Disaster Discourse: The Hagerty Blog

COVID-19, Monkeypox, and Beyond: Is Your Hospital Really Prepared?

As summer approaches, many hospitals anticipated that this could be a time to collectively catch their breath and ease the stress and anxiety put on heroic healthcare workers. They could recharge, reenergize, restore, and rebuild a more resilient pandemic-ready organization for projected fall and winter COVID-19 surges. Instead, unanticipated new Omicron variants have continued to emerge and we now find our nation’s healthcare systems handling over 100,000 new COVID-19 cases, 3,260 COVID-related hospital admissions, and 280 COVID-related deaths daily. On top of needing to respond to the latest COVID-19 case surge, there is an increasing number of Monkeypox cases globally – a disease rarely seen outside of the continent of Africa. All of this as hospitals face financial and operational challenges, including loss of patient volume, negative operating margins, and skyrocketing expenses. 

As we face the reality that COVID-19 will be with us for the foreseeable future, supply chain, inflation, and cost pressures will continue to linger and new diseases that threaten the well-being of our population will continue to emerge, hospitals must ask themselves the question, are we really prepared?

To help answer this question, hospitals should evaluate and optimize the following:

Obtain Federal Funding for COVID-19 Recovery and Future Public Health Preparedness

With the Health & Human Services (HHS) Provider Relief Fund no longer able to provide assistance, due to a lack of sufficient funds, the Federal Emergency Management Agency (FEMA)’s Public Assistance (PA) program is the best way hospitals can continue to receive reimbursement for all COVID-related expenses incurred over the last several years; however, hospitals must act quickly to potentially receive 100 percent federal reimbursement. On July 1, 2022, FEMA PA transitions to a 90 percent cost recovery for ongoing COVID-related expenses. In addition to FEMA PA, hospitals should seek out FEMA Hazard Mitigation Grant Program Funding (HMGP). The Biden Administration has made $3.46 billion available in HMGP funding to states, territories and tribes that had major disaster declarations for COVID-19. Hospitals are eligible to apply to working with their state for a portion of this funding. Finally, hospitals should optimize their funding from HHS’ Assistant Secretary of Preparedness & Response (ASPR) by working with partner facilities to optimize the dollars for regional public health preparedness initiatives such as surge capacity, community public health messaging, disease surveillance and sharing of resources and assets during emergencies.

Conduct After-Action Reviews, Hardwire Organizational Resiliency, and Preparedness Activities

Heroic efforts were undertaken over the last several years to respond to COVID-19. We must memorialize these efforts including how surge capacity was created; staff vacancies were filled; supplies procured; and lives were saved into annexes of hospital emergency operations plans.

Hospitals should conduct a comprehensive after-action report (AAR) and develop an actionable improvement plan that identifies opportunities for improvement, concrete actionable solutions and highlights strengths that can be hardwired, shared across a healthcare system or even the country with other hospitals.

In addition, we need to recognize that infection control measures such as donning and doffing Personal Protection Equipment (PPE) for routine patient contact and not just confirmed infectious cases is likely to stay for the foreseeable future. Accordingly, we must work to shift the mindsets of our caregivers so that responding to a surge of patients becomes more routine and sustainable and does not result in caregiver burnout. This means rethinking staffing, training and support considering the ongoing COVID-19 pandemic and other emerging infectious diseases.

Push the Envelope on Risk Assessments

Scenarios that once seemed unimaginable such as; a hurricane hitting New York City, a global pandemic killing over 6.2 million people, or winter storms causing regional electrical grid failures, used to be viewed as “black swan” once in a hundred year events. These events now more common occurrences. This means risk assessments should be conducted, pushing the imagination and envelope on emergency incident scenarios, and evaluating the risk on all people, processes and systems in your organization. The risk assessments should then be used to drive Emergency Operations Plan (EOP) improvements, Business Continuity Plan development, employee training and drill and exercise development. Risk should be assessed from multiple lenses but especially from the patient and employee perspective.

Serve as a Pillar and Public Health Voice of Reason for your Community

Hospitals are looked to as ‘beacons in the night’. They are expected to always be ready and have the answers when it comes to helping save lives and what people should do to take care of themselves in time of need. We are suffering from the greatest lack of trust in public health and public health messaging as result of the country’s political divide. Therefore, it is up to hospitals at the local level, who are trusted community pillars, to proactively identify emerging threats and communicate effectively with their communities. Hospitals should share public health guidance with their communities and incorporate members into after action report development, risk assessments and preparedness plan enhancement.

Hagerty Can Help

Collectively evaluating and optimizing these four critical areas will make sure your hospital is really prepared for whatever may come next. Hagerty Consulting helps healthcare organizations conduct and storyboard actionable after-action reports; risk and emergency operations plan gap assessments and public health outreach campaigns that position communities for future public health emergencies and organizations for the new Joint Commission Emergency Preparedness standards and Medicare & Medicaid Services (CMS) Emergency Preparedness Rule.

Throughout the COVID-19 pandemic, our team has been helping more than 100 hospitals, healthcare systems, and public health departments obtain the funding they are entitled to, including FEMA PA, in support of their response and recovery.


Jeff Bokseris Hagerty Consulting’s Vice President of Healthcare Programs with strategic expertise in all aspects of healthcare operations, finance, organizational resiliency, institutional preparedness, and recovery. Jeff has over 20 years of experience as a senior leader at NewYork-Presbyterian and Yale New Haven Health and served as Incident Commander guiding 40,000+ employees through numerous internal and external emergency response and recovery operations.