Hospital Evacuations During Harvey and Irma
September 14th, 2017 by CHHS RAs
By CHHS RA Jonathan Lim
The news is now dominated by the story that at least eight people died in a Hollywood, Florida nursing home that lost power and air conditioning because of Hurricane Irma. As of the time of this writing, the details of the incident are still forthcoming; however, it may raise questions about why certain medical care facilities evacuate their patients during a hurricane and others don’t, as well as the sufficiency of emergency preparedness of those facilities.
Hospital accrediting bodies require each hospital to have an emergency plan, and last year, the federal government issued an Emergency Preparedness Rule that required all types of Medicare and Medicaid participating providers and suppliers—including participating nursing homes—to develop complying emergency preparedness plans. Providers must be compliant by November of this year.
Prior to and during Hurricane Harvey, many hospitals took proactive steps for evacuation measures. At least 35 hospitals in the Houston area and surrounding states closed altogether or ordered partial evacuations in anticipation or in response to Hurricane Harvey. However, some evacuation efforts had to be aborted. Notably, Bayshore Medical evacuated 196 of its most critical patients on August 29 but afterwards suspended evacuation. Ben Taub Hospital, Houston’s largest level 1 trauma center, called for an evacuation after the hurricane made landfall, but had to halt its evacuation because of unsafe conditions caused by flooding. Reports stated that only five ambulances could reach the hospital, and that only three evacuation vehicles reached their intended destination.
While some Houston hospitals evacuated patients before the hurricane hit, there are legitimate reasons for holding off on an evacuation: a mass evacuation of all hospitals in a threatened region can create logistical challenges that endanger patients more than staying in place. In the case of Ben Taub, it had already made upgrades to its system to protect against flooding after Tropical Storm Alison in 2001, making a shelter-in-place option more viable. However, the hospital admitted that it only had enough food for a few days, and would require a food drop if it had to wait longer.
Smaller healthcare facilities such as nursing homes may not have the resources to maintain operations in the manner of a hospital such as Ben Taub. In Florida, several hospitals and other healthcare facilities also initiated their evacuation plans in anticipation of Irma. However, the Hollywood, Florida, home evacuated 158 of its residents only after the deaths. At least one other nursing home in Florida has initiated a large-scale evacuation of its patients after news of the deaths and the failure of one of its backup generators. Nursing homes subject to the new emergency preparedness rule may need to submit plans that allow for a more prompt decision to evacuate than larger hospitals.