An Oct. 2 report from the New Jersey Hospital Association finds hospitals took a multi-billion dollar hit as the COVID-19 pandemic slammed into the state earlier this year.

That includes $650 million in lost revenue for both March and April – 32%  each month – mainly due to a two-month pause on elective surgeries.

The new NJHA report finds that between June 30, 2019 and this past June 30, emergency department admissions fell 23% , outpatient visits fell 22%  and hospital admissions fell 8%.

Overall, total patient revenues fell 6.6%, the report says.

Moreover, hospitals shelled out hundreds of millions of dollars to shore up responses to the virus—$214 million in both March and April, according to a May report from the organization.

With federal COVID-relief aid to hospitals across the nation, many New Jersey facilities were able to recoup a sizable chunk of those losses, according to Kerry McKean, a spokesperson for the NJHA.

The “profitable months” of January and February also helped offset some of those losses.

Because of that, New Jersey’s hospitals recorded a net loss of half a billion dollars, McKeon added, but “it’s too soon to know if we have a sustained rebound.”

For the May study, the NJHA’s Center for Health Analytics, Research and Transformation received responses from 30 of the state’s 71 acute care hospitals. McKean said 69 of the 71 were represented in the new findings.

To soften the blow against hospitals, in August Gov. Phil Murphy ordered the state’s facilities to amass a 90-day supply of PPE, such as masks, face shields, gloves and gowns.

The Oct. 2 report finds expenses increased by 12% as hospitals worked to “redirect resources to increase staffing; boost supplies of personal protective equipment, pharmaceuticals and ventilators; and modify operations and facilities to expand capacity,” the NJHA said in a statement.

Murphy suspended elective procedures in mid-March to shift hospital resources toward pandemic efforts, when thousands of new cases and hospitalizations were reported each day.

A sample of some of the most common elective procedures – bariatric surgery, pacemaker insertion, spinal fusion, knee replacement and hernia repair – found that the state’s hospitals performed those procedures 4,336 times in April and May of 2019, compared to just 400 times during the same two months in 2020, according to the Oct. 2 report.

At its peak in April, the virus sent more than 8,100 patients into acute care, compared to just 443 beds filled as of Sept. 28, according to the report.

“These numbers reflect real lives – people at home or on the job who may be experiencing a life-threatening situation but refusing to go to the emergency department,” Cathay Bennett, the NJHA’s president and chief executive officer and president, said in an Oct. 2 statement.

In the spring, field hospitals were set up in conjunction with the U.S. Army Corps of Engineers and the Federal Emergency Management Agency in East Rutherford, Edison and Atlantic City to handle an expected overflow of patients. Unused hospital wings and other facilities were also brought back online.

Marc Levine, president of the New Jersey Medical Society, warned ahead of late-May reopenings that the health care system could undergo growing pains as it lifted restrictions on elective procedures.

“We’re going to find that there are going to be problems that have arisen in non-COVID-19 patients who have delayed care or put off care,” Levine told lawmakers in May. “Our patients, unfortunately, may be affected by practices shutting down and not coming back.”

Editor’s note: This article was updated at 10:05 a.m. EST on Oct. 5, 2020, to include remarks from New Jersey Hospital Association Kerry McKean.