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You'd be surprised, generally its quite easy to fall into a negative loop. In which you can't afford to fix the problems with your hospital. Only making things worse.
I can't count the number of times that I've paused the game on the last day of the month to spend a couple thousand before I lose it and enter the red and/or sell a previous room just to have that to spend. Once, I even had to gut my hospital by selling off nearly half of my rooms because I was so far into the red. I rebounded and that most embarrassing moment caused the most rewarding moment when I finally 3-starred that hospital.
If you're understaffed, or if people are dying, it simply doesn't matter since it can't fail the game and you'll still earn cash. There's just no urgency. At most I have -20k balance in the early game and that never lasts more than a few days.
Hell, I just did the level where surgery was introduced. My prirces were at max, I had people dying and I had rather long queues, and I STILL had 100% rep and 8 million in the bank. I actually thought the game bugged.
Oh it can happen, if you don't know how to basic finance in the game.
Before I was good at the game, I tried and failed at Melt Downs multiple times on lots of different issues. It was because everytime I had a foothold (aka positive cashflow), there was an immediate disaster that wrecked the machines. So therefore, I would need to use my money to repair, replace or buy new janitors. This quickly spiralled into either stagnant growth (aka I could [not] build anything and only had my running costs covered) or I needed loans to buy anything (upgrades, rooms, staff etc).
Since then, I learnt never to take a loan and never build higher than you can take. Your hospital level is the most important in this game and the most basic advice is to just keep that low until you can deal with the next stage. Level 10 being a turning point, thats when stuff gets crazy.