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A KFF Health News analysis of flood hazard mapping identified 100 U.S. nursing homes where a modeled 100-year flood could bring at least 2 feet of water to the buildings. One of them, New Richland Care Center in Minnesota, evacuated 36 residents during a September storm after floodwater entered the building; the facility has since closed. The analysis identifies potential exposure, not a prediction of when a flood will occur.
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 could endanger residents and disrupt care. The risk has already become concrete at New Richland Care Center in Minnesota: staff evacuated 36 residents on Sept. 19 after water entered the facility, which is now shuttered.
The analysis used peer-reviewed flood hazard mapping provided by Fathom, a United Kingdom-based flood simulation company. For each of the 100 facilities, the data predicted at least 2 feet of water in a 100-year flood event. That term describes an event with a 1% chance of occurring in any given year; it does not mean such a flood happens only once every century.
At New Richland Care Center, water came through the front door before sunrise. Administrator Robert Johannsen said staff pushed residents in wheelchairs through about 4 inches of water to buses. As water rose, the last three residents were wheeled out on hospital beds, which firefighters and high school football team volunteers pushed across the street. Johannsen said about 2½ feet of water flowed down the hallways. The government-run facility, near a drainage ditch in southern Minnesota, had flooded three times in 16 years.
The Minnesota storm was large but, according to the National Weather Service, far from historic. The report says some other nursing homes identified as at risk flooded within the past five years, including facilities in Florida, Kentucky, Texas and Washington. The source material does not provide the names of all 100 homes or their individual risk estimates.
Floods Can Interrupt Nursing Home Care
A flood can threaten residents and interrupt the routines and services they rely on. Nursing home residents may be medically frail, cognitively impaired or unable to move independently. Some need daily care that may be difficult to provide during a disaster, while moving them can itself carry health risks.
The stakes extend beyond the immediate flood. A facility closure can separate residents from familiar caregivers and require a rapid move elsewhere. Yet the analysis does not establish that every listed home will flood, or that any particular building will experience the modeled depth. It identifies places where planning for flood exposure may be especially consequential.
The report also points to a difficult choice for operators: staying through a flood can expose residents to rising water, while evacuation can disrupt care and put frail people through a stressful move. That makes preparation and timely decisions important for residents, families and local emergency responders.
Why Evacuation Carries Its Own Risks
The nursing home analysis builds on a 2025 KFF Health News investigation that used Fathom mapping to identify at least 170 U.S. hospitals at risk of significant flooding. KFF’s report says Fathom’s estimates are generally considered more modern than official Federal Emergency Management Agency maps, which can be out of date and may not account for a changing climate.
The United States has nearly 15,000 nursing homes, housing more than 1.2 million people. Some facilities were built near coastlines or waterways in the 1970s, when proximity to water was seen as an amenity, according to David Dosa, a geriatrics specialist at UMass Chan Medical School. Flood exposure can also affect places far from a coastline or major river: Fathom chief scientific officer Oliver Wing said that areas where rain falls can face flooding.
Experience after Hurricane Katrina in 2005 shaped the industry’s approach to evacuation. Dosa said residents died both in facilities that tried to withstand the storm and during some evacuations. A peer-reviewed study he co-wrote in 2011 recorded more than 270 nursing home evacuations before three Gulf hurricanes; the affected regions had a cumulative 277 more resident deaths than expected in the following 30 days. The study described a significant increase in mortality and morbidity associated with evacuation. A separate 2024 study found a 16% greater chance of emergency room visits among Florida assisted living residents evacuated before Hurricane Irma in 2017. Assisted living residents generally need less care than nursing home residents.
““There was at least 2½ feet of water flowing down the hallways.””
— Robert Johannsen, New Richland Care Center administrator
What the Flood Model Cannot Predict
The analysis describes modeled exposure; it does not say when or whether any one home will flood. A 100-year event has a 1% annual chance in the model’s framing, and such an event can occur more than once in a century. The source material does not include facility-by-facility forecasts, the assumptions behind each estimate, or a complete list of the 100 homes.
It is also unclear from the supplied report material what protective measures each facility has in place, whether the homes have changed their plans since the mapping was produced, or what the long-term status of New Richland Care Center will be. The material says it is shuttered after the September flooding, but does not provide a reopening date or describe where all residents went.
Climate scientists cited in the report say warming can contribute to heavier rainfall and rising seas, while storm patterns are changing. The analysis itself does not establish that climate change caused the Minnesota flood or quantify how much it affected the modeled risk at each facility.
Planning for the Next Flood
The immediate next steps for the homes identified depend on decisions by facility operators and local authorities. The report does not announce a federal response, a required action for the 100 facilities, or a deadline for new protections. Readers and families seeking details about a specific home would need to contact that facility or local emergency officials.
For operators, the findings focus attention on whether emergency plans account for water entering buildings, how residents can be moved safely, and where buses or receiving facilities would be available. The New Richland evacuation shows how staff, firefighters and community volunteers took part in getting residents out as water rose. The source material does not say whether that response plan was written in advance or what changes the facility will make.
Further reporting or updated mapping could clarify which sites face the greatest exposure and whether flood protection, evacuation arrangements or facility locations have changed. Until then, the analysis provides a risk signal rather than a schedule: the timing and severity of any future flood remain unknown.
Key Questions
What did the KFF Health News analysis find?
It identified 100 U.S. nursing homes where Fathom flood mapping predicted at least 2 feet of water in a modeled 100-year flood event.
Does a 100-year flood happen only once every century?
No. The term refers to a flood with a 1% chance in any given year. Such an event can occur more than once in a century.
What happened at New Richland Care Center?
Staff evacuated 36 residents on Sept. 19 after water entered the building. Administrator Robert Johannsen said floodwater reached about 2½ feet in the hallways. The facility is now shuttered.
Does being on the list mean a nursing home will flood?
No. The analysis identifies modeled flood exposure; it does not predict whether or when a particular facility will flood.
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