Stormy Weather

Donald Jones, president and owner of Southern Medical Equipment, Cullman, Ala., emerged unscathed from the string of tornadoes that devastated wide swaths of the southern United States April 27. The same cannot be said of his four business locations — all hit on the same evening.

Southern Medical’s facilities in Cullman, Albertville, Huntsville and a warehouse in Tuscaloosa all received varying degrees of damage. In one astonishing display, massive winds splintered the front bay doors of Jones’ 16,000-sq.-ft. warehouse. As the force blew through the building, it splintered the back door and blew equipment out the other end, including an 18-foot trailer.

Despite a solid emergency plan, Jones admits that he was caught off guard.

“We did not anticipate tornadoes hitting all four locations and service areas at one time,” he laments. “Our phone communications were knocked out. Our emergency plan and backup system were useless. All phone, email, Internet and even cell phones were useless. We were unable to contact our oxygen patients, but knowing which patients were critical, we went to those patients that evening as soon as we were made aware of any needs.”

The next days averaged 16 to 18 hours long as Jones scrambled to serve his patients. “Luckily our oxygen vendor [LifeGas] out of Birmingham knew of our plight, and along with other dealers was able to supply our cylinder and liquid oxygen needs,” reports Jones.

“When we lost our warehouse, we lost several of our liquid reservoirs, which we intended to use as dictated by our emergency plan. We were able to acquire large T-tanks, and we were running cylinders night and day. We made numerous deliveries. All total, we had 776 various contacts for cylinders and oxygen for the next 10 days.”

In a stroke of luck, Southern Medical’s home office in Cullman merely had its awning blown off and a staircase detached. Jones describes these inconveniences as “relatively minor” when compared to other nearby buildings that were completely destroyed.

The Alabama tornadoes — the National Weather Service estimates 53 of them on that one April day — left 238 dead, with fatalities resulting from the same band of storms in six other southern states. Just days earlier, severe storms and tornadoes in North Carolina and Virginia were a prelude to a string of disastrous spring storms. Following in May, a massive tornado devastated Joplin, Mo., and on June 1, multiple tornadoes slammed western Massachusetts, destroying parts of Springfield.

Through all the storms, area HME providers figured out how to function.

Disaster in Joplin

Tim Moore, regional manager of Wilkinson Home Care Equipment in Joplin, Mo., knew something was wrong when he got an odd Facebook message from a friend on Sunday, May 22. The note asked, “Is your store all right?” From Moore’s home 60 miles from Joplin, all seemed well. But after checking the news, the reality began to sink in that a massive tornado was sweeping through the city.

Moore immediately contacted staff members who lived in Joplin — the store manager, pharmacists, pharmacy technicians and respiratory therapist Summer Bright — to see if they were OK. By the time he got in touch with Bright, she had already started contacting patients to assess their oxygen and CPAP needs.

“I worked with some of our staff in [the corporate office in Nevada, Mo.,] because we fill our own tanks with a transfill system,” says Moore. “We filled all the empty tanks that we had and we left Nevada at 9:30 or so Sunday night, about three or four hours after the tornado struck. We brought all the tanks we could bring down so we could meet the needs of our patients.”

Wilkinson Home Care got lucky. Just four city blocks south, destruction reigned.

“We put quite a few tanks and supplies out, and most of what we put out was actually for our competitors’ customers,” says Moore. “We’ll either write it off as a good will gesture in a time of disaster, or as in other times, the insurance companies have allowed within reason supplies to be billed with little or no documentation. At this point, it is about getting supplies and services to people that need it.”

Bent but Not Broken

When a line of tornadoes hit Raleigh, N.C.-based Van Products Mobility April 16, many assumed that the venerable business would have to shut its doors indefinitely. Establishments just across the highway were destroyed, but Van Products sustained a “glancing blow” that, while doing a lot of damage, didn’t render the location a complete loss.

Tim Harrell, Van Products president and CEO, quickly worked to correct assumptions through technology. Under such conditions, says Harrell, “Communication is the number one problem. You must have a phone service provider that will forward those calls to cell phones. We also have a Facebook page and website, and the people that handle my digital and social media marketing helped to get the word out.”

Harrell understands how customers would think the worst. On the day of the tornado, employees called him screaming as they hid underneath tables and in the bathroom.

“They thought the building was coming down,” remembers Harrell. “It did not come down, but a huge 12-in.-thick cinder block wall got blown out and landed on some of the vehicles.”

With undamaged parts and goods still available to be sold, the battle of perception was not always easy to overcome. “We had one customer who had a special wheelchair ordered,” says Harrell. “The chair was safe, in excellent condition and had sustained no damage, but he wanted to refuse this $25,000 chair. We had to convince him that nothing happened to the chair.”

Without electricity for about three weeks, Harrell moved to a building next door where he was able to establish operations. “There is a fine line,” he says. “You don’t want people to think everything is absolutely horrible, because they may assume everything is storm-damaged, and it was not. Let people know you are still in business, you may have to relocate and here is how you can call us.”

Harrell counts himself lucky that rentable space was available nearby. Ken Glover, RPH, was not so lucky. The sturdy 100-year-old building that once housed Glover Drug in Cordova, Ala., was no more, heavily damaged by two tornadoes on April 27.

With no space available in Cordova — either occupied or more likely destroyed — Glover searched for and found a temporary trailer in Memphis, moved it back to Alabama and reopened his doors on May 17.

“We were one of the first downtown businesses to open, and it was nice to see familiar faces,” he says. “I now have a plan on my desk of what the new permanent fixture will look like, and we are looking in that direction.”

In addition to the operation in Cordova (population 2,400), Glover has two other pharmacy/home care locations in Jasper and one in Dora, Ala. All four sites had power knocked out after the first storm hit at the crack of dawn, essentially rendering backup protocols useless.

“We have a plan in place for disasters such as fires, tornadoes and floods,” says Glover. “But this plan did not encompass total destruction within a 30- to 40-mile radius, with all of our locations knocked out at one time.”

After learning of the first tornado, Glover sent a crew to Cordova to check the damage. When he heard about the destruction, he went to the store to retrieve what he could.

“There were leaks, roof damage and the window was blown out,” he says. “All the buildings around us were crumbled. I was able to get our computer system, prescription records and the controlled drugs because we did not know what kind of security would be available.”

After securing the window with plywood, Glover initially thought he had a “fixable situation.” Little did he know another tornado would strike the same location later that day. After returning to his Dora store, Glover visited a nursing home under heavy rains to deliver medicine to a patient, then wound his way back to Cordova to retrieve a printer.

On the way back to the car at 4:40 p.m., the alarm warning went off. “Another tornado had been spotted and was on a direct path to where I was,” reports Glover. “I jumped in my car and drove about eight miles home. I walked out on my back porch with my daughter, and we watched the tornado as it came over the city of Cordova.”

Upon returning to the site after the second tornado, Glover realized that the “fixable situation” was a lost cause. “Total destruction,” he says. “I have never seen anything like it in my whole life. Ten buildings sitting right where I had parked my car at 4:40 were gone. At that point, probably three-quarters of Alabama was without power.”

Running off a generator at the Dora location, Glover Drug was the only drug store for miles, and people were coming from everywhere for help, Glover says. Despite the lack of regular phones and spotty cell coverage, Jennifer Weathers, RN, the provider’s DMEPOS coordinator, says the company was able to get the word out.

“Cell service was terrible, but we were able to use Facebook, Twitter and text messaging,” reports Weathers. “We could get online on our phones with Facebook apps. We have a Facebook fan page, so we were able to communicate with customers using that. That was exciting, because we were able to ease their minds that we had all their supplies here at the Dora store. We opened the Dora store two days after the storm.”

• Read the “Emergency Plans Were ‘Overwhelmed’” sidebar to learn how HME providers plans were overwhelmed.

Emergency Plans Were ‘Overwhelmed’

The Alabama tornadoes left a situation that was almost “too large to plan for,” says Mike Hamilton, executive director of the Alabama Durable Medical Equipment Dealers Association. He notes that most providers’ emergency preparedness plans were “overwhelmed because the storms covered such a huge area.”

Here’s an account and some advice from Randy Puckett, general manager of Global Medical Equipment and Supplies in Haleyville, Ala., about how his company handled the massive disaster:

“We lost power and the emergency plan went into effect. We started using inverters and generators to power a limited number of PCs, getting our servers and phones back up.

“Once phones were back up, we started gathering information about our oxygen patients who [might] be in need. We divided up the list and started making phone calls to each one of our patients. About 75 percent of our patients in the affected areas we were not able to get hold of via phone. The cell and land-line service was pretty much knocked out.

“If the power grid goes down, a lot of the DMEs around here can’t function. They can go back to a pay-for delivery ticket system with handwriting. In our scenario, we had a 5,000-watt generator. We piped that into the machine, shut off the main breaker, and we were able to have lights and able to conduct a fairly normal business day.

“Here in Haleyville, we were the only pharmacy able to function. There are three here, and two hours after the event with the power out, we were able to function filling prescriptions, making and receiving phone calls.

“Off-site backups are crucial. With oxygen patients, if you don’t have their phone number and address at an off-site location and your systems get wiped out, you don’t even know who they are and you have no way to follow up with them. You don’t know if they are dead or alive. You don’t know their status. Once a month, print out your contact list for your oxygen patients and get it off site.

“It’s so important that you have these emergency plans in place, and that you have generators. It’s really easy to ignore when these disasters do not happen.”