Fond du Lac, WI · 2025-01-14

OSHA Injury Report: Agnesian St. Francis Home

Injury · Days away from work

At a glance

On 2025-01-14, an injury at Agnesian St. Francis Home in 33 Everett Street, Fond du Lac, WI 54935 resulted in days away from work. Employee was certified Nursing Assistant LTC in nursing Care Facilities Skilled Nursing Facilities.

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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: Days away from work (code 2)
Type: Injury (code 1)
Days away from work: 1
Days restricted or transferred: 112

Before the incident

patient handling lift

What happened

Back Left neckshoulder [REDACTED] [REDACTED] Home2025WC178003Certified Nursing Assistant LTC

Injury or illness

Strain

Object or substance involved

resident room

Summary line

Resident had to go to bathroom but could not sit up she asked for help I put my right arm around her upper back and she gave me her right hand in my left hand I counted 123 went to pull her up

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
Employees at this establishment (2025 average): 335
Hours worked at this establishment (2025 total): 284,657
EIN: 391029998
Establishment ID: 662786
Employer case #: WC177535

When (timing detail)

Date of incident: 2025-01-14
Shift started: 22:07
Time of incident: 00:23
Filing year: 2025
Submitted to OSHA: 2026-01-16

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View Agnesian St. Francis Home's full OSHA safety record →

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Source

Data from OSHA ITA Form 300/301 electronic submissions, filing year 2025. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.

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