Berkshire BG-0220A · Home Health Services Caregiver Activity Notes
0
hours this week
$0.00
you pay aide
$0.00
expected back
This week
Each caregiver keeps their own ongoing week, archive, and timesheet. Switch to load that person.
Flat indemnity paid per day of care (any hours). One form claims each day. Update yearly for COLA.
Each day's flat benefit is claimed once, by the top aide who worked that day — a second aide the same day isn't needed (it's auto-kept as “Record only”). Reorder with the arrows. On a day the top aide is off (vacation), the next one automatically claims it. Marking an aide “Record only” frees that day for the next.
Each worked day gets its own naturally-worded note. Edit any of them, or hit ↻ to reword one.
Hours by day
Date
Start · Stop
Hrs
Care provided
A simple overnight (ends in the a.m.) auto-splits at midnight as you type. For a continuous stay across several days (e.g. Fri 8pm → Sun 7am), use the button above — it fills each day correctly and carries any next-week hours into the next pay period.
Signatures — tap to sign
✍️ Tap to sign
✍️ Tap to sign
Sign once during setup — each caregiver signs their box, and the insured/POA signs theirs. Signatures are saved and printed on every week's form automatically, so you're never asked to sign again. Switch caregivers to set up each one. Tap a box anytime to update.
Email / Share PDF builds the finished form and opens the iOS share sheet — pick Mail to send it, no printer needed. Print still works if you ever want paper.
Not connected. Add your Supabase details below to sync both phones.
Use the same email and password on both phones. Create the account once, then just sign in on the other phone.
Sets a new password for this account on every device. After updating, sign in with it on your other phone.
On: every change saves and syncs automatically — good for logging hours daily. Off: changes still save on this device, but only push to the other phone when you tap Save to archive or Sync now — good if you'd rather submit once a week.
Supabase setup (one time per phone)
Paste these once on each phone (find them in Supabase → Project Settings → API). Then sign in with your email and password. After that it stays connected.
Saved weeks · payments & reimbursement
No saved weeks yet. Fill out a week and tap “Save to archive.”
Backup & restore
Your saved weeks live in this browser on this Mac. Download a backup occasionally (or before clearing browser data) so you can restore them here or on another computer.
Fixed details — hardwired (unlock only to correct)
These stay the same every week and print automatically. They're locked so they can't be changed by accident.
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📊 Statement
Overnight / multi-day stay
For an aide who stays continuously through the night across days. Enter when they arrived and when they finally left — we'll split it correctly per day (and carry next-week hours into the next pay period).
Sign here
✕
Sign on the line with your finger or Apple Pencil — turn your phone sideways for more room. Tap Done when finished.