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 admin Spv RN LTC S 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
- 77
Before the incident
Regular job duties
What happened
reacted in a way to help prevent the fall I was able to prevent the fall by assisting him back to bed
Injury or illness
Strain
Object or substance involved
Fall Prevention Preventing Patient from Fall
Summary line
Resident was attempting to get out of bed As I was walking into the room I noticed that he was beginning to fall I reacted in a way to help prevent the fall I was able to prevent the fall by assisting him back to bed
Employee and industry
- Job description
- Admin Spv RN LTC S
- SOC code
- 29-2061 — Licensed Practical and Licensed Vocational Nurses
- NAICS code
- 623110 — Nursing Care Facilities (Skilled Nursing Facilities)
- NAICS vintage
- 2022
- Avg employees
- 188
- Total hours worked
- 264568
- EIN
- 391029998
- Establishment ID
- 662786
- Employer case #
- WC171045
When (timing detail)
- Date of incident
- Shift started
- 6:00:00.000
- Time of incident
- 8:00:00.000
- Submitted
- 29FEB24:21:33:00
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year unspecified. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.