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A KFF Health News analysis using flood hazard mapping from Fathom identified 100 U.S. nursing homes where a modeled 100-year flood could bring at least 2 feet of water to the buildings. A September flood forced the evacuation of 36 residents from New Richland Care Center in Minnesota, illustrating the stakes for residents who may be harmed both by flooding and by relocation.
A KFF Health News analysis identified 100 U.S. nursing homes where a modeled 100-year flood could bring at least 2 feet of water to the buildings, a level that can threaten residents and disrupt care. A September flood at New Richland Care Center in Minnesota forced staff to evacuate all 36 residents, showing how quickly the risk can become an emergency.
At New Richland Care Center, water entered through the front door shortly before sunrise on Sept. 19. Administrator Robert Johannsen told KFF Health News that staff moved residents in wheelchairs through about four inches of water to buses. The final three residents left on hospital beds as firefighters and high school football team volunteers pushed them across the street. Johannsen said water later flowed about 2½ feet through the hallways. The government-run facility is about 100 yards from a drainage ditch and has flooded three times in 16 years.
The analysis used peer-reviewed flood hazard mapping from Fathom, a U.K.-based flood modeling company. Its data estimated that a 100-year flood event could bring at least two feet of water to each of the 100 facilities. A 100-year flood has a 1% chance in any given year; that probability does not mean such a flood occurs only once every 100 years. The supplied report does not identify all 100 homes by name or provide a facility-by-facility risk estimate.
KFF Health News said the work builds on its 2025 investigation, which used Fathom mapping to identify at least 170 U.S. hospitals at risk of significant flooding. The report notes that FEMA flood maps can be out of date and may not account for a changing climate. Fathom’s estimates are described as more modern than those official maps, but they are model-based projections rather than records of flooding at every listed home.
Floods Can Disrupt Nursing Home Care
Nursing home residents may be medically frail, cognitively impaired or unable to move without assistance. Floodwater can cut off routine care, power or access to essential services; evacuation can also interrupt care and place residents under physical and emotional strain. The report says the U.S. has nearly 15,000 nursing homes serving more than 1.2 million people, so planning for hazards affects a large population.
The Minnesota evacuation illustrates the narrow decisions facing staff: remaining in a flooded building can expose residents to immediate danger, while moving them can carry its own health risks. The analysis identifies potential exposure, but does not establish that all 100 homes will flood or that any particular evacuation will cause harm. Its value is in highlighting facilities that may warrant closer planning and preparation.
Why Flood Risk Reaches Care Homes
Many nursing homes were built near coastlines or waterways in the 1970s, when proximity to water could make surroundings more comfortable, according to David Dosa, head of geriatrics at UMass Chan Medical School. Such locations can also expose facilities to flood hazards. The report says storms can threaten places that were once considered lower risk, while changing storm patterns may bring more intense events in some regions.
Disaster planning has to weigh evacuation against sheltering in place. After Hurricane Katrina flooded parts of the New Orleans area in 2005, deaths occurred at facilities that stayed during the storm, the report says. The nursing home industry subsequently shifted toward evacuations, but research has also associated evacuations with health risks. A 2011 study co-authored by Dosa recorded more than 270 nursing home evacuations ahead of three Gulf hurricanes and found 277 more resident deaths than expected across the affected regions during the following 30 days. The study suggested an association; the supplied account does not establish that evacuation alone caused those deaths.
A 2024 study led by Cassandra Hua found a 16% greater chance of emergency room visits among residents of Florida assisted living facilities evacuated before Hurricane Irma in 2017. Assisted living residents generally need less care than nursing home residents, so the report cautions against treating that result as a direct measure of nursing home outcomes.
““There was at least 2½ feet of water flowing down the hallways.””
— Robert Johannsen, New Richland Care Center administrator
What the Flood Models Cannot Show
The analysis describes modeled risk, not a prediction that a specific flood will occur at any one facility. The supplied material does not name all 100 homes, give the probability of flooding at each site beyond the 100-year-event framing, or describe how individual facilities have prepared. It also does not specify the year of the Sept. 19 Minnesota flood or when New Richland Care Center may reopen.
The report excerpt says other identified homes have flooded in recent years, including facilities in Florida, Kentucky, Texas and Washington, but ends before providing further details. It is unclear from the material which additional facilities have flooded, what protective measures the 100 homes have in place, and how local or federal agencies may respond to the analysis.
Facility Plans Will Shape Readiness
The report points to a need for nursing homes and local emergency responders to prepare for flooding, including decisions about when to move residents and how to maintain care during a disruption. The supplied material does not announce a new federal requirement, funding program or response tied to the analysis. It also does not say what steps New Richland officials will take before the care center reopens.
Further reporting or information from the facilities and public agencies could clarify which homes have evacuation plans, what flood protections are in place and how residents would be moved safely. For now, the analysis identifies locations where planners may need to examine those questions; it does not establish that flooding is imminent at any listed home.
Key Questions
What did the KFF Health News analysis find?
It identified 100 U.S. nursing homes where Fathom’s flood mapping estimated at least two feet of water during a modeled 100-year flood event.
What does a 100-year flood mean?
It describes an event with a 1% chance of occurring in any given year. It can happen more than once within a century.
What happened at New Richland Care Center?
Floodwater entered the Minnesota facility on Sept. 19, and staff evacuated all 36 residents. Administrator Robert Johannsen said water later flowed about 2½ feet through the hallways.
Does the analysis mean the 100 homes will flood?
No. It identifies modeled exposure in a specified flood scenario. It does not predict that a flood will occur at each facility or say when one might happen.
Why can evacuating residents also be risky?
Many nursing home residents need continuous medical or daily care and may be frail or have limited mobility. The report cites studies associating evacuations with increased health risks, while also describing the dangers of remaining in a flooded facility.
Source: rss
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