Natural disasters are a part of the ecological system, so they are beyond human control. To reduce devastating effects, researchers in Emergency Management seek to understand the causes and cycles of natural disasters so that warning systems may be improved and better advice may be given to the general public about protecting themselves and their property. Emergency management is a relatively new discipline, so much research is still needed to understand the complex interaction of human activity and the natural environment. Therefore, this study was designed to explore the impact of the 2009 flood on the healthcare system in Fargo, North Dakota, and Moorhead, Minnesota, when many health facilities were evacuated. This research is unique because it examined the simultaneous evacuation of multiple healthcare facilities: two Fargo hospitals, all Fargo nursing homes, and the largest Moorhead nursing home. A qualitative approach was used: 27 in-depth interviews were conducted with leaders of the healthcare facilities and other involved parties (e.g., community officials, ambulance providers, public health personnel) to understand their decisions and actions as a record flood triggered evacuations. The researcher found that (1) the healthcare facilities had done minimal pre-planning and preparation for the flood, even though the area had been threatened by previous flooding, and (2) each facility wasted time and resources by working independently to arrange transportation and to locate alternative healthcare facilities to house their patients. The recommendation is made that healthcare facilities coordinate their efforts during natural disasters.