Rising Waters: The Flood Risk Facing American Hospitals

Introduction

As climate change intensifies, the threat of flooding looms larger over American hospitals, particularly those situated near rivers and coastal areas. A recent investigation by KFF Health News, utilizing advanced flood simulation data from Fathom, reveals that approximately 170 hospitals across the United States are at significant risk of flooding. This alarming trend raises questions about the preparedness of these facilities to handle extreme weather events, especially as storms become more frequent and severe.

The Vulnerability of Peninsula Hospital

Peninsula Hospital, a psychiatric facility located on the banks of the Tennessee River, exemplifies the precarious situation many hospitals face. According to simulations, a severe storm could inundate the hospital with up to 11 feet of water, effectively isolating it from surrounding roads. Aurora, a former patient, described her experience at the hospital, noting that its proximity to the river felt like being trapped in a “moat.” Her concerns highlight the vulnerability of patients in such facilities, who may be unable to evacuate in an emergency.

Covenant Health, which operates Peninsula Hospital, claims to have a proactive emergency planning strategy but has not disclosed specific details about flood preparedness. This lack of transparency raises concerns about the adequacy of their plans in the face of potential disasters.

Nationwide Flood Risk Assessment

The KFF Health News investigation identified nearly 30,000 patient beds across the 170 hospitals at risk. This assessment is particularly critical as many of these facilities serve as essential healthcare providers in their communities. Flooding can disrupt patient care, block access to emergency services, and necessitate evacuations, often leaving vulnerable populations without immediate medical assistance.

Historically, flood risk assessments have relied heavily on outdated Federal Emergency Management Agency (FEMA) maps, which often fail to reflect current realities exacerbated by climate change. These maps, some decades old, do not account for the increasing frequency and intensity of storms. In contrast, private companies like Fathom offer more accurate simulations, although access to this data often comes at a cost, leaving many hospitals reliant on inadequate government resources.

The Consequences of Inaction

Caleb Dresser, an emergency room physician and climate change researcher, expressed concern over the lack of awareness regarding flood risks. “If you don’t have the information to know you’re at risk, then how can you triage that problem?” he asked. This sentiment echoes the tragic lessons learned from past disasters, such as Hurricane Katrina, where inadequate preparation led to the loss of lives in hospitals.

In 2005, Hurricane Katrina exposed the vulnerabilities of healthcare facilities, with 45 bodies recovered from New Orleans’ Memorial Medical Center. More recently, Hurricane Helene in 2024 nearly resulted in a similar tragedy when Unicoi County Hospital in Tennessee was engulfed by floodwaters, prompting dramatic helicopter rescues.

The Role of Government and Policy

The investigation comes at a time when federal support for flood risk management has diminished. The Trump administration’s cuts to FEMA and the dismantling of programs designed to protect critical infrastructure from flooding have raised alarms among experts. Alice Hill, a former climate risk advisor in the Obama administration, warned that these policy changes could lead to catastrophic consequences, stating, “People will die as a result of some of the choices being made today.”

In 2015, Hill helped establish the Federal Flood Risk Management Standard, which mandated that hospitals and other essential structures be elevated or fortified to qualify for federal funding. However, this standard was abandoned in March 2020, further jeopardizing the safety of healthcare facilities.

A Comprehensive Flood Risk Analysis

The KFF Health News investigation utilized Fathom’s advanced flood hazard mapping to assess the risk faced by hospitals. By comparing the locations of over 7,000 facilities to peer-reviewed flood data, the investigation identified hospitals at significant risk of flooding. A “100-year flood,” which has a 1% chance of occurring in any given year, was used as a benchmark for assessing risk.

The findings revealed that hospitals in coastal states like Florida, Louisiana, and Texas are particularly vulnerable, but the threat extends far beyond these regions. Inland hospitals, especially in areas like Appalachia and the Midwest, are also at risk from rising rivers and creeks. Even in the arid West, storms can lead to unexpected flooding, demonstrating that no region is immune.

The Underreported Risk

The investigation likely undercounts the number of hospitals at risk, as it did not include outpatient clinics, nursing homes, or standalone emergency rooms. Oliver Wing, chief scientific officer at Fathom, emphasized that “flood risk is everywhere,” and just because a facility has not experienced flooding in the past does not mean it is safe.

Dresser noted that even minor flooding can incapacitate a hospital, disrupting power supplies essential for life-saving equipment. Rural hospitals, in particular, face unique challenges, often lacking the resources to prioritize long-term flood preparedness.

Urban Flooding: A Growing Concern

Urban hospitals are not exempt from flooding risks either. For instance, Kadlec Regional Medical Center and Lourdes Behavioral Health in Richland, Washington, are situated near a creek that could overflow during a 100-year flood, potentially inundating the facilities. Both hospitals have disaster plans in place but have not provided specific details regarding flood preparedness.

Interestingly, one-third of the hospitals identified as at risk are located in areas that FEMA has not classified as flood hazard zones. This discrepancy raises questions about the reliability of FEMA’s mapping and the potential for hospitals to be caught off guard by flooding.

The Future of Flood Risk Management

FEMA’s flood maps, established in the 1960s, were intended to guide insurance requirements and building codes. However, they are often outdated and do not reflect the current state of flood risk. FEMA has announced plans to modernize its mapping through the Future of Flood Risk Data initiative, but progress has been slow, and public updates have been sparse.

Chad Berginnis, executive director of the Association of State Floodplain Managers, expressed frustration over the lack of communication from FEMA regarding flood risk management. As climate change continues to exacerbate flooding, the need for accurate and timely data becomes increasingly urgent.

Conclusion

The findings from the KFF Health News investigation underscore the pressing need for hospitals to reassess their flood preparedness in light of changing climate conditions. As storms become more severe and flooding risks escalate, healthcare facilities must prioritize emergency planning and invest in infrastructure improvements. The safety of patients and communities depends on proactive measures to mitigate the risks posed by rising waters. Without adequate preparation, the consequences could be dire, echoing the lessons learned from past disasters.

Hospitals at Risk: The Growing Threat of Flooding in Appalachia

A Year After Hurricane Helene: A Community’s Struggle

In September 2024, Hurricane Helene unleashed its fury on Southern Appalachia, leaving a trail of destruction and chaos. Among the hardest hit was Unicoi County Hospital in Erwin, Tennessee, where Angel Mitchell found herself trapped while visiting her ailing mother. As the Nolichucky River overflowed its banks, the hospital, situated in a floodplain, became an island surrounded by rising waters. Staff attempted to secure the facility, but the floodwaters breached the doors, forcing patients and staff to seek refuge on the roof.

Mitchell recounted the harrowing experience, stating, “The lights went out. People fled to the roof, where the roar of rushing water nearly drowned out the approach of rescue helicopters.” Ultimately, 70 individuals, including Mitchell and her mother, were airlifted to safety. The hospital remains closed, and its future is uncertain, raising critical questions about the safety of healthcare facilities in flood-prone areas.

The Broader Context: Flood Risks in Appalachia

The situation at Unicoi County Hospital is not an isolated incident. According to KFF Health News, a recent analysis identified 39 inland hospitals, including 16 in Appalachia, that are at risk of flooding due to rising water levels in nearby rivers and creeks. This alarming trend highlights a growing concern for healthcare facilities built in vulnerable locations.

For instance, Buchanan General Hospital in Virginia is projected to be engulfed by over five feet of water during a 100-year flood event. Similarly, LECOM Medical Center in Erie, Pennsylvania, faces potential flooding from a small drainage creek located less than 50 feet from its emergency room entrance. These examples underscore the urgent need for hospitals to reassess their locations and flood preparedness strategies.

The Risks in Charleston, West Virginia

Charleston, West Virginia, presents a particularly precarious scenario. The city, home to approximately 50,000 residents, is situated at the confluence of two rivers in a wide, flat valley. A single storm could inundate five of the city’s six hospitals, along with schools and emergency services. Behrang Bidadian, a floodplain manager at the West Virginia GIS Technical Center, remarked, “I hate to say it, but it has all the elements of a real disaster.”

At CAMC Memorial Hospital, the largest facility in Charleston, flood modeling predicts that the Kanawha River could bring as much as five feet of water into the emergency room. Across town, CAMC Women and Children’s Hospital could be surrounded by floodwaters, effectively cutting off all exits. The potential for disaster looms large, yet the hospital system has taken steps to mitigate risks. CAMC spokesperson Dale Witte noted that the hospital has elevated electrical infrastructure and acquired flood-proofing equipment, including a deployable floodwall.

Historical Context: The Evolution of Flood Management

The increasing frequency and intensity of flooding events can be attributed to climate change, which has led to more severe weather patterns. Historically, hospitals have been built in areas deemed safe based on past weather patterns. However, as climate change alters these patterns, many facilities find themselves in jeopardy.

The Federal Emergency Management Agency (FEMA) has long recognized the importance of flood risk management, but the challenge remains significant. Hospitals, as critical infrastructure, must not only provide care but also ensure their own safety during emergencies. The lessons learned from Hurricane Katrina in 2005, where hospitals were overwhelmed and patients were stranded, continue to resonate in discussions about flood preparedness.

The Call for Action: Rethinking Hospital Locations

The question remains: Why are hospitals still being built in flood-prone areas? Angel Mitchell’s poignant inquiry reflects a broader concern about the planning and zoning processes that allow such developments. As communities grapple with the realities of climate change, it is imperative for policymakers to reassess where critical infrastructure is located.

Experts advocate for a multi-faceted approach to flood risk management, including stricter zoning laws, improved floodplain mapping, and enhanced emergency preparedness plans. Hospitals must not only invest in physical infrastructure but also in training staff to respond effectively to flooding scenarios.

Conclusion: A Collective Responsibility

The risks posed by flooding to hospitals in Appalachia and beyond are a pressing concern that requires immediate attention. As communities face the realities of climate change, the safety of healthcare facilities must be prioritized. The experiences of individuals like Angel Mitchell serve as a stark reminder of the potential consequences of inaction.

In the face of increasing flood risks, it is crucial for healthcare systems, policymakers, and communities to work together to ensure that hospitals are not only places of healing but also safe havens during emergencies. The time for action is now, as the stakes have never been higher.

Rising Waters: The Growing Flood Risk for Hospitals in the U.S.

As climate change intensifies, the threat of flooding looms larger over many American cities, particularly those with critical infrastructure like hospitals. A recent analysis has revealed that over 170 hospitals across the United States are at significant risk of flooding, a situation exacerbated by climate change and inadequate governmental preparedness. This alarming trend raises questions about the safety of healthcare facilities and the communities they serve.

The Vulnerability of Charleston’s Hospitals

In Charleston, West Virginia, the situation is particularly dire. The city, situated at the confluence of the Elk and Kanawha rivers, faces the potential of severe flooding. According to data from Fathom, a flood-risk modeling company, a severe rainstorm could inundate facilities like CAMC General Hospital with over 10 feet of water on three sides. This risk is not merely theoretical; it reflects a growing reality as extreme weather events become more frequent due to climate change.

Shanen Wright, a lifelong resident of Charleston, expressed a common sentiment among locals: immediate concerns, such as the opioid crisis and economic decline, often overshadow the looming threat of flooding. “It’s not to say it’s not a possibility,” Wright noted, reflecting on the unpredictability of natural disasters. “I’m sure the people in Asheville and Texas, where floods took so many lives, didn’t see it coming either.”

A National Crisis

The flooding risk is not confined to Charleston. Hospitals across the nation are increasingly vulnerable. The analysis conducted by Fathom utilized advanced simulations to assess flood risks, revealing that many hospitals are situated in areas with at least a 1% chance of flooding in any given year. This statistic, often referred to as a “100-year flood,” can occur more frequently than its name suggests, highlighting the urgent need for preparedness.

The historical context of flooding in the U.S. underscores the gravity of this issue. From Hurricane Katrina in 2005 to Superstorm Sandy in 2012, the nation has witnessed the devastating impact of floods on healthcare facilities. These events have prompted some hospitals to take proactive measures, but many remain unprepared.

Government Inaction and Its Consequences

Despite the scientific consensus on climate change and its effects, governmental responses have often been inadequate. The Trump administration, for instance, has been criticized for its dismissive stance on climate change, labeling it as “the greatest con job ever perpetrated on the world.” This skepticism has led to significant cuts in funding and staffing for agencies like FEMA, NOAA, and the National Weather Service, which are crucial for disaster preparedness and response.

Daniel Swain, a climate scientist at the University of California, emphasized the dangers of ignoring climate data. “It’s akin to enforcing malpractice scientifically,” he stated, highlighting the risks of making decisions without considering critical information. The disbanding of FEMA’s Technical Mapping Advisory Council and the cancellation of programs aimed at building resilient infrastructure have left communities more vulnerable to flooding.

The Cost of Inaction

Experts warn that the lack of preparedness will lead to a cycle of flooding, rebuilding, and flooding again. “The president is saying we are closed for business when it comes to hazard mitigation,” said Berginnis of the Association of State Floodplain Managers. This cycle not only endangers lives but also incurs significant financial costs. The need for investment in flood mitigation is urgent, yet it often takes tragic events to spur action.

FEMA’s recent statements have focused on recovery efforts rather than preventive measures. While the agency has provided billions for recovery in states like Texas and New Mexico, the absence of funding for future flood protection remains a critical gap.

Lessons from the Past

Some hospitals have learned from past disasters. The former Coney Island Hospital in New York City, which faced catastrophic flooding during Superstorm Sandy, has since undergone a $923 million reconstruction project. Now known as Ruth Bader Ginsburg Hospital, it features a 4-foot flood wall and elevated patient care areas, making it one of the most flood-proofed hospitals in the nation. However, as CEO Svetlana Lipyanskaya noted, the question of flooding is “not an if but a when.”

The experience of Unicoi County Hospital in Tennessee serves as a stark reminder of the potential consequences of flooding. During Hurricane Helene in 2024, the hospital was surrounded by 12 feet of water, necessitating rooftop rescues for patients and staff. Such incidents highlight the urgent need for hospitals to assess their vulnerabilities and take action.

The Path Forward

The analysis conducted by Fathom utilized sophisticated modeling to identify at-risk hospitals, revealing that many are located in areas not covered by FEMA’s outdated flood hazard maps. This discrepancy underscores the need for updated data and proactive measures to protect healthcare facilities.

As climate change continues to reshape weather patterns, the importance of investing in flood resilience cannot be overstated. Hospitals must prioritize infrastructure improvements, and governments must commit to funding and policies that enhance disaster preparedness.

Conclusion

The growing flood risk for hospitals in the U.S. is a pressing issue that demands immediate attention. As communities grapple with the realities of climate change, the safety of healthcare facilities must be a priority. By learning from past disasters and investing in resilient infrastructure, we can better prepare for the challenges that lie ahead. The water is indeed coming, and it is time to act before it is too late.