The ‘Four Outs’ Operators Should Follow in an Active Shooter Situation

Editor’s Note: This story was published to Senior Housing News shortly before news broke of the Las Vegas shooting early Monday.

Hurricanes Harvey and Irma have certainly tested the emergency preparedness of senior living communities along the Gulf Coast in recent weeks. Unfortunately, not all potential disasters are as predictable as hurricanes—but senior housing communities 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 for senior living communities.


The Active Shooter/Armed Intruder Readiness Program features a toolkit aimed to help senior living communities plan for, respond to and recover from such scenarios. The toolkit can be easily customized to fit a specific community’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, emergency preparedness/disaster management and public safety consulting services firm based in Bradley, Illinois.

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. While educational materials from the U.S. Department of Homeland Security and the Federal Bureau of Investigations (FBI) on how to handle active shooter/armed intruder situations are already available, they aren’t specific to the senior living 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 Senior Housing 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.

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“[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 you think a noise sounds like gunshots, treat the noise as gunfire until you know otherwise. Staff should try to identify the shooter’s location and, if possible, they should move themselves and residents out of the building as quietly and as quickly as they can.

“Leave belongings behind, but bring a phone if it’s in possession… [and] 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, Colorado, in 2015, and the Pulse Nightclub shooting in Orlando, Florida, in 2016—it’s important to remember that senior housing communities 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.

“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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