Massachusetts inspects every assisted living residence at least once every two years. At its most recent compliance review on August 27, 2024, the state cited 6 findings at Benchmark Senior Living at Woburn. 4 of them had already been cited at the previous review. Across the 145 Massachusetts residences with a published report, the median is 6.
This page covers one review, not a history, and it is not a score or a ranking. A finding means the state identified something the residence has to correct; it does not on its own mean a resident was harmed. The state does not publish what happened after this review, so a finding listed here may since have been fixed. Where the state withheld private details, such as a resident's medication or the date of an incident, the text reads [redacted].
Facility details
What the state found
6 findings · 4 repeatEmergency call response · Food and dietary servicesDuring the last ten days of the months of July 2024 there were 125 e-call response times over the fifteen (15) minutes required by Residence policy.Repeat finding▼
Emergency call response: How quickly staff answer a resident's emergency call button.
Food and dietary services: Meals, dietary review and how the kitchen is run.
The state cited these together under one finding.
EOEA reviewed the Personalized Emergency Response procedures developed to provide timely assistance to a Resident in the event of an emergency needs situation.
During the last ten days of the months of July 2024 there were 125 e-call response times over the fifteen (15) minutes required by Residence policy.
Documentation of Residence management monitoring response times over the fifteen (15) minute limit, in accordance with the ALR policy, was missing for July 2024.
EOEA reviewed Residence’s dietary plan reviews from the 2023 calendar year through the date of the Compliance Review to confirm consistency with the most recent edition of the Dietary Guidelines.
Menus lacked the inclusion of the required language designating that the meal selections meet the minimum dietary standards of the daily recommended allowances of sodium, sugar and fat content as established by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences.
This was also cited at the previous compliance review.
General Requirements for an ALR: Emergency Response Dietary Reviews
651 CMR 12.04(2)(b) (3)(b),(4)
Resident screening and assessment · Resident care plansInconsistent with documenting all requirements of Assessments and Service Plans. Inconsistent Bedrail assessments.▼
Resident screening and assessment: Checking, before and during residency, that the residence can meet a resident's needs.
Resident care plans: The written plan describing the care each resident is assessed to need.
The state cited these together under one finding.
EOEA reviewed five (5) Resident Records reviewing documentation from April 2022 through the date of the Compliance Review to determine compliance with the requirements for Screenings, Assessments and Service Plan Development and Requirements.
Documentation of individualized enrichment activities provided to the residents was missing in four (4) Special Care Residence (SCR) records.
EOEA reviewed the Residence records of 13 Residents utilizing bed rails / U-bars or similar devices for the period of 2023 through the date of the Compliance Review to determine compliance with the required assessment by a physical/occupational therapist every six months.
Documentation of an assessment conducted by a physical/occupational therapist every six months for five (5) Residents noting that the Resident can independently navigate around a bed rail/ U-bar for the calendar years reviewed was missing.
General Requirements for an ALR: Screening and Assessment Service Plan Development and Requirements
651 CMR 12.04(8)(3) 651 CMR 12.08(1)(s)
Quality assurance programMissing or incomplete components of the Quality Assurance and Performance Improvement requirements. Unsafe SAMM and LMARepeat finding▼
The residence's own program for auditing and improving the care it gives.
EOEA reviewed documentation to ensure the Residence has established an effective, ongoing quality improvement and assurance program for Service Planning, Safety
Assurances, and Medication Quality from July 26, 2023, through the date of the Compliance Review.
Documentation of the date of the review and the person responsible for the follow up to findings was missing for the 2023 calendar year reviewed.
Resident Safety Assurances
Documentation of the date of the review and the person responsible for the follow up to findings was missing for the 2023 calendar year reviewed.
EOEA reviewed the Residence’s quarterly medication documentation audits from July 26, 2023 through the date of the Compliance Review to ensure compliance with SAMM, LMA and Residence policies.
Documentation of the date of the person responsible for the follow up to findings was missing for the 2023 calendar year reviewed.
EOEA observed one (1) Personal Care (PC) staff and one (1) nurse providing medication assistance to nine (9) Residents to ensure the Residence has developed and implemented systems that support and promote safe SAMM and LMA.
EOEA observed one (1) PC staff not practicing hand hygiene prior to providing care to four (4) Residents.
EOEA observed one (1) PC staff document the Resident’s Medication Administration Record prior to observing the Resident’s actions.
EOEA observed one (1) Resident’s family filled cassette missing a label including the Resident’s name.
EOEA observed one (1) expired medication in one (1) Resident’s Medication Storage Unit.
EOEA observed one (1) [redacted] without a documented open date in one (1) Resident’s Medication Storage Unit.
EOEA observed the nurse crush one (1) Resident’s medication and could not provide a crushed medication physician order.
This was also cited at the previous compliance review.
General Requirements for an ALR-Service and Service Coordination: Quality Assurance and Performance Improvement
651 CMR 12.04(10)(a)(b)(c)(2),(d)(e)
Emergency drills · Incident reportingThe Residence filed 19 incident reports greater than 24 hours after the occurrence of the incident or accident.Repeat finding▼
Emergency drills: Fire and elopement drills the residence must run and document on every shift.
Incident reporting: Telling the state, on time, when something happens to a resident.
The state cited these together under one finding.
EOEA reviewed the Residence’s Emergency Plan to ensure compliance that the Residence can address potential disasters and emergencies.
Documentation of fire drills was missing for the first shift for the 2023 calendar year reviewed.
Documentation of elopement drill was missing for the third shift for the 2023 calendar year reviewed.
EOEA reviewed the Residence records and incident reports from July 2023 through the date of the Compliance Review to determine whether the Residence complied with the requirement to qualifying incidents to EOEA within 24 hours after the occurrence of the incident or accident.
The Residence filed 19 incident reports greater than 24 hours after the occurrence of the incident or accident.
This was also cited at the previous compliance review.
Emergency Preparedness Plan and Reporting Requirements: Evacuation Drills and Rehearsals Reporting Resident Specific Emergencies
651 CMR 12.04(11)(a)(3)(4)
Resident recordsMissing information is necessary for the continuity of care.▼
Records that keep a resident's care information complete and available to staff.
EOEA reviewed the documentation maintained in two 90-day correspondence logs to communicate information necessary to maintain the continuity of care for Residents.
Both logs did not consistently document all significant or pertinent information necessary to maintain the continuity of care for all Residents.
Record Requirements: Correspondence Log
651 CMR 12.05(4)
Staff trainingBiannual skills evaluations were not consistently documented for all PC staff.Repeat finding▼
Training and skills checks the residence must give and document for its staff.
EOEA reviewed the records of seven (7) Personal Care (PC) staff to determine compliance with Personal Care evaluation requirements in the calendar year 2023 through the date of the Compliance Review.
Documentation confirming the completion of Personal Care (PC) skills and SAMM evaluations every six months was missing from seven (7) records.
Corrective Actions
This was also cited at the previous compliance review.
Training Requirements: Supervision
651 CMR 12.07(8)
Glossary
Abbreviations the state uses without explaining themWhat the residence must doThe residence must send the state a plan to correct each finding, what it will do to keep it from happening again, who is responsible and by when. The state also asked for specific proof, listed here as written.▼
Specific Corrective Actions.
Submit to EOEA the following:
Documentation confirming that all applicable residents have a current bed rail assessment.
Documentation confirming PC Skills evaluations have been completed by a nurse for all PC staff.