Client Cancellations & Service Changes

Overview

Client cancellations and service changes are among the most frequent operational events TheKey manages, directly affecting caregiver scheduling, billing, and client retention. Cancellations arise from a range of causes — hospitalization, client dissatisfaction, financial constraints, temporary travel, and end-of-life transitions — and must be handled promptly and consistently. How TheKey responds to a cancellation determines whether care resumes, whether fees are charged, and whether the client relationship is preserved. A documented cancellation policy, standardized deactivation reasons in WellSky, and clear internal communication protocols all govern this process.

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Key People

• Amanda Steben-Allard — Care Manager who produced detailed weekly care management notes (2017) tracking individual client cancellations, hospitalizations, and service holds.
• Timothy Thomas — Early operations contact handling caregiver notifications and client family communications around shift cancellations.
• Christina Leo — Handled formal service agreement cancellations (e.g., live-in care) and hospital-related care offers to families.
• Allison Brennan — Coordinated billing and care adjustments during client hospitalizations (e.g., Shirley Cooper case, 2023).
• Chuck Terlesky — Winnipeg operations; involved in applying cancellation policy and billing disputes related to late cancellations.
• John Janiga — Referenced the signed client agreement to resolve cancellation fee disputes in Winnipeg.
• Joey Taylor — General Manager (Montreal); flagged urgent client cancellations and end-of-life service closures.
• Mina Levy / Jhonna Vallejo / Kristal Parris — Scheduling coordinators managing shift-level cancellation communications (2025).
• Nikita Moreau — Handled weekend summaries and caregiver-side cancellations.

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Processes & Policies

Cancellation Fee Policy (from signed client agreement):

• Cancellations not received within the required notice window are subject to a fee equal to the full billing rate for the entire scheduled shift. [Re: Updated Cancellation Policy — 2024-08-08 — Timon Page]
• Winnipeg practice: charge the full shift if cancellation is received with less than 24 hours' notice. [Re: St. Goddard Miles - Winnipeg Client - Credit Requested — 2023-11-15 — Chuck Terlesky]
• Clients and families should be directed to the signed client agreement when disputing fees. [Re: St. Goddard Miles — 2023-11-15 — John Janiga]

Hospitalization Protocol:

• When a client is admitted to hospital, care is cancelled until further notice. Staff confirm the cancellation with the client's family or contact, then notify the assigned caregiver(s) directly.
• Affected caregivers are offered replacement shifts where possible. [Re: Shift Cancelled — 2020-12-29 — Gaelle Guiteau]
• TheKey can continue providing caregiver support at the hospital if the family requests it. [Re: Dad is in the hospital — 2019-03-14 — Christina Leo]; [Shirley Cooper Billing — 2023-01-03 — Allison Brennan]
• A point person is assigned to follow up with family for return-to-care planning. [General_Manager_Playbook.txt]

WellSky Deactivation Reason Dictionary (standard categories):

• Hospitalization – First Admission
• Admitted to Hospital/Rehab
• No Longer Needs Care
• Moved to Assisted Living/LTC
• Moved Out of Area
• Chose Another Provider
• Client Dissatisfied
• Financial/Cost Issue
• Family Decision
• Caregiver Unavailable / Agency Unable to Staff
• Seasonal/Temporary Hold
• Deceased

Notes must clearly document what led to the cancellation, what service recovery actions were taken, and whether client recovery is considered possible. [Wellsky Deactivation Reason Dictionary.txt]

Caregiver Notification:

• Coordinators notify affected caregivers by email or phone as soon as a cancellation is confirmed.
• Message should acknowledge the cancellation reason (where appropriate) and offer alternative shifts. [Re: Shift Cancelled — 2020-12-29]
• In WellSky/scheduling systems, activity log tags distinguish "cancel by caregiver" from "cancel by client." [Quality Metrics Training Deck]

Tracking Cancellations Tied to Pricing Changes:

• When a rate increase is implemented, notes should be added to the accounts of clients who cancel service as a direct result. [Re: Spreadsheet shared — 2023-03-28 — Cheryl Cartwright]

Lifeguard Device Cancellations:

• Separate 30-day written notice required; device must be returned; final month prorated from cancellation date. [Lifeguard_Canada.txt]

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Timeline & Key Events

• 2015–2017 — Timothy Thomas managing shift cancellation notifications ad hoc by email; Amanda Steben-Allard producing weekly care management logs with per-client cancellation status.
• 2017-09-12 — Ainbinder: care cancelled after refusing care; charged 49 hours. [Care Management September 12 — 2017-09-12]
• 2019-03-14 — Family inquiry about cancellation charges during hospitalization; Christina Leo offered in-hospital care as an alternative.
• 2020-12-29 — Multiple same-day hospitalization cancellations (St-Pierre, Waxman); coordinators notified caregivers and sought replacement shifts.
• 2021-06-14 — Live-in care agreement formally cancelled; confirmation sent to client family by Christina Leo.
• 2023-01-03 — Shirley Cooper hospitalized; caregivers redirected to hospital at adjusted rate ($38.00/hr). [Shirley Cooper Billing — 2023-01-03 — Allison Brennan]
• 2023-11-14/15 — St. Goddard Miles (Winnipeg) billing dispute over late cancellation; policy discussion between Chuck Terlesky and John Janiga results in referral to signed agreement.
• 2024-08-08 — Updated Cancellation Policy circulated, formalizing full-shift billing rate as the cancellation fee. [Re: Updated Cancellation Policy — Timon Page]
• 2025-10-29 / 11-26 — Scheduling team (Mina Levy, Jhonna Vallejo, Kristal Parris) handling hospital-related cancellations with confirmation requests sent to caregivers.

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Key Decisions

• Full-shift billing applies when cancellation notice is not given within the required timeframe, as codified in the signed client agreement and reinforced in the 2024 policy update.
• In-hospital care is an option to offer families when a client is hospitalized, preventing a full service lapse and preserving the client relationship.
• WellSky deactivation reason codes are the authoritative method for classifying cancellations; notes must accompany each deactivation to capture recovery potential.
• Pricing-driven cancellations are to be flagged and tracked separately as a business metric.
• In the Winnipeg market, the established local practice of charging the full shift for sub-24-hour cancellations was confirmed as consistent with the client agreement.

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Open Questions & Gaps

• Notice window not consistently specified: The 2024 policy references a timeframe but the exact hours (24 hrs? 48 hrs?) are not uniformly stated across all documents and markets. Winnipeg uses 24 hours; other markets may differ.
• Triage of "non-urgent" cancellations: A 2024 email flagged that a client cancelling care due to hospitalization was incorrectly routed through a non-urgent call queue — suggesting after-hours triage protocols may need review. [Fwd: NON URGENT CLIENT — 2024-10-30 — Joey Taylor]
• Service recovery tracking: While WellSky notes are required to address recovery potential, there is no documented follow-up SLA or owner assigned to re-engage cancelled clients.
• Caregiver-side cancellations are referenced in WellSky tagging but no formal caregiver cancellation policy or consequence framework is visible in current sources.
• Credits and billing disputes: The St. Goddard Miles case suggests inconsistent handling of credit requests; a standardized credit approval process is not documented.

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Related Topics

1. Caregiver Scheduling & Shift Management

2. Client Billing & Invoice Disputes

3. WellSky Deactivation & Client Records

4. Hospital-to-Home Transitions

5. Client Retention & Service Recovery