Kay graduated from a diploma program nursing school (RN) in 1978 and moved to charge nurse within months of graduation. She then completed her BSN at UT Arlington in 1982. She went on to work as charge nurse, supervisor and head nurse/nurse manager on medical, cardiac and lithotripsy units before moving into healthcare quality in 1990. She achieved her certification as a CPHQ (Certified Professional in Healthcare Quality) in 1992. In 1995, she saw a need for quality medical record reviews and KDJ Consultants was launched. Kay worked to expand KDJ from a handful of nurses to a thriving business working with physician groups, hospital systems and health plans with studies including HEDIS, GPRO, GTT, and OTT. Kay retired as the CEO of KDJ Consultants in 2018, but continues in an advisory role as President of the Board of Directors.