Long-term care providers should consider a “flat” crisis management approach that relies on a core group of staff members, experts advised Wednesday at the LeadingAge annual conference.

Many hospitals and other large organizations require all essential personnel to be available during an emergency, noted D. Scott Crabtree, CEO and President of Broadway Services Inc., which operates Lambeth House, a continuing care retirement community in New Orleans.The CCRC, which has gone through crises including Hurricane Katrina, has developed best practices for emergency management.

Crabtree believes that this type of all-hands-on-deck response is impractical and inefficient. Certain staff members will need to prioritize their own families or have other responsibilities during a crisis, he said. And he emphasized how difficult it is to train a large workforce for and to have clear communications among many people during a crisis.

Rather than involving many people with multiple “layers” of responsibility, Crabtree advocated for a “flat” plan. This might mean having a relatively small team committed to showing up at the facility, to be supported by a more ad-hoc team of workers who assist when they are able.

The crisis response team ideally would be made up entirely of volunteers, who represent the facility’s “natural leaders,” Crabtree explained. Leadership is not defined by job title, and a facility’s leaders might include maintenance workers or certified nursing assistants, he reminded attendees of the educational session.

Even though the Lambert House emergency staff is a small group of about 60 people, they are extremely reliable and well prepared, Crabtree said. They receive regular training and get additional pay for every hour they are available during a crisis, “even when sleeping,” he explained. Replacing a team member who leaves can prove challenging, Crabtree acknowledged, but he said turnover among this group is very low.

Crabtree and his co-presenters also said that providers should be sure they are planning for human-caused crises, such as live shooters and sabotage events like the recent air traffic control fire in Chicago. These situations have been given less attention and are “an area to focus on,” said Mark Schaaf, business development liaison at insurance and risk mitigation firm Zurich.

Cybercrimes in particular pose an increasingly urgent threat, warned Karen Jordan, vice president of program management at insurer Aon Affinity’s Healthcare Division. Hackers are avidly targeting medical records, largely to perpetrate pharmaceutical fraud, she said. By obtaining a person’s identification and medical information, the criminals are able to acquire medications that can be sold on the street. It’s “only a matter of time until a direct hit at a senior living site,” Jordan predicted.

The LeadingAge annual conference is the nation’s largest gathering of long-term care providers, with nearly 8,000 registrations this year. The event concluded Wednesday.