income North Philadelphia families to travel farther for pediatric care or go without it altogether.
In one fell swoop, the megacorporation whose official mission statement is “We Improve Lives,” significantly reduced the availability of pediatric care in North/Northeast Philadelphia. Lavishly paid executives in Center City, far removed from Einstein’s North Philadelphia location, are dictating decisions, and Einstein nurses, currently in contract negotiations, are worried that the health of their very vulnerable patient community is no longer a priority.
“Jefferson, my employer with whom I should have a shared mission of caring for our community, has chosen to divest from community-based pediatric practice availability and, instead, invest in an Eagles practice facility,” says longtime Einstein Mother/Baby nurse and Einstein Nurses United member Carla Le’coin, RN. “What’s happening is a systematic and methodical corporate amputation of accessible pediatric services for humble neighborhoods.
“It isn’t right – and it isn’t why I came to work at Einstein.”
Management told ENU in bargaining on Tuesday, April 21st, that they are working on a list of Pediatrics providers to give to Einstein patients. But they aren’t doing anything to make up for the care they are taking out of the community.
“The peds closures, especially the one at the hospital, cause an undue hardship for our mothers who already experience barriers to care,” say the Einstein Labor & Delivery nurses in a joint statement. “The Paley clinic is steps away from Broad and Olney, which is the busiest transportation system in the state. Now the parents will have to travel much farther and transfer several buses to get vital newborn care in the first days of life. We are concerned that care, and therefore complications may be missed due to this hardship. This will contribute to an increase in inequities for this underserved population. Babies deserve the same good care no matter where they live.”
BILLIONS FOR SUBURBAN EXPANSION BUT NOT FOR NORTH PHILADELPHIA
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According to a May 4, 2026, article in the Philadelphia Business Journal, Jefferson Health is actively planning to expand its geographic footprint:
“Jefferson Health CEO Dr. Joseph Cacchione said the 33-hospital system continues to look for opportunities to fill in gaps in care coverage following its August 2024 merger with the Lehigh Valley Health Network.
“Cacchione said he would like to see Jefferson invest more than $1 billion on multiple projects that could include ambulatory care centers, community hospitals and smaller "neighborhood" hospitals with emergency departments.
“While declining to disclose specific locations being targeted, Cacchione noted Bucks and Montgomery counties are a priority and the health system also wants to have a larger presence in Delaware.
“‘We've got to meet people where they are,’ Cacchione said.”
Unless those people are in North Philadelphia.
Also according to the article, “Jefferson is already spending about $49 million on emergency department expansions and modernizations at Thomas Jefferson University Hospital in Center City and Abington Jefferson Hospital in Montgomery County. Jefferson is also planning to expand the bed count at 195-bed Jefferson Einstein Montgomery Hospital in East Norriton to keep up with patient demand, Cacchione said. The number of beds that will be added is still to be determined.”
Meanwhile, at Jefferson Einstein Philadelphia Hospital, Jefferson is actively short-changing the hospital and its patient community:
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Jefferson is refusing to improve staffing – a key quality of care indicator – in the hospital.
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Jefferson has eliminated critical patient-care positions at Einstein (see below).
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Jefferson is delaying much needed physical improvements to the hospital.
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Jefferson Einstein nurses don’t have access to the supplies they need.
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Jefferson shuttered or sold its pediatric clinics in a move that could potentially force thousands of low-income North Philadelphia families to travel farther for pediatric care or go without it altogether.
CRITICAL POSITIONS ELMINATED
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Over the course of the current contract, which started in June 2023, Jefferson has laid off roughly 1,000 employees across their enterprise, including direct care providers at Einstein. This process has included sending a critical service that was once provided at Einstein.
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Jefferson got rid of the Nurse Navigator position. The Nurse Navigator helped the most vulnerable in the community understand and thrive in the often daunting and overwhelming world of appointments, medications, and care.
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Jefferson laid off the Einstein dialysis nurses. This puts more strain on nurses (and therefore their patients) in the hospital who now must take on additional duties of caring for dialysis patients in addition to their existing patient load, without increased staffing levels.
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Jefferson ended the Ventricular Assist Device (VAD) program. By removing this life sustaining program from Einstein, patients from the community are now required to travel further for VAD care. This system allows for the patients without working hearts to live so seconds are a matter of life and death.
These decisions, directly affecting quality of patient care, have resulted in nurses fleeing the hospital. In less than three years, more than 400 union nurses have left Einstein. This is a staggering amount and directly affects patient care. See “Safe Staffing Saves Lives” in RESEARCH BEHIND THE ISSUES, below.
IRRESPONSIBLE SPENDING
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Providing context to a reported a $104 million operating loss in first quarter of fiscal 2026:
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Jefferson set the record for Philadelphia non-profit healthcare CEO pay with an $8 million payout to former CEO Stephen Klasko in 2022. Current CEO Joseph Cacchione’s most recent reported compensation is over $5.5 million per year.
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Jefferson spent hundreds of thousands of dollars on signage outside the hospital to rebrand Einstein Hospital as Jefferson Einstein Hospital.
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During the height of the COVID pandemic and ongoing, Jefferson has chosen to spend hundreds of thousands of dollars on union-busting consultants from across the country (money they could have devoted to patient care), effectively funneling Pennsylvania taxpayer dollars to out-of-state union busters.
A HISTORY OF IRRESPONSIBLE, UNSAFE STAFFING CUTS
Dr. Joseph Cacchione was named CEO of Thomas Jefferson University and Jefferson Health in September 2022. According to a Business Journal article, “Cacchione said he was in the middle of playing in a golf tournament in Ohio when he got the word he was the pick for the Jefferson job”.
In May 2025, Jefferson extended Cacchione’s contract as CEO for another five years. Only a few months later, Jefferson posted a $196 million operating loss for the fiscal year.
Prior to his role at Jefferson, Cacchione was the Executive Vice President, Clinical and Network Services for Ascension, one of the largest nonprofit healthcare systems in the US (2019 - 2022). Prior to that role, he was the CEO of Ascension Michigan (2018 - 2019) and the Interim Market President of Genesys from July 2022 through August 2022. During that time, Cacchione was listed as one of Michigan’s highest paid non-profit healthcare executives, bringing in $3.86M in 2022.
In 2022, the New York Times published an exposé on Ascension, focusing on the drastic cost-cutting measures imposed at two hospitals: St. Joseph in Illinois and Genesys in Michigan. The authors detail reports of chronic understaffing, unsafe patient conditions, overworked staff, robots that replaced nursing assistants, and Ascension lobbying against legislation that would set minimum nurse-to-patient ratios.
To cut labor costs, Ascension implemented robotic “telesitters”, which were essentially cameras mounted on poles to replace nursing aides. Made by the company AvaSure, 450 of these robots were installed across 50 of Ascension’s hospitals by 2019. The New York Times report details how “nurses said patients, many of them already disoriented, were confused by the disembodied voices coming from TeleSitters”.
Jefferson currently has a subscription with AvaSure. In their FY2024 Nursing Annual Report, the Campus Chief Nursing Officer Bob Kautzman notes “expand[ing] subscription to Avasure devices to appropriate units” as a priority for Jefferson Moss-Magee Rehabilitation, in alignment with the Jefferson Health Integrated Nursing Strategy.
Moreover, in January 2024, two Jefferson nursing executives presented at a webinar held by AvaSure: Colleen Mallozzi, RN, Senior Vice President and Chief Nursing Informatics Officer and Laura Gartner, DNP, RN, Clinical Informatics Director. In the webinar, they extolled the benefits of the virtual nursing pilot program.
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