Severe Weather Preparation: Readiness is Constant, Not Reactive

How a Constant State of Readiness Protects Healthcare Facilities Before, During, and After Severe Weather

Severe weather events such as hurricanes, snowstorms, and ice storms, and are no longer isolated disruptions. They are seasonally predictable operational tests for hospital and healthcare facilities and should be a component of ongoing operational planning. With an influx of less experienced hospital facility managers transitioning into leadership positions in hospitals and systems across the country, we turned to Paul Cantrell for emergency storm preparation insight.

Paul is a retired Vice President of Facilities Management and Planning, Design, and Construction at Beth Israel Lahey Health in Boston. Prior to beginning his facility career, Paul was a Chief Engineer on ocean-going vessels up to the size of aircraft carriers. He sailed through hurricanes and blizzards, while designing, building, converting, and operating the most technologically advanced ships the world had to offer. On the ocean, survival is based on preparation.

The Healthcare Facilities Network is home to this video conversation, with Paul’s key insights captured below.

Constant State of Readiness: Mandatory

For some Facilities Management (FM) leaders, storm preparation is approached as an event-driven exercise, a one-off: a storm is forecast, your teams prepare, systems are checked. But the organizations that perform best during extreme weather don’t rely on last-minute preparation. They operate in what CREF defines as a Constant State of Readiness. Readiness is a proactive, ongoing approach to facilities management that reduces risk, strengthens compliance, and ensures operational continuity every day.

In healthcare environments, the goal is not to scramble to get ready for the storm in proceeding days. It is to be prepared and waiting for the storm to arrive, whether the storm is generated by the environment or by Joint Commission surveyors.

A Constant State of Readiness ensures systems are continuously validated, risks are identified and mitigated in advance, and teams operate with clarity and consistency. Storms and Joint Commission Surveyors can create new problems, but they also expose and at times augment existing problems in hospitals.

Below, Paul illustrates the actions organizations should undertake before, during, and after a significant storm. A more in-depth conversation with Paul is found here.

Pre-Event Readiness: Preparation Before the Forecast

In a reactive model, preparation begins when a storm is predicted. In a Constant State of Readiness, preparation is embedded into daily operations, including:

Continuous Power System Validation Facilities teams should not wait for a storm to test emergency power systems. Generators should be tested regularly under load, fuel levels maintained above minimum thresholds, and transfer switches verified for proper operation. Yes, most hospitals conduct these tests, they are bound to do so, but not all do. But going a step beyond testing, the truly prepared organization understands upstream power sources and potential vulnerabilities to that source.

Further, when power instability occurs, teams operating from a position of readiness can make proactive decisions, such as transitioning to generator power, to protect sensitive infrastructure during the height of storms. This layer of preparedness is being lost as aging employees retire from the FM world.

Ongoing Water System Risk Mitigation Facilities operating in a Constant State of Readiness identify freeze-prone areas in advance. Heat tracing systems are consistently monitored, and low-flow or exposed piping is evaluated regularly. Standing, untreated water presents a continuous risk, not just during storms. Facilities teams must ensure that vulnerable systems are protected year-round.

Identifying and Managing Hidden Risk Zones Freeze failures often occur in areas that are not part of routine focus: vestibules, loading docks, exterior walls, mechanical rooms with outside air exposure, and offsite buildings. These spaces are particularly susceptible to temperature fluctuations and limited monitoring. Targeted walkthroughs should focus on these zones, identifying vulnerabilities before they are exposed under stress.

Eliminating Workarounds Before They Become Risks Unauthorized space heaters and temporary fixes frequently appear during cold weather. While intended to improve comfort, they introduce fire hazards, electrical risks, and compliance issues. More importantly, they indicate underlying deficiencies in system performance. Facilities leaders should eliminate these workarounds and address root causes of system failure proactively.

Staffing and Resource Planning as a Continuous Process Storm readiness depends on having the right personnel available at the right time. This requires continuous planning and not reactive scheduling. Facilities teams should maintain staffing models that support extended coverage, coordinate with contractors in advance, and ensure access to specialized expertise in HVAC, electrical systems, and building automation.

During the Event: Execute from a Position of Strength

Facilities operating in a Constant State of Readiness approach storm management with confidence. They are not discovering vulnerabilities in real time; they are executing against a known plan.

Active Monitoring and Real-Time Awareness During severe weather, teams should monitor wind direction, snow drift patterns, air intake exposure, and filter conditions. Snow infiltration into air handling systems can lead to frozen filters and system shutdowns. Understand your building and know where water intrusion can occur during wind-driven rainstorms. Combining building automation system data with physical inspections ensures a complete understanding of building and system performance during an event.

Proactive Power Management Power conditions can fluctuate rapidly during storms. Facilities leaders must monitor electrical performance closely and act decisively. Transitioning to emergency power before a failure occurs can prevent damage and maintain operational continuity.

Structured Documentation During Operations Storm response often involves manual overrides and temporary adjustments. Without proper documentation, these changes can create long-term operational risk. All actions should be logged, temporary fixes tracked, and systems returned to normal configurations once conditions stabilize. Documenting during real-time creates a how-to book for future leaders.

Post-Event: Where Readiness Becomes Improvement

For many organizations, the storm ends when conditions improve. In reality, the post-event phase is often where the greatest risk—and opportunity—exists.

Managing the Thaw and Secondary Failures As temperatures rise, frozen systems begin to thaw. This can expose hidden damage and lead to delayed failures. Facilities teams should maintain vigilance, inspect critical systems thoroughly, and continue monitoring conditions even after the storm has passed.

Capturing Near Misses as Strategic Data Some of the most valuable insights come from near misses, or those situations where failure almost occurred but was avoided. These events highlight vulnerabilities that may not have caused disruption but represent future risk. Documenting and analyzing these near misses strengthens long-term preparedness.

Driving Continuous Improvement and Capital Planning Storm events create visibility into infrastructure weaknesses. Facilities leaders should use this opportunity to advocate for improvements, secure capital funding, and align long-term planning with operational risk. Often, there is no better time to advocate for more money and support than when the hospital is facing adverse risk. Don’t let it go to waste without trying.

Final Thought: Readiness Is a Daily Discipline

Emergency storm preparation in hospitals is not about reacting to weather events. It is about building systems, processes, and teams that are always ready. As CREF so aptly discusses with clients, Constant State of Readiness ensures that risks are identified before they become failures, systems perform under stress, and teams operate with clarity and confidence. In healthcare facilities, readiness is not storm-dependent, it is continuous.

Top 10 Storm Readiness Actions

1. Know your biggest risks: Prioritize power stability, freezing water systems, and staff availability to prevent cascading failures.
2. Top off and validate emergency power: Ensure generators, fuel levels, and incoming power feeds are fully prepared before the storm.
3. Be ready to switch to generator power: Move to emergency power proactively during instability to protect sensitive equipment.
4. Protect water systems from freezing: Focus on sprinkler systems, exposed piping, and low-flow lines to prevent costly damage.
5. Inspect hidden risk zones: Check vestibules, loading docks, exterior walls, and mechanical rooms where failures often occur.
6. Eliminate unsafe workarounds: Remove non-compliant space heaters and address underlying HVAC or comfort issues.
7. Prepare roof and exterior infrastructure: Stage ice melt, tools, and monitor snow load to reduce structural and access risks.
8. Staff for 24/7 coverage: Ensure continuous support with internal teams and pre-coordinated contractors.
9. Monitor actively during the event: Track wind, snow drift, and system performance through continuous rounds and BAS oversight.
10. Document everything: Capture actions, overrides, and lessons learned to improve future storm preparedness and justify capital needs.