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Safety Incidents OSHA Severe Injury Reports · 2015–2025

Dousman, WI —

OSHA Injury Report: Wisconsin Masonic Home Inc. CP/RSL/MW

Injury · Job transfer or restriction

At a glance

On , an injury at Wisconsin Masonic Home Inc. CP/RSL/MW in 410 N. Main Street, Dousman, WI 53118 resulted in job transfer or restriction. Employee was resident Assistant in assisted-living facilities without on-site nursing care facilities.

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Where did this happen?

Establishment
Wisconsin Masonic Home Inc. CP/RSL/MW
Parent company
Wisconsin Masonic Home inc.
Street
410 N. Main Street
City
Dousman
State
WI
ZIP
53118
On-site location
Riverside Lodge Assisted Living Resident Room

What was the outcome?

Outcome
Job transfer or restriction (code 3)
Type
Injury (code 1)
Days restricted or transferred
7

Before the incident

Helping adjust a resident.

What happened

Staff leaned over the back of a recliner to assist the resident in moving and felt her rib pop out and then back in.

Injury or illness

Strained chest wall.

Object or substance involved

Resident.

Summary line

Sprained chest assisting resident in [REDACTED].

Employee and industry

Job description
Resident Assistant
SOC code
31-1131 — Nursing Assistants
NAICS code
623312 — Assisted-living facilities without on-site nursing care facilities
NAICS vintage
2022
Avg employees
181
Total hours worked
231112
EIN
390813463
Establishment ID
62234
Employer case #
CP-23-15

When (timing detail)

Date of incident
Shift started
5:53:00.000
Time of incident
9:00:00.000
Filing year
2023
Submitted
16FEB24:15:46:00

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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 — no per-record IMIS deep link exists.