A year later
Joplin hospitals rebuild, become better prepared
The healthcare community serving Joplin, Mo., is working hard to rebuild capacity one year after a tornado destroyed one of its hospitals, as emergency preparedness experts try to use Joplin’s experience to allow other hospitals to become better prepared.
Executives for Mercy Hospital Joplin— known as St. John’s Regional Medical Center before the May 22, 2011 storm—and two-hospital Freeman Health System are in the middle of post-storm construction projects worth about $1 billion, the vast majority of that at Mercy.
Mercy Joplin, part of 25-hospital Mercy health system, Chesterfield, Mo., expects to have spent $980 million restoring services affected by the storm once all is said and done. “It’s been a flurry of activity,” said Gary Pulsipher, president and CEO of Mercy Joplin. Mercy Hospital Joplin opened a $105 million, 110-bed component hospital in April, which replaced trailerlike facilities with 46 beds. A permanent hospital slated for completion in March 2015 is expected to cost about $500 million.
Freeman, with two campuses in Joplin and a 25-bed critical-access hospital in Neosho, Mo., worked quickly to expand after the storm hit. Freeman added a 12-bed transitional intensivecare unit shortly after the storm and another 29 private beds in April, said Paula Baker, president and CEO of Freeman. That brings Freeman Health’s two-campus Joplin bed count to 421 from 382, and the system plans to add another 29 beds in September, for a cost between the two of $16 million, spokeswoman Christen Stark said. Other construction projects will bring its tornado-associated spending to $24.7 million, Stark said.
Given how many beds were lost when the tornado destroyed St. John’s, executives for both hospitals say Joplin and the surrounding area can support the beds being created at the two competitors. “Absolutely,” Pulsipher said in an e-mail. He noted that Mercy Joplin and its recently leased and nearby Mercy Hospital Carthage combined will have fewer licensed beds than the old St. John’s did before the storm. Before the storm, St. John’s staffed 341 beds, according to the American Hospital Association (May 30, 2011, p. 6).
Similarly, Freeman executives are moving full steam ahead. “I’m very optimistic about Freeman’s future growth,” Baker said.
Both hospitals are struggling with tornadorelated financial issues. Though an expected payout from storm-related insurance claims will soften the blow, the big hit taken to Mercy Joplin’s patient capacity created big losses. In the year ended Dec. 31, Mercy Joplin posted an operating loss of $72.6 million, which, including a $338 million partial insurance payout, produced a net income of $337.3 million, according to financial documents filed for municipal bond investors. Parent Mercy, meanwhile, posted big investment losses and actually fared better financially as a result of the insurance payout, which offset the investment losses at the system of $82.4 million. Mercy’s net income was $256.3 million, but after taking out Joplin’s results, it would have lost $81 million.
At the same time, Freeman has seen a big increase in patients that has sharply boosted staffing and supply costs, as well as uncompensated care provisions. But in general, it’s doing better. Financial data posted for municipal bond investors showed Freeman to have posted operating income of $8.3 million in the year ended March 31, and net income was $31.2 million
Outside of Joplin, industry officials want to spread the word about what can be learned from the hospitals’ response to the Joplin tornado, which created unexpected obstacles to first responders. The Missouri Hospital Association last week published a report that details the events during and after the tornado, and identified ways emergency preparations might be improved. The authors of the report hope it will be useful outside of Missouri given the number of tornadoes and other disasters hitting hospitals and communities across the country.
Joplin’s healthcare system did a good job of responding to a disaster that was “outside the scope of what any (emergency) planner expects,” said Dave Dillon, MHA spokesman. “Plans are an important part of preparation, but the most important part is having the staff understand incident command and what their roles are,” he said, and that it’s hard to describe their actions “as anything less than heroic.”
Nevertheless, the Joplin response was hampered by the loss of electronic communications and for a time was relying on messengers to communicate, Dillon said. The MHA report, called “Preparedness and Partnerships: Lessons Learned from the Missouri Disasters of 2011,” highlights some ways to keep communication problems to a minimum.
Wendy Thomas, a meteorologist with the American Meteorological Society’s Policy Program, said that over time it has become apparent that the hospital industry in general has relied on building designs that carry tornado risks. The industry’s “cookie cutter” approach, she said, has led to the use of a lot of exposed windows, backup generators that can be vulnerable to risks, and elevator systems with rooftop penthouses that are also vulnerable to projectiles and other wind dangers.