• Healthcare workers are facing pay cuts, reassignments, furloughs, and layoffs caused by coronavirus social distancing rules and shutdowns.
  • “Because it’s this huge healthcare crisis, you don’t expect healthcare workers to be impacted in this way,” one nurse told Business Insider.
  • Hospitals are seeing reductions in surgeries and visits, even as others see surges of coronavirus cases.
  • Congress passed a $2 trillion coronavirus relief package in March called the CARES Act that provides $100 billion for hospitals, but that hasn’t stopped the cuts.
  • Lawmakers are now debating hazard pay for frontline workers, and Democrats want to give the hospital industry another $100 billion in relief funding.
  • Visit Business Insider’s homepage for more stories.

Before the coronavirus pandemic, St. Clair Hospital in Pittsburgh would have 40 to 60 surgeries a day on the calendar. But now, a surgery nurse tells Business Insider, only about five to 15 are scheduled for any given day.

The hospital is down to procedures that need to be done quickly for a patient’s health, such as fixing broken bones or performing appendectomies. More surgeries can come up in cases of emergency, but the volume of surgeries has dropped.

“There are probably about seven or eight nurses on, and half the time you don’t have anything to do,” the nurse said. “It’s like a waiting game to just clock out.”

But the St. Clair nurses don’t want to clock out early, given that they already have been hit with fewer hours, lowering their pay, the nurse said. Hospitals in parts of the country where a lot of people are infected with the coronavirus are overwhelmed with patients to test and treat, but other hospitals – or other parts of a hospital – are far more deserted.

This nurse and others who spoke for this story asked their names not be shared because they feared they might lose their jobs for speaking out. Business Insider verified their identities.

Doctor visits have moved online, and because people are shuttered inside following stay-at-home orders, they’re less likely to get hurt from playing sports or falling off a bike. Patients are calling to cancel surgeries that can wait, and hospitals themselves are moving back appointments following orders from federal and state officials.

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That’s leading to a loss in revenue and leaving healthcare workers taking a direct financial hit. Across the US, hospitals are slashing pay, laying off workers, reassigning people to other departments, or cutting hours. Labor Department data from March shows some of the biggest employment declines occurred in outpatient settings, while overall hospital employment was roughly flat.

At St. Clair, some healthcare workers have been placed on a one-week-on, one-week-off schedule, reducing their pay. The St. Clair nurse has started taking shifts in another unit because otherwise her paycheck would be cut in half. Before the pandemic, she had been looking forward to picking up overtime to help pay off student loans.

‘You never know what you’re going to walk into’

“Going to work every day is rough,” she said. “You never know what you’re going to walk into.”

All the while, healthcare workers brace for when they might be hit with a surge of coronavirus patients themselves.

St. Clair did not respond to a request for comment, but memos from hospital leadership, obtained by Business Insider, shows the hospital gave employees another week of paid time off. The hospital is also letting workers who exhaust their paid time off incur a negative balance for up to a week, and providing a fund for workers in financial hardship. The memos don’t detail how many workers had their hours cut.

“Some employees will be redeployed to meet other critical needs and some, unfortunately, will be flexed down,” Andrea Kalina, senior vice president at St. Clair, said in a memo dated March 25.

For hospitals like St. Clair, relief is supposed to be on the way. Congress passed a $2 trillion coronavirus relief package in March called the CARES Act, and while it provides $100 billion for hospitals, the promise of the funding hasn’t been able to stop the drastic job changes healthcare workers are facing.

“It’s not clear when federal relief dollars will arrive or whether they will fill the gap,” Carlos Migoya, president and CEO of Jackson Health System in Miami, said in an email to employees late last week. “This has forced us to make agonizing decisions in order to keep Jackson alive.”

Hospitals reassess which workers they need

Starting later this month, Jackson will have some hospital employees work up to two fewer days a week, which would effectively cut their pay, but the decision won’t extend to doctors and nurses. The executive team is taking a 20% salary cut, and other top management saw a 10% pay cut.

Medical University of South Carolina in Charleston started temporarily laying off 900 workers this week, a move it expects will last through June. Salaried employees are facing a 15% cut, and hourly workers who don’t care for patients will be working fewer hours.

The hospital confirmed that workers won’t face cuts if they are treating patients with COVID-19, as the disease caused by the coronavirus is known. Though some hourly workers already had reduced hours due to lower volume, they won’t see more cuts if they’re moved onto the COVID-19 response team, said hospital spokeswoman Heather Woolwine.

The cuts at MUSC came as the hospital saw a 75% drop in surgeries, 30% fewer patients arriving at the hospital, and 70% fewer patients arriving there by ambulance. Without staffing changes, it projected a $100 million loss through June 30.

In Oklahoma, Hillcrest HealthCare System announced it is putting about 600 employees on an estimated 90-day furlough, which is a temporary layoff without pay, though some might be called back sooner if they’re needed. The furloughs affect workers in administration, surgery, and outpatient care, where patient visits have gone down, said Rachel Weaver Smith, spokeswoman for Hillcrest.

About 20% of staff are facing furloughs, reassignments, or reduced hours or pay, but the changes don’t extend to staff treating people with COVID-19, Weaver Smith said.

Alteon Health, a medical staffing company, had announced it would move salaried workers to be paid hourly which would result in a pay cut – and that it would end paid time off. The company recalibrated later, saying in a company memo that workers could take paid time off on a case-by-case basis, but it will still be limiting hours for some clinicians. Alteon also said it isn’t paying bonuses.

“If a clinician isn’t going to be busy working at a hospital, we don’t want them exposed to the virus,” Dr. Steve Holtzclaw, the company’s CEO, said the memo to staff. “The best thing for their health and safety is to have them home resting with their families and preparing for surges.”

‘You don’t expect healthcare workers to be impacted in this way’

There’s no central place where hospitals are reporting all of their layoffs or how much money they’re losing. The American Hospital Association, which represents more than 5,000 hospitals, has sounded the alarm about the industry’s financial difficulties and said that quickly distributing funding from the CARES Act would help facilities keep their doors open.

About $30 billion will go out in the coming days, according to Seema Verma, administrator of the Centers for Medicare and Medicaid Services, but it’s not clear when or how the rest will be distributed.

Read more: Here’s exactly what the $2 trillion coronavirus stimulus bill means for hospitals, doctors, and health insurers

“We dont know how much reduction in patient volume is actually occurring,” said Gerard Anderson, professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. “Realistically there is no good information about this situation with hospitals. $100 billion might be useful and it might not be useful.”

At Rady Children’s Hospital in San Diego, a nurse said healthcare workers were frustrated with new hospital policies requiring workers whose shifts are canceled, and who can’t find slots elsewhere, to dip into paid time off.

After that, the hospital is letting them accrue a negative balance of 80 hours of paid time off, but if they need to take more time because of quarantine measures or not having enough shifts, then that time will be uncompensated. Eventually, the healthcare workers will have to work those extra hours, amount to two weeks of work, at a later date.

‘Sidelined and not taken care of’

Nurses at Rady assembled information about other area hospitals, finding they added 80 hours of paid time off for workers rather than having them incur a negative balance. The findings, shared with Business Insider, were provided to the union representative, who went to the hospital administration, according to a second nurse. Rady did not respond to inquiries about its policies.

“I do not feel like I am valued as an employee. In the midst of this crisis we have kind of been sidelined and not taken care of in any way,” said a nurse who had more than 15 years of experience.

“Because it’s this huge healthcare crisis, you don’t expect healthcare workers to be impacted in this way,” the nurse added. Rather than try to fight for hours, some workers are filing for unemployment or taking a leave of absence, she said.

“Everyone is just on edge and stressed out about getting their hours,” the nurse said.

Healthcare workers in parts of the country that are less busy point out that they are still putting their own health at risk, and that surges to their hospitals may still be ahead. Because some people who are infected don’t have symptoms, healthcare workers don’t always know whether they might be exposed to the coronavirus.

One part-time surgery nurse in Ohio, who is 60, opted to work in the “med-surg” unit, where she checks on patients before and after surgery. The change to her job will allow her to keep her pay, but she has to do more training. The alternative would have been to dip into vacation time or take a leave of absence, she said.

“Add COVID on top of that, which is so virulent and contagious that you’re not sure how much you’re going to be exposed,” she said. “Am I going to be the one that dies or am I going to be someone that has a fever for a day? No one knows.”

Democrats want to double funding to hospitals and to set up a ‘Heroes Fund’

Healthcare’s economic challenges have reached the notice of Congress. On Tuesday, Senate Democrats called for instituting what they called a “Heroes Fund” as part of the next phase of government relief. The fund would give essential workers, including healthcare workers directly involved in fighting the coronavirus pandemic, as much as $25,000 in hazard pay this year.

“They deserve it. They are risking their lives,” Senate Minority Leader Chuck Schumer said in a call with reporters.

Democrats want the money included in a “CARES 2” bill for late April.

On Thursday, Democrats tried to replace an interim package meant to help small businesses with their own proposal, which would have given hospitals another $100 billion. Majority Leader Mitch McConnell objected to the change, saying the interim bill should focus only on helping small businesses.

“Do not block emergency aid you do not support just because you want something more,” he urged Democrats from the Senate floor.

The Republican proposal was a standalone bill that would have given small businesses a $250 billion boost, for a total of $600 billion relief when added to the CARES Act. While Democrats supported that measure, they wanted more help for states and hospitals, and so they objected to the GOP bill. As a result, both bills failed and the Senate won’t meet again until Monday.

It’s not yet clear how long the agreement over an interim bill will be drawn out. House Speaker Nancy Pelosi didn’t provide a timeline to reporters Friday but said the small business funding needed “more data and more oversight” and that the bill McConnell proposed “would never pass the House by unanimous consent.” She indicated Democrats would continue to push for hospital funding in the interim legislation.

“We want those hospitals to be funded and equipped,” Pelosi said.