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Bouncing back from Hurricane Andrew; the heartland story.

With Hurricane Andrew bearing down on South Florida on a Sunday evening late in August, the U.S. Weather Service warned that it could hit the coast shortly after midnight.

Nursing homes east of interstate 95 in Dade County - believed to be directly in the projected path of the hurricane - were ordered to evacuate their facilities.

At Heartland Health Care Center, a skilled nursing and rehabilitation facility in Kendall, Florida, administrator Mavis Matthews took in 13 of those patients, even though Heartland was at virtual capacity.

Heartland HHC is a two-story building and most of the second floor was occupied by non-ambulatory residents. After consulting with the regional operating manager of Health Care & Retirement Corporation, operator of Heartland Health Care Center at Kendall and five other long term care facilities in Florida, Matthews planned to awaken residents at midnight and bring them into the central common areas on both floors for maximum possible safety.

With an ear on the weather advisories, Mavis decided to postpone rousing residents from sleep until almost 2 a.m.

"We knew that we might be facing a real ordeal and we wanted everyone to have as much rest as possible," she recalls.

Furniture, including chairs and a few beds, were brought to the assembly areas and the residents arrived without any grumbling or complaint shortly after 2 a.m. Precautions had been taken: Mattresses were placed against the windows and plastic bags had been brought in to serve as back-up toilets in case plumbing was damaged. However, the staff decided not to tell the residents just how bad it was or might get.

The hurricane struck the Heartland Center and the Kendall area at 3 a.m. and lasted almost three hours.

What did it sound like? Most of those at Heartland who experienced it agreed that "it sounded like a long rumbling train."

As for Matthews, "I have no idea," she says, recalling that her mind was on so many things throughout the 180 minutes that she doesn't remember hearing the storm at all.

Many of the 40 or so staff members on duty also recollect little about the storm itself, including a few who saw trees fall on their cars parked outside the home, demolishing several of the vehicles.

At the height of the storm, the 160-mile-an-house winds ripped off most of the roofing. Windows were shattered throughout the building. At one point it took three people to hold a door shut to prevent flying glass and other airborne materials from coming into an area where residents were assembled. Electrical service was lost.

As water began to pour into the second floor, ceilings in some rooms began to collapse.

Now Matthews faced her toughest decision. Should she have the second floor residents - many in wheelchairs - brought to the first floor?

The decision was yes, and the move was completed without incident.

Generators were providing auxiliary power. Soon water began infiltrating the north wings of the main floor from above and everyone was moved into other sections of the main floor.

Still there was no panic.

When the storm finally passed and time came to begin assessing the damage, it was clear the building - while still structurally sound - was uninhabitable.

For Matthews, what followed was the most difficult time of all. She was on the phone constantly with HCR officials, including regional director Joe Schmitt, who the day before had come to the company's center at Fort Lauderdale, where it was originally expected that the hurricane would hit hardest.

All HCR centers in Florida had gone through advance preparations similar to those of Heartland at Kendall, but none of the others was seriously damaged.

With the Kendall Center uninhabitable, Matthews, Schmitt and others set out the logistics of moving approximately 130 Kendall residents to the five other HCR facilities, two of which are relatively new and had some beds available.

Transportation, though,was obviously going to be a major problem and getting into or out of the disaster area immediately seemed a virtual impossibility. But after several hours of frantic phone calls - literally "walking through the Yellow Pages" - office manager Teresa Fernandez found a Gray Line bus lines operator in another county outside the immediate disaster area willing to rent three buses. The buses arrived within 90 minutes.

Rosters were quickly made up to match individual patients with the HCR facility to which they would be taken. Charts and labelled medications were rounded up on wheeled carts and taken to the buses; most personal property was left behind. Some Kendall staff members agreed to take on temporary assignments in the other facilities. Others would stay on for the clean-up and were invited to bring their families with them if their homes were seriously damaged. In fact, while there were no serious injuries, the family homes of at least half of the 140 employees were badly damaged. As many as 30 staff families lost everything, including cars and personal property.

The staging and coordination of the move were not without problems or incident. For example, the buses were without seatbelts, a serious challenge for transporting non-ambulatory patients. Cathy Dumas, RN, found herself to be the sole caregiver on a bus of 60 residents. "We had taken some restraint materials with us, but 46 residents had no available support," she recalls. "We had to assess which needed them most, and some of the more ambulatory residents helped with keeping the others in place. We brought some supplemental feeding implements along, and we had just enough oxygen tanks to make the trip."

One resident even stopped breathing en route, requiring Dumas to perform CPR. "I didn't know if a hospital would be available if we needed one, and I knew we couldn't reach a fire department." Her attitude through all this? "|You just have to do this,' I told myself, |and, God willing, we'll make it.'"

By midnight Monday, all the Heartland of Kendall hurricane victims were fed, clothed, and in bed at another HCR facility - an accomplishment that HCR executive vice president Keith Weikel calls "simply remarkable."

The heroics were not yet over. Swift action by the HCR team probably saved the Kendall center from total destruction by rainfall after the hurricane had passed.

Ken McManis, HCR's east region construction director, cut short a family vacation when he got word of the pending hurricane. After stopping at the Atlanta airport to trade his small car for a van to carry food and other supplies, he arrived in Fort Lauderdale by noon on the day of the hurricane.

Advised by the HCR team on the scene not to try to get to Kendall that day, Ken began trying to contact contractors to temporarily seal the building from possible destruction from more rainfall.

Arriving in Kendall early the next day, Ken and a contracting crew were able to reseal the roof, 60 percent of which had been ripped to shreds. All broken glass - some 30 large panes - was replaced. And all of this just in time: More rain came Thursday evening and heavy rain fell on Saturday.

Some 57 tons of air conditioning, which had been on the roof, was destroyed. Some of it was immediately replaced, an important step since mildew is an immediate, serious problem in such situations in that climate.

Staff members dived into recovery and return of personal property of residents, removal of the water logged carpet, drenched ceiling material, and other clean up chores.

While the final bids are not yet in, Ken believes repair of the facility, which was built in 1988, may come in at less than $1 million.

While the construction crew geared up, word about the Kendall disaster spread quickly across HCR. On the day of the hurricane, calls asking what could be done to help began pouring in from many of the other 128 HCR facilities as well as suppliers across the country.

To help sort out the needs at the Kendall facility and to match up the offers to help, Mary Drzewiecki in the corporate personnel department was assigned to coordinate the effort.

In addition to the obvious need for clothing and food, Mary found an amazing demand for charcoal. Without gas or electricity, charcoal for cooking was quickly used up in the disaster area. Mary was able to generate a steady flow of the needed charcoal to the facility. Bedding, diapers, baby food, and personal hygiene items also were badly needed and contributions from suppliers and other HCR facilities helped answer that need.

When employees in many HCR facilities took up cash collections, Mary formed a Heartland of Kendall Relief Fund, which she now expects will reach at least $30,000. She will work with Joe Schmitt and Mavis Matthews to see that the funds are used most effectively.

Today's bottom line, though, is that Heartland is once again fully occupied and in operation - and has been since mid-October. McManis and the construction crew had met a tremendous challenge.

"When the residents came back," says Dumas, "they were shocked by the damage in surrounding areas. But they were excited to be back."

While it will be months, perhaps years, before life will fully return to normal at Heartland of Kendall, particularly for staff employees, Keith Weikel observes that the teamwork, dedication, and caring attitude of HCR employees helped immensely in averting injuries and even more serious loss. Matthews says she can't say enough about the staff and its efforts. As for Dumas, "It was truly a group effort. Everyone saw a job to do, and they did it."

Sam P. Allen is on the communications staff of the Health Care & Retirement Corporation, Toledo, OH.
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Title Annotation:Florida
Author:Allen, Sam P.
Publication:Nursing Homes
Date:Nov 1, 1992
Words:1608
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