How to Run an Assisted Living Business from Another State (And Make It Work)

Transcript

00:00:00
Have you been wondering if you can operate an assisted living business out of state? I'm here to answer that question for you in this video. By the way, I actually I have operated two assisted living businesses out of state. So, it's totally possible. If you want to figure out how, make sure you stick around for today's video. Hey friend, I'm Brandon Gustafson. I help first-time assisted living entrepreneurs launch profitable, purpose-driven businesses, creating prosperity, purpose, and peace in their lives. Super

00:00:30
excited to have you here on the channel with me today to talk about the idea of operating out of state and if you can do it, how you can do it, and how you can be successful and profitable in doing this. So, let's hop into that. Before we do though, want to remind you I will talk at the end of the video about the roadmap challenge, but if you want to learn more, go to roadmapchallenge.com. And if you need some help and some guidance, you're trying to figure out how to get into assisted living and

00:00:53
you're just not sure how, I have a 30- secondond quiz. You have the QR code over here in the bottom of the screen. Go to aliquiz.com. Take that 30 secondond quiz. We'll help you out as you're trying to figure out how to launch your assisted living business. All right, with that, let's get into today's video. Hey friend, it's Brandon Gustafson. Super excited to have you here as we talk about the idea of operating out of state. Can you do it? Should you do it? Should you consider doing this?

00:01:18
and why or why not. I'm super excited to get into this topic with you. For those of you who don't know my story, what I want to share with you is when I was getting into this, I live in Utah and I wanted to get into assisted living and I was looking at opportunities here that were local to me uh that looked like they were really good. I actually found one that was just like this beautiful home, existing facility, looked perfect for assisted living, like an assisted living mansion, if you will. And I was

00:01:46
super excited about it. And I got the numbers and I ran the numbers. And if you need some help with that, make sure you go to assisted livinginvesting.net/calc. You can get the free underwriting calculator or just type in calculator down below. We'll get it over to you. But I ran the numbers and I was like, this this doesn't make sense. Like I'm going to lose money if I move forward with this opportunity. So I went back to the drawing board and started looking. And through a connection that I had, I

00:02:10
was able to meet a guy who was in Denver, Colorado. He was purchasing a facility in Denver and the people they were buying from had a second facility in Colorado Springs and his group didn't want to purchase that one. They were based in Denver. They didn't want to do anything that was farther away. And so they were like, "Yeah, let me put you in contact with our broker with the sellers and you guys can have a conversation." That's how we found our opportunity, our our facility in Colorado Springs. Uh we

00:02:38
purchased it. Colorado Springs, by the way, is about a 12-h hour drive from where I live in Utah. Um, or if I fly, it's a, you know, an hour and a half flight and then an hour drive down to Colorado Springs. And that for me, I I was honestly just looking at the numbers and not all that concerned. I never was concerned about operating out of state. It I mean, it came up in our conversations, my dad and I, who's my business partner, and we're like, "Yeah, you know what? It feels like we could do

00:03:06
this. shouldn't be that big a deal. We'll find and hire the right people. They'll run the business for us. We'll have good communication. Everything will be fine. So, we just dove in. We figured it out. Had not operated a business out of state, but I had worked remotely, right? This was my experience. You can do it. That was kind of my thought and I just jumped in and oh my gosh, I'm so glad I did. It was an incredible experience. My second facility, we kind of followed the same path and we're

00:03:32
like, we we do want to do this. This works good. I think this can be a sustainable model for us. So, we went and we found a facility in Nampa, Idaho. Um, and this was something that I spent a lot more time. If you're interested in learning about like why it's so important for you to do market research, type in research down below and I will do a video on why market research is absolutely key. But I did some market research, identified this as an area for us to go to and it has been an incredible experience. We have been

00:04:01
operating remotely since 2020 and it has been successful. It's been profitable and I don't think I will go back to a different model. It has forced me to create systems and processes to make our businesses work. And once I eventually do start operating in Utah, because I do have plans to do that in the future, I will have built systems and processes that make it so that I am not forced to be working in the business. And this is super important for you. Okay. with that story there to kind of illustrate my

00:04:34
path to doing this. I wanted to talk to you about why you should consider operating out of state because I think it is an incredible option for a lot of people and I think it's something you should be considering. One is like I mentioned it forces you to create these systems and processes that make your business more valuable. It forces you to think about, okay, if this thing happens, if I have a person quit or I have a person call out or whatever it is and they can't cover a shift or we have

00:05:02
residents that leave or whatever, how are we going to handle that? And you have to write processes for it so that your staff know how to handle those situations because, you know, I live from my Idaho facility, it's like a 5-h hour drive, 5, six hour drive. So, it takes me quite a while to get there. If it was Colorado, it was uh I would have to fly in, and I did this before. Fly in in the morning, drive an hour down to Colorado Springs, be there for a period of time, drive back to Denver, fly home,

00:05:28
all in one day. It was a long day. I was It was not the funnest day ever, but I could do it. But it was a lot easier for me to say, "Okay, we've got the system. We've got this process in place. This is how you handle that situation." And we were able to very rarely I think one time in the entire time that we've owned this since 2020 have we had to drop everything and get up to the facility. One time and it was in our first year of operating. And if you're interested in

00:05:54
learning about that story type and admin down below admin to hear that story I'll share it with you. All right. So the next thing that it does is it forces you to look at things and handle them at a macro level. You're not getting really caught up in the day-to-day things. the little leaky toilet or the sink that that's having issues, the dishwasher that makes a banging noise. Those things, yes, you want to fix them, but you as an owner don't need to be doing that. Those are things that should be

00:06:20
trickling up to you and then you can delegate who's going to do it. And so when you're out of state, it forces you to look at things at a macro level. How are we operating as a business? Is this functioning? Is this working? And this does not mean that you should be out of state to do this. It doesn't mean that you have to be out of state to do it, but I truly believe that if you want to be successful in this business, there's a book by Benjamin Hardy. It's called Who, Not How. So, we'll link that down

00:06:48
below for you so you can go grab that. But the idea there about who, not how is you find people, you find who's to help you carry out this process. And for me, the forcing function was doing it out of state. And it's worked really well. Forces me to look at that macro level, which really helps. and it helps it become more passive. So, those of you that are interested in doing this and you're like, man, I want to do assisted living, but I want it to be passive. Like, I resonate with you. Type in

00:07:13
passive down below cuz you're my people, right? That's what you want to do. That doesn't mean that those of you that want to be active are wrong because I think you can do this and be successful. And also, I know from a lot of comments that people fill out when they go to aliquiz.com and take the 30 secondond quiz that they want to start out active and then they want to move to being passive. So, this video is really designed to help you understand how you can do that. So, make sure you go take

00:07:41
the quiz. Uh, and if you are a person that like out of the gate wants to be passive, type in passive. If you want to be active, just type in active down below. would love to hear where you're at on that process and and the continuum of those things uh to see how you want to get started. Would love to hear that. The other thing that I would say when it comes to operating out of state and how you can be successful and why it's possible to do this is you have to understand that building the right team

00:08:10
is absolutely crucial. You have to have a really good team in place. You need to have those systems and processes and then you need to have the people that can carry out those systems and processes. So you need to spend a lot of time building out that team. This means number one, you have to find and hire a good administrator. Now, if you're interested in learning about how to do that, type in hire, and I will do a video that's kind of more specific around the hiring process, what that looks like, and how you go about finding

00:08:37
and hiring a good administrator. Uh, so hire is the word that I want you to type if you're interested in doing that. But if you can find that person, they are going to just be this incredible resource for you in carrying out your vision. You need to find somebody that has experience, that has the license, that is great at communicating both with you, with your staff, with the residents, with their families. They need to be a good communicator. They need to be able to stay on top of all the rules and regulations and the

00:09:06
shifting industry and know exactly what's going on because that is their job. They need to make sure that those things are staying in place so that the business can continue to run. So this is a really key important thing for it. But if you can find and hire a good administrator, you will be in a really good situation. I've gone through this process. I've hired four different administrators since 2020. So, I've gotten very familiar with the process and the tools that you use and the fear

00:09:34
of having somebody quit on you in the middle of the night and not answering your texts and how you're going to handle that. I've experienced all of those things and they're real. It it happens. It can happen and it's extremely stressful, but you can also make it through this process. So, find and hire a good administrator. That's the first thing you need to do. And the next thing that you need to do is make sure you have enough staff so that you're avoiding burnout for everybody.

00:10:00
This is something that's really hard. You're going to have a state minimum in your state. And it it's going to tell you the minimum amount of staff that you need to have in your facility. It's going to tell you that based off of how many residents you have. A lot of states are shifting over to a model that is you just have to meet the care needs of the resident. So you just want to look at their care plans. What do they need? Does anybody need a twoerson lift? Yes or no? and you can adjust your staffing

00:10:23
ratios based off of that. But I would also strongly encourage you don't just do the bare minimum on that because you're going to save a bunch of money, which you will, but if you do that, you're going to have extremely high turnover. Your administrator is going to get burned out because they will probably be working the floor and that leads to them quitting and it leads to the just it spirals and and just keeps going down. kind of snowballs into this big process that makes it really hard

00:10:48
for you to run a successful business. So, make sure you are sufficiently staffed. Make sure you spend time upfront understanding what having a slightly heavier, it doesn't need to be super heavy, but a slightly heavier staffing model is going to do to your income and how that's going to impact things. So, you need to understand these things and find a really good balance. Uh, but make sure you're fully staffed, you're paying them well, that they are happy, and that makes everybody's life a

00:11:15
lot better, including the residents, which is what we're doing all of this for, right? And the other thing that I'll say when it comes to staffing is you need to create really clear roles and responsibilities. When you do that and you have kind of this tiered hierarchy of the administrator does this, maybe you have an assistant administrator or a house manager, they're working through, they're coordinating staffing schedules. You've got your med techs that have to be on to help pass medications. You've got

00:11:40
caregivers. You've got your housekeeping staff. You got maintenance people. You got nurses. Which of these people are going to be contracted? Which of them are going to be your employees? Are they full-time employees? Are they part-time? Are you going to do W2? Are you going to do 1099? You know, what what are you going to do with all this? There's a ton of questions, right? there. There's a lot there, but the more that you spend time outlining this, and you should be doing this in your business plan. And if

00:12:03
you need help building a business plan, type in BP down below. We'll give you the link to the the business plan checklist or you can go to assistedlivinginvesting.net/BP checklist right there and and you can get that and it can help you out as you're trying to figure out how to move forward with this. But you spend time when you're doing your business plan to plan out exactly what your staffing model is, the roles, the responsibilities, how many staff you're going to need. You spend that time so

00:12:29
that when you have launched the business, you know what you're doing. You move forward with confidence and everything works really well for you. And I would say you should also be incentivizing your staff, specifically your administrator. Maybe you want to do it with everybody, but the more you can incentivize people to do things that you want to get the results that you want, you're going to be a lot more successful. So, if you need a higher census, then maybe you incentivize and you say, "Hey, if we get our census at

00:12:58
100%, we'll give you x amount. If we're at 90%, we'll give you x amount." And so, if you can hit these census numbers, then great. Maybe it's going to be based off of your net operating income, your NOI, or maybe it's based off of some other type of expenses that you have that are high. when you do these things, you really get some cost controls and you are incentivizing people, they will work on that. So, make sure you're paying attention to what you're incentivizing because whatever you

00:13:22
incentivize and whatever you promote, that's what you're going to get. And so, just because you have a high census doesn't mean that you're going to necessarily be profitable. Because if you're not controlling costs and you have a lot of residents in there, but they're spending money on all kinds of extra things, then all of that money is going away. you're not getting that on the back end for you as an ownership group. So, you need to identify what are the KPIs, what are the things that I

00:13:46
want to see and then you incentivize those things and that's when you're going to really start to see all of this snowball and give you a lot more income earning potential. Now, let's talk about why you need systems. Systems, especially when you're working out of state, they're so so important. I can't emphasize that enough. When you have these systems, you have strong policies and procedures, which you need to obtain your facility license so you can start operating. But when you have them and

00:14:12
you follow them, it makes it so much easier for your staff or your administrator to know what you want, to know how to handle certain situations. And when they have that manual uh that tells them what to do, it lets them move forward with confidence and that they don't they don't get this sick feeling in my in my in their gut that says, "Oh, oh crap, you know, this person fell. What do I do?" They know because they've had the instructions. They they know how to handle that situation. If somebody

00:14:37
needs to call emergency services, they know where those numbers are. They know how to react to that. And that's really going to help them have a lot of confidence in the way that they are operating. And it makes it so much easier for you because then they don't call you every time something happens. Our resident fell. What do we do? Well, look at the standard operating procedure. It's in there. Those policies and procedures, they are there for a reason. How do we onboard new residents

00:15:00
when they come in? What about new staff when we hire a new staff? What about if a staff member does something we have to let them go? How do we handle that? All of these things are going to be in your policies and procedures. And then when those situations come up, and they will inevitably, it's going to happen. You know where to direct people. They know what to do and how to handle those situations. They can move forward with confidence and know that they're doing things the right way. I would also

00:15:26
encourage you as you are running the business to identify standard operating procedures or SOPs that you can add for your most important tasks. Add them to your policies and procedures manual, but these should be the things that are core to your business. It doesn't need to be every single thing. In the book, The E-Myth Revisited, we'll link that down below for you, he talks about systematizing everything that you do. He uses McDonald's as an example. And in the example there, you know, if if you

00:15:54
think about McDonald's, you could go to any McDonald's worldwide and ask for a Big Mac, you're going to get the exact same thing, the exact same amount of lettuce and pickles and sauce and burger and cheese and bread and everything. Everything's there. And what's incredible is they're typically high schoolers that are doing this, right? It's because those processes are so clear that it makes it so easy for somebody to know how to do it. That's what you need to be creating for your

00:16:19
business. And it's okay that you don't have all of those on day one. That's totally fine. But as time goes on, you should be creating these standard operating procedures so people know how to handle these situations. Start with your core ones, five, 10 of them. Create those, refine them, use them, make sure it's very clear, and that's going to add a ton of value to your staff. And eventually, if you wanted to sell the business or scale the business, you have these now that are going to help you be

00:16:45
able to grow your business. Super, super valuable. And I would encourage you to have a process in place for how to escalate big issues. Um, so if you have something that that a staff member can handle, let them handle it. If they need to escalate it up to an administrator, let them escalate it up to the administrator, let them handle it. And if that has to come up to you as the owner, as the operator, then have a process for what is appropriate to come up to your level. Give people the autonomy. Give them and delegate to them

00:17:12
the responsibilities to get those things done. That is going to save you a ton of time, a ton of headaches because you won't get called every single time something happens. You know, the toilet is plugged. What do we do? Go get a plunger and fix it. Right? Those are the types of things you should not be doing that as an owner. You shouldn't be. Even if you're not somebody that's out of state, somebody should just be taking care of that stuff. Okay? And that situation, maybe it's like backlog

00:17:37
because somebody's throwing in paper towels or something like that and you got to call a plumber. Well, then call a plumber. I don't have to call the plumber. uh get the quotes, talk to them, let's figure it out. Give people the autonomy, delegate to them the responsibilities. It's going to save you a ton of time, makes them feel empowered and helps them be able to move forward and know that, hey, they got my back. I'm going to be good with this, right? So, when you do those things and you

00:18:00
have these systems and processes in place, it will change your life. So, make sure you're doing that. Another big one that I want to talk about is communication. Communication is absolutely key. So, in our Colorado facility before we sold it in June of 2025, one thing that was really rough for us is our administrator, who I love her, she did an incredible job for us. Uh, she went through a ton of really hard things, but she was not the best communicator in the world, to be nice. And that was really frustrating for me,

00:18:32
especially as an owner that's out of state. You need somebody that will communicate to you. When you ask a question, they need to get back to you. When you have regular meetings, they need to attend those meetings. Um, you need to have something in place that lets you know what's going on in the facility. And when you have regular check-ins with your administrator, when you are regularly reviewing the financials so that you can talk through those issues with your administrator who's doing the day-to-day of the

00:18:58
business, when you have those things in place, you can make sure that everything is getting to the end of the line, that you can be profitable. You should also be ensuring that all of the care is tracked and and using like an EHR system. If you're interested in learning more about that, type in EHR down below. But when you have that to track all of the cares that are provided to a resident, that's going to allow you to go back and update care plans so that you can potentially get paid more money

00:19:24
that's appropriate to the level of care that you're providing to your residents. Um, you're going to be able to set expectations as well. And the other thing that I want to point out to you is that you should have expectations set for when you ask a question, how quickly they should be responding to you. This doesn't mean that you say jump and they say how high. But it means, hey, if I ask you a question, it means I need a response. I need you to get back to me within at least 24 hours. The things I'm

00:19:50
asking you for are pretty simple, and it's probably because a regulatory agency is asking me for those things, and so I need that information. or a bank or or somebody like that, somebody high up is needing this information. That's why I'm asking you for it. And so, I need you to respond to me quickly. And that was something that my administrator in Colorado lacked a little bit of. But my administrators in Idaho that I've hired, I've gone through a few of them there have all been

00:20:15
incredible at. They're great at communicating. And that is something that I learned pretty early on in the process that I need a good communicator. And I think you should as well if you're going to operate out of state or if you are going to uh just operate remotely. and delegate the responsibilities that you have somebody that is great at communicating. You need that type of a person in your facility if you want this to be successful. And the last thing I want to share with you is you need to

00:20:38
choose your market wisely. And I talked about this. If you want to hear a little bit about my entire story about market research and why we decided to go with Idaho, type in research down below. Uh we mentioned that at the start of the video. But what I want you to learn here is that you need to do your market research. You need to understand, is the market going to work well for assisted living? How comfortable am I with how far away it is? Uh, do I need it to be within a 3-hour driving distance or can

00:21:05
it be an hour flight and an hour drive? Is that okay for me? Can I handle that in the budget or am I okay with it being clear on the entire other side of the country and I don't have to worry about it or think about it because I know somebody else has got it for me. What are you comfortable with? You need to outline that. come up with an idea of what that's going to look like for you and then you start researching and figuring out how that's going to work. Understand the rules and the regulations

00:21:29
in that state. Even if you're not the administrator, you should have at least a base understanding of what that's going to look like so that you can speak intelligently to it. And when you do those things, you can move forward with confidence that you have something that you can trust in somebody to operate for you out of state. So, we talked about a lot in in this video, all geared around helping you get some guidance on how to operate out out of state. If you found this helpful, make sure you like the

00:21:54
video, subscribe, ring the bell as well so that you get notified every time we put out more content like this. We go live on Tuesdays typically and we put out content on Thursdays as well. But to quickly recap for you, we have talked today about why you should consider operating out of state. I personally love it. I think it is an incredible opportunity. It forces you to do a lot of good things to help you run a more efficient business. You need to build the right team. It's absolutely crucial

00:22:19
that you build that right team. Build systems as well. Super important for you to build systems and make sure you have somebody that can communicate. Communication is so so important for you in this world. And then make sure you choose your market wisely. That's going to allow you to be successful. I told you at the start of the video that I was going to tell you a little bit more about my roadmap challenge. I would love to have you there. Go check it out. roadmapchallenge.com. This is a live

00:22:42
coaching experience. If you get a VIP ticket, you can be in a room with me. It's virtual and ask me any question. I am an open book. Ask me any questions about anything that you have need some help with, need some guidance with. But in the challenge, again, it's live. I'm teaching you how to uh get clear on your vision for why you want to do assisted living, which is going to be a huge impact on how you write your business plan and helping you be successful there. We go through the numbers, how to

00:23:09
underwrite to making sure this is actually going to be profitable for you. We go through the different paths that you can go down as you're trying to launch your assisted living business. We talk about how to obtain funds and we talk about the licensing process and what that looks like. So, if you need help with any of those things or all of them, go check us out roadmapchallenge.com. Go learn a little bit more about it. Again, it's live. I would love to have you in an upcoming challenge. Would love to have you there.

00:23:32
Again, it's roadmapchallenge.com. And if you're interested in one of my coaching programs, but you're not sure which one is going to be the best fit for you, I do have a quiz. Again, QR code over here in the bottom of the screen, aliquiz.com. Takes you 30 seconds. Go fill that out. It will tell you which of the programs, including potentially the roadmap challenge, which one is best for you. Are you curious about assisted living, but you're not sure how to get started? At Assisted Living Investing, I help

00:23:57
first-time assisted living entrepreneurs launch profitable, purpose-driven businesses, creating prosperity, purpose, and peace in their lives. I would love to help you and coach you along the path. I love coaching. It is like my favorite thing to do. Would love to help you out as you're trying to get into this. 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 are going to be successful. Thanks for watching

00:24:19
and have a great day.