Ep. 149 – Marcia Miller – Alternatives for Assisted Living

When it comes to assisted care living, there are other alternatives much better and more affordable than the big facilities.

The adult family care home is an affordable form of assisted living, where the homeowner lives with their residents and offers them a more personalized type of care. It is also a great venture to start as part of your retirement plan to help you gain financial stability.

In this episode of the Secure Your Retirement podcast, we have Marcia Miller, owner/CEO of the Serenity Adult Family Care Home, a 5-bed residential assisted living facility. She’s also the founder of the Spill the Beans Institute, where she helps people learn how to care for their loved ones at home.

Listen in to learn how starting an adult family care home can help you gain financial stability while providing quality care for your loved ones.

In this episode, find out:

• Why private caregiving homes should be considered as a viable option.
• The one-on-one experience that the adult family care home provides as opposed to the big assisted living facilities.
• How you can gain the skills to care for your loved ones at home and gain some financial stability while at it.
• How being a caregiver can help you plan for your retirement.
• How a good health assessment is used to determine if a client is eligible for an adult family care home.
• How to find an adult family care home for your loved one if you’re in Florida.
• The importance of preparing and planning for assisted living at any age as part of your retirement.

Tweetable Quotes:

• “The adult family care home is where the owner lives with the residents.”– Marcia Miller
• “The adult family care home price points are way less than say a nursing home, and you get to give your loved one a person-centered care that they truly need and deserve.”– Marcia Miller

Get in Touch with Marcia:

LinkedIn: https://www.linkedin.com/in/marcia-miller-927b80166/

Resources:

If you are in or nearing retirement and you want to gain clarity on what questions you should be asking, learn what the biggest retirement myths are, and identify what you can do to achieve peace of mind for your retirement, get started today by requesting our complimentary video course, Four Steps to Secure Your Retirement!

To access the course, simply visit POMWealth.net/podcast.

Here’s the Full Transcript:

Radon:	Welcome everyone to our podcast today. We are actually, on the podcast today, going to be doing an interview. We tell you every week… we kind of go back and forth between what Murs and I call retirement and action and then when we think we can bring something of value, we bring in a special guest. And today I think we have a very special guest. Her name is Marcia Miller. She heads up what’s called the Spill the Beans Institute, and we’ll learn more about what that means. And she is coming to us today out of Orlando, Florida, where she says, it’s not that warm, but it’s better than here in North Carolina, I’m sure. So anyway, Marcia, thank you so much for coming on to our podcast and having a nice conversation with us.
Marcia:	Good morning. And it is my pleasure. And I don’t mind telling you I was in Greensboro, North Carolina for about 11 years.
Radon:	Oh, okay. Great. So then you know North Carolina then.
Marcia:	Yep.
Radon:	Good. So Marcia, could you… just because, I mean, obviously we’re bringing you on as a guest… it’s called Spill the Beans Institute… that probably doesn’t tell our audience very much about what you do and what your background is. And I think what you do in your background is going to fit very nicely with our audience. So could you please just tell us a little bit of background, what the institute is about, and what you do and what your background is?
Marcia:	So I’m the owner/CEO of Serenity Adult Family Care Home, which is a five bed community here in Orlando, Florida. And just in keeping with the conversations that you’ve been having about individuals knowing all of their options when they get ready to select a care home… and oftentimes the private homes are overlooked and so just wanted to come on and talk a little bit about it as option. I got into it because I was a caregiver of my own family member for about six or seven years. And when I started my journey, wow, what an eye opener.
Murs:	Great. So, so my immediate thought is when we talk to clients and sometimes they’re younger, but we’re always thinking about this idea, hey, you got to kind of plan in the back of your mind when things start to health wise, start to deteriorate, you got to have a plan… whether it’s having someone come into the house, whether it’s family members, or some help, or transitioning into a different type of community and we like presenting as many options as possible, at least making sure the ideas are out there. And quite honestly, I’ve never really heard of the private side, the smaller side, that you’re talking about, which I think could bring a lot to the table for certain individuals.
	We go through exercises all the time from the financial perspective of, hey, can you afford to move into what’s called a CRC, a continuous care retirement community that eventually transitions into assisted living if needed or going directly into assisted living. And so can you tell us a little bit more about how that… because those are obviously larger institutions. They have big staff, big places, big campuses essentially. And so tell us some of the differences between that idea and then this private home idea.
Marcia:	Sure. So in caring for my aunt, what I discovered… you know how it is… they get the phone call and you’re not sure what you’re going to do and you don’t know anything about the industry. My background is business development and marketing… it has nothing to do with healthcare. But I learned quickly what to expect from the larger communities. And then I started doing research and discovered, ooh, there are private communities, [inaudible 00:04:23] so you can have something that is appropriate. So I selected a larger community for my auntie. But little things started to bother me… things like, you couldn’t get a bath every day. She was a registered your nurse for 30 years, so that really bothered us as a family. We wanted more care. I figured out what we needed to get licensed. I got licensed and I brought her home.
	Now in Florida, you have the adult family care home, which is what I have, where the owner lives with the residents. So I live with my clients. Now, the assisted living facilities in the private homes, you do not have to live with your clients. You have a little bit more flexibility there, but we provide the same type of care to the individuals that we’re serving. And the price points are way less than, say, a nursing home. And you get to give your loved ones that person centered care that they truly need and deserve. So that’s basically the difference. Pricing is a big part of it. And the fact that now you have one-on-one… if any of my residents sneezes, I know who it is and get to them really quickly.
Radon:	So, I mean, that again is very intriguing, I guess. So I want to be clear on one thing you just said. So you drew a difference there between assisted living and the way you are set up. What is… how would you describe how yours are set up? Just a… I mean, a place where people have someone there that can check in on them. I mean, how would you describe it compared to an assisted living?
Marcia:	They’re identical. It is… this is my home. This is a four bedroom house with three bathrooms. They live here with me. My staff is here today. She comes in at seven. She takes care of them. I have a weekend staff. I operate it just the way an assisted living does. For licensing standpoint, the only difference, is that I must live with my clients.
Radon:	Okay.
Marcia:	Whereas in the AlF, in a private home, you are not required to live with your clients. That is the biggest difference. In terms of the kinds of clients you serve, we pretty much can do the same kinds of clients. It’s a standard license. There are just certain things you cannot do. Like if it’s a bedbound individual, someone that’s high acuity, that’s not something either one can do. If that makes.
Radon:	Yep, absolutely. So, now you gave us the background here as to how you got into this. And I just want to kind of… and we’ll come back probably and have a big round conversation here, but now you’ve got this Spill the Beans Institute. What is that really about? And what are you trying to accomplish with that?
Marcia:	So in keeping with the whole notion of preparing for retirement… so here I am, I’m 64 and don’t look it, but we’re getting to that place where we have to understand, are we ready for true retirement when it’s not cruises, when it’s a health issue involved. And so in keeping with that, I wanted caregivers to understand, you can start this business, in your home. You can care of your loved one in your home and get them some friends. Now you have a little more financial independence, a little bit more flexibility. You can grow your business. Once you have one facility, you can start another facility. So I started the training company to provide the soft skills development that they needed before they took on the regulatory test, because what I discovered is yes, I did it by taking the regulatory test, but everything I learned was not discovered in that class. It was learned in the trenches. And so that’s the purpose of the Spill the Beans, is to give caregivers out there an opportunity to keep their loved ones at home, but provide some financial stability for themselves.
Murs:	Got you. Yeah. And I agree. I think a lot of understanding any type of environment that you’re in, really comes from actually being in the environment… like you said, the trenches. And so being able to get a taste of it before you actually decide to go through all the regulatory… because we know the regulatory on that side is very strict and there’s a lot to it. So I think it makes a lot of sense. How long is your program, as far as from… is it online base? Is it in person? How long does it take to kind of get through your program?
Marcia:	It is, believe it or not, a two hour Spill the Beans. I tell you everything from soup to nuts. And I videotaped myself doing the entire curriculum. The hard part… the two hours is great. The conversation… you’re learning. The hard part is I’ve now given you a copy of my business plan. Now you got to go do the work. I’m giving you a copy of my financial projections. You’re seeing real numbers. This is how it looks like. Now you have to put the work in, do the research, but then you also have me as your mentor… someone that’s going to come alongside you and help walk you through the process because that makes a big deal. Nobody wanted to help me in the beginning. So I had to learn it on my own.
Radon:	So I guess as I think it through… because again, I didn’t realize when I was… I’ve read about the smaller homes. So in the scenario then, if I paint a picture, let’s say, I’ve got a scenario where I’ve got a mom or a dad or somebody who I need to take care of. I’ve got a couple of options. I can either put them into a facility, assisted living or some type of a retirement community. They could choose to live there or I could bring them home and I could take care of them at home. The dilemma I’ve got there is, if I have to bring somebody in, I’ve got all that expense to assist me or it’s just all me all the time. Right? So if I bring in this other person, now I’ve got this expense. So it sounds like what you’re saying is if I put this structure together and maybe I bring in two to three or four, now I’m getting some in revenue off of these other folks, but now we’re sharing this nurse or sharing this caregiver that might come in throughout the day.
Marcia:	That’s correct. That is exactly right. And that’s what I did initially before I quit my job… was I had her… I sprung her from the community that she was located in, brought her home, got her two other friends, residents, and then hired staff. And that gave me the opportunity to start up, before I was able to quit my job, and then have the revenue and now it could expand. Now I’m get ready to start a second community. So that’s a great way to plan for your retirement, have a little extra put aside, and then the caregiving burden is not always just on your back.
Radon:	Yep. So does it work then… I’m assuming, because based on a couple things you said, if the person becomes more in a scenario where they need more care, then based on the way the licensing is that you have in this facility, they would then have to go potentially to another particular location or facility to get that more acute care or bedridden care, that kind of thing.
Marcia:	So that’s a really great point. And in one sense, yes, you could transition them to a larger, skilled nursing environment, or if they are hospice eligible, then they can age in place. So in the almost eight years that I’ve been doing this, I think I have transitioned maybe seven and no one went to a hospital. We got them on hospice. They were able to age in place at their home. So we had the extra support of hospice doctors and nurses alongside with our own team to help navigate them through, until they went to glory. So it doesn’t have to be where you move them out. Now it, if there’s a situation where they need round the clock nursing care, then absolutely that is going to be their best…. the best decision is to put them into a nursing home.
Murs:	So if we have clients that are always kind of thinking about how do I know what I want essentially and how do I find it? How do you go about finding these private smaller type of institutions? And then I guess, how does someone make the decision as to what they want? Do they want to be at the larger… do they want to be at the smaller? It seems like with the smaller you’re going to have more one-on-one care, the price is a little bit lower, but how do they go about making this decision and where do they find the houses?
Marcia:	Okay. So that’s a really, really great question. So let’s start with, how do you make a decision? The diagnosis that you have is going to be the first step. So along with your physician, you’re going to determine whether the individual is exit seeking. If they’re exit seeking, then you’re going to have to find a community that’s secure memory care. If the person is just kind of confused, they might be a great place for a small community. If they’re aggressive and combative, small community’s not going to work because that will upset the entire household… been there, done that. You learn as you go, right? So the diagnosis and understanding, a good health assessment of that potential client, will help to determine which direction.
	Two, I couldn’t find these facilities on my own. Yes, the state website, if you a query, you can pull it up, but then you don’t know what you’re looking for. So I decided to create a nonprofit organization to help support the work that we are doing. So I am the founder and executive director for the Residential Home Care Network, here in Florida. And what that is, is a database where people can find us. We created it as a nonprofit organization, so it’s not about making money, but the members of the network are only 16 beds and under. And then we had sponsors to come alongside us who believed in the vision, like VITAS Healthcare and Seniors Blue Book, and all these other individual partners that helps them for us financially to help get the word out that we are a viable option. So when you go to that website for Florida, you will see video tours that I have created of each individual home. You will have contact information of the owners directly. Now you can find us.
Radon:	Very good. Good. Now in the scenario… I mean, obviously you’ve done this in Florida and I mean your Institute and learning it, you could do it anywhere in the country. But do you find in your research that the licensing, say, from one state to the other carries a vast difference? Or do you say that they’re somewhat-
Marcia:	Vast difference. Everybody is different. I’m talking to some individuals that don’t really require licensing. You can do… here in Florida, if you have two individuals that you care for, they’re seniors, you don’t need a license. However, in another state it may be required. So it varies from state to state. So while my training program covers soft skills, everybody needs to do a business plan before you get into business. That’s just step one. Going to do the hard skills, that’s going to be different from state to state.
Radon:	And then as far as… I know in facilities, a person could get government assistance through something like Medicaid or whatever. I’m assuming in a home like this, they would not qualify to be able to have Medicaid… it would have to be a private pay?
Marcia:	Not necessarily. So here’s the other conundrum. So here at the state of Florida, for example, and I’ll use me, I am a Medicaid facility so that I can take on Medicaid clients. However, the reimbursement rate is different for the adult family care homes than it is for the assisted living facilities. And so let’s lose real talk… in the adult family care homes, our reimbursement rate is $12.25 a day.
Radon:	Oh wow.
Marcia:	In the assisted living, it’s anywhere between 1100 and 1400 a month depending on who you’re credentialed with.
Radon:	I got you.
Marcia:	So in my scenario, yes, I am Medicaid Certified, all of that, and I am must take one low income client, where in the ALF where you’re not required to, but, let’s be practical $12 a day… really?
Radon:	Right.
Marcia:	So, yeah. So as they’re talking about retirement planning, and this is a costly proposition, it’s only going to get more expensive. And so I just love the conversation about what are we doing now, even our age group and the ones that are still younger, what are we doing now, to prepare for, not only I’m going on a cruise and living on a beach someplace, but what if life happens and it’s not the same?
Murs:	Right. Yeah. Well, I think this has been a very intriguing conversation. I know it’s going to open some eyes of some of our listeners that there are other options out there, and I’m sure it’s here in North Carolina, as well. We just got to go looking for it. So I thank you very much for coming on, and kind of opening our eyes a little bit here. Can you tell us, and tell our listeners, if they’re interested in the Spill the Beans… if they’re interested in just learning more about the institutes and different things out there, what’s the best way to learn more and learn more from you?
Marcia:	Sure. It’s steponetrainingsolutions.com. That is the name of our company and Spill the Beans is just one training that we have developed. So that will be the best place for them to reach us.
Radon:	Very good. So what we’ll do is we’ll make sure that is all there on our web website and in our show notes. So they’ll have the link and all that… good things so they can go and at least do their research and try to figure out are they more attracted to the larger facility or would it be possible to do the smaller facility? So Marcia, we certainly do appreciate you coming on and talking with us today. Thank you so much. And it’s been very, very insightful.
Marcia:	It’s my pleasure. Thank you so much for having me.