When storms rage across the United States, most people trust that hospitals—those beacons of safety and care—will stand strong, ready to help. But a sweeping new investigation from KFF Health News reveals a sobering truth: more than 170 hospitals across the country are at significant risk of flooding, endangering patient care, emergency services, and the very ability of these institutions to function when they’re needed most.
According to the October 5, 2025, report, these vulnerable hospitals collectively represent nearly 30,000 patient beds, stretching from the coasts to deep inland. Some are large trauma centers in bustling cities; others are small rural hospitals, often the only medical lifeline for miles around. The threat? Floodwaters that could rise with little warning, blocking roads, overwhelming emergency rooms, and in the worst cases, forcing chaotic evacuations.
Take Peninsula Hospital in Louisville, Tennessee. Nestled on the edge of the Tennessee River, this decades-old psychiatric facility could, during a major storm, find itself submerged under 11 feet of water. All access roads would be cut off, leaving patients and staff trapped on an island of rising fear. Aurora, a former patient who was committed to Peninsula as a teenager, described her reaction to a computer simulation of such a flood: "My first feeling is doom. These are probably some of the most vulnerable people."
Peninsula is far from alone. The KFF Health News investigation, using data from Fathom—a leader in flood simulation—identified these 170-plus at-risk hospitals by mapping their locations against sophisticated, peer-reviewed hazard models. Fathom’s technology uses laser-precision elevation data from the U.S. Geological Survey to simulate flooding at a scale as fine as 10 meters. The findings are stark: in many cases, the threat is not even shown on the official flood maps issued by the Federal Emergency Management Agency (FEMA), which have long served as the nation’s go-to tool for assessing flood risk. But as climate change accelerates and storms grow fiercer, FEMA’s maps are increasingly out of date, missing huge swaths of risk that private firms like Fathom now capture.
Caleb Dresser, an emergency room doctor and climate change researcher at Harvard, summed up the concern: "If you don’t have the information to know you’re at risk, then how can you triage that problem?"
The consequences of ignoring these risks are not theoretical. The deadliest hospital flooding in modern U.S. history happened 20 years ago during Hurricane Katrina, when 45 bodies were recovered from New Orleans’ Memorial Medical Center. More recently, in September 2024, Unicoi County Hospital in Erwin, Tennessee, was overwhelmed by floodwaters from Hurricane Helene. Paramedic Rebecca Harrison recalled the chaos: "I was scared to death, thinking, ‘This is it.’ Alarms were going off. People were screaming. It was chaos." Ultimately, 70 people, including patients and staff, had to be rescued by helicopter from the hospital’s roof.
Flood risk is not limited to coastal regions. The investigation found that hospitals in Appalachia, the Midwest, and even the arid American West could be surrounded by several feet of water during extreme weather. In Charleston, West Virginia, for example, five of the city’s six hospitals could be flooded simultaneously if the Kanawha and Elk rivers overflow their banks. In Richland, Washington, Kadlec Regional Medical Center and Lourdes Behavioral Health are at risk of 5 to 15 feet of water from a 100-year flood event. And in Erie, Pennsylvania, a small drainage creek just 50 feet from the ER at LECOM Medical Center could inundate the hospital during a major storm.
One of the most troubling findings is that at least 21 of the at-risk hospitals are designated as "critical access"—meaning there’s no other hospital within 25 miles, on average. If floodwaters close these facilities, entire communities could be left without emergency care.
Despite the gravity of the threat, the official response has, in many cases, lagged behind the science. FEMA’s flood maps, launched in the 1960s, were originally intended to guide insurance requirements and building codes. But they represent only a "snapshot in time," as FEMA itself admits, and don’t predict future flooding or account for climate change. Private companies like Fathom and First Street now offer more accurate, forward-looking simulations—but their data is often behind paywalls, making public planning and timely warnings difficult.
Chad Berginnis, executive director of the Association of State Floodplain Managers, highlighted the disconnect: "There has been not a single bit of loosening of what I’m calling the FEMA cone of silence. I’ve never seen anything like it."
The Trump administration’s approach to disaster preparedness has also drawn sharp criticism from experts. According to KFF Health News, the administration has slashed funding and staff at key federal agencies like FEMA and NOAA, disbanded advisory councils, and canceled grant programs designed to protect hospitals and other vital infrastructure from floods. In March 2025, enforcement of the Federal Flood Risk Management Standard—which required hospitals to be built or upgraded with extra flood protections—was halted. Alice Hill, who led the creation of the standard during the Obama administration, warned: "People will die as a result of some of the choices being made today. We will be less prepared than we are now. And we already were, in my estimation, poorly prepared."
Not all hospitals are standing still. CAMC Memorial Hospital in Charleston, West Virginia, for instance, has elevated its electrical systems and purchased deployable floodwalls to prepare for the worst. In New York City, the former Coney Island Hospital was rebuilt as Ruth Bader Ginsburg Hospital after Superstorm Sandy, with a $923 million FEMA-funded project that elevated patient care areas and added a four-foot floodwall. CEO Svetlana Lipyanskaya said, "The question of flooding is not an if but a when. I hope it doesn’t happen in my lifetime, but frankly, I’d be surprised. The water is coming."
Experts say that what’s needed now is a systematic, nationwide response: modernize flood risk maps, make the most accurate data publicly accessible, secure funding to strengthen hospital infrastructure, and develop robust evacuation and emergency protocols. As climate change continues to fuel stronger storms and heavier rainfall, the stakes couldn’t be higher. For many communities, the resilience of their hospitals may well determine who survives the next big storm.
