A small Tennessee hospital that was destroyed by a surging river throughout Hurricane Helene will quickly be rebuilt on low-lying farmland that might face a number of toes of flooding in a a lot smaller storm, risking one other catastrophe if the brand new facility is just not constructed to resist excessive climate, based on a KFF Well being Information evaluation.
Ballad Well being introduced in January that it might spend about $44 million to rebuild the 10-bed Unicoi County Hospital in a discipline behind a Walmart in Unicoi, Tennessee, about 7 miles from the shuttered hospital that was the location of catastrophic flooding and a daring helicopter rescue on Sept. 27, 2024.
However the brand new location additionally faces important flood danger, based on a KFF Well being Information evaluation of data from Fathom and First Avenue, two local weather knowledge corporations whose flood modeling is taken into account extra subtle than outdated flood maps printed by the Federal Emergency Administration Company. Each Fathom and First Avenue estimate {that a} 100-year flood — a climate occasion extra widespread and fewer intense than Helene — might cowl a lot of the hospital web site with greater than 2 toes of water.
“The proposed site is so obviously a flood plain geomorphologically,” mentioned Oliver Wing, chief scientific officer at Fathom. “You don’t need a model to see that.”
Wing mentioned the brand new hospital web site was truly extra prone to flood than the outdated web site and “very risky” for growth attributable to a close-by creek and potential storm runoff from mountains to the west. However the flooding could be much less highly effective than on the outdated web site, Wing mentioned, and its influence may very well be lessened by elevating the hospital or constructing earthen embankments.
Ballad Well being confirmed the brand new hospital location however didn’t reply to questions on flood danger or defenses deliberate for the location. In a quick written assertion, spokesperson Molly Luton mentioned Ballad was working with geotechnical professionals, Zurich Insurance coverage Group, and a high-profile structure agency in Nashville, Earl Swensson Associates, to “plan and build a safe hospital for the Unicoi County community.” Luton mentioned Ballad can be working with FEMA, which is offering about $7.4 million for the rebuild.
FEMA has served because the nation’s de facto authority for estimating flood danger for half a century, and its flood maps usually decide which buildings should be designed to resist a flood. However these maps are sometimes incomplete and don’t account for the impacts of local weather change. FEMA’s flood maps of Unicoi, final up to date in 2008, don’t establish the brand new hospital web site as a flood hazard zone.
Nationwide, FEMA maps don’t seize a lot of the flood danger recognized by Fathom and First Avenue, which use subtle pc fashions and detailed terrain knowledge to create flood simulations which are relied on by main builders, insurance coverage corporations, and authorities companies. First Avenue publishes a lot of its modeling on-line, whereas Fathom shared knowledge with KFF Well being Information via a data-use settlement.
Chad Berginnis, govt director of the Affiliation of State Floodplain Managers, mentioned that whereas the hilly terrain of northeastern Tennessee might restrict Ballad’s choices to rebuild, it shouldn’t ignore the information from Fathom and First Avenue or rely purely on FEMA’s maps, which recommend the hospital may very well be constructed with minimal flood protections.
If Ballad builds behind the Walmart, Berginnis mentioned, it ought to comply with the newest requirements from the American Society of Civil Engineers, which advocate elevating hospitals sufficient to resist a 1,000-year flood — just like the one attributable to Helene.
Based on these requirements and Google Earth elevation knowledge, that might require earthwork to lift the bottom of the Unicoi web site by no less than 8 toes and as a lot as 18 toes earlier than development.
“It’s going to require some elevation, and there is going to be some cost,” Berginnis mentioned. “But, my God, you just lost your dang hospital.”
The destruction of Unicoi County Hospital in 2024 prompted a KFF Well being Information investigation into hospital flood danger, which used Fathom knowledge to establish greater than 170 hospitals throughout the nation that face the best danger of great or harmful flooding. Of these hospitals, no less than 39 confronted circumstances just like Unicoi’s: Close by rivers or creeks have been predicted to swell past their banks and engulf the ability.
Ballad Well being, which owns Unicoi and 19 different hospitals in Tennessee and Virginia, is the nation’s largest state-sanctioned hospital monopoly and the one choice for hospital care for many residents in a 29-county area of Appalachia.
In a information launch asserting the Unicoi reconstruction, Ballad mentioned it was finalizing a land buy for the brand new hospital web site and anticipated development to start within the spring and final two years. Ballad Well being Chief Working Officer Eric Deaton mentioned the reconstruction announcement was “a long-awaited step toward healing.”
“Rebuilding Unicoi County Hospital is about more than bricks and mortar,” Deaton mentioned within the launch. “It’s about keeping care close to home for people who have been through so much.”
Tennessee state Rep. Renea Jones, a Republican whose district consists of each the outdated and new Unicoi hospital websites, praised the reconstruction plan in Ballad’s information launch. The discharge didn’t point out that Ballad would purchase about 15 acres of land for the brand new hospital from Jones’ household, which was first reported by native tv station WJHL and later confirmed by Tennessee public information.
Jones didn’t comply with be interviewed in regards to the sale of the property or its flood danger.
The destroyed Unicoi County Hospital, which price $30 million, was constructed alongside a bend of the Nolichucky River despite the fact that FEMA had labeled that space a flood zone for many years. Mountain States Well being Alliance started development in 2017, then later grew to become Ballad Well being, which opened the hospital in 2018.
Alan Levine, who was the CEO of Mountain States and now leads Ballad, advised KFF Well being Information in a 2024 interview that Mountain States was conscious of the flood danger when Unicoi was constructed however believed levees might defend the ability.
“I feel like everything we did when we built it was done the right way,” Levine mentioned.
Helene proved an excessive amount of to deal with. Because the hurricane carved a lethal path throughout Southern states and into Appalachia, heavy rainfall induced the Nolichucky to overspill its banks and engulf the hospital in as a lot as 12 toes of water.
Floodwater pushed contained in the hospital and reduce the ability, forcing sufferers and employees to evacuate to the roof in hopes of rescue. Finally, helicopters plucked 70 folks from the roof and the speeding water, narrowly avoiding fatalities.
Angel Mitchell, a Unicoi survivor who was airlifted to security together with her ailing mom, mentioned she was appalled that the hospital could be rebuilt in an space weak to a different flood.
However the worst half, Mitchell mentioned, was that locals would have little selection however to tolerate the chance due to Ballad’s monopoly.
“It’s ridiculous,” Mitchell mentioned. “We want to go somewhere to heal, not somewhere to worry.”
