The episode title refers to mile marker 54 where Martha's husband Hank died.
The Texas State Capitol is seen in the background from the roof of the hospital. The hospital could be the Seton Medical Center from the camera angle.
The hospital scenes were filmed at the abandoned Brackenridge Hospital which is adjacent to the university of Texas campus in Austin. This hospital was vacated in May 2017 and is scheduled for demolition in Summer 2019.
This episode is dedicated to Dwayne Haevischer.