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As hospitals across the Southeast continued to feel the effects of Hurricane Helene, those in Florida worked to evacuate patients, if needed, and prepare for yet another storm.

Now, in the aftermath of Milton, the latest hurricane to strike the state, Florida hospitals have been tasked with balancing the needs and safety of current patients with taking on additional ones from other healthcare facilities and treating people with weather-related injuries or needs.

"Our hospitals have absolutely been tested numerous times in a short period of time because of the back-to-back storms," Mary Mayhew, president and CEO of the Florida Hospital Association (FHA), told MedPage Today.

Through the process, hospitals across the state have "reexamined every aspect of their emergency preparedness plan," and are "learning from one another," and "making critical investments," she noted.

"As a result of that, for the most part, our hospitals withstood the impact of Milton without any major damage, and are operational, with very few exceptions," she said.

But that doesn't mean there haven't been ongoing challenges for Florida hospitals.

Ultimately, there were about 20 hospitals that made the difficult decision to evacuate patients, based on information regarding Milton's path or a risk assessment of their facility's susceptibility to flooding, with a focus on keeping patients safe, Mayhew said.

Among the health systems that needed to evacuate patients -- and take evacuated patients on -- was HCA Healthcare, which has dozens of hospitals across the state.

Prior to Milton's arrival, HCA Florida closed five hospitals in mandatory evacuation zones, according to an emailed statement. The process included transferring some 400 patients to other HCA facilities throughout the state via air and ground.

Meanwhile, HCA Florida's other 43 hospitals maintained city electricity or generator power and continued to care for patients, the health system said.

As of Thursday afternoon, HCA said that one of the closed facilities, HCA Florida Fawcett Hospital in Port Charlotte, had reopened. And efforts were underway to reopen the others: HCA Florida Pasadena Hospital in St. Petersburg, HCA Florida Largo West Hospital, HCA Florida Englewood Hospital, and HCA Florida West Tampa Hospital.

Aside from reopening efforts, other facilities "are preparing to receive patients from non-HCA Florida Healthcare hospitals as needed, as well as patients we may receive from long-term care and assisted living facilities," HCA stated. Its emergency rooms also are "expecting to receive an influx of patients with typical post-storm and recovery illnesses and injuries, such as cuts, broken bones, and cardiac events."

Overnight, as Milton moved across the state, a disruption in public water and sewer in St. Petersburg caused concern for hospitals in the area that had remained open, Mayhew said. But utilities have since been restored.

Now, much of the concern has shifted to managing capacity.

Currently, there are hospitals that are at capacity and seeking opportunities to transfer some patients, Mayhew said. Adding to potential capacity challenges are hospitals' role in sheltering certain individuals and "responding to increased patient needs in their community," in the wake of a devastating weather event.

There also is the unknown, Mayhew said. For instance, many other healthcare providers, such as local physician offices and urgent care centers, are without power and have sustained damage, and it may take time for them to resume operations.

"That just creates a ripple effect on the increasing demand in the hospital emergency departments and inpatient admissions," she said.

Furthermore, there were some 200 assisted living facilities in the state that evacuated individuals, further contributing to capacity issues for hospitals, including their ability to efficiently discharge patients when needed, she noted.

Despite the demands, hospital staff have been working around the clock to care for patients, Mayhew said, and doing so while they are also contending with the needs of their own families and homes in the wake of the storm.

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