How to Navigate the Regulatory Maze and Launch Your Assisted Living Business

Transcript

00:00:01
Hey friend, it's Brandon Gustafson with Assisted Living Investing. Super excited to have you here with me today on the channel. We are going to be talking about uh the regulatory maze that is healthcare and is assisted living. There's so many things here that that you need to be aware of and it is one of those things that so many people uh as they are trying to get into this this industry, trying to get into this business, they're just they feel overwhelmed. So, if that's you, this is

00:00:29
the video for you. We're going to talk about all of the different rules and regulations, uh, depending on the phase that that you're in and what you can do to kind of navigate those things and help you, uh, just get around them and and make some progress and and be successful here. So, you're in the right spot. Make sure you stick around as we're going to get into all of it in today's video. Hey friend, my name is Brandon Gsutafson. I uh help first-time assisted living entrepreneurs launch

00:00:57
profitable, purpose-driven businesses, creating prosperity, purpose, and peace in their lives. I love coaching people, helping people. And that's why I do uh my YouTube channel. Uh that's why I have my coaching business. Uh go to assistedlivinginvesting.net to see all about uh what I do, what I teach you. And if you want to know which of my programs is a good fit for you, go take the 30 secondond quiz, aliquiz.com. We'll have that link down below for you and help you out as you're trying to to

00:01:24
get started on your on your journey to launching your assisted living business. If you stick around to the end of the video, I'll also tell you a little bit more about my roadmap challenge. We have one as of the recording of this live video in one week. So, go to roadmapchallenge.com to learn more about that. Would love to have you inside our next challenge and and help you out as you're trying to just make progress and figure out how to do this. It's a great experience. Uh stick around till the end of the video.

00:01:48
I'll tell you more, but go check out roadmapchallenge.com if you want to join the challenge. All right, sorry I'm feeling a little bit stuffy today, so I'll try to uh not cough into the microphone, but no promises. Uh but with that, let's get into our video topic for today. Again, we're we're going through um the regulations. So, today we're going to be talking about several things. Uh we're going to talk about the types of regulations you're going to be dealing

00:02:16
with, and there's quite a few of them. Uh, so we're going to talk about those. We're going to talk about zoning and permitting your home. Once you identify the perfect property, we're going to talk about what that's going to look like, how you're going to navigate that. Then we're going to talk about licensing, the licensing process, and everything you need to know about that. Medicaid. If you want to learn about Medicaid, this is going to be a great opportunity for you to kind of get a a

00:02:38
quick overview of what that's like. And I have several videos on the channel here that talk about Medicaid. And then we're going to talk about maintaining your license. This is that forgotten step uh and there's there's quite a few forgotten steps when it comes to assisted living if I'm being honest, but this is a big one uh that you have to maintain your license and there's ongoing fees and things like that. Nothing for you to be scared of at all, but something that I do want you to be

00:03:02
aware of as you are trying to get into this and launch your own own business. All right, so let's see. The first one that I want to talk with you about, and I need to adjust my screen around just ever so slightly. Uh, all righty. Uh, so the types of regulations that you're going to be dealing with, uh, this is healthcare, right? This is a healthcare business. While you do own real estate, this is a real estate play. Um, this is also a business play. You're going to own a business, but it is a healthcare

00:03:37
business. and in the world of healthcare. I've worked in healthcare since uh 2015 I think maybe even longer than that. Um and what I have come to realize and I have a masters in healthcare administration. I got this as I was going through grad school. There are a lot of different regulations in the world of healthcare. There's there's just a lot. And the other thing that adds complexity to this is they are always changing. So I used to actually work for a medical device company. This

00:04:08
was years ago and I did regulatory affairs. So what my job was is I had to be aware of what was going on in the industry. Uh pay attention to what Congress was working on, what rules and regulations they were passing. Uh and then specifically for the devices that I was over, they were like midline and picks and and things like that. uh for for medical devices uh we had to be aware of anything that was happening that was going to impact us uh from a regulatory standpoint and then as we were trying to get those devices or

00:04:47
maintain the the the I can't remember the exact word for it but the regulatory status of that device we had to update documentation and that was working with engineers and that was working with um uh just several different people inside of the medical device company, the people that would make it, the people that would do the um making sure that uh like it didn't have microbes on it, uh that it was safe uh for for the use that that it had just this huge a huge conglomerate of people that had to do

00:05:19
this and I was in charge of all the regulations. So, I had to spend a lot of time doing this. So, I'm very familiar with regulations with healthcare and what that looks like. You don't need a full-time regulatory person to do assisted living. So, let me be clear on that. But what I learned from that process is it's always changing. There's always something new and you need to stay up to date. You need to get on mailing lists for your state. Um, and you need to figure out what is going on in the world. You need

00:05:48
to pay attention to uh sessions at the local government level to see what are they talking about, what are uh what are any of the the new rules and regulations and laws that people are going to be passing. how is that going to impact me? Not just from a healthcare standpoint, but also from a business standpoint. You need to pay attention to these things. And if you've not been a person that's politically active, um, and I'm not going to get into politics and and you know, parties and all of those things,

00:06:15
but what I do want you to realize is you need to be an advocate for the things that are going to benefit you. Write your congressperson, talk to them, and do this more at a local level. um the federal stuff because assisted living is is much more at a state level. Um the federal level isn't going to impact things. Could it in the future? Absolutely. Does it today? Not really. Um so this is all at a state level, but you need to get very familiar with that. Know your congressperson, talk to them,

00:06:46
write them letters, talk to their staff, get to know them, be an advocate for the things that are going to benefit you. And that's from a business standpoint and from a regulatory standpoint in owning a healthcare business. So these are big things and and then when something does shift in the landscape, you know how to handle it. And this is huge. All right. You're going to also as you go through this, you're going to be dealing with zoning and permitting for the house. And we're going to talk about

00:07:11
that here in just a second. But zoning and permitting is is something that a lot of people um I think you you think about it and you realize, oh yeah, I'm probably going to have to do that. But for a lot of you that own real estate that want to get into this, uh, that it's one of those roadblocks that could throw everything off for you, um, you need to make sure your numbers are correct. Go to assisted livinginvesting.net, grab the free underwriting calculator. It's there at the very top of the page. Can't miss it.

00:07:39
Big light blue box, uh, under get your free underwriting calculator. And then the other thing that you need to do is you've got to figure out what the zoning is for your property. you need to go talk to the city planner or the county planner, the the planning department and go build a relationship with that person and figure out what's going on because those things can shift and maybe there's a special use permit that has to get in into place um or you have to reszone a property and what does that process look

00:08:07
like? You're going to have to understand these things. Uh it's big. HOAs is another one. So, HOAs um they cannot I've told you all this several times, but HOAs cannot stop you from doing assisted living, but they can make your life difficult. So, if you have an HOA, um talk to them early and often. Don't don't just jump into this and do it without um without talking to them cuz that can create big legal issues. You kind of want to avoid those. Um so, so avoid that and talk to them and tell

00:08:39
them, "Hey, this is what I'm doing." Make sure you have read the CCNRs and the bylaws. Uh, make sure that you know your rights. And if it comes down to it, then make sure that you are working with a real estate attorney to have those conversations with them. And so, HOAs are something that you will probably encounter at some point in your journey. One of my homes is in an HOA and it works fine for us, but there are certain things we can and can't do because our home is in a property. Like, I cannot

00:09:04
have signage outside of my facility because signage is something that is against the HOA. Now, I can have the business and we can do that. We can care for people. That's fine. But I can't have anything outside my business, outside of my home that is advertising the the type of stuff we do. We've tried. We get fined for it. Um, and yeah, you have to kind of work around that. The other one is you are going to be working with the health department or the equivalent in your state. And we'll talk about that here in

00:09:33
just a little bit as well. But you need to understand that you are working with an agency, a government agency who is going to give you the guidance, the direction on what you can and cannot do um in your home. And so this is going to this is something you need to understand as well. uh when it comes to licensing, when it comes to maintaining the license, when it comes to other regul regulations that are coming up, make sure you have a good uh a good hold and a good relationship with the people in

00:10:01
the health department agency because they have some sway with the local governments as well when it comes to regulations and passing things that are going to be friendly to you or at least not detrimental. And so that's something that you want to be paying attention to as well. Um, sorry you guys probably can't hear it, but I am stuffy and it is bugging me as I talk. So, this is the joy of doing this stuff live. Anyways, uh, zoning and permitting. Uh, let's talk about that. Let's let's dive deep into this zoning

00:10:31
and permitting. Uh, this is when you're looking at the you want to start off with this. You want to start looking at the local municipalities zoning website. So, when I was first getting started with this, what I found to be the best way to do this is I would just get on uh you know, city.gov or whatever the city's website is. Um, mycity.gov. These are these are just like madeup names. Um, this is not what you're looking for. So, if you live in uh I don't know, if you live in Salt Lake

00:10:58
City, it's like uh Salt Lake City.gov or something like that. Uh if I lived in uh Minneapolis, minneapolis.gov, you know, something along those lines. You want to look for the it's usually a.gov domain. Uh sometimes could be a.org, but you want to look for your city's specific site. Um and then you want to and I would actually suggest doing an internet search for something along the lines of um planning department for my city. And um that's going to get you to a spot where you can

00:11:29
figure out the municipalities um site where it's talking about city planning. From there, what you're going to do is you're going to look for what is um what typically there's a map online. Um some of these maps are really nice. They're interactive. You can search on them. They're uh you can you can click on things. Some of them are just a huge PDF that you can't do anything with. Depends on your m municip your your on your municipality. Um, and I it's really surprising actually. Some of the bigger

00:11:59
cities that are more well-known have the crappier websites and some of the more rural ones that you would think, oh, they're not very tech-savvy have some of the best ones. So, go and find yours. Um, look at it. It will go find the address where your home is or the homes that you want to buy. Figure out what the zoning is. Um, and once you have kind of done that leg work, then you can have a conversation with the city planner or the equivalent in your municipality and you want to reach out to them. You want to say, "Hey, I see

00:12:27
that this I want to turn a home into an assisted living facility into a business. It's a residential setting. We're caring for residents. Uh, it's a going to be licensed facility or unlicensed, whatever you want to do." Um, and I see that the zoning classification is R2. Um, what does that mean for me? Can I do that here? Do I need a special use permit? Do I need uh what other types of things do I need to do uh to to get this ready? And they can tell you, yeah, it's actually it's

00:12:55
perfect. Uh you don't have to do anything. Or uh you do need to have a special use permit, but that's just this form over here that you got to fill out and then you're good. Or uh that's the wrong zone. Uh you either need to look for somewhere else or we can do special zoning for it. And there's a process for that which can include up to having like uh putting it out for public comment and uh and and having to get approvals which is can be very lengthy. So you kind of need to figure out what that's going to

00:13:21
look like um and for for you in your situation and that's going to save you a ton of time uh on on the back end because you won't have just moved forward with it with brute force. uh you will have gotten out of what I call the hustle zone and you're going to shift yourself up into f the focus zone because you are uh you're doing things the right way. If you want to learn more about that, join us in our next roadmap challenge, roadmapchallenge.com. Uh the focus zone and the hustle zone. I

00:13:51
talk a lot about it there. Okay. Uh so you're going to figure those things out and then um you you're building a relationship. They're going to tell you, "Hey, um, yep, you need to have a fire department come." And they'll be able to connect you with somebody at the fire department to get that. They'll tell you, um, if you need to have like a specific municipality business license, sometimes, uh, these, depending on the municipality, sometimes they need that. Uh, so that's something

00:14:15
you want to pay attention to. There's just a lot of balls that are in the air. And then that's going to lead you into HOA concerns as well. Uh, because you you can you can navigate the zoning process. you can navigate all of that um and and still run into a hiccup with your with your HOA. And like I mentioned uh just a few minutes ago, your HOA cannot stop you, but they can definitely make your life difficult. And so you want to pay attention uh to to the board there, to the bylaws, to the CCNRs, and

00:14:48
get very familiar with them. Use AI to help you um to put in this is what I want to do. um here's our CCNRs and bylaws. Can I do this here? Who do I need to talk to if I can't uh to get uh special permission? How do I frame this in a way that makes it so that they have to tell me? Yes. Like these are types of things that you could be asking it to do for you. And then you can go take that to your HOA board and be like, "Yep, I I'm doing this. We have the zoning in place. Um it's going to be a licensed

00:15:21
facility. we are making sure that we are following the the rules with parking uh because that can be a big thing in CCNRs and bylaws. Um and um you know you can kind of address those things up front and and then hopefully it just kind of falls into place for you and it's not a big deal. If you do then you have to decide if it's worth finding and hiring a good real estate attorney to be on your team to help you navigate those uh the HOA piece of it to help you get that in place. Um, but what I would say is

00:15:53
spend the majority of your time upfront working through zoning and permitting because that can shut you down. If it is not zoned properly um and the reasoning process is impossible or prohibitive, then um that can make it so that you are not able to get into into this. All right, this is we're going through regulations. This is going to be super helpful for you. Thank you, Angela. Yes, I will. I had some vitamin C earlier today. Um, so I appreciate that. Um, I I will say this is this is regulation

00:16:26
stuff, right? It's regulatory. It can be a little bit dry. Um, and so I apologize for that. Um, but this is also stuff you need to know as you're trying to get into it. So, I'm just like real talk here, uh, helping you out and and figuring out what you need to do. So, if you follow this and you go through each of these things that I'm talking through, you're going to be so much further ahead than people. And we talk about this in my programs all the time as well. All right. licensing process.

00:16:49
Um, let's talk about that. Figure out um who the licensing agency is. This is oftentimes the most difficult piece of this when it comes to licensing. Um, you have to figure out who the agency is. I uh my initial experience with this when I was first getting started is I talked to I needed to talk to the state of Utah. I that's where I wanted to do this was it's where I live. I wanted to get started in Utah. started talking to people there, started just like playing phone tag. And it probably took me three

00:17:21
days of spending about 30 to 60 minutes every single day trying to figure out who I was supposed to talk to just to figure out who the licensing agency was in the state of Utah. It took me forever playing phone tag. This has been the same experience for a lot of my students where the you start calling people, you get phone tag. I have had conversations with people on Facebook that this is too hard. I' I've spent like 3 hours on on on hold and just bouncing around between people. This is the part of the reality

00:17:55
of doing this. Once you find them and build a relationship is so much easier. They're great people to work with. Um but it can be really really difficult to find the right agency and that taking that amount of time to do it and that amount of effort can feel discouraging to a lot of people. So, I just want you to know that it's normal that that can happen. Okay? And um that it will be okay. All right? So, once you figure that out, there is oftent times going to be an application, what I would call a

00:18:29
checklist, right? This is quote unquote checklist. It's it's it's basically these are the pieces. These are the documents we're going to need from you as you are um as you're trying to get your license. We're going to need uh your tax ID number. We'll need you to fill out this specific application. We'll need uh insurance information. Maybe they need bank information. They're going to need policies and procedures. They're going to need uh uh other, you know, uh let's

00:18:55
see, I've got a list here. Uh other legal documents. They're going to have uh just a bunch of things that they're going to request. You need to just compile those things. You put them together. Um I talk about this in my success system program. I have a a very simple framework that helps you know what you should be doing in this phase, the things you should be gathering, how you pull them together, and and how you can move forward with that and submit your application. It makes your life a

00:19:24
lot easier. Okay? So, you need to grab all of these things. You need to submit them and then you've got to build a relationship with them and wait. Um, the thing that you're going to find is the the policies and procedures is going to take a lot of time. Now, you can you can pay somebody to do this for you. So, you do not have to do it by yourself. You can pay somebody uh typically $1,500 $2,500. Um, you can do what I did, which was write them yourself, and that took forever. This was before AI. You could

00:19:57
write them using AI, and I actually have a master class in my success system that talks about that. You could um also uh in my success system I have examples. I have like my policies and procedures that you can use to help you um write your own uh your own policies and procedures. So I I can help you out a ton with those things. But that is the thing that's going to take you the longest and it needs to to kind of follow a structure that you are uh going to fill out. If you're interested in learning more about this,

00:20:28
just type in P and P down below and I'll do a video that's specific on policies and procedures um for the kind of the structure that that you need to have there. Okay, so policies and procedures are going to take take a ton of time. They need to be specific. They need to hit on all the regulations for the state and then they need to get approved by a person of the state. The other thing with my experience is because like I mentioned, it can be hard to find these people. Once you do, they're great to

00:20:55
work with. Um, they can help you write your policies and procedures, uh, making sure they're not writing them for you, but they can help make sure that you are hitting on all the regulations so that you can get everything approved. All right, so that's the licensing process in a in a nutshell, a very simplified version of it. It can take some time. Uh, you got to be patient. You got to find the right agency. Once you do, you have a checklist. You just get all those things compiled and submit it. It's not

00:21:22
that hard. um it just feels overwhelming and daunting. And there are fees um here as well uh depending on if you're doing a brand new facility or if you're doing a change of ownership uh for that facility. Um there there's different fees. There's usually a base fee and then there's a fee per bed that you're licensing for. Um so you just want to keep that in mind. Uh it can be I would say anywhere from like $3 to $15,000 depending on your state to get licensed um based off of those fees. So, you just

00:21:52
want to look at that and um and and see what you need help with. So, yeah. Um yeah, Angela, I see your comment here. So, more on PMPs. I'll I'll add that to the list. Um syndicates um and you know, this is your direction, but net worth is an issue. I get it. Um yeah, I think syndications are are a really fun interesting way to to get into this. and I don't know what your experience is with um with real estate investing and setting up syndications uh and those types of things. Um it might be worth

00:22:26
worth it for you to like find somebody that has experience with the syndication um if you've got more of the experience on the healthcare side because that can be it can be a lot to try to do um all of that together at the same time. Um, and if you're doing a syndication, you're bringing in partners and and things like that anyways. And so finding um those general partners to help you out and building the syndication, I think, is going to benefit you. You just got to be careful. Make sure you vet

00:22:55
people um as you're as you're doing that. But that could be something that could really help you out with that. But I'll add I'll add the those things to the list. All right, let's talk about Medicaid. Um, so Medicaid, this is something you do not have to do Medicaid if you don't want to. Um, but if you are going to get into this, you're already dealing with a bunch of rules and regulations, Medicaid is just another one. It's not that hard. Um, I I truly believe that Medicaid is

00:23:22
the best kept secret in assisted living. I think it is one of the best ways for you to fill your beds quickly and to fill your beds with quality residents and still get paid um really well. Um, the first thing you have to do if you want to be doing Medicaid is you have to become a licensed facility, this is not available for unlicensed. I saw this as a comment um in a YouTube video a few weeks ago. You know, can can you do this? Can you be unlicensed? And and I would say generally the question the the

00:23:50
answer to that question is no. You cannot be a Medicaid provider if you are unlicensed. Could that be different in your state? Absolutely. I'm not going to say always or never. I want to try to stay away from those words. um because that can that can just speaking in in those terms. It makes it really hard for people um to to just kind of understand and be like, "Oh, come on. Well, I'm not I want to be unlicensed. Guess I can't do anything with Medicaid." There may be stipulations, there may be programs,

00:24:18
there may be instances where you can do this, but I would say generally you need to be licensed if you want to be serving a Medicaid population. You need to figure out the department. again. Um, and this is going to more than likely be a different department than who you were talking to when you were trying to get your facility license. So, if it was Department of Health and the Department of Health for your facility license, you could be looking at the Department of Health and Welfare for Medicaid. So, you

00:24:44
need to figure out who that is and then fill out their application. It's very similar to uh the application that you have filled out to become a licensed provider. Uh, it's a little bit easier. Uh, a few different things that you're going to need to add to them. you know, give provide them with, but you don't have to do like a full policies and procedures uh type of a thing. So, there's easier uh shorter forms uh easier documents, but you do need to give them exactly what they ask for.

00:25:13
And if you have questions about one of the things that they're asking for, then ask for clarification because this can delay your Medicaid application significantly. Um, if you uh it took us four months to get Medicaid certified in Colorado and the biggest reason for that is the bank information. They told me they needed bank information. So, I just was like, "Oh, it's a voided check. Send them a voided check." And, you know, we'll be good. But then they told me they needed uh

00:25:42
they needed a letter from the bank on their letterhead. So, I gave that to them. And then they're like, "Well, actually, it needs to be a wet signature." So, I went to the bank. I got the wet signature. I sent it to them. And they're like, "Well, now we need that, but you you don't have the voided check on there." I was like, "I already sent it to you. Why? Fine. I'll just give you all of the things." Well, now we need this thing. We need a bank statement that has the account number on

00:26:06
it. So, it took me forever. And it it's it's one of those things that it's not, oh, I send it and then the next day they get back to me. It's I send it into a portal and then I've got to wait five to 10 days before anybody gets back to me. and and to know if I gave them the exact right thing that they gave that they had asked for. And that was super frustrating. And so when I did this in Idaho, uh it took us less than 3 weeks to get certified in Idaho. I had a conversation with the person was like,

00:26:35
"Okay, what things do you specifically need?" Um I I know you say this on on your list, but what do you really need so I can make sure I provide that the first time? And so I went from 4 months in Colorado down to 3 weeks in Idaho because I kind of learned the process and and it was just that much easier. So you want to make sure you do that. And then once you are certified as a Medicaid provider, you're going to need to contract with excuse me with any third-party administrators that they

00:27:05
have. These could be called managed care organizations or MCOs's. This could be thirdparty administrators or TPA or 3PA. Just kind of depends on, you know, welcome to healthcare. There's acronyms everywhere. Um, you need to figure out who they are. Could be that they they have multiple um thirdparty administrators in your state. Uh, like in Idaho, we have three of them. Uh, could be like in Colorado, we just had one. Um, and and you just need to contract with that specific group. But that's a separate piece of application

00:27:34
process that you got to do. And so, you need to figure out what that is going to entail. Typically, it's just a form. you give them your your facility license number and then you give them the Medicaid certification certi certificate. Um, and that's typically all they need, but you want to make sure that you understand what their process is so you can become contracted with them and then you can bill. Um, and we talked about Medicaid. I'm not going to go deep into just kind of the woods of

00:28:02
of a Medicaid a resident of yours who is on Medicaid and and you being on Medicaid and how those things have to match up. I have a video on that. Uh so if you're interested in it, type Medicaid down below. We'll get you the link for it. Um but uh yeah, Medicaid can be confusing, but also I I really think it can be an incredible uh way of of helping a lot of good people um that need this help. And then once you do that, you're going to have to learn the billing process. The thing with Medicaid billing is it's

00:28:31
going to be different for each uh third party administrator that you are contracted with. They're going to have their own systems. similar, but it is something that you're going to have to understand what it is, what the different codes are, um how you bill in their specific software, uh and what that's going to look like. I will say for those of you that you're like, I want to get into this, but I don't have any experience in healthcare at all. Um my dad, who uh is comes from the

00:28:56
construction industry, works for a very large electrical contractor that does work nationwide. Um he handles our Medicaid process. Now I don't touch he probably knows more than I do. I have this experience this deep experience of working in healthcare and regulations and things like that. Um but it was something that I and I actually government programs have done a lot with those uh like Medicaid and Medicare and I handed this off to him and he picked it up and he ran with it and now he probably knows as much if not more

00:29:26
specifically about the the Medicaid processes in our states. So you can learn these things. You don't have to have this whole, you know, career worth of of knowledge in it. You can learn it. It's it's fine. It's it'll take some time, but you can do it. And that's going to help you out a ton. All right. Now, let's talk about maintaining your license. All right. So, maintaining your license. This is this is the one thing that gets overlooked by a lot of people. So once

00:29:56
you have your license, once you're if you're Medicaid, once you become Medicaid certified, you know that that whole process, but we're just going to talk specifically about licensing. Once you are licensed, you are going to have to do annual certifications and there are fees associated with that. They're not the same fees as what you had with that initial license that I told you was 3 to 15,000. Um that's that's a onetime upfront fee. your um ongoing annual reertification fees are going to be much

00:30:26
lower. Typically, it's a few hundred plus a certain amount per bed that you're you're um licensed for. Um I would say typically this is less than $1,000. And by this point, you have a business that is that is cash flowing and and adding $1,000 to it once a year is not going to be a big deal. But it's something that I don't want you to get blindsided by. And if you fail to do this, and you shouldn't do it because they will send you emails like months in advance to make sure you get reertified.

00:30:53
Um, so you should be fine, but if you were to let it lapse, the license goes away and then you would have to restart the process to get rellicensed for your facility. And that is lengthy and expensive. Again, you'd have to at that point, if you let your license lapse, would have to pay that $3 to $15,000 chunk again to get rellicensed. And then you you don't you lose all the the like grandfathering in of old rules and things like that. So, you want to make sure that you maintain your license, uh

00:31:25
pay those fees, reertify annually. Uh it's going to help you out. The other thing is as you're going through this, you're going to have regular and surprise surveys where they the state just comes in and they're like um and this could be a complaint survey that somebody a staff member or resident resident family somebody in the community files against you and they can come in and and see hey are you is this a complaint is this complaint uh legitimate or not? Um they'll they'll

00:31:52
look at that. Uh this could just be regular surveys. um they come in and they like we want we need to see all your policies and procedures, all the documentation for your residents. Um you can get um just all kinds of just surveys. They're going to happen. You need to be prepared for them. All right? So you need to document absolutely everything in healthcare. If it didn't get documented, it didn't happen. And so you have to document everything. All of the care that you provide. And this is

00:32:20
going to benefit you as well because it it can allow you to increase your rates um whether it's Medicaid or private pay. The more you document the care that you provide, the the more you're able to charge people, but it also protects you when you have a survey happen in your facility. So, make sure you are documenting absolutely everything that's going to help you out as you're trying to, you know, move forward um with this and maintain your license. Um, and then I would say you also need to have follow

00:32:52
and update your policies and procedures. Um, so you needed to build them when you were doing your your your facility license. That's a big one. But then you also have to um you're also going to need to make sure that they are followed by your staff, that they are fully trained on them when you have new staff come in. and you're going to need to make sure that they are updated um to current rules. This is where what we talked about at the start of the video where you need to be paying

00:33:20
attention to the rules and the regulations and everything that's going on. Um you need to pay attention to those things and then make sure your policies and procedures are in line with uh what that what that looks like. Okay? Uh so you have to maintain those, keep them updated, and then retrain your staff on them. Make sure that they understand what it looks like. That's how you maintain your license. So, there's a lot of information there for you. Uh, we went through a ton here and

00:33:46
it's regulations and it's it's it's just kind of the rules and the regulations and the drive part of uh of running a facility. But it's also one of those things that is absolutely most important. Um, because without it, you cannot run your facility. And for those of you that are wanting to do this as an unlicensed facility for you, I would say you're still going to need to follow a lot of this information. um you know, the things we talked about today, the types of regulations you're going to be

00:34:12
dealing with, um and and just getting familiar with the landscape, the political landscape in in your local community, in your state is going to benefit you because that's what's that's there's a trigger there potentially that could make you go from being unlicensed to licensed. And so, you need to pay attention to that. the zoning and permitting you're going to have to have regardless of if you're licensed or unlicensed the licensing process. While you don't have to do that per se, you're

00:34:38
still going to want to make sure you have insurance and make sure that you I would highly suggest you still have policies and procedures because it excuse me it it allow it forces you to have standard operating procedures for your business to run a more efficient and more profitable business. So, you should be doing that. Um, if you want to do Medicaid, you could probably skip it if you're unlicensed because in most states you're not going to be able to do that. But then you're going to

00:35:04
continually need to maintain things, your policies and procedures, um, making sure your staff are trained. Like everything that we talked about here, there's a variation of it that exists for unlicensed facilities. So, don't think you're off the hook. You still need to be doing these things if you want to have a successful and profitable business. All right. Um, so we talked about those things. We talked about the different types of regulations that uh that you need to have. Um the the zoning

00:35:31
and permitting process. Uh we talked about licensing, the licensing process, the Medicaid process, and then maintaining your license. So, we talked about a bunch. Um Angela, you you mentioned here um you're a little confused about zoning. So, what I would say here with zoning, um, the process that you go through when it comes to zoning is you you have your address, right? So, if you go to uh if you Google, I don't know where you're at, but uh let's just say you're in Atlanta. Uh, so you look at

00:36:06
Atlanta zoning um Atlanta city zoning. Um, and it could be the county for Atlanta, which I don't know what that is. Um, but you would look at, um, Atlanta City Zoning Department. Um, so you'd find that information. Um, you would look on there and you should be looking for something that basically does um, what's it called? Um, it's like a it's like a zoning map. Um there there's going to to be something on there that that tells you, hey, this is the this is the um this is it's it's a

00:36:40
map. Sometimes it's interactive, sometimes it's just a huge PDF. Um but it's like colorful. Um so it'll say, you know, green is R1 zoning and pink is C3 zoning. Uh typically R is going to stand for residential, stand for commercial. You may have like a uh high R or HR which stands for like high residential like high HDR high density residential like there there may be some acronyms. They may have something that makes sense. They may have something that's like A67 and then you have to look at a

00:37:12
crosswalk and it'll tell you what that is. But basically what you need to find is I I have this map. It's huge. It's interactive or is this a big PDF? It's colorful. I find my address on it. I look at it. what color is that that address? Then I go over and it'll have a key for you. It'll tell you um that this is zoned R1 or R3 or or C7 or whatever. It'll tell you what it is and then you can take that and you can go over and um yeah, on Zillow it'll tell you um most

00:37:42
homes uh their zoning listed. Um so yeah, uh you need to look at the city planning department. Absolutely. So once you do that, once you say, "Okay, so this is an R2. what does that mean? Now, so then your next internet search is going to say, what does R2 um zoning stand for in Atlanta? And that will tell you um what that means. They'll give you a definition. Once you have that information, that's when I would talk to a city planner and say, I want to you you have to kind of explain what you're

00:38:11
going to do. And I stay away from assisted living facility. That has a connotation of um it's a large, you know, big box facility. They're thinking, "Oh, you're gonna knock down this house and you're gonna build a building on it. You can't do that." That's that's what they're going to think. So, you need to explain to them, um, this is a small residential, um, home where we're taking care of the elderly or mental health or whatever population you want to work with. Um,

00:38:37
and it will be a licensed facility with the state. We can have by the license that we want to have, we can have uh, 10 people, 20 people, whatever number it is. And I saw that the zoning um, was R2. And my understanding of that zoning is I I believe I can do this as long as I have this special use permit. Um, is that accurate? And what do I need to do to get that special use permit? That's the kind of conversation you want to have as you're trying to figure out zoning. What you want to as you and you

00:39:07
want to do this early on. Uh, and the reason for it is you might run into something where the zoning is R1 and R1 is single family home only. You can't have a business. You can't do anything with it. and there's no way to do any kind of special permit. And that's not always what R1 is. Uh but just as an example, um and if that's the case, then it can it can absolutely pause like stop you from from doing this because if you move forward with it, even if you did it with an unlicensed facility, somebody

00:39:36
finds out about it, reports you, you could get fined, business could get shut down. You you want to avoid all of those things. Um so you want to make sure you have that understanding. A lot of times it's not going to be a problem, but I have talked to dozens of municipalities over the years. And what I have found is some of them super easy to work with, uh, if it needs a special permit or needs reszoning or whatever, easy process. Other municipalities, it's like pulling hair out and it is it's the

00:40:05
worst experience and you can't figure things out and you just move on because it's just not worth working with that municipality. So, you need to figure this this stuff out early on. That's that's kind of the the quick highle uh version of that, but you need to figure out the zoning process for for your state um and understand what that is. So, yeah, hope that helps. Um all right, so let's see. Uh I just want to remind you all uh we've got our roadmap challenge coming up. It's a week from

00:40:31
today. We will not be doing a live next week because of the roadmap challenge. So, we'd love to have you in there. Um roadmapchallenge.com if you're interested in learning uh more about that that program. I would love to have you in there. It is a live coaching experience. You can ask me whatever if you're in the VIP uh session and um we do this as a one-day uh event now and it worked really well last time. It's it's a lot. I will lose my voice by the end of it. Uh but it will be it will be a

00:40:55
fun one. Um we go through how to build uh your why uh why you want to get into assisted living. We do some vision exercises uh there to help you out. We help you understand the underwriting process to see if this will actually be profitable. Um, and uh, let's see. We talk about the four paths to getting started. Which one's going to be the best for you? And I take you through a quiz. And then we go through the funding and the licensing process. Uh, similar to what we did today for licensing, but

00:41:21
I give you a little more information, more specific information. And then, um, and and we talk through a bunch of stuff. There's a workbook. I can help you out, you know, answering your questions. I love doing it. It it's it's so much fun for me. Go to roadmapchallenge.com. Uh, I would love to have you in there. uh it will help you out as you're trying to get beyond one of these three big barriers that I hear from people. You don't know how to get started if you don't understand

00:41:45
funding and you don't understand licensing. We address all of those things inside of the roadmap challenge. So, we'd love to have you there. Uh and if you can't go to the roadmap challenge, doesn't work for you, then go grab the book at the ali.com. Uh there it goes. Uh the profitable assisted living facility will help you out. I have actually uh finished the recording for the audiobook and working with uh an engineer to uh edit and master that. So, we'll hopefully have that out on Audible for people as well.

00:42:13
Uh so, if you like listening to my voice for some weird reason, you'll be able to do that. Um it's a long book, so there there's a lot of words there. Took me a long time to record it, but that will be coming out as well. We'll have the link at the ALI book once it's available. Um or you can go on Amazon uh to get it there. Are you curious about assisted living, but you're not sure how to get started? At Assisted Living Investing, I help first-time assisted living entrepreneurs launch profitable,

00:42:38
purpose-driven businesses, creating prosperity, purpose, and peace in their lives. I love helping and coaching people. It's one of my favorite things to do. Would love to help you do that. Go check out roadmapchallenge.com or take the quiz at aliquiz.com to see which of my coaching programs is going to be the best fit for you. And remember, it doesn't take a lot, just a little bit. Just keep going step by step by step. And I promise you, if you do and you are consistent and persistent, you're going to be successful. Thanks

00:43:01
for watching and have a great day.