Small, rural hospitals are in the midst of a rocky year: earlier this year, when few had any covid-19 patients, hospitals that were already cash-strapped had to stop elective surgeries and other services that are their main money-makers. And now that the pandemic is hitting some rural communities, they're struggling to provide the supplies and staffing to deal with the influx of patients.

"Pandemic-related federal money has helped struggling rural hospitals stay afloat. But as Congress considers additional aid this month, advocates and policymakers would like to move beyond stopgap measures to change the hospitals’ long-term trajectory," April Simpson

reports

for Stateline. "As the pandemic persists, it’s unclear how long struggling rural hospitals can hang on."

The pandemic was hardly the beginning of rural hospitals' financial struggle. "Since 2010, 128 rural hospitals have closed, including a record 18 hospitals last year. Even more rural hospitals were on track to shut down this year until Congress in March approved $100 billion to health care providers in the CARES Act," Simpson reports. "The support

included $10 billion

in targeted funding that was allocated based on operating expenses before covid-19. Earlier this month, the U.S. Health and Human Services Department announced

another $1 billion

targeted to certain hospitals that serve rural populations." Some small rural hospitals also got aid from the Paycheck Protection Program and from a $150 million grant program meant to help hospitals with increased expenses related to the pandemic.

But hospitals' losses and needs may far outstrip federal relief. "The American Hospital Association estimates hospitals and health systems lost $202.6 billion between March and June and are projected to lose an additional $120.5 billion through the end of 2020. The slow recovery of inpatient and outpatient volumes adds to the strain," Simpson reports. "The association’s findings are based on an electronic survey representing 1,360 member hospitals across 48 states and Washington, D.C. Rural hospitals and health care systems represented about one-third of respondents."