COVID-19 is having a “significant adverse impact” on the finances of Kennett-Square, PA-based Genesis Healthcare, with estimates showing that the incremental expenses and lost revenue caused by the virus cost Genesis approximately $213 million in the second quarter. That’s according to the firm’s second quarter earnings, released late Monday. 

Since March, 241 of Genesis’ 361 facilities have experienced one or more positive cases of COVID-19 among patients and residents. 

In response to concerns about its financial stability, Genesis performed an assessment of its cash flow and debt obligations. Results, the organization said, showed that it is unlikely that the organization will be able to generate sufficient cash flows to meet its required financial obligations, including its rent obligations, its debt service obligations and other obligations due to third parties. 

“The existence of these conditions raises substantial doubt about the Company’s ability to continue as a going concern for the twelve-month period following the date the financial statements are issued,” the firm said in its release. 

The operator reported $67 million in lost revenue associated with COVID-19 during the second quarter of 2020, and $74 million for the first six months of the year total.

Genesis Healthcare is a holding company with subsidiaries that, on a combined basis, comprise one of the nation’s largest long-term and post-acute care companies, providing services to more than 350 skilled nursing facilities and assisted/senior living communities in 25 states nationwide.

See also: Genesis questions company’s viability after pandemic causes $213M in lost revenue, skyrocketing expenses