Quality Assurance & Audits

Overview

Quality Assurance (QA) at TheKey encompasses the systems, processes, and personnel responsible for verifying that care delivery meets clinical, operational, and regulatory standards. This includes in-person QA visits with clients, internal compliance audits by state/region, new client financial audits, weekly clinical and quality reporting, caregiver record audits, and satisfaction measurement via Medallia. QA directly affects client retention, caregiver compliance, regulatory standing, and GM incentive compensation, making it a core operational discipline across all markets.

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Key People

• Megan Edusada — Authors weekly Clinical and Quality Recaps covering CEA, Medallia, and TheKey Match metrics (recurring, 2026-02 through 2026-04).
• Bridgett Scherer — Distributes Quality Score MTD updates and manages QAV (Quality Assurance Visit) form launches [Quality Score Update - MTD March — 2026-03-11; March QAV Forms Live in URLs — 2026-03-05].
• Audra Williams — Engages on Quality Score updates; involved in the National Quality Team [Quality Summit | National Quality Team Deck — 2026-03-11].
• Andrea Nobis — Responds to Quality Score discussions.
• Amelia Howard — Forwards Quality Score updates internally.
• Nicole Avedis — Schedules internal audit reviews (Ohio, IL, WI) and Compliance Resource Guide reviews.
• Timothy Thomas — Named attendee/organizer on multiple internal audit and compliance meetings (Ohio, IL & WI, Quality Summit).
• Christina Archer — Leads Ohio compliance discussions including TB compliance requirements for caregivers [2026-02-23].
• Julie Sminchak / Laura Horval / Alysce Craig — Participants in Ohio caregiver compliance thread [2026-02-23].
• A. Aponte (aaponte@thekey.com) — Issues recurring "Action Required" New Client Audit Results emails flagging open balances.
• Abby Cnossen — QA and compliance lead for the Midwest; reviewing care plans and caregiver file compliance [Midwest_Cheat_Sheet_v2].
• Lucie Cote — Involved in Quebec Compliance Guide verification [2026-02-23].
• John Andrew Hawkins — Engages on Quebec Operating System Compliance Guide [2026-03-30 to 2026-03-31].
• Irin Eva — Manages booking audits for Canada locations [2026-03-25].
• Tiffany Silton / Amanda Fults / Cheryl Logan — Involved in Incident Reporting and Internal Compliance meetings [2026-02-26 to 2026-03-04].
• Natalie Graham — Coordinates Quality Summit logistics.

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Processes & Policies

Quality Assurance Visits (QAVs)

• Client Success Managers (CSMs) or RNs conduct in-person QA visits to verify caregivers are meeting client needs and care plans are current.
• Tier 1 clients: in-person QA visit at least once per month (more frequently if state regulations require).
• Tier 2 clients: QA visits per SLA cadence.
• Tier 4 clients: follow-up as needed.
• QAV forms are managed via URL-based links; updated forms were released for March 2026 [March QAV Forms Live in URLs — 2026-03-05 — Bridgett Scherer].
• If a Medallia survey detects a detractor score (<6), an in-person QA visit or care plan revision is triggered [Medallia_Playbook_and_SOP_v12025].

New Client Audits

• Weekly audit emails are sent by A. Aponte flagging open dollar balances associated with new clients (e.g., $6K–$39K open balances).
• These are marked "Action Required," indicating follow-up accountability sits with market leadership.

Inactive Caregiver Audits

• Conducted monthly by the HR Service Center. April 2026 audit completed 2026-04-03.

Internal Compliance Audits (State/Regional)

• State-specific internal audits are scheduled as formal review meetings (e.g., Ohio audit April 13, 2026; IL & WI audit April 9, 2026).
• Ohio has specific TB compliance and broader caregiver compliance requirements that prompted dedicated discussion threads and a scheduled compliance meeting [2026-02-23 to 2026-02-24].
• Canadian locations (Quebec) have a separate compliance guide under active development and verification [2026-02-23 to 2026-03-31].

LHA Quality Standards (Canada)

• All Licensed Home Attendants (LHAs) are subject to quarterly audit by the Clinical Quality team.
• CSMs must recertify annually on LHA protocols.
• Client satisfaction survey sent within 7 days of assessment [LHA_Business_Rules_Canada].

Documentation Compliance

• Managers periodically audit documentation to ensure accuracy and timeliness.
• Caregiver care workers are required to submit documentation accurately and on time [TheKey_Kansas_Policies_Procedures_Manual].

Medallia & Weekly Reporting

• Medallia survey responses must be reviewed daily by CSM/GM within 1 business day.
• Detractor alerts (score <6) require CSM/GM follow-up.
• Weekly Clinical and Quality Recaps (authored by Megan Edusada) cover CEA metrics, Medallia scores, and TheKey Match data.

GM Incentive Plan

• Quality metric compliance is included in GM incentive compensation, with an initial target of 70% and an expected increase to 90% over time [Monthly_GM_Meeting_2026_Incentive_Plan_Update].

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Timeline & Key Events

| Date | Event |

|------|-------|

| 2024-05 | Quality Metrics Training Deck (Train the Trainer) published |

| 2025-07 | Medallia SLA document issued |

| 2026-02-23 | Ohio caregiver compliance requirements updated; TB compliance discussion scheduled then canceled (2026-02-24) |

| 2026-02-23 | Quebec Compliance Guide verification initiated by Lucie Cote |

| 2026-02-24 | New Client Audit: $22K open balance flagged |

| 2026-03-02 | New Client Audit: $6K open balance flagged |

| 2026-03-04 | Incident Reporting and Internal Compliance meeting held |

| 2026-03-05 | March QAV Forms pushed live via URL |

| 2026-03-09 | New Client Audit: $15K open balance flagged |

| 2026-03-10–11 | TheKey Quality Summit (2-day event); National Quality Team Deck shared |

| 2026-03-11 | Quality Score MTD March distributed; active discussion across leadership |

| 2026-03-17 | New Client Audit: $39K open balance flagged |

| 2026-03-23 | New Client Audit: $34K open balance flagged |

| 2026-03-25 | Canada booking audit conducted for Good Friday (April 3) coverage |

| 2026-03-30 | New Client Audit: $35K open balance flagged |

| 2026-03-31 | Quebec Compliance Guide thread still active |

| 2026-04-03 | Monthly Inactive Caregiver Audit completed by HR Service Center |

| 2026-04-09 | IL & WI Internal Audit Review scheduled |

| 2026-04-13 | Ohio Internal Audit Summary meeting scheduled |

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Key Decisions

• QA visit frequency is tier-based: Tier 1 clients receive monthly in-person QAV as a minimum standard; other tiers follow SLA-defined cadences.
• Quality metric included in GM incentive plan at 70% initial compliance threshold, with expectation to ratchet to 90% within a quarter.
• State-specific compliance audits are conducted separately for Ohio, Illinois, Wisconsin, and Canadian provinces, acknowledging material jurisdictional differences.
• Accreditation Canada identified as a strategic priority for the Vancouver/Canadian market to formalize quality claims beyond marketing language [Vancouver Strategic Framework — 2026-03-27].
• Medallia detractor response SLA is 1 business day, with QA visits as a mandated intervention for low scores.

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Open Questions & Gaps

• Ohio TB compliance: A scheduled discussion was canceled on 2026-02-24 with no confirmed resolution in available records. Current status of Ohio TB requirements for caregivers is unclear.
• Quebec Compliance Guide: Thread remained active through 2026-03-31 with multiple forwarding and verification exchanges; final approval or publication status is unknown.
• New Client Audit open balances: Weekly "Action Required" emails flagging $6K–$39K open balances appear consistently; it is unclear whether these are resolved, escalated, or tracked in aggregate anywhere.
• Quality Summit outputs: The summit occurred March 10–11, 2026 but no summary of decisions or action items is available in the current document set.
• IL & WI internal audit findings: Audit scheduled for April 9, 2026; no results captured yet.
• Accreditation Canada pursuit: Identified as strategic but no timeline or owner assigned in available materials.

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Related Topics

1. Medallia & Client Satisfaction Surveys

2. Caregiver Compliance & Credentialing

3. State & Provincial Regulatory Compliance

4. Client Tiering & SLA Management

5. Incident Reporting & Internal Compliance