In an effort to rebuild the Unicoi County Hospital following its destruction by Hurricane Helene, Ballad Health has announced plans to construct a new facility on a plot of low-lying farmland in Unicoi, Tennessee. This decision comes despite concerns about significant flood risks at the new site, which could experience flooding in less severe storms.
The hospital, destroyed on September 27, 2024, when floodwaters from Hurricane Helene inundated the facility and forced emergency evacuations, will be relocated approximately 7 miles from its original location. The new $44 million construction project will sit behind a Walmart in Unicoi, Tennessee. However, climate data companies Fathom and First Street are warning that a 100-year flood could submerge the new site under more than 2 feet of water, posing a substantial risk.
Oliver Wing, Chief Scientific Officer at Fathom, remarked, The proposed site is so obviously a flood plain geomorphologically. You don’t need a model to see that.
The new hospital location presents a higher flooding risk than the prior site due to a nearby creek and potential runoff from mountain storms. To mitigate flooding, Wing suggests elevating the hospital or constructing embankments.
Ballad Health confirmed the site but did not address queries regarding flood defenses. Spokesperson Molly Luton indicated that they are working with geotechnical professionals and an architecture firm, Earl Swensson Associates, to ensure a safe facility. FEMA, although contributing $7.4 million to the rebuilding process, has outdated flood maps not indicative of the risks highlighted by Fathom and First Street.
Chad Berginnis, Executive Director of the Association of State Floodplain Managers, expressed concerns over ignoring advanced data from Fathom and First Street in favor of FEMA’s less comprehensive maps. He emphasized that elevation—potentially needing to raise the site by 8 to 18 feet—is crucial, adhering to the highest standards like those recommended by the American Society of Civil Engineers, to withstand potential future floods akin to Hurricane Helene.
The previous hospital, costing $30 million, was built despite known flood risks identified by FEMA decades ago. Alan Levine, who was CEO during its construction, stated that the original development followed proper protocols at that time.
Challenges from the aftermath of Hurricane Helene showed the vulnerability of Unicoi County Hospital to intense weather events. Angel Mitchell, a survivor of the initial flood, expressed frustration over the hospital’s decision to rebuild in a potentially flood-prone area, pointing out the constraints residents face under Ballad’s hospital monopoly in the region.
State Representative Renea Jones’s family is selling the land for the new site, as per local reports, although Jones remains silent on flood risks associated with the area. Despite these challenges, Ballad Health views the reconstruction as pivotal for community healthcare, with plans to finalize the land purchase and commence construction shortly.
- Topics: Tennessee, Flooding, Hurricane
- Data Contributors: KFF Health News, Fathom, First Street
Contributions to this report were made by Holly K. Hacker and Lauren Sausser of KFF Health News.

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