HLM: How will you be compensated for treating the patients transferred from Palisades?
Garrett: "With an emergency situation the sending hospital, the receiving hospital and the insurance companies get together to work out a fair settlement. There is nothing really prescribed ahead of time when something like this happens because usually they don't make those contingencies.
Whether it is Medicare or a private insurance company, those will be worked out. With Medicare it will be worked out through a fiscal intermediary and with the private insurance companies it will be worked out directly with those insurance companies—in our case Palisades and Hackensack together."
HLM: There have been some suggestions in the media that New York University Langone Medical Center in Manhattan was not adequately prepared for this disaster. Is that criticism fair?
Garrett: "It's tough. It is always easy to be the Monday morning quarterback. But these are tough decisions to make. If you overreact, people criticize you as well. You can be accused of disrupting patient care. At NYU they had to move a lot of critical care patients, even patients who'd just had liver transplants.
You can imagine that if they overreacted and the storm didn't come or wasn't as bad as it turned out to be there would be criticism on the other side that you might have endangered patient care by overreacting.
These are difficult decisions. My advice would be, let the dust settle. Once everything gets back to normal in a couple of weeks let's do a fair critique. Let's see what information was available at the time and come to see how we can do things better."
HLM: Do you have advice for other hospital leaders who may someday face a disaster threat?
Garrett: "Always prepare for the worst and get ahead of it. As much as you may think you are ahead of it use the time wisely to really plan and get staff involved. We here have a great team effort and team culture. That helps. If you can build that culture when you have a disaster of this magnitude it is enormously helpful."