Healthcare providers along the East Coast from North Carolina to New England girded themselves for an expected beating from Hurricane Irene, which was on track to make landfall in North Carolina on Saturday and then move north along the coast.

The precautions included a mandatory evacuation of hospitals and nursing homes in low-lying areas of New York City. HHS activated the National Disaster Medical System and U.S. Public Health Service to provide medical teams, public health teams and hospital support.

The scene was all too familiar for Leslie Hirsch, president and CEO of Denville, N.J.-based St. Clare's Health System (part of Catholic Health Initiatives), who started as CEO of New Orleans-based Touro Infirmary one week before Katrina ravaged the Gulf Coast in August 2005. Hirsch is now preparing his system for this hurricane after New Jersey Gov. Chris Christie declared a state of emergency.

“Our command center is in full operation,” Hirsch said. “We're in disaster-alert mode,” he said, adding that first and foremost, St. Clare's is assessing its patient census. “We've cut off elective surgeries and elective admissions.” St. Clare's will also accelerate—where appropriate—patient discharges, he said.

University Health Systems of Eastern Carolina, Greenville, N.C., owns, leases or is affiliated with eight hospitals that could be affected by Irene, spokeswoman Beth Anne Atkins said. The one most clearly in Irene's projected path is 19-bed Outer Banks Hospital, Nags Head, N.C., and that hospital was discharging or relocating all inpatients, Atkins said. Outer Banks Hospital planned to stay open for emergency care with a skeleton staff, and close if Dare County emergency officials suggested it, she said.

Systemwide, some scheduled surgeries were postponed if they required an overnight stay, Atkins said. The hospitals stocked up on blood, medical gases, water, food and fuel for emergency vehicles, she said. The system also removed a crane working on its children's hospital construction site in Greenville and shifted its three emergency helicopters to a hangar at an inland airport.

Farther south and away from the area where Irene is expected to make landfall, New Hanover Regional Medical Center, Wilmington, N.C., scheduled lockdowns at its three area hospitals Friday evening, and outpatient sites were scheduled to close Friday afternoon. All elective surgeries and procedures scheduled for Saturday were postponed.

In nearby Bolivia, N.C., officials at Brunswick Novant Community Hospital have been grateful as big storms bypassed the area over the past few years while their 74-bed replacement hospital was under construction, spokeswoman Amy Myers said. The hospital, which opened the new facility in July, planned to lock all doors except to the emergency department Friday evening and asked staff members working Friday night and Saturday to make plans to stay at the hospital if necessary.

Sentara Healthcare, Norfolk, Va., evacuated 93 residents at its Sentara Nursing Center-Currituck, Barco, N.C., pursuant to an evacuation order issued by Currituck County, according to a Sentara release.

Seven of Sentara's 10 hospitals are in the Hampton Roads region of Virginia near the coast, and they stocked up on all the necessary supplies and opened their incident command centers to deal with Irene, said Vicky Gray, senior vice president. Volunteers offered child-care service for nurses who needed to stay at their posts, Gray said. Sentara's home-health agencies would be visiting every patient by midmorning Saturday, she said.

New York Mayor Michael Bloomberg ordered hospitals, nursing homes and residents in highly flood-prone areas to evacuate ahead of Hurricane Irene. “Now, we have never done a mandatory evacuation before and we wouldn't be doing this now if we didn't think the storm had the potential to be very serious,” Bloomberg said in a news conference.

Two-campus Staten Island University Hospital said on its website that roughly 360 patients would be transferred by the end of the day Friday. The Veterans Administration New York Harbor Healthcare System said its Manhattan Medical Center would transfer about 100 patients elsewhere in the system.

NYU Langone Medical Center said in a news release the evacuation would include 400 Tisch Hospital and Rusk Institute of Rehabilitation Medicine patients. New York City Health and Hospitals Corp. said about 250 patients would be transferred before the end of the day Friday from Coney Island Hospital. Other New York hospitals included in the evacuation were Peninsula Hospital Center and St. John's Episcopal Hospital-South Shore.