Hurricane Milton: Record evacuation of healthcare facilities, flooding and power outages

Hurricane Milton prompted the biggest evacuation of healthcare facilities in Florida’s history.

Tampa General Hospital remained open throughout Hurricane Milton. The system said its "AquaFence," a barrier to guard against storm surge, withstood flooding and strong winds.

Given Florida’s extensive history with hurricanes, that’s no small statement, says Mary Mayhew, president and CEO of the Florida Hospital Association.

“There were over 400 total healthcare facilities that evacuated, the largest evacuation of health care facilities the state has ever experienced in advance of a storm,’ Mayhew told Chief Healthcare Executive®.

Florida state officials said Thursday morning that 401 healthcare facilities evacuated, including 223 assisted living facilities and 76 nursing homes.

Some hospitals were forced to evacuate ahead of the storm. Mayhew said 21 Florida hospitals had to evacuate, and state officials said 8 other freestanding hospital emergency departments shut down and evacuated ahead of the storm.

Most facilities avoided major damage from Milton, although some systems were still conducting assessments of their facilities Thursday.

“Our hospitals have fared remarkably well, which is a testament to all of the investments they continue to make in hardening their facilities and ensuring that their staff are ready, that they have the supplies they need,” Mayhew said Thursday. “Their physical plants did not sustain any major damage.”

One hospital did suffer some damage from a tornado spawned by Milton Wednesday, Mayhew said.

Milton hit Florida's west-central coast late Wednesday. The storm came just two weeks after Hurricane Helene caused significant damage along Florida’s west coast and the “Big Bend” region. Eight hospitals evacuated due to Helene, along with a host of other facilities.

HCA Florida, which operates more than 40 hospitals in the state, is evaluating its facilities after Milton.

“We’re continuing to assess the needs of our HCA Florida Healthcare hospitals and work to ensure critical resources like generators, fuel and water are positioned in impacted areas,” HCA Florida said in a statement.

HCA Florida Largo Hospital evacuated more than 200 patients early Thursday morning and transferred them to other facilities due to flooding in the facility’s basement, Fox 13 in Tampa reported. The facility is temporarily closed. HCA Florida evacuated a few other hospitals ahead of the storm.

While most healthcare facilities avoided major damage, many lost electricity due to the storm. State officials said early Thursday that 165 healthcare facilities lost electricity, including 70 assisted living facilities, three hospitals and 17 hospital emergency departments. (The story continues below.)

Capacity challenges

Florida hospitals will face some significant challenges in the coming days.

With so many nursing homes, assisted living centers and other facilities evacuating, hospitals won’t be able to easily discharge some patients who no longer need acute care, said Tom Cotter, executive director of Healthcare Ready, a nonprofit organization that works to ensure access to care in emergencies.

“You don't have a good place to discharge your patients from the hospital who maybe can be discharged a little early into a long-term care facility, for example, or a rehab facility,” Cotter told Chief Healthcare Executive. “So it's been an enormous operation to get patients out and where they need to be, and it'll be an enormous operation to return them back to their home.”

“You can't necessarily send patients home either. If they live in the evacuation areas, it wouldn't be ethical to do so,” he said.

Mayhew says the closure and evacuation of post-acute facilities will pose some challenges for hospitals, and underscores the dependencies across the healthcare continuum.

“There undoubtedly are patients in our hospitals that will be ready for discharge but cannot be safely and timely discharged back to their assisted living facility or their nursing home because it remains closed,” Mayhew said. “There certainly are many nursing homes and assisted living facilities that are older buildings that may have sustained damage. It may take time for the state to approve their reopening.”

As some hospitals face delays in transferring patients, they'll also be accommodating new patients who need care after the storm. So some facilities are going to be dealing with a heavy volume.

“That's going to exacerbate some of the capacity challenges that hospitals are facing today,” Mayhew said. “Many of our hospitals are at max capacity in the region most impacted by Milton.”

While Milton has passed, the threat of flooding from Florida rivers remains a worry for hospitals.

“The risk of that has not gone away, and that may take several days before we experience the full extent of the flooding risk,” Mayhew said.

AdventHealth North Pinellas began evacuating patients ahead of Hurricane Milton. While the hospital remained closed Thursday, AdventHealth's other hospitals and emergency departments in the Tampa Bay area were open.

‘An incredible effort’

Tampa General Hospital avoided major flooding. Its “AquaFence,” a barrier designed to protect the main hospital campus from storm surge, stood up to floodwaters and hurricane force winds, the system said. The main hospital and its other hospitals remained open throughout the storm, and the system plans to open outpatient facilities and clinics Friday.

“Preparing for Hurricane Milton was an incredible effort by the entire team and a true test of our resources, but it ensured we could continue to provide exceptional care for our patients in a high-quality, safe and uninterrupted environment before, during and after the storm,” John Couris, president and CEO of Tampa General Hospital, said in a statement.

BayCare Health System, which operates 16 hospitals in west-central Florida, kept all but one of its hospitals open through the storm. Morton Plant North Bay Hospital remained closed Thursday.

“We want to assure those in our communities that all patients are safe at BayCare’s 16 hospitals post-Hurricane Milton, including in St. Petersburg where there are local infrastructure issues,” BayCare said on its Facebook page Thursday afternoon.

AdventHealth said nearly all of its hospitals and emergency departments are fully operational and caring for patients. Only AdventHealth North Pinellas, which evacuated before the storm, remained closed Thursday.

The system said some hospitals, including AdventHealth Carrollwood and AdventHealth Tampa, suffered “minor water intrusion that affected some areas of the facilities.” But officials said there were no injuries or interruptions to patient care.

During the hurricane, the AdventHealth hospitals delivered more than two dozen babies and performed several critical surgeries.

“We are grateful to everyone who worked tirelessly to ensure the safety of our patients and maintain hospital operations,” David Ottati, president and CEO of the AdventHealth West Florida Division, said in a statement. “Their commitment exemplifies the strength of our AdventHealth family.”

S​​arasota Memorial Healthcare System braced for the worst, as Mliton landed just south of Sarasota. David Verinder, Sarasota Memoria’s president and CEO, told MSNBC, “We’re relieved somewhat, to be quite honest with you.”

The Sarasota region has seen three named storms over the past month. As a result, Verinder told MSNBC, “I think we’ve built some muscle memory.”

Lee Health said its hospitals remained open and it is assessing facilities, but found no major damage early Thursday. The system planned to resume elective surgeries Monday.

A significant number of hospital and healthcare workers lost their homes or suffered property damage because of Helene, Mayhew said. On Thursday afternoon, Mayhew said she hadn’t heard if healthcare workers suffered property losses due to Milton.

“We will evaluate the extent to which those healthcare heroes have been impacted by the storm,” Mayhew said.