(CNN) - Hospitals, nursing homes and other medical facilities along the 300 miles of coastline in the potential path of massive Hurricane Florence are preparing the best they can.
There are mandatory evacuation orders for at least a million people in coastal areas of the Carolinas and Virginia. That requires health care facilities to figure out what they need to close or keep open. If you need a hospital or doctor, be sure to look at the website for the facility you are going to first, or call, because circumstances change quickly in these kinds of emergencies.
In Charleston, South Carolina, whether a hospital can stay open largely is based on where the facility is. Many, such as the East Cooper Regional Medical Center, have had to cancel elective surgeries while trying to keep the emergency rooms open to accept emergency patients. In contrast, the Hilton Head Regional Medical Center went back to normal operations on Wednesday because of the southern shift in the track of the hurricane.
Hospitals such as the major Roper St. Francis Healthcare facilities will remain open, but their express care and physician partners facilities closed because they don't meet the state's "shelter in place" requirements needed to withstand a disaster, according to the hospital's website. The facility posts constant updates on social media accounts to keep patients informed of what's open in the storm.
"We have activated our emergency teams for our 3 hospitals. Patient safety is critical. For more than 150 years, we'll be here for the Lowcountry, no matter the weather," Roper St. Francis said on its Twitter feed.
Roper St. Francis keeps supplies for emergencies such as this on the top floor of its facilities, including thousands of gallons of water in case the water supply gets cut off. Staff checked its power generators before the storm and reminded patients looking at its Facebook page, "We've been around since 1789, that's longer than the feds even tracked hurricanes. No matter what #hurricaneflorence brings, our team is ready."
Because of Monday's closure order from the governor, medical facilities in the direct path of the hurricane and some nursing homes have had to move their patients inland. "It is not an easy operation," said J. Randal Lee, the president of the South Carolina Health Care Association. The association represents more than 90% of long-term care facilities in South Carolina. "It's a complicated process when you are evacuating people with an average age that is over 80. Some of these residents haven't left the building since they first moved there."
Lee said they've moved patients from all their nursing homes in Georgetown, parts of Dorchester and Berkeley County and Charleston. "We are working around the clock to move patients and supplies, too." With nursing facilities at over 90% occupancy in the state, that means many residents won't "have a warm bed waiting for them." Instead, Lee said, they will likely have to stay on a mattress on the floor. But these residents don't go to shelters, which are not equipped to handle this patient population.
Evacuating older, frail patients can put the patients at risk. Studies have shown that moving this patient population can be bad for their health. Lee said residents have died in past evacuations.
"This is a great strain on our residents," Lee said. "But our No. 1 concern is their safety and we know they are in good hands with our staff."
Patients at the Tidelands Waccamaw, Tidelands Georgetown and Tidelands Health Rehabilitation Hospital were being forced to evacuate. Patients are being sent to other hospitals out of the path of the hurricane. Patients are being removed by ambulance, medical buses and by helicopter.
Some staff also went with the patients to make sure they had the right kind of care. A skeleton crew will stay on property at Waccamaw and Georgetown to ride out the storm and continue caring for patients who were too sick to be safely evacuated. The hope is that the remaining staff will be able to open the facilities quickly once the hurricane passes, according to the hospital.
"In 70 years here we have certainly had to weather our share of hurricanes," said Amy Stevens, vice president of marketing and communications for Tidelands Health. She said it's still to be determined how many patients will be evacuated. She estimates it will be about 100 in total from all Tidelands' facilities. They have until 1 p.m. Thursday to complete the evacuation, according to the order.
"Obviously, if you work in the medical field, our team of doctors and medical nurses have dedicated their lives to this community and they will continue to do that as long as it is safe to do so," Stevens said.
Stevens was supposed to head to Disney World on Saturday. She said she's had the fortune of being on vacation during other hurricanes, but this time she will ride out the storm with the crew on location. She said her husband and dog evacuated this morning. "He wasn't going to, but when we got up this morning and saw that the track turned and is heading this way, just to be safe," Stevens said. "That way I'm not worried about him and the pup, whereas I know I'm in one of the safest places I could be at our facility."
Stevens said Tidelands does hurricane preparation all year. At an in-depth review earlier in the year staff worked with engineers, weather experts and ran through "slosh" models, making sure their buildings were ready for any storm, even a level 3 direct strike at high tide, she said. The facility team has also been working for days to lay in supplies, and all the generators have been tested.
"I sat in our meeting this morning and listened to the head emergency physician, who talked about how this is what we train for, to be here for the community," Stevens said. "It was very inspiring to see."