Home · The first 90 days
Onboarding

Your first ninety days

You've seen what RootBound is and what this role owns. This is how you step into it — week by week, system by system, relationship by relationship — until the whole machine is running through you.

A note before you start

I built RootBound because I lived the gap it closes. What I need from you isn't to memorize it — it's to hold it together and make it bigger than one founder can.

The first ninety days are deliberately paced: land and learn, then take the controls, then build and extend. Nobody expects you to drive on day one. They expect you to listen first, earn the chart, and then never let an episode fall through.

Before day one

Your onboarding paperwork

RootBound engages the Clinic Director — and most of its team — as 1099 independent contractors, not W-2 employees. The same basics apply to anyone you bring on: get these signed and on file before the first shift, and the ninety days start clean.

The paperwork on file
Independent Contractor Agreement — scope, term, deliverables, confidentiality, IP assignment, and non-solicitation. It's what defines the engagement as 1099, not employment.
IRS Form W-9 — legal / business name and TIN, so RootBound can issue a year-end 1099-NEC. No tax is withheld at source.
Direct-deposit / ACH authorization — where invoices are paid — plus an emergency contact on file.
Professional credentials — current license(s), DEA where applicable, and a Certificate of Insurance for professional liability (malpractice).
Background & exclusion screening — a standard background check plus an OIG / SAM exclusion check, required to touch federal health dollars.
Acknowledged & provisioned
HIPAA & confidentiality — sign the confidentiality acknowledgment and any Business Associate terms; complete HIPAA basics before any chart access.
Compliance acknowledgments — read and sign the three root barriers, the financing-disclosure rule, and the Follow-Up SOP escalation rule.
System access — Healthie, Radix, RPM dashboards, financing portals, the shared drive, and a @rootboundhealth.com address — each with MFA and minimum-necessary scope.
Invoicing setup — agreed rate, monthly invoice cadence, and net terms confirmed with the bookkeeper.
Equipment & expense policy — what's provided, and how pre-approved expenses are reimbursed.
What 1099 means for you
As a contractor you carry your own taxes (self-employment tax and quarterly estimates), health coverage, retirement, and time off — RootBound withholds nothing, and the agreement (not a benefits package) sets your terms. Send completed paperwork to onboarding@rootboundhealth.com.
The arc

Ninety days, three movements

Days 31–60
Take the controls

Own the follow-up backbone and the operating cadence. Run the dashboard. Become the named owner on live episodes.

Days 61–90
Build & extend

Advance the network and funding — first hospital MOU, the PHSKC conversation, the first grant filings.

The through-line
By Day 90, every program has a named owner, the cadence runs without the founder, and no episode falls through — measured, not assumed.
The plan, movement by movement

What you actually do

Get equipped & oriented
Provision every system — Healthie, Radix, RPM dashboards, financing portals, shared drive (Week 1).
Read the canon — Follow-Up SOP, Glow Ops Manual, the Continuum & Rural proposal, the PHSKC packet.
Shadow all six service lines and sit in on live telehealth and after-hours coverage.
Meet the team 1:1 — founder, coordinator, insurance producer, bookkeeper, counsel.
Build your picture
Walk the current dashboard — know each KPI, its source, and who reports it today.
Map open episodes across the four follow-up tracks; note where ownership is fuzzy.
Trace the three entities — how money and referrals legally flow between PLLC, RBCA, Foundation.
Draft a 30-day observations memo for the founder: what's working, what's at risk.
Operations
Take ownership of the Follow-Up SOP — you are now the escalation point for red-flag routing.
Run the operating cadence — chair the weekly ops review; own the monthly board pack draft.
Become a named episode owner on live TLC and follow-up cases — hold them to closure.
Own the KPI dashboard — the founder should read it, not assemble it.
Programs & margin
Tighten Glow protocol governance — device certification, RN algorithms, margin discipline.
Audit the Continuum tier mix and the RBCA coverage-review completion rate.
Run a compliance mystery shop — test the "is this insurance?" deflection script.
Ship one process fix from your 30-day memo and measure the result.
The network
Sign the first hospital case-manager MOU for TLC referrals — warm one discharge-planner relationship to live.
Advance the PHSKC §318 conversation toward a draft MOU with the HIV/STD Control Program.
Map the specialist referral matrix and the FQHC / Critical Access Hospital partners.
The funding
Stand up the Foundation — support the 501(c)(3) filing and seat an independent board.
File the first RCORP-Planning application and open the USDA Community Facilities feasibility.
Pilot the Rooted rural tier on telehealth + cellular RPM in one Eastern WA county.
At Day 90
Programs owned, cadence self-sustaining, one MOU signed, one grant filed, one rural pilot live. You're running it.
How the days run

The operating rhythm

CadenceWhat happensYou own / co-ownSource
DailyRed-flag triage, after-hours handoff review, reconciliationCoordinator → you for escalationHealthie
WeeklyOps review — open episodes, dispute queue, RBCA enrollment logDirector (chair)Weekly ops dashboard
MonthlyTier-mix, contribution margin, commissions, Foundation cashDirector + bookkeeperMonthly board pack
QuarterlyMystery shop, inter-entity FMV review, Foundation board meetingDirector + founder + counselRisk register
AnnuallyGoverning-agreement review, sponsor renewals, compliance trainingFounder + counsel; you executeCompliance calendar
When something can't wait

Red-flag routing — the path to you

Step 01
Detect
Red flag surfaces — symptom report, RPM threshold breach, missed critical follow-up, or positive result.
Step 02
Route
Coordinator routes by severity. Clinical red flags go straight to a clinician; the after-hours line is staffed, not a queue.
Step 03
Escalate
After three attempts, or on any critical flag, it escalates to the Director — that's you. Decide, act, document.
Step 04
Close
Resolution charted in Healthie, owner signs off, audit log complete. Nothing closes without a note.

For TLC specifically, a High or Critical risk score pulls first contact to ≤ 24 hours — the risk score overrides the condition window upward, never down. When in doubt, escalate early; the system is built to absorb it.

Who you work with

Your people — the inner team

RoleWhat they ownYour relationship to them
Founder & Medical DirectorClinical authority, vision, board, strategic relationshipsYou report to him; he hands you operations to free his
Care CoordinatorScheduling, follow-up outreach, dispute queue, reconciliationYour closest operational partner; escalates to you
Insurance Producer (RBCA)All coverage solicitation — ACA, indemnity, accident productsThe boundary partner; all insurance talk deflects to them
BookkeeperQuickBooks, inter-entity coding, monthly financialsCo-owns the monthly board pack with you
CounselThree governing agreements, FMV basis, compliance reviewQuarterly partner on regulatory hygiene

The directory — everyone you oversee

Every person below reports into operations through you. The founder, Kal Elliott, is the only one who doesn't — you report to him. Reach the rest here.

Care Coordinator
[ name on file ]

Your closest operational partner — scheduling, follow-up outreach, the dispute queue, and reconciliation. Escalates to you.

care@rootboundhealth.com
(425) 699-6873 · ext. 2
Insurance Producer · RBCA
[ name on file ]

Holds all coverage solicitation — ACA, indemnity, accident products. The boundary partner; all insurance talk deflects to them.

coverage@rootboundhealth.com
(425) 699-6873 · ext. 3
Bookkeeper
[ name on file ]

QuickBooks, inter-entity coding, and the monthly financials. Co-owns the board pack and confirms your invoicing.

billing@rootboundhealth.com
(425) 699-6873 · ext. 4
Counsel
[ name on file ]

The three governing agreements, FMV basis, and compliance review. Your quarterly partner on regulatory hygiene.

legal@rootboundhealth.com
(425) 699-6873 · ext. 5

Names, direct emails, and extensions above are placeholders on the standard @rootboundhealth.com pattern — confirm them against the live roster before sharing. As the team grows (RN Care Manager, Medical Assistant, second provider, Licensed Esthetician, Community Health Worker, PMHNP, administrative and front-desk staff — see the staffing plan in the handbook), add each new contractor here.

How we divide the call

Decision rights — yours, shared, hers

You decide together
New partnerships & MOUs
Grant applications & budgets
Pricing & tier changes
Hiring beyond the current team
The founder holds
Clinical authority & scope of practice
Mission direction & brand
Board & entity governance
Capital structure & major spend

When a call is ambiguous, default to surface early — the cost of an over-shared decision is a five-minute conversation; the cost of an under-shared one can be a wall.

The bright lines

What you must never do

Root barrier 1 · DPC statute
Never let PLLC staff solicit insurance. All coverage talk deflects to RBCA — verbatim, off the laminated card.
Never let the direct fee cover anything beyond primary care.
Root barrier 2 · AKS / Stark
Never move money between entities without a written agreement, FMV basis, and a dated invoice.
Never tie any payment to referral volume — flat fees only, no bonuses.
Root barrier 3 · Reg Z / TILA
Never let staff paraphrase financing terms — Cherry renders its own disclosures.
Never close a financed visit without a signed receipt and chart note on file.
The scorecard

What "good" looks like

By 12 months
≥1
grant ≥ $25K awarded
1
rural pilot county live on RPM
100%
mystery shops passed clean
PHSKC
§318 conversation at draft MOU
The one that matters most
Zero episodes that went quiet. No one fell through — and the data proves it.
Your first move

Listen first. Earn the chart. Then never let go.

The ninety days are a runway, not a test. Hold the programs together, keep the root barriers clean, turn relationships into reach — and the rest of the role is yours to write.