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pdfHOSPITAL RECOVERY
FOLLOWING HURRICANE MARIA
OMB Control # 0693-0078
Expiration Date 7/31/2022
A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with an information collection subject to the
requirements of the Paperwork Reduction Act of 1995 unless the information collection has a currently
valid OMB Control Number. The approved OMB Control Number for this information collection is 06930078. Without this approval, we could not conduct this information collection. Public reporting for this
information collection is estimated to be approximately 25 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the information collection. All responses to this information collection are
voluntary. Send comments regarding this burden estimate or any other aspect of this information
collection, including suggestions for reducing this burden to the National Institute of Standards and
Technology at: 100 Bureau Drive, Gaithersburg, MD 20899, Attn: Dr. Maria Dillard, Associate Team
Lead for the NIST Hurricane Maria Program, NIST Engineering Laboratory; or contact at
maria.dillard@nist.gov.
This survey asks questions about the following hospital: [Displays hospital name and address of
record]
O1. Is your hospital location today the same as it was at the time of Hurricane Maria?
Yes
No (the hospital has moved to a new location after Hurricane Maria)
O2. Were you employed at this hospital prior to Hurricane Maria?
Yes
No
O3. Are you knowledgeable about Hurricane Maria's physical and non-physical impacts on this
hospital, such as those to services, resources, and infrastructure?
Yes, I know or can readily obtain this information
Somewhat, but there is another individual at this institution who is better suited to provide the
information on these topics
No
O4. Can you provide us with the name and contact information for someone who meets these criteria?
No, I do not know anyone who could provide this type of information for this hospital.
Yes, please contact the following individual:
Name
Phone number
Email address
Section A: Information from Respondents
Section A: Information from Respondents
The first set of questions asks about your position and experience, as well as some basic information
about your hospital.
A1. What best describes your current position in this hospital? [please list your job title or a brief
description of your job]
A2. How long have you worked for or with this hospital? (years)
A3. How long have you worked in this position for any healthcare organization? (years)
[includes current hospital and any past experience in the same position]
A4. In 2017 (before Hurricane Maria), what was your hospital's ownership structure?
Interviewer: read list of responses
Public
Public/Private
Private - Single owner
Private - Partnership (multiple owners)
Private - Corporation or Franchise
Private - Non profit
Other (please specify):
A5. Has your hospital's ownership structure changed since Hurricane Maria?
Yes (please specify current ownership structure):
No
A6. Which of the following has most negatively impacted your hospital's ability to provide services?
Interviewer: read list, select one response
Economic recession or Economic downturn of 2008
Hurricane Irma
Hurricane Maria
Earthquakes in 2019/2020
COVID-19
A7. How would you characterize your hospital's recovery from Hurricane Maria on a scale from 0 to 5,
where 0=not at all recovered and 5=fully recovered?
0 = not at all
recovered
1
2
3
4
5 = fully
recovered
Section B: Changes in Resources and Service
In this survey, we will ask about different time periods. We are interested in the general situation for
your hospital, to the best of your recollection, at the following times:
Before Hurricane Maria, which is referred to as 2017;
Approximately 1 year after Hurricane Maria, which is referred to as 2019;
And approximately 2 years after Hurricane Maria and before COVID-19, which is referred to as
2020.
Section B: Changes in Resources and Service
The next set of questions is about your hospital's resources in 2017, before Hurricane Maria and in
January 2020, before COVID-19. Please provide your best estimate and answer to the best of your
knowledge.
B1. What was your hospital's annual operating budget? (Report to the nearest thousand USD$)
Interviewer: read each statement and then record response in the units specified.
a. In 2017 (before Hurricane Maria)?
$
0
b. In 2020 (before COVID-19)?
$
0
Total
$
0
B2. How many staffed beds did your hospital have? (Report to the nearest whole number#)
Interviewer: read each statement and then record response in the units specified.
a. In 2017 (before Hurricane Maria)?
#
0
b. In 2020 (before COVID-19)?
#
0
Total
#
0
B3. What was your hospital's average occupancy rate? (Report to the nearest percent %)
Interviewer: read each statement and then record response in the units specified.
a. In 2017 (before Hurricane Maria)?
0
%
b. In 2020 (before COVID-19)?
0
%
Total
0
%
B4. How many hospital-wide staff meetings were held each month, on average?
Interviewer: read each statement and then record response in the units specified.
a. In 2017 (before Hurricane Maria)?
b. In 2020 (before COVID-19)?
<1
1-3
4-6
7 or more
B5. Before Hurricane Maria (in 2017), what percent of your hospital's purchased supplies in the
following categories came from outside of the Commonwealth?
Interviewer: then ask
How about before COVID-19 (in 2020), what percent of your purchased supplies in the following
categories came from outside of the Commonwealth?
Interviewer: Repeat for each Supply type.
(Please provide your best estimate and answer to the best of your knowledge)
2017 (Before Hurricane
Maria)
2020 (Before COVID19)
a. Food
%
%
b. Computers/Tablets
%
%
c. Cleaning products
%
%
d. Pharmaceuticals/Medicines
%
%
e. Treatment supplies (e.g., dressings,
splints, IV bags)
%
%
Now we will focus on any changes in the services provided by your hospital.
B6. Before Hurricane Maria (in 2017), did your hospital provide any of the following services? (Select
all that apply)
Interviewer: Repeat for each service type
2017 (Before Hurricane Maria)
Clinical Services
Emergency Services
Out-Patient Clinic Services
Surgical Services
Obstetrics/Delivery Services
Physical
Therapy/Rehabilitation
Services
Non-ICU Floor Services
ICU Services
Cardiac monitored/Non-ICU
Services
Intensive Care Unit Beds
Yes
No
Don't know
2017 (Before Hurricane Maria)
Transportation
Services
Ground ambulance
Air medevac
Support Services
Kitchen and Cooking
Services
Housekeeping/Cleaning
Services
Laundry Services
Medical Records Services
Hospital Administration
Services
Laboratory Testing Services
Radiology Services
Pharmacy Services
Blood Bank Services
Chaplain Services
Yes
Community Services
Birthing/Parenting Training
First aid/CPR Training
Fitness Classes
Food Pantry/Food Bank
AA/Al-Anon Meetings
No
Don't know
For the following questions, please consider all services that fall under the relevant category and
compare to your hospital's services before Hurricane Maria, in the year 2017.
B7. About what percentage of clinical services was restored:
Interviewer: Record from zero to 100%. Read each statement and then record response.
a. By 2019, approximately 1 year after Hurricane Maria?
0
%
b. In 2020, before COVID 19?
0
%
Total
0
%
Clinical Services refers to: Emergency Services, Out-Patient Clinic Services, Surgical
Services, Obstetrics/Delivery Services, Physical Therapy/Rehabilitation Services,
Non-ICU Floor Services, ICU Services, Cardiac monitored/Non-ICU Services, and
Intensive Care Unit Beds
B8. About what percentage of transportation services was restored:
Interviewer: Record from zero to 100%. Read each statement and then record response.
a. By 2019, approximately 1 year after Hurricane Maria?
0
%
b. In 2020, before COVID 19?
0
%
Total
0
%
a. By 2019, approximately 1 year after Hurricane Maria?
0
%
b. In 2020, before COVID 19?
0
%
Total
0
%
a. By 2019, approximately 1 year after Hurricane Maria?
0
%
b. In 2020, before COVID 19?
0
%
Total
0
%
Transportation Services refers to: Ground ambulance, Air medevac
B9. About what percentage of support services was restored:
Interviewer: Record from zero to 100%. Read each statement and then record response.
Support Services refers to: Kitchen and Cooking Services, Housekeeping/Cleaning
Services, Laundry Services, Medical Records Services, Hospital Administration
Services, Laboratory Testing Services, Radiology Services, Pharmacy Services,
Blood Bank Services, Chaplain Services
B10. About what percentage of community services was restored:
Interviewer: Record from zero to 100%. Read each statement and then record response.
Community Services refers to: Birthing/Parenting Training, First aid/CPR Training,
Fitness Classes, Food Pantry/Food Bank, AA/Al-Anon Meetings
B11. What is your best estimate of the number of physicians working within your hospital on an
average day? (This is intended to be different from the total number of physicians that have privileges
at your hospital.)
Section C: Physical Impacts & Repair
Section C: Physical Impacts & Repair
The next set of questions focuses on physical damage and repairs associated with your hospital
campus. If you are unsure of any responses, please just answer to the best of your ability.
C1. Did your hospital campus suffer any physical damage due to Hurricane Maria?
Yes
No
Don't know
C1a. Is your hospital campus made up of more than one building?
Yes
No
Don't know
C1b. Please identify the building where most of the services of your hospital are performed. (This is
likely the building with the most beds.)
Please answer the following questions for ${q://QID346/ChoiceTextEntryValue}, the building you have
identified above.
If you are unsure of any responses, please just answer to the best of your ability.
C2. How would you characterize the:
Interviewer: Read list of responses. Repeat list of responses as needed.
a. Building damage?
b. Contents/inventory damage?
c. Machinery/equipment damage?
None
Minor
Moderate
Severe
Complete
Loss
C3. About what percent area of all the roof cover was damaged or lost as a result of Hurricane Maria?
Interviewer if needed: The roof covering is the exterior part of the roof system that protects the building
from the weather. Common types of roof cover include asphalt shingles, clay tiles, rubber membranes,
and built-up asphalt roofs.
No roof cover damage
Less than 25 %
25-50 %
51-75 %
76-100 %
Don't know
C4. About what percent area of all the roof structures and/or decking was damaged or lost as a result
of Hurricane Maria?
Interviewer if needed: The roof decking and/or roof structure is the intermediate section of the roof
between the internal structural components and the weatherproofing layers. Roof decking and/or
structures include roof beams, joists, or girders, the roof structural members that support the decking,
also precast planks or single or double T for concrete roofs.
No roof structure and/or decking damage
Less than 25 %
25-50 %
51-75 %
76-100 %
Don't know
C5. About how many of the windows and doors were damaged by Hurricane Maria?
Interviewer: Read list
None
A few
Several
Most or all of them
Don't know
C6. How many exterior walls were damaged by Hurricane Maria?
Interviewer: Read list
Interviewer if needed: Damage to the exterior walls of the building can range from very little or no
visible damage, minor damages like marks or dents that need paint or patching for repair, partial failure
of one wall, failure of one wall, to the failure of more than one wall.
None
A few
Several
Most or all of them
Don't know
C6a. How would you describe the damage to the exterior walls caused by Hurricane Maria?
Interviewer: Read list
None
Minor
Moderate
Severe
Complete
Don't know
C7. How would you describe the damage to the interior finishes (ceilings, paint, tile, carpet, etc.) and
contents (furniture, equipment, etc.) caused by Hurricane Maria?
Interviewer: Read list
Interviewer if needed: Interior finish includes things like floors, walls, ceilings, tiles, marble, plastic,
wood, and paint, whereas contents refers to the furniture, appliances/equipment and things inside of
the building.
None
Minor
Moderate
Severe
Complete
Don't know
C8. How would you describe the extent to which water entered the building during Hurricane Maria, in
terms of building space, with 0% meaning no water intrusion and 100% meaning water intruded inside
the whole building?
Interviewer if needed: Water intrusion is the unwelcome and uncontrolled movement of water into a
building. Water intrusion can originate from rain and floods.
Don't know
C9. Did flooding from rising water occur at the building site? For example, within a parking lot or a
walkway leading to the facility.
Interviewer if needed: Flooding from rising water can involve the overflow of inland or tidal waters, the
unusual and rapid accumulation of runoff surface waters from any source, or mudslides.
Yes
No
Don't know
C9a. Did flood water enter the building?
Yes
No
Don't know
C9b. About what was the maximum water height inside the building? (Please provide your best
estimate in meters.)
Don't know
C10. Was equipment mounted on the roof damaged or dislodged by the hurricane?
Interviewer if needed: Roof-mounted equipment includes air conditioners, compressors, conduits,
condensers, pipes, vents, ducts, etc.
Yes
No
Don't know
C11. Was the damage to this building similar to the damage to the other buildings on your hospital
campus?
Yes
No
Don't know
C11a. How would you describe the damage to the other buildings?
Much higher
Higher
Lower
Much lower
C12. When thinking about your entire hospital campus, did the damage cause your hospital to close
completely?
Yes
No
Don't know
C12a. How long did it take for your hospital to reopen at any level of service? (days)
C12b. Did the damage directly inhibit your hospital's ability to provide any services following the hazard
event?
Yes
No
Don't know
The next set of questions asks about the impact of Hurricane Maria on utilities and the back up or
emergency reserves. Please answer to the best of your knowledge. If your hospital does not use a
particular utility, please indicate "Not Applicable".
Utilities
electric power
water/sewer
oxygen
internet/IT
land-line telephone
Section C: Physical Impacts & Repair Q13-16
C13. Did your hospital lose ${lm://Field/1}?
Yes
No
Don't know
Not applicable
C14. About how many days until ${lm://Field/1} was fully repaired? (days)
C15. Did your hospital have backup systems or emergency reserves for ${lm://Field/1}?
Yes
No
Don't know
Not applicable
C16. Did your hospital use backup systems or emergency reserves for ${lm://Field/1}?
Yes
No
Don't know
Back-up system damaged by HM
Not applicable
Section C: Physical Impacts & Repair Q17-Q21
C17. Did utility issues following Hurricane Maria directly inhibit your hospital's ability to provide any
services in 2019 (the year after Hurricane Maria)?
Yes
No
Don't know
C18. Did ground transportation issues (i.e. road/bridge closures) following Hurricane Maria directly
inhibit your hospital's ability to provide any services in 2019 (the year after Hurricane Maria)?
Yes
No
Don't know
C19. Did air transportation issues (i.e. air traffic control, damage to landing pad) following Hurricane
Maria directly inhibit your hospital's ability to provide any services in 2019 (the year after Hurricane
Maria)?
Yes
No
Don't know
C20. What temporary measures were put into place to get your hospital back to a functional state?
Interviewer, READ LIST, select all that apply.
Tents, trailers, or other temporary structures
Prepackaged food (MREs)
Delivery of water
Generators
Other (please describe):
C21. About what percentage of the repairs to your hospital campus were completed ...
Interviewer: Read each statement and record response.
a. In 2019 (approximately 1 year after Hurricane Maria)?
0
%
b. In 2020 (before COVID 19)?
0
%
Total
0
%
Section D: Non-physical Impacts
Section D: Non-physical Impacts
The following set of questions focus on non-physical impacts. The first questions ask about impacts
within the first year after Hurricane Maria. If you are unsure of any responses, please just answer to the
best of your ability.
D1. To what extent were the following a problem within the first year after Hurricane Maria?
Interviewer: Read List, ask
Would you say this was?
a. Employees had trouble
reporting to work due to
transportation problems?
b. Employees had trouble
reporting to work due to housing
problems?
c. Employees had trouble
reporting to work because their
children were not yet back to
school?
Not a
problem
Minor
problem
Moderate
problem
Major
problem
Don't
know
Would you say this was?
d. Employees had trouble
reporting to work because their
children were not yet back to
daycare/childcare?
e. Employees had trouble
reporting to work because of
disaster-related physical health
issues?
f. Employees had trouble
reporting to work because of
disaster-related mental health
issues?
Not a
problem
Minor
problem
Moderate
problem
Major
problem
Yes
No
Don't
know
D2. Within the first year after Hurricane Maria...
[Interviewer: Repeat lead-in for 2b through 2d if needed]
a. did your hospital transfer any patients to other
hospitals as a result of the hurricane?
b. did the utility loss result in the need to transfer
patients to other hospitals?
c. did your hospital accept any patient transfers from
other hospitals as a result of the hurricane?
d. did your hospital accept any patients transferred
from other facilities such as nursing homes as a result
of the hurricane?
Don't know
The next set of questions will reference impacts in the first 2 weeks after Hurricane Maria, or the
second half of September 2017.
D3. Within the first two weeks after Hurricane Maria, were there any DEATHS at this facility directly
related to the hurricane?
Yes
No
Don't know
D3a. Were these deaths from injuries caused by damage to the building (falling ceiling, broken glass,
etc.)?
Yes
No
Don't know
D3b. Were these deaths from flooding (drowning)?
Yes
No
Don't know
D3c. Were these deaths because conditions worsened by loss of power, water or other limitations?
Yes
No
Don't know
D4. Within the first two weeks after Hurricane Maria, were there any INJURIES at this facility directly
related to the hurricane?
Yes
No
Don't know
D4a. Were these injuries from injuries caused by damage to the building (falling ceiling, broken glass,
etc.)?
Yes
No
Don't know
D4b. Were these injuries because of clean-up or recovery activities?
Yes
No
Don't know
D4c. Were these injuries because conditions worsened by loss of power, water or other limitations?
Yes
No
Don't know
Section E: Decisions, Planning and Communication
Section E: Decisions, Planning, and Communication
The following set of questions focus on decisions, planning and communication. If you are unsure of
any responses, please just answer to the best of your ability.
E1. Before Hurricane Maria (in 2017), how would you characterize the culture of your hospital in
relation to natural hazard risks?
Regularly planned for potential natural hazards and set aside funds to minimize risks
Occasionally planned for potential natural hazards and set aside funds to minimize risks
Acknowledged natural hazards risks, but did not have financial or other means to help minimize
risks
Did not discuss or plan for natural hazards risks
Deliberately avoided the topic of natural hazard risks
E2. Please indicate to what extent you agree with the following statement:
Before Hurricane Maria (in 2017), my hospital was adequately prepared for potential hurricane
impacts.
Interviewer: Read list of responses, select one
Agree
Somewhat agree
Neither agree, nor disagree
Somewhat disagree
Disagree
E3. Before Hurricane Maria (in 2017), did your hospital have an emergency plan for natural hazard
events such as hurricanes in place?
Yes
No
Don't know
E3a. What percentage of hospital administration and/or staff was familiar with the plan and its
contents? (%)
E3b. How would you characterize the implementation of the emergency plan during Hurricane Maria?
Interviewer: read list of responses, select one
Very Good
Good
Acceptable
Poor
Very Poor
E4. Before Hurricane Maria (in 2017), how would you rate your hospital's connection to other local
organizations (e.g., businesses, schools, and churches)?
Interviewer: For example, did you co-sponsor events, offer space, or help promote activities of these
organizations?
Would you say:
Interviewer: read list of responses, select one
Very connected
Somewhat connected
Average
Somewhat disconnected
Very disconnected
E5. Before COVID 19 (in 2020), how would you rate your hospital's connection to other local
organizations (e.g., businesses, schools, and churches)?
Interviewer: For example, did you co-sponsor events, offer space, or help promote activities of these
organizations?
Would you say:
Interviewer: read list of responses, select one
Very connected
Somewhat connected
Average
Somewhat disconnected
Very disconnected
Section F: Recovery Q1-Q3
Section F: Recovery
The last set of questions address the recovery of your hospital and surrounding areas. If you are
unsure of any responses, please just answer to the best of your ability.
F1. Regarding the recovery of the entire Commonwealth of Puerto Rico since Hurricane Maria, would
you say it is:
Interviewer: read list of responses, select one
Fully recovered
Partially recovered
Still in survival/response mode
Will never recover (please explain)
F2. Regarding the recovery of the municipios your hospital serves, since Hurricane Maria would you
say the municipios are:
Interviewer: read list of responses, select one
Fully recovered
Partially recovered
Still in survival/response mode
Will never recover (please explain)
F3. Regarding the recovery of your hospital since Hurricane Maria, would you say it is:
Interviewer: read list of responses, select one
Fully recovered
Partially recovered
Still in survival/response mode
Will never recover (please explain)
F4. Before Hurricane Maria, did your hospital have private insurance coverage on any of the following?
The Buildings
The Contents (for
example, furniture,
medical supplies,
medical equipment)
Business interruption
Yes
No
Don't know
Did your hospital file claims for insurance on the following insurance types?
Yes
No
Don't know
Yes
» The Buildings
»
The Contents (for
example, furniture,
medical supplies,
medical equipment)
»
Business interruption
No
Don't know
When did you receive money from the following insurance policy claims? Please provide your best
recollection of the timing of funds received.
» The Buildings
»
The Contents (for
example, furniture,
medical supplies,
medical equipment)
»
Business interruption
Less
than 6
mos
6 - 12
mos
12 - 18
mos
18 - 24
mos
24+
mos
NEVER
Don't
know
5. Did your hospital apply for any of the following assistance types?
Yes
Federal financial
assistance (FEMA,
SBA, HHS,
Medicare/Medicaid,
Other)
Commonwealth/PR
funds
No
Don't know
Municipal government
funds
Private/bank loans
When did you receive funding from the following assistance types? Please provide your best
recollection of the timing of funds received.
Less
than 6
mos
6 - 12
mos
12 - 18
mos
18 - 24
mos
24+
mos
NEVER
Don't
know
»
Federal financial
assistance (FEMA,
SBA, HHS,
Medicare/Medicaid,
Other)
»
Commonwealth/PR
funds
»
Municipal government
funds
» Private/bank loans
Less
than 6
mos
6 - 12
mos
12 - 18
mos
18 - 24
mos
24+
mos
NEVER
Don't
know
F6. To what extent did the following factors make important contributions to your hospital's recovery in
2019 (approximately 1 year after Hurricane Maria)?
Interviewer read: Select either "Major contribution, minor contribution, no contribution or not applicable"
for the following:
Effective leadership and sound
decision making
A clearly understood process for
making and approving decisions
The provision of adequate and
timely financial resources (including
disaster assistance)
Having materials easily accessible
(e.g., building materials)
Having needed equipment
accessible (e.g., construction
equipment, generators)
Being able to hire contractors for
building repairs
Employees
Patients
Recovered utility services
Personal networks/knowing the
right people
Sharing resources with other
organizations in the community
Major
contribution
Minor
contribution
No
contribution
Not applicable
F6a. Of these factors, please rank the 3 most important to your hospital's recovery where 1 is the most
important factor:
Interviewer: Read list
» Effective leadership and sound decision making
» A clearly understood process for making and approving decisions
» The provision of adequate and timely financial resources (including disaster assistance)
» Having materials easily accessible (e.g., building materials)
» Having needed equipment accessible (e.g., construction equipment, generators)
» Being able to hire contractors for building repairs
» Employees
» Patients
» Recovered utility services
» Personal networks/knowing the right people
» Sharing resources with other organizations in the community
END
F7. We would like to hear more from you about your hospital's experience of Hurricane Maria and the
process of recovery through a more discussion-based approach. Would you be willing to share your
hospital's story in a face-to-face interview or by video conference?
Yes
No
Maybe
If you encounter any issues in completing this survey, please feel free to contact the survey helpdesk at
EstudioHMhelp@erg.com or xxx-xxx-xxxx.
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| File Type | application/pdf |
| File Modified | 2021-09-13 |
| File Created | 2021-09-07 |