This article was initially published by KFF Health News, a nationwide newsroom dedicated to comprehensive journalism focused on health matters.
In the event of a severe storm, Peninsula Hospital could find itself entirely submerged.
This long-established psychiatric facility located near the Tennessee River could be engulfed by as much as 11 feet of water during a major storm, effectively isolating it by severing all surrounding road access, as per an advanced computer flood risk simulation.
Aurora, a young woman who was hospitalized at Peninsula as an adolescent, remarked on its proximity to the river, likening it to a moat confining her and many others within. KFF Health News has chosen not to disclose her full name due to her sharing of sensitive medical information.
“Doom is the first thought that comes to mind,” Aurora expressed while observing the simulation of the river encroaching upon the hospital. “These are among the most vulnerable individuals here.”
Covenant Health, the operator of Peninsula Hospital, stated in a press release that it implements a “proactive and comprehensive emergency planning strategy” but did not elaborate or respond to specific inquiries.
Peninsula is one of approximately 170 hospitals across the United States, encompassing nearly 30,000 beds, identified as being at the highest risk for significant flooding. This awareness comes from a lengthy investigative effort by KFF Health News, utilizing data shared by Fathom, a company at the forefront of flood simulation technology. At several of these hospitals, potential flooding from heavy storms poses serious challenges to patient care, obstructs access to emergency services, and may necessitate evacuations—often leaving no alternative healthcare facilities within a reasonable distance.
Significantly, much of the potential flooding risk associated with hospitals is not reflected in the flood maps issued by the Federal Emergency Management Agency (FEMA). These maps have been the standard for flood risk assessments for over fifty years, despite being outdated and occasionally incomplete. As FEMA’s maps become disconnected from the realities posed by climate change, private firms like Fathom have emerged, offering predictive flood simulations. However, access to many of their forecasts is restricted, leaving the public primarily dependent on free but limited governmental resources.
“This situation is extremely alarming,” said Caleb Dresser, a climate change researcher who also works as an emergency room physician and serves as an assistant professor at Harvard University. “Without adequate information on flood risks, how can we prioritize emergency responses?”
The most deadly instance of hospital flooding in recent U.S. history happened two decades ago during Hurricane Katrina, leading to the tragic deaths of 45 individuals at New Orleans’ Memorial Medical Center, including patients who investigators believed had been euthanized. Just last year, an overwhelming influx of water during Hurricane Helene nearly resulted in more fatalities when helicopters had to rescue many from Unicoi County Hospital in Erwin, Tennessee.
Rebecca Harrison, a paramedic, called her family from the rooftop to bid farewell.
“I was absolutely terrified, thinking, ‘This is the end,’” Harrison recounted in an interview with CBS News, which followed Unicoi survivors as part of KFF Health News’ detailed examination. “It was utter chaos—alarms ringing, screams echoing everywhere.”
This investigative report, one of the first to assess hospital flood risks amidst an era of climate change and increasing storm severity, coincides with significant cuts by the administration of Donald Trump to federal agencies charged with climate forecasting and emergency management, including FEMA programs intended to safeguard hospitals and critical infrastructure from flooding.
FEMA, when approached for comments, acknowledged that flooding is both a prevalent and costly disaster, yet their response lacked specifics regarding hospitals. FEMA spokesperson Daniel Llargués defended policy changes by stating they are a response to inefficiencies under previous administrations.
Alice Hill, a former climate risk advisor for the Obama administration, criticized the current administration’s disregard for climate and flood risks, predicting that such negligence will result in significant loss of life and financial strain.
In 2015, Hill spearheaded the Federal Flood Risk Management Standard, stipulating that hospitals and other essential facilities must elevate or enhance flood protections to secure federal funding.
However, FEMA ceased enforcement of this standard in March.
“Lives will be on the line as a direct consequence of these decisions being made right now,” Hill asserted. “We will not be as prepared as we ought to be, and truthfully, we weren’t prepared enough even before these changes.”
‘Flood risk is pervasive’
KFF Health News identified over 170 hospitals at risk of flooding by analyzing the locations of more than 7,000 medical facilities alongside peer-reviewed flood hazard mapping by Fathom. This UK-based entity utilizes precise elevation data from the U.S. Geological Survey to simulate flooding scenarios.
Hospitals were categorized as being at significant risk if Fathom’s 100-year flood data indicated that a foot or more of water could affect a substantial portion of their structures or restrict access to the hospital. A 100-year flood represents an extreme event with about a 1% annual chance of occurrence, although such events can be more frequent.
The investigation revealed alarming flood hazards for critical trauma centers, rural hospitals, facilities devoted to pediatrics, and long-term care establishments catering to elderly and disabled patients. At least 21 of these hospitals serve as critical access points, with the next nearest healthcare facility found an average of 25 miles away.
Numerous hospitals situated in coastal regions, predominantly in Florida, Louisiana, Texas, and New York, are under threat from flooding. Additionally, hospitals located further inland may face risks from rising river or creek levels, particularly in regions like Appalachia and the Midwest. Even in typically arid areas of the Western U.S., extreme storms can result in several feet of water accumulating around hospitals, according to data supplied by Fathom.
The research likely underestimates the number of hospitals at risk, as it did not account for potential flooding at some facilities and did not include independent ERs, outpatient centers, or nursing homes.
“The reality is that flood risk pervades every area. It is the most widespread of threats,” stated Oliver Wing, scientific officer at Fathom, who reviewed the investigative outcomes. “Just because a region hasn’t suffered an extreme flood previously doesn’t guarantee immunity in the future.”
According to Dresser, the emergency room physician, even minor flooding can incapacitate an unprepared hospital by disrupting power supplies essential for life-saving equipment like ventilators and cardiac monitors, with rural hospitals likely being the most at risk.
“Many rural hospitals are eliminating pediatric and psychiatric units,” Dresser noted. “In their financially precarious states, long-term threats can be hard to prioritize, even when they could threaten the very existence of some institutions.”
Urban hospitals are also susceptible to severe flooding. Data from Fathom indicates a risk of 5 to 15 feet of flooding around Kadlec Regional Medical Center and Lourdes Behavioral Health, both located on either side of a small creek in Richland, Washington.
According to Fathom’s assessments, a 100-year flood could potentially cause the nearby Columbia River to overflow its levees, leading to flooding that could affect the hospitals following creek patterns accumulating tons of water surrounding them. Lourdes Behavioral Health, constructed on land intended for water storage by the U.S. Army Corps of Engineers in 1961, might be particularly vulnerable, with the ability to contain enough water equivalent to at least 40 Olympic-sized swimming pools.
Both Kadlec and Lourdes indicated they have disaster response strategies in place but did not provide comments concerning flood preparedness. A spokesperson for Lourdes stated that FEMA flood maps do not classify their facility as being within a 100-year floodplain.
This scenario is not isolated; among the 170 hospitals projected to face significant flood risks, roughly one-third are sited in areas that the FEMA flood risk maps do not designate as hazardous.
Sometimes, the discrepancies are stark. Ochsner Choctaw General in Alabama, the only hospital within a 30-mile radius, is highlighted by FEMA as a facility that would remain unaffected by flooding based on its maps. Conversely, data from Fathom foresees that a similar flood situation would lead to flooding impacting most of the hospital, including the ER and the helicopter landing site.
FEMA flood mapping began in the 1960s under the National Flood Insurance Program, aiming to identify areas requiring insurance and necessary flood-proofing in building codes. According to FEMA, these maps represent a “snapshot in time” and are not meant for predicting future flooding scenarios.
FEMA spokesperson Geoff Harbaugh mentioned that modernization efforts for their maps are underway through the Future of Flood Risk Data initiative, aimed at better predicting flood risks and providing invaluable information for safeguarding lives and property.
This program was launched under the first Trump administration in 2019, yet has issued scant public updates. Harbaugh did not disclose specific timelines for this program.
Chad Berginnis, executive director of the Association of State Floodplain Managers, expressed uncertainty regarding whether FEMA is advancing map updates, citing diminished communication with external experts on flood risks.
“There has been a complete cessation of communication, which I find unprecedented,” Berginnis lamented.
With worsening climate conditions, floods are expected to intensify, jeopardizing previously stable regions while inundating already flood-prone areas. The National Oceanic and Atmospheric Administration has reported that 2024 has set a record as the warmest year, surpassing the previous 20th-century average by more than 2°F. Scientists worldwide estimate that every additional degree of warming correlates with a 4% increase in extreme rainfall intensity.
“Bringing warmer air results in greater moisture retention, which leads to heavier rainfall,” explained Kelly Van Baalen, a sea level rise expert at Climate Central. “What constitutes a 100-year flood today might redefine as a once-in-a-decade flood in the future.”
This worrying scenario raises concerns specifically about Peninsula Hospital, a facility that has functioned a mere few feet from the Tennessee River for years, despite lacking a recorded history of flooding.
Hospital spokesperson Josh Cox stated that the Tennessee Valley Authority oversees the river, utilizing dams to manage water levels while producing electricity. TVA forecasts claim these dams could protect Peninsula even in a 500-year flood event.
Fathom’s flood simulations take these protective measures into account, emphasizing that even the best dams could falter under extreme storm conditions. Their predictions are supported by another modeling entity, First Street, which also warns that severe storms could provoke flooding exceeding 10 feet around Peninsula Hospital.
“This hospital is situated right beside a significant river in the United States,” noted Wing from Fathom. “It is improbable that such a location is devoid of risk.”
Jack Goodwin, 75, a retired TVA worker, has resided close to Peninsula for three decades and felt assured in the dams’ capabilities. After reviewing Fathom’s assessments, however, he began researching flood insurance options.
“Water has the potential to rise rapidly, and the devastation it brings is immense,” Goodwin expressed. “Just because we’ve never experienced a flood here doesn’t mean it’s not possible in the future.”
‘Every aspect of a true disaster is present’
One year ago, during Hurricane Helene, Angel Mitchell found herself visiting her ill mother at Unicoi County Hospital situated in Erwin, Tennessee.
The hospital was overwhelmed by the nearby Nolichucky River, which swelled from the storm, surging over its banks. Despite staff efforts to secure the doors, water intruded, trapping patients and visitors. The power went out. Amid the panic, people ascended to the roof while rescue helicopters battled to reach them amidst the din of rushing water, Mitchell noted.
Ultimately, on September 27, 2024, 70 individuals, including Mitchell and her mother, were airlifted to safety. The hospital remains closed, with its owner, Ballad Health, declaring that its reopening timeline is uncertain.
“Why would a hospital be built in such perilous proximity to danger?” Mitchell asked CBS News. “Communities rely on these facilities for essential medical assistance, yet they raise serious safety risks.”
Beyond Unicoi, KFF Health News pinpointed 39 inland hospitals—16 of which are situated in Appalachia—where Fathom’s projections suggest they could flood when adjacent rivers, creeks, or drainage systems overflow, even during less severe storms.
For instance, just in the Cumberland Mountains of Virginia, a 100-year flood is forecasted to inundate Buchanan General Hospital with over 5 feet of water.
Additionally, in Erie, Pennsylvania, LECOM Medical Center and its Behavioral Health Pavilion stand at risk of flooding because a small drainage creek is located less than 50 feet from the front doors of their emergency department.
Neither facility has responded to inquiries regarding flood risk or their preparedness.
Meanwhile, in Charleston, West Virginia, situated at the confluence of two rivers in a spacious valley housing approximately 50,000 residents, one storm could potentially inundate five of the city’s six hospitals alongside schools, churches, fire stations, and other essential structures.
“Regrettably, I must admit that all components of a genuine disaster scenario are present here,” noted Behrang Bidadian, a floodplain manager at the West Virginia GIS Technical Center.
At Charleston’s largest medical facility, CAMC Memorial Hospital, Fathom’s assessment indicates it could be surrounded by up to 5 feet of flooding from the Kanawha River. Meanwhile, another of the city’s facilities, CAMC Women and Children’s Hospital, may likewise become stranded due to Elk River flooding.
At the urban core, where the rivers are predicted to converge, Thomas Orthopedic Hospital could be besieged by over 10 feet of water from three directions.
WVU Medicine, which manages Thomas Orthopedic Hospital, has not responded to multiple requests for comments.
Dale Witte, spokesperson for CAMC, affirmed their awareness of flooding risks and mentioned that preparations have been made by elevating electrical systems and obtaining flood-proofing materials, such as deployable flood barriers. Regular reviews and drills of their disaster plans also occur, although local hospitals have yet to face an actual flood emergency.
Wright, a longtime Charleston resident living near CAMC Memorial, noted that many locals are more focused on pressing issues such as the opioid crisis and industrial decline rather than flood risks.
Tugboats and coal barges navigate past his home like cars on a road.
“It’s not that flooding isn’t a possibility,” he remarked. “I bet people in places that experienced catastrophic flooding were also caught off guard.”
‘Floodwaters are imminent’
Despite broad scientific agreement linking climate change with worsening weather patterns, the Trump administration has adopted a stance that downplays global warming concerns. During a September speech at the United Nations, Trump declared climate change “the greatest deception ever inflicted upon the world.”
This administration has implemented substantial operational and financial cuts at FEMA, NOAA, and the National Weather Service. Within FEMA, such reductions prompted a group of 191 current and former employees to release a letter in August, alleging the agency is suffering internal disintegration.
Daniel Swain, a climate scientist at the University of California, opined that this rejection of climate change leaves the nation vulnerable to extreme weather events today and in the future.
“It resembles ignoring significant health indicators in medical practice,” Swain explained. “Imagine making judgments about a patient’s health while disregarding a portion of their critical data.”
Under the Trump administration, FEMA has also executed actions that critics argue will exacerbate vulnerability to flooding, including:
- The disbandment of the Technical Mapping Advisory Council, which had continuously urged FEMA to modernize its flood maps to reflect future risks and the implications of climate change.
- The cancellation of the Building Resilient Infrastructure and Communities program, which had provided funding to bolster communities and essential infrastructure, such as hospitals, against floods and other natural disasters.
- After halting enforcement of the Federal Flood Risk Management Standard earlier this year, FEMA has signaled plans to withdraw it altogether, a standard aimed at fortifying structures against flood threats and conserving taxpayer dollars over time.
Berginnis, from the floodplain managers’ organization, lamented the administration’s unwillingness to confront climate change-related disruptions, which may lead to a recurring, destructive cycle of flooding followed by costly rebuilding efforts.
“The message from the president seems to indicate a reluctance to invest in flood mitigation strategies,” Berginnis noted. “It is disheartening that we need tragic reminders like loss of life to underscore the necessity of making these investments.”
FEMA did not clarify specific details concerning these decisions. In a statement to KFF Health News, spokesperson Llargués highlighted the agency’s efforts in responding to severe flooding in Texas and New Mexico, noting that billions of dollars were allocated for recovery and rebuilding initiatives. However, no references were made regarding funding for preventive measures against flood risks.
Specific hospitals, such as the former Coney Island Hospital in New York City, have firsthand experience with the hazards of flooding and have taken steps to prepare for future incidents.
Superstorm Sandy in 2012 necessitated the evacuation of hundreds of patients from the hospital. When waters receded, the facility was discovered to contain fish and a sea turtle.
Years later, it reopened under the designation Ruth Bader Ginsburg Hospital, following a FEMA-funded $923 million restoration project that included the installation of a 4-foot floodwall and the elevation of patient care facilities and crucial utilities above the ground floor.
Presently, it is considered one of the most flood-resilient hospitals in the country.
Yet, despite its preparedness, it has yet to face the test of a flood.
Svetlana Lipyanskaya, CEO of NYC Health+Hospitals/South Brooklyn Health, which encompasses the updated hospital, stated that flooding is not a matter of if, but when.
“I hope it won’t happen while I’m alive,” she admitted, “but honestly, I would be surprised if it doesn’t. The water is on its way.”
Understand the methodology behind this report.
Videos produced by Hannah Norman. Data visualizations crafted by Lydia Zuraw. CBS News correspondent David Schechter, photojournalist Chance Horner, and producer Aparna Zalani have contributed to this report.
