Hurricane Helene destroyed a Tennessee hospital. Officials knew it was at risk.

he rooftop of Unicoi County Hospital in Erwin, Tennessee, where dozens of patients, staffers, and first responders were rescued by helicopter after floodwaters from the nearby Nolichucky River overwhelmed the building during Hurricane Helene. (Maddy Alewine for KFF Health News)

Erwin, Tennessee — April Boyd texted her husband before she boarded the helicopter.

“So, I don’t want to be dramatic,” she wrote on Sept. 27, “but we are gonna fly and rescue patients from the rooftop of Unicoi hospital.”

Earlier that day, Hurricane Helene roared into the Southern Appalachian Mountains after moving north through Florida and Georgia. The storm prompted a deadly flash flood that tore through Unicoi County in eastern Tennessee, trapping dozens of people on the rooftop of the county hospital.

The fast-moving floodwaters had made earlier rescue attempts by ambulance and boat impossible. Trees, trailers, buildings, caskets, and cars swept past the hospital in murky, brown rapids that overwhelmed the one-story structure with 12 feet of water on all sides.

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