Hospitals faced significant challenges in responding to the COVID-19 pandemic, especially in efficiently testing patients for the virus and caring for them while keeping their staffs safe, according to a new report based on interviews with administrators from 323 hospitals across the United States.

The report released Monday by the Department of Health and Human Services Office of the Inspector General found that hospitals did not have enough testing supplies and struggled with uncertain wait times to receive test results for possible COVID-19 patients.

“One hospital that was holding presumptive positive patients in intensive care unit beds reported that testing with a quick turnaround would free up bed availability and increase patient and staff safety,” the report reads. “An administrator at another hospital noted that the sooner the hospital knows whether patients are negative, the faster it can move them to a lower level of care that consumes fewer resources.”

“As one administrator put it, ‘sitting with 60 patients with presumed positives in our hospital isn’t healthy for anybody,’” it added.

While testing in the U.S. has improved in recent weeks, the country was slow to make testing widely available across the country. People have also reported having to wait several days to get their results, as labs tried to work through a backlog of tests.

During the interviews, conducted between March 23 through March 27, investigators focused on identifying hospitals’ biggest challenges, their strategies to mitigate those challenges and how the federal government could be most helpful.

Hospitals said other challenges included trying to protect their staff, given the shortages of protective gear. They noted that the delays in receiving testing results led doctors and others to use more protective equipment out of caution. One administrator said that the hospital was using 2,000 masks per day, compared to a typical 200.

Hospitals said the supply chain for getting that equipment was backed up and the supplies they received from the Strategic National Stockpile were insufficient for their needs. Administrators also said they faced price gouging on things like masks, which each could cost $6 now compared to the normal price of 50 cents.

Instead, hospitals have been looking to nontraditional sources for supplies, such as online stores, paint shops or home supply stores.

Many hospitals also warned that the pandemic is a financial stressor, and administrators said they were taking steps such as tracking all spending related to the pandemic to be reimbursed in the future or laying off staff, a step that can exacerbate workforce shortages.

Doctors are also reusing protective gear or have set up remote testing facilities where staff can wear the same protective gear all day, rather than changing as they move throughout a hospital.

Hospital executives said they wanted the government to help make testing easier and more available, provide medical supplies and protective gear, and loosen restrictions on transferring or gifting equipment. They also said they wanted the government to loosen regulations to make it easier for hospitals to reassign doctors and shift responsibilities more easily and allow hospitals to establish remote surge facilities, a step the Centers for Medicare and Medicaid Services approved last week.