Beyond the checklist: Creating impactful elopement drills in senior living

Elopement—when a resident leaves a facility without staff knowledge or permission—poses a serious safety risk in senior living communities. The Centers for Medicare & Medicaid Services (CMS) requires facilities to maintain systems that prevent adverse events and ensure resident safety as part of their emergency preparedness and quality assurance programs.¹

While many communities conduct elopement drills, these exercises can become routine and may not fully reflect the complexity of real-world elopement scenarios. One of the most common contributors to elopement is assumption—staff may assume a resident is in their room, or that a door alarm was triggered by a visitor, or that someone else is monitoring a high-risk individual. Effective drills challenge these assumptions and help staff recognize how easily a lapse can occur.

How to create real-world elopement scenarios

• Use a pseudo-resident: Develop a fictional resident profile with a name, age, diagnosis, and behavioral traits. This allows staff to practice identifying risk factors and responding to a missing person scenario without involving actual residents.
• Involve a real resident (with consent and supervision): For a more immersive experience, choose a cognitively able resident who consents to participate. Have them “hide” in a safe, supervised location.
  • Avoid informing all staff in advance to simulate a real-time response.
  • Monitor the resident throughout the drill to ensure safety.
• Tailor the drill to your community: Every building is different. Use your actual floor plan, staffing levels, and known risk areas (e.g., side exits, courtyards, or unsecured stairwells) to design the scenario. Include realistic variables like shift changes, visitor traffic, or weather conditions.
• Challenge common assumptions: Create scenarios that test how staff respond to ambiguous situations, such as dismissing a door alarm as a visitor error, or seeing a resident near an exit but assuming someone else is monitoring them. These moments reveal how easily assumptions can delay response.
• Include role-specific tasks: Assign clear responsibilities to each role, such as nurses, aides, reception, maintenance, and leadership. This ensures everyone knows their part in a coordinated response and helps identify any role confusion or communication breakdowns.

Best practices for realistic drills

• Script the scenario: Include details like last the resident’s last known location, clothing, medical needs, and time of disappearance.
• Test communication systems: Use the same radios, phones, or alert systems that would be used in a real event.
• Track response time: Measure how long it takes to notice the resident is missing, initiate a search, and locate them.
• Debrief thoroughly: Review what went well, what was missed, and how assumptions may have delayed the response.

By designing drills that reflect the real-world dynamics of your community, you empower staff to respond with confidence and prevent future incidents.

(1) SOM - Appendix PP
Elopement Prevention Archives - LeadingAge