While your organization may have a well-thought-out emergency plan, have you considered what you will do if a crisis exceeds your expectations?

LeadingAge CAST Patrons Richard Foor, vice president of information technology at Givens Communities in Asheville, NC, and Joe Velderman, MCP, vice president of innovation at Cypress Living in Fort Myers, FL, faced and recovered from very challenging scenarios. From those experiences, they’ve summarized some lessons learned that can help providers across a range of care settings and community types to weather any storm.

“A community’s resilience is measured not by how it plans for the best days, but by how it prepares for the worst,“ said Velderman. “Our organization has faced multiple severe weather events in recent years,” he said, noting that they’ve learned the importance of advance planning to safeguard their residents and staff when disasters strike.

Before and After the Storms

Givens Communities includes four physical campuses, including two life plan communities with assisted living and skilled nursing facilities, two affordable housing communities, and home care. They rely on technology to coordinate quality care and use tools for efficiency, strategy, and communication.

After Hurricane Helene caused extensive damage throughout western North Carolina in September 2024, the entire region lost terrestrial communications for days. Cellular towers and fiber communications were inoperable in all Givens Communities campuses. Water service was not restored for weeks, and potable water was lost for two months. Givens Communities’ server room generators were under floodwaters.

As the storm abated, only one communications connection was operational—a single mobile satellite communications device for all four campuses. Technology failover procedures already in place required the technology team be present to implement them, however; washed-out roads initially prevented team members from traveling to the campuses.

By working with partners outside of the region to acquire additional communication satellites, Givens Communities restored some sort of communications at three campuses within four days. Fiber returned to the Asheville campus after seven days, and Givens Communities rotated satellites to other sites as needed. However, due to unprecedented storm damage, some residents were without cable, phone, or internet for several weeks.

Located on Florida’s Gulf Coast, Cypress Living includes Cypress Cove, a life plan community with over 700 residents featuring 425 independent living homes, 44 assisted living residences, 44 specialized memory care residences, and 64 skilled nursing units. Cypress at Home, a comprehensive home and community-based provider organization, has four connected services lines, including a care management team, home care team, and medical team.

Cypress depends heavily on technology for nearly every aspect of its operation, including network and systems infrastructure that enables staff communications, resident communications and entertainment, and life safety systems. Over 2,500 devices connect to the Wi-Fi network each day. Nearly every department uses enterprise applications, usually cloud-hosted ones, to drive workflows, collect information, and analyze outcomes—including sales and marketing, finance, clinical services, resident services, culinary, and facilities.

After Hurricane Ian struck southwest Florida in September 2022, the first floor of every structure on the Cypress Cove campus flooded with several inches of water. Cell towers lay on the ground. The campus had no utilities, power, water, gas service, phone service, TV, or broadband. The saltwater storm surge damaged most of the underground fiber-optic infrastructure on campus, which ultimately required extensive replacement.

Only the primary fiber internet connection and internal network / Wi-Fi network were operational, offering connectivity for information, communication, and telecommunication. By enabling Wi-Fi calling on mobile phones, team members were able to make calls.

Lessons Learned

Both providers survived complete disruption of their infrastructure, and both used a variety of implementations to successfully recover their operations. Foor and Velderman presented several strategies they used during storm recovery. Those are presented below in order of easiest to most difficult, to help your organization build disaster recovery preparation from the ground up, according to your capacity and budget.

Team-based Supports

1. Anticipate Using Analog Methods: Analog communications may be your only option for some period of time. Create a plan and maintain supplies (pen and paper, white boards, and markers).
2. Empower Non-Technical Staff to Assist in Emergencies: Givens Communities had implemented and strategically positioned failover connectivity tools like fiber failover, cellular backbones, cellular MiFi, and satellite options, plus replacement tools like laptops, cell phones, and tablets, in anticipation of challenges to communications and access to patient and resident records. However, Foor notes the need to also implement restoration failovers that do not require technical knowledge or ability, in case the technology team cannot mobilize. He suggests making “kits” with easy-to-follow non-technical instructions and pictures to enable non-technical team members on campus to assist in connectivity restoration. Preconfigure ports and locations, and test the setup and instructions on a regular basis.
3. Ready Two Technology Teams: During and after a storm, the technology team at Cypress Living splits into an “A-Team” and a “B-Team.” The A-Team is onsite through a storm to maintain critical infrastructure components such as life safety systems, network communications, Wi-Fi, and phone systems. The B-Team is available remotely while A-Team is on the ground, then comes onsite after the storm to relieve the A-Team and continue restoration efforts.
4. Prepare to Tap Remote Workers: Givens Communities innovated during the crisis, pivoting quickly to remote workers with cloud services already in place.

Resident-centered Supports

1. Educate Residents on How to Prepare: Cypress Living creates and shares with residents an emergency supply list to encourage them to stock up on practical items, such as battery-charging devices to power cell phones, emergency radios, flashlights, and water.
2. Provide Ways to Charge Essential Devices: Cypress Living provides emergency power outlets throughout the community to charge critical equipment such as oxygen concentrators, blood sugar monitors, and mobile phones.
3. Prep for Resident Communication Needs: Creating a crisis communications plan outlining tasks to ensure regular communications, and assigning those responsibilities, is important to being able to reassure key audiences as soon as possible.
   In the early post-storm days at Givens Communities, social media emerged as a highly effective tool to help reassure family members that residents were safe and cared for without having to find a way to call everyone. Updating social media regularly for family and community members can be very helpful, as can providing a link for residents’ families to communicate with a campus representative who took messages for residents. Don’t forget to provide access to local news and outgoing phone access for residents.

Technical Supports

1. Carefully Plan Redundancies for Power and Internet: To increase the chances of retaining a working backup, have three physically unique routes to the internet. At Cypress Living, three carriers serve the enterprise. The primary carrier is a 1gb synchronous fiber connection, the secondary carrier is a business coaxial connection, and the tertiary connection is a 5G wireless connection, soon to be replaced with Starlink satellite internet, which is more likely to remain operational during a natural disaster.
2. Raise Critical Equipment: Cypress Living now ensures that all critical infrastructure placed on the first floor is installed two to three feet above the floor, including heavy uninterruptible power supply units (UPS).
3. Employ Hardening Techniques: As it replaces its underground fiber-optic infrastructure, Cypress Living is installing fiber cables that are intended to be submerged and is hermetically sealing all fiber terminations in waterproof, submersible enclosures. This mitigation ensures that future storm surges cause minimal damage.
4. Ensure Critical Technology Infrastructure Is Available: Cypress Living assessed that its critical technology infrastructure, including the main data frame (MDF) and independent data frames (IDF), needs to be available at all times. Each MDF/IDF has a UPS on all critical infrastructure and emergency generator power supplying constant power to the UPS. As power goes out from the grid, the UPS will carry over the critical infrastructure with power long enough for the generator to power up and begin supplying emergency power. Each UPS is monitored 24/7 using Simple Network Management Protocol monitoring to ensure that power is stable and batteries have capacity.
5. Help May Arrive from Unanticipated Sources: Both Cypress Living and Givens Communities received much-appreciated support from their vendors, including CDW, K4Connect, BCI Integrated Solutions, and Ruckus Networks.

Planning Ahead

Advance planning, and collaboration, are essential to mitigating the effects of natural disasters. Said Givens Communities’ Foor, “In response to the increasing frequency of catastrophic events that were historically considered centennial or millennial in nature, we’ll continue to refine our disaster preparedness approach by listening to residents, team members, and collaborating with others in our industry to use innovation and flexible technologies to effectively mitigate and respond to emerging environmental challenges.”

At LeadingAge CAST, we encourage you to use the information in this article as a starting point to put in place measures that will protect your technology, and your residents and staff, in the event that a disaster happens in your area.

For more on the experiences of members impacted by this year’s hurricanes, available resources, and the ways other LeadingAge members pitched in to help colleagues recover, see our Hurricane Season 2024 Updates and Disaster Relief serial post.