Types of Assisted Living Licenses: What You Need to Know

Transcript

00:00:04
hey friend it is Brandon Gustafson with Assisted Living investing excited to have you here at Assisted Living investing we are here to help beginners like you uh launch their Assisted Living business in 12 months so excited to have you here with me today today we're going to be talking about the different types of licenses that are available available to you in Assisted Living so wanted to get into that topic um for us today um and before I do that I'm going to share my screen and just remind you to get

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over to the website I've got a free business plan checklist so if you want that go over to the website Assisted Living investing. netb checklist we got a ticker coming down across the the bottom as we go through this video today um so make sure you go and grab that free checklist and uh we'll get it out to you and uh yeah just a reminder that we are going to be talking about uh the types of licenses in assisted living today I am just quickly turning this to public so we can put the link out on Facebook um all right let me

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tell you a little bit about myself as well as I continue doing that sorry my computer's going super slow today wait for it there it goes okay so uh for those of you who don't know me uh my name is Brandon gust and I own two assisted living facilities have owned them for um over three years now and I offer operate them out of state so one of those facilities is in Colorado one is in Idaho and I live in Salt Lake City so I do this all out of state and um have been doing that for a few years now

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have really enjoyed it I've also uh been able to secure over one and a half million dollar in SBA funding and for those of you that are interested in Grants um if you're interested in learning more about that comment grants down below because I have done over a million dollars in grant funding as well so I have a lot of experience just kind of working through different areas of healthcare have been in the healthcare industry for over a decade as well and uh have a masters in healthcare administration so uh that's a little bit

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of background about me if you um are new here and you're just trying to figure out what this looks like and how this is going to work for you then please comment newbie down below and if you've been here for a while and you're trying to figure out you know maybe your next facility or just trying to understand the different license types that are available uh as you look to expand then type in operator um down below here as well and with that uh let's get into the topic so there's there's actually quite

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a few different licenses that are available um to you um here thanks Deborah for your comment on grants um I'll uh I'll work on getting um if I can by the end of the video I'll I'll give you some links um for some videos that I've talked about Granton um anyways there's there's quite a few different types of uh licenses as you get into assisted living that that I want to make you aware of of uh so we're going to go through each of those today and as you're here if you're live go ahead and

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type questions as we go through this there will be time at the end for some Q&A uh for you and I'll I'll answer questions they could be about the license types here or anything else that uh that you might be interested in so um a basic Assisted Living license we're going to start there um what is that basic license uh really it is um you know it's kind of you're you're providing services for residents this is the type of license that you probably think of when you're thinking of

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Assisted Living um it's going to do room and board for your uh for your resident uh you're providing basic assistance with ADLs which are activities of daily living so that could be things like uh medication management dressing toileting um feeding food all of those types of things and you're providing personal care services here as well so whatever the resident needs you're there and you're helping them out and uh providing them with the Serv that they need so they can feel comfortable and happy and

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safe in the home um this really is kind of that basic kind of catchall Assisted Living um which what you typically think of now the next one is a limited Assisted Living license and a limited license is something that is a little bit more limited in scope um so you're going to be a little more niched down when you get into this typically it's going to be a smaller home so we've talked a lot about care homes in the past um so if you're watching watching this and you're interested about Care

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Homes comment that down below as well and I can get you some of the the links there but we've talked about licensed and unlicensed Care Homes but typically this more limited license is going to be something that is um kind of those smaller types of Care Homes you know three to six residents somewhere in there and you're working with with a specific group um you know a niche populations could be special needs could be um could be Elderly Care could be um something with mental illness it could

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be a variety of different areas but uh what what you want to know here is that that you're going to just kind of be working with with kind of this limited group and when you go through the application process um one of the things that you're going to find as you go through that is there there's kind of boxes that you're checking um or you're explaining who you're going to be serving uh as you go through that through that application process and in doing that um you're going to select uh

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these types boxes so this is kind of where this comes into play as you're working on getting this thing out um now let's move on to the next one we we're going to talk about enhanced Assisted Living licenses so this is going to be a more comprehensive care this is not quite at the level of um a Skilled Nursing Facility but it's maybe a little bit more advanced than what you would see in a typical assisted living home so uh you're providing more comprehensive care uh there's higher higher levels of

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care so uh a really good way of kind of differentiating this um in my mind is you have a resident who needs help getting off of their bed in that basic uh type of license uh it's like a single person left but when you get to the point where you are needing a two-person lift that all of a sudden is a higher level of care you're going to need more staff you're going to need more people there uh this could be um something along the lines of uh they they just need some extra care and things because

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they're they're suffering from Dementia or Alzheimer's or things like that though they're not quite at the level of needing memory care which is going to be our next section so this enhanced license is just you know a slightly higher level of care there might be a little bit of nursing services that are coming into play here as you're providing care to your residents and getting to to know um their needs and what uh what they need help with so uh just wanted to kind of get that out

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there now let's get into um and relle so this is these are so each state so relle asks a question here I'm going to address it um because I think this is a good time and then we'll get into memory care so the the question is are these licenses in every state and these are so the the licenses themselves they might be called something slightly different um and what we've gone through here to that first point where was basic and limited and enhanced Services um those are more boxes that you're checking um

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and and things that you're doing it kind of falls under this umbrella of of more of a of a an assisted living license and now we're going to talk about in memory care and skilled nursing and Beyond um are separate types of things so each state I don't know that I would say every state is going to have those specific levels of care outlined in in their process um but in general um these are good guidelines to understand there's there's kind of this basic assisted living with varying levels of

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care that could happen in there and then beyond that you get into higher levels of care um each state is going to be different but I kind of want to give a comprehensive overview so you know what you're getting into as you get into this so um and group homes are kind of more that limited um type of Assisted Living they're just going to be smaller um it it is a good way of kind of differentiating though because they're um and I think um if this would be useful comment this down below um I

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think we're going to get into like facility types um in in a future video so there there's like group home assisted living uh memory care and so these are the licensed the license types but there's also like a facility type and and the type of the level of care that you're providing so if you're interested in learning more about that then type in level of care below and I'll get that on the list we won't get too deep into that today um but um I can I can build something for us in a future

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live video um okay let's get back to this you have more questions please type them in there um Memory Care license so when you're dealing with memory care uh these are people that it's very much specialized these are people that deal with um severe Dementia or Alzheimer's um they need to typically be in a secure environment so your facility is going to be a locked facility because you don't want them to wander um you need to have some specialized staff training here as well something that I think is really

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cool and I've been talking to a buddy of mine in Idaho um who is doing this and I was talking with somebody down in Texas that's doing something similar is the idea of kind of creating and I love this idea it's kind of creating this locked Community locked area but you're able to allow your residents to like go in the backyard and and they could do gardening or they could uh you know have an old truck to fix up or or something like that something that keeps their mind active and even though they're suffering

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from dementia and Alzheimer and and some of those things that are really hard for them to do and they can't remember everything they um being able to interact with those types of activities really keep their hands busy keeps their mind active and improves their quality of life uh immensely so if you are really interested and passionate about going the route of doing memory care and want to work with a population that is Dementia or Alzheimer's um comment down below memory care because I'd love to do

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a deep dive on that um if you're interested and if there's enough people I can build some content around what a memory care facility is is and some of the really cool strategies that you can do there but this license type is is going to deal specifically with that and when you go through um like the inspections for your home to get it ready there's a different level of uh what you need to show that you're able to to care for these residents than you would in a basic Assisted Living because

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it is a locked facility you make sure that it is secure for your residents and that they're not going to be able to get out and wander and and get lost because that's something that you definitely would would like to avoid so that's Memory Care uh let's get into an Extended congregant Care license so this is an ECC um this is like a step below a nursing home but it is something that is a higher level of care than than a typical um than than a typical assisted living or memory care home so your

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extended services to your residents they're requiring a high level of care uh than a standard Assisted Living um there's more nursing care that is provided and while it's not quite at a nursing home level you there there's a lot more involved and this is something that I don't see a lot in like the smaller residential um space in care homes or residential Assisted Living this is going to be something that is typically going to be in more of a a big box type of a facility but um it's

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something you want to be aware of as wherec as well because it's it's kind of along that Continuum of Care that you may end up needing to provide to your residents or that you may need to refer out because they're just not um at your level of care and you can't help them you can't provide the care that they need and so that's something that you just kind of want to be aware of that these ECC um homes this ECC license exists and it could be something that you know if you're really passionate

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about this group of people you might want to look at it without having to be a Skilled Nursing Facility uh and still be into in the Assisted Living realm and then um beyond that there's also Specialty Care Assisted Living licenses and this is again like we talked about um this is going to be um as you're going through that application process to get licensed for your facility there's going to be boxes that you're going to check and and you see this a lot actually with Medicaid um

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specifically when you're doing the Medicaid certification uh there's going to be different waivers that you would um be working with so these are just kind of boxes that you're going to check um who you want to Service uh it could be Mental Health Developmental Disabilities could be special needs could be any number of thing things and so if you are passionate about a certain population um this is kind of the route that you would want to go and and working through this I was working with

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somebody in the Mastermind group and and she wanted to do something that was very specific to special needs um she has a very close um relationship with an individual who has um autism and so was building a house kind of around that and so that's what we were looking at at doing there and it's it's a slightly different type of application and and different types of um conversations to have at the state level and and things like that uh to help you get there you want to have specialized staff training

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to make sure that your staff um understand how to meet the needs of the residents as well and then you want to have that facility be designed for the specific needs of the type of Resident that you are working on and this could be a group home it could be an assisted living um home but you're kind of catering to a specific group of people so that when you have uh available rooms you are able to work directly with that type of a of an individual to bring them into the home so that is a specialty

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care Assisted Living license so if you have any questions let's go ahead and type those in I know I've got a few over here and um some of those were kind of asking for some links I'm going to go and grab those um if you are watching the replay those will not come up I don't believe the chat saves there um so I just want to make sure that that is clear but while people are typing up questions I'm going to go ahead and find these um really quick so I'm going to type in on my channel this will take a

00:14:36
second so um but while while I'm doing that I want to remind you to like the video subscribe and ring the bell as well so you get notified um every time we go live on on these we go live on Tuesdays um and then we put out long firm videos on Thursdays as well so we're probably a lot of content on here for you to help you um get what you need there um so here's a grants one for you Deborah and um the other one that you asked for was Care Homes so I'm going to go back over here and and do this uh I

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and while I'm doing this I'll I'll also kind of plug a little bit of my website if you get over to Assisted Living investing. net I have some incredible resources and on YouTube we'll have links to all of those down below so make sure you go and watch that because I think that will help you out quite a bit um but also um on top of that I have some programs coaching programs so there's um you know the business plan checklist um if you need some help building that business plan which really

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is one of the core principles of of what I teach uh is building that business plan it's the base of everything that you're going to do um the business planning guide um is available we'll have links on that on YouTube as well and if you feel like you need kind of a a more in-depth um program we have our Mastermind program where um what we do there is we kind of get in and and help you it's a year-long program and can help you um get to get to where you want to go um and and launching that Assisted

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Living business in in the next 12 months so uh I love coaching people love helping people out and and getting through things so I almost have this link here for a care home for you Deborah and we'll go Care Homes alrighty so there's those um let me review these questions here really quick so um relle you already own a rent home that has three bedrooms um and it's getting ready to be vacant so that is great um the thing that you're going to want to do with with the three bedrooms there is

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run the numbers and make sure it's going to work for you um and you can watch that care home video that I just put into the chat there uh it will help you out quite a bit um the the reason for doing that is you want to just you don't want to get upside down in in one of these um types of situations if you get over to the website I have the free underwriting calculator there as well so you can get access to that and um and run some numbers and see if it's going to um be profitable or not because I'd

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hate for you to get into this and be like this is what I want to do it's a three-bedroom home this is the perfect spot for it and then you run the numbers and you're like I'm losing a lot of money what you have to understand with this type of business is it takes money um to uh to run the business you have to pay your staff and and and doing things there um so it it like it it's costly and so something you want to make sure that you are very confident in your ability for it to be profitable before

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you go through the renovation process and things like that uh again if you want to work with me directly um for the next year on that check out The Mastermind we I do a free strategy call with people um so you can go to Assisted Living investing. net strategy and set up a call and we can jump on there and and kind of chat through things and see if it's a good fit for you or not um I'm not going to tell you I'm not going to try to offer something to you if it's not a good it so I just kind of want to

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put that out there if you'd like to talk a little bit about your situation and see if um see if assisted living is right for you um let's see we talked about group homes we got those you're welcome um Deborah have a question on here um how do you make profit out of a business going through government contracts or private pay so yeah so the way that you work that and I'm not going to try to say your name because I'm gonna say it wrong um so I'm just going to say a um that's first ini still there

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uh so a um what what I would say here is you want to underwrite this you want to go and grab that calculator that's on the website and and get familiar with the numbers and and see how it's going to work um you in in a private pay setting you get to set your rates um I mean you got to make sure that they're they're um that people are going to pay them but you could have rates that are you know anywhere from 3,000 to 12 15,000 just kind of depends on the um the the type of care that you're going

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to provide um the type of amenities you're going to be offering and those types of things so you kind of do a market analysis see what's going to work for you and then you're going to um start the the facility and and people will pay um that amount um to to come into the home and in doing that um you know you can figure out if you're going to be profitable or not from a Medicaid standpoint and I have a bunch of videos on the channel um that talk about Medicaid but um you can you can do this

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in in Medicaid Medicaid you're going to get paid two ways one is going to come from the resident um through their social security and then one is a daily rate that comes from the state um based off of the level of care that you're providing um so in a private pay or a Medicaid setting you still want to be documenting all the care that you're providing and then based off of that you're going to be able to raise the rates um it Medicaid's a little bit more complicated of a process to do that but

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in a private pay setting it is relatively straightforward um you want to do this on an annual basis or every time there's a significant change in the level of care that is needed for a resident so you want to be doing this on a regular basis and make sure that you are charging an appropriate amount for the amount of care that you are providing to your residents um but that's how you're going to be able to increase those rates and and make sure that you remain profitable as you go and

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get into this business so um you can do it both ways um I am largely Medicaid uh and there's not a lot of people out there like me that teach the idea of doing Medicaid it's because I have a lot of background in government programs Medicare Medicaid I have a lot of understanding of how that works and how you can leverage that um you know that lever and and make it successful for you some people don't want to do it and that's fine um it it's probably easier to go the route of being a private pay

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facility but you can do this through Public Funding um through being a Medicaid provider it's it it's very possible for you to be profitable and and do that while being a Medicaid provider so yes hopefully that answers your your question there um does the government pay staff uh question from Deborah so um no the government is not going to pay it unless there's some kind of going to be some kind of a grant in place or some kind of a program um during covid era there may have been some arpa funds that

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uh and you're welcome um there may have been some private F or some funds that kind of went into helping pay um some of that payroll but it is uh this is something that you are handling on your own um so you're the one that needs to budget that in place and make sure that that is is all you know in line so that you can pay that um and it's it's something that honestly like to be to be frank and transparent and honest with you this is what is going to make or break uh one of the like two or three

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things that make or break um a deal for you is you have to understand what that Staffing model is going to look like how much is going to cost to pay staff because it is your biggest expense um it is it's something that I mean depending on the size of the facility um our payroll is 10 to 11,000 10 10 to no probably 14,000 depending on the facility um and and how much people are working um per pay period um that we have to pay so you know 20 to 20 to $30,000 a month in wages and so this is why um going through the process of

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understanding um how much you can get coming back so like I was just talking about how much you can charge people uh as from a monthly or daily perspective is going to really come into play because you've got to figure out how much your wages are and make sure you're going to be able to cover that and then the other big one that will make or break a deal is your debt service so how much that real estate is going to cost and what your payment to the bank is going to be whether it's the SBA uh

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private money lender you know whoever it is um you want to make sure that those two things if you can kind of hone in on what they are and you're comfortable with that and then your um the amount of income that you have coming in is going to cover that plus some like that's where you're going to see your margins at um and and this is why you know I I caution people big time um there was the question I can't remember who it was earlier I think it was Michelle um with a three-bed home um margins can get really

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really Slim when you do that um you're you're not going to have payroll of 10 to $20,000 you know it's probably not going to be that high but it's still going to be a significant amount and if you are only charging somebody three to $4,000 per bed to stay in the home and you only have three beds um all of a sudden like it it really can can shrink things um quite a bit it's doable you want to make sure that you follow you know watch some of my videos U make sure you understand

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the numbers and things like that get familiar with it I'm not saying that you cannot do it I'm just telling you that the margins get really Slim really quick when you have a smaller home I like to sit in in the phase of 10 plus beds I'm more comfortable with 12 plus um I I don't think I personally would ever go with something that has less than eight beds but that's me personally and my uh risk tolerance level with the type of home that I want to build that doesn't mean that you can't do something smaller

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um it's just like where I'm at and and what I would do and and what I would look at so hopefully that helps and I went kind of off topic there Deborah but hopefully that answers your your question there so um I will stay on here for just a second as I close things up but there's any other questions um then feel free to type those in um but just want to remind you to get over to the website assist living investing. netb checklist to get that free business plan checklist kind of gives you an

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understanding of what needs to be included in the business plan again it is the base of everything that you're going to do it it creates it sets the stage for for everything you're going to do uh in in getting things ready U there's there's five pillars that I teach the first one is business plan uh number two is getting the facility number three is obtaining the funding four is getting that facility license a lot of what we talked about today in the live session and then number five is

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launching and and scaling the business and I teach all of that in the Mastermind program or in the accelerator course um all those are available on the website so go ahead and and grab those and get the free checklist as well um um and Deborah glad I gave you an extra minute there so $3,500 per bed does the government help the client pay so if you are um yeah like $3,500 a bed is very reasonable if not low um for for a lot of Assisted Living because of the amount of care that you're providing you're

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providing meals and and housing and everything so 3500 is you know very reasonable um if not low uh if they so the government will help pay for that if they are a Medicaid resident and you are a certified Medicaid um provider so uh in that in that sense yes it will but there's a few caveats that kind of fall into into that process I'm going to grab really quick for you on my channel a uh the process for getting approved for Medicaid so you can kind of watch that and get a feel for what that looks

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like as well um and that will hopefully help you understand a little bit of the process of what Medicaid is how to get Medicaid certified and um what that means for you and how you can get reimbursed there so our Medicaid residents um we get between $4 and $5,000 per bed um for our Medicaid residents um going through that and uh of that um 75 to 80% of that is comes from Government funding um comes through the daily rate that we Bild to Medicaid uh Medicaid is a federally funded program that is administered at a state

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level so it it's government funded basically um and it kind of goes through that process that that video that I just gave you will help you better understand a little bit of what that looks like and then if you need some extra guidance there then just feel free to reach out to me um you can do that at Assisted Living investing. net strategy um to set up one of those free strategy sessions so um yeah hopefully helps you out a little bit um and I can try to stall for you for just another minute if you had

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any extra follow-up questions there um but hopefully that has been helpful for everybody to understand the different license types and um maybe the different areas that you want to get into once you get Beyond one of those license types now you're getting into skilled nursing and we don't talk about skilled nursing on on this channel it is a higher level of care um that was it would be what is called the nursing home a lot of people think when they say Assisted Living they use nursing home and assisted living

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interchangeably that is not the case they are different things and so you want to be aware um that we are talking about Assisted Living not nursing homes not skilled nursing and so if that is um you know just I want you to keep that in mind skilled nursing is is a high level of care it's a different application process a different process to to get you where you want to go so uh if you're interested more in in that um go ahead and type skill nursing we can get into a call or do a live session on that um

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later on as well so and Deborah you're welcome I'm happy to help uh again we do these live sessions on Tuesdays typically they're at 1 pm Eastern I had a bunch of meetings and stuff today so we had to do it later but uh love having the engagement and a lot of people here um and uh thank you for being here and for your attention uh does residential Assisted Living sound interesting to you but you don't know how to get started at Assisted Living investing. net we help we're here to help beginners like you

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launch their Assisted Living business in 12 months um and want to remind you that it doesn't take a lot it really doesn't just takes a little bit just keep going keep making progress step by step by step and if you do that and you're consistent and persistent in your efforts to do this you're going to be okay you're going to be able to make it so again thanks for watching and we will talk to you next week thanks and have a good day