The Road to Financial Freedom

S2, E1: The Ultimate Guide to Residential Assisted Living, with Isabelle Guarino-Smith

August 01, 2022 CamaPlan Podcasts Season 2 Episode 1

Info

The Road to Financial Freedom

Aug 01, 2022 Season 2 Episode 1

CamaPlan Podcasts

Today’s guest, Isabelle Guarino-Smith, of the Residential Assisted Living Academy has been following in her late Father’s footsteps, Gene Guarino, by leading, teaching, inspiring her students. She is here today, keeping Gene's legacy alive by helping others understand the need for Residential Assisted living. As well as explaining the many benefits that this type of living can have on, not only the person living in the facility but also how it can be beneficial from an investment point of view. Isabelle is the COO of RAL Academy, named a top influencer in the assisted living community, owns and operates three assisted living facilities that she inherited from her father, and much more!

More from Camaplan:

https://www.camaplan.com/

For more information on the RAL Academy and Isabelle:

www.RAL101.com

https://www.ralnationalconvention.com/

https://get.residentialassistedlivingacademy.com/blueprint/

https://pitchmastersacademy.com/

https://qf872.infusionsoft.app/app/orderForms/RAL-NAT-CON-2022?cookieUUID=270678cf-b409-4fe2-b0f9-3d58d75511e5

Use Promo code: CAMAPLAN for $100 off tickets to this event!

https://twitter.com/ralacademy

https://www.facebook.com/ResidentialAssistedLivingAcademy/

https://www.instagram.com/ralacademy/?hl=en

Call the number below during business hours (8:30 AM - 5 PM EST) to schedule a phone consultation: (215) 283-2868 Toll Free: (866) 559-4430.

TRTFF 2.1

Ricci Truong: [00:00:00] Views expressed by Cama plan podcast. Guests may not reflect those of Cama Plan Cama plan does not guarantee the accuracy of information provided by guests, nor does it endorse or recommend any individual or organization Cama plan is not an investment advisor, CPA, realtor, or attorney. You are encouraged to conduct your own due diligence before making investment choices.

For any tax legal accounting, investment, or other questions, please consult a specialist. Welcome back to the road to financial freedom, where experts share stories and secrets to unlocking financial independence. This podcast is brought to you by Camma plan a self-directed IRA administrator, focusing on educating investors on how to grow retirement savings faster through alternative investments.

I'm Ricci Truong Cama plan team member and podcast host. In each episode, we're going to take an in-depth look at the many roads taken financial freedom and how they differ for each guest.

[00:01:00] 2022 has been a year of ups and downs, and we're only halfway through this ride. The housing market has been crazy for many investors and owners, alike. Millennials are finally able to get into that housing game and they're finding their future homes. But what about the baby boomers? They're the ones that are gonna be moving out of those single family homes. What do they do next? That's gonna depend on their financial situation and could also depend On their children and grandchildren's decisions.

Today we have our guest Isabelle Guarino Smith, and she is going to be filling in those gaps for us. She's the Residential Assisted Living Academy's, COO. She is the leading lady for the team at RAL also known as the Residential Assisted Living Academy . And she has been working in this position as COO for six years.

She's been featured in magazines and articles regarding senior housing. And most recently was given the title And what I think is the coolest, the top influencer in senior housing. Hi, Isabelle, how you doing today? Welcome to the podcast.

Isabelle Guarino Smith: Doing so good. Thanks for having me. And that was a beautiful introduction.

Ricci Truong: Thank you. We're trying something new.

Isabelle Guarino Smith: I love it.

Ricci Truong: So really excited to be speaking with you today.

Isabelle's gonna be leading off our podcast series for season two. So I think it's a great way to introduce our podcast again, after our hiatus and what a great guest to have on here.

Isabelle Guarino Smith: So happy to be here. Thanks for having me.

Ricci Truong: Thank you. So I would love you to tell us, a little bit about you. What is your background? What got you into the residential assisted living tell me about it.

Isabelle Guarino Smith: Yeah. So for me and my family, honestly, it started pretty close to home. My grandmother fell, broke her hip and the doctor called and basically said she needs 24 7 care. What are you guys gonna do?

And a lot of [00:03:00] families deal with a situation just like this with their own loved ones. And it comes a time where you say, oh gosh, are we gonna quit? Is someone gonna quit their job and take care of grandma full time? Or are we gonna put her into a. Home. And as soon as you say it, you feel a little icky, right?

It's no not beloved grandma in a home. And in home care is another option, but it's extremely expensive. My grandmother was living in upstate New York. We were living in Arizona and I think a lot of people think of Arizona and Florida as oh, there's a lot of seniors.

So we figure. There's gotta be better opportunity in Arizona. We have to be able to find something more suitable because there was really nothing we felt comfortable with in upstate New York for her. So we searched and we found residential assisted living. And my dad being the real estate investor that he was, he ended up purchasing the home and the business right away instead of just getting, my grandmother, a bed in the home.

He was like, no, let's go all in. [00:04:00] Let's do this. And over the course of the next couple years, I watched him go from being, a landlord and overseeing all of these homes and being a little cranky, dealing with tenants and toilets and all the drama that comes with it to being like this super lighthearted, loving guy.

And every time he went to visit. His home for grandmas. We were like, why are you like so happy? Like he was making better cash flow. He was so fulfilled. And so slowly I was like, tell me more. And I started visiting the homes and really getting involved and growing into my role there.

I ended up quitting my job as a flight attendant and joining my father full time with the company, I was his first employee and we've built the team to over 50 people and built eight companies over the last couple years. It's been a lot of fun and my dad passed in October. So everything was left and blessed to be left.

I'm very thankful and grateful that he left everything to me. So now I'm the proud owner and operator of three residential assisted living care homes here in Arizona, as well as [00:05:00] those other eight companies where we teach and train investors and entrepreneurs to do exactly what we do.

Ricci Truong: Wow. Wow. So usually when, a parent that owns a business passes away, it's a burden for the family.

How did it fall onto you, did it feel like a burden? I know you said it felt like a blessing. Can you go into that a little bit more?

Isabelle Guarino Smith: Yeah. I always, actually I feel like that's my mission right now is to encourage, adults who have children to not just leave them trusts full of money.

Money's cool. But making an impact is way cooler. I've had the such an blessed opportunity to have those three cash flowing businesses passed down to me where I'm making a massive impact on our community by providing really awesome jobs, helping families just yesterday. I got a call from one of my old bosses and she was telling me like my "sister it's her brother's wife.

My [00:06:00] sister needs assisted living. What do we do?" And just the pain and the drama and the guilt and the frustration and anger and all these emotions you feel in her voice. And to be able to be like, Deep breath. It's okay. I've got you. Like I'll, help guide you to the right place was so it's this is why we do what we do to be able to help these families in times of need.

But more importantly than that, if I can catch you before you need it and have you open your own home, now you can solve a problem for your own family. My dad built these for his mom, with the intention, for him to move one day right into them. So we wouldn't have the burden of having to, figure out what to do when he needs it.

He passed before he needed it, but my mom's still here and maybe she'll need it one day. , I think it's a major blessing and I'm super grateful that I was able to really learn the ins and outs of the business and work alongside with him, over the last couple of years. So that way I did feel confident and comfortable being able to take everything over and take the reins from there.[00:07:00]

Ricci Truong: Wow. Yeah. You just speak so passionately about what you do, and I know that you teach courses, is that correct on how to own these facilities?

Isabelle Guarino Smith: Yeah. Yep. So we teach investors, entrepreneurs, medical professionals, whoever you are, who wants to get into this industry, how to own and operate, or just invest in these type of.

Ricci Truong: Oh, wow. That is really cool. I just, I never hear people speak so passionately about what they do. It's usually a dead end job or, something they don't love. And you can we're on video right now for those of you listening on podcasts. But her eyes just light up talking about this.

It's so intriguing to me. I know you had mentioned your father. That was Gene Guarino correct?

Isabelle Guarino Smith: Yes. Yes.

Ricci Truong: And I heard that he's an inspiration. So we had spoken about this, but the, principal at Cama plan, our CEO he's actually taken one of the courses when your father was still teaching.

And he just told us it was a [00:08:00] cool experience, very enlightening. And I just, it's really interesting to see how someone can become so passionate about what they do. Your father was passionate. He passed that down to you. It's awesome. I was. Looking into, your courses and things like that.

And what makes someone want. Be in this realm is it specifically like your same story of grandma needs to find somewhere to go? We gotta learn. And we have to be that landlord almost like someone had spoken on a previous, podcast you were on and said, it's almost like parents owning a college, housing for their child to live in.

Tell me. What your clientele is and how do they really get into that comfort zone, especially if they don't come from a medical background,

Isabelle Guarino Smith: yeah. We are, the people in our courses are there for all sorts of reasons. A lot of people don't think about this time of life until it does hit them in the face.

So there are many people in there who have their own stories, their [00:09:00] own experiences of either currently dealing with this or dealing with it in the past, or having fear of dealing with it very soon in the future. So that is definitely one category of someone who's interested in getting involved in this.

A lot of other people are just there because the returns on their other single family investments are nowhere near as good. And maybe we met them at a real estate event or somewhere where, our offering was way more attractive and competitive to be cash flowing, $10,000 a month or more on one single family home when they might be using it as a rental, getting a couple hundred bucks a month, it's very attractive to them.

So a lot of just real estate investors are honestly there, mostly for the cash flow. And then I think. My dad experienced that fulfillment side. You don't get a lot of fulfillment outta being a landlord. You don't get a lot of fulfillment. Maybe you do outta doing fix and flips, right? You feel a little bit of joy once it's done and it's beautiful, but then it's over and you're out of the job.

That's not cash flow. That's cash. Now, you're still stuck in the rat race [00:10:00] doing fix and flip. So real estate investors are really attracted to this. And then oftentimes we do see medical professionals who are really sad and burdened by what's happening in the larger facilities in the hospitals, things of that nature.

And they say I've got to help. So many people go into a medical profession. They want to help people and then they get in the environment and they're literally physically not able to do that because they're being so overworked or the way the systems are set up. It's pretty corrupt. So it's pretty fun and interesting to watch them, try to come into our industry and basically say, I just want to help yeah, the cash flow's cool.

But I'm making money of being a doctor over here. Or, we have all sorts, anesthesiologist, dentist, whatever. It's usually not about the money for them. It is way more about the impact. So we have all sorts of people in there. Our impact people are at home people, our cash flow people, whoever you are, whatever attracts you to this, it doesn't really matter.

Anyone can get into it. There's no, restrictions on who [00:11:00] you are to get involved.

Ricci Truong: Wow. That's interesting. So you had mentioned something about people being worried about other types of facilities. So take me through what makes a residential assisted living facility versus I believe you called them a big box facility.

I think that's what we talked about in our last meeting. tell me like why it would be more enticing for a family member to put grandma or grandpa into your type of housing.

Yeah. So in a big box facility, right? That's what I, that's what I term like the Brookdale, the sunrise, the atrium. We've all seen them. We've all driven by them. They're the big boxes. So those are typically, there's a couple things that are going on. Number one, the resident to caregiver ratio is significantly higher than it is in our homes. So over there you might have one to 15, one to 25 at nighttime. I've seen up from one to 50 that's insane.

Isabelle Guarino Smith: One person [00:12:00] cannot take care of 50 people. And that's where you hear the horror stories is that my mom called her call button at 10:00 PM. And someone didn't come until 2:00 AM. It's not that caregiver's fault. It's the fault of the system being set up to say. That's okay. That's allowed, it is what it is.

We only have one person on tonight. That's not okay. In our homes. They're single family homes in residential setting, just like you or I live in, so a normal neighborhood per se, typically upscale, typically in a luxury setting. But usually a large property that's custom, built and or retrofit for seniors.

So our homes here in Arizona, they are 10 bedroom, 10 bath homes. I know that sounds very big, but they're only between. 3,500 & 6,000 square feet. So it's not crazy big. It's just, we've retrofit them to suit what we're looking for. They still have the shared kitchen, bedrooms, bathrooms, everything the, a little library and office.

They still have everything that you need. It's a [00:13:00] regular home just instead of mom, dad, and two kids. It's 10 seniors. They have 24 7 care. The ratio is more like four to one or five to one at the max. So it's a lot better resident to ratio caregiver, the other big component or difference between a large facility and a residential assisted living facility is the cost of care.

So the cost in a big box facility, they might lock you in at, let's say $5,000 a month, right? The national average is $4,500 a month to have assisted living care. That's the national average. So every state varies up or down, right? So let's say you're at a big box facility and you've agreed to.

5,000 for grandpa to live there. That bathing day is on Tuesday and grandpa wanted to take his bath on Saturday. That's an extra $500 or breakfast was from seven to nine, but he wasn't hungry until 10 30 extra $500. So that first month, even though you've signed up for $5,000 to [00:14:00] pay for his all in care, the bill comes in its nine grand.

And you're like, what the heck happened, grandpa and he's I don't know. I'm just living my life. It's not like they're telling him, they're just gonna rack up the bill and send it to you. At the end of the month, we hear this story time and time again, in our homes, it is truly that one flat rate.

And it includes whatever that senior wants all their meals whenever they want them their, medications their care, their love and care, going to the bathroom, showering, bathing, whatever they need whenever they want it. If they don't want a bath on Tuesday, Great. We'll give it to you when you want it.

So the care, the level, of care and the price points are two major differences. Another difference that's in favor of a big box would be the level of activities you can provide. So a lot of those you go and they've got pickle ball courts, they've got movie theaters, dance, see there's gyms, right?

When you're in a residential home, you're only able to have so many amenities. So a lot of our students like to build homes that have [00:15:00] movie theaters, hair salons, and then a nice feature in the backyard, whether that's a pool or a garden or walking paths, but we're not gonna have all the same amenities that a big box will.

So that is one difference that kind of leans their. Something to remember is if it hurts to get out of bed and walk to the kitchen, you're probably not playing pickleball. So those features are really there to attract daughter, Judy the adult child paying for mom or dad's care. They're not for grandma or grandpa's use, it's really for daughter, Judy to say, wow, I'd love to live here. This looks amazing and trust and believe it attracts her. But at the end of the day, when she finds out, mom's never even stepped outside the door, let alone go to the tennis court. It's okay, what am I paying for?

Ricci Truong: Wow. Okay.

So take me through how much it would be for someone to invest in this type of facility. Is it, unreachable? Is it crowdfunded? How do they do this?

Isabelle Guarino Smith: The funding [00:16:00] components, there's kind of four different ways to get started, and they're all gonna range on how much you need or how to raise that capital. So first you could lease a home to do this. You could be partnering with someone who's gonna retrofit the property and you're just gonna lease the property from them.

You don't even have to own it. So you just have to come up with that money for the lease. And then probably two months of carrying costs while you're getting the business up and running. You can also buy land and build a custom home from the ground up. We've got students in the Midwest who do this all the time.

Obviously that's the cost of the land, the cost of the renovation. And then again, you're carrying cost to keep it, running for a couple months until you're full. Second, you can buy a single family home and convert it to become an Rao. So that's again, the cost of the real estate, how much renovation you actually need.

We're always gonna advise, don't buy like a thousand square foot home and you're gonna be adding on four. Like that. Doesn't make sense. Start with something that's. Already as close to what you want it to be. So it's the most minor renovations possible, but [00:17:00] you're not gonna find a 10 bedroom, 10 bath anywhere, you're gonna have to do renovations , but as, as close to it as possible.

And then the other way that you could do get into this is buying the real estate and the business. Like I mentioned, my dad did when we first got in the game, that's one of the fastest quote, unquote, easiest ways to get into this because you're up and running cash flowing day one. But the capital on that is obviously gonna be a lot heavier because it's that business and the real estate purchase right away.

So it ranges with each of the four categories. And then depending on where you are in the country, we've seen people in for 300,000 and we've seen people in for 3 million. It completely ranges. But in our training, we always teach you. Don't use your own money, right? Robert always says, like you're being lazy.

If you use your own money, other people's money. So you could definitely do syndications. You could do crowdfunding. I know with you guys and like the IRAs and everything like that, there's a lot of opportunities that you can invest. So I know that [00:18:00] partnering, with Cama plan and different companies like that, that can help you, find creative ways to get that capital.

It's a real benefit to you. And that's why I think it is such a perfect fit for us to be talking today because raising the capital for these projects, a lot of people don't, I don't want you to use your own money. We don't advise. That's not what we do. It's not what our students do. But a lot of people that is their first concern is how am I gonna come up with that money?

And it's. Don't worry, deep breath. You don't have to there's options and can plans got your back?

Ricci Truong: thank you. Yeah, we totally do. And that is something that we definitely do. We find big syndications and we love having our investors invest into these syndications so that, other terms would be a crowd funding for, our younger folks on this but yeah, no, Hey, if anyone wants to, give me some money, I can start this investment.

We can go all in I'm in . That's amazing. So you had mentioned four different like regions, or I guess pricing tiers. Am I saying that correctly? [00:19:00]

Isabelle Guarino Smith: Those four ways to get started yeah.

Ricci Truong: Okay. So tell me about the four different ways that someone can get started. I, you said there's a range from, the 300,000 to the 3 million, what's it look like in between there.

Isabelle Guarino Smith: Yeah. So again, it's gonna really range on your like state and then of those four ways you could get started what you're doing. So if you're like leasing the property and you just need carrying costs, that's very. That's on your lowest end of how much capital you're gonna need. If you're building land and going custom from the ground up, that's where our students get into the high millions, right?

Because if you're building a custom, for example, Brad, our student out in Kansas, I wanna say he spent at least 2 million on the land custom build for a 16 bed, 16 bath home out there. It is stunning. Wow. And he's making a ton of money right now, but it, it cost him a bit upfront. He's a general contractor by trade.

So he was like, this is right up [00:20:00] my alley. I wanna do this. I love to do this. So it just depends for us. Like I said, the first one we purchased the real estate and the business when you're purchasing the business, obviously there's many ways you can evaluate a business. This isn't like tech, right?

Like the new TikTok where they're saying, oh, it's gonna be worth 10 X this one day. So we're gonna pay $5 billion. No, it's not that it's more of it has to do with your, your cap rates and your different percentages like that. And we go through how to evaluate the businesses in our training so that our students know exactly what to look for and what to avoid where that good range is.

But it really just depends on those four routes. And then where in the country you are on how to take that next step and what to do. But the most important thing is what we just said. You don't have to use your own capital, so it's nothing to be afraid of because you're gonna feel really confident and ready to move forward. Once you've learned all the information that you.

Ricci Truong: Yeah, definitely. And I feel like having a teacher that's so passionate [00:21:00] about what they do, it makes the student, who's also the investor feel more comfortable and confident in what they're going to be getting into.

Isabelle Guarino Smith: I appreciate that. Yeah. Yeah.

Ricci Truong: Yeah, definitely. We had mentioned earlier that your father had. Hired you as the first employee. Are you the only one in your family that does this, or is it like a family affair?

Isabelle Guarino Smith: So over the course of the last couple years we have had my sister, her husband, my youngest brother, my other brother, his wife, my brother-in-law currently works for us, his wife, my uncles.

It's all sorts of family, my husband, my mother-in-law, my custom of my cousins. We've got plenty of non-family too, but lots of fam in the business. And it's been super fun. Being able to work with them. I it probably the best experience of my life. Honestly.

Ricci Truong: Really? Yeah. I've seen other businesses where you get involved with family and or friends and it just isn't the best match up. So I guess you're really lucky in the fact that everyone is working [00:22:00] together. Do they all love it as much as you are? They all as passionate?

Isabelle Guarino Smith: What's interesting is I always tell people like, okay, so don't work with family or friends who does that leave enemies and strangers. I wanna work with people.

I love, I like have fun every day I go to work cuz I wanna talk to them, and we'll talk work, and then we'll talk life. And it's this is great because work is so much a part of our lives. So why wouldn't you want to combine them? And why wouldn't you wanna spend more time with the people you love the most?

Now I know not everyone has the best family in the world, , this comes with a big asterisk on it. But no, I think that most of throughout the years we've had family members come and we've had family members go. So not everyone is still in the business. This definitely over the years you've got to really remember that.

If you are going to work with family and friends, it's so important to have everything written down and contracts laid out because I always start that relationship by saying, Hey, I love you. And I wanna work with you and I trust you, but I don't trust your [00:23:00] spouse's lawyer. Because at the end of the day, when something happens, that's what it comes down to.

I don't want things to go wrong. I don't want this to ruin our relationship going forward. So it's so important to have everything contracted, make sure everything's really clear. And also continuously giving people an opportunity to outgrow you. Like I said, we've had family members here and when some of them are gone now and some of them have outgrown us or we outgrew them.

And having that really open, honest relationship to be able to say that I think is what can keep relationships strong and moving forward. If you're not able to be honest with them normal, then you're not gonna be able to be honest with them in business. So I think that's also something to remember before even considering getting into business with family.

How honest are you with them?

Ricci Truong: That's so true. I love that. Speaking of family then, so what did grandma think? Had she ever been in one of those other types of facilities before [00:24:00] you found the residential living and brought her in there? Cause she lived in the one your dad owned, correct?

Isabelle Guarino Smith: She never made it, she passed before. We owned it. Oh no, but I know. But it all started because of her. And I feel like , in the weirdest way, like destiny, like we wouldn't have been in this industry. We wouldn't have even known about it unless this happened to her and it completely changed the trajectory of my entire family's lives.

So in the strangest way, it's a massive blessing. She passed before she could move in, but in the interim we didn't have her in a home cuz we couldn't find anything that we felt suitable. We had her with in home care, which in home care obviously is where a caregiver comes to your home. And if you need 24 7 care, the rate is $27 an hour on average. So 27 times 24 times 30 that's 19 grand a month. It's insanely expensive. So when people say, oh, don't worry, [00:25:00] mom, I'll never make you move and never make you leave your home. Yeah. You're really gonna foot that bill. Like most people can't afford that, on top of all of your life bills. Just. Shelling out an extra 20 K for your mom or dad to stay at their own home. So many people say, oh, I don't need 24, 7. I'll take nights and weekends. And I just need someone to be there while I'm at work. If a senior needs 24 7 care and you are gonna be the caregiver on nights and weekends say goodbye to church wine club, book club, your kids' PTO meeting.

Like you don't have a life anymore because it's not like grandma, you can just pack her up, put her in the car and truck her over to a soccer game every day. It's painful. It's hard for them to get up and move and walk around this isn't golden girls. This is like the last three years of their life, so it's very different. So in-home care is usually very short term, temporary or people commit to, Hey, I'm gonna be the nights and weekends caregiver. And we're only gonna have it during the [00:26:00] day, which is still insanely expensive.

Yeah. You said $19,000 and that's a month. Is that correct?

That's what you just said, right? cause I was too busy with my eyes bulging outta my head, like a cartoon character. When you said it, that I couldn't comprehend the rest of what you were saying. That's insane.

Ricci Truong: So then tell me about. If in home care is so much how reasonable is what you do, because I would equate that to be something similar possibly in my own mind.

Isabelle Guarino Smith: I think it's as similar as you can get, right? Because in home care, you're obviously in your residential home, you've got one on one care, residential assisted. Living's kind of that next step where it's yeah, you might have 10 other roomies, living in the house. They're not in your bedroom.

You still have your own private bedroom, private bath, but your care is four to one or five to one. So your care ratios, obviously a little bit up, and then you're still in a residential setting, but you do have other people living in the home. Then a big box is where you have, usually 20 or [00:27:00] more.

It could be upwards of thousands in one facility, which feels a lot more. Hospital not even apartment vibes, cuz it's not individual like rooms a lot of time it's or it is individual rooms. It's more, it's not like home. It's just, I don't know. It feels very hospital like so residential assisted living and assisted living.

The average cost in the nation right now is $4,500 per month per resident. So in the grand scheme of assisted living world, that's very reasonable when you're comparing from in-home care, or a big box facility, which might upcharge you for other things. So it totally ranges on your state. I wanna say DC is one of the highest rates right now.

Wow. At 6,900 a month on average. That I. Met quite a few people in DC who are paying for their parents 10 K a month to live in an assisted living home. It's wild.

Ricci Truong: So then when a [00:28:00] Judy, as you call her daughter, Judy, I love that. When you're trying to, when you're in the facility and you're trying to convince her to do assisted residential living, what is the enticement factor besides, just the, the beautiful home that they're gonna be moving into. Is there certain amenities that you usually offer? Do you have a certain kind of staff? Is there a certain kind of care level that you

handle?

Isabelle Guarino Smith: Yeah, most of the time senior, living's like an avocado, right? It's too ripe. It's like perfect for a day or two, and then it's gone bad. So when someone needs assisted living, they're not touring being like, oh, I think my mom might need this in a couple weeks or a couple months. It is almost always. She needs to move in now or like tomorrow, like it's, they're touring and they are stressed to the max and it's just okay, I'm seeing three or four properties, which one is the best, which one, do I feel the most confident and comfortable in?

So when you walk in to the home that wow factor, not only with beautiful real estate and, [00:29:00] decorations and whatever, but the comforting factor, the fact that you are a home, and you feel good. And then being able to meet your managers and your caregivers, the different levels of licensing will range.

If you are going to be just a assisted living home or if you're gonna offer memory care. Having a memory care licensed home, which let's be real. I forget my keys every day. We're all dealing with some form of memory loss. , so it's important that, even if you're not licensed for it, you're going to be dealing with it at. Some way, shape or form, right? Because we're all having issues like that. But when you have a true home that's licensed for dementia or memory care what you will need is a little bit of different requirements for the physicality of the home, different locks on the doors. You might have stairs in those homes versus our homes.

Don't often have stairs. They're usually single level, or if they do have stairs, there's an elevator or a chairlift in memory care homes. People are, who [00:30:00] are moving in. Not always, but traditionally people who are moving in. Their bodies are with it. It's their minds that aren't anymore. So physically they can move around. Usually the activities in those homes are much more active, they're actually doing dance class, they're able to do a lot more physical activities in those homes, but the leveling of licensure is a little bit higher.

The cost to live in the home is a little bit higher, usually somewhere between 500 and $1,500 per month, more per person, if you need memory care. And the level of the licensing of your caregivers is also higher. So you're paying them a little bit more because they've gone to more schooling or more training to get that level of licensing, just because there's different things you have to deal with and be aware.

It's a very different vibe in those homes than in a traditional assisted living home where it's a lot of physical issues. Like people are having trouble walking, bathing, going to the bathroom, putting the spoon up to their [00:31:00] mouth anymore. It's more physical things that they can't live alone. They literally need help, versus memory care. It's like they also can't live alone, but it's because they need that support, to remember where they are, what's going on, who they are.

Ricci Truong: That is interesting. I didn't realize there was so many different levels that could be within assisted living. So imagine I am the investor, what kind of range . Can they expect to make from an investment like this? Is there a possibility of, something specific or does it depend on the industry or the area that they're located in?

Isabelle Guarino Smith: Yeah. We teach our investors to get involved through one of three ways. So first is they could own the real estate and lease it to an operator. If they do this, then they should be making about twice the fair market rent because the person who's leasing the home from them, not only are they signing a longer term contract, not typically like a single family who wants to do a one or two year, they might be signing a [00:32:00] 3, 5, 8, 10 year contract with the landlord. So it's a longer contract. They're paying you more. Why are they paying you more? Because you retrofit the home, it's ready to go for them. You did a lot of the labor and the hard work up front. You may have even got the license on the home.

People will pay for that hard work that you've done too, to get the home, to have that stamp of approval from the state. So you've retrofit it. You've possibly got the license. They're willing to pay you more. They're willing to sign a longer contract and you might not be in charge of any of the maintenance, depending on how you set up that contract that could be fully on the operator.

So one way an investor could get involved is to just own the real estate, right? The other way is to just be a private lender or JV partner. So not even owning the real estate, not being an operator, literally just lending on this. Usually people are getting 12% plus a couple points when they're doing that on their money, but it really ranges depending on the deal that [00:33:00] you get involved with at our convention, I was telling you about our RAL national convention that we host in the fall.

There's a lot of people there who have a lot of capital who are basically walking around, trying to network and find good deals to invest in. So if you are on the operator side or the investing side, that is a great kind of place to match, make and meet people and network and see, if you want to partner with someone there, because there's a lot of opportunity, the third way that investor could get involved is we do right now and what we mostly teach our students to do. So that's to own the real estate and operate the business. Now we're not working in the homes and that's not what I advise you to do. But when I say operate the business, from an owner's box perspective. So it's more of Hiring those people setting up the policies and procedures, making sure things are running properly from more of a passive perspective.

It's definitely an active investment. In the beginning. You have to be way more hands on getting this up and running, [00:34:00] but you can transition it to passive over the years. So in that scenario, if you have 10 residents at the $4,500 a month, mark that's 45,000 coming in every single month as. Gross, 10 residents, times 45, that's 45,000. Now your expenses, including your staff all in should be and food and vacancies and miscellaneous and landscapers. And everything, all your expenses for 10 bedroom home should range right around that $28,000 mark. And then let's say your lease cuz in this scenario, you own the real estate and the business.

So let's say your mortgage payment is right about 7,000 a month because this is a home that has 10 people in it. So it's probably a bigger property, right? That's leaving you with $10,000 a month of net to you. That's your take home as the owner or $120,000 a year. Three different ways to get involved, getting that twice the fair market rent on the lease, getting that 12% plus a [00:35:00] couple points or that $10,000 a month of residual income coming in every single month.

Of course we teach you to do more than one because most people are like, I just need 10, 10 K just every month, just like to pay the bills and survive and get by and have fun. But if you want more than that, it's do two or three. We call it the three pack. We really encourage at least three. Cuz you can share your resources.

You can share your staff. You can, if one home's full, you can have residents come to another home. It's a lot better idea to have kind of more than one. Because if you're gonna do it, why not really do it,

Ricci Truong: yeah. For sure. I was gonna ask, but you started to touch on the topic, and I was just about to think of the question in my head and you had almost answered it, but tell me a little bit about staffing for these kinds of facilities.

Especially if for me, I'm not a medical background at all. I wouldn't know where to begin. How does someone, I'm sure you teach it in your course and we're getting a sneak peek of it here, but tell me a little bit about how [00:36:00] that works

Isabelle Guarino Smith: So in the beginning, the main person you're gonna want to focus on hiring is that licensed administrator.

So they're licensed through the state. You can find them on regular job websites indeed, or whatever you like to use. And they typically have experience in these. They're typically a caregiver who then went to school and kind of upgraded and trained up to become an administrator of the home.

It's somewhat similar to a property manager, but they do have more of that medical background. So jobs that they might be in charge of hiring and firing your staff, doing payroll, figuring out who's coming for those shifts. They might be in charge of the grocery shopping, dealing with the handyman and the landscapers.

They might be in charge of marketing or touring your facilities or welcoming the families, welcoming a resident and dealing with the doctors and doing that level of care assessment. So there's a lot of different things that they might be in charge of. They're pretty much running the business for you.

So you want to be besties with them. You wanna make sure that you really know and trust [00:37:00] them because they really are the heart and soul of your business for us, none of the residents or the families in our homes know that I'm the owner, they haven't even met me or seen my face. They know the manager the administrator that's who they.

Deal with and communicate with, I don't care if they don't know me, she is the face of the business. She's the one there every day. And I want them to rely on her and trust in her. So she, that person is gonna be your key, hire your first hire and your most key, crucial player. This other people that you're gonna be hiring is obviously your care caregivers.

And again, you can rely heavily on your administrator, help you with this because they're gonna be the ones running that staff. The caregivers are really in charge of the day to day care of the residents. So whatever they need from, bathing and getting up, helping take medications, whatever the senior needs, that is their primary focus.

And obviously communicating with the families as needed to make sure that the resident has everything that they need. And that they're really happy in some homes. The caregivers are [00:38:00] also in charge of cooking and cleaning. In other homes, you'll have a private. So in our homes, remember I said the average rate's 4,500, we have some homes that are above average, right?

Where most of our residents are paying six, $7,000 a month in that home. There's a private chef because we can afford it, right? Hey, so you get three beautiful meals a day, right? And the private chefs in charge of that, it also allows our caregivers to not have to worry and focus on that. They get to give extra care and love to the residents.

When you have a home that's at that average rate or below average, you might not be able to afford extra amenities like that. So the caregivers might also be in charge of cooking and cleaning and things of that nature.

Ricci Truong: Interesting. I hope one day I get to be in one of those fancy facilities with a chef. Hey, every meal, gosh, nice about it.

4,500. Fresh meals cooked by a chef, someone who will clean my room and do my laundry. I wanna move in, yeah. That's [00:39:00] actually pretty good.

oh my gosh. That sounds amazing. I would love to do that now. , can you be any age to be in an assisted living? Cause I would love that.

Isabelle Guarino Smith: I know, it's so funny. Most, mostly people are older, right? Your average person is a female who's 85 years or older typically. There's people who come in who are younger, maybe dealing with other issues who do need assisted living. We had a guy who was like 45.

He was wheelchair bound. And he was in there. He had, some health issues and he needed it. But typically, no, it's really for a lot of older residents who need that support and help. But I I think it'd be a really fun concept. Maybe we could just make our own home where we all live. We pay a flat rate, we get a chef, we get a, cleaner and we just make our own little pre golden girls home.

Ricci Truong: I love that. I'd be like Oprah, like having her private chef every day. Like I would be, I don't have to do weight Watchers, hey . So that brings me to a question because I was [00:40:00] intrigued is their, a version for a special needs home, or like a recovery home for people with drug addiction or anything like that. Would that fall in this realm of assisted living as well that you have seen, or that could be started?

Isabelle Guarino Smith: Similar but different. So through the state, they're all considered group homes. We're just one of the categories of group homes. But we do have a ton of people who come to our training who ask about homes for developmentally disabled adults.

There is a massive need in that, realm of the world right now, because what happens if you have, let's just say an autistic child whose outlives you. And who's going to take care of them. You took care of them their whole life. They're more than likely still living with you. It is terrifying for these parents of these children who have, more needs than, they're maybe able to take care of themselves.

The government does pay a little bit of funding, just like they do for seniors, about $1,800 a [00:41:00] month. I've been told. But those homes really aren't giving them top quality care, food love it's really bad. And unfortunately we haven't cracked the code with developmentally disabled homes, but I am desperate to help these parents because it's so similar.

I just need to find out how to make it make sense right now. It's the, I can't figure out the financial component to make it make sense to anyone. If we can crack that code, we can figure it out. So if. I'm still mulling that one over when it comes to recovery homes or shared homes, for clean and sober for maybe vets, maybe kids who were aged out of foster care. We've seen LGBTQIA+ homes, right? For kids who've been kicked out of their homes who need a place to live. There's absolutely a ton of opportunity in shared housing. In 2020, we launched a company recovery housing academy, which teaches and trains on exactly that because it is so similar and because [00:42:00] there's a lot of government funding, not a little, a lot in, especially the clean and sober recovery and justice involved categories.

The government will literally write you a check to. These different categories of people. So it's a lot easier to set those up and to get them running, but you have a lot more turnover and a lot more drama. We learned over the last couple years. So my heart is really focused on the senior category, but those are all different types of group homes. And we do teach and train on the recovery homes as well. Haven't cracked the code on developmentally disabled, but to come. And I will let you know when we do .

Ricci Truong: Yeah, please do. Because I actually, it hits home for me. I have an uncle with down syndrome and my he's lived with my grandparents, my entire life and his entire life. And he is rounding 50. That's not usual for down syndrome, but. Rounding 50. And I know that my dad is set to take care of him once [00:43:00] my grandmother passes. But she's also living life. I don't think she's going anytime soon. But it's, that's a worry, that's a thought, so please let me know.

Cuz I'll be part, I'll be first investor. I swear. So you had mentioned that you have other companies, okay. This is news to me. What else is what else is around the corner? Or what else are you doing that you're keeping hush. Hush.

Isabelle Guarino Smith: Yeah. So we have the residential assisted living academy, which is what we've been mostly chatting about and focusing on today under kind of that umbrella of companies.

We have the RAL national convention, which I mentioned. There's over usually 600 to 800 people there and 70 different vendors, 30 different speakers this year, Tracy tutor from Bravo's million dollar listing, Los Angeles is gonna be there. Wow. Wow. yeah it's a fun event and it's like kind of everyone who's in the industry or wanting to get into the industry. We love to invite them to come to that event because it's just a super fun place to [00:44:00] network, honestly, party and just have fun and learn all about different tips and tricks to really being successful in the industry.

Ricci Truong: I've heard some celebrities show up there too. Is that correct?

Isabelle Guarino Smith: Yes. We always have fun. There's been. So many great people in the past, Robert Kiyosaki likes to drop by the most interesting man in the world from those Doe's commercials back in the day used to come. like all sorts of fun people. It's a great event. We have the RAL national association, which is the only association for all of these smaller care home owners.

There's about 30,000 of these homes across the country today. And there was no association to represent them. So we created that. We got legal backing and lobbying power for them, lots of group discounts and different informational things for accrediting, CEU, and different things of that nature. So the RAL national association is a great kind of source for people who are in this industry who need to be represented because when something comes across, the table of a state.

The big [00:45:00] box facilities have a lot more lobbying, power and money to get things, to be pushed their way. So when no one is standing up for the smaller homes in our voice, in the industry, it's an issue. So we found that void in the market and just jumped right in and said, Nope, we're gonna do this.

We're gonna help. And we're gonna be here. So we P we give out like legal updates on everything that's happening across the United States at all times on that website so that people can just be in the know and whenever there's like a petition or something to sign, we're always like everybody come on.

so that, one's a fun one. We have pitch masters academy, which teaches people how to pitch, to raise capital and work with investors and syndicators and things of that nature. The nuts to bolts of creating that business plan to like getting in front of those investors formally or informally.

So that's a really cool program and training and company that we have and know, and love. And I think that's. Rounding out my, top five .

Ricci Truong: Wow. You are a busy lady. That is for sure. And speaking of [00:46:00] being busy, tell me about being the one of the top influencers under 30, in the senior housing community. That's just a big title. How do you live up to that?

Isabelle Guarino Smith: Thank you, they had reached out to us and it was really interesting because every year we attend all of the conventions that have anything to do with senior housing. And typically we're surrounded by the owners of the Brookdales and the sunrises.

And they look at us like you're small peas over there. So to have them reach out and basically say, we wanna honor you, and we wanna give you this, title and award. I was like, oh my gosh, this is incredible. And it really just shows the trends in the market and kind of what's happening.

What we're seeing. When COVID happened in 2020, people were ripping their parents out of big box facilities and begging to come into our homes because the level of care there was being exposed, people were seeing. There's tons of staff in and out, and you can't control [00:47:00] any disease coming in or out.

And so all of this happened and senior housing got a really bad rap during that time, but we just started rising to the top during that time because all of the people were trying to come to our homes, realizing smaller is better, and at the big conventions, the only topic that they all wanna talk about now is how do we make our homes look and feel like yours?

And it's you can't like your, you're trying, you'll see. You'll notice in, if you look into this people big facilities are now purchasing entire lots and building like mini neighborhoods now. And so they'll have five or six in a cul-de-sac and they're all residential homes, but technically they're all run.

The one conglomerate. So they're trying to do what we do. It's just very different, right? It's still the ones I've been and still don't feel as homey as ours do. But it's really crazy. So I think that award happened, honestly, because of COVID and because of the exposure to what we're doing, and [00:48:00] everyone saying there has to be another alternative, it's everyone's sick of taxis.

Where's the Uber. That's what we're trying to do is saying we're new. You might not know us. You might not feel comfortable yet, but as soon as you get inside that first Uber you're gonna be like, never again. I get a taxi.

Ricci Truong: wow. That's like a great analogy. I love that. Cuz like I was always sketchy about getting into the Uber originally cuz taxi was everywhere, wow.

And to be so successful through COVID where so many businesses were just closing their doors. That's absolutely incredible. What you did.

Isabelle Guarino Smith: Yeah it was strangely enough. I know many businesses sadly went out of business and a lot of businesses. We're here on zoom right now. They're booming.

They're doing better than ever. It just happened to be, we'd been preaching the message for a long time and it finally caught wind. And then it really turned in our favor and a lot of different press articles. News articles came out really just saying that same thing that people don't want these big facilities anymore.

They want something [00:49:00] small intimate that feels very homey. And it was pointing exactly to us, which is, better than we could have ever asked for. Hey, you got that big

neon flashing sign. That's perfect. Yeah. Who doesn't want that for marketing purposes?

Yep. Yep. Wow.

Ricci Truong: Okay. So we had mentioned like baby boomers, right? These are your ideal market that you're accommodating. So how does someone pay for something like this? When you are a senior, is it coming from them?

Is it coming from outside funds is insurance paying for it. Tell me about that.

Isabelle Guarino Smith: Yeah. So funding for the homes comes from a couple different ways, right? It's the senior served in a time of war. They might have VA benefits, which is an awesome opportunity to help them pay for it. Some seniors do rely on Medicare, Medicaid.

Like I said, it usually will be able to support about $1,800 a month for the seniors. So it's not much, but it does help some seniors some people have [00:50:00] saved up the baby boomers have saved up a lot of cash, they might have their IRA investments or they're planning to sell their homes. Like you mentioned at the beginning of this to pay for their needs. So a lot of people think that this greatest transfer of wealth from the baby boomers to the millennial. Honey, you're forgetting about assisted living. It's gonna go to pay for their time of need the cost of assisted.

Living's gone up 79% over the last 10 years. And if you look genworth.com/costofcare tells you how much assisted living will cost in your area. And the coolest part is there's a little toggle that you can say how much will it cost in 10 years? Like my mom doesn't need it now. Maybe in 20 years, maybe in 10 years, it is skyrocketing because the demand is completely not being met with the supply.

And as we all know, economics, like that's a case of a crisis right there, right in front of us. Currently the silent generation is who's in [00:51:00] assisted living, but the baby boomers, there's 76 million of them and they will need a lot of care and homes to live in. So this is a major opportunity that transfer of wealth is going from the baby boomers to the assisted living and whatever is left over will get passed back to down generations.

But if I have any say in it, I'm gonna take both pieces of the pie instead of just one. And you guys could too it's definitely up to you a crisis or an opportunity, however you wanna see it.

Ricci Truong: I remember when we last spoke , you were talking about The need for the assisted living facilities. I remember you mentioned 1.3 million beds are short. And is that over the next 20 years or is that right now?

Isabelle Guarino Smith: No, that is by 2025. So even in the next three years, we're we are 1.3 million beds short for the need. And then at the peak so in, I wanna say in 15 or 20 years at the peak when baby, cuz baby boomers aren't in assisted living yet.

[00:52:00] They're still thriving. My, my mom's baby boomer. She's doing great. livin' her best life. But no, but they don't need it yet. But when they do at the peak, there will be 11,500 people turning 85 every single day. That's crazy. This is. The fastest growing demographic on our planet, the 85 and up group, we've never had this many seniors alive at one time ever.

And the important thing to remember is it's not like it's this big balloon. It's not like the baby boomers come and then no need for assisted living. So all those homes are gonna shut down. No, hello. Almost every baby boomer had kids. And so the, if you look at demographics our world used to look more like a triangle, and now it looks like a rectangle because there's just more people alive than ever before.

So the baby boomers. Yeah. But they had kids and those kids had kids. And so it kept growing and growing. It's more rectangular now there's just more millions of people alive. So it's not something. Dies off [00:53:00] after the baby boomers are not no longer with us. It's something that's gonna keep going. Like we're gonna need this one day.

Unless we're getting care in the metaverse. I don't think anything's gonna be changing anytime soon.

Ricci Truong: Wow. Yeah. That's really interesting cuz I was thinking about that the other day. Like just there's so many baby boomers coming into this, cuz that was such a huge generational boom.

That's why they were named that generation. And all of them, I feel like during that time they all had multiple children. It wasn't just one, one child. So yeah. Wow. It's the need for it's insane. Yeah. I love that. I so that means that this business is not gonna be going away. It's something that's almost generational.

It can help build like generational wealth for a family that owns it. Huh?

100%. If you think just of my family's story, which is so similar to so many people, we needed it for my grandmother. I will keep it right now and be cash flowing until my mother needs it. And then one day I will be able to live in it and pass my children, a cash [00:54:00] flowing asset that they can one day live in and their kids can one day live in.

Truly every family should just have one of these. If anything, just to be your, retirement plan. I have so many friends who, whenever we talk about oh, our parents or what's going on, all of them say, can my parents come live in your home? Can my parents come live in your home?

And it's you should get your own come on, I'll teach you how to do it. To each the, they can all come live in my home, cuz this is the thing we're all gonna get involved in senior housing one way or another. You're either writing the check to somebody else lying in the bed or you could be cashing the checks and living there for free.

Isabelle Guarino Smith: It's up to you. I

Ricci Truong: love that. It must make you feel great though. And everyone's your facilities are so amazing. I want my family to live there,

that's a huge compliment. I would take it.

Yes. That's amazing. And so then we've already touched on generational wealth and how it's affected your family in such a positive way. What, how does that equate to financial freedom for you?

Isabelle Guarino Smith: Yeah. So being able to, all three of these homes that my [00:55:00] dad passed me basically are cash flowing $10,000 a month or more, on their own. And so being past that is absolutely like a dream. And that's why I say it was such a blessing that my father left these to me and not a burden at all, because I already knew what to do.

And it was just put it into action and keep them going in the way that I've been trained to do this. Financial freedom is so important and especially with our world getting really crazy, inflation, recession, gas, prices, politics, everything is super wild out there right now. It's the wild west outside. And I think it's more important than ever for people to really be thinking about. All of those things, right? Generational wealth, how are they gonna have enough money to survive up times? And down times like this, isn't something that you should it's just like a one time, make some money.

This is cash flow for the rest of your life. Residual checks coming in every single month, you set it up, you get it running and then you can run this more passively. [00:56:00] And that to me is the best type of financial freedom where I can sit here and be with you and not mind or know or care what's happening because I know it's being taken care of to the utmost quality and getting that check every month. Nothing is more freeing than that.

Ricci Truong: You have a positive outlook on life, and I really appreciate that, cuz there's so many people that are just so dark and gloomy about what they have to say and I just see how much you care. I really enjoy that. So we had mentioned the conference. Is there any promotions or any interesting things that you have going on that you wanna talk about before we, start wrapping up here today?

Isabelle Guarino Smith: Yeah. So the RAL national convention is coming up September 29th through October 1st.

It's in Phoenix, Arizona. And I believe we have a fun little discount code there with your. QR code. So be sure to check that guys out and use the Cama plan promo code so that you guys can get a hundred dollars off your tickets and come to the [00:57:00] event. It's super fun. Honestly, it's a great place just to jump in, get your feet wet and honestly, talk to our past students and really meet a ton of people in the industry to see if this is something you really do wanna get involved in and invested with.

And like I mentioned, you might be meeting a lot of investors, so always put your best foot forward.

Ricci Truong: yeah. And they should probably take that class on how to talk to investors that's your other course that you sponsor, right? Or it's under your umbrella of companies.

Isabelle Guarino Smith: Yep. Pitch masters academy is a great training to learn all of those different steps to, get in front of investors and know what to say, what not to say, how to attract them in the right way.

And that's an awesome opportunity to go from there. I think we also added my dad's free book. Yes. So my dad wrote a book just before he passed and we have it available to you guys for free for listening in today. I think it's free book, page chip. So use that QR code. Go ahead and download it. Learn more.

Yeah I love to share any info that we can so happy to.

Ricci Truong: I love that free info is always [00:58:00] great info and it also gives you like your feet wet into the, making that decision. If you really wanna get into that next step of learning about the process and really getting involved.

So I love that you're giving us those free opportunities and that great discount. That's amazing. Everyone can check out the QR code. You can scan it right on YouTube. The links will be also in the show notes and as well as the links below in YouTube. So if you can't scan a QR code, if we got you no worries.

And then Isabel le is there anything else that you wanted to touch on today that you think is important for our audience to know about you? Your company's, your lifestyle, whatever you want. Tell me something fun.

Isabelle Guarino Smith: Yeah. So I've had a lot of fun sharing with you guys today. This has been a really awesome episode so thank you so much for having me. It's been really fun to be here with you and I've just had fun, having great conversation with you being able to chat about everything. I know. If anybody wants to learn more just about the training, about everything that we offer.

[00:59:00] RAL101.com is a great source to go to free, webinars and free information. And we can also have a chat there. There's an opportunity for you to schedule a discovery call. So if you wanna chat with me or anyone on our team about your next steps, I know that this is a pretty different investment than you might be used to hearing about.

So I'm excited to be able to just expose you to this. And if this is ringing any, bells for you and you're like, man the cash flow sounds good. The impact that you can have on your community sounds good. And maybe your family needs this or might need it in the future. The time is never better than right now.

So I hope to see many of you at the convention and possibly talk to some of you guys at RAL101.com

Ricci Truong: And I definitely wanna take this course and learn more about it because I know we spoke about this before, but my husband and I are just getting into the investment realm of things.

We owned a home and we started renting it out and that's so far our financial freedom journey, but I would love to expand [01:00:00] that. And I definitely wanna look into your course. I hope I can come to that national convention because that sounds like so much fun. I just wanna say thank you again to you Isabelle I really Enjoyed speaking with you. I just wanna thank our sponsor Cama plan as well as our production team honeycomb productions. For more information on Self-directed IRAs, go to camaplan.com where you can request a consult with an expert, view our media library of webinars and previous podcasts, or open an account today! Thank you for listening and remember, to like, follow and share our podcast, The Road to Financial Freedom, to continue with us on this journey on the path to finding success. Please follow the QR code. If you're on YouTube, otherwise check the links below. Thanks for listening!

The Road to Financial Freedom

S2, E1: The Ultimate Guide to Residential Assisted Living, with Isabelle Guarino-Smith

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