During superstorm Sandy four city hospitals were forced to evacuate, three of the hardest hit had to halt crucial services like emergency room operations for weeks or months. NY1's Erin Billups reports on whether these hospitals are prepared for the next big storm.

As Hurricane Sandy sent the East River surging across the FDR drive, officials at city-owned Bellevue Hospital realized they faced a dire situation.

"The basement filled up very quickly and that's when we began to lose a lot of our critical infrastructure that really put us in a dangerous situation," said Michael Rawlings, Chief Operating Officer of NYC Health + Hospitals/Bellevue

The hospital had lost its power from Con Ed and by 11:30 p.m., staff calculated they only had 30 minutes before the rising waters flooded the fuel tanks for the generators, and crucial electrical switches.

"There were patients that were on critical equipment ventilators and such." said Marcy Pressman, Deputy Executive Director, NYC Health + Hospitals/Bellevue. "There was no way we were going to let anything happen to our patients."

Staffers quickly organized a bucket brigade. Every available hand passed buckets of diesel fuel up 13 flights of stairs to the back-up generator for 12 hours, until the National Guard relieved them.

Every patient survived.

In the aftermath of Sandy, resiliency plans were drafted to prepare for the next big storm. Five years later, the result is a tale of two cities.

Privately-owned NYU Langone Medical Center has funded and built state of the art flood protections.

"What we are doing now, is sort of third and fourth level of resiliency that gives us sort of flexibility and will enable us to withstand a Sandy level event, plus seven feet higher than that," said Paul Schwabacher, Senior vice president facility manager of NYU Langone Medical Center.

Paul Schwabacher is the senior facilities manager at NYU Langone Medical Center, the hospital's point person for implementing a multibillion-dollar series of resiliency upgrades. 

Paid for by its own $6 billion capital expansion and a $1.3 billion federal emergency management agency grant. 

These hydraulic flood barriers have been installed outside every entrance facing the East River.

Three new buildings have been built, all with reinforced, waterproofed concrete and flood-proof elevators.

Inside, like a submarine, the hospital's basement has multiple layers of protections.

"So if for some reason, we had a problem with the exterior barrier we would have this closed and then it would just prevent the water from continuing so the whole campus is segmented," said Schwabacher.

The energy building is the crown jewel of NYU's resiliency efforts, its own power plant.

"So what this gives us is on site generation of more power," said Schwabacher.

NYU's facility manager says he's confident the hospital could continue serving patients during the next Sandy.

Officials at NYC Health and Hospitals say they too, are better protected.

But, the resiliency work at the city-run facilities is less ambitious and is proceeding at a far slower pace because of financial constraints and bureaucracy.

One of those facilities is Coney Island Hospital in Brooklyn. 

"The water made its way up Ocean Parkway into the campus here and put I'd say about a foot of water on the first floor," said Dan Collins, Facilities Director at Coney Island Hospital.

A concrete flood wall remains in the planning stages, but for now, Coney Island Hospital is relying on walls around the perimeter.

"It's filled with sand, about four and a half feet high, it's about 2,600 linear feet around the entire perimeter," said Collins.

The sand walls have been in place for over a year and will be the main barrier for the hospital for the foreseeable future.

Less than half of the $1.7 billion FEMA allocated to city-run hospitals, to share, has been spent.

At Coney Island, there is a plan to replace a parking lot with a new building to house an elevated emergency room, but the hospital would not say when that will happen. 

At Bellevue, electrical switching has been moved up, high pressure water pumps were installed above flood levels and flood doors have been installed in the basement.

"We are certainly a lot better prepared today to deal with flooding than we were pre-sandy but I think until our five hundred year flood wall goes up along the FDR will we really feel like we are able to defend in place here," said Rawlings. 

But the city's plan for that barrier has been delayed and is at least seven years out from completion.