LOUISVILLE, Tenn. — When a giant storm hits, Peninsula Hospital could possibly be underwater.
At this decades-old psychiatric hospital on the sting of the Tennessee River, an intense storm may submerge the constructing in 11 toes of water, slicing off all roads across the facility, in accordance with a complicated laptop simulation of flood danger.
Aurora, a younger lady who was dedicated to Peninsula as a teen, mentioned the hospital sits so near the river that it felt like a moat protecting her and dozens of different sufferers inside. KFF Well being Information agreed to not publish her full title as a result of she shared personal medical historical past.
“My first feeling is doom,” Aurora mentioned as she watched the simulation of the river rising across the hospital. “These are most likely a number of the most weak individuals.”
Covenant Well being, which runs Peninsula Hospital, mentioned in a press release it has a “proactive and thorough method to emergency planning” however declined to offer particulars or reply questions.
Peninsula is one among about 170 American hospitals, totaling almost 30,000 affected person beds from coast to coast, that face the best danger of serious or harmful flooding, in accordance with a months-long KFF Well being Information investigation primarily based on knowledge offered by Fathom, an organization thought of a pacesetter in flood simulation. At many of those hospitals, flooding from heavy storms has the potential to jeopardize affected person care, block entry to emergency rooms, and pressure evacuations. Typically there is no such thing as a different hospital close by.
A lot of this danger to hospitals is just not captured by flood maps issued by the Federal Emergency Administration Company, which have served because the nation’s de facto software for flood estimation for half a century, regardless of being incomplete and generally many years outdated. As FEMA’s maps have turn into divorced from the truth of a altering local weather, personal corporations like Fathom have stuffed the hole with simulations of future floods. However a lot of their predictions are behind a paywall, leaving the general public largely reliant on free, considerably restricted authorities maps.
“That is extremely regarding,” mentioned Caleb Dresser, who research local weather change and is each an emergency room physician and a Harvard College assistant professor. “If you do not have the knowledge to know you are in danger, then how will you triage that drawback?”
The deadliest hospital flooding in trendy American historical past occurred 20 years in the past throughout Hurricane Katrina, when the our bodies of 45 individuals have been recovered from New Orleans’ Memorial Medical Heart, together with some sufferers whom investigators suspected were euthanized. Extra flooding deaths have been narrowly prevented one yr in the past when helicopters rescued dozens of people as Hurricane Helene engulfed Unicoi County Hospital in Erwin, Tennessee.
Rebecca Harrison, a paramedic, referred to as her kids from the Unicoi roof to say goodbye.
“I used to be scared to loss of life, considering, ‘That is it,'” Harrison advised CBS Information, which interviewed Unicoi survivors as a part of KFF Well being Information’ investigation. “Alarms have been going off. Folks have been screaming. It was chaos.”
The investigation — among the many first to research nationwide hospital flood danger in an period of warming climate and worsening storms — comes because the administration of President Donald Trump has slashed federal businesses that forecast and respond to extreme weather and in addition dismantled FEMA packages designed to guard hospitals and different necessary buildings from floods.
When requested to remark, FEMA mentioned flooding is a standard, pricey, and “underneath appreciated” catastrophe however made no assertion particular to hospitals. Spokesperson Daniel Llargués defended the administration’s modifications to FEMA by reissuing an August assertion that dismissed criticism as coming from “bureaucrats who presided over many years of inefficiency.”
Alice Hill, an Obama administration local weather danger professional, mentioned the Trump administration’s dismissal of local weather change and worsening floods would waste billions of {dollars} and endanger lives.
In 2015, Hill led the creation of the Federal Flood Danger Administration Customary, which required that hospitals and different important constructions be elevated or incorporate further flood protections to qualify for federal funding.
FEMA stopped enforcing the usual in March.
“Folks will die on account of a number of the selections being made in the present day,” Hill mentioned. “We will probably be much less ready than we are actually. And we already have been, in my estimation, poorly ready.”
“Flood danger is all over the place”
The KFF Well being Information investigation recognized greater than 170 hospitals dealing with a flood danger by evaluating the areas of greater than 7,000 services to peer-reviewed flood hazard mapping provided by Fathom, a United Kingdom firm that simulates flooding in areas as small as 10 meters utilizing laser-precision elevation measurements from the U.S. Geological Survey.
Hospitals have been decided to have a major danger if Fathom’s 100-year flood knowledge predicted {that a} foot or extra of water may attain a substantial portion of their buildings, excluding parking garages, or reduce off highway entry to the hospital. A 100-year flood is an intense climate occasion that has roughly a 1% probability of occurring in any given yr however can occur extra typically.
The investigation discovered heightened flood dangers at giant trauma facilities, small rural hospitals, kids’s hospitals, and long-term care services that serve older and disabled sufferers. Not less than 21 are vital entry hospitals, with the next-closest hospital 25 miles away, on common.
Flooding threatens dozens of hospitals in coastal areas, together with in Florida, Louisiana, Texas, and New York. Farther inland, flooding of rivers or creeks may envelop different hospitals, significantly in Appalachia and the Midwest. Even within the sun-soaked cities and arid expanses of the American West, storms have the potential to encompass some hospitals with a number of toes of pooling water, in accordance with Fathom’s knowledge.
These findings are probably an undercount of hospitals in danger as a result of the investigation neglected pockets of potential flooding at some hospitals. It excluded services like stand-alone ERs, outpatient clinics, and nursing properties.
“The truth is that flood danger is all over the place. It’s the most pervasive of perils,” mentioned Oliver Wing, the chief scientific officer at Fathom, who reviewed the findings. “Simply because you have not skilled an excessive doesn’t suggest you by no means will.”
Dresser, the ER physician, mentioned even a small quantity of flooding can shut down an unprepared hospital, typically by interrupting its energy provide, which is required for life-sustaining tools like ventilators and coronary heart displays. He mentioned essentially the most weak hospitals would probably be in rural areas.
“Lots of rural hospitals are actually closing their pediatric models, closing their psychiatry models,” Dresser mentioned. “In a financially confused scenario, it may be exhausting to prioritize long-term threats, even when they’re, for some establishments, doubtlessly existential.”
City hospitals can face harmful flooding, too. Fathom’s knowledge predicts 5 to fifteen toes of water round neighboring hospitals — Kadlec Regional Medical Heart and Lourdes Behavioral Well being — that straddle a tiny creek in Richland, Washington.
By Fathom’s estimate, a 100-year flood may trigger the close by Columbia River to spill over a levee that protects Richland, then loosely observe the creek to the hospitals. Among the deepest flooding is estimated round Lourdes, which was constructed on land the U.S. Military Corps of Engineers put aside in 1961 as a “ponding and drainage easement.”
On the time, this land was imagined to be able to storing sufficient water to fill no less than 40 Olympic-size swimming swimming pools, in accordance with military documents obtained via the Freedom of Data Act. A psychological well being facility has occupied this spot for the reason that Seventies.
Each Kadlec and Lourdes mentioned in statements that they’ve catastrophe plans however didn’t reply questions on flooding. Tina Baumgardner, a Lourdes spokesperson, mentioned authorities flood maps present the hospital is just not in a 100-year flood plain.
This isn’t unusual. Of the greater than 170 hospitals with important flood danger recognized by KFF Well being Information, one-third are positioned in areas that FEMA has not designated as flood hazard zones.
Typically the distinction is stark. For instance, at Ochsner Choctaw Normal in Alabama — the one hospital for 30 miles in any course — FEMA maps counsel a 100-year flood would overflow a close-by creek however spare the hospital. Fathom’s knowledge predicts the identical occasion would flood a lot of the hospital with 1 to 2 toes of water, together with the ER and the helicopter pad.
Ochsner Well being didn’t reply questions on flooding preparations at Choctaw Normal.
FEMA flood maps have been launched within the ’60s as a part of the Nationwide Flood Insurance coverage Program to find out the place insurance coverage is required and constructing codes ought to embrace flood-proofing. In response to a FEMA assertion, the maps present solely a “snapshot in time” and should not supposed to foretell the place flooding will or will not occur.
FEMA spokesperson Geoff Harbaugh mentioned the company intends to modernize its maps via the Way forward for Flood Danger Information initiative, which can allow the company to “higher challenge flood danger” and provides Individuals “the knowledge they should defend their lives and property.”
This system was launched by the primary Trump administration in 2019 however has since acquired sparse public updates. Harbaugh declined to offer an in depth replace or timeline for this system.
Chad Berginnis, govt director of the Affiliation of State Floodplain Managers, mentioned it’s unknown whether or not FEMA continues to be attempting to improve its maps underneath Mr. Trump, because the company has reduce off communications with exterior flooding consultants.
“There was not a single little bit of loosening of what I am calling the FEMA cone of silence,” Berginnis mentioned. “I’ve by no means seen something prefer it.”
Floods are anticipated to worsen as a warming local weather fuels stronger storms, drenching areas which might be already flood-prone and bringing a brand new degree of flooding to areas as soon as thought of decrease danger.
The Nationwide Oceanic and Atmospheric Administration has mentioned that 2024 was the warmest yr on document — greater than 2 levels Fahrenheit larger than the Twentieth-century common. Scientists throughout the globe have estimated that every diploma of worldwide warming correlates to a 4% enhance within the depth of maximum rainfall.
“Hotter air can maintain extra moisture, so this leads us to expertise heavier downpours,” mentioned Kelly Van Baalen, a sea degree rise professional on the nonprofit Climate Central. “A 100-year flood in the present day could possibly be a 10-year flood tomorrow.”
Intensifying storms increase issues about Peninsula Hospital, which has operated for many years mere toes from the Tennessee River however has no identified historical past of flooding.
Peninsula spokesperson Josh Cox mentioned the river is overseen by the Tennessee Valley Authority, which makes use of dams to handle water ranges and generate electrical energy. Estimates offered by the TVA counsel the dams may maintain Peninsula dry even in a 500-year flood.
Fathom, nonetheless, mentioned its flood simulation accounts for the dams and confused that a big sufficient storm may drop extra rain than even the TVA may management. These predictions are echoed by one other flood modeling agency, First Street, which additionally says an intense storm may trigger greater than 10 toes of flooding within the space round Peninsula.
“It is a hospital proper on the banks of a significant American river,” mentioned Wing, the Fathom scientist. “It simply is not conceivable that such a location is risk-free.”
Jack Goodwin, 75, a retired TVA worker who has lived subsequent to Peninsula for 3 many years, mentioned he was assured the dams may defend the realm. However after reviewing Fathom’s predictions, Goodwin started to analysis flood insurance coverage.
“Water can rise shortly and immediately, and the destruction is large,” he mentioned. “Simply because we have by no means seen it right here doesn’t suggest we can’t see it.”
“All the weather of an actual catastrophe”
One yr in the past, as Hurricane Helene carved a lethal path throughout Southern Appalachia, Angel Mitchell was visiting her ailing mom at Unicoi County Hospital within the tiny city of Erwin, Tennessee.
Swollen by Helene, the close by Nolichucky River spilled over its banks and round the hospital, which was inbuilt a flood plain. Workers tried to bar the doorways, Mitchell mentioned, however the water bought in, trapping her and others inside. The lights went out. Folks fled to the roof, the place the roar of speeding water almost drowned out the method of rescue helicopters, Mitchell mentioned.
Probability Horner/CBS Information 
Finally, 70 individuals, together with Mitchell and her mom, have been airlifted to safety on Sept. 27, 2024, narrowly escaping the hospital with no single loss of life. The hospital stays closed, and the corporate that owns it, Ballad Health, has mentioned its reopening is uncertain.
“Why permit one thing — particularly a hospital — to be inbuilt an space like that?” Mitchell advised CBS Information. “Folks must depend on these areas to get medical assist, and so they’re harmful.”
Past Unicoi, KFF Well being Information recognized 39 inland hospitals — together with 16 in Appalachia — that Fathom predicts may flood when close by rivers, creeks, or drainage canals overspill their banks, even in storms far much less intense than Helene.
For instance, within the Cumberland Mountains of southwestern Virginia, a 100-year flood is projected to trigger Slate Creek to engulf Buchanan Normal Hospital in additional than 5 toes of water.
Close to the Nice Lakes in Erie, Pennsylvania, LECOM Medical Heart and Behavioral Well being Pavilion may turn into flooded by a small drainage creek that’s lower than 50 toes from the entrance door of the ER.
Neither Buchanan nor LECOM responded to questions on flooding or preparations.
And in West Virginia’s capital of Charleston, the place about 50,000 individuals dwell on the junction of two rivers in a large and flat valley, a single storm may doubtlessly flood 5 of town’s six hospitals without delay, together with faculties, church buildings, fireplace departments, and different services.
“I hate to say it,” mentioned Behrang Bidadian, a flood plain supervisor on the West Virginia GIS Technical Center, “however it has all the weather of an actual catastrophe.”
On the largest hospital in Charleston, CAMC Memorial Hospital, Fathom predicts that the Kanawha River may carry as a lot as 5 toes of flooding to the ER. Throughout city, the Elk River may encompass CAMC Ladies and Youngsters’s Hospital, slicing off all exits.
And within the middle of town, the place the overflowing rivers are predicted to merge, Thomas Orthopedic Hospital could possibly be besieged by greater than 10 toes of water on three sides.
WVU Medication, which owns Thomas Orthopedic Hospital, didn’t reply to requests for remark.
CAMC spokesperson Dale Witte mentioned the hospital system is conscious of its flood danger and has ready by elevating electrical infrastructure and buying flood-proofing tools, like a deployable floodwall. CAMC additionally frequently revises and drills its catastrophe plans, Witte mentioned, though he added that hospitals there have by no means been examined by an actual flood.
Shanen Wright, 48, a lifelong Charleston resident who lives close to CAMC Memorial, mentioned many within the metropolis have little fear about flooding within the face of extra speedy issues, just like the opioid epidemic and the decline of producing and mining.
Tugboats and coal barges sail previous his neighborhood as in the event that they have been automobiles on his avenue.
“It is to not say it is not a risk,” he mentioned. “I am positive the individuals in Asheville and the individuals in Texas, the place the floods took so many lives, they most likely did not see it coming both.”
Daniel Chang/KFF Well being Information 
“The water is coming”
Regardless of large scientific consensus that local weather change fuels extra harmful climate, the Trump administration has taken the position that issues about international warming are overblown. In a speech to the United Nations in September, Mr. Trump referred to as local weather change “the best con job ever perpetrated on the world.”
The Trump administration has made deep employees and funding cuts to FEMA, NOAA, and the Nationwide Climate Service. At FEMA, the cuts prompted 191 present and former workers to publish a letter in August warning that the agency is being dismantled from inside.
Daniel Swain, a College of California local weather scientist, mentioned the administration’s rejection of local weather change has left the nation much less ready for excessive climate, now and sooner or later.
“It is akin to implementing malpractice scientifically,” Swain mentioned. “Think about making a medical resolution the place you aren’t allowed to take a look at 20% of the affected person’s important indicators or take a look at outcomes.”
Beneath Mr. Trump, FEMA has additionally taken actions critics say will depart the nation more vulnerable to flooding, particularly:
- FEMA disbanded the Technical Mapping Advisory Council, which had repeatedly pushed the agency to modernize its flood maps to estimate future danger and account for the impacts of local weather change.
- FEMA canceled its Building Resilient Infrastructure and Communities program, which offered grants to assist communities and important buildings, together with hospitals, defend themselves from floods and different pure disasters.
- And after stopping enforcement early this yr, FEMA intends to rescind the Federal Flood Danger Administration Customary, which was designed to harden buildings in opposition to future floods and save tax {dollars} in the long term.
Berginnis, of the Affiliation of State Floodplain Managers, mentioned the administration’s unwillingness to organize for local weather change and worsening storms would lead to a harmful and expensive cycle of flooding, rebuilding, and flooding once more.
“The president is saying we’re closed for enterprise in terms of hazard mitigation,” Berginnis mentioned. “It bugs me to no finish that we’ve got to have reminders — like individuals dying — to indicate us why it is necessary to make these investments.”
FEMA didn’t reply particular questions on these selections. Within the assertion to KFF Well being Information, spokesperson Llargués touted the administration’s response to flooding in Texas and New Mexico and mentioned FEMA had offered billions of {dollars} to assist individuals and communities get better and rebuild. He didn’t point out any FEMA funding for safeguarding in opposition to future floods.
Few hospitals perceive this risk greater than the previous Coney Island Hospital in New York Metropolis, which has suffered catastrophic flooding earlier than and has ready for it to come back once more.
Superstorm Sandy in 2012 compelled the hospital to evacuate tons of of sufferers. When the water receded, fish and a sea turtle have been discovered within the constructing.
Eleven years later, the ability reopened as Ruth Bader Ginsburg Hospital, remodeled by a FEMA-funded $923 million reconstruction challenge that added a 4-foot floodwall and elevated affected person care areas and utility infrastructure above the primary flooring.
It’s now probably probably the most flood-proofed hospitals within the nation.
However, to date, no storm has examined the ability.
Svetlana Lipyanskaya, CEO of NYC Well being+Hospitals/South Brooklyn Well being, which incorporates the rebuilt hospital, mentioned the query of flooding is “not an if however a when.”
“I hope it does not occur in my lifetime,” she mentioned, “however frankly, I would be stunned. The water is coming.”
CBS Information correspondent David Schechter and photojournalist Probability Horner contributed to this report.
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is without doubt one of the core working packages at KFF — the unbiased supply for well being coverage analysis, polling, and journalism.
Methodology
After Hurricane Helene made landfall a yr in the past, a raging river flooded a rural hospital in japanese Tennessee. Sufferers and workers have been rescued from the rooftop. Floods have hit hospitals from New York to Nebraska to Texas lately. We wished to find out what number of different U.S. hospitals face related peril. Finally, we discovered greater than 170 hospitals in danger.
For this evaluation, we used knowledge from Fathom, a United Kingdom-based firm that makes a speciality of flood-risk modeling throughout the globe. To evaluate the USA’ vulnerability, Fathom makes use of refined laptop simulations and detailed terrain knowledge masking the nation. It accounts for environmental components equivalent to local weather change, soil circumstances, and plenty of rivers and creeks not mapped by different sources. Fathom’s modeling has been peer-reviewed and used by insurance companies, the World Financial institution, the Nature Conservancy, and authorities businesses in Florida, Texas, and elsewhere. The Iowa Flood Heart has validated Fathom’s U.S. data.
By means of a knowledge use settlement, Fathom shared its U.S. mapping knowledge that predicts areas with no less than a 1% probability of flooding in any given yr. Fathom’s knowledge estimates the consequences of three main types of flooding: coastal, fluvial (from overflowing rivers, lakes, or streams), and pluvial (rainfall that the bottom cannot take up). The info additionally accounts for dams, reservoirs, and different constructions that defend in opposition to floods.
To establish at-risk hospitals, we used a publicly out there Division of Homeland Safety database containing the GPS coordinates of greater than 7,000 short-term acute, vital entry, rehab, and psychiatric hospitals — principally any hospital with inpatient companies. (DHS underneath the Trump administration has discontinued public entry to the database, so knowledge for hospitals and different infrastructure is now not broadly out there.)
Utilizing GPS coordinates because the centerpoint, we created a circle with a 150-yard radius round every hospital, which generally captured the constructing plus close by grounds and entry roads. We then mapped Fathom’s flood-risk knowledge to see the place it overlapped with these circles. We began by searching for hospitals the place no less than 20% of the circle’s space had a predicted flood depth of no less than 1 foot. That gave us an preliminary listing of greater than 320 hospitals throughout the U.S.
From there, we visually inspected these hospitals utilizing mapping software program and Google Maps, each satellite tv for pc and avenue view. We trimmed our listing to solely the hospitals the place a substantial portion of the constructing or all entry roads have been predicted to have no less than a foot of flooding.
If two hospitals have been mapped to the identical constructing — for example, a small rehab facility inside a big hospital — we counted just one hospital. We additionally excluded hospitals not too long ago transformed to nursing properties or for different makes use of.
We ended up with an inventory of 171 hospitals throughout the U.S. That’s almost definitely an undercount. Some hospitals may nonetheless face important affect from flooding that’s not deep sufficient or widespread sufficient to suit our methodology. Our evaluation additionally doesn’t account for a way flooding farther from a hospital may have an effect on workers or sufferers. And it doesn’t assess what steps hospitals could have already taken to organize for extreme climate occasions.
We additionally ran a spatial evaluation evaluating Fathom’s knowledge with flood hazard maps from the Federal Emergency Administration Company, which in lots of instances are incomplete or have not been up to date in years. We discovered that a few third of hospitals recognized as flood dangers by Fathom’s knowledge didn’t overlap in any respect with FEMA’s 100- or 500-year hazard areas.
Fathom offered steerage and suggestions as we developed our evaluation.
David Schechter and
contributed to this report.
