Brett Kelman
A small Tennessee hospital that was destroyed by a surging river throughout Hurricane Helene will quickly be rebuilt on low-lying farmland that would face a number of ft of flooding in a a lot smaller storm, risking one other catastrophe if the brand new facility shouldn’t be constructed to resist excessive climate, in accordance with a KFF Health News evaluation.
Ballad Health introduced in January that it could spend about $44 million to rebuild the 10-bed Unicoi County Hospital in a area 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.
But the brand new location additionally faces important flood danger, in accordance with a KFF Health News evaluate of data from Fathom and First Street, two local weather knowledge firms whose flood modeling is taken into account extra subtle than outdated flood maps printed by the Federal Emergency Management Agency. Both Fathom and First Street estimate {that a} 100-year flood — a climate occasion extra frequent and fewer intense than Helene — may cowl a lot of the hospital web site with greater than 2 ft of water.
“The proposed site is so obviously a flood plain geomorphologically,” stated Oliver Wing, chief scientific officer at Fathom. “You don’t need a model to see that.”
Wing stated the brand new hospital web site was truly extra more likely to flood than the outdated web site and “very risky” for improvement on account of a close-by creek and potential storm runoff from mountains to the west. But the flooding could be much less highly effective than on the outdated web site, Wing stated, and its influence could possibly be lessened by elevating the hospital or constructing earthen embankments.
Ballad Health confirmed the brand new hospital location however didn’t reply to questions on flood danger or defenses deliberate for the location. In a short written assertion, spokesperson Molly Luton stated Ballad was working with geotechnical professionals, Zurich Insurance 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 stated Ballad can also 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 typically decide which buildings should be designed to resist a flood. But 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 Street, which use subtle pc fashions and detailed terrain knowledge to create flood simulations which are relied on by main builders, insurance coverage firms, and authorities businesses. First Street publishes a lot of its modeling on-line, whereas Fathom shared knowledge with KFF Health News by means of a data-use settlement.
Chad Berginnis, government director of the Association of State Floodplain Managers, stated that whereas the hilly terrain of northeastern Tennessee could restrict Ballad’s choices to rebuild, it shouldn’t ignore the info from Fathom and First Street or rely purely on FEMA’s maps, which recommend the hospital could possibly be constructed with minimal flood protections.
If Ballad builds behind the Walmart, Berginnis stated, it ought to comply with the latest standards from the American Society of Civil Engineers, which suggest elevating hospitals sufficient to resist a 1,000-year flood — just like the one attributable to Helene.
According to these requirements and Google Earth elevation knowledge, that would require earthwork to boost the bottom of the Unicoi web site by no less than 8 ft and as a lot as 18 ft earlier than building.
“It’s going to require some elevation, and there is going to be some cost,” Berginnis stated. “But, my God, you just lost your dang hospital.”
The destruction of Unicoi County Hospital in 2024 prompted a KFF Health News investigation into hospital flood danger, which used Fathom knowledge to establish greater than 170 hospitals throughout the nation that face the best danger of serious or harmful flooding. Of these hospitals, no less than 39 confronted circumstances much like Unicoi’s: Nearby rivers or creeks have been predicted to swell past their banks and engulf the power.
Ballad Health, which owns Unicoi and 19 different hospitals in Tennessee and Virginia, is the nation’s largest state-sanctioned hospital monopoly and the one possibility for hospital care for many residents in a 29-county area of Appalachia.
In a information launch saying the Unicoi reconstruction, Ballad stated it was finalizing a land buy for the brand new hospital web site and anticipated building to start within the spring and final two years. Ballad Health Chief Operating Officer Eric Deaton stated the reconstruction announcement was “a long-awaited step toward healing.”
“Rebuilding Unicoi County Hospital is about more than bricks and mortar,” Deaton stated 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 contains each the outdated and new Unicoi hospital websites, praised the reconstruction plan in Ballad’s information launch. The launch 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 local television station WJHL and later confirmed by Tennessee public data.
Jones didn’t conform to be interviewed concerning the sale of the property or its flood danger.
The destroyed Unicoi County Hospital, which value $30 million, was constructed alongside a bend of the Nolichucky River though FEMA had labeled that space a flood zone for many years. Mountain States Health Alliance started building in 2017, then later turned Ballad Health, which opened the hospital in 2018.
Alan Levine, who was the CEO of Mountain States and now leads Ballad, instructed KFF Health News in a 2024 interview that Mountain States was conscious of the flood danger when Unicoi was constructed however believed levees may defend the power.
“I feel like everything we did when we built it was done the right way,” Levine stated.
Helene proved an excessive amount of to deal with. As 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 ft of water.
Floodwater pushed contained in the hospital and reduce the facility, forcing sufferers and employees to evacuate to the roof in hopes of rescue. Ultimately, helicopters plucked 70 individuals from the roof and the dashing water, narrowly avoiding fatalities.
Angel Mitchell, a Unicoi survivor who was airlifted to security together with her ailing mom, stated she was appalled that the hospital could be rebuilt in an space weak to a different flood.
But the worst half, Mitchell stated, was that locals would have little selection however to tolerate the chance due to Ballad’s monopoly.
“It’s ridiculous,” Mitchell stated. “We want to go somewhere to heal, not somewhere to worry.”
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working packages at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
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