A report released Monday by the Department of Health and Human Services (HHS) inspector general details the “severe shortages” of testing supplies and medical gear experienced by hospitals, and alludes to the disorganized nature of the federal response.

The government report stands in contrast to the rhetoric coming from the government’s top elected official. President Donald Trump wants you to believe that officials who have criticized his administration’s coronavirus response are part of a plot to take him down, and despite a mountain of evidence to the contrary, he insists federal agencies have done “an unbelievable,” “incredible” job procuring supplies for states.

Now, however, even his own government is acknowledging those talking points are at odds with the reality experienced by health care providers at hospitals that are struggling to contain the coronavirus outbreak while keeping workers safe.

The report, which is based on a random sample of administrators from 323 hospitals across the country conducted March 23-27 — a period of time before the worst of the coronavirus pandemic hit the US — makes clear the notion that hospitals don’t have enough masks for health care workers and ventilators for patients does not stem from some sort of conspiracy to take down Trump. It is coming directly from hospitals’ experience treating patients.

But Trump still seems unwilling to do more.

“We are meant to be the backup,” he reiterated on Sunday.

“We are throwing all of our PPE best practices out the window”

The IG report paints a picture of hospitals that don’t have all the resources they need and are struggling to get by with what they have. It indicates that even when federal help has been forthcoming, supplies sent from the federal stockpile have been insufficient or damaged.

One administrator told HHS that “the supplies the hospital received ‘won’t even last a day.’”

The following passage highlights these problems:

Hospital administrators expressed uncertainty about availability of PPE from Federal and State sources. Some hospitals noted that at the time of our interview they had not received supplies from the Strategic National Stockpile, or that the supplies that they had received were not sufficient in quantity or quality. ... One health system reported that it received 1,000 masks from the Federal and State governments, but it had been expecting a larger resupply. Further, 500 of the masks were for children and therefore unusable for the health system’s adult staff. One hospital reported receiving a shipment of 2,300 N95 masks from a State strategic reserve, but the masks were not useable because the elastic bands had dry-rotted. Another hospital reported that the last two shipments it had received from a Federal agency contained PPE that expired in 2010. The shipment contained construction masks that looked different than traditional masks and did not contain a true N95 seal.

To make do, the report details how hospitals are jury-rigging ventilators from other equipment.

“Our staff had figured out that we could transition some anesthesia machines using t-connectors and viral filters to turn them into ventilators. You jury-rig the anesthesia machine by using a t-connector, you can support four patients off one of these,” one administrator said.

Trump has repeatedly insisted that it’s up to the states to obtain their own ventilators and other supplies. State officials have pointed out that the problem with this approach is that resource-strapped states end up driving up prices by not only bidding against each other, but also in some cases having to compete with the federal government.

The IG report indicates that hospitals are struggling with this same problem.

As one hospital administrator noted, “We are all competing for the same items and there are only so many people on the other end of the supply chain.” Another administrator reported being concerned about poor quality products despite high-prices and “…wonder[ing] if you get what you paid for.”

“We are throwing all of our PPE best practices out the window,” the report quotes one administrator as saying.

In addition to supply problems, the report notes that hospitals “reported instances of receiving conflicting guidance from different Federal, State, and local authorities.”

“[The inconsistency] makes everyone nervous. It would have been better if there was coordination and consistency in guidance among the different levels of government,” one administrator said, with another adding: “It’s difficult when a doctor or nurse shows you legitimate information from legitimate sources and they’re contradictory.”

Trump will try and blame everyone but himself

Trump is famously sensitive to any and all criticism, and to the extent he notices the latest IG report, it’s unlikely he’ll respond well to it.

The HHS report comes two days after Trump fired intelligence community Inspector General Michael Atkinson for not doing his political bidding with a whistleblower’s complaint about his dealings with Ukraine — one that resulted in his impeachment. And it comes just a day after the Associated Press broke news that the federal government waited until mid-March to try and replenish the national stockpile of medical gear. By that time, “hospitals in several states were treating thousands of infected patients without adequate equipment and were pleading for shipments from the Strategic National Stockpile,” the AP reported.

An exchange from Sunday’s White House coronavirus task force briefing illustrates how Trump responds to criticisms of the sort the HHS inspector general is now making. When a reporter tried to ask him about the AP report, Trump cut him off and went on the attack.

“Are you ready? ... the people that you’re looking at — FEMA, the military — what they’ve done is a miracle. What they’ve done for states is incredible, and you should be thanking them for what they’ve done and not always asking wise-guy questions,” Trump said, before abruptly ending the briefing.

"You should be thanking them for what they have done, not always asking wise guy questions" -- Trump ends the press briefing by berating an Associated Press reporter who dared to ask him about the government's slow response to coronavirus pic.twitter.com/EUq6SG42aN — Aaron Rupar (@atrupar) April 6, 2020

Trump’s subtext was that states and hospitals should just be happy for any federal help they can get. But the new IG report reveals the myriad ways in which what they’re getting isn’t enough.

The news moves fast. To stay updated, follow Aaron Rupar on Twitter, and read more of Vox’s policy and politics coverage.