In the current world crisis of the SARS-CoV-2 pandemic, hospitals in the United States and across the globe have had to adapt to circumstances that have been unprecedented in many people’s lifetime. Hospitals across the United States have resorted to utilizing their resources at full capacity and even beyond, innovating hospital units in warehouses and tents. Many hospitals in the United States are also trauma centers, which are expected to respond to incidents like a single gunshot wound in a patient, to a mass casualty train wreck. These trauma centers have mass casualty incident preparedness plans, as well as resource capacity or surge plans. However, plans for mass casualty incidents (MCI’s) occurring while at resource capacity is not something commonly planned for, but is important to consider given the current situation. In this paper, we will conduct an extensive literature review of hospitals’ MCI and surge capacity plans. A case study of a trauma hospital in Miami, Florida, and a children's hospital in Little Rock, Arkansas was also conducted by way of a questionnaire. The information gathered led to the conclusion that this facility had a standard MCI plan as well as a surge plan but did not coalesce the two ideas into a single plan, though, as we have seen, an MCI can occur during this pandemic, putting additional stress on hospital facilities and personnel.