Holly Okay. Hacker and Brett Kelman and Daniel Chang and Hannah Norman, KFF Health News and Lydia Zuraw, KFF Health News
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LOUISVILLE, Tenn. — When an enormous storm hits, Peninsula Hospital may very well be underwater.
At this decades-old psychiatric hospital on the sting of the Tennessee River, an intense storm might submerge the constructing in 11 ft of water, slicing off all roads across the facility, in response to a classy pc simulation of flood threat.
Aurora, a younger lady who was dedicated to Peninsula as a young person, stated the hospital sits so near the river that it felt like a moat conserving her and dozens of different sufferers inside. KFF Health News agreed to not publish her full identify as a result of she shared non-public medical historical past.
“My first feeling is doom,” Aurora stated as she watched the simulation of the river rising across the hospital. “These are probably some of the most vulnerable people.”
Covenant Health, which runs Peninsula Hospital, stated in a press release it has a “proactive and thorough approach to emergency planning” however declined to supply particulars or reply questions.
Peninsula is certainly one of about 170 American hospitals, totaling practically 30,000 affected person beds from coast to coast, that face the best threat of serious or harmful flooding, in response to a months-long KFF Health News 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 power evacuations. Sometimes there is no such thing as a different hospital close by.
Much of this threat to hospitals is just not captured by flood maps issued by the Federal Emergency Management Agency, 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de facto device for flood estimation for half a century, regardless of being incomplete and typically a long time outdated.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 grow to be divorced from the fact of a altering local weather, non-public corporations like Fathom have stuffed the hole with simulations of future floods. But a lot of their predictions are behind a paywall, leaving the general public principally reliant on free, considerably restricted authorities maps.
“This is highly concerning,” stated Caleb Dresser, who research local weather change and is each an emergency room physician and a Harvard University 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 trendy American historical past occurred 20 years in the past throughout Hurricane Katrina, when the our bodies of 45 folks have been recovered from New Orleans’ Memorial Medical Center, together with some sufferers whom investigators suspected were euthanized. More flooding deaths have been narrowly averted one 12 months 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 was scared to death, thinking, ‘This is it,’” Harrison advised CBS News, which interviewed Unicoi survivors as a part of KFF Health News’ 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 agencies that forecast and respond to extreme weather and in addition dismantled FEMA packages designed to guard hospitals and different essential buildings from floods.
When requested to remark, FEMA stated flooding is a typical, expensive, 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, stated 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 Risk Management Standard, which required that hospitals and different important constructions be elevated or incorporate additional flood protections to qualify for federal funding.
FEMA stopped enforcing the usual in March.
“People will die as a result of some of the choices being made today,” Hill stated. “We will be less prepared than we are now. And we already were, in my estimation, poorly prepared.”
‘Flood Risk Is Everywhere’
The KFF Health News investigation recognized greater than 170 hospitals dealing with a flood threat by evaluating the areas of greater than 7,000 amenities 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 big threat if Fathom’s 100-year flood knowledge predicted {that a} foot or extra of water might 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% likelihood of occurring in any given 12 months however can occur extra usually.
The investigation discovered heightened flood dangers at giant trauma facilities, small rural hospitals, kids’s hospitals, and long-term care amenities that serve older and disabled sufferers. At least 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 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 ft of pooling water, in response to Fathom’s knowledge.
These findings are seemingly an undercount of hospitals in danger as a result of the investigation neglected pockets of potential flooding at some hospitals. It excluded amenities like stand-alone ERs, outpatient clinics, and nursing properties.
“The reality is that flood risk is everywhere. It is the most pervasive of perils,” stated 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, stated even a small quantity of flooding can shut down an unprepared hospital, usually by interrupting its energy provide, which is required for life-sustaining gear like ventilators and coronary heart screens. He stated probably the most weak hospitals would seemingly be in rural areas.
“A lot of rural hospitals are now closing their pediatric units, closing their psychiatry units,” Dresser stated. “In a financially stressed situation, it can be hard to prioritize long-term threats, even if they are, for some institutions, potentially existential.”
Urban hospitals can face harmful flooding, too. Fathom’s knowledge predicts 5 to fifteen ft of water round neighboring hospitals — Kadlec Regional Medical Center and Lourdes Behavioral Health — 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 observe the creek to the hospitals. Some of the deepest flooding is estimated round Lourdes, which was constructed on land the U.S. Army Corps of Engineers put aside in 1961 as a “ponding and drainage easement.”
At 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 response to military documents obtained via the Freedom of Information Act. A psychological well being facility has occupied this spot for the reason that Seventies.
Both Kadlec and Lourdes stated in statements that they’ve catastrophe plans however didn’t reply questions on flooding. Tina Baumgardner, a Lourdes spokesperson, stated authorities flood maps present the hospital is just not in a 100-year flood plain.
This is just not unusual. Of the greater than 170 hospitals with vital flood threat recognized by KFF Health News, one-third are situated in areas that FEMA has not designated as flood hazard zones.
Sometimes the distinction is stark. For instance, at Ochsner Choctaw General 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 ft of water, together with the ER and the helicopter pad.
Ochsner Health didn’t reply questions on flooding preparations at Choctaw General.
FEMA flood maps have been launched within the ’60s as a part of the National Flood Insurance Program to find out the place insurance coverage is required and constructing codes ought to embody flood-proofing. According to a FEMA assertion, the maps present solely a “snapshot in time” and are usually not supposed to foretell the place flooding will or gained’t occur.
FEMA spokesperson Geoff Harbaugh stated the company intends to modernize its maps via the Future of Flood Risk Data initiative, which is able to allow the company to “better project flood risk” and provides Americans “the information they need to protect their lives and property.”
The program 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 Association of State Floodplain Managers, stated it’s unknown whether or not FEMA remains to be making an attempt to improve its maps beneath Trump, because the company has reduce off communications with exterior flooding specialists.
“There has been not a single bit of loosening of what I’m calling the FEMA cone of silence,” Berginnis stated. “I’ve never seen anything like it.”
Floods are anticipated to worsen as a warming local weather fuels stronger storms, drenching areas which can be already flood-prone and bringing a brand new degree of flooding to areas as soon as thought of decrease threat.
The National Oceanic and Atmospheric Administration has stated that 2024 was the warmest 12 months on report — 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 utmost rainfall.
“Warmer air can hold more moisture, so this leads us to experience heavier downpours,” stated Kelly Van Baalen, a sea degree rise professional on the nonprofit Climate Central. “A 100-year flood today could be a 10-year flood tomorrow.”
Intensifying storms elevate considerations about Peninsula Hospital, which has operated for many years mere ft from the Tennessee River however has no identified historical past of flooding.
Peninsula spokesperson Josh Cox stated 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, stated its flood simulation accounts for the dams and burdened 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 Street, which additionally says an intense storm might trigger greater than 10 ft of flooding within the space round Peninsula.
“It’s a hospital right on the banks of a major American river,” stated 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, stated he was assured the dams might defend the realm. But after reviewing Fathom’s predictions, Goodwin started to analysis flood insurance coverage.
“Water can rise quickly and suddenly, and the destruction is tremendous,” he stated. “Just because we’ve never seen it here doesn’t mean we won’t see it.”
‘All the Elements of a Real Disaster’
One 12 months 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. Staff tried to bar the doorways, Mitchell stated, however the water acquired in, trapping her and others inside. The lights went out. People fled to the roof, the place the roar of dashing water practically drowned out the strategy of rescue helicopters, Mitchell stated.
Ultimately, 70 folks from the hospital, together with Mitchell and her mom, have been airlifted to safety on Sept. 27, 2024. The hospital stays closed, and the corporate that owns it, Ballad Health, has stated its reopening is uncertain.
“Why allow something — especially a hospital — to be built in an area like that?” Mitchell advised CBS News. “People have to rely on these areas to get medical help, and they’re dangerous.”
Beyond Unicoi, KFF Health News 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 General Hospital in additional than 5 ft of water.
Near the Great Lakes in Erie, Pennsylvania, LECOM Medical Center and Behavioral Health Pavilion might grow to be flooded by a small drainage creek that’s lower than 50 ft 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 dwell on the junction of two rivers in a large and flat valley, a single storm might doubtlessly flood 5 of town’s six hospitals without delay, together with faculties, church buildings, hearth departments, and different amenities.
“I hate to say it,” stated Behrang Bidadian, a flood plain supervisor on the West Virginia GIS Technical Center, “but it has all the elements of a real disaster.”
At the biggest hospital in Charleston, CAMC Memorial Hospital, Fathom predicts that the Kanawha River might deliver as a lot as 5 ft of flooding to the ER. Across city, the Elk River might encompass CAMC Women and Children’s Hospital, slicing off all exits.
And within the heart of town, the place the overflowing rivers are predicted to merge, Thomas Orthopedic Hospital may very well be besieged by greater than 10 ft of water on three sides.
WVU Medicine, which owns Thomas Orthopedic Hospital, didn’t reply to requests for remark.
CAMC spokesperson Dale Witte stated 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 often revises and drills its catastrophe plans, Witte stated, 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, stated many within the metropolis have little fear about flooding within the face of extra instant 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 vehicles on his road.
“It’s not to say it’s not a possibility,” he stated. “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’
Despite large scientific consensus that local weather change fuels extra harmful climate, the Trump administration has taken the position that considerations 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 workers and funding cuts to FEMA, NOAA, and the National Weather Service. At FEMA, the cuts prompted 191 present and former workers to publish a letter in August warning that the company is being dismantled from inside.
Daniel Swain, a University of California local weather scientist, stated 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 stated. “Imagine making a medical decision where you are not allowed to look at 20% of the patient’s vital signs or test results.”
Under Trump, FEMA has additionally taken actions critics say will go away the nation extra weak to flooding, particularly:
FEMA disbanded the Technical Mapping Advisory Council, which had repeatedly pushed the agency to modernize its flood maps to estimate future threat 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 12 months, FEMA intends to rescind the Federal Flood Risk Management Standard, which was designed to harden buildings in opposition to future floods and save tax {dollars} in the long term.
Berginnis, of the Association of State Floodplain Managers, stated the administration’s unwillingness to arrange 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 are closed for business when it comes to hazard mitigation,” Berginnis stated. “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 choices. In the assertion to KFF Health News, spokesperson Llargués touted the administration’s response to flooding in Texas and New Mexico and stated FEMA had offered billions of {dollars} to assist folks 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 menace greater than the previous Coney Island Hospital in New York City, 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 a whole bunch of sufferers. When the water receded, fish and a sea turtle have been discovered within the constructing.
Eleven years later, the power reopened as Ruth Bader Ginsburg Hospital, remodeled by a FEMA-funded $923 million reconstruction undertaking that added a 4-foot floodwall and elevated affected person care areas and utility infrastructure above the primary ground.
It is now seemingly probably the most flood-proofed hospitals within the nation.
But, to this point, no storm has examined the power.
Svetlana Lipyanskaya, CEO of NYC Health+Hospitals/South Brooklyn Health, which incorporates the rebuilt hospital, stated the query of flooding is “not an if but a when.”
“I hope it doesn’t happen in my lifetime,” she stated, “but frankly, I’d be surprised. The water is coming.”
Methodology
After Hurricane Helene made landfall a 12 months in the past, a raging river flooded a rural hospital in jap Tennessee. Patients and workers have been rescued from the rooftop. Floods have hit hospitals from New York to Nebraska to Texas in recent times. We wished to find out what number of different U.S. hospitals face comparable peril. Ultimately, 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 assess the United States’ vulnerability, Fathom makes use of refined pc simulations and detailed terrain knowledge overlaying the nation. It accounts for environmental components similar 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 Bank, the Nature Conservancy, and authorities companies in Florida, Texas, and elsewhere. The Iowa Flood Center has validated Fathom’s U.S. data.
Through an information use settlement, Fathom shared its U.S. mapping knowledge that predicts areas with at the least a 1% likelihood of flooding in any given 12 months. Fathom’s knowledge estimates the results of three main types of flooding: coastal, fluvial (from overflowing rivers, lakes, or streams), and pluvial (rainfall that the bottom can’t take up). The knowledge additionally accounts for dams, reservoirs, and different constructions that defend in opposition to floods.
To establish at-risk hospitals, we used a publicly obtainable Department of Homeland Security database containing the GPS coordinates of greater than 7,000 short-term acute, vital entry, rehab, and psychiatric hospitals — mainly any hospital with inpatient providers. (DHS beneath the Trump administration has discontinued public entry to the database, so knowledge for hospitals and different infrastructure is not extensively obtainable.)
Using GPS coordinates because the centerpoint, we created a circle with a 150-yard radius round every hospital, which normally 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 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 have been predicted to have at the least a foot of flooding.
If two hospitals have 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 properties or for different makes use of.
We ended up with a listing of 171 hospitals throughout the U.S. That is probably an undercount. Some hospitals might nonetheless face vital influence from flooding that isn’t deep sufficient or widespread sufficient to suit our methodology. Our evaluation additionally doesn’t account for the way flooding farther from a hospital might have an effect on workers or sufferers. And it doesn’t assess what steps hospitals could have already taken to arrange for extreme climate occasions.
We additionally ran a spatial evaluation evaluating Fathom’s knowledge with flood hazard maps from the Federal Emergency Management Agency, 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 knowledge didn’t overlap in any respect with FEMA’s 100- or 500-year hazard areas.
Fathom offered steering and suggestions as we developed our evaluation.
CBS News correspondent David Schechter and photojournalist Chance Horner contributed to this report.
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 impartial supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
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