CNN  — 

Shut out of the stimulus package that passed the House last week, hospitals and nursing homes are hoping they can convince the Senate to give them an additional infusion of funding in its version of the $1.9 trillion relief bill.

Congress last year created and poured $178 billion into the Provider Relief Fund to help hospitals, nursing homes and other health care providers pay for coronavirus-related expenses and offset revenue losses from postponing elective procedures.

Hospitals, however, say that only $4.4 billion will remain in the fund by the end of the month. Yet the pandemic remains a source of financial stress for many medical centers, they contend. They continue to treat many coronavirus patients, who require more intensive and costly care, and are still paying a hefty premium for staff, particularly nurses, and personal protective equipment. At the same time, many are seeing fewer non-Covid patients since some people remain reluctant to go to health care facilities for fear of contracting the virus.

Total hospital revenue in 2021 could be between $53 billion and $122 billion lower than pre-pandemic levels, according to a study released last week by the American Hospital Association, which is seeking to build a case for why its members needs more federal aid.

The association is asking Congress to funnel another $35 billion to the Provider Relief Fund to replace some of that revenue reduction.

“More is needed to keep our patients and communities safe, particularly in regards to our efforts to support vaccination efforts and to protect health care workers as well,” said Rick Pollack, CEO of the American Hospital Association. “It’s red alert time for the Provider Relief Fund, which has kept so many hospitals and other providers afloat during this past year.”

Nursing homes also hit

One of the main industry groups for nursing homes also argues that Congress should assist its members by adding to the fund. The industry estimates that it will lose $94 billion over 2020 and 2021, according to an analysis by the American Health Care Association and National Center for Assisted Living.

Nursing homes have received approximately $13 billion from the Provider Relief Fund, only 7% of the total, according to the association. Assisted living communities were allocated approximately $3 billion, but only about $1 billion has been distributed.

“While the Provider Relief Fund was a major lifeline and helped numerous providers stem the tide last year, the pandemic persists and more is needed immediately,” the association said in a statement. “Without additional government assistance, thousands of facilities may be unable to keep their doors open.”

The industry group is requesting $20 billion in aid, either through the fund or enhanced federal Medicaid matching money.

Money for vaccines instead

President Joe Biden and Democratic leaders in the House, however, did not include another round of funding for hospitals and nursing homes in their massive proposals, which would provide billions of dollars for vaccines and testing and more generous subsidies for health care coverage, as well as $1,400 in direct payments and additional unemployment, nutrition and housing aid.

While marking up the legislation in the House Energy and Commerce Committee last month, Rep. Brett Guthrie, a Republican from Kentucky, unsuccessfully tried to insert $35 billion for the fund, questioning why lawmakers are not taking care of providers.

The committee’s chair, Rep. Frank Pallone of New Jersey, countered that $24 billion remained unobligated in the fund at that time. Plus, he said, for providers to return to normal operations, the pandemic has to be stopped.

“If we provide more money to the Provider Relief Fund – they already have $24 billion they are not using – we’d probably have to cut back on the vaccine or the testing or the additional health care workforce,” Pallone said, adding that it “doesn’t make sense” since the fund hasn’t been drained yet.

Hospitals and nursing homes are still holding out hope that the Senate will be amenable to injecting more dollars into the Provider Relief Fund. GOP Sen. Susan Collins of Maine and Democratic Sen. Joe Manchin of West Virginia authored a non-binding amendment that would add $35 billion to the fund. It passed the chamber by a vote of 99 to 1 last month.

“We are still very much in the game,” Pollack said.