Disasters are events caused by man-made mechanisms or nature-induced actions. A medical surge exists when mass causalities occur and individuals are transported to the hospital. This study was performed to explore the attitudes of hospital executives towards disaster preparation and the provision of services during a disaster. The problem addressed in the current study was that hospital executives in Florida and the Gulf Coast do not place management emphasis on disaster preparedness and readiness. This research was a phenomenological qualitative study in which surveys were used to gather hospital executives' reactions to disaster preparedness. The theoretical framework for this study was based primarily on the dynamic balance model, social justice, public policy window theory, and the economic models of cost benefit and cost utility analysis. The attitudes of 39 Gulf Coast hospital executives were explored. Key results showed that hospital executives viewed the procurement and maintenance of supplies and staffing as a paramount role. Hospital executives also viewed process management and intradepartmental meetings as a necessary management tool. In terms of fiscal management, their main attitude toward funding disaster related care was to borrow from capital fund projects. Finally, they saw the need to collaborate with other health agencies in their communities as well as government administrators and legislators. The conclusions were that there were areas and opportunities for improvement that hospital executives could address. Hospital executives should increase disaster readiness and preparation by activating their experts in clinical and patient care services to monitor the ongoing use of hospital beds. In this way the hospital executive could ensure that there are always beds available for critical mass causalities. Hospital executives could also use these experts in patient care to monitor and ensure quality. Finally, the chief fiscal officer of the hospital needs to be alerted to ensure that patient care that can be billed for from third parties is maximized by obtaining correct billing information and ensuring that the patient care clinical staff correctly identify billable procedures. Future research should include surveying all hospital executives, examining other geographic areas with different disaster types, and community health and government collaborators.