The office closes. Care keeps going.

The AI talks, collects and clarifies. What happens next is decided by your business rules: your agency’s own rules, one scenario at a time. For each scenario you set the decision, the timed steps (for example, text the caregiver after 10 minutes and call after 15), who is told and when, what happens when a shift can’t be left uncovered, and which AxisCare updates are switched on.

• Safe defaults. A call-off asks the on-call manager first unless you choose otherwise.
• Nothing new runs until you save it. A scenario that is off, or was never saved, doesn’t start new behavior on its own.
• A person is always behind it. Every scenario has an on-call floor, so someone always hears; a notice with nobody picked goes to the whole team, never to nobody.
• A policy you can print. The business rules print as a document your team can review.

Is it fully AI? The voice and text agent is AI. Every consequential action follows your rules and approvals, and a person is always behind it.

The agent never assumes a call is a call-off. The greeting is neutral, and your on-call manager is paged only about a call-off the caregiver actually voiced. Once it is confirmed, your decision applies:

• Ask the on-call manager first (the default). The request goes by text (reply to start or hold outreach) or by email with one-tap links. If nobody answers in time, you choose what happens: ask again, start anyway or keep waiting.
• Start finding a replacement right away.
• Let the on-call manager handle it. No caregivers are texted.

Outreach goes to two groups: the client’s preferred caregivers, then every caregiver whose availability covers the whole shift. Each group is texted at once, best skill matches first, with a wait between groups. Offers wait for caregiver quiet hours to end unless the shift starts within 12 hours, and can show your pickup rate. Acceptances are held for approval.

A shift is never offered to a caregiver who is blocked for that client, lacks the RN or LPN license a skilled shift needs, or is a known mismatch for the client’s gender or pet needs. By default your on-call manager hears at the start, again if the shift still isn’t covered, and when it is. On AxisCare, the replacement is assigned to the visit when that switch in your business rules is on (it is by default), and a call log is added if you turn that on. More on call-out management.

HeyHomeCare watches your synced schedule. When a shift has started and the caregiver hasn’t clocked in, the caregiver hears first, every time:

• At 10 minutes by default, a text with a clock-in link, asking them to reply 1 if they’re there or 2 if they can’t make it.
• At 15 minutes, an automated call, answered with the keypad.
• Only after that (at 20 minutes by default, and you can remove the step), a text to the client, if they agreed to texts, or their authorized contact to confirm the caregiver is there.

Answers run your follow-ups. A caregiver who can’t make it can create a call-off, and your call-off rules take over. If the caregiver made it after all (they clock in, the client confirms, or someone presses Undo), everything reverses: the call-off is cancelled, everyone who was told hears, the caregiver is reminded to clock in, and they aren’t charged with a call-off.

Running late (off until you save it) works the same way: the new arrival time is recorded, the client hears only when the caregiver will be later than the limit you set, and for clients whose contact goes through family, their authorized contacts are told instead. HeyHomeCare never clocks a caregiver in or out and never enters care notes; it nudges and sends the clock-in link. See EVV clock-in by phone and text.

Some shifts can’t wait for a replacement: a 24-hour shift, or one that starts right after another visit for the same client. When one of those loses its caregiver, your on-call manager and chosen team hear at once, and the caregiver who is already with the client is asked, by text or automated call, whether they can stay. A “no” reaches on-call right away, and the caregiver who called off is never asked to cover their own gap.

New-client inquiries are business you don’t want to lose at 9 pm. The agent captures the caller’s details first, in case the call drops, then transfers the call live to your on-call, sales or client-care person at any hour, including during quiet hours. If nobody answers, the details go to the people you chose, and an optional text or email sends the caller your agency’s link. On AxisCare, the inquiry can become a lead.

Emergencies (a fall, an injury, an animal bite, harassment or a threat, missed medication, a death, anything unsafe) always go to a person through a live transfer, and your notify list hears if nobody answers. The agent never handles an emergency alone, never gives clinical advice and never calls 911.

Caregiver questions about schedules, availability and clock-in problems are answered or taken as a message, as your business rules say. After hours, payroll and HR questions become a message for the next business day, and a time-off request goes to the office to approve.

Every call-off, late arrival, missed clock-in and new-client inquiry becomes an official record: every text and call sent, every reply, every step skipped and why, every AxisCare update and every reversal. The office opens to:

• Today: what happened overnight and what needs a person now.
• Records: the history for each caregiver, with CSV export, for evaluations and pay disputes.
• Activity: every recent call and text, with transcripts.
• Reports: call-offs and late and missed clock-ins, month by month and by office.

With “Keep your system, add the after-hours line,” your scheduling system stays the source of truth: HeyHomeCare reads it into its own synced copy, and if the sync goes stale, it stops chasing attendance rather than act on old data. An agency can instead run its whole agency on HeyHomeCare (scheduling, clock-ins, billing and payroll) with the same line on top; see the plan.

• AxisCare readsVisits, caregivers, clients, each client’s preferred caregiver, responsible parties and clock-in state.
• AxisCare writesOnly three things, each behind a switch in your business rules: the covered visit, a call log and a lead. No EVV write, no clock-ins and no visit notes.
• WellSkyWellSky Personal Care is coming: your agency buys API access from WellSky, which takes weeks. Until then, the line answers by forwarding and on-call gets the facts to act in WellSky. See the WellSky page.
• Other systemsAlayaCare is built and is switched on once AlayaCare’s partner agreement is in place. For any other system, the line answers by forwarding and on-call gets the facts to act in your system; ask us before you plan around a connection.
• Your numberKeep it: forward it after hours on your phone system, or port it in.

HIPAA and safety

• HeyHomeCare signs a BAA with your agency before any client information flows.
• Integration credentials are encrypted, logs are redacted, and each agency’s data is kept separate.
• Texts to caregivers and staff name clients by initials only.
• Callers are verified one way: a number on your caregiver roster counts, and an unlisted caller who says they’re a caregiver gives their date of birth and employee ID. Never the last four of a Social Security number.
• A client’s details go only to the caregiver assigned to that visit.

More on security and the AxisCare integration.

Related pages

• After-hours answering that resolves calls
• Caregiver call-out management
• Last-minute shift fill
• EVV clock-in by phone and text
• AxisCare integration
• Security and HIPAA