Once, every Philly neighborhood had a hospital. Just one independent survives.

The list of the deceased is long and continues to grow: Hahnemann University Hospital. Mount Sinai Hospital. Graduate Hospital. Metropolitan Hospital. St. Agnes. Philadelphia General. Once, every Philadelphia neighborhood had its own hospital, much as it had its own church, its own elementary school, its own library. But after decades of upheavals in health care, and the emergence of sprawling medical systems, only a single, independent neighborhood hospital survives in the city. And it operates out of a handsome Italianate building that was constructed before the invention of penicillin, insulin, or X-rays.

Kensington Hospital, which faces Norris Square in North Philadelphia, is no longer a full-service general hospital, but it can be considered a hospital, nonetheless. It cares primarily for people with severe infections related to drug and alcohol use, a grueling treatment that requires intravenous courses of antibiotics to be administered over many days. But Kensington Hospital also maintains a small staff of other specialists, including a gynecologist and podiatrist; provides addiction treatment, and operates its own community health clinic. You can still see the “Kensington Hospital” sign on its western facade, as well as an old-fashion, backlit commercial sign next to the main entrance.

The story of Kensington Hospital is, in many ways, the story of the Kensington neighborhood — its ups, downs, and, hopefully, ups again — over the last 130 years. According to a Historical Commission nomination prepared by Steven J. Peitzman, a physician who has immersed himself in Philadelphia’s medical history, the hospital’s main building began its life in 1873 as the home of Isaac Stead, a wealthy Kensington mill owner. Stead had commissioned a fine mansion on the south side of Norris Square, which, like the city’s other squares, was lined with ornate brownstones and churches. The architects, who remain unknown, gave him a perfect Italianate cube, with a carved stone balcony over the main entrance.

Those were heady days for Kensington, which had become the global center of carpet manufacturing. Known as the “Workshop of the World," the thriving industrial neighborhood drew immigrants by the thousands. Initially, factory owners and their workers lived in close proximity. That mix didn’t last long. By 1880, Stead had sold the house, and the neighborhood was beginning to grapple with the problems of poverty.

Enter Howard A. Kelly, a young, Penn-trained gynecologist, who wanted to improve access to health care in working-class neighborhoods. Kelly had been influenced by Robert Koch, who was the first scientist to explain how bacteria caused diseases such as tuberculosis and cholera, and Joseph Lister, who pioneered the use of antiseptics in surgery. Soon after completing his residency at Episcopal Hospital in the mid-1880s, Kelly opened Kensington’s first gynecological clinic, operating out of a small rowhouse. With the help of several philanthropists, he purchased the Stead mansion and opened the Kensington Hospital for Women in 1890.

Kelly had big plans for the hospital. In the mission statement, he vowed to treat all women “regardless of age or color.” The mansion was upgraded to ensure that the rooms received plenty of light and air. But even before the hospital opened, Kelly had developed a reputation as a pioneering gynecologist. He was soon recruited by Johns Hopkins in Baltimore to help start its medical school. Kelly is famous for developing several innovative surgical techniques, including the curved forceps known as Kelly clamps still used by doctors today.

Kelly maintained his ties with Kensington Hospital, helping it raise operating funds from big factory owners, such as Disston, Stetson and Cramp. Their contributions allowed the hospital to expand beyond its original mansion. The firm of Watson & Huckel was hired to design the additions. A dormitory for nurses built next door in 1905, in a style that deferred to the original house. They later added a modern stair tower and a mansard-style fourth floor to Stead’s mansion. At some point, the hospital replaced the deteriorated green serpentine stone on the facade with buff brick. Watson & Huckel helped convert several ordinary Philadelphia buildings to institutional use, including the Banca D’Italia on Seventh Street in Bella Vista.

But despite Kensington Hospital’s steady growth, the institution was hit hard during the Great Depression. The damage was compounded during World War II, when all medical institutions faced a shortage of doctors and nurses. The hospital was on the verge of closing in 1945 when it was purchased by two doctors, Benjamin Ulanski and Leopold Vaccaro, who nursed the institution back to health. As African Americans and Latinos began moving to Norris Square, the doctors began expanding services, dropping “for Women” from the hospital’s name.

Philanthropic donations dried up in the ‘60s, but the hospital soldiered on. In the 1980s, it proudly advertised itself as the only hospital in Philadelphia catering to Spanish-speaking residents. Around this time, it also began developing a specialty in addiction treatment.

Still, the hospital was often on life support. The ‘90s saw a wave of hospital mergers. Those consolidations gave way to the large health systems that dominate the city today. Several attempts to make a match with a better-endowed hospital failed. By 1999, it was one of four independent hospitals operating in the city. Today, despite having its fourth floor boarded up, it is the last one standing.

Located just a few blocks west of booming Fishtown, the Norris Square neighborhood has begun to see the effects of gentrification. Several surviving brownstones on the square are being renovated, and the pleasant park is increasingly populated by people walking dogs. The epicenter of the addiction crisis that plagued the neighborhood for so many years has shifted to the north. In 2019, Peitzman succeeded in getting the hospital listed on the Philadelphia Historic Register. For a building that has seen it all, the honor was more than deserved.

Note: An earlier version of this story incorrectly attributed the design of the Stead mansion to Watson & Huckel.