Abstract: At 8:00 a.m. on May 27, 2023, an employee working as an activities director for a skilled nursing facility reportedly contracted COVID-19. The employee routinely performed patient room visits in lieu of in person group activities due to the hazards posed by COVID-19. She worked on December 23 and December 24, 2022, and wore a surgical mask and face shield when interacting with patients and other staff. At this time there were no confirmed or suspect COVID-19 cases at the facility. The employee began to experience symptoms on December 25, 2022, including fatigue and a body ache. The employee took a COVID-19 test on December 27, 2022, and received a positive test result on December 29, 2022. The employee was hospitalized from December 30, 2022, through January 3, 2023. The employee unable to identify how she was exposed to COVID-19. The employee's immediate family members began exhibiting COVID-19 symptoms when she was first hospitalized. The employee stated that the only coworker she worked closely with on the 23rd and 24th was an activities assistant. The employee later clarified that they were not within 6 feet for a cumulative 15 minutes within a 24-hour period. The coworker later tested negative for COVID-19 on December 27, 2022, December 31, 2022, and January 3, 2022. The employee was hospitalized due to COVID-19.