Minnesota Flooding Turns a Nursing Home Risk Into a Real-World Evacuation
Floodwater entered New Richland Care Center before sunrise, and the response had to be immediate. Staff moved 36 residents out of the building on Sept. 19 as water climbed from inches to feet, with the last three residents carried out on hospital beds lifted as high as possible while firefighters and high school football players pushed them across the street.
The scene in southern Minnesota was not a one-off disaster so much as a preview. A KFF Health News analysis of proprietary flood modeling from Fathom identified 100 U.S. nursing homes where a severe storm could bring at least 2 feet of water to the building, enough to endanger residents, disrupt care, and force evacuation. New Richland Care Center is one of them.
The facility sits about 100 yards from a drainage ditch and has flooded three times in 16 years. This September’s storm was large but not historic by weather standards, which makes the episode more troubling rather than less. If a relatively ordinary storm can overwhelm the grounds, the clinical and operational vulnerability is already baked into the site.
Frailty Makes Flood Exposure a Medical Emergency
Nursing home residents are not simply people who need a different building. Many are medically frail, cognitively impaired, or unable to move without assistance, which means flood risk quickly becomes a patient safety crisis. Daily care cannot be paused during a disaster, yet moving residents can trigger a cascade of harm: hypothermia, pressure injuries, medication interruptions, delirium, and emergency department transfers.
David Dosa, head of geriatrics at UMass Chan Medical School, has studied nursing home evacuations since Hurricane Katrina. After the levee failures flooded parts of New Orleans in 2005, dozens of people died in facilities that tried to shelter in place. The industry then shifted toward evacuation planning, but moving frail residents has its own dangers.
A 2011 study co-written by Dosa found that more than 270 nursing home evacuations occurred ahead of three Gulf hurricanes and that the affected regions recorded 277 more deaths than expected in the 30 days that followed each storm. The signal was not subtle: evacuation itself carried measurable mortality and morbidity. A separate 2024 study found a 16% greater chance of emergency department visits among residents of Florida assisted living facilities who were evacuated before Hurricane Irma, and nursing home residents are generally even more medically vulnerable.
Older adults do not tolerate environmental disruption well, especially when oxygen, dialysis, wound care, dementia support, and routine medications are all tethered to a facility that may suddenly become inaccessible. In that setting, water is not merely water. It is a threat multiplier.
Why the Flood Map Sees Danger Where Old FEMA Maps Miss It
The analysis draws on Fathom’s flood modeling, which estimates coastal, river, and rainfall-driven flooding and incorporates climate-related changes, soil conditions, and terrain in a way that older official maps often do not. FEMA maps can lag behind the present risk environment. Fathom’s approach is designed to capture the weather patterns and hydrologic shifts that are already reshaping exposure in parts of the country once considered relatively safe.
Climate scientists say a warming atmosphere can hold more moisture, making intense rainfall more likely, while sea-level rise and changing storm tracks raise the stakes in coastal and inland communities alike. Drew Gronewold, a climate scientist at the University of Michigan, said storm systems are now reaching places that were historically less prepared for flooding. In other regions, storms are becoming less frequent but more intense, delivering rainfall that can overwhelm drainage systems, culverts, and low-lying facilities.
One line from the New Richland case cuts through the abstraction. The farmland around the town funnels runoff into creeks and ditches that empty into a low basin near the nursing home. In practical terms, the site functions like a catchment area. When the rain came, stormwater pooled in a nearby baseball diamond and then moved through streets toward the building.
Oliver Wing, Fathom’s chief scientific officer, described the danger bluntly: the area had been shaped to keep water off crop fields, with the unintended consequence of pushing it toward vulnerable people. The hydrology is not theoretical. It is visible in the path water took across the town and into the hallway of a nursing home.
New Richland Care Center was later left with knee-high watermarks, mud-smeared floors, and damaged belongings, including photo albums that could not be replaced. The building, one of the largest employers in town with 85 employees, is expected to remain closed for five months to a year while repairs proceed. Residents were relocated across about nine area nursing homes after first being moved to a school gymnasium.
A Warning for the 1.2 Million People Living in Nursing Homes
The United States has nearly 15,000 nursing homes housing more than 1.2 million people, and the population inside them is among the least able to absorb a failed evacuation or a prolonged power and water outage. Even a few inches of flooding can interrupt staffing, medication delivery, food service, oxygen support, and waste management. Once floodwater reaches a building entrance, the entire care model starts to unravel.
Some of the 100 nursing homes identified in the analysis have already flooded in recent years, including facilities in Florida, Kentucky, Texas, and Washington. Other examples from past storms show how quickly disaster response can turn into a rescue operation. During Superstorm Sandy, five facilities flooded in New York, while another elevated center narrowly stayed above water. In Indiana, more than 150 people were evacuated from Munster Med Inn during Hurricane Ike, with some residents carried down stairs in the dark by National Guard personnel.
The New Richland evacuation adds a painful local example to a national pattern. Staff had little time, residents had little mobility, and the flood arrived with enough force to make the hallway itself dangerous. For nursing homes in flood-prone settings, the central question is not whether severe weather can happen. It is whether the building can safely protect residents when it does not.
KFF Health News’ analysis used Fathom data and Centers for Medicare & Medicaid Services facility locations to identify nursing homes where modeled flood depths could reach at least 2 feet during a 100-year flood event. The methodology focused on whether floodwater overlapped with the building footprint and surrounding grounds, then narrowed the list to the 100 facilities with the greatest predicted flooding. The analysis did not measure how flooding beyond the footprint might affect staff, transport routes, or nearby infrastructure, and it did not assess each facility’s preparation efforts.
Even with those limits, the clinical and operational picture is plain. Some nursing homes are sitting in places where the next heavy storm could turn a routine shift into an evacuation, a hospitalization, or worse.