Crouse Hospital in Syracuse is losing $300,000 per day as the financial burden of the coronavirus pandemic takes hold on hospitals across New York, leaving some with enough cash on hand to pay bills for one to two days.

Crouse has been forced to find temporary ways to increase its cash flow and quickly cut expenses as it waits for the federal government to deliver promised financial aid to make it through the crisis.

“It’s affected us tremendously,” said Kimberly Boynton, president and CEO of Crouse Health. “As we move forward, we’re looking at all options out there as far as financial mitigation strategies.”

Crouse Health has lost about $4.2 million over the past two weeks and shelled out an extra $3 million for personal protective equipment for its doctors and nurses as the hospital prepares to handle a rising number of people infected with the virus that causes COVID-19.

Crouse and other hospitals have been forced to cancel money-making elective surgeries, medical procedures and wellness visits to free up employees and hospital beds to handle an expected surge of patients infected with the virus.

If the crisis continues unabated through June, with no elective procedures and only sick visits to doctors, Crouse stands to lose about $20 million, Boynton said.

Crouse’s trouble highlights the painful contradiction of the industry right now: At a time when hospitals have never been more essential, they are threatened with historic losses.

Crouse has not laid off any of its 3,100 employees, but some staffers have been temporarily redeployed from two out-patient surgery centers to other areas of the hospital, said Bob Allen, a Crouse vice president. Other employees have the option of using accrued benefit time or to file for temporary unemployment benefits.

Hospitals across New York are in a similar situation, with urgent needs for financial aid, according to the Greater New York Hospital Association.

St. Joseph’s Health in Syracuse said Wednesday it will furlough workers because of the financial strain. The hospital did not say how many workers would be furloughed or for how long.

Officials at University Hospital at Upstate Medical University had no immediate comment about the financial impact of the coronavirus pandemic.

At least 30 hospitals in New York are on a state watch list for closure because they have less than 15 days cash on hand to pay their bills, and some of those hospitals are down to enough operating cash for a day or two, said Kenneth Raske, the association’s president. No Syracuse hospitals are on that list.

“We desperately need to ensure that these financially fragile hospitals, and all hospitals in New York for that matter, have the financial resources to maintain operations over this crisis period,” Raske wrote in a letter Monday to U.S. Health and Human Services Secretary Alex Azar.

Raske appealed to Azar to immediately send New York hospitals some of the $100 billion in aid that Congress included last week in a $2.2 trillion coronavirus relief bill aimed at helping address the financial crisis caused by the pandemic.

Members of New York’s congressional delegation turned up the heat Wednesday, led by U.S. Sen. Charles Schumer, D-N.Y., who called Azar to explain the urgency of the situation.

Schumer, the Senate Democratic leader, had held up the CARES Act, the coronavirus relief bill passed by Congress, to negotiate a larger financial aid package for local hospitals.

Schumer and U.S. Sen. Kirsten Gillibrand said they want Azar to understand that New York hospitals need a proportional share of the $100 billion to reflect that the state is the epicenter of the virus pandemic in the United States.

As of Wednesday, 1,941 people had died in New York state and 83,712 people had confirmed infection with the coronavirus, according to Gov. Andrew Cuomo. Most of the deaths and infections have been in New York City, but hospitalizations have been rising across Upstate New York as well.

U.S. Reps. John Katko, R-Camillus, and Anthony Brindisi, D-Utica, wrote to Azar on Wednesday telling him that hospitals in Central New York don’t have time to wait weeks for the promised federal aid.

“I think the hospitals need money very quickly,” Katko said in an interview. “They’re going to be hemorrhaging, especially if this lasts until the end of June. They’re going to have catastrophic losses. I know they can’t go forever without paying bills."

Raske, of the Greater New York Hospital Association, said most hospitals in the state lost revenue in the past month from the cancellation of elective procedures, and increased staffing and supply costs to provide care to COVID-19 patients.

He told Azar that’s a difficult situation for many hospitals in New York because they operated with some of the lowest margins nationally, with an average operating margin of 1.5 percent in 2018.

Crouse Hospital had been in the middle of a relatively good quarter, with year-over-year revenue up about 2 percent through mid-March when it began canceling elective procedures and surgeries, Boynton said.

Now, the hospital is taking emergency measures to preserve cash, she said. Crouse usually keeps about 45 days cash on hand for operating expenses.

To save money, Crouse plans to apply to spread its federal payroll tax payments through 2021 and 2022, defer some pension payments until January 2021, and apply for accelerated payments from Medicare that are available as part of the federal response to coronavirus, Boynton said.

Crouse also may apply for aid through a federal program that would allow the hospital to receive employer retention credits for keeping staffers on the payroll through the crisis.

At the same time, Crouse is working with lending institutions for a small line of credit to supplement its $500 million per year budget, Boynton said.

“We’re leaving no stone unturned,” Boynton said. “We’re trying to make sure the cash flow continues.”

Crouse Hospital has kept other services fully operating through the crisis, including its neonatal intensive care unit, which serves 17 counties in Upstate New York.

“We want everyone to know we are here for the community,” Boynton said. “We’ll continue to be here for them.”

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