By DEVNA BOSE and DEVI SHASTRI

Hospitals and other health care facilities on Florida’s Gulf Coast — still reeling from Hurricane Helene — are now revving up for Hurricane Milton.

The system, which is shaping up to be one of the most powerful to hit the region in years, is expected to make landfall near the Tampa area late Wednesday. Long-term care facilities in counties where mandatory evacuations have been issued are taking their patients elsewhere, while hospitals are largely on guard, preparing to stay open through the storm.

According to Florida Gov. Ron DeSantis’ website, 10 hospitals have reported evacuations as of Tuesday afternoon. Three hundred health care facilities have evacuated as of this morning, the most many of the staff working there could remember, said Florida Agency for Health Care Administration deputy secretary Kim Smoak. That count included 63 nursing homes and 169 assisted living facilities.

Steve McCoy, chief of the Florida Department of Health’s Bureau of Emergency Medical Oversight, said it is the state’s “largest evacuation ever.”

Health officials are using almost 600 vehicles to take patients out of the storm’s path, tracking them with blue wristbands that show where they were evacuated from and where they are being sent. They plan to keep getting patients out through the night, until winds reach sustained speeds of 40 mph and driving conditions become unsafe.

“I’ve lived on the Gulf Coast my entire life and in Sarasota for 20 years. I’ve never seen anything like this,” said David Verinder, CEO of Sarasota Memorial Health Care System. “Our anxieties are high, but we’re as prepared as we know how to be.”

Hospitals brace for hurricane

Tampa General Hospital has stocked up on more than five days of supplies, including food, linens and 5,000 gallons of water, in addition to an on-site well. In the event of a power disruption, the hospital also has an energy plant with generators and boilers located 33 feet above sea level.

Tampa General deployed an “aquafence” to successfully prevent storm-surge flooding during Hurricane Helene two weeks ago. The barrier will be up again when Milton makes landfall and can withstand a storm surge of 15 feet. The U.S. National Hurricane Center estimates Milton’s surges will be 10 to 15 feet high at their peak.

No one will be working on the first floor of Tampa General Hospital for the foreseeable future — just in case.

“While AquaFence has proven effective in the past, it is just the first line of defense and one of many mitigation efforts we’ve implemented this week to safely continue care for our patients,” said Jennifer Crabtree, chief of staff at Tampa General.

The Tampa health system has shuttered many urgent care and imaging locations, but its four hospital campuses are prepared to remain open through the storm.

HCA Florida Healthcare, one of the state’s largest health care networks, has evacuated patients from five hospitals to sister facilities. The closed HCA Florida hospitals are Pasadena Hospital in St. Petersburg, Largo West Hospital in Largo, Florida Englewood Hospital in Englewood, West Tampa Hospital in Tampa and Fawcett Hospital in Port Charlotte, where strong winds and flooding caused major damage in 2022 during Hurricane Ian.

AdventHealth North Pinellas evacuated its 40 patients Tuesday afternoon, transferring them to nearby hospitals in their health system. The hospital’s emergency department remains open. Randy Haffner, CEO and president of AdventHealth Florida, said in an emailed statement that the system is “as prepared as we can be with water, generators, sandbags, satellite phones and the best caregivers there are.”

Hospitals are shuttering nearby, but Sarasota Memorial Health Care System also plans to stay open through the storm and shelter in place, Verinder said. Still, “we are concerned about the many unknowns,” he said.

Verinder estimates the system, stocked with enough food, water, linens and medications for at least seven days and 200,000 gallons of fuel, will be expected to shelter and support more than 4,000 people during the hurricane, though they are already close to capacity.

More than 2,500 staff members are gearing up for multiple nights in the hospital starting Tuesday, so Sarasota Memorial is providing childcare and pet shelters at both of its campuses.

“We are not a designated medical shelter, but we are working with the county to care for medically dependent persons assigned to the hospital because of the acuity of their needs … and patients evacuated from other hospitals in the region,” he said.

Dr. Matt Shannon, director of community emergency medicine at University of Florida Health, said the state’s flagship is prepared to take patients.

“The emergency department… we never close,” he said. “We have five emergency departments, all of which are open and functioning. This is not our first rodeo — we’ve been through this many times before.”

Repeated rough hurricane seasons have hardened Florida facilities and prepared them for Milton, said Mary Mayhew, president and CEO of the Florida Hospital Association. Still, the sheer power of Hurricane Milton and the back-to-back nature of storms will affect “a wide swath of the state and the hospitals.”

“It’s increasing the vulnerabilities in the area, from flooding to clogged drains to debris that hasn’t been removed that may exacerbate the situation that is already forecasted to be catastrophic,” Mayhew said. “Area hospitals routinely prepare for the worst and hope for the best.”

Long-term care facilities evacuate

In a briefing Tuesday, state officials and long-term care industry representatives urged nursing homes and assisted living facilities to prepare for long power outages, damage to sewer systems and being unable to access electronic health records.