Hospitals and other medical facilities play a key role in the health and well being of a community. They are considered part of a community's critical infrastructure. Much expense and time is spent to make sure that they will remain operational or be quickly restored to a normal operational level when a community is struck by a disaster since people's lives depend on the urgent care that the facility provides with its highly trained staff and state-of-the art equipment. But what happens when the medical facility itself is directly impacted by the disaster event? Not only is it unable to provide expected services to the residents who show up on the doorstep expecting help, but the occupants of the facility (staff and patients) may themselves now be part of the casualty count. While some attention is being put to building structures that are more resilient in the face of severe weather, too many locations that were constructed years or decades ago are not designed to withstand the impacts of straight-line winds or tornadoes. While retrofitting of the building can certainly help, a more critical need is to have advance and specific warning of an impending severe weather event so that staff and caregivers can implement severe weather procedures to protect the patients in their care. Unfortunately, even as the patient census numbers seem to be increasing at many facilities, the number of staff members is declining resulting in situations where there are inadequate personnel available to move patients to less vulnerable locations. Implementing a “Code Black” or whatever other local term is used to denote a need to place people into refuge locations unnecessarily too frequently can diminish the response each successive time. Another factor causing confusion at the least and over reaction at the worse is relying on the sounding of outdoor warning sirens as the ‘trigger” to implement a sheltering process. More and more communities are sounding the sirens for severe thunderstorms with straight-line winds in excess of 70mph; while this action will help people that are outdoors, it only adds to the uncertainty of whether or not the process truly needs to be implemented. To help alleviate this type of situation which too often results in sheltering activities not being completed in time if at all, hospitals and other critical medical facilities must find a better way to increase awareness of severe weather situations that might truly impact their location. Having the strategic information necessary to make an informed decision on whether or not to interrupt facility operations and move forward with emergency sheltering procedures will result in less disruption of everyday activities, better outcomes for the patients and better utilization of staff time. More effective use of a weather risk management tool will have a positive impact on reducing injury and mortality and better preparing the facility staff to survive the storm so that it can continue to provide medical care for an impacted community. This is the bottom line of disaster risk reduction for hospitals.