In this episode Jared discusses elder care planning with Brian Levy, Chief Relationship Officer at Manchester Care Homes and Cambridge Caregivers. They break down the elder care continuum, from in-home private caregiving to assisted living and care homes, and explain how families should think about these decisions before a crisis occurs. Brian shares insights on the true cost of care, what long-term care insurance does and doesn’t cover, and why understanding current care needs is critical. This episode provides a practical framework for incorporating elder care into a broader financial plan.

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Welcome to Financial Planning for Oil and Gas Professionals hosted by certified financial planners Justin Brownlee and Jared Machen of Brownlee Wealth Management, the only podcast dedicated to those of you in the oil and gas profession to help you optimize investments, lower future taxes and grow your wealth. Learn more and subscribe today @brownlee wealth management.com.

Welcome back to another episode of FPO and Chief Financial Planning for Oil and Gas Professionals. This week on the podcast, excited to welcome Brian Levy. You are the chief relationship officer for Manchester Homes and Cambridge Caregivers.

You're going to talk to us about kind of elder care. Brian, welcome to the podcast.

Thanks for having me.

So I would love for you to just kind of start at the 10,000 foot level. Can you share a little bit about the work you do and who you do it for?

Like what are your companies, what do you, what do they do and then what do you do within your company?

We are here to serve communities and create jobs. I mean I know that sounds, it's the basics. 80% of our staff are foreign born immigrants. So they are here to work and we have plenty of work for them.

We have four boutique assisted living care homes. They're in Dallas only. We're not scaling that division. We're scaling the Cambridge division which is in home concierge level. Private duty caregiving.

We have divisions based in Dallas, divisions in Fort Worth, Houston and Austin.

Awesome. I love that. The Texas connection. Yeah. We have offices in the Woodlands, Houston proper and Fort Worth.

So we can scale together.

We can, we can scale together. So I would love for you to talk about just like the idea of private care. Right.

Like, like if you think about our listener, they're kind of probably thinking about private, you know, kind of end of life increased care needs from kind of two dimensions of hey, my parents are probably getting really close to that and then I'm not immortal.

So like also I just got kicked off my company paid health insurance and I'm starting to pay those premiums and they're realizing how big of a line item retirement, you know that health care is going to be in retirement.

So I'm curious like just is somebody is thinking about that person is kind of the target listener, what kind of advice for them or maybe even just set the stage of okay, what does private care look like? How is that different from what's generally available and when and when might they.

Consider that lots unpacked there. Let's start with plan ahead. Your target audience, your listeners, they're planners. You don't want to Be caught in crisis mode with no plan.

Whether it's big or small, whether it's for you or a loved one, kind of have a sense of what the plan is or at least what your path will be. Who's your first call? You know, typically adult children with aging parents or young elders that are declining.

They go to a wealth advisor, a lawyer, a doctor, or clergy. And those are the people that refer to us. So back to your original question.

What I'm doing is building the relationships with those, those verticals, if you will, to let them know who we are and what we do and serve as a resource. It's not a sale. We're not, you know, the cheap, you know, used car salesman. I'm not selling. I'm just a resource.

Whether someone needs DME or home health or hospice or assisted living, skilled nursing, there's so many different options. I'm just helping them navigate this complex maze of elder care.

Awesome. Well, I think a good next step is to talk about some of those acronyms you used. Right? Because, like, a lot of people might not even know.

So I'm curious if you could just give us the continuum of maybe highest need to lowest need or lowest need to highest need and talk about where Cambridge and Manchester homes kind of sits in that ecosystem.

I appreciate you saying that about the acronyms. Our industry, as I'm sure others, it's riddled with acronyms. It's healthcare. I have a lexicon of elder care terms.

On my websites, people can look up and know what a SNF is or an AL or an il, skilled nursing facility, assisted living facility, independent living facility, et cetera. The continuum of care really starts with a beginning of do you need help at home? Do you need just a caregiver to help mom get her life organized?

She doesn't have a diagnosis, but she just needs a little help. All the way to ADL's activities of daily living. I use the example Mom. So we'll stick with Mom.

Mom needs help toileting, bathing, grooming, getting her life organized, her day organized. She's very confused. And so having a calm sense at home of organization and consistency. And then all the way to, okay, is it time to move?

Is it time to not be at home? It's time to go to assisted living or independent living, where there's a little bit more supervision.

You'll need this big house, assisted living or a care home.

Assisted living, I would suggest, is for the person who's starting to decline and they're still going to happy hour and movie Night and shuffleboard and it's like a cruise ship right under the umbrella of assisted living. And then there's a care home which is a concept of. I don't know, a lot of viewers might not be familiar with this. So imagine our concept.

Manchester Care Homes is a concept where you have a multi million dollar mansion, custom purpose built with eight bedrooms and nine bathrooms. So every room is a master bedroom. That's for people that really need full care. They can't live independently.

Awesome. So it sounds like you can help families along the way. And on the spectrum, that's what I.

Do with our company is I'm just a resource. I'm building relationships. My title, Chief Relationship Officer. I'm just building relationships to help people can navigate that complex maze.

Yeah, yeah. And it's interesting. It's much like financial planning where there is a best estimate at what my needs gonna be a few years from now.

But also that can change. And the answer that's right tomorrow is gonna be different than the answer that's right five years from now. It's gonna be different than the.

That's ten years from now.

That's right. And we are very proactive in doing assessments and helping people navigate that complex maze.

Whether they come to us and say we want to move into your care home, we're not for everyone. And we'll be the first to tell you this is a great opportunity for both of us. We can meet your care needs or we can't meet your care needs.

Here's why and here's where we think you should go.

I think one of the cool things about medicine is it's changing a lot. Right. Concierge medicine was something nobody was talking about 10 years ago and. Right.

The idea of like assisted living and like care in home, it's something I feel like it's probably a newer concept. You can maybe, maybe it's getting more institutionalized. Right. Maybe more democratized is the right word.

So like, are there any, you know, is, is, is your listener. Listen to this. Hey, I can. I can age in place in my home.

I think pretty much anyone's going to want to sign up for that because it's minimally disruptive to your life. Are there any kind of downsides or maybe what's the rationale? Why wouldn't I do this?

Well, for one, it's, it's very cost, it's costly, it's about double what it would cost to move into a care home on a monthly basis. So Basic ball our care homes, Manchester Care homes, rates are 9,700 per month. Aging in place at home. $34 an hour.

Okay.

Times 24, times 7. It adds up, right? And we have about 350 caregivers, CNAs, LVNs, and RNs W2 on our staff.

So we can handle everything from an engagement that's just companionship and advocacy. If a loved one is in the hospital or in a skilled nursing facility and they need someone just to be.

Be to help them be an advocate all the way to full care at home with a nurse, for instance. With somebody like als, that would be full care with a nurse at home.

Incredible. I love it because there's kind of a choose your own adventure element to it.

It's everything customized.

If you want an institutionalized buddy slash accountability partner just to make sure you're doing the things you need to be doing, it sounds like you could do that with a few number hours a week. If you wanted somebody 24 hours nonstop, every waking moment, you can have that as well.

We literally do it all. I have a client who is old, but not too old. His golf team died. All of his golf partners were older.

So his daughter called, and we put together an activities calendar, and we literally take him to topgolf every Saturday. That's companionship. Then we have someone's mom who is on the decline, but not totally declining.

So we just kind of help her keep her independent, but we help her as she navigates her life from wake up to bedtime. And then it's. And then we also travel with our clients.

So we have clients that have ranches and lake houses and third homes in California and Colorado, and we just go. We go with them wherever they are, wherever home is.

I love that. Yeah. And I want to. I want to touch on the W2 component because we kind of glossed over it. But when I met with.

So my introduction to Cambridge was, you know, one of your community liaisons, Rachel Bryan, came and introduced yourself and was telling me about the organization, and it kind of stopped me in my tracks because, you know, I've had some family navigate private home care, and I've seen how messy that labyrinth is.

And the fact that your employees, I think being W2, I'd say it's a point of differentiation, and that should really matter to the people that are navigating this space. So if you could just in layman terms, kind of say, hey, why is that important and what does that mean for end consumers?

Great point. I appreciate you asking. W2 employees are really important. They're not contractors.

We're not grabbing somebody off Craigslist and sending them to your house tomorrow. We vet them, we interview them, we background check them.

We are licensed by the state of Texas and with that license we have to do a state background check. We actually do a national background check. They get the same insurance that I do.

So all of our caregivers get health insurance, life insurance, 401k, PTO, gas stipends. Our CEO has a policy where everybody can have a no interest loan.

So when you think a caregiver has a flat tire or a broken refrigerator or a funeral in their country of origin, they're gonna have to front a whole lot of money. He just writes em a check. And it makes it sticky. So there's a reason we have 90 plus percent retention rate.

It makes them sticky and then they become family. I have caregivers that have been with us 12, 13, 14 years. That's a long time to be at one company.

And that's the other thing too is like the continuity of experience. Right. Matters if like you thinking about your loved one having the same people in your cor advocating for you, you can't really put a price on that.

But like, I think if you ask anyone doing this, we prioritize our people like it. That's kind of window dressing and word salad. But you're, you're building infrastructure that says, hey, here is how we're going to make it.

So we have a tagline, we make lives better. And it's a double entendre because we make the lives better for our clients, but also our caregivers. They are a family.

The alternative is using a private caregiver, somebody that you, a family would find on Craigslist or their neighbor's best friend's housekeeper's daughter. They're not trained, they're not background checked. Training. Let's go, let's back up to training for a second.

Training is a huge, huge component to our operation. We have 42 paid training sessions throughout the year for all of our caregivers.

And what that does is it gives them the skills to do what they're asked to do, but it also gives them the confidence knowing that whatever engagement they walk into, they are trained to do that task.

Yeah, yeah, I think that's so important. Right. It's just like, it's kind of like one of our core values at our firm is excellence. Right. And like, how do we continue to get better?

And we're not even competing with everybody because I feel like we're doing great things. But it's different. Yeah, it's an internal motivation.

We're different. It's like we train our staff to be indispensable. How can you be different? Caregivers are dime a dozen. What can you do to be different?

Even something so simple as a smile.

Yeah. And excitement. Right. And again, it's one thing to say, hey, be excited to be here.

It's another thing to give somebody the economic incentives to where they are excited to be here.

That's right.

And so I'm curious for you, thinking about, you know, as. As you grow this business, who do you do your best work for? Right.

Like, there's probably like a client type of, like, in light of what you've said and how you position yourself to the industry, it's a pretty compelling value proposition. But who are you? Kind of, hey, here is who we're going after, and here's how we serve them.

It sounds like families with complexity, but I'd love for kind of you or, hey, families with, you know, high incomes that are willing to pay for this because there are kind of some economic constraints. Who are the families you do your best work for?

Although we're here to serve all communities, it's not an inexpensive proposition here. I mean, care is expensive.

And so we have staff that we call concierge level that are accustomed to walking in a 22,000 square foot house or flying in a private plane, or going to their third home in California and not saying, wow, they're just. They blend in.

And, you know, I was telling someone on the way here, we have a situation where I'm dealing with the client, the bodyguard, the chef, the driver, and the doorman. And those are a lot of components. And then throw a caregiver into the mix, and they're trained to do their job and not get in the way of others.

Yeah. Wow. And so my guess is this service is in demand. So, like, it sounds like, hey, be prepared. Think about where you might send a person.

Is it too early to start? Is there a wait list? I'm curious, like, how the timing works or is because you have, you know, you have hourly W2 or you have W2 people on staff.

Is it easier to kind of add capacity and bring people on?

Good question. It's never too early. I mean, never, ever, ever too early.

And nobody calls me and says, next week my mom might fall, or this summer, dad might get diagnosed. You know, they're in crisis mode. Always have a plan, even if it's not your end game, at least you have a plan.

You know who to call to even start the conversation. These are lifelong decisions and they're expensive decisions not to be made in crisis mode. And that's why I always preach have a plan.

Yeah, yeah. So it's interesting because in a lot of ways it's similar to hiring an advisor. Right.

There's like, hey, what am I, what is the service I'm actually going to get and what is the service I'm getting marketed? And there might be kind of a disconnect between those two.

So if, you know, a lot of our clients are engineer types of very risk management, very on top of it, they'll kind of begin doing due diligence today. How do I even suss out like who is a good fit for my family? What types of questions do I ask? What are the things I'm looking for?

And maybe talk about it might be easier or harder to answer.

You know, for a care home versus kind of assisted assisted living, you know, how might somebody begin to develop criterion for identifying good options for their family?

Ooh, we could take two avenues here. For one, it's got to feel good to you. Yeah, we all know what home feels like. Right.

The other avenue is focus on who is the care for and understand their current baseline. You know, we have a lot of adult children that say, well, mom used to play bridge or mom, mom used to do.

It's not what they used to, it's what do they do today, not yesterday, not last week.

And that's a really difficult conversation we're having with adult children who don't want to admit or really get their arms around the fact that their folks are declining.

Yeah, I would love for you to touch on kind of the economics of this, maybe like the costs. And what type of care does insurance cover? Does it not cover long term care?

And I know there's probably some policy specific parameters, but just in broad so somebody can begin to think about planning for this financial.

Sure.

So for one, like we talked about earlier, long term care insurance, it's great if you have it, understand your policy, know your policy and have a copy of the complete policy, not just the summary. And then recognize your policy is probably not going to cover all of the costs of care, whether it's in a care home, a facility or at home.

So market rate In Dallas and Fort Worth is Dallas, Fort Worth and Houston, 34 an hour. That's just pretty market rate for in home care for our care homes. Like I mentioned, it's 9,700.

That ranges from probably 3,500 all the way up to 17,000. Just a lot of variables. Ask a lot of questions. Ask what you haven't. That you should. There's a list of, I always guide people on our website.

There's a list of frequently asked questions section.

And these are questions that I've taken from prospective clients on the care homes, I mean on the Cambridge side and prospective residents for on the Manchester side. Questions that you should be asking. And I tell prospective residents, I hope you're looking elsewhere as well, just so you have a comparison.

Ask these questions because once you get the answers to these questions, the answer will be easy where you want to be.

Yeah, yeah, I love that. Just, hey, get a, get a bigger sample size so you have something to.

Compare to and you have to have something to compare it to.

Yeah, I think that's hugely, hugely important.

So just ask a lot of questions because, and know what to ask.

I mean that's part of the problem is people are, you know, if you told me that I had to be in your business, I'm like, I don't know anything about wealth management. I sure don't. You don't know anything about elder care. So go to the experts and learn.

You know, it's, it truly is learning a new language like it would be when you're communicating with somebody with brain change. It is a new language.

Yeah, yeah.

And that's the thing I tell people a lot when like they're, they're trying to make sense of it is, hey, can this person 1.0 is, can this person answer my question? 2.0 is what questions am I not even asking that I should be asking about this?

Yeah, there are a lot of variables.

Yeah. In one financial planner side, Brian and I were talking about this before we hit record.

You know, I think some listeners might hear this and think, oh, long term care insurance, it can cover this type of expense. Maybe I should go out and get a policy. Policies are very, very different. Right.

Like, I think like long term care insurance is fairly new, you know, and again, the difference between policies that were issued decades ago versus the ones today have very different mechanics.

Very different.

The policies from yesteryear, when our grandparents retired from Sears or IBM or all these big companies that was part of their retirement program, they don't do that. They don't do that these days.

So the policies that you and I would be offered today don't look anything like the policies that we're seeing with our clients.

Yeah, I would love for you to talk. You know, I, I work for a small Business. And so I'm kind of biased towards small businesses.

But I would love for you to talk about kind of the difference between like a care home and a large facility. Right. Because there's probably, you know, it feels more boutique.

Some people might gravitate towards that, but there's also probably a listener that says, hey, I like the big institutional brand or the larger infrastructure. Hey, there's going to be like all the specialists are in house.

So maybe just kind of can contrast the pros and the cons of maybe a care home versus a larger facility.

It's like dickies compared Railhead. Yeah, you know, I mean everybody, you have a customer. I personally like to work with family owned and operated companies.

You've got this, you know, the phone number to all the executives. There's just more high touch, more communication and just a different level of customer service.

Not to knock any of the large facilities, but we operate differently.

And I always tell people there's no memo that goes to Ohio to get approval for something that's going to take three weeks, you know, office next to the CEO and if we want to put a backup generator in the care home and knock on the, knock on the wall and you know, that's how things get done. It's the same with the vendors that we work with, Home health, hospice, dme, those kind of companies.

There's franchises, large corporate, corporate entities and then there's the mom and pops that just get it done. And we enjoy those kind of relationships because there's a level of customer service and communication that's just different.

Yeah. I mean, and I would. Agency is like such a, such a big word. Right. Like we have all the tools we need to fix it. Right.

And there's few little bureaucracy. And I mean healthcare isn't exactly a space where there's not enough hands involved and not enough layers and paperwork and all that stuff.

So I would love for you to talk about kind of like, hey, thinking about the businesses going forward. You kind of have the home, you know, the home care and kind of the assisted living. What's kind of the focus going forward?

And do you plan to stay in Texas or expand nationally and at what speed?

Yeah, so the focus, the focus was we were going, we had four boutique assisted living care homes and built from the ground up and got full right away. And families came to us and said, well, we need moom bomb in tomorrow. And they said, well, we're full but we'll pull someone from the floor.

We have the staff, we'll go to your House. We did that a couple of times and realized, wait a minute, that's not only a business model, but maybe we should get licensed and do it right.

So we got licensed, did it right. And that just took off like a gremlin. And so we started scaling that division, and it truly, we grow 30% year over year over year.

And so that division is, like we said, we opened an office in Fort Worth and then Houston. Now Austin will roll into San Antonio soon, and then look at the Southeast. Atlanta, Tampa, Jacksonville, Miami, those kind of markets.

That's exciting times. Well, Brian, I think, you know, this answers all my questions. Been very helpful for our audience. I would love for you. I can tell.

And I've listened to a couple of your podcasts.

I know you do this for your audience, and I would love for you to kind of talk about the Manchester Living Podcast and what you're talking about there and just kind of generally where people can learn more, appreciate it.

You're an excellent podcaster, by the way.

Thank you.

So I started the Manchester Living Podcast because I. I took the approach of education, not the sales approach. You know, we can't. We can't be all things to all people. But I want to be a resource to my stakeholders that are calling me, saying, I need help.

And so it's strictly to help people navigate the complex maze of elder care.

And I'll take a subject matter ranging from what is hospice to what is concierge medicine, how to communicate with people with brain change, things like that. And I'll find to thought leaders and experts in whatever subject matter I'm covering. And we just have a conversation. It's not a sales.

It's not monetized. Like, it's not monetized. It's not a sales tool. It's truly just to educate the audience. Manchesterlivingpodcast.com There's 56 episodes and running.

Recently interviewed Dr. Cooper from the Cooper Fitness Center. That was an exciting episode. Learned a lot on that. It's a labor of love. I enjoyed about a as much as you do. Awesome.

Awesome. Yeah, I've listened to a few episodes. I can definitely recommend it. I think there's something to be said about a podcast that is not monetized.

Hey, my goal is education, and it's abundantly clear that, hey, I think, you know, before you even start calling places, just listening to that podcast and developing a framework and a timeline of hey, when. What needs to be true for my loved one for us to start making calls.

Sure.

Or to see what availability is Start.

Thinking about what your loved one needs way ahead of time, and then learn as much as you can about that and then the answers will fall in place.

Yeah, I love what you're doing because there's really a continuum of, hey, how do I take. How do I support you across the seasons of life? Right. And it's a really. There's a really low opt in and then a really high potential ceiling.

So you could be with clients for decades, which is really exciting and cool.

It is exciting and I love working with. I had a client that called me years ago, fortunately, five years ago, when he said, I'm going pheasant hunting.

Can you have a caregiver stay with my wife over the weekend? I'm going up pheasant hunting. Sure.

Over the years, that engagement alone evolved to care for his wife, to care for him and his wife all the way to 24, seven care for both of them. And it started with just a simple weekend. And that's when we feel like we really get to know the families and we become part of their plan.

Yeah.

And I mean, I think, I think there's something to be said about taking, you know, when it comes to family care, I think every stake is high stakes, but. Right. It's like, it's so. It's so awesome. The idea of, hey, begin to introduce my family to this. Begin to see what this is like.

See what I like and don't like and what I need before I need help with five ADL's.

That's right.

Right.

So, like, baby steps.

Baby steps.

It's the little thing. It's like when you think that your folks shouldn't be driving, you know they shouldn't be driving. So what are we gonna do about that?

Not get in a family argument and grab the keys and take them away, but have a plan, you know, have a plan to not just take the keys away, but how do we replace that with a different way to keep your folks independent with a companion caregiver to take them where they need to go.

Yeah, yeah. And that's, that's.

I mean, one of the things that's abundantly clear is the dignity there of like, hey, how do we preserve life as much as possible in a seasonally appropriate.

As adult children, it's our job to keep our folks healthy and safe. I like to say our parents taught us how to use a spoon. So now it's our turn to give back.

So. Good. Well, Brian, is there anything else that we didn't get to talk about that you think would be helpful for our audience before we wrap up.

Plan ahead and check out the Manchester Living Podcast, CambridgeCareGivers.com and ManchesterCareHomes.com There's a virtual tour of the care home on the website, so if anybody has any questions, call me. I'd love to be of resource. Can't help people manage their money, but I can talk elder care with them, so awesome.

Cool. Well, that's where we'll wrap it up. Thank you Brian for coming on the podcast.

We appreciate you educating our audience on the importance of elder care ideas for podcasts or future episodes or future guests, or want to have Brian on to talk about more stuff? Podcastrownleingwealthmanagement.com thanks. We'll see you next time.

Thanks for listening to this episode of the podcast podcast.

You can subscribe or connect with us at brownlee wealth management.com or send ideas for future episodes to podcast brownleewealthmanagement.com thanks and we'll see you next time. This podcast is for informational purposes only. Nothing discussed during this show or episode should be viewed as investment, legal and tax advice.

If you have questions pertaining to your specific situation, please consult the appropriate qualified professional.