The Critical Steps SNFs Should Take in an Active Shooter Situation

The recent hurricanes that have battered states along the Gulf Coast have undoubtedly put the disaster preparedness of long-term care facilities in the region to the test. But not all potential disasters are as predictable as hurricanes, and long-term care facilities still need to be ready to handle them.

For this reason, Chicago-based risk management, insurance brokerage and advisory firm Willis Towers Watson (Nasdaq: WLTW) has released its free Active Shooter/Armed Intruder Readiness Program.

The program features a toolkit aimed to help senior living and long-term care facilities plan for, respond to, and recover from such scenarios. The toolkit can be easily customized to fit a specific facility’s needs and requirements, according to Willis.


Materials include a critical action steps training video; examples of policies and procedures for active shooter/armed intruder situations; a company and community readiness plan and checklist; as well as a recording of a webinar titled “Active Shooter Response Plan,” hosted by Willis Towers Watson and Sorensen, Wilder & Associates, a safety and security consulting firm based in Bradley, Ill.

Willis Towers Watson consults with operators and owners of more than 2,000 senior living communities across the country.

The development of the program originated from client interest, according JoAnne Carlin, vice president of clinical risk services for Wills Towers Watson’s senior living practice. Though educational materials from the U.S. Department of Homeland Security and the Federal Bureau of Investigations (FBI) on how to handle active shooter and armed intruder situations are already available, they aren’t specific to the senior and long-term care industry.


“The uniqueness of senior living is the fact that the workers who go to work in these environments are there to help residents who really can’t perform all the activities of daily living,” Carlin told Skilled Nursing News. “And so, there is a bit of a dilemma between following [guidelines] for office buildings and schools—where people can basically help themselves—to our employees in senior living trying to decide how they can preserve life for themselves [as well as] protect the residents.”

From this starting point, Steve Wilder, CEO of Sorensen, Wilder & Associates, adapted the available materials for the senior housing industry.

“[Wilder is a] professional advisor and certified in this type of training, and he was the person who developed the script and the methodology of … what we explained in the training video and the sample policy [designed] to help guide the employees to think of how they are going to address any situation that would come up with an armed intruder,” said Carlin.

In the instructional video, Wilder highlighted the “Four Outs” that staff members should follow in an active shooter situation: Get Out, Hide Out, Keep Out, and Take Out.

He stressed that if employees and residents think they hear gunshots, treat it as gunfire until you know otherwise. Staff should try to identify the shooter’s location and, if possible, move themselves and residents out of the building as quietly and as quickly as possible.

“Leave belongings behind, but bring a phone if it’s in possession … If time allows, announce that there is an active shooter in the building,” Wilder said in the video.

With several active shooter incidents occurring in recent years—including the Planned Parenthood shooting in Colorado Springs, Colo., in 2015, and the Pulse Nightclub shooting in Orlando, Fla., in 2016—it’s important to remember that senior housing and long-term care facilities are not immune, and consequently need resources and guidelines to help promote the safety of staff and residents alike, according to John Atkinson, managing partner of Willis Towers Watson’s senior living practice.

This past May, for instance, a gunman killed two nursing home employees and a local police chief at the Pine Kirk Care Center in Kirkersville, Ohio. In 2009, seven nursing home residents and one nurse were shot to death at a facility in Carthage, N.C.

“An active shooter event is something that no one wants to imagine happening in a senior living community, but the reality is that all places where people congregate, including senior living communities, are vulnerable,” said Atkinson in a press release. “This vulnerability calls for an increased need for preparedness.”

This need is particularly true, as preparedness for such scenarios is an aspect that agencies should implement as part of their Hazards Vulnerability Assessment programs, according to Carlin.

“There have been documented shootings in nursing homes and every time one of these episodes occurs, everyone stops and thinks, especially when you’re responsible with others’ lives,” said Carlin. “There’s no predictability—I think that’s the scariest part, and yet we’re all compelled to be prepared, just like you’re prepared for a hurricane or any other hazard that might befall a community. We need to be prepared for something like this because it is happening.”

Written by Carlo Calma

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