Through the end of the year, reporters will be looking back at and following up on stories and topics that resonated strongly with our readers in 2018, according to metrics on lohud.com. This story is part of that series.

The August shooting that left a husband and wife dead devastated the community at Westchester Medical Center.

The violence reverberated beyond the Valhalla facility and shook hospitals throughout the region.

At a time when headlines reference episodes like the Westchester Medical Center shooting and the November shooting that killed four people at Chicago’s Mercy Hospital, questions about hospital safety seem as crucial as ever.

Hospitals in the Hudson Valley are working to address safety concerns and strengthen security to keep patients and staff healthy.

Medical Center shooting

The shooting at Westchester Medical Center on Aug. 8 was a mercy killing. Richard DeLucia, 71, shot and killed his 70-year-old wife, Ann DeLucia, before he fatally shot himself, officials said.

According to a note found at the couple’s Yorktown home, Richard DeLucia was distraught about his wife’s health issues and wanted to end her suffering.

Killings like that may not directly threaten staff and patients throughout the building, but any violence in a hospital can be a scary experience that can put people in danger.

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“Much of what is happening today in communities across the country is making all of us feel more vulnerable,” Westchester Medical Center told The Journal News/lohud in a statement recently.

That vulnerability is felt in hospitals close to home, particularly after the Valhalla shooting.

“It’s something that you can’t a hundred percent stop here at St. John’s,” said Yonkers Police First Deputy Chief Tim Hodges, who works closely with the security team at St. John’s Riverside Hospital in Yonkers. “To slip in a small handgun into a hospital, it’s so easy to do. It’s so scary to think about, but it’s just a very tough thing. You can’t have everybody go through a metal detector. Two thousand employees, and the in and out traffic.”

Concerns

Shootings at hospitals are nothing new, but they were typically suicides and mercy killings, said Alan Butler, who works in health care security and is on the Board of Directors for the International Association for Healthcare Security and Safety.

“But the active shooter piece has changed health care security,” he said.

Butler estimated that 95 percent of hospitals follow the Department of Homeland Security’s training protocol, which urges people to run first, hide second and fight third if they encounter an active shooter. Hospitals dealing with an active shooter typically send out a code silver alert, which lets people know that a combative person with a weapon is on the loose, or a violent situation is unfolding.

Several local hospitals were reluctant to go into detail about security concerns, but the easy access to health care facilities is a significant source of worry.

“One of the concerns is, as you know, this is an open campus, same as a shopping mall,” said Henry Coleman, director of inter-facilities at St. John’s Riverside Hospital, where he leads the security team. “So you have to be a little more concerned because you really have less control than you do in a closed environment.”

What can be done?

Hospitals typically take a three-pronged approach to security, Butler said — staff training, security personnel, and systems integration, such as locks, cameras and panic alarm hardware.

Hospitals say they have strengthened training in recent years.

“If I had to point to one thing that has changed over the years, it would be the greater emphasis we place on de-escalation skills,” said James Fortunato, vice president of safety and hospitality for Health Quest, a network that includes Putnam Hospital Center in Carmel. “All security officers across Health Quest are required to be certified in de-escalation so they have the skills to defuse potentially volatile situations.”

Northern Westchester Hospital in Mount Kisco has also offered de-escalation training to its staff, and worked with Westchester County police on active-shooter training, said Michael Caruso, the hospital’s vice president of facilities management.

Employees at Montefiore Nyack Hospital undergo annual safety training and assessments, and the facility works closely with law enforcement agencies to drill for emergencies and disasters, said Lauren Malone, a spokeswoman for the hospital.

Westchester Medical Center said it upgraded its staff emergency communications platforms and protocols after the terrorist attacks on Sept. 11, 2001, and began active-shooter training in 2012. The hospital also said it has armed security officers on patrol at all hours, led by Tom Belfiore, who has worked with safety and security for the NYPD, Westchester County police, the Port Authority of New York and New Jersey, and Major League Baseball.

Caruso said 70 percent of Northern Westchester Hospital’s security staff are retired police officers. At St. John’s Riverside Hospital, many of the security officers and supervisors are off-duty or retired police officers, Hodges said.

Hodges said cameras also help St. John’s staff monitor security at the hospital’s five facilities in Yonkers and Dobbs Ferry. Westchester Medical Center said it has hundreds of security cameras across its campus.

“We also use a visitor management system that identifies, registers and photographs visitors,” Westchester Medical Center said.

Visitors at Northern Westchester Hospital are allowed in 24 hours a day, but they will now be required to use one of three entrances, where they will be greeted by a concierge and security officer, Caruso said. Visitors will have to show identification and receive a visitor badge, he said.

Even with all those security measures in place, the lack of metal detectors makes it possible for someone to slip into a hospital with a gun.

“If we wanted to create safe health care, you lock the doors,” Butler said. “The problem is, you can’t do that. Health care administrators are fighting this battle of trying to find the balance between an open, caring environment and a safe patient-care environment.”

Placing metal detectors at every hospital entrance is problematic because many hospitals have multiple entrances, and every metal detector requires a trained security officer to monitor it, Butler said.

“It becomes very cumbersome,” he said.

Many hospitals use metal detectors in their emergency rooms, though, Butler said.

“They know first and foremost, that’s the main receiving portal for most hospitals,” he said, adding that emergency rooms are sometimes the only entrance to a hospital overnight. “It is the most dynamic and risk-based environment. That door is an after-hours portal.”

Some security officers use handheld metal detectors as they patrol hospitals, Butler said.

“You can’t search everybody, but you can look for pre-indicators,” said Hodges, the Yonkers police chief. “You can look for people that are maybe holding a heavy bag, or if they’re grabbing their waistband, or holding it in a certain way like they might be armed.”

Patients can also do their part to help keep hospitals safe, said Coleman, the security chief at St. John’s.

“If you see something, say something,” he said. “Everyone in this building is a security personnel. In other words, you have to be involved.”

Twitter: @MattSpillane

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