In 2018, Oregon earthquake specialists held a preparedness workshop in Newport for the state’s 11 coastal hospitals. They knew a major Cascadia earthquake and tsunami would cut water and power supplies to the area and would devastate the transportation infrastructure, turning communities into islands that would have to fend for themselves. They wanted coastal hospitals to be prepared -- and none was.
That prediction startled one of the attendees, Dr. Lesley Ogden, CEO of Samaritan North Lincoln Hospital in Lincoln City and Samaritan Pacific Communities Hospital in Newport. She realized that the earthquake planning for the company’s hospitals would fall short.
“This was the first time I realized the full extent of the devastation that could occur and what we would be faced with,” Ogden said.
Samaritan Health Services ramped up its planning to ensure that its two hospitals on the coast would meet the highest earthquake standards. It built an addition to its hospital in Newport that opened last year and remodeled the old building on site, bringing it up to earthquake standards.
Then this month it opened a new hospital in Lincoln City. State engineers say that facility sets a new benchmark for earthquake readiness not only among hospitals but also among all new buildings in the state.
“It has one of the highest standards of new buildings in Oregon,” said Yumei Wang, resilience engineer at the Department of Geology and Mineral Industries in Salem. “It’s designed to withstand a very significant earthquake like a magnitude 9.”
Samaritan hired an architectural firm, HGA, and a builder, Skanska, that have extensive experience building hospitals and medical facilities in California, and it brought on a facilities director who had experience running hospitals in the San Francisco Bay area.
“We had a level of earthquake resiliency knowledge with our design and build team that I don’t think a whole lot of people necessarily have in Oregon,” Ogden said. “We believe that this hospital has as good (a chance) as any of surviving even a 9.0 Cascadia event.”
The former hospital, about 50 years old, would not have withstood a strong quake. It was made out of wood and the ground is not stable, containing sediment that would likely liquefy with violent shaking.
The architects accounted for that in the new building by securing it with 91 pilings driven 60 to 80 feet into the earth. The building itself, which is mostly concrete, has metal support beams attached to the pilings.
And inside the building, which spans 50,000 square feet, all of the 90-degree connections of wiring and tubing are flexible instead of being rigid.
“Anytime two pieces come together in a rigid format, that is a potential for failure, and so our design included taking that failure point out,” Ogden said.
In terms of services, the new hospital has the same staff and offers the same care as the old building. As before, it is a critical access hospital, a Centers for Medicare & Medicaid Services program that aims to encourage hospitals to locate in rural areas that are underserved by medical services. To qualify, a hospital can have a maximum of 25 beds and must offer 24/7 emergency care, be located more than 35 miles from another hospital and have an average length of stay of 96 hours. In exchange, it receives bigger reimbursements than other hospitals because they’re based on cost - not determined by set rates.
“That allows us to stay here and operate,” Ogden said.
The hospital serves Lincoln City and beyond, stretching south to Depot Bay and northeast east to Rose Lodge, an area of 25,000 people.
The old hospital had 25 beds but many were often empty. So the hospital has 16 with the possibility to expand.
North Lincoln has the same staff -- with 28 physicians, 16 physician assistants or nurse practitioners and 107 nurses -- though Ogden suspects they’ll have to hire more employees as demand steps up.
Its services include family and internal medicine, pediatrics, orthopedics, urology, birthing suites and surgery but it does not have an ear, nose and throat expert, an endocrinologist, rheumatologist or neurologist.
“We don’t have the population to support that,” Ogden said.
The hospital brings in cardiologists and nephrologists or kidney specialists a few times a week from its hospitals in Albany or Corvallis.
One addition to the hospital involves concierge service for patients. They walk in, check in and then go to what’s known as an out-patient flex room where they can have their blood drawn and get a pre-surgical screening.
“All of these services are coming to the patient so the patient never has to find anything in the hospital - they just step through the door,” Ogden said.
Though the hospital is open and running, the planning has not stopped. Ogden said the administration is now working on ensuring that both of Samaritan’s hospitals on the coast can remain independent while waiting for the infrastructure to be rebuilt so supplies can arrive.
Neither hospital is in a tsunami zone, but they’re likely to be isolated after a big earthquake and need their own water, food, power and supplies.
“On the coast, the hospitals need to be self-sufficient for three weeks because it would take the state and the feds that long to provide support because the transportation system would be down,” said Wang, of the Department of Geology and Mineral Industries.
Samaritan is looking into building a fuel depot or possibly sharing one with Lincoln City and setting up a filtration system that could filter water out of a nearby lake. And in Newport, two dams in the city will likely break in the event of a big quake.
“The biggest issue for us is water and power,” Ogden said.
The hospital system is not the only one working on upgrades. By 2022, all hospitals in the state have to meet what’s known as life safety standards, which means the buildings have to be able to withstand strong shaking so that people can at least be out.
But there’s no state law that requires that hospitals be self-sufficient and meet the standards that Samaritan set.