Officials advise residents to seek Treasure Coast shelter as Dorian inches closer

Arlease Hall, the St. Lucie County Health Department Spokeswoman, advises Treasure Coast residents to seek shelter as Hurricane Dorian makes its way toward Florida on Monday, September 2, 2019.

Arlease Hall, the St. Lucie County Health Department Spokeswoman, advises Treasure Coast residents to seek shelter as Hurricane Dorian makes its way toward Florida on Monday, September 2, 2019.

More than 100 health care facilities have been evacuated in Florida, displacing thousands of patients and residents, as state officials remain wary of storm surge and flooding that Hurricane Dorian could bring on its path up the east coast.

Dorian was downgraded Tuesday to a widening yet weakened Category 2 storm and now looks unlikely to unleash its full wrath on the state’s densely populated coastline. But dozens of facilities, fearing days of power outages or water damage in low-lying evacuation areas, have moved patients and residents to other facilities and buildings inland.

Many of the evacuated facilities — including eight hospitals, 19 nursing homes and 86 assisted living facilities — were subject to mandatory evacuation orders that directed them to leave. But uncertainty over the storm’s track prompted many others to preemptively evacuate, including some facilities in Miami-Dade.

The eight hospitals fully evacuated are Advent Health in New Smyrna Beach in Volusia County, Cape Canaveral Hospital in Brevard County, Cleveland Clinic South in Martin County, Samaritan Medical Center in Palm Beach County, Stuart Sebastian River Medical Center in Indian River County, and Baptist Beaches, Baptist Nassau and Halifax Psychiatric Center North in Volusia County, Agency for Health Care Administration Mary Mayhew said.

Gov. Ron DeSantis said Monday that Port St. Lucie Hospital in St. Lucie County had also evacuated, but Mayhew said it was one of a few hospitals including Cleveland Clinic North in Martin County that had lowered its number of patients by discharging ones who were well enough to be released early.

State officials say they have been closely monitoring those evacuations and helping transport some people when asked. At least 119 patients from five healthcare facilities were moved with help from state officials as of Monday night. But most facilities have been using transportation agreements they have with companies and their own vans and buses, Mayhew said.

Many have been moved to other hospitals and long-term care facilities, though some assisted living facilities have moved their residents into hotels or other accommodations, she added.

“They may use a hotel and make sure that the staff and all of the same requirements, around patient safety and our expectations, are still in place,” she said.

The decision to evacuate — a time-intensive process that can take 24 to 36 hours on average — is precarious, said Kristen Knapp, spokeswoman for the Florida Health Care Association, which represents many nursing homes in the state.

Some patients are in fragile medical condition and require special care in transport, and those with conditions like dementia or Alzheimer’s can find evacuations jarring, she said. Providers have cautioned that some residents can experience “transfer trauma” if facilities decide to move residents rather than shelter in place.

There is no exact formula for whether or not to move out ahead of a storm — decisions are made on a facility-by-facility basis and usually based on risk of storm surge and flooding. Many of the facilities evacuated ahead of Dorian were in zones under mandatory evacuation orders or low-lying coastal areas at risk of flooding.

Facilities that evacuate are required to have a communication plan for how to tell family members that residents are being moved, Knapp added. But those plans usually encompass a toll-free hotline and social media, she said. She encouraged loved ones to contact facilities to stay updated on status of evacuated patients.

The number of facilities that have been evacuated in past storms varied and was largely dependent on where the storm eventually went.

In Irma, which swept up the spine of the state, 79 nursing homes and 463 assisted living facilities were evacuated ahead of the storm. Evacuations for Hurricane Michael, which battered the Panhandle, included nine nursing homes.

For facilities that keep residents in place, Dorian could test how prepared they are if the storm knocks out electricity. After a Broward County nursing home’s air conditioning went out during Irma in 2017, a dozen residents died.

State lawmakers passed a mandate last year requiring emergency backup power to tamp down temperatures at nursing homes and assisted living facilities. But nearly 60% of the state’s nursing homes have been given more time to meet the new requirements.

Mayhew said Tuesday she is still evaluating whether or not the state will grant more time to those facilities after the variances expire at the end of the year.

“What I need to verify is that we’ve had significant efforts statewide by facilities to comply with this requirement,” she said, adding she was aware of delays with local permits. “I’ll need to have very specific information about why they have been unable to fulfill this requirement for the end of this year.”

Evacuated patients and residents will have to wait for Dorian to pass — and its impact to the coast to become clear — before officials can determine when or if they can return. Dorian is forecast to skirt the Florida coast through Wednesday, and facilities will need to wait for mandatory evacuation orders to be lifted and for state officials to check building conditions before they are cleared.

Scott Rivkees, the state’s surgeon general, said the Florida Department of Health helped set up nearly 400 ambulance teams — many from other states — in Lake City, Gainesville, Orlando and Miami-Dade to help with any needed evacuations after the storm.

Elizabeth Koh is a state government reporter in the Miami Herald and Tampa Bay Times’ Tallahassee bureau, where she covers health care politics and policy (and the occasional hurricane). A Brown University graduate, she has also covered local politics for the Washington Post and national politics for the Dallas Morning News’ D.C. bureau.

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