LTC Shots Fired Tabletop Exercise - HCANJ

1 Homeland Security Exercise and Evaluation Program (HSEEP)After Action report /Improvement PlanLTC Shots Fired (AAR/IP)FOUOLTC Shots FiredTabletop ExerciseFebruary 15, 2013 AFTERACTIONREPORT/IMPROVEMENTPLANPREPARE D ,MPH,REHS,MEP,CEMDIRECTOR,EMERGENCYPREPA REDNESSF ebruary 15, 2013 Homeland Security Exercise and Evaluation Program (HSEEP)After Action report /Improvement PlanLTC Shots Fired (AAR/IP)FOUOThis page is intentionally Security Exercise and Evaluation Program (HSEEP)After Action report /Improvement PlanLTC Shots Fired (AAR/IP)Handling Instructions1 title of this document is the LTC Shots Fired information gathered in this AAR/IP is classified as For Official Use Only (FOUO) andshould be handled as sensitive information not to be disclosed.

2 This document should besafeguarded, handled, transmitted, and stored in accordance with appropriate securitydirectives. Reproduction of this document, in whole or in part, without prior approval fromHealth Care Association of New Jersey is a minimum, the attached materials will be disseminated only on a need-to-know basis andwhen unattended, will be stored in a locked container or area offering sufficient protectionagainst theft, compromise, inadvertent access, and unauthorized of Contact (POC):J. David Weidner, MPH, REHS, MEP, CEMD irector, Emergency PreparednessHealth Care Association of New Jersey4 AAA Drive Suite 203 Hamilton Square, New Jersey Security Exercise and Evaluation Program (HSEEP)After Action report /Improvement PlanLTC Shots Fired (AAR/IP)Handling Instructions2 HCANJ /LANJFOUOThis page is intentionally Handling Instructions.

3 1 Contents ..3 Executive Summary ..5 Section 1: Exercise Overview ..7 Participating 2: Exercise Design Summary ..9 Exercise Purpose and Design ..9 Capabilities and Activities Identified for Demonstration ..9 Scenario 3: Analysis of 4: A: Improvement Plan ..16 Contents4 HCANJ /LANJFOUOThis page is intentionally 1: Exercise Overview5 HCANJ /LANJFOUOEXECUTIVESUMMARYThe LTC Shots Fired Tabletop Exercise was developed to test the capabilities of long term carefacilities, including skilled nursing and assisted living facilities to respond to an Active Shooterevent within their operations. The Exercise commenced with a short educational seminar toprovide players with basic knowledge of the challenges inherent to an Active Shooter event.

4 TheLTC Shots Fired Tabletop Exercise is tangible evidence of the Health Care Association of NewJersey s ( HCANJ ) and Leading Age New Jersey s (LANJ) commitment to provide continuedtraining, education and exercises via the Homeland Security Exercise and Evaluation Program(HSEEP) process. Since many of the players participating in this Exercise have had no priorexperience in discussion-based exercises and due to the short time period allowed for theexercise, it was important that the design of this Exercise draw out and identify areas ofimprovement in a positive manner, as well as, encourage our member facilities to become moreactive in the HSEEP Exercise following objectives were developed for LTC Shots Fired : Objective 1:Identify and evaluate plans for response and mitigation ofpotential workplace violence such as an Active Shooter event.

5 Objective 2:Assess the roles and effectiveness of coordination between lawenforcement officials and LTC owners/operators in reacting to an ActiveShooter event in accordance with existing plans. Objective 3:Examine and evaluate facility incident response plans usedduring an Active Shooter event. Objective 4:Assess the methods and effectiveness of internal and externalcommunications during an Active Shooter event in accordance with existingplans and SOPs. Objective 5:Identify and evaluate response, mitigation, and recovery actionsassociated with an Active Shooter event at their facility. Objective 6:Identify gaps, redundancies, developmental activities, and bestpractices in standard procedures in response to an Active Shooter purpose of this report is to analyze Exercise results, identify strengths to be maintained andbuilt upon, identify potential areas for further improvement, and support the development ofcorrective actions that will guide future emergency preparedness grant initiatives to advanceoverall emergency preparedness within each of our member facilities.

6 As such, this AAR/IP willbe made readily available to all HCANJ and LANJ members via our website and may bedistributed to all players for their review and StrengthsThe major strengths identified during this Exercise are as follows: Facilities recognize the importance of providing their employees with training andSection 1: Exercise Overview6 HCANJ /LANJFOUO education related to Active Shooter situations; Facilities identified adequate policies and procedures for visitor accountability; Existing emergency operations plans provide a suitable foundation for the addition ofActive Shooter policies, plans, and Areas for ImprovementThroughout the Exercise , several opportunities for improvement in the response to the scenariowere identified.

7 The primary areas for improvement are as follows: Facilities recognize that the LTC environment often provides limitations to physicalsecurity and therefore they must rely on other strategies to address Active Shootersituations; Facilities must establish relationships and open-lines of communication with locallaw enforcement agencies and local offices of emergency management; Facilities must augment existing emergency operations plans with specificinformation related to active shooter situations and provide training and education totheir Exercise met all pre-established objectives related to the identification of internal plans,policies and procedures essential to address a regional catastrophic weather-related eventresulting in evacuations and medical surge.

8 HCANJ member participants indicated that theexercise was a positive learning experience, that they had the opportunity to network with theircolleagues, and expressed an increased interest in HCANJ s emergency preparedness 1: Exercise Overview7 HCANJ /LANJFOUOSECTION1:EXERCISEOVERVIEWE xercise DetailsExercise NameLTC Shots FiredType of ExerciseSeminar and Discussion Based Tabletop Exercise (TTX) Exercise Start DateJanuary 16, 2013 9:00amExercise End DateJanuary 16, 2013 12 hoursLocationRobert Wood Johnson Center for Health and WellnessSponsorHealth Care Association of New Jersey ( HCANJ ) / Leading Age New Jersey (LANJ)Grant funding provided under the auspices of the New Jersey Department of Health andSenior Services (NJDHSS), United States Department of Health and Human Services(HHS), Assistant Secretary for Preparedness and Response (ASPR), Office ofPreparedness and Emergency Operations (OPEO), Division of National HealthcarePreparedness Programs (DNHPP) Hospital Preparedness Program (HPP)

9 ProgramHealthcare Association Emergency Preparedness ProgramMissionResponseCapabilitiesCommun ications, PlanningScenario TypeActive ShooterSection 1: Exercise Overview8 HCANJ /LANJFOUOE xercise DirectorJ. David Weidner Exercise DirectorDirector, Emergency PreparednessHealth Care Association of New Jersey4 AAA Drive Suite 203 Hamilton, New Jersey OrganizationsChelsea @ Brick, Jewish Home @ Rockleigh, Stonebridge @ Montgomery, Jewish Home @Rockleigh, Wanaque Convalescent Center, Hamilton Continuing Care Center, OceanViewCenter for Rehab, Francis E. Parker Memorial Home, Bella Terra Senior Living, SomersetMedical Center, Parker @ Stonegate, McCarrick Care Center, Park Place Center, PreaknessHealthcare Center, Westfield Center, Forest Hill Health Care Center, Warren Haven,Brandywine @ The Gables, Woodbury Mews, Morristown Medical Center, CourthouseConvalescent Center, Seacrest Village, Jersey Shore Center, Medicenter Rehab and Nursing,Brandywine @Governor s Crossing, Barnegat Rehab & Nursing Center, Masonic Home of NJ,Bergen Regional Medical Center, Somerville Police Department, NJ State Police, Sussex CountySheriff s Office.

10 Riverview Estates Baptist Home, New Jersey Department of Health, HomeCare Association of New Jersey, New Jersey Office of Homeland Security and PreparednessNumber of ParticipantsPlayers - 64 Evaluators 5 Facilitators - 6 Section 4: Conclusion9 HCANJ /LANJFOUOSECTION2:EXERCISEDESIGNSUM MARYE xercise Purpose and DesignAn Active Shooter is defined as an individual who is actively engaged in killing or attempting tokill people. In most cases Active Shooters use a firearm(s) and display no pattern or method forselection of their victims. In some cases, Active Shooters use other weapons and/or improvisedexplosive devices to cause additional victims and act as an impediment to police and the probability of an Active Shooter event occurring within a long term care facility isrelatively low, the business impact and the impact to the health and well being of residents, staffand their families is great.