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 33 Everett Street, 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
- 94
Before the incident
Boosting patient up in bed
What happened
residents room doing a two assist boost in bed and upon reaching down to grab the draw sheet and boost resident 220 my scapula dislocated Didnt know it was dislocated upon injury just thought it was bad shoulder pain until my chiropractor visit on [REDACTED] My chiropractor confirmed it was dislocated and since I was working on in dislocated shoulder for the few days after I was straining my rotator cuff
Injury or illness
Dislocation
Object or substance involved
Repositioning Boosting up Toward Head
Summary line
Was in residents room doing a two assist boost in bed and upon reaching down to grab the draw sheet and boost resident 220 my scapula dislocated Didnt know it was dislocated upon injury just thought it was bad shoulder pain until my chiropractor visit
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
- 2022
- Employees at this establishment (2023 average)
- 188
- Hours worked at this establishment (2023 total)
- 264,568
- EIN
- 391029998
- Establishment ID
- 662786
- Employer case #
- WC170916
When (timing detail)
- Date of incident
- Shift started
- 14:00
- Time of incident
- 19:00
- Filing year
- 2023
- Submitted to OSHA
- 2024-02-29
More injuries at Agnesian St. Francis Home
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2023. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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