Courtesy of New York City Health and Hospitals Corp.

Superstorm Sandy's floodwaters submerged the basement and subsequently inundated nine to 12 inches of the first floor of the Health and Hospital Corp.'s Coney Island hospital.

Health-care owners, contractors and other stakeholders are grappling with a host of issues in Superstorm Sandy's wake. As the storm's waters filled hospital basements and, in many cases, reached first floors, one question that has arisen is where to relocate the information-technology and other critical systems and equipment that typically reside there. While the 2001 terrorist attacks caused many hospitals to install wide-area networks and create remote backup systems, stormproofing is prompting a look into their basements.

Many hospitals in the region's low-lying areas were severely flooded, including the basements of New York City Health and Hospitals Corp.'s (HHC) Bellevue, Coney Island and Coler-Goldwater hospitals. At Bellevue, where water gushed in through two loading docks, more than 200 pieces of "very important equipment" were destroyed in the 186,000-sq-ft basement, says an HHC spokesman. At the Coney Island hospital, waters not only filled the basement but rose nine to 12 inches in the first floor.

HHC's Coney Island community clinic was "obliterated" by the storm, the spokesman adds. HHC had to notify nearly 10,000 patients that their personal information was possibly compromised because, in the storm's aftermath, documents and eight computers were lost, the spokesman says.

"For the last 100 years, the assumption was that our basements were completely usable space for all sorts of things—MEP [mechanical, electrical and plumbing], IT [information technology], storage, kitchens and heavy equipment such as radiation oncology machines," says Stephen Miller, planning director at Continuum Health Partners, a partnership of several New York City hospitals. "Everyone is re-evaluating this now."

One solution would be to relocate some basement-dwelling equipment to the upper floors, even to the rooftop or in penthouses, said speakers at a recent ENR New York health-care conference. But many hospitals do not have room to spare on their upper floors, and those that do would need to install larger ducts.

"If you put all your systems on the very highest floors, to get those systems distributed downward, you have to start with very large ducts and conduits," says Anita O'Brien, project executive at HHC's Harlem Hospital Center. Rooftop systems are also vulnerable to the high winds of severe weather, she adds.

Miller says, "We can only build to a certain size. Mechanical rooms take up a certain area, and as soon as you move them out of the basement, you still have your kitchen" and other critical components to locate. Hospitals prefer to keep patients and offices on upper floors that have windows, and moving IT and other "non-patient items" to those floors could mean sacrificing bed space, he adds.