Stop Losing Money: 2027 CPT Changes & Audit Protection with Rick Gawenda

This is the Willpower Podcast live at the Growth Code Conference. No scripts, no fluff, just real conversations with rehab owners in the room sharing what's working right now. Today I'm joined by Rick Gawenda, founder of the Gawenda Seminars and Consulting, diving into documentation, CPT coding, reimbursement strategy, regulatory changes, and I promise you, all done in an entertaining way. It's going to blow your mind. This is how we're going to maximize your practice in an era of constant payment reform. Here we go. Rick, thank you so much for being on the Willpower Podcast here at Growth Code. It is so exciting to have you on the show.

I appreciate it. Thanks for having me.

Man, I've seen you talk so many times, and it seems like the coolest thing with your expertise is that what you talk about is constantly evolving and changing. So for the very few human beings who don't know who you are, Share a little bit about your expertise.

Sure. So my name is Rick Gawenda. I'm a physical therapist. It's hard to believe it'd be 35 years.

Wow.

This fall. So looking forward to our 35-year reunion. But for about the last 24 years, I have had my company, Gawenda Seminars and Consulting, where I kind of specialize in outpatient physical, occupational, and speech therapy in terms of, you know, documentation, CPT coding, billing, productivity, kind of revenue enhancement. And then over the last probably 5, 6, 7 years, getting more involved with, I guess I'll call it quote legal issues and licensure issues where therapists and assistants kind of get into trouble with the licensing board or perhaps the Medicare program. And you know, so now attorneys retain me as a kind of an expert to help their clients maybe, you know, keep their license and all the scary stuff. Not go to jail, so to speak.

That's, I didn't know you were doing that now. And it's so interesting because it does bleed so beautifully with what you're known for. It seems to me like you're tackling all the really scary stuff that a private practice owner doesn't understand about owning a business.

Correct. I mean, none of us that are physical therapists, OTs, SLPs went to school to open up a business. You know, we kind of evolved into that, and none of us went to school to be a consultant or hospital administrator. So as you start your business, I think we're just so focused on trying to grow the business, the marketing, etc. But then how do you stay up to date with all the regulatory and payment issues and that unfortunately are different with every insurance carrier.

Yeah, it's, it's constantly evolving like we were talking about just a second ago. Um, you, you feel very passionate to me about this.

What—

why are you so passionate about helping owners in this way?

Because it's tough. I mean, you know, the joke out there that the restaurant business is tough with small margins. I think the therapy business is also tough. And I think if you look at over the last 15 to 17 years You look at how inflation, you know, I think they say about a dollar back in 2010, you now need $1.43 now. So just as you look at the inflation, the cost to do business, but yet unfortunately some payers are actually being paid less today than we were back in 2010. And, you know, there are people that do things quote wrong. They're not doing it intentionally wrong. They just don't know. Right. So, you know, how do we educate them so that they're going to be around. You know, obviously we're at the Growth Conference, we're dealing with pediatrics.

Yes.

I have 3 granddaughters, a 4th one on the way.

Yes.

You know, so if they ever, you know, if they needed therapy, I want therapists to be there. Me, I'm getting up there myself, getting close to Medicare age. I hope I never need therapy, but if we do, you know, we want therapists to be there and open and available and have options where to go.

It's almost when we all become clinicians, when we all become healthcare providers, none of us ever go into it because we're passionate about reimbursement. Like, we never think about that element of it. And it is such a complex part of our business that— so when we jump in, I remember being tearful, upset about like worrying about like, my gosh, am I going to get audited and go to jail for doing things I didn't even know I was, was or wasn't doing? As an owner, I got a lot more education around it, but it was still one of the greatest fears that I had was this idea of like, I don't know all that I don't know, 'cause it's constantly evolving.

No, and I agree, 'cause there are times I do the initial call where people contact me to check in about my services and how I can help them. And one of the things I say is when they ask me, well, what do I need to know? My response is, well, I don't know what you know, else you don't know what you don't know.

Right.

So, you know, there are common mistakes that people make and you try to educate as best you can. No, you're going to probably make some mistakes. And again, none of us, as we said, went into therapy school to own a business.

Right. You know, it's so cool being here with you at Growth Code too. This is one of my favorite events of any— I say sometimes it's the best. In the industry because anything PT, OT, or SLP related, this is probably one of the greatest downloads of information. It's overwhelming how well it's run. It's 4 days. Um, what are you speaking on?

Yeah, so I get to do, uh, 2 sessions. Uh, one, we're gonna kind of do a high-level documentation, so kind of from the initial eval through discharge, because unfortunately, uh, insurers are back on the, uh, medical record reviews in the audit, especially in the pediatric population. So we're going to go through the necessities of documentation to hopefully give you the tools that you need so you can self-audit that. And I don't say if you get audited, it's when you get audited. I mean, at some point, insurance company is going to request records from you.

Sure.

You know, can you pass the audit? And then we'll do another session kind of giving all the regulatory payment updates for 2026. And as you know, you and I are doing this podcast right now. You know, we have a government shutdown looming here and there's some key provisions we need passed. Here, you know, to keep telehealth going under the Medicare program. Obviously, I know we're at growth code, which is pediatrics, but, you know, many state Medicaid programs, commercial payers, they kind of follow what Medicare is doing.

Yeah.

So we need some stuff to get passed by the government here. And, you know, we'll give some updates. And we've also got some big changes coming to speech therapy in 2027.

Yes, I've heard they're going to timed units.

I heard that's about all I can say. But I'm not being elusive. It's just I've got NDAs signed with the AMA. So you have NDAs signed with the AMA?

I think you made it when you have that kind of relationship with the AMA.

Well, no, anybody could have it. It's, you know, it's just when they went through the process to bring these new codes in 2027, you can, you know, you can listen in on the meetings and get all the handouts and all that, what they're going to discuss. But by doing so, you sign an NDA.

Yes.

Where you can't discuss anything until it becomes publicly available. Right. So the only thing I can say publicly is in 2027, 92507 is being deleted. Replaced with 10 new CPT codes for speech. Wow.

So lots of changes going on.

Yeah.

So if someone who's a PT, OT, or an SLP leader or business owner, what would you say the top 3 things they should be aware of right now? Obviously you can't share in great detail, but what would you say the top 3 things are they should be aware of with the most recent changes?

Yeah, I mean, I think number 1, just knowing that in January 2027 with the speech therapy CPT code changes coming, You know, more information will become available in July. We'll see what Medicare is going to do in terms of payment. Then how do you take what Medicare is doing with payment and kind of, kind of, quote, guesstimate what your state Medicaid is going to do, your Blue Cross, Aetna, Cigna, you know, how is that going to change all your reimbursement in 2027?

So it does change all the reimbursement across all the commercial payers as well.

I think you're going to see significant decrease in reimbursement for, because again, a lot of, pediatric SLPs do 30-minute sessions, right? So I think you're going to see that reimbursement for a 30-minute session decrease significantly. So how do you then plan for that when you're doing your 2027 budget? But also, how is that going to impact what you can pay an SLP or an SLP assistant if you're able to use them? So I think that's number one. Number two, I think, is just trying to stay current with all the regulatory and payment changes from the various insurers.

There's just many. There's too many to mention.

And what I tell people is, you know, when we had our practices and all all that, you know, we probably dealt with 200, 300 different insurers. But what I tell practices is, what are your top 5, 6, 7 insurers that maybe make up 80, 85% of your visits, right? Keep up to date with them, you know, create that Aetna folder, that Cigna folder, that Blue Cross folder, whatever, you know, check their websites monthly, download policies. Because if you can follow those 5, 6, 7 payers and be compliant with all their rules and regs, you're probably gonna be okay with all the ones you don't know.

Well, that's nice. It's that Pareto's law still applies. You know, 20%, they say, of what we know produces 80% of the results. So in that case, if you can get those 6, 7, that's like the 20% that hopefully will cascade across the other ones to some degree or not.

Correct. And the keyword being hope. Yeah. I mean, you always have that outlier. I gotta disclose that as we're doing a podcast. Well, Rick said if I did these 5, I'm gonna be okay with all the other payers. You know, obviously you hope. And then the third one, just as people, you know, practices, you know, they pay money for marketing, they pay money for HR, etc. You know, if you need to use a consultant, pay the money. You know, I'd rather have— and if I'm not the person, I'll tell you, go talk to this person. But, you know, why not pay an hour, 2 hours of consulting to make sure you're doing things right? Because the motto of 'I didn't know' won't help you with an insurer. It won't help you with the government.

Right. It might make the difference between, you know, the intent of when you're sued, not sued, but when you're looked at. But here's the thing. I love how you're mentioning it. Like, why wouldn't you invest in someone or something that would help you get clear on these elements to make sure that you're safe? But I would also throw in there to actually maximize what you can get, because one of the things I've loved about you, Rick, for my whole career, especially when I had my 5 locations, is that your message wasn't fear-based. Our industry is so fear-based. It's like in college, your license is your livelihood. They kick you right in the gut, right with that. Like if you mess up, you're going to jail. And what I have always felt from your messages is like, hey, we're gonna talk about this from a place of maximizing reimbursement for what you should be getting. And by doing that and focusing on maximizing that ethically, you are then protecting yourself from the dangers that are out there, for sure.

That's very kind of you to say, and it's probably one of the comments I've gotten from other people that I don't do the scare factor because again, I think we're all trying to do it right.

Yeah.

And, you know, we are, quote, trying to maximize reimbursement, you know, legally and ethically so we can stay open, right, to take care, to take care of the pediatrics, to the adults, the geriatrics. But you have to make money. To be open. And, you know, some people say they feel sorry, we don't— I feel guilty charging patients, etc. But that's the way you stay open to then take care of them.

Yes, it's interesting because the typical student— and not all, I think they're getting better— but especially for the last 20 years of my experiences, the typical new graduate will come into the PT/OT/SLP space from a place of like, all right, I'm not here for the money. I am going to underbill for what I do if I'm not sure, because heaven forbid I overbill. So there's this kind of like, because they're not educated, they will tend to underbill, but then they tend to overdocument, which is interesting because the one case that I ever had in my company that went to a state board, the overdocumentation was what got us in trouble. Like she was detailing all these elements and they were like, wait, you said this. Let's get into that rabbit hole. So there's a balance in those things, isn't there?

There is. An analogy I'll use is a witness on the witness stand. So, you know, when I get to go to court and I'm, you know, testifying, now obviously if the attorney that has retained me, when he or she's asking me questions, you know, I'm gonna be more, quote, talkative and give the answers. When I go under cross, by the opposing attorney, it's you answer the question and you just wait for the next question. And sometimes the attorney would just be there quiet and I'm just sitting there quiet because he or she's just hoping that the quietness makes me feel awkward to then keep on blabbing.

Oh man, that's me in a second.

I think it's the same thing with the notes. You don't wanna be too wordy and all that, but you just wanna be succinct and to the point.

Wow. Is there any other documentation-based recommendations you can give to our audience that might be either just the important ones you have to remember or even newer things that have come up that they should be aware of?

Yeah, I mean, I think when I look at, you know, denials now, I think we don't do a good job in the industry of out. You know, we're not really documenting why the patient needs us for therapy services. So, you know, what has changed with this patient? Obviously, we're here at a growth conference with pediatrics, and what's a child lagging behind in developmentally? Right. So, you know, they're 6 months of age, what should they be doing, what are they not doing, that kind of stuff. So we're going to do a good job showing the difference between, you know, here's what they should be doing, here's where they're at, and that gap, the change between, you know, being at the forehead of here's what I should be doing, but, you know, they're down at the chest of functioning down here. It's that gap, that's the decline, that's a change in function we got to try to improve. So that, you know, writing function-based goals, and probably the biggest thing— I know we could talk for hours on this— is on the daily note, we always do a great job documenting what the patient did in therapy that day, right? As a therapist or assistant, we don't do a good job documenting what we did for that child or for that patient that day in terms of the verbal instruction, verbal correction, technique correction, posture correction. Because that's what we're being paid for.

I'm guessing this is where a lot of people devalue themselves accidentally and underbill is because they're only documenting what they did and they see that as like that's what they bill for, but they don't take into account the family education. They don't take into account those elements. And so when they're not trained properly and they don't know how to value what they do, they end up undervaluing, which undervalues not just their company, but the entire industry?

Well, I think, you know, the analogy I use is, you know, if I ask you, when does therapy begin? You know, therapy begins when I come get you in the waiting room.

Yes.

And I'm bringing you back as a patient, or I'm bringing, you know, your daughter or son back, and I'm now asking, you know, how'd you fare after the last therapy visit? How the exercise is going at home? How is this? How's that?

Right.

Well, that 3, 4, or 5-minute conversation, that's assessment time, right? That's billable time. Because then that's going to help me decide what to do with you today, what not to do with you today, what to change today. Wow. Well, that 4 or 5 minutes of time, could that have got you to that third unit? Could have got you to that fourth unit?

Because we're down to minutes. I mean, it's sometimes just a 2 to 3 minute differential.

It is.

That, that costs you maybe $25, $26, $27 or more over hundreds of visits a year. Like, it's just, it adds up so fast.

Yeah, that and then just billing the wrong code. You know, obviously, as you look from therapeutic activity to neuro rehab to therapeutic exercise, those payers that pay on a per CPT code basis, they pay differently.

Yes.

And I see so many PTs and PTAs, you know, we just lump everything under Therax, right? Under Medicare, Therax pays, you know, $28, $29. Therapeutic activities is paying $35, $36, $37. So if you truly are working on functional activities But you're lumping everything under the wrong code.

Yes.

Sometimes the way you make more money is not by working harder. It's not by seeing more patients, billing more units. It's just billing the right CPT code based on your documentation.

Yeah. Rockstars, I want to just hit really hard what Rick said, because I think so many times we get into the traps as leaders and owners of just increasing volume as the primary lever. That's just one of many levers. But why wouldn't we hyperfocus on maximizing what we're already doing first. And it goes beyond billing and coding and understanding documentation. But I would say that's the biggest, like, confusion gap for us is those areas. Then it goes into, like, learning how to manage schedules efficiently to balance provider retention with maximum production. Yeah, but it really begins there, and we don't address it because we don't know how to get help.

I agree. I think that, and, and many practices don't set budgets Yes, you know, they don't— you talk to them in January and, okay, show me your budget for the year, and it's gonna give you the deer-in-the-headlight look.

Totally.

Budget, you know, B-U-D-G-E-T. Well, we don't have a budget. Okay, well, show me last year's numbers. Yeah, we don't have that either. You know, so a lot of small practices, you know, they don't know how to do QuickBooks and run P&L statements and all that. But like you said, you're not making— you're not losing money just on one thing. Usually it's multiple things that's causing you to be in the red and you're not in the black just for one thing. You're doing multiple things right to be in the black, but I think you need to have statistical data.

Yes.

But you need to have budgets and try to meet those budgets.

Amazing.

I think you also need to share information with staff. Yeah. I think, I think practices, you know, you don't need to send, share all the P&L stuff, but we had our practices, we had to quote the Tuesday huddle. And the Tuesday huddle from the week before, we would say, okay, here were the metrics, here's how we did. And so the team knew how they did the previous week, which then, you know, as you're going forward, might explain why you did get a bonus this month, why you didn't get a bonus this month if you're doing profit share and things like that.

What's brilliant about that, Rick, is how that not only educates them and makes them more of a leader, which by the way creates retention because they feel like they're being invested in, they feel like there's transparency, but it also eliminates so many of those confusion— confusing, time-sucking talks that we have with people who are like, hey, why am I not getting paid? Why can't I get a raise? When they see the numbers, they don't feel the need to go do research and get misinformation regarding like what the average physical therapist or OT or SLP is making and then come back and be like, well, I should be making 20 grand more. It's like, no, they see the P&Ls, they're getting retained and solving problems that you're going to face as a leader.

Yeah, and I think one thing universities need to do better, uh, maybe APTA, AOTA, ASHA at large conferences have a session on, you know, what is a true cost of an employee.

Yeah.

So I think, you know, and I'll just pick on PTs since I'm a PT, you know, a lot of PTs when they graduate, I get the DPT programs, I get your six figures in debt, and I get— understand you want $90,000, $95,000, $100,000 coming out of school. Yeah, right. It's not going to happen. And if it does happen, you're going to be working your tail off.

Right.

But what people don't understand is that if they're making $80,000, what's it really costing your employer?

Right.

And typically, you know, we're adding on about 30-35% onto that.

For benefits.

For benefits. People don't understand that when I give you a paycheck every 2 weeks, I'm paying the employer taxes to the government, you know, all of that. So that $80,000 I'm paying you, um, you probably cost me maybe $105,000, right, in there somewhere. Plus, you know, Susie at the front desk— I love Susie, she doesn't generate income, but we need Susie, right? But we have to pay for Susie, and that comes from something, and that comes from you doing visits. So people think, well, you know, if I do 6 visits a day, it makes up my salary and benefits, and you get 15-20%. But they don't think about the heat, no, the AC, utilities, Susie the PTA, things like that. So I mean, they do a better job explaining the actual cost to run a practice and all that.

So you cover all these things. So Goenda Seminars and Consulting provides a lot of different services to help actually fill this gap, and I don't actually know of another better service. And this isn't meant to be like promotional, even though it's starting to sound that way. I'm pervas— one of my friends told me I'm pervasively salesy about things that I love.

Well, thank you.

But I love what you do because again, it's a lifeblood. It's such an affordable, clear ROI that not only helps like increase your income but actually helps people sleep better at night. So talk about how you help people in that regard.

Yeah, so I think the nice business model we've set up, I love it, it's called à la carte. So you try to have different packages or different things depending on your needs and your your funds. So we do have a website membership service that has 3 different levels of membership, but all 3 levels get you access to all the written content on my website.

So it's constantly updated, yes?

Yes, I publish about 1 to 3 new articles per week under current news.

Oh my gosh.

And I know when I first started this, you know, one of my nicknames I was given around the country was Mr. Medicare. And then people realize I'm just not Medicare, you know, I talk on commercial payers and Medicaid and pediatrics, things like that. So, you know, my website is from pediatrics to geriatrics for PT, OT, SLP. You know, all this content can apply to you. So I've got current news articles, I've got over 30 different topics on frequently asked questions where you get the answers to the most common questions. And then, you know, we do webinars, we have webinar packages, then I do consulting.

You will meet with practices?

Yeah, I meet with practices. You know, we do a lot of consulting, you know, phone calls, Zoom, Microsoft Teams. And then for some of the larger practices, they'll bring me in on-site and we'll do like an all-day on-site training session for their staff, where 40, 50, 60, 80 therapists, assistants, I'll do an 8-hour talk on CPT coding, billing, documentation.

And this way your staff all hears the same thing and changes how they see money. I think if we can help them understand Most people, when they understand it, they just get it and they immediately start producing better, coding more accurately, getting more money. Yeah, that's amazing.

Yeah. And I think it's just changing the mindset. You know, I think it's making sure that the— as I call them kids since I'm getting up there in age, as they're coming out of school, totally— that these owners are not, quote, greedy. You know, isn't that funny?

They think they're like walking in with all this money. We're in the lowest margin business in healthcare and they think we're going home rich.

Correct. So I think it's making it, you know, what can you share with them? How can you educate them so they see this? But also, and I know I think there's a talk here at Growth Code, you know, changing the payment structures.

Yeah.

And so if you do want to make that $100,000 coming out, well, there's a give and take. We're gonna give you maybe a lower base, but if you hit these thresholds, visits and units, you win, I win, and We both win. So a lot of it's set up, in my opinion, the kind of the wrong way where the owner has all the risk, right? The therapist who gets a guaranteed salary has no risk.

It's funny because, um, when I was starting my practice, I had a coach who was a chiropractor, but he evolved into owning multiple hospitals in Arizona. So he oversaw like surgeons, physical therapy departments, and he was just a genius. He was telling me, he's like, chiropractors are trained to think like entrepreneurs, whereas PTs, OTs, and SLPs aren't. He says that chiropractors are trained so when they're coming out of school, they want the low salary, high profit sharing because they know they can control their income.

Yep.

I think because PTs haven't been exposed to that, and OTs and SLPs, that they come into the industry thinking that that's some sort of like weird risk. But what happens is because things are created that way, everyone can win so much more. I believe what you just said is true, and I have for years. If we could get into a profit-sharing model with our PTs, OTs, and SLPs, we would solve so many organic problems with how people view money because they would be tied to it. So if they have someone like you in their corner and they're able to communicate that to their teams and then show their numbers in a way that's transparent without showing everything, because there's, there's a lot of education that goes into that. But if they can understand the 20% that gets them 80% of the way there, they'll be free to really control their future, which is what we want.

Yeah. And you have the checks and balances because again, when you do have these incentive programs, the different payment structures that kind of incentivize your payment based on visits, units, and all that. You do need to have your checks and balances to make sure you're not overbilling, documentation still there, ethical, and all that.

That's amazing.

Yeah.

So as people are listening, they're probably wondering how they find out more about Goenda Seminars and Consulting. How do you— how do they get a hold of that information?

What—

and we'll put it whatever you want in the show notes, but just right now, if you want to put a plug in, I'd appreciate it.

Sure. So website would just be, you know, www. Gawendasseminars.com. My email is rick, just r-i-c-k, at gawendasseminars.com. And I'll give you my phone number. You can call me, 661-645-1490. And people are amazed because they'll answer the phone and I'll get silent and they'll go, is this Rick? I go, yes. They go, I didn't think you'd answer. Well, I go, you called me. It is so— it's my phone number.

Amazing with your brand that you're so accessible. Like, it's, it's really cool. It's on brand for you, actually.

Yeah, it is. No, and I, people are amazed I give my personal phone number, but I figure you want to talk to me and why give you another number that a receptionist has to then take a message, relay it to me, call you back. Just call me. If I don't answer, leave me a message. I will call you back.

Rick, so awesome. Okay, let's do some rapid fire questions to wrap things up.

I love that.

Okay. Your quick take on AI note takers as it pertains to your expertise.

Yeah, you know, AI, I'm all for it. I think we just have to be careful because as much as the practices now are getting into the AI, insurers are too as well. So I think it's got to be careful that every note does not sound the same and you got to make it unique to that patient. That'd be my quick advice.

Got it. Love that. I'm sure that could be another episode, by the way.

Yep.

What is a book that you've read that you love to recommend to people?

This is, this is going to be sad. I don't read books, believe it or not.

Because you're too busy reading articles on changes in healthcare.

Yeah, reading healthcare policies and CMS manuals. And, uh, you know, right now as we're doing this talk, we got that impending government shutdown. So I'm reading the legislation and all of that. So yeah, I do have to do better on books. I do agree with that.

I actually, you know what's funny? Gary Vee, he's a big— yeah, so he hates books. He won't read them. And I will tell you that like for me, I struggle with podcasts, which is so funny because this is a podcast, but it's a matter of like where we consume content. And obviously you've got your own methodology, but what would be something— what do you do for entertainment? Is there a movie that you like? Totally like not like just something that you like that you saw recently. Is there anything like that?

Okay, well, this is gonna either make the ladies happy and the guys think I'm weird. It's with my wife who you've met, Michelle. It's her and I just watching a Hallmark movie, the rom-com.

Dude, rom-coms are so underrated. I mean, we might be losing half my audience right now, but I will tell you, like, I miss the days of like legitimately funny rom-coms like Notting Hill. Like, those were some of my favorite movies.

That's actually one of my wife's favorites. Yep. And of course, her favorite is The Notebook.

Well, yeah. So that definitely for me goes a little bit further into that.

Yeah, that's not a rom-com. That's a touching story. But it's actually just her and I sitting watching, you know, the The Hallmark Christmas movies are right now. You got the Valentine's Day ones coming out and just sitting there. It's a feel-good. I mean, you know, you know how it's going to end. You pretty well know they're breaking up about an hour and 37 minutes into the movie. But, you know, it's just one of those things where just, I don't know, I get you. It's just that, you know what it is?

It's positive.

It is.

And I think it's weird in a world where like horror movies are dominating and coming out like on a weekly basis. Yeah, it's nice to have something that's just uplifting regardless of where its source is. Okay. What about travel? Where's somewhere you've been or are going that you're excited about?

Yeah. So one of the— I think one of my favorite trips my wife and I just did back in '23 was Iceland.

Really?

We did. We did Iceland in the summer of 2023. So I just loved it. Probably one of my favorite places I've been.

It's a bucket list place for me.

Yeah, it's great. I recommend you go there. And then I plan— I just got done— well, I shouldn't say I got done planning, but my wife and I are going this September to Kenya and South Africa to do safaris and all that for a bunch of days and then headed down to Cape Town for whale watching and fine wine and food.

Dan, I have been to those places and you are going to love it so much. Cape Town is one of my favorite cities on earth.

Yep, that's who we're finishing up.

Awesome. Okay, final question.

All right.

You know, this is— I never take for granted how this is out there in the world, right? There's a— your descendants You have 6 daughters.

6 daughters.

4 great— sorry, 4 granddaughters.

3 granddaughters. 4th one is due in May.

All girls.

All girls.

So they're going to be watching this one day.

Uh-oh.

What would you want them to know about why you're so passionate about this? Because like, you know, PTs, you could talk about why it's hard and all that. But what do you want them to know why you took this stand the way that you're doing?

Boy, you know, I think it's just something I just believed in. And you know, our daughters, 5 of them already graduated. The 6th one graduates this May. So we have 6 out of college. So I think my wife and I are very proud of all 6 of the girls getting, you know, college degrees and all that. But we said to each one, you don't go into school, don't pick a degree because of the money potential. You have to love what you do. And, you know, again, I did not go to PT school to do what I'm doing now, right? People always ask how I got into it, and the quick story is our hospital back in 1999 got on 100% Medicare review. My director didn't know how to do it, whatever, so I took the charge. Took me a year and a half. Wow. I just fell in love with the process because I think for me it's, it's always changing. Yeah, the rules are changing, the game is changing. And I love the game. And I, you know, I love to try to beat the insurance company. And, you know, and I just love that the practices— because again, you know, at some point I may need therapy. We have family that's used therapy, whether PT, OT, SLP, and we need these practices to be around. And it's tough. It's a low profit margin. I just love what I do. I wake up every day and I enjoy what I do.

You know, Rick, that was a beautiful way to wrap it up. I want to tell the girls as well, Michelle and the girls, who I love by the way. Michelle's amazing. Shout out to Michelle.

She's definitely my better three-quarters. People say better half. She's the better three-quarters.

That's so amazing. I want the girls to know how you have impacted the industry, and I mean this. I met you so long ago. I think I saw you spoke when I was out of school for maybe 3 or 4 years. I've been in PT for a long time.

Okay.

And you, again, you're, you're a light in the darkest part of our industry. And, and in our space, physical therapy, occupational therapy, and speech, you know, they are the most passionate leaders and business owners of any healthcare group because they aren't— there's no real financial incentive to go into this. So as they are frontline with people going through the darkest times of their lives, very selflessly, you are there defending them. You were there for your whole career taking a stand for people, and you've been, you know, quietly doing it. And just because of your goodness, it's become more known now. But that's not what drives you. You know, this, this recent, you know, notoriety has nothing to do with the love that you have. And I just hope that your girls will always know from the outside how influential you are, not just as an industry expert, but as a human being. So thank you for all that you've done.

Very kind. Thank you. Thanks for having me. Appreciate it.

Absolutely. And Rockstars, thank you so much for being a part of this show here at this special series here at Growth Code. As always, this is Will reminding you to lead with love and to never give up. Until next time.