Recovering from Tornado Damage, Hospital Seeks Normalcy

Less than twelve weeks after a strong tornado crippled a small Mississippi hospital, its interim CEO shares his thoughts on the way forward.

On April 28 Winston Medical Center in Louisville, MS, was severely damaged by an EF4 tornado that killed nine people in the rural county located 90 miles northeast of Jackson.

Interim CEO Paul Black had been on the job for less than one week when the storm crippled the 27-bed hospital and forced the evacuation and temporary closure of an adjacent nursing home.

Black spoke with me in the days after the storm about the medical center's efforts to provide care to a physically and emotionally scarred community.

He spoke with me again this week to provide an update on the medical center's recovery.

HLM: How have things changed since last we spoke?

Black: We got the temporary facility was up and running by May 19, so we were in a temporary hospital unit that was provided by [Federal Emergency Management Agency] within three weeks of the tornado. That gives us the ability to provide hospital services to the residents here in Winston County. It's not everything we have going, but we are getting close to doing that.

We have the clinic open that is in front of the hospital and it opened about one week later. So, we are back to where we consider our 'new normal' as far as hospital services. We are in the process of repairing part of our nursing home so we can get 76 residents back home.

That is scheduled to open and take patients on Sept. 1. As far as the long-term prospects, we are still collecting data from insurance companies, talking to FEMA and others to determine what our final funding amounts are going to be or what resources we are going to have to rebuild.

HLM: How is the temporary hospital working for you?

Black: It's pretty sturdy. Once you get inside the structure you can't tell you're in a temporary. The inpatient area is a ward concept. There aren't designated rooms, so that is a little different than what people are used to. But we haven't had any complaints. People can put up with that if they are back home being taken care of and don't have to travel great distances.

The biggest issue on the inpatient side that we haven't come up with a solution yet is people are used to having a TV when they are in the hospital and we don't have that service right now.

HLM: Will you refurbish the hospital or raze it and rebuild?

Black: We found out that we did have some structural damage, especially in our three-story tower. So it's looking that it may be more cost efficient to tear down the existing building and rebuild.

HLM: How big would the new hospital be?

Black: We'd be back probably smaller as far as bed size is concerned, trying to offer the same basic services as we did prior to the tornado. We are pursuing the critical access designation.

HLM: Do you have a timeframe on opening the new hospital?

Black: I am not real sure on the construction start but I've been told anywhere from 18–24 months from the date of the storm. We are in a slow process right now. Once we get everything decided as far as funding and deciding what the plan is we are going to do our best to speed up the process as far as construction is concerned so we can get opened as fast as we can.

HLM: How far along are you on planning for the new hospital?

Black: We don't have the numbers yet from our insurance company. Once we get those we are also gathering some reports and giving it to FEMA to let them determine how much the funding is going to be. Once we get those numbers we can start making definite plans. We are now putting out RFQs for architectural services so we can be somewhat ready when those numbers come in and we can start making long-term decisions along those lines.

HLM: What clinical services are unavailable?

Black: We are able to do our geri-psych services but we don't have the facilities that would meet the code requirements to be able to house those patients. And of course, our nursing home is not operational. It will at least partially be back on Sept. 1. We do not have CT or mammogram services but we are looking real hard to try to bring some of that on site within the next month or so.

HLM: What is the community doing to access those services?

Black: They have to travel 20–30 miles to get the services that we were providing. It does put a strain on them, especially when you are talking about the primarily Medicare population that we service here.

HLM: Are you getting help from nearby providers?

Black: We have had a lot of offers for help. Right now we haven't had to rely on any one facility to help us out but if we do have a situation where we need help we do reach out to them. One of the biggest things that other facilities have done for us is for some of the employees we have had to lay off. Some other facilities are making room for them and letting them work part-time at least until we can bring them back on board.

HLM: How many employees were laid off?

Black: We ended up having to lay off about 130 employees. Most of them were in the nursing home. But we are optimistic about being able to bring the majority of them back.

HLM: How did you prioritize the recovery?

Black: Shortly after the storm, when you get your wits about you and you try to figure out what is going on, you start to work with the state department of health to get that temporary facility heading our way. That was our focus from the very beginning.

At the same time we were working on trying to get a building together to get our clinic back open. Those things came together pretty quick, three to four weeks to get those back on line. Once we started treating patients again our next focus was on what we do with the nursing home to get it back open.

Now we are in this slow phase where we are waiting on some evaluations and reports. In the meantime we are talking amongst ourselves about possibilities out there so that when we do get some concrete information that we can go forward fairly quickly.

HLM: What have you learned from this process?

Black: The biggest thing I found out is that the staff really comes together and understands our importance to the community. Sometimes we get a little jaded and come to think of it as just a job like everything else.

When you get into this type of situation you realize how much the community needs to have a hospital and how the employees really start to appreciate the fact that we are needed and that it's something that helps the community, not just from a healthcare standpoint, but from an economic standpoint as well.

HLM: How is the community doing psychologically?

Black: We are handling it OK. We've had our ups and downs, but every day brings a little bit of hope, a little better vision into the future. As each day goes forward and we can make some progress it will be a whole lot better. A big thing for us is when we can get some determinations and a plan for the new hospital that we can put out to the community. That is going to help everybody.

HLM: How are you communicating with the community at large?

Black: We do numerous things. We do some radio spots. We get out and talk to the community. We have our Facebook page. We try to put all sorts of notices and things like that out so the public can see as much as they can. We use the newspaper, all sorts of media to get the word out.

HLM: Any complaints about the recovery?

Black: Sometimes I get a little impatient, but that is just me wanting things to happen faster than they probably can. We want things to be done quickly, but we have to be patient in what we do so we don't knee jerk and make the wrong decision.

HLM: Are you still interim CEO?

Black: I'm still currently just the interim. No decision has been made on that, although things have been busy so that really hasn't come up here in the last few weeks.

HLM: Last time we spoke your office was a loaner pickup truck. Do you have an office yet?

Black: We have some temporary buildings. We rented some space about a half-mile from the temporary hospital. We have our business office, administrative, and medical records up here.