Published 10:56 PM EDT Sep 12, 2018
WILMINGTON, N.C. – Nursing homes are evacuating residents at historic clips or stockpiling supplies. Hospitals are bolstering staff and closely following disaster plans. Hospice care facilities are moving into nearby hospitals.
As Hurricane Florence aims its fury at the East Coast, health care officials and emergency planners are prepping hospitals and nursing homes – often the most vulnerable outposts in disasters – ahead of the storm's landfall.
At Trinity Grove, a nursing home in Myrtle Grove, employee Pete Nero checked on the building's 750-kilowatt generator. About 100 residents will shelter in place at the facility that sits near Masonboro Island, less than 2 miles from the coast.
“We are as prepared as we can be,” Nero said.
In North Carolina, at least 40 of the state’s 130 hospitals are in the direct path of the storm, which is forecast to deliver punishing winds of up to 130 mph, torrential rains and up to 13 feet of storm surge when it stalls along the South Carolina-North Carolina coast Thursday night into Saturday.
About 10 of the state's nursing homes located in coastal and eastern counties also began evacuating as early as Monday.
On Monday, South Carolina Gov. Henry McMaster called for a "Mandatory Medical Evacuation" of nursing homes, hospitals and other health care facilities in the storm's path, and officials took the rare step of evacuating all 32 nursing homes and assisted-living facilities in the state's coastal region.
As of Wednesday, more than 1,700 people had been evacuated from health care facilities along the South Carolina coast.
Last year's hurricanes in Texas, Florida and Puerto Rico exposed hospitals and nursing homes as being at most risk in the wake of disasters. At a Broward County, Florida, nursing home, 14 residents died following Hurricane Irma, while hundreds of the nearly 3,000 estimated deaths from Hurricane Maria in Puerto Rico were attributed to a lack of health care access.
The average age of residents evacuating from nursing homes in South Carolina is 83, and moving them is risky, said Randy Lee, president of the South Carolina Health Care Association. The residents are ferried in ambulances or buses, along with mattresses and their medical supplies, to nursing homes farther inland.
Lee said it was the first time he knew of that so many nursing home residents were moved from their facilities at once.
"We have residents who have not left the building in 10 years," he said. "This could be very traumatic for them."
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A debate over whether to leave
The debate over whether to move frail nursing home residents – many with Alzheimer's, dementia or other ailments – has flared nationally since Hurricane Katrina in 2005, when several hundred people died in local hospitals or nursing homes that lost power or during arduous evacuations.
State nursing home officials often dispute whether it's worth evacuating residents in the run-up to a storm that's a Category 2 or 3, Lee said. But with a major storm such as Florence, there wasn't much of a choice.
"When you get a Category 4 or potentially Category 5," Lee said, "it's just not an option to stay in place."
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Despite its close proximity to the coast, Trinity Grove in North Carolina remained opened, leaving residents with the difficult choice of evacuating on their own or staying.
Kay Torrens, 88, and her husband, Leo, 87, have lived at the facility for 25 years. She's decided to leave and ride out the storm with a relative in Virginia while her husband stays behind.
She said she trusts the facility to keep Leo safe, but Florence's menace was too much for her.
“We intended to stay here, but the flooding and the rain are the issues,” Kay Torrens said. “We’ll just hunker down and see what happens.”
The staff at Thrive at Prince Creek, an assisted-living facility just 2 miles off the coast in Murrells Inlet, South Carolina, wasn't taking any chances. It began evacuating all of its 42 senior citizens, some with dementia and other special medical needs, as well as 23 staffers Monday morning and moved them 250 miles inland to a sister property in Greer.
The caravan included two large passenger buses, a smaller bus, a box truck loaded with supplies and five other vehicles with team members, said Jacque Richardson, the facility's president. It took an hour-and-a-half to load the residents and five-and-a-half hours to complete the trip, she said.
"We started our war room on Monday at 6 in the morning and had all hands on deck,” Richardson said.
Hospitals were on similar high-alert. All seven of North Carolina's trauma hospitals have been in daily conference calls with state emergency officials since Monday to make sure disaster plans are in place and supplies staged for the storm, said Bill Gentry, who heads the executive master’s program at the Department of Health Policy and Management at the University of North Carolina at Chapel Hill.
Medical teams have been deployed to the Goldsboro area to stage a 200-bed mobile hospital, known as a "State Medical Assistant Team," or SMAT, to take in overflow patients from area hospitals that may be incapacitated or hard to reach because of flooded roads, he said.
State health officials have also upgraded their communication system and disaster plans since Hurricane Matthew battered the state two years ago.
'Flooding is flooding'
Still, Florence's sheer size – bigger than the state of North Carolina – and combination of strong winds and heavy rains will likely challenge the best-intentioned plans, Gentry said. North Carolina is likely to experience what the Houston area did during Harvey when historic floods cut off residents from hospitals, he said.
"Flooding is flooding," said Gentry, a former official with the North Carolina Office of Emergency Management. "Trying to get people from Point A to Point B with 6 or 7 feet of water outside, no matter how good your communication is, is going to be tough."
An overtaxed generator stopped working during Matthew, and water was cut off from the 440-bed Southeastern Regional Medical Center in Lumberton, North Carolina, because of widespread floods. Hospital staffers were forced to take the unwanted step of evacuating 13 critical care patients and Neonatal Intensive Care Unit babies in the wake of the storm.
As Florence aimed at North Carolina's coast, hospital executives brought in an extra generator, loaded up on water and made sure they had sufficient staff through the weekend, said Joann Anderson, the hospital's chief executive.
They also have discharged patients who are able to leave early – a process known as "decompressing" – and have been in constant contact with local emergency officials, she said.
Despite all the prepping, hospital staffers remain worried.
"There’s a lot of anxiety," Anderson said. "It's definitely stronger, definitely bigger, definitely a lot of uncertainty because of that."
Liv Osby of the Greenville News contributed to this report.
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