Shelter-in-Place Tabletop Exercise for Health Care Facilities

This exercise is part of our catalog of tabletop exercises for health care facilities.

Scenario Overview

Participants work as the management team for a fictional nursing home when a rumble shakes the facility and a news report announces that a chemical cloud has been released, forcing all area buildings to shelter in place. With little warning and limited information, the facility is thrust into a tense and uncertain situation.

As the incident develops, chaos spreads among residents, family members, and staff. Residents become unsettled, family members grow angry and demanding, and staff members struggle to maintain calm while continuing to provide care with limited resources. Leadership must make difficult decisions about how to keep residents, staff, and guests safe while also controlling access to the facility and preventing people on the outside from getting in.

This exercise challenges health care leaders to handle a prolonged shelter-in-place emergency involving vulnerable residents, staffing constraints, family communications, and continuity of care under stressful and restrictive conditions.

Why This Scenario Matters for Health Care Facilities

Health care facilities must maintain safe, functional environments for patients or residents, staff, visitors, and families. A shelter-in-place order caused by a chemical release or similar external hazard can immediately affect life safety, access control, staffing, and the ability to continue delivering care inside the facility.

This exercise helps leadership teams evaluate how they would respond when an external threat forces residents and staff to remain inside for an extended period, requiring strong coordination across life safety, care delivery, communications, and operations.

Exercise Objectives

• Evaluate leadership decision-making during a prolonged shelter-in-place emergency.
• Discuss how to protect residents, staff, and guests while maintaining continuity of care.
• Review staffing, resource, and care-delivery challenges during a restricted operations period.
• Assess communications with families, staff, responders, and other stakeholders.
• Examine access control and security issues when people outside want to enter the facility.
• Identify opportunities to improve shelter-in-place planning, emergency coordination, and operational resilience.

Typical Participants

• Executive leadership
• Operations management
• Clinical or resident care leadership
• Facilities leadership
• Human resources
• Communications or public affairs staff
• Emergency preparedness or crisis management team members

Exercise Format

Conduct-It-Yourself Tabletop Exercises are structured, discussion-based simulations designed to help organizations test their response to disruptive events without the time and cost of a fully facilitated exercise. Participants are placed in the middle of a realistic scenario as it unfolds and must work through decisions, priorities, and consequences as a leadership team.

Each downloadable exercise package includes everything needed to conduct the session internally, including facilitator instructions, exercise overview materials, participant forms, a detailed scenario script, and a ready-to-run PowerPoint presentation that guides the scenario and discussion. The materials are designed so organizations can conduct the exercise as delivered or customize the storyline and supporting materials to reflect their own facilities, operations, and testing objectives.

Most exercises are designed to be conducted in approximately 2 to 4 hours. A typical agenda includes an exercise overview and scenario briefing, the facilitated disaster simulation discussion, group review and preparation for debriefing, and a structured post-exercise discussion to capture lessons learned and improvement opportunities.

Exercise Focus

• Shelter-in-Place
• Emergency Response
• Crisis Communications

Related Tabletop Exercise Scenarios

Organizations exploring this scenario may also find these exercises useful:

• Cyber Crime Tabletop Exercise for Health Care Facilities
• Multiple Disruptions Tabletop Exercise for Health Care Facilities
• Workplace Hostage Tabletop Exercise for Health Care Facilities
• Gas Main Explosion Tabletop Exercise for Health Care Facilities

Purchase & Download

This exercise is delivered as a downloadable package that includes facilitator instructions, scenario materials, and structured discussion prompts to guide the exercise.