Citing ongoing concerns about staffing levels and stagnant wages, 190 nurses and 89 allied health professionals at Temple Health - Chestnut Hill Hospital announced plans Monday for an informational picket scheduled for Wednesday, Dec. 4, from 7 to 8 a.m. and 11 a.m. to 1 p.m.

The announcement comes almost exactly one year after the staff voted to join the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP), a decision made before Temple Health and additional partners acquired the hospital in January 2023. 

“When Temple took over, we had great hopes because, throughout the Philadelphia region, they own Temple main and Episcopal and Fox Chase, but we quickly learned differently that Temple not only didn't change anything but has refused to change anything,” said James Smith, an ICU nurse and union member at Chestnut Hill Hospital. 

In a statement Monday, Temple Health said it has a strong track record of successful labor negotiations, citing agreements at Temple University Hospital – Main Campus, Temple University Hospital – Jeanes Campus, and Fox Chase Cancer Center. Director of Media Relations Jeremy Walter pointed to Jeanes Hospital as a model, a facility where nurse turnover is among the lowest in the nation.

"We believe we would all be better served as would the employees of Chestnut Hill Hospital if we spent our energies negotiating between us rather than negotiating in the media," Walter said. 

Union members say they intend to continue working during the informational picket but may strike if an agreement cannot be reached soon.

“We've been bargaining since January 2023 and we keep running against brick walls,” Smith said. 

Temple Health, however, strongly disputes Smith's characterization of negotiations. In his statement, Walter called the union's claim of unwillingness to negotiate "disingenuous," and pointed out that first contracts typically take more than 12 months to negotiate nationwide. 

"PASNAP is well aware that the average length of time that it takes to negotiate a first contract nationwide is more than 12 months. For example, at Fox Chase it took more than 12 months," Walter said. "We have not yet been negotiating at Chestnut Hill for 12 months. They know that. It takes two sides to come to an agreement."

State Rep. Tarik Khan (D., Phila.), who represents Chestnut Hill and is also a registered nurse, said he supports the healthcare workers and plans to attend their informational picket. He also plans to reintroduce safe nursing staffing legislation.

"As a nurse, I know how important it is to ensure workers have the resources to do their job,” Khan told the Local. “I'm proud of the nurses and allied professionals at Chestnut Hill for the excellent care they provide for our neighbors, and for fighting for fair wages and working conditions.”

Staffing issues

According to Smith, staffing issues that originated under previous owner Tower Health have reached critical levels, particularly in specialized units. He said nurses in the Intensive Care Unit (ICU) regularly care for three patients each, despite industry standards calling for one nurse per one or two patients – a ratio that is particularly concerning given the intensive nature of ICU care and potential risks.

Smith also noted that ICU staff are being used to cover other departments when they are short-staffed. "I don't think other hospitals do that," said Smith, who has worked at the hospital since 2019 and has been a nurse since 1996.

Other units, he said, “have gone up to six, almost seven patients per nurse, and it's just led to burnout," Smith said. "We can't even retain nurses. We can't retain techs."

According to Kadena Smith-Fleming, a licensed practical nurse (LPN) with almost ten years of experience at Chestnut Hill, the staffing shortages have significant implications for patient care. 

"I usually have six patients on shift, with varying degrees of acuity. People are getting sicker and sicker and have more needs, and you don't have the staff to help facilitate those needs," she told the Local. "And of course, management is asking you to do more and more and more, but you're working with less.”

Temple Health countered these statements with data showing increased hiring across their system. "Every Temple Health hospital and hospital campus has more nurses now than it did before Covid, including Chestnut Hill Hospital," Walter stated. He cited Jeanes Hospital as an example, which has added 87 nurses since the pre-Covid period.

Wage disputes

Wages have become another major point of contention. According to union representatives, rather than increasing pay to match market rates, management has threatened to reduce wages by $3.50 to $5 per hour for all nurses. The union said it submitted wage proposals in August, and while management initially discussed potential merit increases, that option is no longer being considered.

Smith said pay levels have impacted recruitment efforts, as students who rotate through the hospital from programs like Drexel or radiology tech schools "like Chestnut Hill, but when they find out what the wages are, they won't apply or they won't stay."

Temple Health responded that they are constrained in their ability to address wage issues during ongoing negotiations. "We'd love to increase salaries of phlebotomists at Chestnut Hill Hospital, but if we did that unilaterally in the middle of negotiations, the union would find that unacceptable," Walter explained.

A challenging environment

Staffing and wage issues coincide with broader challenges at the century-old community institution.

With small community hospitals facing economic headwinds across the nation, Temple Health reported a $7.43 million loss on its investment five months after acquiring Chestnut Hill. According to Temple’s 2022 and 2023 year-end financial reports, its 60% stake in the acquisition was originally valued at $16.8 million, but the value of that investment was $9.4 million as of June 30, 2023.

Walter said Monday that Temple is working to return Chestnut Hill to profitability. 

“Chestnut Hill Hospital continues to improve financially and we anticipate it being back in the black sometime in 2025 if we can return our focus to operations from labor contract negotiations,” he said. 

Union representatives also note a recent "C" grade in hospital safety from the Leapfrog Group, a nonprofit that collects, analyzes, and publishes data on safety and quality in the healthcare industry. In staffing, the hospital earned a concerning grade of 15 out of 100, the lowest among all regional hospitals rated.

According to Walter, however, that grade was based on data that is more than a year old and dates back to the transition from Tower Health's IT system to Temple's.

"Because of that we did not have the data necessary to complete the Leapfrog questionnaire, therefore much of the data requests were left blank," Walter explained. "That blankness led to lower scores. We now have the Temple quality program available at Chestnut Hill Hospital. Data will be completed in full and Leapfrog scores will improve just as they did at our Jeanes and Main campuses."

Walter also noted several positive quality indicators at Chestnut Hill, including low rates of central line-associated bloodstream infections, catheter-associated urinary tract infections, and hospital-acquired pressure injuries that are "among the best at Temple Health."