Sutherland Springs Church Shooter Practiced by Shooting Dogs, Fracturing Baby’s Skull- Could it happen at your Church?

Every day more information comes out about the terrible murders by the Active Shooter at the Baptist church in Sutherland Springs, Texas. Since my mother was from Texas, and my father taught Adult Baptist Sunday School for 36 years, this one was personal.

This is a classic case of how the risk of an active shooter is everywhere these days. With so many recent shooting incidents, because it was done in a church, it makes it worse and should encourage all churches to hold active shooter training classes for their congregations.

No question that the shooter was a monster. After uncovering his record for domestic violence and even fracturing his infant’s skull, it turned out he practiced his shooting skills on pet dogs. He bought dogs on Craigslist, or took dogs promising to give them good homes, and then practiced shooting and killing them.

Houses of worship have been adverse to putting in stricter security, because they obviously want to be open and welcoming, but that
doesn’t seem to be possible these days.

A is all about Access Control. Most churches have some kind of vestibule, a sort of anteroom before you actually enter the church. Instead of haphazardly asking people to bring in their guns, maybe it’s time to have a “watcher” in the vestibule, keeping an eye out on who’s entering the church or synagogue.

Most shooters enter their chosen site with guns blazing, not hidden.
Getting back to basics, have some kind of access control is the first step. So keeping them out in the first place is the best option.

Another option might be a few cameras with monitoring station in the church office and someone there to watch before the services to catch someone taking their guns out of their car before they even reach the church or synagogue.  This would be a simple solution because it would only need to be manned before, during and immediately after the services.

Another favorite control, panic alarms can be very expensive and useful for a group shooting situation.  It gives the instant ability to ‘sound the alarm’ and get people down, or even better, out the side door and also gives advance notice to the potential victims.

Assuming we’re not profiling the entire group in advance, the best protection is doing quarterly security facility risk assessments.  These assessments give you a quantitative measure of your risk, including not only looking at the threat level (the threat assessment part of the total assessment), but also reviewing a list of the 50 controls we’ve identified that will enhance security, and looking at the interaction between the highest potential risk, balanced by the offsetting, or preventive controls.

Every terrible incident like the shooting at the Baptist Church in Sutherland Springs should be an opportunity for building a foundation of security awareness in your community or congregation.

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Deaths in Florida Nursing Home Rise to 10 – Will Climb Higher

A tenth patient from a Florida nursing home that lost power during Hurricane Irma died Wednesday, as state officials suspended the facility’s license.

On Friday, September 22,   the Hollywood Police Department announced the death of another resident,  94-year-old Martha Murray.

The Agency for Health Care Administration (ACHA) said Wednesday it suspended the license of the Rehabilitation Center at Hollywood Hills, after previously banning the facility from admitting new patients and from receiving Medicaid.

“As more information has come to light on this egregious situation, this facility absolutely cannot continue to have access to patients,” Agency Secretary Justin Senior said in a statement. “This facility failed its residents multiple times throughout this horrifying ordeal.”

The Hollywood Hills Rehabilitation facility was covered in yellow crime scene tape, with highly visible police vehicles.

Convicted embezzler, Dr. Jack Michel, was the owner of the facility where ten seniors died after the generator failed to
function.  The facility has a long list of maintenance problems, lack of care of the patients, and worse.

8 Dead in Nursing Home Disaster in Hollywood, Florida

RISK Alert   #924                #HollywoodDeaths        #CMSFinalRule         #nursinghome   

Dateline,   September 14, 2017,  Fort Lauderdale, FL


The impact of Hurricane Irma on healthcare care organizations in Florida came home yesterday when it was discovered that 8 elderly patients died in a nursing home just north of Miami, in Hollywood, Florida.  Florida Gov. Rick Scott called the situation “unfathomable,” promising to “aggressively demand answers on how this tragic event took place.”

Hollywood police launched a criminal investigation, and agents from the state attorney general’s office and the state Agency for Health Care Administration were on the scene, authorities said. State officials closed the
facil Wednesday night and barred it from admitting new patients.

“This was a terrible incident. The scene was chaotic when I arrived,” said Dr. Randy Katz, medical director for emergency services at Memorial Healthcare System, where about a dozen of the 158 people who were evacuated from the facility were admitted for respiratory distress, dehydration and heat-related issues.

Katz said so many patients needed assistance that his hospital, which is just down the street, called in more than 50 doctors, nurses and other staffers under a mass casualty protocol.

Fire crews were first called to the Hollywood Hills facility at 3 a.m. ET for a report of a cardiac arrest. More fire and emergency response crews were sent when a second call came in at 4 a.m. for a patient having breathing issues, she said. Three people were found dead on the second floor, and by 6:15 a.m., a full-scale evacuation of the facility was underway.

The new CMS Final Rule on Emergency Preparedness stresses the Dr. Donald Miller, an ER doctor, added, “Nursing home patients are generally more frail than the normal population and we need to have controls in place to guard their safety in a crisis situation, like Hurricane Irma.”

Lessons Learned:

1.  Nursing homes need to be on a first name basis with other providers so they can shift patients to safer
facilities during severe weather emergencies like Irma and Harvey.  The new CMS Final Rule on
Emergency Preparedness spells like the procedures for these emergencies.

2.  The November 15, 2017 Deadline for 17 Healthcare Providers to finish their All-Hazards Facility Risk
Assessments is fast approaching.  Emergency Communication Plans need to be finalized, in addition to
staff training and community drills precisely to PREVENT THESE INCIDENTS IN THE FUTURE.

RISKAlerts is a
publication of Risk & Security LLC

Write to for more information on the new CMS
Emergency Preparedness Program, including All Hazards Facility Risk Assessments

RISKAlert No. 843 March 31, 2016 Patient Dies After 6th Floor Fall from Hospital Room

RISKAlert # 843 -March 31, 2016

Maine patient, hospitalized with a severe brain injury after a motorcycle accident, climbed out of a 6th floor window in the hospital and fell to his death at 5:10 pm on March 29th.

Paul Cady, 43, from Hollis, Maine, had entered the hospital on March 9th, after a motorcycle accident, and had been in a medically-induced coma for a period of time following the accident.  His family emphatically stated he was not trying to commit suicide, but that he was only trying to get home to his family.

Portland, Maine -- 03/30/16 -- Paul Cady, as seen in an undated photo provided by his daughter, Miranda Cady. Paul Cady died Tuesday evening after falling from his sixth story window at Maine Medical Center in Portland. Courtesy photo

In Maine, like other states, newly constructed hospital facilities must meet the American Institute of Architects 2006 general guidelines for hospitals, which doesn’t require windows in patient rooms to be operable.  However, if windows in patient rooms are able to be opened, “operation of such windows shall be restricted to inhibit possible escape or suicide,” the standards state.

Recently, hospitals have recognized the value of fresh air and ventilation, but as a Life Safety issue, the amount that the window opens has been regulated by CMS, the Centers for Medicare and Medicaid.  Studies that shown that windows provide a positive effect on both healing and on patient satisfaction, whether the windows can be opened or not.

Registered Architect Gene Wells of Marshall Erdman & Associates, a leading national health care design and construction firm, offers the following: “In today’s hospital, huge efforts are being made to create a healing environment for patients and their families. A non-institutional approach lessens the stress level for people who already have too much stress and leads to better outcomes. Patient’s rooms, in particular, are often designed to reflect local culture, connect with nature or create a hotel-like environment. Operable windows can be an integral part of this atmosphere.

Lessons Learned:

1.  Patient falls from hospital windows are extremely rare in the United States.
2.  This type of incident can create a potential liability issue for healthcare organizations.

                                       RISKAlerts®  are published by Risk & Security LLC
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RISKAlert Case Study #841 – Physician Shot & Killed in Metairie

Dateline:  March 25, 2016 – New Orleans, Louisiana

A local Doctor was shot and killed by a patient while he treated others in his office near East Jefferson General Hospital in New Orleans yesterday.

The 73-year old shooter walked into the doctor’s office, and killed the doctor with a single shot to the head.  He then ran out of the office and into a Wendy’s restaurant.  Jefferson Parish Sheriff’s Office deputies were nearby and they responded and chased the shooter into a nearby Wendy’s restaurant, where the shooter killed himself by putting the gun in his mouth and pulling the trigger.

The doctor, 75-year old Dr. Elbert Goodier, a urologist,  was treating patients at the time of the shooting.  Colleagues said that Dr. Goodier was a very kind and popular physician.  The shooter’s family said that the shooter had been treated by Dr. Goodier in the past.  While the shooter did not have a criminal background, his family said that he had suffered from mental illness in the past.

Dr. Goodier had practiced for 50 years in the New Orleans area, according to East Jefferson General Hospital.

According to Wendy’s employees, a woman was placing her order when
the shooter pulled the triggeWendysShooter-NOLAr as the deputies advanced on him.   The man’s body remained inside of Wendy’s more than an hour after the shootings. Yellow police tape cordoned off the parking lot and the hospital’s exit lanes. Some workers and patrons were also still in the building as of 4 p.m., speaking with
investigators. Outside, other workers, concerned relatives and onlookers watched.

This type of shooting, the Baby Boomer Shooter, is the second attack on a urologist, and one in an increasing number of seniors who attack their physicians.  Another shooter killed his urologist in Reno, Nevada and injured two others before taking his own life. The shooter said had struggled for 3 years with ailments resulting from a botched vasectomy, according to messages he posted on an online support group and a law enforcement investigation.

Lesson Learned

While doctors have not been a target in the past, they have been shot and killed recently by patients unhappy with medical results.  All hospitals and medical offices should review their access controls systems, based on the increasing, and alarming rate of attacks on healthcare workers.

                    Stay Alert and make sure to subscribe to RISKAlerts
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RISKAlert Report # 840, Man Shoots Neighbor, Takes Body to His Lawyer

Dateline:  February 17, 2016

A Florida Man Shot his Neighbor to Death, Put the Body in the Back of his Pickup Truck
and Drove Dead Body to his Lawyer’s Office

A Fort Myers, Florida man shot his neighbor to death during a struggle before loading the body into the back of his pickup truck and driving it to a lawyer’s office, according to the News Press of Fort Myers, Marshall claimed he shot the neighbor in self defense.

Lawyer Robert Harris, said that John Marshall (the shooter), walked into his Fort Myers law firm claiming he had shot and killed neighbor Ted Hubbell in self-defense and had the body outside in the bed of his pickup.

The shocked attorneys called 911 and Marshall spent hours at Harris’ office before finally leaving
for the hospital around 10:30 p.m. that night.  Marshall had a swollen lip, missing tooth and what
appeared to be two broken thumbs.

According to attorney Robert Harris, JohDeath Investigationn
Marshall wrestled a gun away from neighbor
Hubbell and fatally shot him earlier Wednesday.
Harris said late Wednesday that Marshall will
not be arrested, because he shot in self defense.

Lessons Learned:

1.   Avoid fights with neighbors.

2.   If a fight seems unavoidable, call 911 and wait for police in a safe area.

3.   Do not transport a body to your lawyers office in the bed of your
pick up truck!


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Paris Attacks are opening shot in plan to exterminate Western Civilization

The six simultaneous attacks on Paris last night were the opening salvo in a long-planned event designed
to exterminate Western Civilization as we know it.

This is not the teenage shooter with acne and an AK15, these were trained killers, who, according to witness
statements, were professional, controlled and had no interest or compassion for their victims.  They could have
been shooting at a beer can instead of a young girl.   This is different from other terrorists attacks because it is

ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATHGeneral view of the scene with rescue service personnel working near covered bodies outside a restaurant following shooting incidents in Paris, France, November 13, 2015.   REUTERS/Philippe Wojazer      TPX IMAGES OF THE DAY

carried out without emotion.  These terrorists are not killing PEOPLE, they are exterminating western culture, along with the people.   We saw this in Palmyra where treasured antiquities were destroyed, and ISIS plans to exterminate every vestige of
our western culture.

Security measures that may have worked for individual shooters, or small splinter group will not defeat ISIS.
We have been directly targeted and need to take drastic measures and take them immediately.  This assault
has no room left for political correctness, for ‘measured response”, or anything else.  We need to exterminate
this threat quickly and completely to maintain our quality of life.

Everything is at stake now, our paintings, our music, our art, our designer jeans, our freedom of expression,
our families and, ultimately, our lives.  As western leaders meet today, I hope they plan to present an overwhelming
attack aimed precisely at ISIS, with a show of force designed to blow them off the face of the earth.

RISK Alert #790 – St. Cloud Hospital Shooting Threatens CMS Funding

St. Cloud Hospital in Aitkin County, Minnesota, has been threatened with losing Medicare funding by CMS, after a shooting incident where a suicidal patient took the security officers gun and shot him to death
in the hospital.

According to a review by the Center for Medicare and Medicaid Services. The patient, Danny
Hammond, age 50,  told staff he was going to kill himself and any man who came into his room, as soon as he had the chance, the CMS report said. 

Hammond  had been airlifted to the hospital the morning of Oct. 12 after attempting suicide by an intentional overdose, according to the report. He had several warrants out for his arrest after being charged with kidnapping and assaulting his wife, and the hospital obtained the services of Aitkin County officers to monitor Hammond in his hospital room.



At 5:10 a.m. that morning, Hammond charged at Aitkin County deputy Steven Sandberg, took his gun, and fatally shot him. Hammond was subdued with a stun gun and later died.

The CMS Report cites the hospital, “The hospital’s failure to provide direct psychiatric care to the patient … resulted in the patient’s ability to obtain and engage the firearm of a peace officer,” the report said.

In response to the report, the hospital submitted a plan of correction updating its policies and training. According to the document, the hospital already has started mandatory training for staff reinforcing requirements that 72-hour holds can be ordered only by physicians, and that psychiatric consultations and treatment must continue until the hold is lifted. The attending physician and psychiatric provider must agree that services or treatment are no longer necessary.

Lessons  Learned :

Make sure the entire staff has current updated policies and procedures, mandated training which is continually checked and updated.

CMS is becoming more active in tracking shootings and violent incidents in
hospitals, using Medicare and Medicaid funding as a hammer to ensure compliance.

                    Stay Alert and make sure to subscribe to RISKAlerts

A Publication of Risk & Security LLC

NJ Hospital Battles OSHA on Assault Report

Dateline: Paramus , New Jersey,  September 15, 2015

RISK Alert   Case Study   #780

Bergen Regional Medical Center to Hires Law Firm to Fight OSHA on Proposed Fine
for High Number of Workplace Violence Incidents against the Hospital Staff.

Bergen Hospital has been investigated by OSHA (Occupational Safety and Health Administration)
in the past.  In 2014, OSHA found that management “had not developed or implemented adequate
measures to protect workers from assaults

nurse-bruiseOSHA noted that there were 45 incidents of workplace violence in 2013 and 10 in the first quarter of 2014.  OSHA announced the citation this month and a proposed fine of $13,600.

Incidents cited in the OSHA report included:

       A lab tech trying to draw blood was punched.

A security guard was kicked and bitten.

A nurse was pushed to the floor after she intervened when a
patient on patient attack

A mental health assistant was trapped in a room with a patient,
who barricaded himself in his room after he charged and threatened employees.

The OSHA investigation and proposed fine at Bergen Regional mirrors the experience of staff members in hospitals, clinics, and behavioral health organizations around the country, who are all affected by the new OSHA 3148 regulations, which were introduced in 2015 to fight the rising violent incidents occurring in hospitals around the U.S.

The recent update of OSHA 3148 requires Annual Workplace Risk Assessments.
Read the entire text of OSHA 3148, Guidelines for Preventing Workplace Violence at

Lessons Learned:

1.  Any organization that accepts money from any Federal agency has to attest
     that they are up to date with all Federal requirements, including OSHA 3148.

2.  Bergen Regional Medical Center may end up spending more on lawyers
    than the cost of the fine ($13,000).

     WEBINARS at

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SISCO Teams Up with RISK & SECURITY LLC with Security Solutions

For Immediate Release

July 6, 2015 



A new software solution that tracks visitors in any hospital, health care facility, office or manufacturing plant, that blends safety and risk management together meeting all the new compliance guidelines, will be co-marketed by SISCO, (West Palm Beach), and RISK & SECURITY LLC, (Boca Raton)  together
in a new Risk & Security Team partnership.

The Joint Commission has said it expects hospitals to be able to automatically identify every person
in their hospital, at any time.  Besides obviously helping in the FEMA Hospital emergency scenarios,
It also complies with the new CMS Standards for Hospital Security, Safety and Emergency Preparedness
and the new OSHA 3148 standards for controlling and minimizing workplace violence in high-risk
facilities including hospitals and healthcare organizations.

The Fast-Pass© solution is a complete and easy to use security and safety computer application that allows any organization to credential visitors in less than 15 seconds, authorize passage and issue a pass for facility access. The process is seamless and in compliance with Joint Commission guidelines

According to Caroline Ramsey-Hamilton, CEO of Risk & Security LLC, “The new Fast-Pass©
solution is an incredible value for hospitals, healthcare organizations, and other organizations that want
to improve security and prevent unauthorized access.  We are worked with Anthony Zagami for 15 years, and are happy to formalize our partnership with SISCO, which will include a series of sponsored webinars, podcasts and videos to assist security experts dealing with critical security issues.

Hamilton’s industry-leading RISK-Pro software app includes over 75 recommended controls for hospitals, and SISCO is the first vendor identified as meeting the stringent RISK-Pro® standards
for security controls.

Nationwide, Security in hospitals and other high-risk facilities has become a top national concern, as the 55+ plus baby boomers age, and require more healthcare services.  The number of violent and active shooter incidents in hospitals has also increased dramatically over the last 10 years, prompting an array of new security and emergency guidelines and standards designed to reduce violence and protect hospital staff, patients, and visitors.

About Sisco

SISCO is the leading provider of Identity Management Solutions for the Healthcare industry, Maritime, Education, Corporations, Government and Law Enforcement Agencies.  SISCO provides the most superior solution available today as well as expert installation, comprehensive training and unsurpassed customer service which in turn, provides its customers with front line protection for safer working environments.  Please visit or contact at

About Risk & Security LLC

Risk & Security LLC is a security risk assessment and risk analysis company with over 75 years
of combined expertise in security risk assessment, hospital security and emergency preparedness systems.  It developed the top-rated RISK-Pro software app to  help
organizations assess their security risk, active shooter risk, and automatically recommend
cost-effective solutions by Return On Investment.

Risk & Security partners with security companies around the world to provide state-of-the-art security solutions to analyze risk, pro-actively manage emergency preparedness, and recommend
cost-effective security controls justified by return on investment metrics.

Contact Information:

Caroline Ramsey Hamilton

Phone: 301-346-9055