Fond du Lac, WI —
OSHA Injury Report: Agnesian St. Francis Home
Injury · Job transfer or restriction
At a glance
On , an injury at Agnesian St. Francis Home in Fond du Lac, WI 54935 resulted in job transfer or restriction. Employee was certified Nursing Assistant LTC in nursing Care Facilities Skilled Nursing Facilities.
Where did this happen?
- Establishment
- Agnesian St. Francis Home
- Parent company
- SSM Health
- Street
- 33 Everett Street
- City
- Fond du Lac
- State
- WI
- ZIP
- 54935
- On-site location
- patient room
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 49
Before the incident
Was moving a resident in a sit to stand lift and something pulled in my back on the lower left side. Left buttocks and leg are tingly and numb
What happened
Transferring resident to sit to stand resulting in EE straining left low back and buttock
Injury or illness
Strain
Object or substance involved
TRANSFERRING Patient to from SEATED to SEATED Position
Summary line
Was moving a resident in a sit to stand lift and something pulled in my back on the lower left side. Left buttocks and leg are tingly and numb
Employee and industry
- Job description
- Certified Nursing Assistant LTC
- SOC code
- 31-1131 — Nursing Assistants
- NAICS code
- 623110 — Nursing Care Facilities Skilled Nursing Facilities
- NAICS vintage
- 2012
- Avg employees
- 191
- Total hours worked
- 279848
- EIN
- 391029998
- Establishment ID
- 662786
- Employer case #
- WC176794
When (timing detail)
- Date of incident
- Shift started
- 6:00
- Time of incident
- 12:30
- Filing year
- 2024
- Submitted
- 08FEB2025:02:53:00
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.