North Carolina hospitals hunkered down and waited for emergency patients to arrive after Hurricane Florence pummeled the coast near Wrightsville Beach on Friday, bringing 90 mph winds, life-threatening storm surge, and power outages for more than 500,000 residents.
At least four hospitals were running on generator power as of Friday morning and several were dealing with leaking roofs or other property damage, according to the North Carolina Healthcare Association, which has been communicating with its member hospitals throughout the state.
Hospitals anticipated these issues and stocked up on fuel, water, food and other supplies in the week and a half before the storm struck. Facility services teams were quickly repairing leaks and other damage.
"We've gone through enough hurricanes that we've made backups for the backups," said Carolyn Fisher, spokeswoman for Wilmington, N.C.-based New Hanover Regional Medical Center, which was running on generator power and suffered roof damage to an orthopedic hospital under construction. New Hanover evacuated about 40 patients before the storm. As of Friday, about 450 patients remained in the 725-bed hospital and 1,800 physicians and staff were working in shifts at its main campus.
At CarolinaEast Medical Center in New Bern, N.C., where hundreds of the city's residents had already been rescued from floodwater overnight and 150 more were waiting for help Friday morning, a little more than 300 essential staff and 221 patients were sheltering in the 350-bed hospital. The medical center had enough supplies to last five to seven days and enough fuel to power the generators eight to 10 days, spokeswoman Megan McGarvey said.
CarolinaEast, like other hospitals, was still waiting for an influx of patients it anticipates will come once the high winds subside and first responders go back on the road. McGarvey said the medical center is likely to see patients with contusions, bruises, broken bones, and even snake bites experienced by people who were in floodwater.
Lumberton, N.C.-based Southeastern Regional Medical Center, a rural provider about 80 miles from the coast, was just beginning to feel the wind and rain of slow-moving storm midday on Friday. The medical center, which stood up its incident command center on Thursday, was running on emergency generators after losing electricity, said David Sumner, the hospital's incident commander and vice president.
Before the storm, Southeastern Regional discharged patients that could be sent home or to another level of care "to unload the hospital in the event we had additional patients coming in as the result of the storm," Sumner said. As of Friday afternoon, Southeastern Regional had about 195 patients. Its nearby nursing home had 112 patients. Six shelters had been set up by Robinson County, N.C., where Southeastern Regional is located, to take care of minor injuries so patients wouldn't clog the hospital's emergency department.
Though Tidelands Health system was ordered to evacuate patients from its hospitals in Murrells Inlet, S.C., and Georgetown, S.C., small crews of clinical staff, security personnel, and management remained to take care of patients too ill to be moved and to re-open the facilities as quickly as possible after the storm. Earlier in the week, about 100 patients were evacuated from Tidelands with more than 40 nurses traveling with them to hospitals throughout the state.
North Carolina and South Carolina hospitals and other providers prepared for the storm by evacuating patients to inland facilities and discharging those well enough to leave to make room for injured patients in the wake of the storm.
They stocked up on medical supplies, linens, pharmaceuticals, food, water and fuel. They also rescheduled elective procedures and closed outpatient clinics.
During the week, inland hospitals, were busy coordinating with each other to accept patients and nursing staff that evacuated from coastal areas. Blues insurers in South Carolina and North Carolina pitched in to help by offering patients free virtual care visits during the storm. Providers, such as Charleston, S.C.-based MUSC Health, Chapel Hill, N.C.-based UNC HealthCare, and Greenville, N.C.-based Vidant Health are doing so as well.
HHS on Thursday announced several steps to offer relief, including waiving or modifying some Medicare, Medicaid and Children's Health Insurance Program requirements. The agency also created special enrollment opportunities so people can get immediate access to care if needed.
Hospice and home healthcare provider Amedisys, which has more than 8,425 patients and 40 care centers in North and South Carolina, begins preparing its patients for emergencies like hurricanes during the first visit to their living facility or home by ensuring they have an evacuation plan and a means of transportation, said Iris Rancatore, assistant vice president of clinical risk at Amedisys.
More than a week ahead of Hurricane Florence, Amedisys began reassessing patients' needs and coordinating transportation services or extra medicine. It worked with durable medical equipment suppliers to make sure patients had backup oxygen tanks. It also told the electric companies where vulnerable patients were located so they could prioritize restoring power in those areas.
The point is to make sure patient care is uninterrupted, said Rancatore, who oversaw several Louisiana home care agencies in Louisiana during Hurricane Katrina, when there was minimal time to prepare for that 2005 hurricane that killed more than 1,800 and displaced hundreds of thousands. But for Hurricane Florence, Amedisys had plenty of time to prepare.
"Doing all the work ahead of time is key to the success of our agency," Rancatore said, who said Amedisys staff will move back in as soon as the states allow to begin calling patients and going door to door to make sure they are OK.