Live-in Care Services

Overview

Live-in care is a service model in which a caregiver resides at a client's home, providing around-the-clock support rather than working discrete hourly shifts. This arrangement is operationally distinct from standard shift-based care and carries its own billing logic, payroll formulas, scheduling structure, and legal compliance requirements. For TheKey, live-in care represents a meaningful revenue line tracked in dedicated sales goals and gross profit reviews, but it has also been a persistent source of billing errors, payroll disputes, and state-level legal uncertainty — making accurate process alignment a recurring operational priority.

Key People

• Audra Williams — Central figure in live-in billing process alignment; authored the June 2025 "IMPORTANT ACTION REQUIRED" directive and led Michigan-related legal monitoring discussions.
• Joey Taylor — Involved in missed billing resolution for client Barbara Payson and organized the Live-In Gross Profit review (Feb 2026).
• Timothy Thomas — Attendee of the Live-In Gross Profit review meeting (Feb 2026).
• Timon Page — Handled client quotation requests for live-in care and participated in WellSky billing alignment discussions.
• Karla Hodge — Shared the "Payroll Live-in formula for Field" spreadsheet (Feb 2025).
• Julia Jenkins — Issued Q2-2026 sales goals tied to Tableau live-in reporting.
• Tatiana Garcia, Lilian Ciesco, Earl Blair — Engaged in Q2-2026 sales goal discussions.
• Jennifer Roenker — Sent new Live-In SOC (Supervisor of Caregivers?) onboarding notice for Sadie Hodge (Jun 2025).
• Brent Lakatos, Marc Atkinson — Involved in resolving the Barbara Payson missed billing case.
• Cheryl Cartwright — Handled client dispute over daily live-in rate (Claire Brickus case, Jan 2025).
• Bridgett Scherer — Distributed March QAV form URLs (Mar 2026).
• Mae Moses — Participated in monitoring live-in shifts amid pending legal review in Michigan and Tennessee.
• Steve Koyanagi, Amanda Fults, Kendra Smith — Active in Michigan live-in discussions (Aug 2024).
• Diane Mockenhaupt — Participated in live-in hour count discussions (Aug 2024).

Processes & Policies

Billing

• Live-in shifts are billed at a daily rate, distinct from hourly billing used for standard shifts. Client invoices must reflect the correct daily rate agreed at contract time [Re: Claire Brickus — 2025-01-10 — Cheryl Cartwright].
• Missed live-in shift billing must be identified, documented, and communicated to clients before retroactive charges are applied. The Barbara Payson case (shifts on 2/13, 2/20, and 2/27) illustrates the formal notification process required before billing corrections are posted [Re: Barbara Payson — 2026-03-19/23 — Joey Taylor, Marc Atkinson, Brent Lakatos].
• In June–July 2025, an "IMPORTANT ACTION REQUIRED" directive mandated alignment of live-in billing processes within WellSky, suggesting prior inconsistency across branches [IMPORTANT ACTION REQUIRED — 2025-06-23 — Audra Williams].

Payroll

• A dedicated "Payroll Live-in formula for Field" spreadsheet exists to standardize how field staff calculate caregiver pay for live-in arrangements [Spreadsheet — 2025-02-05 — Karla Hodge].
• Live-in payroll is calculated differently from hourly-shift payroll; the formula accounts for on-duty versus off-duty hours within a residential shift.

Scheduling & Shift Structure

• Live-in shifts may be designated as "Shift A" or similar labels within scheduling systems.
• Overnight coverage within live-in arrangements is a distinct coordination challenge, with separate staffing communication channels (e.g., Ontario Staffing) used to fill gaps [Re: Overnight Shift Coverage — 2025-08-01 — Jhonna Vallejo, Ellie Mae Waters].

Quality Assurance

• QAV (Quality Assurance Visit) forms specific to live-in care are distributed via URL on a monthly basis [March QAV Forms Live in URLs — 2026-03-05 — Bridgett Scherer].

Sales Reporting

• Live-in care performance is tracked in Tableau, with goals set on a quarterly basis. Q2-2026 goals were published in Tableau by March 31, 2026 [Q2-26 Sales Goals — 2026-03-30 — Julia Jenkins].

Timeline & Key Events

| Date | Event |

|---|---|

| 2024-08 | Live-in hour count review conducted; Michigan live-in operations flagged for discussion. |

| 2024-09 | Legal review initiated for live-in shift compliance in Michigan and Tennessee. |

| 2024-09 | Quotation process for live-in care handled for client Jason Andrews via CSM Claire McCorquodale. |

| 2025-01 | Client Claire Brickus disputed daily live-in rate on invoice 944615; resolved by Cheryl Cartwright. |

| 2025-02 | "Payroll Live-in formula for Field" spreadsheet shared by Karla Hodge to standardize field payroll. |

| 2025-06 | New Live-In SOC Sadie Hodge onboarded. |

| 2025-06 | Audra Williams issues mandatory WellSky billing alignment directive for live-in services. |

| 2025-07 | WellSky billing alignment follow-up; multiple branches engaged. |

| 2025-08 | Overnight staffing coordination issues documented; Ontario Staffing involved. |

| 2026-02 | Live-In Gross Profit review meeting held (Joey Taylor, Timothy Thomas). |

| 2026-03 | Missed billing for Barbara Payson (Feb shifts) identified and communicated. Q2-2026 Tableau goals published. |

Key Decisions

• WellSky billing standardization (2025-06): A firm directive was issued requiring all branches to align live-in billing practices within WellSky, indicating a decision to centralize and enforce a single billing methodology rather than allow local variation.
• Retroactive billing for missed shifts: The Barbara Payson case established that missed live-in shift billing requires formal client notification before charges are applied — a policy-level decision about client communication standards.
• Tableau as the reporting platform for live-in sales goals: Q2-2026 goals confirm Tableau as the standard tool for tracking live-in revenue performance.
• Legal monitoring in Michigan and Tennessee (2024-09): A decision was made to actively monitor live-in shift practices in these states pending legal clarification, rather than immediately halting or restructuring operations.

Open Questions & Gaps

• Michigan and Tennessee legal status: As of September 2024, compliance for live-in shifts in these states was under review. No evidence in the available emails confirms resolution. Current operational status in these states is unclear.
• WellSky alignment completion: Follow-up emails through July 2025 suggest the billing alignment directive met resistance or confusion. It is not confirmed that all branches reached full compliance.
• Payroll formula scope: The "Payroll Live-in formula for Field" spreadsheet was shared in February 2025, but it is unclear whether it was formally adopted company-wide or remains a field-level tool.
• Gross profit targets: A Live-In Gross Profit review was scheduled for February 2026, but no outcomes or decisions from that meeting appear in available records.
• Overnight staffing gaps: Recurring overnight coverage coordination with Ontario Staffing (August 2025) suggests a potential structural shortage in live-in overnight caregiver availability. No systemic fix is documented.

Related Topics

• Billing & Invoicing Processes
• WellSky System Configuration
• Caregiver Payroll & Compensation
• State Compliance & Legal Monitoring
• Sales Goal Tracking & Tableau Reporting