Late in the evening of October 4, 2015, Williamsburg Regional Hospital Maintenance Director Sean Cottrell was driving back to work due to the intense rain inundating his Kingstree, SC facility.
Eventually, he was driving with his car partially submerged underwater. “I knew I had to just keep driving if I was going to make it,” he recalls vividly.
Over that fateful weekend, Kingstree—the county seat of Williamsburg—would experience 31 inches of rainfall, massive flooding, and become stranded from the outside world as the Black River overflowed and made the small town a virtual island.
The hospital, although a large, sturdy facility, did not fare well.
“There was 4 million pounds of pressure from the rainfall on the roof,” admits Cottrell. “It couldn’t drain the water fast enough. We had a lake on the roof.”
Williamsburg is a critical access hospital, which means it serves a small, rural population and receives cost-based reimbursement for Medicare services. This is done to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in those communities. In other words, they are a small but vital force for their patients and could ill-afford what was about to happen in the months that followed the storm.
When the rain stopped, the water didn’t.
“Waterfalls would happen in the most unbelievable places,” says CEO Sharon Poston with a shake of her head. “The pharmacy had a concrete wall that just turned into a waterfall. We were scratching our heads at where the water was coming from.”
As it turns out, the immense weight of the water on the roof had shifted the drainage system, so much that water filtered out in inappropriate places, with much of it ending up directly underneath the hospital. Cottrell says they estimated that the fire department pumped nearly 6,000 gallons of water from the run-off below the structure.
The combination of sitting water, which eventually led to black mold, and the old building’s dangerous amount of asbestos meant that the hospital’s air quality was becoming unsafe. The staff evacuated the space room by room, bed by bed, as the situation continued to deteriorate. Eventually, after receiving permission from DHEC to go to “zero census,” the hospital made the decision to temporarily suspend services for the sake of public health on February 5, 2016. Williamsburg Regional Hospital was now grappling with a second storm.
What followed was an incredibly chaotic period, but clear through it all was the resiliency of the hospital, its leadership and its community. In a press release announcing the suspension of services, the hospital laid out a plan for constructing a modular temporary hospital that would take the place of its main building. In the meantime, the rural health clinic would be open 24 hours a day and the hospital would rapidly set up a temporary emergency room that would be online within weeks.
“We are NOT abandoning the citizens of Williamsburg County and the surrounding areas,” a Facebook post explaining the situation said. “Please rest assured that every effort is being made to restore full service as quickly as possible.”
The plan was a tall order—the hospital would need to work closely with FEMA and DHEC to make this temporary facility happen, while juggling a staff that would be out of work and skeptical of the hospital’s ability to turn the page.
True to their word, though, a modular emergency room was quickly constructed and became operational on April 22, 2016, which restored some of the most critical services that Williamsburg provides.
At the same time, Poston says they originally provided disaster pay in the hopes of keeping the staff intact, but eventually had to lay off many of their employees until the temporary facility opened. In the meantime, there was a feverish search for temporary buildings that could offer all the services of a full hospital.
“We tried to find something in South Carolina that would work,” Poston notes, but the specific demands of a temporary hospital made things difficult. Eventually, a former Williamsburg administrator came across a portable building company in Michigan that specialized in temporary hospital facilities. The hospital drew up plans for their temporary facility, essentially cutting the square footage of their old space in half while jettisoning only a handful of beds. And then they got to work.
Williamsburg’s temporary hospital might look like a series of giant, interconnected mobile homes from the outside, but that appearance belied the state-of-the-art amenities housed within. Construction would take months, with medical equipment, food services, operating rooms, new beds and more all being installed and prepared for patients. Then, on December 16, 2016, a little more than a year after the historic flooding wreaked havoc over the county, the new hospital came on line.
“It looks like a temporary building and acts like a temporary building,” Cottrell admits, “but it’s actually pretty good for what it is.”
“It’s a real hospital, and it has all of the services we had before,” Poston agrees.
Both administrators acknowledge the temporary feel of what appears to be a half-dozen mobile homes webbed together, but are also clearly enthused about how, inside the facility, there’s a clear sense of revitalization that comes from the shiny new walls and equipment. Although there’s a low ceiling, everything else about the hospital feels sharply conceived and well executed, with a kind of contrast to the stately, though aging, walls of the old building. Sparkling clean walls—which double as top-to-bottom dry erase boards—and shiny new beds and equipment make the experience of the hospital feel like a first-class experience. There are windows in every room, and during the day the sunlight that pours in brings true warmth to the small, cozy patient rooms and workstations.
Poston is clearly proud of how well the temporary facility matches the services of the old building—she eagerly shows off the high-tech imaging tools and advanced nuclear medicine equipment that the hospital boasts, weaving through the long, lengthy hallways with a sense of familiarity and purpose.
“It's beginning to feel like the family again, after about a year or so,” she says of the atmosphere in the hospital. Many of the laid-off staff found other work, so the hospital has been supplementing their workforce to function.
“They didn’t think we would survive, so why come back?” Poston says with some empathy. “They didn’t want to go through that.”
They’ve gradually built back up their regular staff, though, and are currently at 80% capacity. There have been struggles with FEMA, DHEC and their insurance company about how to move forward—Cottrell and Poston both agree that the old building is beyond saving.
“You can’t enter [that building] without a hazmat suit,” Cottrell points out. “The only nice thing about that building is that it will never burn [because of the asbestos].”
Williamsburg’s long-term plan is to build a new hospital, preferably by merging with another hospital to increase their catchment area, but there’s still a lot of details to work out. Technically, their new temporary facility is rated to last for up to 15 years. The hospital is hoping to be out of it in three to five.
In the meantime, though, they are still serving their community, despite all the adversity they have faced, one patient at a time.