LOUISVILLE, Tenn. — When a giant storm hits, Peninsula Hospital might be underwater.
At this decades-old psychiatric hospital on the sting of the Tennessee River, an intense storm might submerge the constructing in 11 toes of water, reducing off all roads across the facility, in keeping with a classy laptop simulation of flood threat.
Aurora, a younger girl who was dedicated to Peninsula as a young person, mentioned the hospital sits so near the river that it felt like a moat retaining 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 probably some of the most vulnerable people.”
Covenant Well being, which runs Peninsula Hospital, mentioned in a press release it has a “proactive and thorough approach to emergency planning” however declined to supply particulars or reply questions.
Peninsula is considered one of about 170 American hospitals, totaling almost 30,000 affected person beds from coast to coast, that face the best threat of serious or harmful flooding, in keeping with a months-long KFF Well being Information investigation primarily based on information 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 drive evacuations. Typically there is no such thing as a different hospital close by.
A lot of this threat to hospitals isn’t captured by flood maps issued by the Federal Emergency Administration Company, which have served because the nation’s de facto device for flood estimation for half a century, regardless of being incomplete and typically a long time outdated. As FEMA’s maps have change into divorced from the truth of a altering local weather, personal firms like Fathom have crammed 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.
“This is highly concerning,” mentioned Caleb Dresser, who research local weather change and is each an emergency room physician and a Harvard College assistant professor. “If you don’t have the information to know you’re at risk, then how can you triage that problem?”
The deadliest hospital flooding in fashionable American historical past occurred 20 years in the past throughout Hurricane Katrina, when the our bodies of 45 folks had been recovered from New Orleans’ Memorial Medical Middle, together with some sufferers whom investigators suspected had been euthanized. Extra flooding deaths had been narrowly prevented one yr in the past when helicopters rescued dozens of individuals 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 was scared to death, thinking, ‘This is it,’” Harrison instructed CBS Information, which interviewed Unicoi survivors as a part of KFF Well being Information’ investigation. “Alarms were going off. People were screaming. It was chaos.”
The investigation — among the many first to investigate nationwide hospital flood threat in an period of warming local weather and worsening storms — comes because the administration of President Donald Trump has slashed federal companies that forecast and reply to excessive climate and in addition dismantled FEMA applications designed to guard hospitals and different essential buildings from floods.
When requested to remark, FEMA mentioned flooding is a standard, pricey, and “under 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 decades of inefficiency.”
Alice Hill, an Obama administration local weather threat 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 Threat Administration Commonplace, which required that hospitals and different important buildings be elevated or incorporate further flood protections to qualify for federal funding.
FEMA stopped implementing the usual in March.
“People will die as a result of some of the choices being made today,” Hill mentioned. “We will be less prepared than we are now. And we already were, in my estimation, poorly prepared.”
‘Flood Risk Is Everywhere’
The KFF Well being Information investigation recognized greater than 170 hospitals going through a flood threat by evaluating the areas of greater than 7,000 services to peer-reviewed flood hazard mapping offered 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 had been decided to have a big threat if Fathom’s 100-year flood information predicted {that a} foot or extra of water might attain a substantial portion of their buildings, excluding parking garages, or lower off street entry to the hospital. A 100-year flood is an intense climate occasion that has roughly a 1% likelihood 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. A minimum of 21 are important 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 might 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 keeping with Fathom’s information.
These findings are possible 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 houses.
“The reality is that flood risk is everywhere. It is the most pervasive of perils,” mentioned Oliver Wing, the chief scientific officer at Fathom, who reviewed the findings. “Just because you’ve never experienced an extreme doesn’t mean you never 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 gear like ventilators and coronary heart screens. He mentioned essentially the most susceptible hospitals would possible be in rural areas.
“A lot of rural hospitals are now closing their pediatric units, closing their psychiatry units,” Dresser mentioned. “In a financially stressed situation, it can be hard to prioritize long-term threats, even if they are, for some institutions, potentially existential.”
City hospitals can face harmful flooding, too. Fathom’s information predicts 5 to fifteen toes of water round neighboring hospitals — Kadlec Regional Medical Middle and Lourdes Behavioral Well being — that straddle a tiny creek in Richland, Washington.
By Fathom’s estimate, a 100-year flood might trigger the close by Columbia River to spill over a levee that protects Richland, then loosely comply with 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 at the least 40 Olympic-size swimming swimming pools, in keeping with navy paperwork obtained via the Freedom of Data Act. A psychological well being facility has occupied this spot because the Nineteen 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 isn’t in a 100-year flood plain.
This isn’t unusual. Of the greater than 170 hospitals with vital flood threat 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 information predicts the identical occasion would flood many 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 had 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 are usually not meant to foretell the place flooding will or gained’t occur.
FEMA spokesperson Geoff Harbaugh mentioned the company intends to modernize its maps via the Way forward for Flood Threat Information initiative, which is able to allow the company to “better project flood risk” and provides People “the information they need to protect 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 supply an in depth replace or timeline for this system.
Chad Berginnis, government 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 Trump, because the company has lower off communications with outdoors flooding consultants.
“There has been not a single bit of loosening of what I’m calling the FEMA cone of silence,” Berginnis mentioned. “I’ve never seen anything like 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 stage of flooding to areas as soon as thought of decrease threat.
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 world warming correlates to a 4% improve within the depth of maximum rainfall.
“Warmer air can hold more moisture, so this leads us to experience heavier downpours,” mentioned Kelly Van Baalen, a sea stage rise professional on the nonprofit Local weather Central. “A 100-year flood today could be a 10-year flood tomorrow.”
Intensifying storms elevate issues about Peninsula Hospital, which has operated for many years mere toes from the Tennessee River however has no recognized 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 might preserve Peninsula dry even in a 500-year flood.
Fathom, nevertheless, mentioned its flood simulation accounts for the dams and harassed that a big sufficient storm might drop extra rain than even the TVA might management. These predictions are echoed by one other flood modeling agency, First Avenue, which additionally says an intense storm might trigger greater than 10 toes of flooding within the space round Peninsula.
“It’s a hospital right on the banks of a major American river,” mentioned Wing, the Fathom scientist. “It just isn’t conceivable that such a location is risk-free.”
Jack Goodwin, 75, a retired TVA worker who has lived subsequent to Peninsula for 3 a long time, mentioned he was assured the dams might defend the world. However after reviewing Fathom’s predictions, Goodwin started to analysis flood insurance coverage.
“Water can rise quickly and suddenly, and the destruction is tremendous,” he mentioned. “Just because we’ve never seen it here doesn’t mean we won’t see it.”
‘All the Elements of a Real Disaster’
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 across the hospital, which was in-built a flood plain. Workers tried to bar the doorways, Mitchell mentioned, however the water obtained in, trapping her and others inside. The lights went out. Individuals fled to the roof, the place the roar of speeding water almost drowned out the method of rescue helicopters, Mitchell mentioned.
In the end, 70 folks from the hospital, together with Mitchell and her mom, had been airlifted to security on Sept. 27, 2024. The hospital stays closed, and the corporate that owns it, Ballad Well being, has mentioned its reopening is unsure.
“Why allow something — especially a hospital — to be built in an area like that?” Mitchell instructed CBS Information. “People have to rely on these areas to get medical help, and they’re dangerous.”
Past Unicoi, KFF Well being Information recognized 39 inland hospitals — together with 16 in Appalachia — that Fathom predicts might 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 Middle and Behavioral Well being Pavilion might change 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 folks stay on the junction of two rivers in a large and flat valley, a single storm might probably flood 5 of the town’s six hospitals without delay, together with colleges, church buildings, hearth departments, and different services.
“I hate to say it,” mentioned Behrang Bidadian, a flood plain supervisor on the West Virginia GIS Technical Middle, “but it has all the elements of a real disaster.”
On the largest hospital in Charleston, CAMC Memorial Hospital, Fathom predicts that the Kanawha River might convey as a lot as 5 toes of flooding to the ER. Throughout city, the Elk River might encompass CAMC Girls and Kids’s Hospital, reducing off all exits.
And within the middle of the town, the place the overflowing rivers are predicted to merge, Thomas Orthopedic Hospital might be besieged by greater than 10 toes of water on three sides.
WVU Drugs, 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 threat and has ready by elevating electrical infrastructure and buying flood-proofing gear, 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 rapid 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 had been vehicles on his road.
“It’s not to say it’s not a possibility,” he mentioned. “I’m sure the people in Asheville and the people in Texas, where the floods took so many lives, they probably didn’t see it coming either.”
‘The Water Is Coming’
Regardless of broad scientific consensus that local weather change fuels extra harmful climate, the Trump administration has taken the place that issues about international warming are overblown. In a speech to the United Nations in September, Trump referred to as local weather change “the greatest 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 staff to publish a letter in August warning that the company 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’s akin to enforcing malpractice scientifically,” Swain mentioned. “Imagine making a medical decision where you are not allowed to look at 20% of the patient’s vital signs or test results.”
Below Trump, FEMA has additionally taken actions critics say will go away the nation extra susceptible to flooding, particularly:
- FEMA disbanded the Technical Mapping Advisory Council, which had repeatedly pushed the company to modernize its flood maps to estimate future threat and account for the impacts of local weather change.
- FEMA canceled its Constructing Resilient Infrastructure and Communities program, which offered grants to assist communities and very 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 Threat Administration Commonplace, 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 arrange for local weather change and worsening storms would lead to a harmful and dear cycle of flooding, rebuilding, and flooding once more.
“The president is saying we are closed for business when it comes to hazard mitigation,” Berginnis mentioned. “It bugs me to no end that we have to have reminders — like people dying — to show us why it’s important 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 folks and communities get well and rebuild. He didn’t point out any FEMA funding for shielding in opposition to future floods.
Few hospitals perceive this menace greater than the previous Coney Island Hospital in New York Metropolis, which has suffered catastrophic flooding earlier than and has ready for it to return once more.
Superstorm Sandy in 2012 compelled the hospital to evacuate lots of of sufferers. When the water receded, fish and a sea turtle had been discovered within the constructing.
Eleven years later, the power reopened as Ruth Bader Ginsburg Hospital, remodeled by a FEMA-funded $923 million reconstruction venture that added a 4-foot floodwall and elevated affected person care areas and utility infrastructure above the primary ground.
It’s now possible one of the flood-proofed hospitals within the nation.
However, thus far, no storm has examined the power.
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 but a when.”
“I hope it doesn’t happen in my lifetime,” she mentioned, “but frankly, I’d be surprised. The water is coming.”
After Hurricane Helene made landfall a yr in the past, a raging river flooded a rural hospital in japanese Tennessee. Sufferers and staff had 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 comparable peril. In the end, we discovered greater than 170 hospitals in danger.
For this evaluation, we used information from Fathom, a United Kingdom-based firm that focuses on flood-risk modeling throughout the globe. To evaluate the USA’ vulnerability, Fathom makes use of refined laptop simulations and detailed terrain information overlaying the nation. It accounts for environmental elements resembling local weather change, soil situations, and lots of rivers and creeks not mapped by different sources. Fathom’s modeling has been peer-reviewed and utilized by insurance coverage firms, the World Financial institution, the Nature Conservancy, and authorities companies in Florida, Texas, and elsewhere. The Iowa Flood Middle has validated Fathom’s U.S. information.
By means of a knowledge use settlement, Fathom shared its U.S. mapping information that predicts areas with at the least a 1% likelihood of flooding in any given yr. Fathom’s information estimates the consequences of three most important varieties of flooding: coastal, fluvial (from overflowing rivers, lakes, or streams), and pluvial (rainfall that the bottom can’t soak up). The info additionally accounts for dams, reservoirs, and different buildings that defend in opposition to floods.
To determine 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, important entry, rehab, and psychiatric hospitals — mainly any hospital with inpatient companies. (DHS underneath the Trump administration has discontinued public entry to the database, so information for hospitals and different infrastructure is not broadly out there.)
Utilizing GPS coordinates because the centerpoint, we created a circle with a 150-yard radius round every hospital, which most often captured the constructing plus close by grounds and entry roads. We then mapped Fathom’s flood-risk information to see the place it overlapped with these circles. We began by on the lookout for hospitals the place at the least 20% of the circle’s space had a predicted flood depth of at the least 1 foot. That gave us an preliminary checklist 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 road view. We trimmed our checklist to solely the hospitals the place a substantial portion of the constructing or all entry roads had been predicted to have at the least a foot of flooding.
If two hospitals had been mapped to the identical constructing — as an example, a small rehab facility inside a big hospital — we counted just one hospital. We additionally excluded hospitals just lately transformed to nursing houses or for different makes use of.
We ended up with an inventory of 171 hospitals throughout the U.S. That’s most certainly an undercount. Some hospitals might nonetheless face vital affect from flooding that isn’t deep sufficient or widespread sufficient to suit our methodology. Our evaluation additionally doesn’t account for a way flooding farther from a hospital might have an effect on staff or sufferers. And it doesn’t assess what steps hospitals might have already taken to arrange for extreme climate occasions.
We additionally ran a spatial evaluation evaluating Fathom’s information with flood hazard maps from the Federal Emergency Administration Company, which in lots of instances are incomplete or haven’t been up to date in years. We discovered that a few third of hospitals recognized as flood dangers by Fathom’s information 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.
CBS Information correspondent David Schechter and photojournalist Likelihood Horner contributed to this report.
