The two major hospital systems in the Memphis area, Baptist Memorial Health Care and Methodist Le Bonheur, have received more than $100 million in combined CARES Act stimulus funding, but spokespeople say it’s nowhere near enough to make them whole.

In the six weeks from mid-March to the end of April, revenue at Baptist was off $118 million, according to CEO Jason Little. Methodist is burning $35 million a month.

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“Right now, that is our projection,” Methodist CEO Michael Ugwueke told University of Tennessee Health Science Center advisory board Friday afternoon. “Considering that pace for the rest of the year, you can do the math.”

Methodist received $40.8 million through the CARES Act. It cut executive pay 20% and furloughed close to 1,000 employees, he said.

“It’s still not enough.”

Buy-in for elective surgeries, which opened May 4, “is very, very slow. It’s trickling in,” Ugwueke said, noting the schedule is off 50% from where it was a year ago.

Baptist, which has 22 hospitals and medical practices in three states, has received $61.45 million in CARES funds.

“That $60 million that is out there is a big help. But, so too is getting back to business in terms of starting elective cases back,” Little said.

By midweek, Baptist was up to about 60% of its normal elective surgery schedule, he said, with the potential to add more and still meet the regulations that say hospitals must have adequate staffing, hospital beds and inventories of PPE.

With the community now two weeks out from when Phase I of the economy reopening, hospital executives are watching closely for any spike in coronavirus cases, juggling that against the elective cases they schedule and the hospital beds required to serve people who by now may have been waiting more than two months for those procedures. Those can include heart catheterizations, screening colonoscopies, orthopedic surgeries and neurological procedures.

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“We’ve had a few more positives admitted in the last week,” said Dr. Richard Aycock, chief of staff at Methodist. “But, it’s been nothing like a surge.”

But hospitals here have seen another, unexpected surge.

“Starting this past weekend, we saw a seriously ill patient population, that had been avoiding the hospital, come in sicker than had they not stayed at home — patients with heart disease and kidney disease and pneumonia that’s non COVID-related,” Aycock said.

“Quite a few,” he said, needed to be in the ICU.

As of 5 p.m. Thursday night, 79% of the 469 ICU beds in the city were full. Only 14% were COVID-positive patients, according to a report the Memphis-Shelby County COVID-19 Task Force received early Friday.

When 75% or more of the beds are occupied, the task force sees the data in red.

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“We notice similar stuff during Christmas or Thanksgiving,” said Dr. Manoj Jain, infectious disease expert advising the task force. “People will delay, ‘Yes, I am not feeling well, but I don’t want to go to the hospital on Christmas Day,’” he said.

What’s surprises Aycock the most is that Memphis has not yet seen what other cities — New York, Chicago and New Orleans — saw in early, devastating surges.

“Fortunately, we did start early enough; we definitely have blended the curve,” he said.

“We’ve deferred it long enough to where we are more ready than we were a month ago,” he said.

Methodist University, where he is working nearly 12-hour shifts, has the capacity to expand from a 375-bed hospital to 700 beds.

“If we can get the staffing for it,” he said.

The cardiovascular ICU in the Sherard Wing has been converted to a yet-to-be used 14-bed negative-pressure COVID ICU wing. (In a negative-pressure environment, a machine pulls air into the room, then filters the air before moving it outside.) Each room has a newly installed anteroom outside its door and wide windows so staff can monitor two rooms at a time, Aycock says as he walks through.

“We will fill this up with ventilator patients.”

While no one envies what hospitals experienced in New York or New Jersey, Little notes that large chunks of the CARES money went to hot-spot cities. The hospitals there were paid for the care they delivered.

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“Not that we would want to change places with a New York City, but one thing they had in their hospitals, when they were treating coronavirus patients, they had revenue coming in because there was revenue associated with the treatment of those patients,” he said.

“It was quite the opposite here. We were preparing for surges; we had empty hospitals, and no revenue.”

To stem the hemorrhage, Baptist closed some departments, including its sleep lab. Now, it’s planning to phase them back in while it closely watches the case numbers and hospital-side data, including its labor force.

Baptist has 1,100 employees working at home.

“We’ve not brought them back yet. That all gets entered into the decision-making here over the next several weeks,” Little said.

Systemwide, elective surgeries are below 50% of where they were even three months ago at Methodist, and patient volume is down 40%.

One hospital, Le Bonheur Children’s, hit 50% of elective capacity Wednesday for the first time since elective surgeries were halted March 8. The reason it did was because he had a docket full of short surgeries, including ear tubes and other minor procedures, Aycock said.

“We’re starting slow, but also in some of our hospitals, some of the patients are not yet ready to pull back on their social distancing and go to a hospital for an elective procedure,” he said.

“If everything goes well this weekend and we don’t see a surge, we’re probably going increase to about 75% sometime during next week.”

Still, he said, it will be a very conscious decision.

“If PPE starts getting in short supply again, that would be a major contributor.”

Aycock, Dr. Carl Sanchez and Uguweke meet every day at 5 p.m. to discuss strategy for the next day.

“We look at each hospital, every day, how their day went, what issues were there,” he said.

Color-coded dashboards show the number of surgeries done each day, plus gastrointestinal, cardiology and radiology procedures.

“Each hospital has its own unique benchmark for 50%,” Aycock said.

“I mean, every day with this disease is a different day. If you’ve seen one day, you’ve seen one day,” he said, noting he’s had patients test positive in the hospital, and they weren’t infected there.

“They were not initially presenting with, I hate to say, COVID-like symptoms because every day we learn new symptoms that are COVID related, whether it’s GI (gastrointestinal), ocular (eyes) or toes.”

Hospitals across the city now are taking measures to reassure the public about how safe it is to be inside.

At Baptist, one of the talking points is the rigor of its employee testing process.

In the last week, of the 2,641 asymptomatic employees it tested, only one was positive.

“I think what that says is that our processes are working,” Little said.

“Our PPE allocation is working. Our COVID-safe areas are working, and we’re really, really proud of that.”

Methodist will begin formally surveying elective surgery patients next week, asking them how comfortable they were, what they noticed and how safe they felt.

“Like I said, the main tenant of this is patient, associate and provider safety,” Aycock said.

For as upbeat as Little is about the numbers, managing against a backdrop of staggering and still-unpredictable losses, he admits, is beyond trying.

“Congress has made a decision to allocate health care organizations another $105 billion that we’ve not yet heard anything about. And in terms of how they’re going to send it out and so on, our real hope and prayer would be that the government sees fit to invest in health care systems in that fashion.”

How that money flows, Little said, “will fully inform how we feel about the future.”