Hi Tim and Earl,
I agree that we should conduct a full audit of our CG staff. To ensure we
have quality caregivers in place, I have already been part of two
terminations recently. I also need to review QA visits recently completed
with Ashley and see if missed visits occurred as well.
I will pull a report with a list of all current caregivers and speak with
Pat and Ashley regarding the concerns raised. While I have witnessed Ashley
having difficult conversations with CGs in the past, I would like to
support her with these upcoming conversations to ensure they are handled
effectively. I am speaking with team today in Milwaukee regarding this.
More interventions to come.
Amelia Howard
On Thu, Mar 5, 2026, 7:32 AM Timothy Thomas <tt@thekey.com> wrote:
> Sounds like we need to conduct a full audit of our CG staff. What are your
> thoughts?
>
> Also is Ashley equipped to have these difficult conversations with CGs?
>
> On Thu, Mar 5, 2026 at 1:28 AM Micah Jakoblich <micah.jakoblich@thekey.com>
> wrote:
>
>> Hi all,
>>
>> I spoke with Earl this afternoon, and he requested an email summarizing
>> today's meeting with Eastcastle Place (ECP) regarding their Preferred
>> Service Providers (PSP) consideration.
>>
>> On March 4, 2026, Roy Merath and I represented TheKey at this meeting.
>>
>> Eastcastle Place was represented by:
>>
>> - Tracy Lappin (Director of Nursing)
>> - Nicole Claas (Director of Social Services)
>> - Teresa Jenkins (Director of Resident Services)
>> - Ashley Orlinski (Healthcare Manager)
>> - Greta (Social Worker)
>> - Toni (Social Worker)
>>
>> Our 3 shared clients/residents currently receiving services at ECP are:
>> Judith Hestoff (SOC: 4/15/2021)
>> Rose Marie Baron (SOC: 1/31/2022)
>> Lee Ann Hill (SOC: 6/12/2023)
>>
>> The purpose of the meeting was to audit and evaluate the PSPs with whom
>> ECP will work. The deadline for finalizing these considerations is late
>> March or early April.
>>
>> Our discussion centered around significant "quality-value" gaps and
>> service delivery issues detrimental to the partnership. ECP was direct
>> about a persistent decline in caregiver quality and service delivery, attributing
>> this to a lack of operational accountability from the Caregiver Manager
>> (CGM/Pat Echols) and Client Success Manager (CSM/Ashley Alford).
>>
>> On a positive note, the team highlighted the following:
>>
>> - Caregiver Excellence: Tandi is considered remarkable for her service
>> delivery, communication, and adherence to our core values.
>> - Leadership Value: ECP deeply values the expertise provided by Roy and
>> me, noting the specific value we add in our respective roles.
>> - Dr. Shadi's research and materials facilitated to staff by HCL and
>> TheKey are of great value and interest to HM/DON
>>
>> *Role and Accountability Concerns*
>> *Responsibility Concerns*: Teresa and team opened meeting level-setting who
>> is directly responsible for overseeing clients versus CGs, and how
>> accountability is maintained.
>> *Role Outlines*: Reviewed CGM and CSM roles, including QA visit
>> adherence. DoRS was fully aware of CGM role and responsibility, and
>> utilizes her as POC for CG
>> *CGM to CG Accountability*: DoRS communicates CG concerns to CGM, but
>> sees no accountability or CG correction
>> *CSM Visibility*: With exception of HM who saw HCL + CSM together onsite
>> multiple times last year; once this year; ECP unaware of CSM onsite
>> presence; lack of check-ins
>> *Lack of Reinforcement*: From ECP's perspective, CG issues relayed by
>> ECP to CGM are not being addressed/corrected by CGM/CSM
>>
>> *Inappropriate Attire and Phone Usage Concerns*
>> *Attire*: Yesterday, CG (CL Lee Ann Hill) attended ECP in inappropriate
>> attire. This follows a previous discussion last week where DoRS addressed
>> the same issue regarding this CG which occurred a week prior with CGM. ECP
>> reports that they see no positive changes or improvements, despite ongoing
>> communication regarding attire concerns.
>> *Professionalism and Phone Usage*: DoRS contacted the CGM regarding CG
>> (CL: Lee Ann Hill). During a memorial service conducted by the ECP Pastor,
>> the CG remained on her phone the entire time while wearing a baseball cap.
>>
>> *Alignment and Professionalism*
>> - There is a visible lack of "blending" between CGs and the ECP team.
>> - CGs frequently appear standoffish toward staff members.
>> - Greetings are rarely exchanged, hindering rapport.
>> ECPs SOP is to obtain detailed statements for all incident report filings.
>> - CGs respond to incident inquiries with silence or avoidance. There is
>> a misconception that being asked for a statement implies "being in trouble."
>>
>> *Organizational Impacts*
>> The DoRS and DSS expressed significant concerns:
>>
>> "I'll have to be honest Micah; the actions of some of the CGs will be the
>> reason if we decide not to move forward."
>> They further stated that while the CG's actions are the root cause, the
>> "recurrent instances" and the fact that they are not addressed/resolved (lack
>> of accountability) are the primary deal-breakers.
>>
>> - Note: Uniforms were discussed early on during talks re: attire. ECP
>> brought this up again and elaborated, stating they would like to
>> distinguish TK CGs apart from ECP staff because the TK CGs are damaging
>> ECP's reputation.
>>
>> *Quality of Service vs Price Premiums*
>> *Cost versus Quality*: DSS reports a significant gap between our rates
>> and service delivery. Although we charge a premium, the quality of service
>> is perceived as inferior to many other agencies that charge $30 or
>> $32/hr and offer superior service delivery.
>>
>> ---
>>
>> Please reach out to me any time with questions or concerns.
>>
>> Thank you,
>> Micah
>>
>>
>>
>> --
>> *Micah Jakoblich*
>> *Milwaukee Home Care Liaison*
>>
>>
>> O: (414) 964-8000
>> C: (414) 242-5803
>> TheKey.com <https://www.thekey.com/>
>> [image: TheKey] <https://www.thekey.com/>
>>
>