Risk Considerations: Armed Security in Senior Care Organizations
Susan Lucot, MSN, RN, MLT (ASCP), CPHRM
Turmoil in the streets and increasing crime have made their way to the doorsteps of senior care organizations across the country. The targeting of these vulnerable populations makes it troubling for staff to protect their residents and maintain their own safety.
Many senior care facilities are exploring proactive measures such as hiring or contracting security guards who carry weapons to protect residents, visitors, staff, and property. These decisions require careful consideration, and facilities should conduct assessments and develop thorough policies and procedures.
Assessments and Policies/Procedures
Before deciding to implement an onsite security program that involves the use of weapons, each senior care organization should conduct a hazard vulnerability assessment (HVA) to quantify the risk of violence near and within their community. The American Society for Health Care Engineering offers a downloadable HVA Tool. In addition, organizations should consider their liability insurance needs to implement an employed or contracted armed security guard program. An insurance broker can provide guidance in this area.
If senior care communities decide to implement this level of protection, they should take a methodical approach that observes state and federal regulations and ensures maximum safety. Even if organizations decide to use energy weapons (e.g., tasers) rather than firearms, they need to understand the potential for bodily injuries and implement guidelines for security guard assessment and selection, training, weapon use, weapon discharge response, and storage.
As with other organizational programs, security programs require well-defined policies procedures. Senior care organizations should consider various policy and procedure aspects, including purpose of weapons, type of weapons, authorization, training, storage, use and discharge, response protocols, and debrief and investigation.
Purpose of Weapons
Security policies should state the rationale for weapon use — e.g., to maintain the security of the community due to an increase in violent threats and incidents within the local geographic area. Appropriate staff should conduct an HVA to ascertain the actual threat.
Type of Weapons
Organizations should describe the type of weapons included in their security programs. Energy weapons (e.g., tasers) have limited lethality, but may subdue a potential perpetrator or aggressor. If facilities plan to use more lethal weapons (e.g., various types of firearms), they should have well-defined purposes.
Authorization to Carry Weapons
Proper vetting of potential candidates to carry weapons should include — at minimum — criminal background (state and federal) and sex offender registry checks, physical and cognitive testing, and formal behavioral health assessment and history. Once candidates have been thoroughly vetted, they should receive adequate and appropriate training in security techniques and weapon safety precautions.
Training of Personnel (Initial, Continuing, and Drills)
Personnel training should encompass initial education as well as ongoing competency evaluations. As part of the training program, organizations should incorporate routine drills to assist security personnel in maintaining proficiency and alertness as to when and where potential violent acts may occur.
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Storage of Weapons
When weapons are not in use, proper storage is required. Security personnel should maintain weapons in a designated area under secured entry with limited personnel access. In addition, security policies should address cleaning and maintenance of the weapons to ensure proper discharge.
Use and Discharge of Weapons
Security personnel should only use weapons during situations involving aggressive and violent behaviors. This would include escalating threats of bodily injury as well as property damage that threatens harm to residents, staff, and visitors (e.g., igniting a fire or throwing projectiles meant to cause harm and/or damage).
Response to Individuals Subdued by Weapons
Security policies should describe procedures for managing subdued perpetrators. These procedures will likely depend on the situation and the type of weapon used. For example, if a perpetrator is subdued using a taser, security personnel should ensure the individual is breathing and out of immediate danger from other hazards. Personnel should contact local law enforcement and, if possible, maintain visual contact of the assailant.
Debrief and Investigation
Following the use or discharge of a weapon, organizations should review events that occurred before, during, and after the incident. A thorough root cause analysis of the situation is recommended, including:
In Summary
Safeguarding residents, visitors, and staff members from violence is a growing concern in many senior care organizations. When considering whether to employ or contract armed security personnel, decision-makers at these facilities should conduct HVAs and carefully consider critical aspects of implementing security policies and procedures that maximize safety and minimize harm. For more general information on this topic, see MedPro’s article Developing a Violence Prevention Program for Senior Care Facilities.
Disclaimer
This document does not constitute legal or medical advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions.
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