NORTH CAROLINA – COVID-19 is taking a major toll on rural hospitals, especially the bottom lines.

The facilities often run on thin margins.

Many of them rely on money from elective surgeries. But the coronavirus has put a pause on many of those surgeries.

Between the loss of not having elective procedures and the cost of labor and equipment to fight COVID-19, the North Carolina Healthcare Association, NCHA, says rural hospitals in the state are losing around $145 million a month.​

The NCHA says this is why rural hospitals must work with other facilities.​

"We see hospitals, small and large, urban and rural, developing these clinically integrated networks," NCHA CEO Steve Lawler says.

The NCHA says it's working with the state to secure $75 million, much of which would go to helping rural facilities.

The organization also says rural hospitals will also have to be leaner and more reliant on virtual visits when the pandemic ends.