A new investigation reveals a critical vulnerability in the nation’s health care infrastructure, identifying at least 170 hospitals across the United States facing a significant risk of severe flooding. The threat, driven by climate change and outdated flood mapping, endangers patient safety and could disrupt essential medical services during extreme weather events. These facilities, which collectively account for nearly 30,000 patient beds, could be inundated by floodwaters, forcing evacuations, blocking access to emergency rooms, and potentially shutting down operations when communities need them most.
The comprehensive analysis, conducted by KFF Health News using advanced flood-simulation data, highlights risks in coastal regions, inland river valleys, and even arid areas. Troublingly, the investigation found that about one-third of these vulnerable hospitals are located in areas not designated as flood hazard zones by the Federal Emergency Management Agency (FEMA), meaning their risk is officially undocumented and potentially overlooked in disaster planning. The findings underscore a growing gap between official risk assessments and the reality of a changing climate, with facilities ranging from major urban trauma centers to small, rural hospitals all exposed to potentially catastrophic flooding.
Undocumented Dangers and Outdated Maps
A primary concern raised by the investigation is the unreliability of official federal flood maps, which have long served as the standard for planning and building regulations. The analysis showed that of the more than 170 hospitals with significant flood risk, approximately one-third are not located in a FEMA-designated 100-year flood plain. This discrepancy means that hospital administrators and local emergency planners who rely solely on FEMA data may be unaware of the true threat they face. Experts argue the federal maps are often incomplete or fail to account for the increasing frequency and intensity of rainfall driven by climate change.
The consequences of this data gap are tangible. For example, Lourdes Behavioral Health in Richland, Washington, faces a predicted inundation of 5 to 15 feet from a 100-year flood event, yet government flood maps indicate it is not in a flood plain. This is not an isolated case. The problem persists across the country, leaving a significant portion of critical health infrastructure unknowingly exposed. In 2015, a federal flood risk management standard was established that required federally funded hospitals to be elevated or incorporate extra flood protections, but FEMA ceased enforcing this rule in March 2025, further compounding the issue. FEMA has acknowledged that flooding is a “common, costly and ‘under appreciated’ disaster,” yet the tools for assessing its risk appear to lag behind the threat.
Geographic Scope of Hospital Flood Risk
The investigation reveals that flood risk is not confined to traditional hurricane zones but is a nationwide problem affecting diverse communities. The vulnerable facilities include large urban medical centers, psychiatric facilities, children’s hospitals, and long-term care centers. The analysis, based on data from the flood simulation company Fathom, modeled a “100-year flood,” defined as an intense weather event with a 1% chance of occurring in any given year.
Inland and Coastal Threats
While hospitals in coastal states like Florida, Louisiana, and New York are at high risk, so are numerous inland facilities located near rivers and creeks. In Louisville, Tennessee, Peninsula Hospital, a psychiatric facility on the bank of the Tennessee River, could be submerged in 11 feet of water during a major storm, with all access roads cut off. In Erie, Pennsylvania, a small creek just 50 feet from the emergency room at LECOM Medical Center poses a significant flood threat. In the West, Kadlec Regional Medical Center in Washington is at risk of being surrounded by several feet of water as the nearby Columbia River could overtop a levee and flood the area.
Rural Communities Face Isolation
The danger is particularly acute for rural areas. The investigation identified at least 21 “critical access” hospitals among the most threatened facilities. These hospitals are often the only medical lifeline for their communities, with the next-closest hospital typically 25 miles away or more. If flooding forces one of these hospitals to close, it could leave an entire region without access to emergency medical care during a disaster, compounding the crisis. The loss of such a facility, even temporarily, would have an outsized impact on residents who already face barriers to health care.
Climate Change and Future Vulnerability
The risks identified in the recent investigation are consistent with broader academic research on the effects of climate change on medical infrastructure. A 2022 study from the Harvard T.H. Chan School of Public Health specifically examined the vulnerability of hospitals on the Atlantic and Gulf Coasts to hurricane-related flooding. That research provides a wider lens for understanding the escalating threat posed by more powerful storms and rising sea levels.
Heightened Hurricane Dangers
The Harvard study, published in the journal GeoHealth, assessed 682 acute care hospitals in 78 metropolitan areas along the coasts. It found that in 25 of those metro areas, half or more of the hospitals were at risk of flooding from a Category 2 storm. The top 10 most at-risk metropolitan areas included Miami-Fort Lauderdale, New York-Newark, and Boston-Cambridge. The study also highlighted the risk to access roads, noting that in 18 metro areas, at least half of the roads within a mile of hospitals could flood in a Category 2 storm, preventing patients and staff from reaching the facilities even if the buildings themselves remained dry.
The Impact of Sea Level Rise
Looking toward the future, the Harvard researchers projected that climate change will significantly worsen the odds of hospital flooding. They calculated that the expected sea level rise within this century will increase the probability of a U.S. hospital flooding by 22%. Hurricanes are also projected to become more severe and strike regions farther north than they have historically, putting new areas and their health systems at risk. This forward-looking data reinforces the urgency of the KFF Health News findings, suggesting that the current list of 170 at-risk hospitals is likely to grow unless significant mitigation efforts are undertaken.