From Preparation to Recovery: HCA Healthcare’s Emergency Response
In this episode of Hospitals in Focus, we revisit a vital topic—disaster preparedness and response. Hurricanes Helene and Milton caused devastating impacts across the Southeast, including catastrophic flooding in Asheville, North Carolina. FAH-member HCA Healthcare stepped up to the challenge, and their Mission Health hospital became a beacon of resilience, treating over 500 emergency patients in the first hours after Hurricane Helene, flying in 400 nurses and 40 physicians from sister facilities, and ensuring the community had access to essential services.
Michael Wargo, HCA Healthcare’s Vice President of Enterprise Preparedness & Emergency Operations, provides listeners with a 360-degree view of emergency preparedness. Mike shares lessons learned, the importance of planning for the “known unknowns,” and how HCA’s leadership prioritizes readiness at all levels. Chip and Mike also explore broader considerations for disaster recovery, from practical on-the-ground strategies to policy changes so hospitals can remain resilient in the face of future disasters.
Key Topics Covered:
- HCA’s approach to readiness with the five “R’s” of emergency operations;
- Mission Hospital’s hurricane response;
- Leadership’s role in fostering a culture of preparedness; and,
- Recovery efforts and challenges taxpaying hospitals face, including the need for commonsense, bipartisan policies to support these critical institutions.
Mike Wargo [00:00:03]:
The magnitude of this storm continued up through North Florida, into Georgia, into the Carolinas. Who would have thought, you know, a high category storm would still be a Category 1 as it entered into North Carolina for Mission Health System, it’s in Appalachia, it’s in the mountainous regions of western North Carolina. It’s a very large health system, provides all the critical services and referral services to all of western North Carolina. So it is the healthcare critical infrastructure of that region.
Chip Kahn [00:00:39]:
Welcome to Hospitals in Focus. From the Federation of American Hospitals, here’s your host, Chip Kahn. We are revisiting a critical disaster preparedness and response. Our discussion comes in the wake of Hurricanes Helene and Milton, which caused devastating impacts across the southeastern United States, including catastrophic flooding in Asheville, North Carolina. When disaster strikes, hospitals have your back. And that was clear from the heroic efforts of hospitals in the path of these storms. From the early preparation to rebuilding. Our returning guest today, Mike Wargo, HCA Healthcare’s Vice President of Enterprise Preparedness and Emergency Operations, will walk us through the lessons learned in disaster preparedness, including what it means to prepare for the unplannable, the approaches taken by HCA Healthcare and policies that would ensure hospitals can recover and continue providing vital services to patients and communities in need.
Chip Kahn [00:01:48]:
Mike, it’s great to have you back on the podcast. Thanks for joining us today.
Mike Wargo [00:01:53]:
Chip, it’s always good to be back and to speak with you and share some lessons learned and lessons applied with the listeners out there.
Chip Kahn [00:02:01]:
Great, Mike. So what I’d like to start off with before we get into the specific recent experiences, remind us what the basics are in terms of state of the art preparations for storm season and the principles of planning that are critical. And maybe a little bit about thinking about the unthinkable or the unplanned.
Mike Wargo [00:02:22]:
Sure, Chip, Often I like to reflect back on 2001 post 9/11. Then Secretary Rumsfeld had the famous quote unknowns. There’s things we know we know, things we know we don’t know and things we don’t know we don’t know. Hurricanes and natural disasters are things that we know are going to occur. So when we have risk to our organizations, to our communities, we can plan in detail for certain things, those known knowns and then the known unknowns, such as active shooter events. We know they’re going to happen, but we don’t know when they’re going to happen or where. To the magnitude. We can put a framework in place that if it were to happen at any random place, there’s a framework to respond and that even holds true with the unknown unknowns that could be the next generation biological agent if it were weaponized or even natural.
Mike Wargo [00:03:18]:
In society, we’ve learned from various experiences on how to begin preparedness for certain risks. So starting with our natural disasters, which are certainly on the rise over the past few years and really pronounced hurricane seasons and wildfire seasons and even tornado seasons, I’m even calling them seasons. But anymore they’re not even seasons, they’re almost year round. When we look at some of these risks like wildfires and tornadoes. Looking at the basics, going to the natural disasters, depending on where our facilities or our organizations are, we can look at the natural disaster risk of that community. We should then really look at what our role in the community is and what resources the community will rely on us for providing. So as healthcare organizations, many of our communities in urban areas have a diversity of organizations. So we may have a high risk for storms such as in the Gulf coast or along the shores of Florida, but there’s a lot of healthcare services there.
Mike Wargo [00:04:29]:
So we can move our patients between facilities and de risk or evacuate as needed and the community still has a service being provided. But when we fast forward to Hurricane Helene in a community like Asheville, North Carolina where Mission Health System is the sole tertiary care center there, the risk is very different because we can’t move all those high risk patients out of that community to other communities. There’s just not a resource that can absorb that volume of patients, that clientele of patients. So we have to look at our risk differently. So how do we do that? First we look at the capabilities of the organization. We bring leaders together to understand what the experience of the leaders are and what the commitment is. We call it in our model, responsible leadership. Through the responsible leadership role, we identify who the responsible executive is.
Mike Wargo [00:05:22]:
That person really sets the culture, sets the tone, or that group of leaders set the tone for the whole organization and for HCA healthcare. Our responsible leadership is across all our officers. It’s with our board of trustees, it’s with our C suite, all the way down to our directors and managers. We all have an individual leadership responsibility to the organization. That means preparing ourselves, becoming educated in the resources that our organization could put into play. It means becoming educated on the incident management model. How do we respond in preparedness for a potential event? How do we respond in the actual event? And how do we then begin recovery and resiliency post impact to ensure really the highest continuity of healthcare for our organization? I like to call it more so readiness. Readiness.
Mike Wargo [00:06:19]:
To me is being prepared with the immediate ability to respond. And often people ask me, what’s the difference between preparedness and readiness? And fundamentally there’s not a significant difference other than in readiness. We really attest through our education, through our training and our general preparedness that we can deliver, we can operationalize our response. And that really holds true with organizations that deal with crisis a lot, whether it’s the natural or the man made crises or disasters. We can have all the equipment that, you know, either the hospital preparedness program provides to us or we can have all the equipment that our organization provides to us. If we don’t train our staff, if we don’t educate our staff, if we don’t drill on our protocols and have those resources at the ready and we’re not familiar with how to respond to the crisis, that’s preparedness. The readiness component is having the experience, having the ability, and immediately going into that response for any of these types of disasters.
Chip Kahn [00:07:26]:
That’s so helpful, Mike. So now, now let’s go into the real world with that, with those principles and look at two cases that I think are going to be real, really great for illustrating what you’re talking about, how it gets operationalized. And I’m going to split them in two from what I hear. First we’ve got Milton, which was the second of the recent hurricanes that I don’t want to say was a traditional hurricane, but basically went across Florida and it was the hurricane that was the sec was, was the focal point. The second was Helene, where the hurricane and the winds were bad when they hit the coast, but then something unique happened. So let’s talk about Milton first and how do you prepare for what’s common, but sort of common in a sense. And then let’s, let’s do a deeper dive. And I’ll come back to that after you talk about Milton.
Mike Wargo [00:08:23]:
Well, as I mentioned earlier, whether it’s a hurricane, a wildfire, tornadoes, these are naturally occurring events that many organizations are very familiar with. And a lot of the organizations identify these type of natural hazards on their HVA or their hazard vulnerability analysis. And that’s where it starts. The organization coming together to realize and to have both subjective and objective discussion on what the risk to the organization is. So for instance, with Hurricane Milton, our hospitals across the state of Florida, our coastal facilities in general, are very well experienced in preparing for and responding to hurricane events. And how we do this is at HCA Healthcare, each year we boil up the risk of our facilities, the H Vac to a division level and that Division shares. You know, the Florida, for example, we have three divisions, east, west and North Florida division. Hurricanes are high ranking in each of those divisions.
Mike Wargo [00:09:27]:
So at the group and corporate level we put a lot of emphasis and resource on what it takes to prepare. Starts with an annual preparedness summit or readiness summit each year that we do in each division and that goes through a framework that we developed in our emergency operations process. And it’s the five Rs, it’s responsible leadership, as I mentioned, readiness, response, resiliency and recovery. So let me start with responsible leadership. We bring the division emergency operation leaders together. That’s a group of folks at our division level that are trained on the incident management process, how to orchestrate pre storm, storm and post storm response and resources. We bring all the facility executives together across these divisions, primarily the COOs, maybe a CEO, either the chief nursing or the chief medical officer and the facility emergency manager. And we go through a readiness checklist that that’s been developed that talks about having your A and B staffing teams pre identified before the season.
Mike Wargo [00:10:36]:
It talks about looking at resources that may be needed if you sustain an impact from a hurricane. How can you manage and maintain operations for up to 72 hours without resources coming in? It talks about flood mitigation plans on your campus. Are you doing construction on site that needs to have mitigation for flooding or for wind damage if a storm is coming in? And then we look at the tools and technologies that we have based on experience. Given the amount of hurricanes HCA Healthcare has experienced over the number of years going back to Katrina and maybe even prior, we clearly identified that when a storm comes in, there are certain patients that we, what we call de risk, we move them out of harm’s way. We, we transfer them from a facility that might be in the cone of the storm, the path of the storm, outside of that cone of risk, to facilities where they’ll be more stable. That experience was really gleaned from Katrina looking at some of the New Orleans hospitals that transferred the lower acuity pre storm and kept the most critical there. As you saw when that impact, and it wasn’t really the storm impact created the crisis in New Orleans, it was the flooding, it was the levee breaches that then flooded the city and brought down infrastructure. We’re going to talk a little bit about that type of scenario with Hurricane Helene in North Carolina.
Mike Wargo [00:11:58]:
But during that Katrina type event, the critical patients were there and they suffered the most. So we reversed the strategy over the past few years to take those most critical, most Fragile patients move them out of harm’s way prior to the event so that we don’t have to go into crisis mode. That if a single facility had an impact, that these already at risk patients for their clinical conditions are at greater risk due to infrastructure loss. That’s the readiness phase, preparing the facilities based on experience on what to expect, how to organize and how to respond. The response component is really locking down your facility. Restricted access. Those that need to be in the facility are in the facility. Our A team, our B team, so that we can maintain care of our patients throughout the storm.
Mike Wargo [00:12:46]:
And immediately post storm, it looks at the leadership who’s going to be at the facility that can manage and troubleshoot any type of crisis that happens. And then readiness also includes reaching out to community partners, reaching out to our neighboring health system. And in the emergency ops world, I like to use the term neighboring health systems. We may compete every day for health care, but during any type of crisis, we need to treat each other like neighbors. We need to support each other as neighbors. If one health system is impacted, that creates a wave of influx into the other health system. So we need to raise the readiness of our community as a whole by supporting one another as neighboring health systems. But it’s important to have communication before understanding what the neighboring health system is going to do so that we can manage our risk appropriately.
Mike Wargo [00:13:32]:
And if that neighboring health system has an impact, can we then help them? Or if we’re the ones that have the impact, can we potentially transfer patients to them either immediately following the crisis or at the appropriate time? The last couple phases that we talk through are the resiliency phase. And the term resiliency is used in many ways. In cybersecurity, it’s used to harden your infrastructure. In finances, it’s talked about how can we reduce our expenses. But in in emergency operation, resiliency really means how do we strengthen the continuity of our operations, that our staff are safe, our patients are safe, and that our staff and our caregivers can continue to give care post impact or during crisis. We saw resiliency really peak during COVID If you guys think back just a few short years ago, we were dealing with an ongoing pandemic that challenged our healthcare providers, challenged our communities. But we still dealt with hurricanes and tornadoes and other crises or syndemics that we responded to. So resiliency is investing in your staff and in your organization that you can maintain the highest care throughout the crisis and following the crisis.
Mike Wargo [00:14:47]:
And then lastly is recovery, rebuilding to a stronger state following the crisis. There’s a few things that we do for recovery immediately following any type of disaster. We do what’s called a hot wash, a term we borrowed from the military. And the hot wash brings leaders and staff members together and we have a short discussion on if this event was to happen again in the near future. What are the immediate action items that we can address now that will give us a better outcome if this were to happen in the short term. That hot wash is pretty critical so that we can identify critical gaps in our preparedness, our readiness and our response. And then lastly, we have after action reports that we do. This is a formal debriefing of all the different functional areas of three components that we capture in our program at HCA Healthcare.
Mike Wargo [00:15:39]:
One, it’s best or valued practices. What did we do that was positive in our action? That could be the program itself coming in? We had a storm reporting service give us updates on the storm. We knew when to respond. We knew when to go into restricted access. Various actions were taken, so that is a best or valued practice. The second category we look at is areas for improvement. What are things that we did, actions that we had taken that maybe didn’t have the best outcome or we were unsure of our actions and the outcome that they would have. That might be an area where we need to invest resources, whether it’s additional education and training.
Mike Wargo [00:16:21]:
It could be a financial or capital investment in the physical plant of the organization to get through the event. And then the third category are notable actions. What are challenges that we were faced and what decisions did we make that we don’t yet if it would know if it was the right choice or the wrong choice. An example that I use, it’s a simple example, but one of the facilities had localized flooding. We didn’t plan for the flooding in the area, but somebody suggested we put a water diversion barrier up at the time. That’s a choice that was made based on a risk that wasn’t assessed. Prior decision was made, did that barrier help or not. That’s a notable action.
Mike Wargo [00:17:03]:
So the next time we have a storm like that, we know that we’re going to have flooding from that direction. Should we preemptively put a flood barrier up or a water directional device up to steer the water in a different direction? They’re the three categories that we look at so comprehensively. That’s the framework getting into any of these risks that any organization can take. And again, I’ll cover them real quick. Responsible leadership, readiness, response, resiliency and recovery.
Chip Kahn [00:17:32]:
Well, this is really Great. In terms of giving us a 360 degree view of emergency response and actionable insights and frankly, just plain common sense. Let’s drill down on one of the storms, this, this, this Helene, because what you described in the Florida situation, I won’t say is a normal storm, but the kind of storms we’re used to and there’s some predictability at least a few days out in it coming. In the Helene situation, you know, my assumption is that you could not have anticipated necessarily that the devastation in Asheville because of that storm. I mean, it had to be. I don’t know whether it was a hundred year or a thousand year storm in terms of that area and the effect on, on water in that area. And beyond that, you’re dealing with a situation, as you mentioned earlier, where your hospital plays a unique role in the community. This isn’t a situation where you’ve got a lot of different hospital systems.
Chip Kahn [00:18:36]:
So let’s do a deep dive and tell us a bit about how this exceptional experience was met by HCA Healthcare and what you think you did right and maybe did wrong in that response.
Mike Wargo [00:18:53]:
Sure, Chip. Let me start by maybe giving an overview of Hurricane Helene. This was a rapidly developing storm that was targeted to come into the Tampa Bay area. So as you can imagine for HCA Healthcare, we’ve got our West Florida division there, we’ve got a great concentration of healthcare facilities and services in the Tampa region. So five days pre storm, all efforts were focused on de risking our Tampa market. And the anticipated storm surge of the Tampa Bay was significant. That we deployed our incident response teams, trained leaders from across the company in different trades, different leadership roles. We bring them at scale from different areas of the company into the market to help support those local leaders.
Mike Wargo [00:19:42]:
That’s where our initial efforts went into. Now the storm went through just, you know, went through the Tampa area with minimal impact. But the magnitude of this storm continued up through North Florida, into Georgia, into the Carolinas. Who would have thought, you know, a high category storm would still be a Category 1 as it entered into North Carolina. That’s pretty impressive in itself and we haven’t seen that, that I’m aware of in quite a number of years. For Mission Health System, it’s in Appalachia, it’s in the mountainous regions of western North Carolina. It’s a very large health system, provides all the critical services and referral services to all of western North Carolina. So it is the healthcare critical infrastructure of that region.
Mike Wargo [00:20:27]:
It’s also in an area that, as I mentioned, is very mountainous. So there’s a lot of ravines, there’s a lot of gorge areas in there with rivers and smaller waterways and streams that we’re well aware of. So this all goes into the profiling of how do we plan for storms in the mountains. Prior to the hurricane making landfall in the Carolinas, particularly in the Asheville area, there was a smaller, pretty intense rainstorm that came in maybe a day or two prior and had localized flooding and some mudslides and things that really saturated the ground in that region prior to Helene making its arrival into Asheville. Now combine the two. You’ve got this category one hurricane that makes landfall up into that area, or, you know, it reaches that area, kind of holds steady, and now it’s a major rain event, so you have full day of heavy rains. So the flash flooding that occurred was just unbelievable. The preparedness of the facility in, in my opinion, was very adequate.
Mike Wargo [00:21:35]:
In the beginning. We organized our response, we brought our teams in, we had our incident management in play. We began all that typical readiness that we do. The big difference here, and this is something that post event, in a discussion with the senior leaders of our organization, they said, how did we miss the preparing for an impact that was so catastrophic in this region? And the difference is we did everything that we normally would do and most healthcare organizations would do in preparedness and readiness. We did our risk assessments, we had our mitigation in play. We educated, we trained. The vulnerability was the community infrastructure. We don’t have authority, we don’t have control over how the community prepares, how our critical infrastructure is built within these communities.
Mike Wargo [00:22:23]:
And when we lost the, the main water and sewer supply to the Asheville area, that had a devastating operational impact on providing health services and public health to all the citizens and visitors of the community. Along those riverways were the fiber lines that were the telecommunication pathways that cellular towers connected to. So cellular service was out. Your primary landline was out, your Internet connectivity was out. The ability to communicate was lost. Lastly, is just your roadways, your access. The storm, the mudslides destroyed major highways. They destroyed all the critical pathways of access for staff to get in and out of work and travel across their communities.
Mike Wargo [00:23:06]:
So it was just compounding devastation on the local infrastructure and critical infrastructure that had secondary impact on healthcare. So I’ll pause there before I get into the response, just to talk a little bit about those vulnerabilities, what I call the intrinsic vulnerabilities that we have control over and those extrinsic vulnerabilities that we don’t have control over. And that’s where our communities really have the responsibility to ensure the proper readiness. Where our critical supply vendors, Telecommunication, water, et cetera, have a responsibility for resiliency and continuity of operations as well.
Chip Kahn [00:23:43]:
Okay, that’s a really good assessment. Why what happened happened in terms of sustainability of the care and continuity of services. How did you make sure that what the hospital provides for the community kept going under all these pressures from the weather event that you just described?
Mike Wargo [00:24:07]:
Well, first I think it’s organizational culture. The culture of HCA healthcare is to do the right thing under any circumstance. Secondly, it was a responsible leadership. From our CEO Sam Hazen to Greg Lowe, our division president and our group leadership. The directive that was given was give all resources in this company to that community. And it wasn’t just the hospital and health system is. However we can support the community, our staff members, their family members, it was all in from our company once the storm settled, the resources from Nashville, from our corporate incident management team and executives. We made our way into North Carolina to back up the locals.
Mike Wargo [00:24:48]:
And that’s important because during a crisis it’s often overlooked the impact that the local leadership personally undertakes. So many of our leaders didn’t know if they lost their own homes, they didn’t know the status of their loved ones with the loss of communication. So getting a team in there to give them relief and either help them or relieve them so they can go home and take care of their own personal business is critical. Our organization very quickly deployed resources. Now we have a full time department, my department, the Enterprise Emergency operations team. We focus on what are the risks that we can face and what contingencies might we need. So we flew in with satellite communications that we distributed using our local air medical helicopter service. Based at mission, we flew those satellite communication devices to our remote centers.
Mike Wargo [00:25:39]:
We began to set up core infrastructure. Starting with leadership, starting with communication. Quickly we identified that the community was overwhelmed. I arrived there the day after the impact and that first night there was well over 300 individuals just in the lobby of the emergency department waiting room. So we knew the impact of the community and the cascading impact of the community was going to be significant. Part of our early assessment was we’re very proud of the resources that we have. But there are times you don’t have a resource or you can quickly be overwhelmed. So we worked with the state office of emergency management.
Mike Wargo [00:26:17]:
We tried to work with the locals, but the loss of communication locally prohibited us from having contacts or direct communication with our local emergency managers. So Leaning on our government relations teams, leaning on the relationships that we had at the state healthcare coalition, state emergency management levels, we made contact with the state office of Emergency Management. We requested state and federal resources, particularly the HHS DEMAT team that came in to decompress our emergency department. That’s a federal team that came on site to help set up triage outside the emergency department to treat low acuity in deployable tents where the more critical patients or the unstable patients were then moved into the emergency department where we had core infrastructure and they were stabilized. That was our top priority was life safety, addressing the immediate needs of the patients and community. Our second priority was infrastructure, the loss of water. How did we manage that? That was the biggest ongoing challenge that we had there. We have a team of very experienced and I’ll call them magicians for a lack of a better term, engineers that came in and truly perform magic.
Mike Wargo [00:27:30]:
They, they quickly assessed the engineering of our water system at the health system. They replumbed the water distribution system that we’re able to bring upwards of 20 or 30 tanker trucks of water in every single day to provide all the volume of operational water needed to keep our operating rooms open, having flushable toilets, sanitary water movement, everything that it takes to run a hospital, we were able to do with supplemental water supply. Major, major infrastructure initiative that was underway just to plumb the intake for the water trucks, to bring those tanker trucks in securely, to keep the constant turnaround of 20 tanker trucks of water every day was just an unbelievable tasking. And let’s not forget, you know, we are a taxpaying organization. We are a publicly traded organization. We have the privilege that we were able to afford to do this initially and ongoing at the cost of the organization. I’ll remind you as a tax paying, publicly traded organization, we don’t get Stafford reimbursement from FEMA post event. So that’s something that I believe there’s an ongoing discussion that needs to be addressed for organizations like ours that are able to stand up and not only keep the critical infrastructure of the community going by the resources we provide, but there’s a lot of resources that were given and offered to the community to make sure that community sustained its livability per se from a public health standpoint.
Mike Wargo [00:29:08]:
The last thing I’ll say is the depth of resources. In our partnership with Health Trust, our GPO to bring in supplies as needed, to bring in warehouse workers to keep all the supplies moving from warehouse into facility was remarkable. To feed thousands and thousands of volunteer responders to keep our patients and family members well fed and the nurses and engineers and all the different ancillary personnel that rallied across the company to come in and focus on Mission Health System, primarily Mission, Maine, but we also took care of some of the outlying facilities that had local infrastructure impacts. The commitment of the organization was just unbelievable. And it wasn’t just about Mission. It was broad. It was about the community and ensuring that those resources that we can provide, we did.
Chip Kahn [00:30:01]:
Where are we right now in terms of recovery of the hospital? I guess we’re many months down the line and the kind of damage to the community in Asheville is unbelievable. Where’s the hospital in terms of its recovery? Are you back up to snuff?
Mike Wargo [00:30:16]:
So what I would say is remarkably there, operationally, given the resources, there was minimal impact to operations with our contingency resources just about a week ago. And now when we’re recording this, it’s now the 17th of December. So it’s a few months past the impact. They just had local community water restored and we just about a week ago shut down tanker operations to that facility. So you can imagine 20 tanker trucks of water for one hospital every single day for multiple months. The feat that, that was just unbelievable. The broader community has, you know, the public health systems are being restored, there is water supply, it’s not on boil status anymore. There is still devastation with broader community infrastructure there that the community still needs help and is still being assisted.
Mike Wargo [00:31:11]:
So I wouldn’t say it’s back to normal, but from a healthcare operations standpoint, I believe that we’re stable on community resources. Communications restored, water is restored, the general infrastructure is back operational a few months later.
Chip Kahn [00:31:26]:
Now, what a story. As we close out our conversation here, you did mention, and I sort of underlined the point that taxpaying hospitals are almost 20% of hospitals across the United States. We happen to have a footprint in terms of some of these big storms that probably is bigger than, larger than other sectors because we are in that area around the Gulf of Mexico and then other areas of the country that are susceptible to weather events. So we have to have the kind of planning and response that you’ve described here. Very briefly, if we don’t get FEMA relief, which the government has chosen not to give us over time, are there tax policies that could be implemented here? I think there’s some precedent for this that might be useful.
Mike Wargo [00:32:21]:
I think when we look at impacts like this and for organizations that are financially challenged as well as operationally challenged, the initial focus is how do we retain our workforce in that community. And I think it’s really important because when you think of Asheville and the devastation to the broader community, not only do we have an impact to the workforce acutely, but you have a populace that migrates out. So I think getting back to reinstating disaster zone employee retention credits that was passed post Katrina, that is one of the strategies, extending and expanding our work opportunity tax credits to help ensure hospitals can retain our workforce as we, as we reopen and rebuild and we restart our normal operations. The second area I would, I would talk about again going to our second party is infrastructure and looking at targeted bonuses related to, you know, infrastructure impacts, depreciation to federally declared disaster zones. This would help us in our rebuilding to a stronger community, in sustaining, going back to resilience and sustaining healthcare operations and public health to the community. Again. We’re very fortunate that we were in a position that we got through this. But if this were to happen at the same frequency of these billion dollar disasters, I don’t know any insurer, I don’t know any organization that can sustain impact after impact after impact without some type of subsidies or support.
Mike Wargo [00:33:52]:
So I think looking at tax credits for those tax paying hospitals to, you know, defer some of the costs, to defer expenses, to rebuild stronger, rebuild better, to prepare in a different manner, and maybe even incentives of better readiness programs to organizations. One thing I didn’t touch on, that I’ll briefly mention here, is part of my team, Melissa Harvey and some of the leaders on my team who were former federal leaders in the hospital preparedness program and other areas of government, recruited them in to look at our readiness standards and to give us a metric and a score on how ready our organization is and where we can put improvements. So some of these gaps, as we assess that true operational readiness, give us a roadmap of where we, as a private organization begins, can invest. But it also tells us a story of where we can partner with our state, our local, our federal partners to advance the preparedness, to advance the readiness not just of our individual organizations, but the broader community. So that when we have an impact like this, we’re all coming together to kind of raise the readiness and have a much better outcome.
Chip Kahn [00:35:08]:
Mike, thanks so much for joining us today and thank you so much for your service, particularly in the case of this Asheville, North Carolina crisis. I know that so many in the community appreciate what HCA Healthcare did to keep the care available and also help the community recover. So with that, really just appreciate you being with us today.
Mike Wargo [00:35:33]:
Thank you. And I truly appreciate the opportunity to share our story and for all the advocacy that you and so many leaders do for us. Thank you.
Chip Kahn [00:35:44]:
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Mr. Michael Wargo serves as HCA Healthcare’s enterprise Vice President for Preparedness & Emergency Operations based in Nashville, TN. Mike joined HCA Healthcare in 2016 as the Assistant VP of Enterprise Emergency Operations, a role in which he was tasked to redesign and lead the organization’s disaster and emergency operations program in readiness, response, and recovery from adverse natural and man-made incidents across both the U.S. and the metro London area of the UK. Mike brings more than 25 years of clinical experience in high quality, patient centered care and nearly two decades in public safety leadership. Mike is the Executive Officer and immediate past Chair of the U.S. Health and Public Health Sector Coordination Council of the National Critical Infrastructure Protection Program sanctioned by Homeland Security Presidential Directive 21. In this role, he collaborates and serves as a trusted advisor to both federal secretary-level & SES leadership and senior private industry executives on readiness, response, and recovery initiatives impacting the U.S. national health security and critical infrastructure protection. Additionally, he served as the Chair of the Emergency Preparedness Committee for the Federation of American Hospitals.
Mike is a veteran healthcare executive with experience leading the medical operations division of Northeast Regional Counter-Terrorism Task Force based in PA. He is the prior Administrator and Chief of Emergency Operations for Lehigh Valley Health Network, and an experienced flight nurse and Administrator of LVHN-MedEvac. Federally, Mike served in an intermittent position as a Supervisory Nurse Specialist for the U.S. Dept. of Health and Human Services National Disaster Medical Services. His combined experience includes both domestic and international homeland security and medical response training & operations. Mike holds multiple certifications in homeland security, disaster preparedness and is one of the first Certified Medical Transport Executives worldwide. He is a graduate of the American Military University with a Master of Business Administration degree, Kutztown University of PA with a Bachelor of Science Degree in Nursing and is a graduate of St. Luke’s School of Nursing with a Diploma of Nursing. Continuing his post-graduate studies, Mike is near completion of the Doctor of Public Health degree program at Indiana University Fairbanks School of Public Health.
Mike was recently awarded with the “Director’s Award for Outstanding Service to Mission” by the U.S. Secret Service for his leading the Pandemic Health Security & Medical Operations of the final 2020 U.S. Presidential Debate.