Paul Contris answers more business questions in an interview. He discusses how the long-term care industry has changed significantly since he started in the 1980s, with the introduction of assisted living and independent living options transforming the industry. He notes the importance of adapting to constant changes in business over decades. When asked about adjustments he's had to make, Paul explains having to adapt to changes in reimbursement systems and regulations that impact revenue and expenses. While challenges remain, he remains optimistic about opportunities in the aging population. He also notes how outsourcing trends have not impacted his business since customers prefer local facilities.

1. Paul Contris Answers More Business Questions
Katherine: Helloeveryone,thankyouforjoiningusonthisneedstobe said.We're here withour
friendPaul Contrisof Welcov andhe'sgoingto be answeringsome more business
questionsforus.
Paul,I getexcitedwhenIhave the opportunitybecausesomanypeople are starting
businesses,aswe talkedaboutinpreviousconversations,andtheydon'tknow whatto
do whenthey're tryingtogrow fast. They're tryingtoget to where youare like in10
minutes orevena year,andtheydon't understandthe patience of itall.Iwantto ask
yousome more questions,definitelyit'sgoingtohelpthose thatare new inbusiness,
that are thinkingaboutbusiness,thatare notquite sure whatto expectotherthanthe
excitementof owningmyownbusiness.Okay?Are youcool withthat?
Paul: Sure.Yes.Thank you.
Katherine: The firstquestionIwantto ask you,what hasbeena surprisingchange inhow business
isdone nowverseswhenyoustarteddoingbusiness?
Paul: Well,Ihate to give awaymy age here,butwhenIstartedin thisbusiness,the longterm
care businesswas1983, 84, and man I'll tell you,we've beenthroughsome major
changesinthe last30 years.I guessfornew businessowners,that'swhatIwould sayis,
the onlysure thingis thatthingsare goingto change.You reallyneedtoexpectthatand
prepare forit. I thinkone of the keysto successislearninghow toadapt to that change.
WhenI started,the longtermcare businesswasprimarilynursinghomes,skillednursing
settings.Itwasreallybefore the adventof all of the wonderfuloptionswe have todayin
the housing,the seniorhousingmarket.Assistedliving,independentliving.That's
probablybeenthe mostsignificantchange isthatthe industryreallytransformedhowit
providesservicestothe elderlyinaverypositive waybecause30years ago,reallythe
onlyplace foryour momor yourdad whentheygotto that pointwhere theyneedsome
extrahelpwasa skillednursingsetting.Theycouldbe there withpeople whohad
medicallycomplex conditions,andalotof timesthe people whowere innursinghomes,
it wasn'treallythatappropriate of a settingforthemand the industryrespondedwith
introducing,likeIsaid,assistedlivingandindependentliving.More residential
apartment-like settingsforpeople whodidn'tneed24hourskillednursing,RN LPN care.
That reallytransformedthe industry.Irememberhearingsomebody,therewaskindof a
commonsayingback in1982, 83, some researchercome upwiththisideaor that
extrapolatingthe numbersoverthe next20years as far as the demandfornew nursing
homes,andthe elderlypopulation,the supply,how itwasincreasingexponentiallyand
theysaidyoucould buildone 120 bednursinghome everyday fornext20 yearsand you
wouldn'tkeepupwiththe demand.
Katherine: Wow.Wow.
Paul: He couldn'thave beenmore wrongbecause backthenthere was,I think,16000 nursing
homesinthe country andtoday there'saboutthe same number.Because what
happened,theycame upwithassistedlivingandindependentlivingandnobodysaw

2. Paul Contris Sept 2016 Interview Page 2 of 5
that comingat the time.
Katherine: Right.
Paul: But that's whathappened.That'sbeenone of the big...andthenthere'ssomanyother
changesas far as the reimbursement,what'shappenedwiththe Medicare andMedicaid
systemsandthat type of thing.I thinkthat'sprobablybeenone of the majorchangesin
the business,the introductionof seniorhousingoptions.
Katherine: Let me ask youthis,I know that's yourbusiness ...withthe livingskilledliving,skilled
nursing...you've seenmanychangesandjustthinkingaboutwhatyou're saying,Iwas
like wowbecause if the otherthingswouldn'thave come alongthenof course he
probablywouldhave beenright. He didn'tsee the change comingeither,withpeople
inventingotherwaysfortheirlovedonestolive indifferenttypesof facilities.Given
that, itdiversifiedthings,sothatwould've been...ifyoudependedsolelyonwhatthat
person'sprojectionswere,youreallyhadtobe flexibleandadjustandlandon yourfeet,
In orderto be in businessforaslongas youhave,30 yearsat least,you've hadtoadjust
to some things.
Talk to me aboutwhat you've hadto adjustto and whatthe learningcurveslookedlike?
The reasonI'm askingthat, as people whoare youngintheirbusiness,whenIsayyoung
Paul it isdefinitelyyoungcomparedtothe time thatyou've beeninbusiness.Someone
who'sjuststartingout, they're thinkingof quittingtheirjobtostartthis businessand
they're expectingittoreplace income immediately.They're notgivingthemselvestime
to learnwhat'shappeningouthere.It'seasyto clockin andclock out because it's
alreadypre-made foryou,butwhenyoucome outhere you've got to create it.Create
the job,create the money,create the clients,youknow youhave todoall thisstuff.I
wantto knowfrom youwhat hasbeenone of the biggestadjustmentsyou've hadto
make overthe 30 years?Or some of the biggestadjustments,because Icanimagine,
everyfewyearsthere wouldbe abigadjustment.Whatwasthe learningcurve like for
you?Did youhave to be quick?Did youhave time?Whatdidthat looklike?
Paul: Well there'sbeenanumberof changesoverthe 30 yearsand I've probablydone a
betterjobat adaptingto some thanothers.There'sprobablybeensome thatmaybe I
was aheadof the curve,saw it coming,made the adjustmentsandhada smooth
transition.Iknowthere wasalsosituationswhere Igotblindsidedorcaughtbysurprise
and kindof had to playcatch up and change something.Ithinkthat'sjustthe nature of
runninga business.Youtryto be as proactive andplanahead as muchas you can, but
there'salwaysgoingtobe...I meanthe latestthingnow inour industryisthe affordable
care act and healthcare reforminitiativesandit'stotallytransformingthe payer
sources,howwe getreimbursedforthe serviceswe provide andthere'sopportunity
there,butthere'salsoa lotof prettymajorheadwinds.It'sreducingourlengthof stay,
our average lengthof stayinour facilitieswhichisreducingourrevenueandatthe
same time,the affordable care acthas createda situationwhere ourhealthinsurance
costs have come up.It's great that the unemploymentisdown,andthe countryisdoing
better,butthat alsomeansthat it'smore challengingtogetgoodemployeesandyou
have to pay themmore.We have,on the expense side,we have upwardpressureson

3. Paul Contris Sept 2016 Interview Page 3 of 5
expensesandonthe revenue side we'vegotpressurespushingrevenue downmakesit
verychallenging.
Katherine: Right.
Paul: Your margingetstighterand tighter,butat the same time,it'shard for me to complain
too muchbecause I am ina businesswhere the fundamentalsare prettypromising.The
demographics,the agingof the population,butI'll tell youitcontinuestoevolveand
change at such a rapid pace it keepsyouonyour toes.
Katherine: Absolutely,absolutely.Whenyoutalkabout,andI'm gladyou said, I’mnot complaining
but youdefinitelygivenussome insight,whattoreallythinkabout.Because youhave
those adjustmentsyouwanttomake,those adjustments,andsome peoplethinkthatif
theirstepsare ordered,nothingshouldbe anobstacle tothem.That'sjustnot howyou
grow.That's not howyou overcome thingsandthat'snot how youbecome someone
whoseesa goodopportunityandseizesthe momentandIlike thatyousaid"sometimes
I'm aheadof the curve,sometimesI'mnot"andso itletspeople know we're always
learning,youend"we're forevergoingtobe on ourtoesand our business"because you
can plateauandyou getboredwiththat,I'm sure,but youhave the opportunityto
create somethingneworto be a part of anotherexperience oranotheropportunityjust
to see whatyou're workingonis growinganddoingwell andsometimesitjustgives
anotheropportunityforimprovement.That'sa lot,that isa lot,and I wouldlike toadd,
that people justbe gentle withyourself,be patientwithyourself.
What Paul istalkingaboutis 30 yearsplus.He has a lot of experience aheadof manyof
us inbusinesssohe'sseenwhere we're going.He alreadyknowswhere we're going.He
still enjoysit, - it’srewarding,andwe justneedtobe patient.
Paul: Amen.
Katherine: We're goingto get there,we're goingtosee some of those rewardstoo,or youcouldgo
back to workfor somebody,thatisyourchoice.
I'm not knockingit,forthose whosaid I wantto be inbusiness,thisismycalling,thisis
whatI'm supposedtodo, Paul islettingyouknow,there'sworkinvolved.Itwill be
rewarding,butthere'sworkinvolved.
What issomethingnewthathascome about,yetyoufoundit wasnot necessaryfor
your business?Letme give youanexample,Idon'twant to give awaytoomuch of my
age eitherPaul,Istill wantpeopletolookatme about21 yearsold,so I'm goingto say
someone toldme thisinformation.There wasatime whenwe couldleave home andwe
didn'tneedourphones,right?Youcan't leave yourhouse withoutyourcell phone now,
you'll double backtogo get it,butthere was a time whenyouwaitedtomake phone
callswhenyougot home.There wasa time whenyouwenttoget flowersyouhadto go
to an actual florist,nowyoucanorder themonline.There are some businessesout
there,like yourparticularbusiness,we can'tputthat online,thatdoesn'tchange.SoI
wantto knowin yourbusiness,whathave younoticedthatotherpeople mightbe trying

4. Paul Contris Sept 2016 Interview Page 4 of 5
or usingthat justneverbecame necessaryforyourbusiness?
Paul: The thingthat jumpsto my mind,kindof new developmentingeneralinthe business
worldoverthe last10 20 yearsthat haven'treallyimpactedourbusinessisthe whole
outsourcingphenomenon.There'ssomanyservices,manufacturing,thattype of thing
where businessare goingoutof the countryto lowercostsettings,andthat's beena
huge issue andchallenge toalot of companies.Mybusiness,youcan'treallydothat.
We provide the servicestoourcustomers,typicallytheyprefertobe ina facilitythatis
close to theirhome,theirhometown,sometimesyouwanttoretire ina whole different
state.Notsomethingthatcan be outsourced.Iguessthat's somethingthatwasn'treally
necessaryforour business.
Katherine: Everythingwon'tfit,andthe reasonI wantedtoask that questionPaul,isthere'sso
manythingsthat glitterandshine andwe call it the BrightShinyObjectsyndrome out
here and people wanttojumpon everynew craze.You have to determineif it'sgoingto
fityour businessbefore youjumponit.Itmay justnot work.Paul,I can't see
outsourcingworkingforyourbusiness.Idon'tknow enoughaboutit,butbecause you
workwithpeople,Ijustcan't see a whole lotof itbeingoutsourcedorany of it being
outsourced.There are goingtobe some thingsthatjustdon't fitour businessandIwant
people topayattentiontothat intheirbusiness.
Theywant to try somethingnew,everyday,andyouhaven'tgivenone processenough
time andthensometimesyoujust gotto realize,doIneedaphone withme all the
time?Yearsago it wasonlydoctorswho were oncall and theyhad a pageron theirhip.
The rest of us were able tosit througha meal and notbe bothered.Now,everybodyhas
theirgadgetrighton theirhip,soeverybody'sbeingpagedorcalledorcommandedto
be somewhere otherthanwhere theycurrentlyare.Isthatreallywhatyouwant inyour
business?Doyoureallywantthatto have to be the wayyoudo business?Can
outsource stuff?If youcan't what are some otheroptions,ordo you justneedtoleave
thingsas theyare?I thinkthisisa goodevaluationtype questionbecause peopleliketo
try thingsbutyou have to ask"Is thisgoing to be the bestuse of my time?My money?
My talents?Myemployee'stalent?Theirtime?How isthisgoingto affectus inthe long
run?" That's whyI wantedtoask that question,Paul.
I wantto say thank youagainfor beingsogracious,answeringthe questionsforthe
audience here onthisneedstobe said,because theyneedtohearfromexperience how
to stay inthisentrepreneurialrace,how tostay there.People are tryingtorushto the
finishline andIhave noideawhybecause they're missingthe experience buttheyneed
to knowthat everylevelof business,everypartof whatyou do,everycouple years
everyyear,you're goingtohave new developments,thingstoadjustto,thingsyou're
learningandit'sjustimportantthat theyknow thatso theycan take theirtime and
reallygetthe full experience.
So I justwantto say thank you.
Paul: Thank you,Katherine,it'smypleasure.

5. Paul Contris Sept 2016 Interview Page 5 of 5
Katherine: Awesome.Nowoutside of thisinterview,how canpeople getintouchwithyou?
Paul: The website is www.welcov.com.
Katherine: Awesome.Until nexttime Paul,have awonderful day.
Paul: Thank youKatherine.