San Angelo may not be in a hurricane zone, but local health-care facilities have disaster relief plans for other emergency situations.

San Angelo Community Medical Center initiated a partial disaster plan in December 2006, when much of the southwest area of the city was without water, said Rebecka Zemlock, a hospital spokeswoman. The hospital received assistance from tanker trucks that brought in water, and medical personnel canceled elective surgeries.

A tornado in 1995 did damage to one of the upper floors of Shannon Medical Center, said Lyndy Stone, a hospital spokeswoman. The hospital initiated a disaster relief plan both to address how it needed to adjust because of the damage and to help larger numbers of people seeking care.

Heather Tiftickjian, a registered nurse and an emergency services director at Shannon, recalled another time when a bus transporting prisoners was involved in a crash. A type of disaster plan was put into effect because the prisoners had to be accompanied by guards while they were getting medical treatment.

Officials at both hospitals said they could not recall a time when the entire facility had to be evacuated because of a natural disaster.

Both Community and Shannon said each department of the hospitals has a plan that outlines how to respond depending on the emergency situation. Both hospitals practice disaster drills at least twice a year and sometimes include city entities, such as the fire and police departments, in the drills.

Afterward, the hospitals evaluate their performance during the drills and try to devise plans to make things run more smoothly.

"The hardest thing is still taking care of patients during the drill," Zemlock said.

Neither hospital moves real patients during drills.

Zemlock said Community develops its evacuation plans and the hospital's parent company, Community Health Systems Inc., approves them.

As the lead trauma facility in the region and a Joint Commission-accredited hospital, Shannon follows evacuation standards set by the not-for-profit organization, said Dale Droll, director of engineering for the hospital.

Shannon has an internal disaster plan, as well as plans for how to deal with regional and state disasters.

Tiftickjian said Shannon's communications center plays a big role in disaster-relief plans. The hub, which is part of the hospital's trauma center, works to communicate with the AirMed1 helicopter, local emergency medical services, and other hospitals.

Ron Perry, county emergency management coordinator, said each nursing home in the area has to have an evacuation plan and an emergency management plan that outlines where patients would go and how they would get to those alternative sites. Perry and a fire marshal must review the plans.

Nursing homes frequently have agreements with other nursing homes to take in residents during emergencies, Perry said.

"It doesn't have to be a natural disaster to call for an evacuation," Perry said.

He cited an incident last summer in a Dallas-area nursing home where residents were evacuated when the facility's air-conditioning system failed.