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Safety Incidents OSHA Severe Injury Reports · 2015–2025

Fond du Lac, WI —

OSHA Injury Report: Agnesian St. Francis Home

Injury · Other recordable case

At a glance

On , an injury at Agnesian St. Francis Home in 33 Everett Street, Fond du Lac, WI 54935 resulted in other recordable case. 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
Other recordable case (code 4)
Type
Injury (code 1)

Before the incident

reattaching cord to recliner resident bedside table was being moved by another staff member water was spilled and fan from resident table came down on employee 's back. Staff stated fan hit right lower back.

What happened

reattaching cord to recliner resident bedside table was being moved by another staff member water was spilled and fan from resident table came down on employee 's back.

Injury or illness

Contusion

Object or substance involved

Falling Flying Object All Other

Summary line

reattaching cord to recliner resident bedside table was being moved by another staff member water was spilled and fan from resident table came down on employee 's back. Staff stated fan hit right lower back.

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 #
WC177052

When (timing detail)

Date of incident
Shift started
14:00
Time of incident
16:00
Filing year
2024
Submitted
08FEB2025:02:53:00

More injuries at Agnesian St. Francis Home

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 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.