Hospital Staff Endures Storm, Faces Layoffs

Charlene Gonzalez wanted to get out of town before Hurricane Katrina hit, but because she was a nurse at the only hospital in this low-lying waterside community, she would lose her job if she did not stay at her post.

Then, after Gonzalez, her husband and more than 100 other employees and their families spent days trapped by rising floodwater, the Pennsylvania-based corporation that owns Chalmette Medical Center, Universal Health Services, told its employees that they could count on only two more weeks of pay.

“They left me to die,” Gonzalez said. “And now nobody’s even called to say, ‘Thank you,’ nobody’s even called to say, ‘I’m sorry.’ ”

In the days following Katrina, southeastern Louisiana’s hospitals became isolated deathtraps as power failed, water rose and severely ill patients could no longer survive. Officials have not accounted for all the patients at the two-story Chalmette hospital, but staff members say at least four died, three of whom were critically ill and had orders that they not be resuscitated.

But it is Universal Health Services’ behavior after the flooding that has infuriated the residents of St. Bernard Parish, a devastated suburb of 65,000 residents, where every neighborhood was inundated. The area remains uninhabitable, buried by mud. The hospital is severely damaged.

Officials at Universal say the anger is understandable after such a catastrophe, but they contend they did everything they could for their patients and employees. They say they tried to evacuate their hospital -- albeit at least a day after emergency officials say they urged it -- but that it was too late to get all the patients out. The company, which had $3.9 billion in revenue last year and says it is the nation’s third-largest hospital management corporation, says it is trying to place employees with some of its 84 other facilities and has started a foundation to aid those who lost their homes.

But Universal says on its website that it is committed to paying through Saturday the 2,800 employees at its three New Orleans-area hospitals, including the 900 at Chalmette. It says they will receive insurance coverage through at least the end of October.

Marc Miller, a vice president at Universal Health Services, said the cutoff of pay on Saturday was subject to change.”This is a highly unusual situation,” Miller said. “No final determination has been made on salary and benefits.”

Jon Sewell, the hospital’s chief executive, said that as he and his employees were trapped in the hospital, the most common question people asked was: Will I have a job?

Three weeks later, he could offer his workers no reassurance. “Everybody’s very emotional about what’s in our future,” Sewell said.

St. Bernard residents say the other major employer in the parish, Exxon Mobil Corp., is still paying employees even though its refineries have not come back on line. Bitterly, they say they do not expect additional help from Universal.

“It’s a betrayal,” Parish Councilman Kenneth Henderson said. “The people treated them good and they turned their backs on us.”

For Henderson, it’s personal. His daughter, Kendal Guerra, is a nurse at the hospital and is seven months’ pregnant. She will lose her health insurance, he said, before she gives birth.

Based in King of Prussia, Penn., Universal Health Services drew 7% of its revenue during the first half of this year from its three New Orleans-area hospitals. All were damaged by Katrina.

Before the storm, the company had invested heavily in its 230-bed hospital in Chalmette, an oil town eight miles east of New Orleans’ French Quarter. It had just opened a new 30-bed intensive care unit when Hurricane Katrina began to form.

Dr. Lee R. Domangue, the hospital’s director of emergency medicine, said that late on Aug. 26, he heard the news about the storm turning toward New Orleans and made a frantic call to hospital administrators.

“I said, ‘Close the hospital,’ ” he recalled in an interview. “‘You have a Category 5 storm going right over you. You have a medical obligation to evacuate.”

Domangue said the answer was no. “It was an administrative decision, against my better judgment,” he said.

Sewell said he did not recall the conversation, but parish emergency officials said they also pleaded with the hospital before Saturday to evacuate quickly, to no avail.

“It was nothing less than depraved indifference,” said Dr. Paul Verrette, medical director of the parish’s emergency preparedness office.

After meeting Saturday with parish officials, Sewell said he was convinced that the hospital needed to evacuate. As with earlier storms, intensive-care patients were taken out first. Sunday, less than 24 hours before Katrina hit, the hospital began evacuating other patients from its first floor.

“Our intention was to do it as long as we could,” Sewell said.

But with medical facilities throughout New Orleans also scrambling to relocate their patients, Chalmette could not find any available beds in Louisiana or surrounding states. Late Sunday, the hospital moved the 50 or so remaining patients to the second floor.

With patients in the facility, employees on hand were required to remain on duty, something the hospital’s officials said was standard emergency procedure in the industry. “It’s like being a policeman or a fireman,” Sewell said.

About 150 staffers and their families hunkered down. Gonzalez, the nurse, had her husband come along. She couldn’t believe they were riding out such a storm in a two-story building, and brought the family airboat.

Several hours after the hurricane struck early Monday, Sewell lay down in his first-floor office for a nap. He felt water on his back. Water was pouring into the hospital, drowning the first-floor generators. The waters that were beginning to rise in New Orleans were inundating St. Bernard Parish. Within two hours, about 16 feet of water covered the first floor, and rescue workers launched airboats off the second floor terrace to retrieve neighbors stranded on their roofs.

For the next three days, up to 400 evacuees took shelter on the hospital’s second floor. Food and water were tightly rationed -- meals consisted of a scoop of cottage cheese, a few slices of fruit and two pieces of ham. Staff desperately tried to keep conditions sanitary without a sewage system and tried to break shatter-proof windows to let fresh air into the scorching building.

By Wednesday, parish officials had found a scrap of dry land to function as a triage center. Sheriff’s deputies, firefighters and civilians began to shuttle patients to the parish jail, which sat on high ground. The next morning, the last of the staff was evacuated by a National Guard helicopter. Sewell was on the last flight off the hospital roof.

Most staff made their way out of the parish on Sept. 2. The following week, at a parish meeting in Baton Rouge, word began to travel among nurses that Universal would give them only two weeks’ pay.

“They would always stress to their employees [that] they want to be active in their community, give to the United Way, and then they do something like that,” said Brenda Ingargiola, the wife of the parish’s emergency management director and a nurse at Chalmette for 29 years.

Charlene Gonzalez’s three grown children have all been promised by their employers that they will not lose their jobs, as has her husband, who works at the Port of New Orleans.

“Everybody’s been taken care of,” she said, but Universal “has left me high and dry.”