One year after Irma, NCH Healthcare System clarifies essential employee, shelter policies

Southwest Florida hospitals morphed into shelters before Hurricane Irma and will do it again for employees.

Recovery continues with damage repairs and insurance claims a year later, and two of three local hospital systems have tweaked policies to clarify what’s expected of employees who work in patient care positions and other essential roles.

The NCH Healthcare System housed 1,600 employees and family members at its two hospitals, along with 60 officers with the Naples Police Department. The freestanding emergency department at Collier Boulevard and Immokalee Road was a shelter to 81 dogs and cats. More than 29,000 meals were served over four days.

NCH’s longstanding policy is for employees in June to submit names of immediate family members who would need to shelter at one of the hospitals. The policy applies to employees scheduled to work during a declared storm and is for family members who live with the employees.

For Irma, some NCH staff members stretched the policy and brought more family than registered; the volume of evacuees swelled to 800 people at each campus, and maintaining their safety was the biggest concern, Scott Wiley, director of emergency preparedness, said after the storm.

Going forward, NCH is requiring documentation from employees about immediate household members who will need to shelter.

More:Hurricane Irma: One year later

Also:Timeline told in stories, photos, videos before, during and after the big storm hit

“We’re trying to be very clear with everybody,” Wiley said, adding that the list of names will be printed out for the registration areas for the next storm.

NCH also has established better definitions of who are considered essential employees and what’s expected when a storm is coming.

“We’ve cleaned it up to be more specific about what positions we expect" to report to work, he said.

There’s been more education for employees about getting homes and family prepared earlier to prevent last-minute scrambling.

In case you missed it:Lee Health claiming $4.6M in Irma-related losses

Physicians Regional ­Healthcare System, with two hospitals in Collier, housed 1,050 employees and family members, along with nearly 100 firefighters and paramedics. About 100 pets were sheltered, and more than 9,500 meals were served.

Scott Lowe, CEO of Physicians Regional, said the system is not instituting policy changes for employees. There were some communication lapses to employees about when they are expected to report to work after Irma; going forward that will be enhanced, he said.

“We got some relief from sister hospitals in Alabama,” Lowe said, referring to hospitals that are part of the Tennessee-based Community Health Systems. “They arrived two days post-storm. It was very welcomed relief to our staff at the time.”

One lesson from Irma is to be better prepared for accommodating patients who are ready for discharge after a storm but can’t because they have no electricity at home and are on oxygen, cannot tolerate heat without air conditioning, or need home health or nursing home care but those services are disrupted, Lowe said.

In 2017:NCH Healthcare System juggles roles as hospital, evacuation shelter

After Irma, there were 10 to 15 patients a day whose safe discharge opportunities were tough, he said.

“We struggled to get them to the next level of care. That lasted a week to 10 days,” he said. “We are going to be prepared to handle those patients.”

The much larger Lee Health, with four hospitals in Lee County, took in 8,349 employees and family members along with 800 pets. Between 30,000 and 40,000 meals were served. Lee Health’s losses totaled $4.6 million, and it is seeking reimbursement from the Federal Emergency Management Agency.

Lee Health learned from Irma that it needed to be clearer to employees about who is expected to work during a hurricane and in the immediate aftermath.

“We just put more definitions on the roles of who us is on team A and team B and added physicians,” said Lisa Sgarlata, chief patient care officer and chief nurse executive.

In 2017:NCH moves 450 evacuees to higher floors at Downtown Baker Hospital

In addition, employees scheduled to work will need to provide the names of immediate family members who would be coming to shelter, she said.

“It wasn’t that well-defined before,” she said, adding that an electronic registry will be used. Family evacuees will have to show a driver’s license.

“Now we will have a tracking tool,” Sgarlata said. “Before Irma came, it wasn’t 100 percent complete. It was done by hand as they entered the facility. That was the biggest change we made.”

Stepping up during Irma:NCH emergency director's hurricane prep 'flawless'

Both of NCH’s hospitals are near the coast and prompted evacuation of several ground floor departments — such as radiology, pharmacy and laboratory services at NCH Downtown — to temporary spots on the second floor.

That scenario will likely happen again for a future storm, said Dr. Allen Weiss, president and CEO. The hospital’s upper floors are tight on space for permanent moves, he said.

“You can get portable pretty fast,” Weiss said.

NCH is out $3.8 million for storm-related expenses, and repairs are ongoing. Weiss said he doesn’t expect insurance to cover the tab.

“We have a big deductible, and we did not reach the deductible, so we’re paying for it out of pocket,” he said.

Irma was capable of bringing out the best in people and the worst, he said.

“We had a lot of the best. We had very little worst,” Weiss said. “It brought people together.”

In 2017:Lee Health fires, then rehires its essential staff

Lowe declined to disclose how much Physicians Regional spent in storm preparation, overtime and repairs. Some insurance claims are pending.

Before Irma, all of the hospitals announced to the public they were not public shelters. Some people showed up anyway in the 11th-hour desperation.

“It wasn’t a lot. People were pretty honest and said they had no place to go,” Lowe said. “We accommodated them. We were certainly stewards of the community.”