June 12, 2025 • 26 mins
Mike Stodden and Wendy Bloomhuff of Rock Valley Physical Therapy share their journeys in private practice and innovative solutions for overcoming administrative barriers to provide exceptional patient care. The conversation reveals how passion for patient relationships drives practice decisions, while exploring the challenges of insurance requirements, administrative burdens, and practice management.
• Mike Stodden merged his successful private practice with Rock Valley PT after 17 years to maintain his patient-centered culture
• Wendy Bloomhuff leads Slate, a service helping private practices manage billing and administrative tasks to focus on patient care
• Insurance pre-certifications and administrative burdens create significant challenges for therapists wanting to focus on treatment
• Direct access has changed how physical therapists interact with both patients and referral sources
• The "art of therapy" comes from experience in knowing where to start with patients and how to progress their care
• Rural clinics face unique challenges in maintaining staffing and administrative support
• Building professional relationships through APTA Nebraska provides support, solutions, and community for therapists
• Physical therapists can help reduce healthcare costs by treating patients directly without unnecessary imaging or medications
Episode Links:
Rock Valley Physical Therapy
Slate
Net Health Therapy Source
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to the APTA Nebraska podcast, where we dive
into the stories, challenges andinnovations shaping physical
therapy in our state.
We're here to advance, promoteand protect the practice of
physical therapy, optimizing thehealth and quality of life for
all Nebraskans.
Join us as we connect withexperts, share insights and
(00:22):
build communities throughout ourprofession.
Connect with experts, shareinsights and build communities
throughout our profession.
All right, welcome back to theAPTA Nebraska podcast.
I'm Brad Dexter, your host, andtoday I have a little member
spotlight that we're going to dofor this conversation.
So I'm joined by Mike Stoddenof Rock Valley PT and Wendy
(00:44):
Blumhoff of Rock Valley PT.
Guys, thanks for joining me.
Thanks, brian, thanks.
So both of them are with RockValley PT.
Both of them are physicaltherapists by trade, but I've
asked them to just tell us alittle bit about themselves and
we'll carry on a little bit of aconversation going from there.
So, Mike, I might start withyou and just ask you to share
(01:06):
with the audience a little bitabout yourself.
Speaker 2 (01:10):
Well, I'm a, I am a physical therapist and I started
my own practice in 2004.
And then I was telling apatient the other day I've
almost been a therapist for 30years so long time and so I'm
operating, mostly treating, outof the Elkhorn Clinic and I
started my own practice it wasStodden Physical Therapy and ran
(01:30):
that for 17 years, built it tofour clinics and then three
years ago I merged with RockValley Physical Therapy, based
out of the Quad Cities inIllinois and Iowa, not to be
confused with Rock Valley up inNorthwest Iowa that we hear all
the time over here.
So the and why did I chooseRock Valley?
Well, they are a privatecompany owned by therapists, led
(01:55):
by therapists, and they wantedto treat the same way I did.
They asked me Mike what, whatdo you want in this?
And I said I want my patientstaken care of the way I've
always done it, I want myculture to stay the same and I
want my employees taken care of.
If we can make, this merger.
And they said well, what aboutyou?
(02:15):
I said those things are firstand that's always the way I've
ran my practice are those aspriorities?
And they Rock Valley executiveteam said, well, that's perfect,
because that's what we do.
Also I said, okay, well, let'stalk.
So I was able to merge intoRock Valley and I'm a partner in
Rock Valley and we're joined byWendy Blumhop who is also a
partner in Rock Valley, and sothat's kind of what has happened
(02:39):
.
So it's, my clinics were inElkhorn for the home base and
then we added to Bennington andthen Gretna and then Alliance
out in the Panhandle, and sothere was a little bit of a
distance there.
Also, it was challenging as anowner.
It's challenging.
(02:59):
There's a lot of differentthings that pull at you and you
wear 19 hats, so it's probablythat I wasn't great at any one
of them.
I tried to be as good as I can.
But it's a matter of having ateam but also having people
around you, like the NebraskaPhysical Therapy Association,
that you can bounce things offof, because everybody goes
(03:20):
through some of the sameproblems or issues.
It's just different scalessometimes.
Speaker 1 (03:33):
Yeah, hey.
So when you 30 years ago, oralmost 30 years ago, when you
had gotten out of school as anew physical therapist, how long
did you practice before youstarted your own clinic, and
what made you kind of take thatjump when you did it?
Speaker 2 (03:42):
So I practiced in New York, nebraska, to start, and
then opened a clinic in Fremontand that was three years went up
to Ottawa, iowa, and then ranthe physical therapy department
at Burgess Health Center, ranthat for six years and I've
always wanted to start my ownpractice and good or bad, I
wanted to make.
I'm kind of a quick start guyand make fast decisions and I
(04:05):
got tired of a bunch of a bunchof committees and and talking
with a bunch of different peoplefor years to try and get
something and I had a chance toopen up my own clinic.
I was like, yeah, you know whatthis looks, great, I'm ready.
I've been able to increaseproductivity everywhere I went
and cure and procure my practiceand so I was able to open up in
2004 in Elkhorn.
Speaker 1 (04:26):
Okay, awesome.
And then maybe just to get intoMike's life a little bit more.
Mike, what does family lifelook like for you?
What do you enjoy doing from arecreational or hobby standpoint
?
Speaker 2 (04:38):
Yeah, well, I love golf and I love sports.
I love to see some of the kidsin the clinic and in fact,
that's kind of how I started.
I would see the sports athletesfirst, which would grow to the
parents, and then thegrandparents and around the
clinic.
I have a bunch of pictures ofhigh school students that went
into college and play.
I have jerseys.
(04:59):
So those were some of thethings that were really
important to me.
Those were some of the thingsthat were really important to me
.
And the golfing is great becauseit's a challenge with every
shot.
I'm not that great but I lovebeing outdoors and love the
exercise, and my kids are out ofthe house and both in college,
and so I'm watching them.
My daughter runs track incollege.
My son got into the physicianassistant program at UNMC and he
(05:24):
loves to golf, so we're golfingtogether now before he starts
his school.
So that's and, uh, I guess, oneother thing I'm I'm kind of a
green thumb.
My dad was a green thumb and hetaught me how to plant, and so
I just spent four or five hoursthis weekend planning all my
planters and I can't wait to seewhat, how they bloom, and I
hope they grow that's great.
Speaker 1 (05:42):
Do you have a favorite golf course?
Speaker 2 (05:44):
well, I'm a member at the Pines and Valley but I've
been out to the Western area andthe dismal golf courses.
Those are challenging but I canget out.
The thing about golf is youmeet such great people.
You talk about business, aboutlife, about just getting to know
somebody, and I've met some ofthe nicest people on the golf
course when you just meet themfor the first time.
Speaker 1 (06:08):
I love it.
Thanks, mike, appreciate that.
Wendy, would you mind tellingus a little bit about yourself?
Speaker 3 (06:13):
Sure, my name is Wendy Blumhoff, so I have worked
for Rock Valley for 18 years.
As Mike mentioned, I am apartner as well.
I actually started with RockValley pretty much had been with
Rock Valley my entire career.
So started as a student wayback in the day for one of my
clinical rotations and quicklycame back to them when I had the
(06:33):
opportunity just a year aftergraduation.
So I have worked in several ofour different regions, all on
the Iowa side.
So I and I'm highly involvedwith APTA Iowa on our side, so
friend of Nebraska for sure, butprimarily PT in Iowa.
(06:55):
More recently I transitionedinto a role for our new
organization called Slate, andSlate is a service where we
provide all RCM services as wellas some other insurance
verification, authorizationservices to privately owned
practices to really help smallprivate practice owners, like
(07:17):
Mike was speaking about earlier,really deal with that
administrative burden and reallyhelp private practices remain
privately owned and privatelyled and help them just be able
to focus on taking care of theircommunities and their patients,
and let us take care of therest.
Speaker 1 (07:32):
That's great.
Thanks for joining us.
Like you said, even thoughyou're on the Iowa side, you're
a friend of Nebraska and you'vecertainly been engaged with some
of the APTA Iowa things acrossthe river.
So thanks for joining us.
Just think about the fact thatover the course of our careers,
(08:00):
there's often simultaneouslygood and hard things that are
happening throughout our lives,throughout our careers.
So can you talk a little bitabout just what has been the
hardest or maybe not the hardest, but what's been hard or
challenging about being aphysical therapist and also
what's brought you joy frombeing a physical therapist?
Speaker 2 (08:18):
Of course, brad, thanks for that question.
So I do believe that some ofthe hardest things when we have
to spend so much administrativetime and office time trying to
get pre-certifications andverifications for insurance
we're fighting those things allthe time.
All we want to do is see thepatients get them in the door
and so we can start to treatthem and get them better, cause
(08:39):
I believe that we're a serviceindustry and we serve our
patients and I believe wechanged their lives and we have
a unique ability to do that withsome, with many physician
offices, they get to see themonce or twice but, yeah, they
follow through the lifetime.
We get to see them two or threetimes a week, up for sometimes
six, eight, 12 weeks aftersurgery and they become like
(09:01):
family.
So that's what's really hard ifwe are limited by the
insurances and visits orpre-certifications.
Some other things that's madeit hard is well, google
everybody's a physical therapistnow because they can look up
exercises like well careful whatyou read.
Speaker 1 (09:20):
And now AI right, you can just yeah.
Speaker 2 (09:23):
And so that's the didactic part, or people can
look that up.
But the art of therapy, Ibelieve, with wisdom and
practice, is that you know whereto start with the patient and
you read the patient becauseyou're looking at them eye to
eye, and how you progress thatpatient in their program, in
their plan of care.
That's the art and that's whatAI or Google doesn't take into
(09:47):
account.
And you know, people are busythese days and it's sometimes
it's hard to get in and hard tohave enough time because they
don't have a lot of time.
They're chasing around, they'rein their job, they're working
all the time, and so just someof the competing schedules of
people.
Now it's really hard to getpeople in, but we do our best to
(10:08):
try and be accommodative towhether it's early in the
morning, late at night, we haveto see somebody over lunch,
that's.
That's some of the challengeswhere I always say yes, and I
probably need to do better, butthat's how I built my practice,
so whenever they need to get in,we get them in.
Speaker 1 (10:25):
And I would imagine you know, as a physical
therapist that's been practicingfor close to 30 years, you've
maybe seen the system change alittle bit.
You've seen, maybe, howpatients are able to access
information.
You've seen those things change.
How has your practice evenchanged and evolved over time?
Speaker 2 (10:48):
The well, with the whole idea of Nebraska being a
direct access state, that issuch a powerful tool and it's a
matter of reminding people hey,you don't need a prescription to
come in and see us.
We want to be that first personyou see for that
musculoskeletal orthopedicproblem, and so it's a matter of
getting that word out and Ibelieve that's what's changed
(11:10):
where it used to be.
We were so heavily relying onreferral relationships.
Now they're very important also.
Referral relationships withphysicians uh, mid-levels, uh
and uh, even even other coaches,nurse practitioners I guess
that's mid-level, uh, but that'sthat's what's changed, I
believe.
And then getting access, andthen online scheduling and and
(11:33):
calling in and and seeing ifthey can change.
So all the AI and I'm probablythe worst AI guy or the IT guy
in the company because I'm oldand I admit it but those things
are changing so fast Sometimesthat's just hard to keep up with
.
Speaker 1 (11:52):
Absolutely so.
You know, you and I have talkedbefore and you mentioned your
clinic that you had underStodden Physical Therapy out in
Alliance, right yeah, and youjust told me a story about, you
know, ultimately needing to shutdown that clinic and the hard
decision that was made there.
(12:13):
Right, I would assume that'sbeen a hard piece of your career
as well.
You know, ultimately we'regetting into PT a lot of the
time to help people to solveproblems and owning your own
clinic right, kind of take someof those things to a new level
and it changes the complexity alittle bit too.
(12:35):
Can you talk about maybe thattime in your life where you
needed to close down that clinicand what some of the challenges
were there?
Speaker 2 (12:46):
Yeah, of course, brad .
So our therapist was able tomove back home near family, and
family is the number one thingalways, whether it's in my life
or Rock Valley has the same idea.
So we're trying to find otherpeople and I talked to eight or
10 different people that couldthey take this clinic over and
(13:06):
they can open up their own shop.
They can do their own thing.
But I didn't get a lot ofpeople that were really excited
about they were somewhatinterested, but I really think
the barrier was that theyweren't comfortable getting
their own insurance contracts.
What the EMR would look like,how much are they gonna learn?
(13:26):
How much is it gonna cost?
And then how are they gonnabill?
Do they have to hire somebodyjust to bill?
Because if you're trying totake care of patients and you're
working 40, 50 hours a week,when do you have time to
actually bill?
Because if you're trying totake care of patients, you're
working 40, 50 hours a week,when do you have time to
actually bill?
All of a sudden, if you'retrying to do that, it's a
(13:48):
70-hour week.
And then who to hire?
And are they adept with theinsurance companies?
Do they know what they're doing, especially in the smaller
rural communities.
So I believe that was a hugebarrier and probably people
didn't take the leap where theycould get in and run their own
practice, and so I really.
It was hard a little story whenI was there a month before we
had to close down filling in andsometimes I sing to patients.
(14:12):
So there's a gal there thatwe're seeing for a stroke and
her daughter was there with herand so I sang the Ave Maria for
them.
I won't sing it now, but that'sokay, and they were there on
the last day when we closed down.
Of course it's an emotionaltime.
We saw so many people in thatcommunity in our clinic and the
(14:40):
daughter says to me, seeing mefor the last time mike, don't
ever stop singing your patients.
Because it was a blessing.
My mother loved it and I and Iwant to, I want to be fully
transparent I cried, I wept andshe gave me a hug and I she said
, I know this is hard.
I said, yes, this is hard.
I wish we had other peoplecoming around, are coming and
taking this over to continue totake care of you.
(15:01):
So it was an emotional time,but the relationships that we
all form, no matter if it'selkhorn or iowa or unmc.
You're out in the lions.
Those are special because weknow we're we're making a
difference in their lives yeah.
Speaker 1 (15:17):
So you know, as physical therapists, we have a
skill set to be able to helppeople, to step in, to change
their lives, to use theknowledge and information that
we've gained from a clinicalperspective.
But you've also shared someinformation about how you've
done that as a business owner.
You've talked about thebarriers and some of the
challenges that exist there.
(15:39):
Again, it gets pretty complex,but I think what's something
unique that you guys are doingat Rock Valley right now is
you're looking at some of thosebarriers that can exist for
private practice owners andyou're trying to eliminate some
of those.
Right and that's not a newconcept, right?
People have been trying to dothat for a long time.
We need to be customer-facing,we need to be patient-facing.
(16:01):
We need to be customer-facing.
We need to be patient-facing.
We need to give them our time.
As people that in yourorganization are in positions of
leadership, you're looking totry to find ways for your
physical therapist to spend timewith their patients and to help
them get better.
Right, which means offeringefficiencies on the back end of
things.
So, wendy, maybe I'll open itup to you to talk a little bit
(16:23):
about what you guys are doingwith Slate and how Rock Valley
is using that because maybethat's something that could be
beneficial to other privatepractice owners within our state
as well.
Speaker 3 (16:34):
Sure, you know and I'm going to go back to a little
bit about the discussion aboutthe Alliance Clinic so you know,
the Alliance Clinic was one ofRock Valley's clinics when Mike
joined Rock Valley and so youknow, the first thing we
struggled with was do we havesomebody within the organization
that wants to, you know, movein and take over that clinic?
And we had a hard time.
(16:55):
We often have a hard time inthose smaller rural communities
finding that person that wantsto lead that clinic,
specifically if they're not fromthat community.
Because we all know clinicsthat do well are those that when
you're living and working inthe community, when you're
living in the community in whichyou work, that just seems to be
the most successful becauseyou're a part of that community,
(17:16):
especially a smaller community,everybody knows you and
everybody understands thatyou're the face of that clinic.
And so, as Mike said, then hehad several conversations with
others to see if they wanted totake over that particular clinic
and and and bring that on astheir own private practice.
And so you know, as hementioned, the struggle there is
is just a lot of theadministrative burden or all of
(17:36):
the other things that get in theway of us being able to take
great care of patients.
And so what Slate is?
You know, the goal of Slate isto be able to take on those
things for smaller privatepractice owners, because we
don't want to discouragesomebody, you know, just out of
school, having several yearsexperience somewhere else, that
says I just want to hang myshingle somewhere and start my
(17:58):
own practice, like that's whatwe want to encourage and we
don't want to discourage thatfrom continuing to happen in
private practice.
And so, you know, slate'smission is just to say, okay,
what is that barrier that we canerase for you?
And so that's where we started.
Obviously, the billing side ofthings doing a really great job
with getting claims out clean,getting paid in an efficient
manner, getting paid what youdeserve to get paid for those
(18:21):
visits, for that hard work thatyou're doing, and then giving
you some consulting with regardsto different patterns and
themes that we see with regardsto where there may be some
improvements that can be made,and then building on that with
then, okay, what's that nextbarrier?
As Mike mentioned earlier,verifying benefits in some cases
it's just mostly a time taker,right.
(18:43):
So being able to do that fororganizations as well as to help
with the prior biggest time.
You know where they're spendingmost of their time and saying,
(19:04):
okay, how can we take that awayfrom you and allow you just more
time to spend with patients,which is ultimately what your
goal was in opening thispractice.
Speaker 1 (19:13):
Yeah, so you kind of get to do kind of an overall
audit of where some of thesticky points or the pain points
might be, and then you'rehelping to try to design
efficiencies on the back end.
Is that?
Speaker 3 (19:28):
accurate yeah.
Speaker 1 (19:30):
Head nods.
Yes absolutely, Mike.
Anything you want to add tothat?
Speaker 2 (19:36):
Well and part of Slate, and as we have a
relationship with Net Health,the EMR and what they've done a
nice job and Wendy's reallychampioned this is to make it a
very good EMR and note-takingsystem, scheduling system.
That is for therapists.
(19:57):
You know that's the last thingwe want to do is spend all this
time trying to do notes.
We're trying to make it asefficient as possible.
There's templates that are madeout there.
We can make them just to fitevery one of our practices,
because I see backs a little bitdifferent probably than anybody
else.
I mean, everybody has their ownindividual practice, right.
So this is what this EMR allowsus to do is to still see these
(20:20):
practices and if you want to gointo a niche practice, we have
the ability to transform thatEMR into what that evaluation
and that progress note lookslike.
So it's been a great, a greattransfer.
Now, it's always hard movingEMRs, but the other thing what
Wendy has is has a whole team ofhow to transition and how to
(20:40):
help and how to guide and how toteach.
That's the other thing thatcould be if people are want to
change EMRs.
Oh, because it's it's likeholding back the tide.
It's so hard to do, but we wantto make that easy as well.
Is there a part of that, wendy,that that you want to add to
that?
Speaker 3 (20:58):
No, I think that's great, mike.
I think you know and we've hadpeople you know ask us well, we
like our EMR, can we?
You know we don't really want tochange EMRs, as Mike said, it's
a big undertaking, but can youjust do billing services for us?
And you know our answer to thatis no.
It's a package deal and thereason for that is we
specifically vetted EMRs, vettedNuthouse, specifically the
(21:20):
therapy source product, to meetthe needs of private practices
and ensure that we were gettingas accurate of information as we
can out of the system, asunique information as we can out
of the system, so that yourbilling looks exactly the way
you want it to going out thedoor.
There's not a whole lot thatneeds to be finagled on the back
end to ensure that you'regetting your claims paid the way
(21:41):
they want to, and so just thecustom, the ability to customize
, as well as the compliance sideof things for TherapySource is
what made like made our decisionto partner with TherapySource.
So we really encourage, youknow, those who are looking for
someone you know, like Slate, todo RCM services for them, like
to look at for that package dealwhere they're really working
(22:03):
closely, intimately with the EMRto ensure that they're
continuing to grow together,because then that ultimately is
going to impact.
You know how efficiently andhow well you're getting paid, so
Good.
Speaker 1 (22:15):
Well, that's.
I think that's just a greatexample of recognizing hey,
there's certain challenges andbarriers to what we're doing,
but let's try to find solutionsto this instead of becoming
disillusioned with the process,right?
So I think I appreciate that,definitely.
All right, I have one morequestion, Mike, I'm going to aim
this directly at you, justbecause Wendy's on the other
(22:35):
side of the river.
We like you, Wendy, Iappreciate that we like you,
wendy.
Speaker 2 (22:49):
Mike, I would love for you to just answer what
value have you found in being amember of APTA Nebraska?
So the idea about the NPTA isyou get to meet so many people
across the state and no matterif they're in a hospital or if
they're in a private practice orthey're in a large group or a
small group or in nursing homes.
I mean, we all have some of thesame issues and then we start
to talk oh yeah, I used to dothis and I did this.
(23:11):
So the relationship buildingthroughout the state is really,
really important.
I think the NPTA NebraskaPhysical Therapy Association is
a great medium for that.
When we went out to Kearneyjust a month ago, we got to talk
to all kinds of people, meetnew people, catch up with some
of the people that I haven'tseen for five years.
It was great to do that and Ibelieve the strength is in the
(23:36):
numbers, because we're havingnot as many applicants for NPTA,
but they're coming in on otherways.
I think the students arestarting to get more involved
and I think having the studentsinvolved and then they stay a
therapist, they stay in Nebraskaand that's going to allow us to
grow and we start with astudent and then they become
(23:58):
leaders in our state, in ourprofession.
So as we work together of thestudent and then they become
leaders in our state, in ourprofession.
So about as we work togetherbecause that's we can't do it
individually when talking toinsurance companies and looking
at different ways to get infront of insurance companies and
promote our physical therapypractice, to promote direct
(24:18):
access, and that's ultimatelygoing to be saving patients
money.
So if we can see them first andget their back better without
x-rays, medicine or MRI, hey youknow what, it's great for the
whole medical system and thepayments that we're trying to
curb so much and being asefficient as we can.
Speaker 1 (24:37):
Yeah, I really appreciate that.
I think what you said in termsof you know, really there's
strength in numbers and listen,a lot of what we do it's not
going to end up being perfect,right, we're not going to find
solutions quick solutions reallyreally fast through legislative
processes or developing newpolicies, right, right, like
(25:02):
those things take a long time todo, but the way that you move
the needle on it is by havingsome amount of unity and and
hopefully you know, this is ourfirst member spotlight for the
APTA Nebraska podcast andhopefully getting to know people
, even through some audio, inthis way helps us take the next
step to connecting anddeveloping a little bit more
community among our professionwithin our state too.
(25:22):
So, mike, thanks for being aguinea pig and Wendy, thanks for
joining us on the podcast aswell.
Appreciate having you guys.
Speaker 3 (25:30):
Thank you.
Speaker 2 (25:30):
Brad, thank you for the opportunity.
It's been great.
So, again, I've not met youbefore, brad, but we're getting
to know you and I got to knowyou at the conference.
So this is what it's about.
So we appreciate theopportunity and how can we help
Nebraska and Iowa too?
Speaker 1 (25:49):
Drop that in there, all right.
Listeners, thanks for joiningus and hope you enjoyed this
episode.
Thank you, brad.
Thank you everyone.
Thanks for tuning in to theAPTA Nebraska podcast.
Stay connected with us for moreconversations that elevate our
profession and improve the livesof Nebraskans.
Don't forget to subscribe,share and join the discussion,
(26:10):
because together we're drivingthe future of physical therapy
forward.
Welcome to the APTA Nebraska podcast, where we dive
into the stories, challenges andinnovations shaping physical
therapy in our state.
We're here to advance, promoteand protect the practice of
physical therapy, optimizing thehealth and quality of life for
all Nebraskans.
Join us as we connect withexperts, share insights and
(00:22):
build communities throughout ourprofession.
Connect with experts, shareinsights and build communities
throughout our profession.
All right, welcome back to theAPTA Nebraska podcast.
I'm Brad Dexter, your host, andtoday I have a little member
spotlight that we're going to dofor this conversation.
So I'm joined by Mike Stoddenof Rock Valley PT and Wendy
(00:44):
Blumhoff of Rock Valley PT.
Guys, thanks for joining me.
Thanks, brian, thanks.
So both of them are with RockValley PT.
Both of them are physicaltherapists by trade, but I've
asked them to just tell us alittle bit about themselves and
we'll carry on a little bit of aconversation going from there.
So, Mike, I might start withyou and just ask you to share
(01:06):
with the audience a little bitabout yourself.
Speaker 2 (01:10):
Well, I'm a, I am a physical therapist and I started
my own practice in 2004.
And then I was telling apatient the other day I've
almost been a therapist for 30years so long time and so I'm
operating, mostly treating, outof the Elkhorn Clinic and I
started my own practice it wasStodden Physical Therapy and ran
(01:30):
that for 17 years, built it tofour clinics and then three
years ago I merged with RockValley Physical Therapy, based
out of the Quad Cities inIllinois and Iowa, not to be
confused with Rock Valley up inNorthwest Iowa that we hear all
the time over here.
So the and why did I chooseRock Valley?
Well, they are a privatecompany owned by therapists, led
(01:55):
by therapists, and they wantedto treat the same way I did.
They asked me Mike what, whatdo you want in this?
And I said I want my patientstaken care of the way I've
always done it, I want myculture to stay the same and I
want my employees taken care of.
If we can make, this merger.
And they said well, what aboutyou?
(02:15):
I said those things are firstand that's always the way I've
ran my practice are those aspriorities?
And they Rock Valley executiveteam said, well, that's perfect,
because that's what we do.
Also I said, okay, well, let'stalk.
So I was able to merge intoRock Valley and I'm a partner in
Rock Valley and we're joined byWendy Blumhop who is also a
partner in Rock Valley, and sothat's kind of what has happened
(02:39):
.
So it's, my clinics were inElkhorn for the home base and
then we added to Bennington andthen Gretna and then Alliance
out in the Panhandle, and sothere was a little bit of a
distance there.
Also, it was challenging as anowner.
It's challenging.
(02:59):
There's a lot of differentthings that pull at you and you
wear 19 hats, so it's probablythat I wasn't great at any one
of them.
I tried to be as good as I can.
But it's a matter of having ateam but also having people
around you, like the NebraskaPhysical Therapy Association,
that you can bounce things offof, because everybody goes
(03:20):
through some of the sameproblems or issues.
It's just different scalessometimes.
Speaker 1 (03:33):
Yeah, hey.
So when you 30 years ago, oralmost 30 years ago, when you
had gotten out of school as anew physical therapist, how long
did you practice before youstarted your own clinic, and
what made you kind of take thatjump when you did it?
Speaker 2 (03:42):
So I practiced in New York, nebraska, to start, and
then opened a clinic in Fremontand that was three years went up
to Ottawa, iowa, and then ranthe physical therapy department
at Burgess Health Center, ranthat for six years and I've
always wanted to start my ownpractice and good or bad, I
wanted to make.
I'm kind of a quick start guyand make fast decisions and I
(04:05):
got tired of a bunch of a bunchof committees and and talking
with a bunch of different peoplefor years to try and get
something and I had a chance toopen up my own clinic.
I was like, yeah, you know whatthis looks, great, I'm ready.
I've been able to increaseproductivity everywhere I went
and cure and procure my practiceand so I was able to open up in
2004 in Elkhorn.
Speaker 1 (04:26):
Okay, awesome.
And then maybe just to get intoMike's life a little bit more.
Mike, what does family lifelook like for you?
What do you enjoy doing from arecreational or hobby standpoint
?
Speaker 2 (04:38):
Yeah, well, I love golf and I love sports.
I love to see some of the kidsin the clinic and in fact,
that's kind of how I started.
I would see the sports athletesfirst, which would grow to the
parents, and then thegrandparents and around the
clinic.
I have a bunch of pictures ofhigh school students that went
into college and play.
I have jerseys.
(04:59):
So those were some of thethings that were really
important to me.
Those were some of the thingsthat were really important to me
.
And the golfing is great becauseit's a challenge with every
shot.
I'm not that great but I lovebeing outdoors and love the
exercise, and my kids are out ofthe house and both in college,
and so I'm watching them.
My daughter runs track incollege.
My son got into the physicianassistant program at UNMC and he
(05:24):
loves to golf, so we're golfingtogether now before he starts
his school.
So that's and, uh, I guess, oneother thing I'm I'm kind of a
green thumb.
My dad was a green thumb and hetaught me how to plant, and so
I just spent four or five hoursthis weekend planning all my
planters and I can't wait to seewhat, how they bloom, and I
hope they grow that's great.
Speaker 1 (05:42):
Do you have a favorite golf course?
Speaker 2 (05:44):
well, I'm a member at the Pines and Valley but I've
been out to the Western area andthe dismal golf courses.
Those are challenging but I canget out.
The thing about golf is youmeet such great people.
You talk about business, aboutlife, about just getting to know
somebody, and I've met some ofthe nicest people on the golf
course when you just meet themfor the first time.
Speaker 1 (06:08):
I love it.
Thanks, mike, appreciate that.
Wendy, would you mind tellingus a little bit about yourself?
Speaker 3 (06:13):
Sure, my name is Wendy Blumhoff, so I have worked
for Rock Valley for 18 years.
As Mike mentioned, I am apartner as well.
I actually started with RockValley pretty much had been with
Rock Valley my entire career.
So started as a student wayback in the day for one of my
clinical rotations and quicklycame back to them when I had the
(06:33):
opportunity just a year aftergraduation.
So I have worked in several ofour different regions, all on
the Iowa side.
So I and I'm highly involvedwith APTA Iowa on our side, so
friend of Nebraska for sure, butprimarily PT in Iowa.
(06:55):
More recently I transitionedinto a role for our new
organization called Slate, andSlate is a service where we
provide all RCM services as wellas some other insurance
verification, authorizationservices to privately owned
practices to really help smallprivate practice owners, like
(07:17):
Mike was speaking about earlier,really deal with that
administrative burden and reallyhelp private practices remain
privately owned and privatelyled and help them just be able
to focus on taking care of theircommunities and their patients,
and let us take care of therest.
Speaker 1 (07:32):
That's great.
Thanks for joining us.
Like you said, even thoughyou're on the Iowa side, you're
a friend of Nebraska and you'vecertainly been engaged with some
of the APTA Iowa things acrossthe river.
So thanks for joining us.
Just think about the fact thatover the course of our careers,
(08:00):
there's often simultaneouslygood and hard things that are
happening throughout our lives,throughout our careers.
So can you talk a little bitabout just what has been the
hardest or maybe not the hardest, but what's been hard or
challenging about being aphysical therapist and also
what's brought you joy frombeing a physical therapist?
Speaker 2 (08:18):
Of course, brad, thanks for that question.
So I do believe that some ofthe hardest things when we have
to spend so much administrativetime and office time trying to
get pre-certifications andverifications for insurance
we're fighting those things allthe time.
All we want to do is see thepatients get them in the door
and so we can start to treatthem and get them better, cause
(08:39):
I believe that we're a serviceindustry and we serve our
patients and I believe wechanged their lives and we have
a unique ability to do that withsome, with many physician
offices, they get to see themonce or twice but, yeah, they
follow through the lifetime.
We get to see them two or threetimes a week, up for sometimes
six, eight, 12 weeks aftersurgery and they become like
(09:01):
family.
So that's what's really hard ifwe are limited by the
insurances and visits orpre-certifications.
Some other things that's madeit hard is well, google
everybody's a physical therapistnow because they can look up
exercises like well careful whatyou read.
Speaker 1 (09:20):
And now AI right, you can just yeah.
Speaker 2 (09:23):
And so that's the didactic part, or people can
look that up.
But the art of therapy, Ibelieve, with wisdom and
practice, is that you know whereto start with the patient and
you read the patient becauseyou're looking at them eye to
eye, and how you progress thatpatient in their program, in
their plan of care.
That's the art and that's whatAI or Google doesn't take into
(09:47):
account.
And you know, people are busythese days and it's sometimes
it's hard to get in and hard tohave enough time because they
don't have a lot of time.
They're chasing around, they'rein their job, they're working
all the time, and so just someof the competing schedules of
people.
Now it's really hard to getpeople in, but we do our best to
(10:08):
try and be accommodative towhether it's early in the
morning, late at night, we haveto see somebody over lunch,
that's.
That's some of the challengeswhere I always say yes, and I
probably need to do better, butthat's how I built my practice,
so whenever they need to get in,we get them in.
Speaker 1 (10:25):
And I would imagine you know, as a physical
therapist that's been practicingfor close to 30 years, you've
maybe seen the system change alittle bit.
You've seen, maybe, howpatients are able to access
information.
You've seen those things change.
How has your practice evenchanged and evolved over time?
Speaker 2 (10:48):
The well, with the whole idea of Nebraska being a
direct access state, that issuch a powerful tool and it's a
matter of reminding people hey,you don't need a prescription to
come in and see us.
We want to be that first personyou see for that
musculoskeletal orthopedicproblem, and so it's a matter of
getting that word out and Ibelieve that's what's changed
(11:10):
where it used to be.
We were so heavily relying onreferral relationships.
Now they're very important also.
Referral relationships withphysicians uh, mid-levels, uh
and uh, even even other coaches,nurse practitioners I guess
that's mid-level, uh, but that'sthat's what's changed, I
believe.
And then getting access, andthen online scheduling and and
(11:33):
calling in and and seeing ifthey can change.
So all the AI and I'm probablythe worst AI guy or the IT guy
in the company because I'm oldand I admit it but those things
are changing so fast Sometimesthat's just hard to keep up with
.
Speaker 1 (11:52):
Absolutely so.
You know, you and I have talkedbefore and you mentioned your
clinic that you had underStodden Physical Therapy out in
Alliance, right yeah, and youjust told me a story about, you
know, ultimately needing to shutdown that clinic and the hard
decision that was made there.
(12:13):
Right, I would assume that'sbeen a hard piece of your career
as well.
You know, ultimately we'regetting into PT a lot of the
time to help people to solveproblems and owning your own
clinic right, kind of take someof those things to a new level
and it changes the complexity alittle bit too.
(12:35):
Can you talk about maybe thattime in your life where you
needed to close down that clinicand what some of the challenges
were there?
Speaker 2 (12:46):
Yeah, of course, brad .
So our therapist was able tomove back home near family, and
family is the number one thingalways, whether it's in my life
or Rock Valley has the same idea.
So we're trying to find otherpeople and I talked to eight or
10 different people that couldthey take this clinic over and
(13:06):
they can open up their own shop.
They can do their own thing.
But I didn't get a lot ofpeople that were really excited
about they were somewhatinterested, but I really think
the barrier was that theyweren't comfortable getting
their own insurance contracts.
What the EMR would look like,how much are they gonna learn?
(13:26):
How much is it gonna cost?
And then how are they gonnabill?
Do they have to hire somebodyjust to bill?
Because if you're trying totake care of patients and you're
working 40, 50 hours a week,when do you have time to
actually bill?
Because if you're trying totake care of patients, you're
working 40, 50 hours a week,when do you have time to
actually bill?
All of a sudden, if you'retrying to do that, it's a
(13:48):
70-hour week.
And then who to hire?
And are they adept with theinsurance companies?
Do they know what they're doing, especially in the smaller
rural communities.
So I believe that was a hugebarrier and probably people
didn't take the leap where theycould get in and run their own
practice, and so I really.
It was hard a little story whenI was there a month before we
had to close down filling in andsometimes I sing to patients.
(14:12):
So there's a gal there thatwe're seeing for a stroke and
her daughter was there with herand so I sang the Ave Maria for
them.
I won't sing it now, but that'sokay, and they were there on
the last day when we closed down.
Of course it's an emotionaltime.
We saw so many people in thatcommunity in our clinic and the
(14:40):
daughter says to me, seeing mefor the last time mike, don't
ever stop singing your patients.
Because it was a blessing.
My mother loved it and I and Iwant to, I want to be fully
transparent I cried, I wept andshe gave me a hug and I she said
, I know this is hard.
I said, yes, this is hard.
I wish we had other peoplecoming around, are coming and
taking this over to continue totake care of you.
(15:01):
So it was an emotional time,but the relationships that we
all form, no matter if it'selkhorn or iowa or unmc.
You're out in the lions.
Those are special because weknow we're we're making a
difference in their lives yeah.
Speaker 1 (15:17):
So you know, as physical therapists, we have a
skill set to be able to helppeople, to step in, to change
their lives, to use theknowledge and information that
we've gained from a clinicalperspective.
But you've also shared someinformation about how you've
done that as a business owner.
You've talked about thebarriers and some of the
challenges that exist there.
(15:39):
Again, it gets pretty complex,but I think what's something
unique that you guys are doingat Rock Valley right now is
you're looking at some of thosebarriers that can exist for
private practice owners andyou're trying to eliminate some
of those.
Right and that's not a newconcept, right?
People have been trying to dothat for a long time.
We need to be customer-facing,we need to be patient-facing.
(16:01):
We need to be customer-facing.
We need to be patient-facing.
We need to give them our time.
As people that in yourorganization are in positions of
leadership, you're looking totry to find ways for your
physical therapist to spend timewith their patients and to help
them get better.
Right, which means offeringefficiencies on the back end of
things.
So, wendy, maybe I'll open itup to you to talk a little bit
(16:23):
about what you guys are doingwith Slate and how Rock Valley
is using that because maybethat's something that could be
beneficial to other privatepractice owners within our state
as well.
Speaker 3 (16:34):
Sure, you know and I'm going to go back to a little
bit about the discussion aboutthe Alliance Clinic so you know,
the Alliance Clinic was one ofRock Valley's clinics when Mike
joined Rock Valley and so youknow, the first thing we
struggled with was do we havesomebody within the organization
that wants to, you know, movein and take over that clinic?
And we had a hard time.
(16:55):
We often have a hard time inthose smaller rural communities
finding that person that wantsto lead that clinic,
specifically if they're not fromthat community.
Because we all know clinicsthat do well are those that when
you're living and working inthe community, when you're
living in the community in whichyou work, that just seems to be
the most successful becauseyou're a part of that community,
(17:16):
especially a smaller community,everybody knows you and
everybody understands thatyou're the face of that clinic.
And so, as Mike said, then hehad several conversations with
others to see if they wanted totake over that particular clinic
and and and bring that on astheir own private practice.
And so you know, as hementioned, the struggle there is
is just a lot of theadministrative burden or all of
(17:36):
the other things that get in theway of us being able to take
great care of patients.
And so what Slate is?
You know, the goal of Slate isto be able to take on those
things for smaller privatepractice owners, because we
don't want to discouragesomebody, you know, just out of
school, having several yearsexperience somewhere else, that
says I just want to hang myshingle somewhere and start my
(17:58):
own practice, like that's whatwe want to encourage and we
don't want to discourage thatfrom continuing to happen in
private practice.
And so, you know, slate'smission is just to say, okay,
what is that barrier that we canerase for you?
And so that's where we started.
Obviously, the billing side ofthings doing a really great job
with getting claims out clean,getting paid in an efficient
manner, getting paid what youdeserve to get paid for those
(18:21):
visits, for that hard work thatyou're doing, and then giving
you some consulting with regardsto different patterns and
themes that we see with regardsto where there may be some
improvements that can be made,and then building on that with
then, okay, what's that nextbarrier?
As Mike mentioned earlier,verifying benefits in some cases
it's just mostly a time taker,right.
(18:43):
So being able to do that fororganizations as well as to help
with the prior biggest time.
You know where they're spendingmost of their time and saying,
(19:04):
okay, how can we take that awayfrom you and allow you just more
time to spend with patients,which is ultimately what your
goal was in opening thispractice.
Speaker 1 (19:13):
Yeah, so you kind of get to do kind of an overall
audit of where some of thesticky points or the pain points
might be, and then you'rehelping to try to design
efficiencies on the back end.
Is that?
Speaker 3 (19:28):
accurate yeah.
Speaker 1 (19:30):
Head nods.
Yes absolutely, Mike.
Anything you want to add tothat?
Speaker 2 (19:36):
Well and part of Slate, and as we have a
relationship with Net Health,the EMR and what they've done a
nice job and Wendy's reallychampioned this is to make it a
very good EMR and note-takingsystem, scheduling system.
That is for therapists.
(19:57):
You know that's the last thingwe want to do is spend all this
time trying to do notes.
We're trying to make it asefficient as possible.
There's templates that are madeout there.
We can make them just to fitevery one of our practices,
because I see backs a little bitdifferent probably than anybody
else.
I mean, everybody has their ownindividual practice, right.
So this is what this EMR allowsus to do is to still see these
(20:20):
practices and if you want to gointo a niche practice, we have
the ability to transform thatEMR into what that evaluation
and that progress note lookslike.
So it's been a great, a greattransfer.
Now, it's always hard movingEMRs, but the other thing what
Wendy has is has a whole team ofhow to transition and how to
(20:40):
help and how to guide and how toteach.
That's the other thing thatcould be if people are want to
change EMRs.
Oh, because it's it's likeholding back the tide.
It's so hard to do, but we wantto make that easy as well.
Is there a part of that, wendy,that that you want to add to
that?
Speaker 3 (20:58):
No, I think that's great, mike.
I think you know and we've hadpeople you know ask us well, we
like our EMR, can we?
You know we don't really want tochange EMRs, as Mike said, it's
a big undertaking, but can youjust do billing services for us?
And you know our answer to thatis no.
It's a package deal and thereason for that is we
specifically vetted EMRs, vettedNuthouse, specifically the
(21:20):
therapy source product, to meetthe needs of private practices
and ensure that we were gettingas accurate of information as we
can out of the system, asunique information as we can out
of the system, so that yourbilling looks exactly the way
you want it to going out thedoor.
There's not a whole lot thatneeds to be finagled on the back
end to ensure that you'regetting your claims paid the way
(21:41):
they want to, and so just thecustom, the ability to customize
, as well as the compliance sideof things for TherapySource is
what made like made our decisionto partner with TherapySource.
So we really encourage, youknow, those who are looking for
someone you know, like Slate, todo RCM services for them, like
to look at for that package dealwhere they're really working
(22:03):
closely, intimately with the EMRto ensure that they're
continuing to grow together,because then that ultimately is
going to impact.
You know how efficiently andhow well you're getting paid, so
Good.
Speaker 1 (22:15):
Well, that's.
I think that's just a greatexample of recognizing hey,
there's certain challenges andbarriers to what we're doing,
but let's try to find solutionsto this instead of becoming
disillusioned with the process,right?
So I think I appreciate that,definitely.
All right, I have one morequestion, Mike, I'm going to aim
this directly at you, justbecause Wendy's on the other
(22:35):
side of the river.
We like you, Wendy, Iappreciate that we like you,
wendy.
Speaker 2 (22:49):
Mike, I would love for you to just answer what
value have you found in being amember of APTA Nebraska?
So the idea about the NPTA isyou get to meet so many people
across the state and no matterif they're in a hospital or if
they're in a private practice orthey're in a large group or a
small group or in nursing homes.
I mean, we all have some of thesame issues and then we start
to talk oh yeah, I used to dothis and I did this.
(23:11):
So the relationship buildingthroughout the state is really,
really important.
I think the NPTA NebraskaPhysical Therapy Association is
a great medium for that.
When we went out to Kearneyjust a month ago, we got to talk
to all kinds of people, meetnew people, catch up with some
of the people that I haven'tseen for five years.
It was great to do that and Ibelieve the strength is in the
(23:36):
numbers, because we're havingnot as many applicants for NPTA,
but they're coming in on otherways.
I think the students arestarting to get more involved
and I think having the studentsinvolved and then they stay a
therapist, they stay in Nebraskaand that's going to allow us to
grow and we start with astudent and then they become
(23:58):
leaders in our state, in ourprofession.
So as we work together of thestudent and then they become
leaders in our state, in ourprofession.
So about as we work togetherbecause that's we can't do it
individually when talking toinsurance companies and looking
at different ways to get infront of insurance companies and
promote our physical therapypractice, to promote direct
(24:18):
access, and that's ultimatelygoing to be saving patients
money.
So if we can see them first andget their back better without
x-rays, medicine or MRI, hey youknow what, it's great for the
whole medical system and thepayments that we're trying to
curb so much and being asefficient as we can.
Speaker 1 (24:37):
Yeah, I really appreciate that.
I think what you said in termsof you know, really there's
strength in numbers and listen,a lot of what we do it's not
going to end up being perfect,right, we're not going to find
solutions quick solutions reallyreally fast through legislative
processes or developing newpolicies, right, right, like
(25:02):
those things take a long time todo, but the way that you move
the needle on it is by havingsome amount of unity and and
hopefully you know, this is ourfirst member spotlight for the
APTA Nebraska podcast andhopefully getting to know people
, even through some audio, inthis way helps us take the next
step to connecting anddeveloping a little bit more
community among our professionwithin our state too.
(25:22):
So, mike, thanks for being aguinea pig and Wendy, thanks for
joining us on the podcast aswell.
Appreciate having you guys.
Speaker 3 (25:30):
Thank you.
Speaker 2 (25:30):
Brad, thank you for the opportunity.
It's been great.
So, again, I've not met youbefore, brad, but we're getting
to know you and I got to knowyou at the conference.
So this is what it's about.
So we appreciate theopportunity and how can we help
Nebraska and Iowa too?
Speaker 1 (25:49):
Drop that in there, all right.
Listeners, thanks for joiningus and hope you enjoyed this
episode.
Thank you, brad.
Thank you everyone.
Thanks for tuning in to theAPTA Nebraska podcast.
Stay connected with us for moreconversations that elevate our
profession and improve the livesof Nebraskans.
Don't forget to subscribe,share and join the discussion,
(26:10):
because together we're drivingthe future of physical therapy
forward.
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