New Richland, Minnesota — When floodwater poured through the front door of the New Richland Care Center before sunrise on Sept. 19, staff had minutes to act, not days. They wheeled 36 residents through standing water to waiting buses, then sent the last three out on hospital beds cranked as high as they would go, according to administrator Robert Johannsen. Firefighters and members of a high school football team pushed the beds across the street to safety.
The residents made it out. The home did not, at least not for a while. Johannsen says the small, government-run facility — one of the largest employers in town, with 85 workers — will be closed for five months to a year for repairs. Residents who spent the first night in a school gymnasium have since been resettled across roughly nine other nursing homes in the area, and staff are losing their jobs.
“It was an awful experience that I hope nobody ever has to go through,” Johannsen said. “There was at least 2½ feet of water flowing down the hallways.”
That scene is exactly what a new KFF Health News analysis warns could play out elsewhere. Using flood modeling from Fathom, a United Kingdom-based firm whose simulations are widely viewed as more current than the federal government’s often outdated flood maps, the analysis identified 100 U.S. nursing homes where a 100-year flood could push at least 2 feet of water into the building. Some could see far more.
A 100-year flood sounds like a distant threat. It’s really just a storm with a 1% chance of occurring in any given year — and climate researchers say those odds are shifting as storms dump heavier rain on regions that never planned for it.
The stakes are uniquely high in long-term care. The country’s nearly 15,000 nursing homes house more than 1.2 million people, many of them medically fragile, cognitively impaired, or unable to walk. Staying put through a disaster can be deadly, but leaving carries risks too — and when a building goes offline, even temporarily, it strains a supply of nursing home beds that was already shrinking.
Evacuation research makes the dilemma plain. A 2011 study co-authored by Dr. David Dosa of UMass Chan Medical School, who has studied nursing home evacuations since Hurricane Katrina, tracked more than 270 evacuations ahead of three Gulf Coast hurricanes and counted roughly 277 more resident deaths than expected in the following 30 days. “It’s Russian roulette,” Dosa said. “You are damned if you do. You are damned if you don’t.”
A 2024 study of Florida assisted living facilities evacuated before Hurricane Irma found a 16% greater chance of emergency room visits among displaced residents. The researcher who led the work, Cassandra Hua of UMass Lowell, noted that nursing home residents are usually at higher risk, “so anything you see in assisted living might be multiplied in a nursing home setting.”
New Richland, for its part, had been warned by history. The home flooded in 2010 and 2016 and was partly surrounded by water in 2023 before this September’s storm, which dropped 4 to 8 inches of rain across southeastern Minnesota. Runoff from nearby farms pooled in a low-lying baseball diamond at the edge of town, then swamped the streets around a building that sits about 100 yards from a drainage ditch.
Why there? Oliver Wing, Fathom’s chief scientific officer, didn’t mince words. The land around New Richland has been engineered to keep water off crops, he said, and funnel it toward the town. “The choice has been made that we don’t want water in our crop fields,” he said. “We want it in the nursing homes of vulnerable people.”
The 100 homes flagged in the analysis now face the same arithmetic New Richland did — and so do the state agencies that license them.
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