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Remote Support Bulletin
ABSTRACT:
This support bulletin will address some recent disturbances for remote support, and we wanted to address the cause, short-term, and long-term fix. We also want to discuss how this will impact PCC (Point Click Care) customers specifically.
TECH SUMMARY:
In recent weeks some sites have lost remote access requiring a manual disabling and enabling of remote support. All distributors should review their sites to determine which were affected. These disconnections occurred during updates to our VPN server that we regularly conduct for security reasons. Given the importance of speed surrounding security issues, we can’t always have these changes scheduled. These security measures are a common and necessary practice for all servers and will continue to be. We have confirmed a way to correct the source of the issue with the service that manages the VPN connection allowing remote access. Please continue to report issues with remote access as soon as possible.
PCC:
For PCC facilities, in particularly we will lose syncing capabilities without this access. Once facilities with PCC have are back online, we will need a manual sync.
Email to Text:
This form of notification should not be considered a primary method of notifying caregivers. Any sites relaying strictly on this form of notification should conduct a review to make the necessary changes. The main function of this service is to allow escalation to administrative staff when calls are not being answered or in otherwise emergencies where regular notification hardware requires replacement. Additionally, at any time, any site can change to their SMTP server or 3rd-party service to send these alerts.
Scheduled reports:
Any reports that do not go out as scheduled due to disruptions in remote access can always generate these reports manually for the time being.
Solution:
We will be applying the solution to our server here on the morning of 12/02/2019. There will be no downtime or need to concern facilities as these changes are not done on the cubes themselves. None of the security updates will occur until after this time. For any sites not on remote access at this time, we will need to re-push our solution when they do come back online to prevent future disruptions.
1. Disable and Re-enable remote support via front panel

a. Use the Scroll Down Button and select Remote Support on the Main System menu.

b. Press the Select button when you are done.

c. If Remote Support is disabled, the screen will ask you if you want
to enable it.
d. If Remote Support is enabled, the screen will ask if you want to
disable it.

e. Select Yes or No using the Scroll Up or Scroll Down Button.
f. Press the Select button when you are done.
g. When you finish, press the Exit Button.
h. Repeat these steps to re-enable

2. Disable and Re-enable remote support via interface

a. Log in to server locally if IP address is known
b. Select System Settings
c. Select Network Settings
d. Change “Enable remote Support to “No”
e. Save Changes
f.  Repeat steps to re-enable remote support
 
CONCLUSION:
We recognize the frustration of losing access to sites that require remote access to send emails or texts. For sites currently online this will no longer be an issue after 12/02/2019. Furthermore, the steps above can be sent directly to end users to prevent the need for any onsite visits. Please remember to review current access for all sites as well as review to ensure there are adequate notification configurations in place.
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RCM 3.2 Policies
ABSTRACT:
RCare Mobile (RCM) version 3.2.0 was released on 10/15/19. This version of RCM addresses all known issues in addition to solidifying the platform and adding new functionality. There is one potential issue that remains in the software. This issue can be avoided by following existing RCM polices.
TECH SUMMARY:
RCM 3.2.0 contains a known path to a state where RCM phones will not receive alerts. If the policies below are followed this path can easily be avoided.
Path to error:
If an RCM phone loses Wi-Fi connection while the phone is in Do Not Disturb Mode and an alert is triggered during that outage the phone will not receive the alert until the phone is manually activated.
Related Policies:
Do Not Disturb Mode: Do Not Disturb Mode should not be used at any time. Please train staff to never lower the volume below the “Vibrate” setting. [Do Not Disturb is the lowest level in the volume settings accessible via the “rocker” switch on the side of the phones.] Note: If the phone is in Do Not Disturb Mode and on Wi-Fi an alert will pull the phone out of Do Not Disturb and “wakes up” the device.
Log-in/Log-Out: 
The Log-in and Log-Out features of RCM not only allow for efficient management and reporting of staffing hours but also drive back-end functionality. For both reasons staff need to be trained to log out of RCM when leaving Wi-Fi for planned breaks, meals etc. If the building has known Wi-Fi “dead spots” staff need to be trained to manually activate the phone and confirm connection to Wi-Fi.
Wi-Fi Connectivity: 
RCM functions on a dedicated Wi-Fi network. Clinical staff need to be made aware of any deficiencies in coverage, strength etc. that may affect the phones connection to said dedicated Wi-Fi. Although 3.2.0 has added an audible notification when Wi-Fi is lost, if staff plan to leave Wi-Fi for extended periods they should be following the log in/out policy above. Note: If the RCM app is unlocked users can select other networks. An RCM phone on the wrong network is the same as that phone not being on Wi-Fi at all. Phones should be locked after install and the RCM phones should only “know” the appropriate nurse call Wi-Fi SSIDs.
Log-in/Log-Out: 
The Log-in and Log-Out features of RCM not only allow for efficient management and reporting of staffing hours but also drive back-end functionality. For both reasons staff need to be trained to log out of RCM when leaving Wi-Fi for planned breaks, meals etc. If the building has known Wi-Fi “dead spots” staff need to be trained to manually activate the phone and confirm connection to Wi-Fi.
Wi-Fi Connectivity: 
RCM functions on a dedicated Wi-Fi network. Clinical staff need to be made aware of any deficiencies in coverage, strength etc. that may affect the phones connection to said dedicated Wi-Fi. Although 3.2.0 has added an audible notification when Wi-Fi is lost, if staff plan to leave Wi-Fi for extended periods they should be following the log in/out policy above. Note: If the RCM app is unlocked users can select other networks. An RCM phone on the wrong network is the same as that phone not being on Wi-Fi at all. Phones should be locked after install and the RCM phones should only “know” the appropriate nurse call Wi-Fi SSIDs.
CONCLUSION:
If any or all of the above policies are followed the path to not receiving alerts can easily be avoided. The primary solutions/takeaways are:
● Do Not Disturb Mode: Train staff on how Do Not Disturb Mode is activated and ensure they don’t enter or use that mode.
● Checking the Phone when reentering Wi-Fi: In situations where temporary Wi-Fi outages can’t be avoided (e.g. elevators, stairwells etc.) train staff to manually check their phone for alerts when reentering good Wi-Fi.
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Remote Support Changes
ABSTRACT:
We will be switching our public IP address for our remote support server on Saturday, March 16th 2019. We are changing ISP’s here and will be receiving a new Public IP address.
TECH SUMMARY:
Currently the remote support server is on public IP address 209.252.247.27 and only this IP address. It will be moving to 184.9.55.187. Normally, opening Outgoing Port 1194 or 1195 and entering in a valid Gateway and DNS into the cube’s network configuration will be enough to get the facility’s nurse call system on remote support.
However, some facility’s IT staff requires that these outgoing ports be limited to the specific IP address of our Remote Support Server in order to prevent unwanted guests. Given the nature of the variety of different hardware and firewall configurations, we cannot provide a universal set of instructions for how to ensure this transition goes smoothly. This change is the responsibility of whomever manages the firewall configuration for these facilities.
Any server built or that has received in-house service since November 26th, 2018 will be on port 1195 instead of Port 1194. It is strongly advised that everyone open both ports 1194 and 1195 to 184.9.55.187 though as every single facility will require an update to their remote support key that will use port 1195. It is important to note that no changes to the server itself are necessary for any of these changes.
 
SOLUTION:
It is paramount that you contact your facility IT department or whoever manages the facility’s firewall to verify whether they have configured their firewall to point to our public IP address. If they have, they should add the new network information immediately.
Sites that are restricting outgoing port 1194 or 1195 need to add in the new address, preferably on Friday, March 15th 2019 before these changes are made to assure a minimal service interruption.
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RCare Alexa Skill
ABSTRACT:
RCare has integrated an RCare skill right into Alexa for better care in senior housing communities. Now your residents can vocally request help without pressing a button. Your busy caregivers also get a hands-free way to reset the call without taking an eye off the resident.
With the RCare Nurse Call skill, residents can use Alexa- enabled devices to call for assistance using the simple command: “Alexa, tell my nurse I need help.” Just like a pull cord or a push button, the voice command sends a call out to caregivers. The difference is that the residents can use voice commands to get help even when their help buttons are out of reach.
TECH SUMMARY:
 
Getting Started
First off, you need to install your Echo device. This will require that you install the Alexa app on your smart phone or tablet. Follow the Amazon’s directions to install the device and get it connected to WiFi.
Amazon requires a device to be associated with an Amazon account. This can either be a unique account for each resident or a shared account for the facility. Since each individual device is paired separately, either
situation can be handled by the RCare Nurse Call skill. Note that if the resident wants to use the reminder, list, or shopping functionality of Alexa, they should use an individual account.
Alexa integration must also be enabled for your nurse call system. Contact your distributor or RCare support to do this.
Installing the RCare Nurse Call Skill
Once the Echo device is ready to go, you need to install the skill:
1. Open the Alexa app on your smart phone or tablet.
2. From the app menu, select Skills & Games.
3. In the search field, enter RCare and press Search. The RCare Nurse Call should show up in the search results.
4. Press RCare Nurse Call to open the skill details page.
5. Press the ENABLE button.
The RCare Nurse Call skill is now enabled for the Amazon account logged into the Alexa app. All Echo devices associated to this Amazon account will have the skill on them. They still need to be paired to an account in the nurse call system in order for the skill be used, though, which is detailed in the next step.
Pairing a Device to an Account
Now that the Echo device is ready and the skill is installed, you need to pair it to an account in the nurse call system:
1. At the device you want to pair, say “Alexa, launch my nurse”.
2. The device should respond that the device is not yet paired. To pair, say “pair device”.
3. The device will respond with a six digit pairing code. Write this down or note it in the card in the Alexa app on your smart phone or tablet.
4. Open and log in to the nurse call system web interface.
5. Click Accounts in the menu bar.
6. Find and click the account with which you want pair the Echo device.
7. Scroll down to the Alexa Echo Devices section of the account page and click Add Echo Device.
8. Enter the pairing code and a description for this Alexa device. You will usually want to add the location of the device in there, for example Room 123 – Kitchen.
9. Click Save
The device is now paired! You can check the pairing status of any Echo device at any time by saying “Alexa, ask my nurse for pair status”.
Using the Skill as a Resident
Residents can interact with the skill with a few simple phrases:
“Alexa, tell my nurse to check in” – This will check in the resident for the day. This can be used instead of requiring a resident to press a pendant or other action for checking in.
“Alexa, tell my nurse I need help” – This will trigger a nurse call similar to a pendant push or cord pull. The triggering device on the nurse call system will be Alexa Device.
Using the Skill as a Caregiver
Caregivers can also interact with the skill:
“Alexa, tell my nurse to reset call” – This will reset any calls triggered for the associated account. This works for calls triggered by not just Alexa but any device. Caregivers may still need to reset the pull cord or pendant devices themselves.
CONCLUSION:
When combined with the built-in Alexa reminders, residents will never miss a check-in using the RCare Nurse Call skill. They can simply say “Alexa, tell my nurse to check in” instead of hunting down their check- in device.
Busy caregivers dealing with a crisis situation can now use voice commands to indicate the incident is being handled and stop caregiver devices from additional alerting. They can simply say “Alexa, tell my nurse to reset the call”. This allows the caregiver to focus on the resident instead of fumbling with pendants or pull cords.
Safety. Efficiency. Between your beloved residents, your compassionate staff, your RCare nurse call technology and the always available Alexa, life just got a little bit better.
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Gen-4 Transition
ABSTRACT:
This week’s tech bulletin will be to inform distributors that G3 Wireless Network Equipment will have an End of Life of January 1, 2020. This week’s tech bulletin will provide guidelines for what this means regarding service coverage as well as a few themes regarding how to transition an older G3 facility to G4.
TECH SUMMARY:
 
No More sales of G3 wireless networking devices: 01/01/2020
No More sales of G3 transmitters: 01/01/2020 or Until Inventory Runs out
No More Troubleshooting/Support from RCare: 01/01/2021
What questions you’ll need to ask to complete a transition…
1) Will you be starting with a Hybrid System or straight to G4?
2) How much G4 equipment you’ll need?
3) Where is the existing G3 equipment (This will need to be removed to prevent interference)? If you do not have an up to date locator map or detailed descriptions in the locator description section, you will need to obtain this information.
4) What will it take to physical swap out old equipment?
5) Will I move to G4 Pendants as well?
6) Moving to ALP?
7) How much time will it take?
CONCLUSION:
We will be releasing a detailed step by step guide to help distributors answer these questions, but this bulletin is an introduction to a task that will eventually be required across the board. We would like to provide as much information as we can to prepare for the inevitability of this change over.
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Forget Wi-Fi
ABSTRACT:
This week’s tech bulletin will show you how to properly forget an SSID for RPhones or devices running RCare Mobile (RCM) phones. Forgetting SSID’s is helpful when the facility has multiple networks that an RCM phone could log into. Many facilities often have unprotected guest networks that the phone could accidentally hop to and cause the RCM Phone to temporarily lose access to the cube, and thus lose access to appropriate incident notifications.
TECH SUMMARY:
 
Step 1: RCM Settings
 
1)     Log onto RCM Admin Settings
2)     Make sure Application Lock down is turned off
3)     Enable Sticky Wi-Fi is on (Left). (Older versions of RCM require Last Good SSID to be manually entered (Right).
4)     Ensure Server (Cube) Address has been entered correctly. If the phone has recently connected to the Cube, this value is likely correct.
Step 2: Log onto Android Settings
1)     Use finger to swipe down from upper right-hand corner of phone. (Left)
2)     Select Android Settings option in upper right hand corner. (Blue icon, Left)
3)     Select connected wifi drop down or Gear in Upper right hand corner. NOTE: Each will bring you to a screen that looks slightly different, but functionally for the sake of logging into and                        forgetting networks, they are the same. (Right)
Step 3: Connect and forget
1)     Find Wi-Fi you do not want from list of available Wi-Fi options, then press and hold (Left)
2)     When not connected, the only option will be to connect. NOTE: You will need the facility to provide you with the Wi-Fi password for each undesirable network so that you can log on and forget.
         Forget is only an option for the currently connected Network (Right)
Step 4: Forget Network
1)     Selected Connected Network to forget (Left)
2)     Select Forgot (Center)
3)     You may also press and hold to forget network (Right)
 
CONCLUSION:
To better ensure consistent functionality of RCM Phones, it is important to properly forget undesirable networks on the device. The Wi-Fi Scanner built into RCare Mobile can be used when diagnosing whether the phone is connecting to undesirable networks. Because this is a feature on Android itself, it cannot be done remotely and must be done in person by either the distributor or end users. Most of the time forgetting is a bad thing, but with RCM it is crucial for correct operations.
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CMOS Battery
ABSTRACT:
There is a specific “Cube down” issue that is rather easy to fix with access to a monitor and keyboard.  For example: power outages, or a Cube is reset that has been working for some time with no issues, and suddenly gets stuck in “Starting Up”.  This bulletin will explain the steps for repairing this issue.
TECH SUMMARY:
 
If you get this “Starting Up….” Screen for more than 5-6 minutes it may be time to get a monitor and keyboard.  These must be separate monitor and keyboard that you can hook up via VGA, PS/2, or USB connection.
1)     Safely Power Down/Remove Power
2)     Plug in Monitor and Keyboard
3)     Power Server back up.  HD Cubes will have button on front
        panel. URack cubes will require technician to hold on Green
        Check mark button to power up cube.
4)     Let Cube attempt to power up.  If Cube gets stuck on failed
        (code seen below, then you have a CMOS battery issue, which
         controls the date and time settings on the server.  The server is
         attempting to load “in the future” because the server thinks its
         set to the year 1900.  This stops the start up process.  It only
         manifests itself after a power cycle.
5)     Hard power cycle the server again and when you see the
        “SUPERMICRO” screen below.  Begin hitting Delete key
        continuously until the screen goes into bios mode.  If you don’t
        hit the key in time, you will need to start back over at step 1.
BIOS SCREEN
1)     This will bring you to the BIOS Screen.  You will automatically
         be at the Main tab where you will see the date and time.
2)     Enter Day, Press Enter
3)     Enter Month, Press enter
4)     Enter Year, Press Enter
5)     Press down key
6)     Enter Hour, Press Enter
7)     Enter Minute, Press Enter
8)     Enter Seconds, Press Enter
9)     Use Right key to move to “Save and Exit Tab”
10)   Use Down key to select “Save Changes and Reset”, Press Enter

11)   Server should reboot properly

Replacing CMOS Battery:

It is a generic CR 2032 Battery dime battery.  It may be in a different location depending on the type of server you have.  Pictured below is an HD Cube.  You will not need to replace the battery to bring it back online.  However, If the server is shut down or rebooted you will have to repeat these steps every time until the battery is properly replaced.

 
CONCLUSION:
At first this may be alarming, especially if it happens in the middle of the night.  But this document can be passed to end users as well.  If the front of the Cube now properly displays the facility name and the monitor is asking for a username, then you have completed boot up.  It is a simple starting up issue related to a dead battery that can easily be replaced to get you going.
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Voice-to-Voice Options
ABSTRACT:
The purpose of this week’s tech bulletin is to inform distributors of some of the variety of options for obtaining two-way voice to voice communication. There is too much variability to discuss all potential configurations, so these represent several of the more common ways in which Response Care can be integrated. The installers knowledge of third party equipment is key to a successful integration.
TECH SUMMARY:
 
Option 1: D3900 dialers
The RC-D3900 dialers must now have their analog lines connected to a 2 port or 24 Port ATA that needs to be purchased from and programmed by Response Care prior to installation. Individual devices are no longer learned into the dialers. When an incident occurs, a SIP or RCM phone places a call through the server, to the network, to the ATA, which has a 50 pin Telco connector going to the analog lines that run to the dialer. A 66 Block is typically used for punching down the 50 pin Telco connector, but this is at the discretion of the installer. This needs to be preplanned prior to installation to avoid delays and unexpected equipment costs.
Pros: Most of the programming and Response Care software requirements are preprogrammed prior to installation. If the analog lines are already run from a prior phone system, there is very little labor involved in this integration.
Cons: A lot of failure points that make troubleshooting more complex.
Option 2:
IC-300 VOIP Intercom
This is a very simply alternative to the dialer that requires Intercom box to be connected via POE to the facilities network.

Pros: Simply communications path that significantly reduces installation and programming time. Fewer failure points make troubleshooting much easier.

Con: Running ethernet lines. How the network goes, so goes the entire notification system. It is prudent to include a redundant method of communication such as a CC-900 Caregiver console as a fail safe if the facility experiences major network problems.
Option 3: GSM Dialer

The GSM Dialer option essentially puts a cell phone in the room required for two way communication.

Pros: Reliability. Pre-programming of GSM dialer discourages programming errors that could complicate troubleshooting during an installation.

Cons: Requires Network knowledge and understanding of Analog versus digital PBX to properly integrate. This requires a knowledgeable installer and assistance from the facility IT staff or PBX Vendor.

Sangoma cards are required for any strict Analog communications. Each sangoma card has 4 analog phone ports, and any HD cube can have as many as 4 sangoma cards. A VOIP PBX connects via ethernet. Depending on network infrastructure, distributors may be required to purchase additional third party equipment that require assistant from outside venders. Response Care does no troubleshoot PBX, SIP Trunk, POTS lines, ect. It is the responsibility of the integrator to inform Response Care of the configuration and the dial plan for us to program what is required on our end.

Pros: Customize facility based on existing infrastructure to save costs

Cons: Requires intimate knowledge of

 
CONCLUSION:
Remember, you are the integrator. Response Care will assist is providing the equipment based on the information we are provided prior to installation. Misunderstanding what the customer wants, the existing infrastructure, and what we can or cannot do won’t be good for anyone. Integrators must have knowledgeable about third party equipment for voice to voice if it is to be used. Otherwise, there could be long delays with Response Care going through fruitless trial and error guesses.
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Backup Notifications
ABSTRACT:
This week’s bulletin will cover what to do in an emergency when the system is still functioning, but your method of notification has gone down. It behooves integrators to have a backup plan in place for these types of situations.
TECH SUMMARY:
Different scenarios may come up that you did not anticipate.  Different notification problem scenarios are coming up all the time, even for RCare.  Being prepared with a backup plan regardless of those scenarios will prevent catastrophes for end users that are left without a way to be notified of incidents.  Here are just some potential scenarios that may arise.
1)     Page encoder RFCD light goes on, but there’s no one able to get on site for a day or two.  End user will not have the equipment or know how, even with RCare’s help, to turn off RFCD feature.
2)     Page Encoder transmitter has stopped working – Pagers alone should never be your only method of notification.
3)     RCM Phone has a battery or charging port that has stopped working.  If there is no backup phones available (There should be), then an entire section or floor may be without a way to receive incidents.
4)     Network issues at facility with no IT – Network issues can bring down any notification method that requires access to the network including, dialers, RCM Phones, VOIP Intercom, SIP voice-to-voice, DLC’s, etc..  You may have RCM that communicates with IC-300’s and a redundant DLC backup, but if all of them are on the same network when they have issues, they’re all dead.

5)     Facility has storm or accident that causes power issues.  Integration device is not plugged into UPS (It should be) and the power supply has died.

SOLUTION:
1)     Have multiple methods on site

2)     Teach end users how to use web interface as a backup.  Ensure they have a web browser that allows “Beep on Active Incident” before install has been completed.  Beep on active incident can be found as a check box in the users tab.  You should create users for the facility with a limited range of accessibility.  Guest user should also have this box checked.

3)     Email or Email to text -This will allow end users to receive alerts while a permanent solution is in the process of being implemented.a.      First, elect Message Receivers

b.      Select Add new drop down box to select “Email”

c.      Then select “Add”.

d.      Adding an email should be self-explanatory.

e.      Email to Text – In the example below there is a 10 digit phone number with area code followed by @ and then the service provider domain.  Each service provider is different.  Here is a link to potential service provider domains.  http://www.emailtextmessages.com/

f.      Message receivers will need to be added to Notification chain just like any other message receiver

 
CONCLUSION:
Redundancy and prior proper planning will prevent most issues regarding notification method issues without too much down time.  It won’t however prepare for every situation.  This is where the web interface and email or email to text comes into play.  If the facility has rules against computer/cell phone use, the facility will have to determine whether their rules or their notifications are more important.  Nonetheless, ANY system that is functioning, but whose method of notification has gone down, can use these options in an emergency.  Awareness of these scenarios and solutions will help yourselves and your end users avoid panicking.
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RCare Check-Ins
ABSTRACT:
The focus of this week’s bulletin will be understanding how to set up RCare check-in devices to get a “clean” Check-in Report.  Without following the steps exactly, it is common to obtain false information in these reports that can become confusing.
TECH SUMMARY:
There are three features that are required to set up to isolate an RCare Check-in device in order get a proper Check-In Report.  First, set up the device correctly.  Second, Isolate RCare Check-In accounts/groups.  Last, Generating Report.
1)     Set Device Function

Individual devices need to have a device function of RCare Check-in.  If it is not set correctly, any signals coming from this device will not be considered a “Check-In”.  It is important to note that there is a distinction between “Supervision” and “Check-In”.  A supervision signal alone does not constitute a “Check-In”. This can be seen in images below.  Despite the fact the system has received and processed a signal, it will not process any activations as an “RCare Check-In”.

2)     Device Isolation
Devices designated to be RCare Check-In devices need to be in their own separate accounts in their own separate groups.  The reason for this is because the RCare Check-In Report does not discriminate between accounts or devices that are set to RCare Check-in function or not.  It will simply pull every single account for the group you have selected.  Then it will review the last received “RCare Check-In” signal from those accounts.
3)     Creating Report
  • Select Reports Tab.
  • Then select RCare-Check-in Report.
  • Select Group to conduct Reporting on
  • Select desired file format to generate report

Any report can also be configured to be automatically report on a scheduled basis at the bottom of the Reports tab.

 
CONCLUSION:
There has been recent confusion over these reports and why so many “Never” shows up.  This bulletin explains why that occurs and how to avoid it moving forward.  The keys to take away are the system will only do what you tell it to do.  You must be very specific with the configuration because the reporting tool for RCare Check-In’s does not do that querying for you.  Remember to set the correct device Function, isolate the device, and generating report.