The financial challenges caused by the COVID-19 pandemic have forced hundreds of hospitals across the nation to furlough, lay off or reduce pay for workers. U.S. hospitals are estimated to lose $200 billion between March 1 and June 30, according to a report from the American Hospital Association. The combination of canceled elective procedures, which make up about $161 billion of the expected revenue losses, and the costs of preparing for a surge of COVID-19 patients have created a cash crunch for hospitals.

Though Congress has allocated $175 billion in relief aid for hospitals and other healthcare providers, it isn’t enough to cover the lost revenue and higher expenses some are experiencing due to the pandemic. Even before the coronavirus swept America, forcing hospitals to stop providing lucrative nonessential surgery and other services, many smaller hospitals were on the financial brink. Hospitals are taking a number of steps to offset the financial damage. Executives, clinicians and other staff are taking pay cuts, capital projects are being put on hold, and some employees are losing their jobs.

Nearly 270 hospitals and health systems have furloughed workers in recent months and several others have implemented layoffs. Some layoffs since May 1:

1. Grand Forks, N.D.-based Altru Health System — 167 employees.

2. Bluefield (W.Va.) Regional Medical Center — 340 employees.

3. University of Mississippi Medical Center in Jackson — 250 employees.

4. Dallas-based Baylor Scott & White Health — 1,200 employees.

5. Pittsburgh-based Allegheny Health Network — 250 employees.

6. Duluth, Minn.-based Essentia Health — 900 employees.

7. Buffalo, N.Y.-based Erie County Medical Center — 70 employees.

8. Valley View Hospital in Glenwood Springs, Colo., — 100 employees.

9. Fulton County Medical Center in McConnellsburg, Pa. — 36 employees.

10. King City, Calif.-based Mee Memorial Healthcare System — 55 employees.