Editor’s Note: This is the second part of a two-part series covering the Montesano Health and Rehabilitation Center fire of Sept.14, 2022, and will focus primarily on the emergency management and patient transport aspects. The fire itself was covered in a Thursday’s edition of The Daily World.
While firefighters saddled up from multiple departments to tackle the roof fire at the rehabilitation center, a second emergency was unfolding yards from the blaze, as 77 patients, many of them elderly, non-mobile, or otherwise requiring specific medical care, were evacuated from the building.
The evacuation proceeded smoothly, said Sr. Capt. Jeff Smith of the Montesano Fire Department, who took initial command of the incident. Rehab center staff got the building evacuated in minutes, clearing the structure.
“The staff did a phenomenal job, getting the residents to their muster area in the parking lot,” Smith said.
Montesano Police Chief Brett Vance, then serving as public safety director for the city, voiced gratitude for the staff, who made the smooth evac possible.
“Thank god we had a nice summer night. It wasn’t raining. It wasn’t overly cold,” Vance said. “The nursing home was great. They got every blanket imaginable.”
As he took command of the fire a little over an hour after the first alarm, Aberdeen Fire Chief Dave Golding said he was already looking at the expanding scope of the incident, and was in the process of reaching out to Grays Harbor County Emergency Management when they called him first.
“My thought process when I was going to contact emergency management was, I’ve got 80 some people in a parking lot I need to move,” Golding said. “Logistically, I cannot handle that. I need help to move these patients.”
Emergency Management duty officer Nick Falley contacted Golding.
“Upon hearing about the event, we first validated the information by calling on-scene personnel. Once the information was validated, we evaluated how activating the Emergency Operations Center (EOC) could benefit on scene personnel in their response,” said Falley and Deputy Director of Emergency Management Hannah Cleverly in an email. “Once that was identified, the EOC was activated to support the response.”
As the incident developed, the Montesano School District quickly offered the gym of the junior high school as a collection point for the residents. Transporting them was an effort undertaken by multiple groups, Vance said.
“We called transit. We called our school district. They started bringing buses,” Vance said. “The school has been a great partner, a great neighbor. The school district and the city have always worked great together.”
Transport was complicated by the logistical requirements of some of the patients, Vance said— many were non-ambulatory, requiring buses with provision for handicapped people. Golding praised the Montesano police for getting that side of the issue organized and moving.
“We needed buses. School buses are one thing. We realized we needed transit lift buses,” Vance said. “Not only did they have to get the people to the facility, they had to get their med carts over there. They had to get oxygen.”
When he got off the fire scene, Golding visited the gym to check in.
“I was impressed. This gym was set up really well,” Golding said. “The incident management team did a great job. They did what they were trained to do. They mitigated that aspect of the incident.”
Vance praised the community spirit of Montesano; residents buying hundreds of dollars of goods at the grocery store and bringing them to the gym, trying to ensure any possible need the patients evacuated there was met.
“Our community had stuff delivered to the gymnasium,” Vance said. “Everything from Depends to juices to water to pizzas. People just started buying stuff and taking it to the gymnasium.”
With the patients out of immediate danger, the question of what to do next with them came to the fore. Emergency Management, working with the Northwest Healthcare Response Network, began working the problem, Golding said.
“They were reaching out, starting that ball rolling pretty early on their own,” Golding said. “That was part two of the emergency management group. They stood up a whole emergency management team for this. Part of that was finding destinations.”
Beds across the state had to be found, quickly and after hours, for all 77 patients. Chief John R. Batiste of the Washington State Patrol reached out early to see what was needed, Vance said.
“This was predominantly driven by the Northwest Healthcare Response Network. They activated a virtual Emergency Operations Center and worked closely with Montesano Health and Rehab to track the displaced and unique needs of each resident,” Cleverly and Falley said. “From there, the Network worked with healthcare facilities across the state to assess their capacity to accept additional residents.”
Locating places to go didn’t solve the other half of the problem — transporting them to those disparate locations that had available space.
“When the need for moving residents was identified, we assisted Chief Vance in requesting Washington State Fire Mobilization from the Washington State Patrol’s Fire Marshal Office to allow for ambulances from agencies outside of Homeland Security Region 3 to respond to the temporary shelter and move them to identified facilities within the state,” Cleverly and Falley said.
Medic units responded from counties across Washington, making their way to Montesano to transport patients from the collection point in the gym as soon as somewhere to land could be found for them. The Emergency Management team reached up to the state level, activating mechanisms in place to see what out-of-county resources were available, Golding said.
“I want to say they pulled a page out of the state mobilization handbook and did a resource request outside the county for multiple medic units,” Golding said. “They were able to pull transporting units from Pierce, Thurston, Lewis and Pacific county.”
The turnout was geographically impressive, Smith said.
“It was a show of resources. We had a lot of people and ambulances from all over the state,” Smith said. “It was a parade of ambulances.”
Vance said that when he cleared the fire scene when the last patients were evacuated and went to the gym, ambulances were lined up, evacuating patients as destinations were locked in.
“I stayed at the fire until the last bus was getting over there,” Vance said. “It was pretty impressive to show up and have nothing but 20 or 30 ambulances.”
The first ambulance left the gym at 8:39 p.m., Cleverly and Falley said, when the Washington State Patrol gave the nod to start moving patients. The last patient was cleared before 2 a.m., Vance said.
“Emergency Management was instrumental in making that process run smoothly,” Golding said. “Smoother than anyone ever thought it possible.”
The strength of the wolf is the pack; without close coordination between the various departments and agencies, local, county and state, this response, without a single casualty from the fire itself, would not have been possible, Cleverly and Falley said.
“A response of this level cannot be executed by any one agency in Grays Harbor County. This truly took a county-wide, region-wide, and state-wide response to make it happen,” Cleverly and Falley said. “We are beyond thankful for all of the response partners that came to assist Grays Harbor County and the city of Montesano last September.”
Long after the fire was extinguished and the patients were rehomed, organizations across the county are still applying the lessons learned on that September evening.
“From this incident we learned many things. Two areas that we focused on to learn from this event were communications and resource ordering,” Cleverly and Falley said. “With communications, there was a lack of timely and accurate public information. When it comes to resource ordering, this event showed how little resources we have available within Grays Harbor County. It took time to find the right people to fill the right roles to make this event move forward.”
It was the first time the division had gotten involved in this manner to an ongoing incident, Cleverly and Falley said.
“This was a very unique situation,” Cleverly and Falley said. “We were glad that we were in a position to be able to assist in facilitating the successful resolution to this event.”
Golding said it was eye-opening, seeing Emergency Management lean into the incident in a way not previously seen.
“They’ve done a lot of things over the years. But in recent history this would be kind of their biggest dive into an ongoing actual incident. When it gets down to a fire, they’re not really thought of,” Golding said. “Without their assistance I don’t even want to think how the patient movement would have gone. It probably would have been a disaster itself.“
Plans to reopen the facility have swirled around, but a hard answer to what comes next is unsure. Calls to the facility go unanswered. A conversation with Genesis HealthCare, the holding company that formerly owned the facility, say that it’s been sold to another management company.
“Hopefully it gets repaired and everyone can come back soon,” Smith said.