Yes, if she was physically present in the US the same year she meets the Substantial Presence Test, the starting date of her non-residence status is the earliest date in US including vacations, but not days when travel was restricted because of medical reasons.
So if she was on vacation in the states on January 1 2024, and she meets the 183 days in 2024, her start date would be January 1, 2024.
According to the IRS:
"You are treated as present in the U.S. on any day you are physically present in the country, at any time during the day. However, there are exceptions to this rule. Do not count the following as days of presence in the U.S. for the substantial presence test:
- Days you commute to work in the U.S. from a residence in Canada or Mexico if you regularly commute from Canada or Mexico.
- Days you are in the U.S. for less than 24 hours, when you are in transit between two places outside the United States.
- Days you are in the U.S. as a crew member of a foreign vessel.
- Days you are unable to leave the U.S. because of a medical condition that develops while you are in the United States.
- Days you are an exempt individual"
"If you meet both the green card test and the substantial presence test in the same year, your residency starting date is the earlier of:
The first day you are present in the United States during the year you pass the substantial presence test, or
The first day you are present in the U.S. as a lawful permanent resident (green card holder)."
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