Workplace Hostage Tabletop Exercise for Health Care Facilities

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

Scenario Overview

Participants are the management team of a fictional nursing home when the facility is thrown into chaos by the sound of gunfire. Employees begin screaming and running in every direction, residents become frightened and upset, and the shooter takes hostages while remaining staff flee the building.

As law enforcement negotiates with the shooter, fear and confusion spread through the facility. Leadership must make urgent decisions about staff accountability, resident safety, communications, and continuity of care while a portion of the facility is now closed as a crime scene and normal operations are badly disrupted.

This exercise challenges health care leaders to evaluate how they would respond to a workplace hostage event involving immediate life-safety concerns, vulnerable residents, intense emotional distress, and significant operational consequences.

Why This Scenario Matters for Health Care Facilities

Health care facilities must maintain safe environments for patients, residents, staff, visitors, and families. A workplace violence incident in a care setting can create immediate life-safety concerns while also affecting continuity of care, regulatory obligations, public trust, and staff wellbeing.

This exercise helps leadership teams evaluate how they would respond when a violent hostage incident disrupts care operations, requires coordination with law enforcement, affects vulnerable residents or patients, and creates pressure to communicate responsibly with internal and external audiences.

Exercise Objectives

• Evaluate leadership decision-making during a workplace hostage incident in a care environment.
• Discuss emergency response priorities for staff safety, resident protection, and coordination with law enforcement.
• Review crisis communications with staff, families, residents, and external stakeholders.
• Assess public relations and media response during a high-profile, emotionally charged emergency.
• Examine the operational impact of losing access to part of the facility because of a crime scene investigation.
• Identify opportunities to strengthen workplace violence preparedness, staff support, and recovery planning.

Typical Participants

• Executive leadership
• Operations management
• Clinical or resident care leadership
• Human resources
• Security or safety personnel
• 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

• Emergency Response
• Crisis Communications
• Public Relations

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
• Gas Main Explosion Tabletop Exercise for Health Care Facilities
• Shelter-in-Place 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.