Touchpoints at Manchester: Unexplained Fracture - CT
The nursing assistant who transferred the woman on December 24, 2024, couldn't remember who helped her. The director of nursing services who investigated the fracture couldn't explain why she never found out. The resident's family member learned about the injury from hospice staff, not the facility.
Resident #107 required two staff members and a mechanical lift for all transfers, according to facility policy. But when federal inspectors arrived in August, they found a paper trail that dead-ended in missing details and forgotten specifics.
Nursing Assistant #2 discovered the resident's injured ankle that December morning. During her interview with inspectors on August 12, she said she "could not recall all the details due to the events occurring a while ago." She remembered being told by a nurse that the resident had an injury, then seeing the wrapped ankle herself.
The assistant acknowledged she was "not sure why she had not documented who assisted with the transfer and could not recall at the time of the interview who had assisted her." She knew the resident required two staff for transfers and said "she would not transfer the resident without assistance." But eight months later, the critical detail was gone.
Nursing Assistant #3, also interviewed that day, remembered finding "a bruise or discoloration" on the resident and reporting it to "one of the weekend nurses." The specifics had faded: "I can't really remember a lot, that was awhile back."
An X-ray confirmed the ankle fracture. The night shift nurse received the results and reported them, but the resident wasn't sent to the hospital because she was receiving hospice care. Hospice staff arrived at bedside and recommended a wrap, ice and pain management.
The resident's family member, identified as Person #1 in the inspection report, learned about the fracture through an email from hospice staff. "I was not updated by the facility," they told inspectors. "Most of the updates were from the hospice provider."
The family member described receiving "no explanation from the facility" about how the injury occurred. They noted the resident "was fragile" and had been experiencing weight loss and decline. Eventually, the resident no longer met hospice criteria and was discharged from the service months later.
Director of Nursing Services conducted the formal investigation into what the report called a "fracture of unknown origin." When inspectors interviewed her on August 13, she couldn't explain a fundamental gap in her inquiry.
"She could not recall why she did not ascertain who assisted NA #2 with the transfer because that is a stated question on the investigation form and it would have been important in determining if the transfer had been conducted appropriately," the inspection report stated.
The question wasn't academic. Facility policy requires two people for every mechanical lift transfer: one to operate the lift, one positioned at the resident's feet to guide the lower body during movement. If only one person had attempted the transfer, or if the procedure was performed incorrectly, that could explain the fracture.
But the DNS "could not identify whether or not the resident had been transferred appropriately and did not give an explanation of how the fracture to Resident #107's right ankle may have occurred."
The investigation form specifically prompts administrators to determine who assisted with transfers involving injured residents. The DNS had the form, knew the question was critical, but somehow never got the answer.
Eight months after the fracture, three different staff members told federal inspectors they couldn't remember key details. The nursing assistant couldn't recall her partner. The other assistant couldn't remember much at all. The director of nursing services couldn't explain why she'd left the central question unanswered.
The resident had been fragile, declining, losing weight. She required two people and a mechanical lift just to move from bed to chair. On December 24, someone transferred her incorrectly or something went wrong during a proper transfer.
Nobody knows which.
The facility is disputing the citation for failing to properly investigate the incident. But the inspection report captures a breakdown in basic accountability: a vulnerable resident suffered a fracture, and the people responsible for her care couldn't piece together how it happened.
The family member's notes from that time show updates from hospice about ace wraps and arnica ointment for pain management. No mention from the facility about what caused their loved one's broken ankle, or whether anyone had been held responsible.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Touchpoints At Manchester from 2025-08-13 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 15, 2026 · Our methodology
TOUCHPOINTS AT MANCHESTER in MANCHESTER, CT was cited for violations during a health inspection on August 13, 2025.
The nursing assistant who transferred the woman on December 24, 2024, couldn't remember who helped her.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.
Frequently Asked Questions
- What happened at TOUCHPOINTS AT MANCHESTER?
- The nursing assistant who transferred the woman on December 24, 2024, couldn't remember who helped her.
- How serious are these violations?
- Violation severity varies from minor documentation issues to serious safety concerns. Review the inspection report for specific deficiency codes and scope. All violations must be corrected within required timeframes and are subject to follow-up verification inspections.
- What should families do?
- Families should: (1) Ask facility administration about specific corrective actions taken, (2) Request to see the follow-up inspection report verifying corrections, (3) Check if this represents a pattern by reviewing prior inspection reports, (4) Compare this facility's ratings with other nursing homes in MANCHESTER, CT, (5) Report any new concerns directly to state authorities.
- Where can I see the full inspection report?
- The complete inspection report is available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request a copy directly from TOUCHPOINTS AT MANCHESTER or from the state Department of Health. The report includes specific deficiency codes, facility responses, and correction timelines. This facility's federal provider number is 075314.
- Has this facility had violations before?
- To check TOUCHPOINTS AT MANCHESTER's history, visit Medicare.gov's Care Compare and review their inspection history, quality ratings, and staffing levels. Look for patterns of repeated violations, especially in critical areas like abuse prevention, medication management, infection control, and resident safety.