Now or Never: Long-Term Care Strategy is a podcast for all those seeking answers and solutions in the long-term care space. Too often we don’t fully understand the necessity of care until it’s too late. This podcast is designed to create solutions, start conversations and bring awareness to the industry that will inevitably impact all Americans.
For the vast majority of our clients, it's a crisis. They didn't. They're not planning for this. So it sounds like a cliche, but it's a reality. So many times, somebody fell down the stairs, broke ahead, went to the hospital.
He's getting discharged from rehab. And they're being told if you go home, you need a home care aide or you need to go to assisted living. So for most people, this is not planned out.
You know, everyone thinks they're healthy and young.
Welcome to now our never Long-Term Care Strategy with Kosta Yepifantsev, a podcast for all those seeking answers and solutions in the long term care space. This podcast is designed to create resources, start conversations and bring awareness to the industry that will inevitably impact all Americans. Here's your host Kosta Yepifantsev.
Hey, y'all, this is Kosta and today I'm here with my guest, Joseph Chu, certified senior advisor and owner of assisted living locators and Bergen County, New Jersey, assisted living locators is a nationwide network of senior care advisors who work together to help families and their loved ones provide a healthy and safe environment that will allow seniors to thrive. Today, we're talking about how to choose the right long term care. So let's start at the beginning. If you're listening to this podcast, you're likely new to the long term care industry, or you will soon need care for yourself or a loved one. Joseph, what's the first step?
Well, thanks so much Kosta, for that great introduction and for having me on your show. And, you know, this is a very confusing process for most people, your average person will know nothing about this unless they're forced to deal with it and make a decision. Right. So yeah, so obvious. I mean, I think the most important thing is figuring out the person in need, what they need, what their level of care is. So, you know, very basic in layman's terms, I'll ask the client, if your loved one mom or dad or your loved one moved into a community or facility today, what exactly what they would they need help with? And then yeah, normally, if they don't answer the question, then I'll ask Do they need med management? Someone to help them take their medicine in the morning? Do they need help?
You know, in layman's terms, going to the bathroom, showering, putting on clothes, getting in and out of bed, and, or even eating. And if they need help with all of those things I mentioned, in our world, we call those ADLs activities of daily living. And in our world, if, if a person needs help with ADLs, that, you know, they could stay home, and if a loved one can take care of them, that's possible. Or they can hire a homecare aide, who's going to take care of those ADLs. Or my job is to help the families find an assisted living community or an assisted living apartment unit cherm home, which takes care of all those ADLs and a lot of the general public doesn't realize the difference between an assisted living community and a nursing home. Okay, so they in many people think oh, yeah, so we're looking for a nursing home, right? And I need to explain, over and over again, try to explain the difference between a nursing home and assisted living community. The joke in our field is we don't call it a facility. That's the F word. So we try not to say assisted living facility, we try to share assisted living community, okay, and in a nutshell, someone who needs to go do as a nursing home where some people call it a sniff, a skilled nursing facility. That's for people who need 24 hour medical care, or skilled medical care, you need the doctors and the nurses and the machines to keep you alive. Right. And so that's when you need to look at the world of sniffs which is a different world than the world I specialize in is assisted living communities. So I think that's the the major thing we need to figure You're out if they don't need medical care or skilled care. And they need help with what we call, we call it non skilled care, everything I mentioned in the ADLs. And that's the world of assisted living, or a home care aide. And if people get shocked when they're learning about this, they're like, oh, so we're gonna get a nurse to take care of me at home, or we're going to get a nurse is going to take care of me, right? The assisted living community, and I need to explain, if you paid for a nurse to help you with all those things, you would be overpaying a lot of money.
Oh, hundreds of 1000s, I would say probably a year to have a nurse take care of you, you know, 24 hours a day or provide some of the basic care that people need for sure.
Yeah.
Right. So yeah, we do a little education exactly that. It's it's very noble work to help, right? Someone who needs help to get up and shower and go to the bathroom, but you're not going to be paying a nurse or a medical doctor, for their time to help you with those things. Yeah.
So I want to talk about pay since we're on the subject. How can you responsibly determine how much you can pay? And what are our options for funding? And how do most people pay for long term care?
This is a tough question. I live in northern New Jersey a few miles outside of New York City. So in my world, let's talk about assisted living first, okay. In my world, private pay, assisted living communities. I'm very sorry to say the average price for a individual to have a private studio for rent and for their care. Average is 8000 a month.
Wow, for$100,000 a year. Yeah. And what does that show you?
It gets you a studio apartment. The the more fancy ones look like a five star hotel, including the dining areas and the rec, recreation areas and the more humble ones look more like a humble Holiday Inn. And three meals a day, housekeeping, they call it carefree living, all the bills are covered. Some places pay for cable TV, but many places you pay a small fee for cable. And, you know, obviously, if you need a cell phone, you would pay for that. Otherwise, you don't have any extra bills, but you do pay for the hairdresser if that comes in, and field field trips, and things like that. But many of the activities and lectures are free. And there's a car service. And here's where I will go ahead, go ahead. And
I was just gonna say the actual care, though, that people receive, like to the assistance with the ADLs. Like you were talking about the activities of daily living, is that in that $100,000 cost?
Great question. So typically, no, typically, nine out of 10 places, there's a price for rent. So a well priced place here in New Jersey in other parts of the country, it might be roughly half or a little more than half.
Yeah, it's like it's about 40% about it's about $60,000 in like Tennessee, for example.
Right? Right. So here in New Jersey, a well priced studio might be 4000 a month, which covers rent and your meals and activities and you know, basic car service here and there. But then they they add something called levels of care. So depending on what you need help with, like, let's say you can't shower on your own, then they'll ask you do you want to shower once a week, she wastes a week or three times a week, and they'll put a price tag on that. As well as all those ADLs they try to charge you only for what you're going to use. And and then med management is usually different.
So there's usually a separate charge for med management and add most usually, like expensive would be 4000 5000 for care that's very expensive. Right for someone who needs a lot of care
and that's on top of the girls.
Yeah, no, no, no, no no. So that 8000 was was a average for both. I should have clarified rent Plus Care good I should have
clarified saying it's gonna cost 12 grand
I should have but but the nice fancy places do cost 8000 For a studio sometimes. Okay.
Wow. So on average, when you are working with clients placing them in an assisted living facility on average, how much do they pay a month for living there, the carefree living aspect, and then also for the actual care that's being provided?
Right? Average is hard to say. But if the end of the day for a pretty nice modern name brand place 8000, that's what they say is average. It's it might be the average. But, you know, if you're in the memory care section, which is a secured, or locked unit with more staff and more help for people with severe dementia, that's going to cost more.
Yeah, I see.
So but the options,
yeah, okay, funding options. I was gonna say real quickly. The trend for memory carry is it's becoming all inclusive pricing. So instead of saying you, you pay this for rent, and this for care, more and more places are doing all inclusive, because they know that the price is astronomical, and it's so hard to swallow.
Yeah. Well, I just want to interject as well.
And I am familiar with that statistic. And I've always wondered if it's because a memory care patients don't typically don't have any type of physical disabilities, or if they are, they're not disabilities that may contribute to like severe ambulatory issues, so it's hard for them to move around. And a lot of staff typically do not want to have to use, you know, gait belts and Hoyer lifts and things like that. And actually, in a lot of ways, if you consider what a caregiver it is, or somebody that's a home health aide, they love to provide companionship services and work with patients who may have Alzheimer's, or dementia, obviously, severe dementia is a completely different animal. But that's something that I've I've noticed the trend as well as memory care units, typically are better staffed with higher quality staff. And a lot of people sort of if you if you are building an assisted living community, they're building it around memory care.
Yeah, yeah. Great. Nice. So great news.
So from the funding perspective, what are the options?
Okay, so the vast majority of people are doing private pay. Very few people had a long term care insurance policy that would actually cover this, and the ones from three to four decades ago, are robust and excellent. They'll actually pay for it for many years. Okay. But the ones after 20 3040 years ago, the ones that are selling now, the insurance companies realize they can't pay for this product. So either they'll charge too much, or what you're getting for what you're the actual policy does not cover much. So that's a very, I mean, out of all the clients I've helped less than 10% actually had a legitimate robust, long term care policy. i So here, let me explain in New Jersey there.
In New Jersey, there's in every town, there's meant there's a handful of private pay, assisted living communities. There are dozens and dozens of options.
But when I look at North Jersey, I only know of three legitimate buildings that we call it direct Medicaid building, which means from day one, those who have Medicaid, which are those who can prove they don't have assets and apply for New Jersey State Medicaid, the from day one, Medicaid will pay for them.
What are the asset levels? In New Jersey?
I forgot this specific number, but you really need to show that you don't have much, and you're not collecting much in Social Security and pension. And so I mean, I want to say this carefully. But those three legitimate buildings I know of it's a huge difference from a private pay building and of service and how nice it is and how pleasant it is the quality of care. That too, and just the cleanliness, and it would it would. For many people, it would be very difficult to put your loved one there. Yeah.
So If I guess for many people that that's the last resort, if you need assisted living, and you can't pay for it, and you have Medicaid, so there's a huge gap with the direct Medicaid buildings, and there's not many of them, and now to pay for a private pay building. So the big discussion is, yeah, very wealthy people can afford that product for years. But what about everyone in between? And I don't want to confuse the issue.
But New Jersey has a great law, that private pay buildings built after 2001, by law need to give 10% of their beds away as Medicaid beds. Wow, very generous.
That is that is generous. Is that just in New Jersey? Are there other states that do that as well?
I mean, as as far as I know, I've only heard of it in New Jersey. Interesting. So when those buildings, usually they have like a two or three year grace period from opening, and then they have to start giving it away. When they, when they have to, in a sense, give away those Medicaid beds. They feel like they're handing out lottery tickets. Right? Right. And so just on a personal level, I've, I've had buildings call me typically at the end of the year, saying, Joe, we have this number of Medicaid beds to give out and I feel like Santa Claus, because I'm connecting the right people to those buildings. And they're not, they're paying nothing or close to nothing, and their neighbors are paying almost $10,000 or close to it.
So you're saying that most of your clients pay for this out of pocket?
They're not on Medicaid, and they don't have long term care insurance?
Yes, so when I have clients who are on Medicaid, I do my best to help them and get get them in the right place and to make the right decisions. But as I shared with you, I only know of three legitimate buildings in North Jersey City.
And then there's a quite a handful in Rockland County, New York, but you're very limited with what you can do. So the private pay world, then those are the majority of our clients.
Yes, it's, they're paying out of pocket.
So kind of play this out. For me this scenario, if you don't mind.
Somebody comes to you and they have saved $500,000 for retirement. And they need long term care. And they want to be in assisted living facility because they cannot live at home anymore. They can live at home, obviously, they want to live at home, but maybe they can only afford to pay for eight hours of care. So what about the other 16 hours? So they choose an assisted living facility for that purpose? When you're explaining to them, that this$500,000 that they have will only last them for years. How does that conversation go?
So this is where it goes here in New Jersey, everything we discussed about getting a Medicaid but in a private pay building. A lot of my clients, they call me and they're already talking to their elder law attorneys and planning their future. And a lot of them.
Their first question with me, or their first strategy with me is, Joe, we want a place where they know the lingo. The lingo is we want to do the private pay spend down and then we want to be guaranteed a Medicaid bed. Got it. So and then there are elder law attorneys here that are very confident that if you work with them, and they usually charge starting 1000 to do your Medicaid application. These are people where it's complex, because it's not so simple for them to prove that they don't have assets. And so they're they're trying to find a place where they know they can private pay for two years or three years, spend out their assets and then get that guaranteed Medicaid bed, which I helped my clients with. I just want to share a lot of times the staff of these buildings, they find it comical because they know in the world of assisted living, your average stay is usually way less than two three years. I mean, anything can happen you sorry to say you could pass or your condition can get worse so that you might have to go to a skilled nursing facility. or hospital. So I mean, the future is unknown. But a lot of the families, they, they want to lock in that guarantee. And so we do, I do help them with that approach and finding a place.
And most of the buildings will discreetly give the guarantee if it's given written, but many buildings will simply say they can't give you a written guarantee.
So the question that I have, because I speak to a lot of professionals in this field that are either doing the cert providing the service that you provide, or their attorney attorneys that provide the Medicaid application services. New Jersey has a look back period. Right. Okay. So when you say get a guaranteed bed, you're saying, because we have to talk about generational wealth at some point, and I'm assuming that all these people aren't saving money for retirement just to spend it all on care. So if let's just say for example, New Jersey has a five year look back period? I believe that's correct. Yeah.
Okay. So,shot. So if I'm wrong, I don't know.
I've got to get my flu shot on Wednesday anyway, so your front, I'll be right in the same boat as you. If they come to you, and say I need to pay $10,000 a month, for five years. So I'll still pay for 60 months. And I'll get an irrevocable trust, for example, to put all my assets in, so I'll pay $600,000 to this assisted living facility, I'll be eligible for Medicaid, and then I'm guaranteed a Medicaid bed. And so anything over $600,000 I can leave to my relatives and loved ones when I pass, but I will have to pay $600,000 To be in assisted living. Is that essentially the gist?
So I mentioned to you before we started recording, I'm not going to talk about stuff that I don't know. No, no, I will talk about stuff that I do know. And I'll just tell you, just watching from the outside what I've seen families do. And it's comical, because when I asked the lawyers and their staff for help, they won't give me anything. I mean, they want to meet directly with the family. And they don't want to share information. I mean, they want their knowledge to be their knowledge. I do know with the five year look back, that's something they start before they even enter the assisted living community. I see. So so they fulfill that separately apply to New Jersey State Medicaid and get approved. And then the assisted living community. We talked briefly about the private pay spend down usually it's two years someplace do probably most places do three years, I see most places brag about the fact that they're not going to make you prove your finances. But some places, they're going to want the family to prove that they can pay for two years or three years. And then some of these places will discreetly give a signed contract saying after those two or three years, it's your job to get approved for Medicaid. And once you do, we will give you the Medicaid bed and these these buildings have lived up to there. Yeah,
yeah. And the only reason why I'm asking I'm gonna try to put you on the hot seat or anything like that. The only reason that I'm asking you is for two reasons. Number one, is I want listeners to have a general concept of how much it costs for long term care and assisted living facility whether when you're paying out of pocket and so whether you are you know, you didn't plan accordingly and you didn't go to your look back period. Prior to having a disability, you kind of have a general understanding of this is going to cost between you know, 206 $100,000 a year. But the second reason that I want to bring it up is because I also want listeners to know that and I'm going to paraphrase what you just said for the state of New Jersey, which I don't have much experience in an assisted living facility is going to make more money on a private pay bed than they are on a Medicaid bed. So whether you are on Medicare, whether you're eligible for Medicaid or you are because you follow the process of the look back period, they're going to say no, you need to pay upfront for two or three years and then you can we'll transition you to your to Medicaid and you can have one of our Medicaid pay beds and not pay for it at all.
So imagine the wealth of people that never get that Medicaid bed and are in that assisted living facility for 678 years, right?
Yeah. And I just want to add, I've seen, I've had clients, and I've seen cases where they've lived three, four or five years in a very expensive place. And then they realized, they're running out of money. And then they go, Oh, my goodness, now we need to go to a place that's going to give us the guarantee. And or they say, Oh, my goodness, we just need to go to a very humble place, which is a tough transition for Noah Dannic.
Absolutely.
So let's talk about the different types of care. And now that you know, the care you need, and how much you can afford, how can you start determining what type of facility or care program is best for you? What are the most critical differences between our main options at home care, assisted living, and facility based care?
So you mentioned, the cost of at home care is usually much more than a living in an assisted living home.
Right. So what what I've seen is extremely wealthy people can stay in their comfortable home and hire at home care as much of it as they need, including 24 hour or living care. And then, compared to that assisted living is a bargain. And then I've seen very wealthy people, instead of going to a small apartment unit, which is what assisted living typically is, they'll get a gigantic, something they call independent living unit, where you get a full kitchen, even though they don't use the full kitchen, it just makes it feel more homey. It looks like a full size apartment looks homey often has a nice balcony or, or patio terrace. And then they'll hire their home care aide at independent living. So you're paying a lot for Independent Living, and then you're paying a lot for your homecare, because that home care aide is just for you. So that's like much better care than assisted living, where if you need to go to the bathroom, you press a button and you wait 15 minutes or more.
Right. Right.
So one of 20 people that she cares for, right?
So I've seen very people who have the money and are willing to spend it.
Sometimes they'll make that decision. Yeah.
So as we know, unfortunately, most care options will be dictated by funding preparation, and what resources are available to those searching for care? How can we best prepare financially and personally, to leave as many doors open as possible?
Well, let me say this, the vast majority of our clients, it's a crisis. They didn't. They're not planning for this. So it sounds like a cliche, but it's a reality. So many times, somebody fell down the stairs, broke ahead, went to the hospital, is getting discharged from rehab. And they're being told if you go home, you need a home care aide, or you need to go to assisted living. So for most people, this is not planned out. You know, everyone thinks you're healthy and young. Or stroke, right?
Yeah, yeah, absolutely. That
can paralyze on the left side or something like that? Absolutely.
So it's interesting to kind of coach somebody to prepare for this. It's not an easy task, because everyone thinks they're young and healthy. And so even even trying to educate people on like, what we're doing now, a lot of the general public, they don't care until they have to care. Right?
Right. So it's kind of humorous my own friends and family members, like the last week. Oh, yeah, you work with nursing homes. Right? And that's humorous to me, because I've got good explained it to them five times. This isn't what a nursing home does. This is what an assisted living home does, but they'll forget. Right into them.
It's all nursing home. So it's, I mean, it's interesting how most people choose not to care.
mean. But the more they, the more we should educate the general public and have people prepare the better.
How do you think is the best way to prepare the general public?
Well, I think most like for me, like, I am drawn in by stories, and real people. So I think when people, I mean, statistics and the macro picture, people seem to just it goes in one ear and out the other. But when it's a personal story, it kind of hits closer to home. I mean, this might sound funny, but I know that Glen Campbell was a great guitarist.
I think I'm thinking about Glen Campbell. And I think it's Sam, I just vaguely remember seeing video clips of him in his memory care facility. And they give him an acoustic guitar. And he still has the chops, like he greatly as good as ever. And to me that hit home like here's a one of the greatest guitarists ever.
And he's living in memory care.
Yeah. And so I think we need to remind people that this could be you.
Right? Right.
Yeah. humanizing the care process, so that people start thinking about it, instead of it being something that they're like, no, no, no, no, you know, this is like the very, very last thing that we're going to ever think about. Right? That's a good perspective. And I honestly, I feel like, you know, something that a lot of people don't talk enough about is the baby boomer generation, people born between 1946 and 1964, are the second largest population segment in the United States.
And so there's a 80% chance that after you turn 75, by the time that you pass, you will need some form of long term care. I think this conversation is going to start happening more and more often, just because the demand for care is only going to increase primarily because 2021 the first baby boomer turns 75.
So
bright, absolutely.
And you know, we many people call it the silver tsunami, right? That is upon us. And absolutely, and for people like us to educate the general public, and to help people to think ahead and plan certainly be very important.
Yeah. So once you finalized the level of care, and the method with which to receive it, what will be the research and vetting process?
What's the best way to find quality care and ensure the standards and practices of those providing services?
Well, let me say this real quick. Because once you look at an assisted living home, and you're interested, they send a nurse to do an assessment. And, and the nurse can say, Okay, you are formally invited to our general assisted living area. Or they might say, we can accept you in general assisted living, but we can invite you to a memory care, or they might say, we can invite you and we strongly recommend the skilled nursing facility.
And when they do that assessment, and it's huge, it's free. They put a price tag on your level of care. So they say we're going to charge you this much for the care. And that might change every few months, if you get better if you get worse, depending on your needs.
I've had clients put security cameras in their mother's unit to see the actual care that they're getting. Right. And then they would argue with, with the staff of the building, saying, You billed me for this, this, this, this this, but you didn't even provide that did you provided this? Right. So a lot is each building has their has their reputation, and their track record. And so I mean, generally speaking, a building that's brand new, there's a risk because everyone, all the employees and staff are new. And so there's no it's not set, and the culture is not set. So there are certain buildings where for many years, they've had a good track record, and better reputation and less complaints about the care. So you really should know about each building and what it's known for.
I see. So with regards to the people who can't afford to pay out of pocket and are on Medicaid and have to go to a Medicaid facility, what's that experience typically like? And how does it differ from somebody that's going into an assisted living facility that they may be able to pay? $10,000 for?
Oh, I mean, it's, it's a different world. It's a different world. I mean, even just pulling up to the building and seeing the lobby and seeing it's just apples and oranges.
Yeah. Is there anything?
Is there anything that you'd like to share so that maybe listeners can have a general expectation?
If they can't afford, which is the vast majority of people that can't afford to pay? Out of pocket for care?
I mean, I don't, I mean, God bless us all, I hope we can all be healthy, and have great dignity in our elder years, and pass peacefully at the right time. So those who really do need help with these ADLs. I mean, it's a tough situation for everybody, even if you're the family that could just barely afford private pay.
It's, it's painful. So this is quite a crisis that, you know, our society is facing, like, how do we help the elderly age with dignity? And how do we take care of them? Absolutely. Awesome.
It's often not a pretty picture.
Yeah. So I want to talk about red flags, and kind of the vetting process for assisted living communities that that you typically deal with so that when people are looking for different options, they know what to look for. What should you keep an eye out for when finalizing this process and committing to a facility or a specific care structure? And what red flags can we prepare for even after proper vetting and preparation?
I think it's like finding a good restaurant, if there's a long line, there's a good indication that the food is good. If it's empty, it's probably bad food, so or bad service. So if a building there before COVID, there were only a few buildings that were always filled with the waiting list. So that is a strong indication, they don't and they did very little marketing, because they didn't have to word His Word of Mouth strong enough. So to me, that speaks volumes. That's an objective. Like, even if I'm convincing the families I'm working with that those are objective realities you can argue with. Now, the opposite is true, too. If a building is under 50%, full, and it feels like a ghost town, and it's been open for many years. Something's wrong. Right. And we people in the industry call that the death spiral. Because they don't have the clients or the sounds bad, but they don't have the heads in the beds. So they don't have the money to pay the staff. So the staff ratio is going down even more, and they're not able to provide that care. And it's in a downward spiral. So the comical thing is, they call that census, the population of the building.
And whenever a client, a potential resident asked for the census, it's comical to me because most buildings will say, Oh, we have two apartments available. It's not true. They say that. So to get the real census, I mean, if you're walking around, and it feels like a ghost town, something's wrong. Unless it really is a brand new building. Yeah.
Do those type of facilities or communities do they end up switching to just being a Medicaid? Primary?
I've never seen that because so here's so here's what happens. Yeah, my understanding from what I know in here is a lot of private equity firms and BlackRock, is it the real estate company, they own these individual buildings. So they'll hire a national company to manage the building. So that national company will put their logo and color scheme and design scheme throughout the building.
A lot of people think those companies own the building, but they know they're being paid to manage the bill. thing I see, what I've seen is the owners, I've seen really nice buildings in New Jersey, cheap fire, the old management company hire the new one at lightning speed. And they changed the branding and all the signs overnight change the staff. And it's a new company now.
Wow. So interesting point of view.
Yeah. I mean, they're not happy with the way it was managed. And they think this new management company will do a better job. And it happens quite a bit.
Would you say that's the norm?
It's not the majority. It's not that but but it happens. And so what's going hot on here in North Jersey is they're constructing beautiful, huge, high end assisted living, left and right. And I think these companies are thinking it's just competition thing.
They think that they could starve out their competition and then raise their prices later.
But I guess it's good for the client, because the competition brings the quality up, and in some some cases, brings the pricing a little more reasonably down.
Yeah. So we always like to end the show with a call to action. What's your best advice for someone entering the long term care industry as a patient, as a caregiver? Or as an industry professional?
Okay, so knowledge is power. So for all of them, the more you understand and know, this world, you're at an advantage. So education, talking to people seeing the big picture. I mean, you really, I mean, the worst case, the worst thing is, being in the wrong building. Like I, I've seen some people in a skilled nursing facility where they don't even belong there. Right. And that's, that's minimum 10,000 a month in New Jersey, for shared room for hospital like setting. So you know, education, knowledge.
Yeah. Good.
All right. Thank you very much.
This has been absolutely fantastic. And thank you for offering your perspective on assisted living facilities and communities, the differences between all the various options that people have home care. And also, I think you made some very interesting points and pointed out some really good trends for people to look out for. And also, thank you very much for the service that you provide.
Oh, my pleasure, and it's an honor to be on your show. And thanks for having me.
And thanks for the work that you're doing.
Thank you for joining us on this episode of now, our never Long Term Care Strategy with Kosta Yepifantsev if you enjoyed listening and you want to hear more, make sure you subscribe on Apple podcast, Spotify, or wherever you find your podcasts. Leave us a review or better yet, share this episode with a friend. Now we're never Long Term Care strategy with Kosta Yepifantsev is a Kosta Yepifantsev production.
Today's episode was written and produced by Morgan Franklin production assistants by Mike Franklin. Want to find out more about Kosta? Visit us at kostayepifantsev.com