man standing in physical therapy clinic entrance



Frequently Asked Questions by Sellers Considering A Sale or Partnership of Their Physical Therapy Practice.

1. What can I expect from a partnership with Upstream?
At Upstream, we’re experts at building successful partnerships. When you become a partner, you’ll be joining a family of more than 450 partners dedicated to clinical excellence, professional development and supporting the communities in which we serve. We’ll work closely with you to identify and support growth initiatives and expansion opportunities; create greater access for patients and providers; and provide you and your staff with professional development pathways (including continuing education, advanced certifications, and leadership development programs specific to each level of advancement).

2. Will the name of my practice change post-close?
In most circumstances we do not change the existing brand name unless we mutually agree that it makes either strategic or economic sense for the partnership going forward. Upstream currently operates under 23 market specific brands.

3. What is included in the suite of services you provide to partners?
Upstream has been built on a foundation of ownership by physical and occupational therapists, so we know the importance of focusing on patient care. As such, we’ll take care of operational distractions like revenue cycle (i.e., billing and collections), compliance, human resources, recruiting, marketing, accounting, information technology, contracting and credentialing, medical records and much more. That way, you can stay focused on what’s really important – providing great patient care.

4. How much of my practice can I sell/retain?
When you join the Upstream family, you are able to retain a range of equity or ownership based on your own financial needs, risk tolerance and plans for the future. Our flexible transaction design allows you to benefit from the continued growth of the business while achieving economic security. In certain circumstances, Upstream will also consider acquiring 100% of the interests in the practice.

5. How is my practice valued and what information do you need in order to value it?
We recognize that every business is different. We also realize that every business deal can be equally as unique. During the valuation process, we will review the brand reputation, business financials, operational metrics, historic trends and other key performance measures in order to determine the maximum value for your practice.

6. What is my role after the sale/post-closing?
We’re flexible with how we build our partnership with your practice. Your operational role can vary based on your own personal and professional goals and objectives. Some partners choose to be clinic directors or treating therapists, while others pursue leadership roles within the company. We’ll work with you and your team to ensure our partnership provides opportunities that fit your personal objectives.

7. How do you help your partners grow?
Upstream is the industry leader in de novo (new clinic) growth and we’ve built a robust infrastructure to support our partners to help them strategically expand by adding new clinics in their communities. We also work with our partners to expand through acquisitions (strategic tuck-ins) as well as developing existing service lines and introducing new ones.

8. Will I receive cash distributions as a partner?
Equity partners at Upstream typically receive quarterly distributions of the free cash flow of the business based on their pro-rata ownership, taking into consideration near-term cash requirements such as the addition of a new clinic within the partnership.

9. Can I be a partner with Upstream and, simultaneously, own the buildings in which my clinics are located (i.e., be the landlord)?
Yes, many of our partners own the buildings in which they practice and Upstream leases these spaces from them at fair market values.

10. What happens immediately after completing the transaction process?
Our dedicated Integrations Team will be onsite with you and your staff immediately after closing to help ensure a smooth transition into the partnership for you and your staff.

11. Will my culture change after becoming part of the Upstream family?
Upstream is committed to retaining and fostering a positive culture across our family of brands. We are looking for practice owners who are like-hearted and like-minded in culture, goals and philosophy of care. To learn more about the Upstream culture, click here:

12. Is Upstream privately owned or publicly owned?
Upstream was founded in 2004 and, today, is the third largest operator of outpatient physical therapy clinics in the United States. Upstream is sponsored by Revelstoke Capital Partners, a leading private equity firm that partners with entrepreneurs and management teams to build exceptional companies.

13. What does the due diligence process include?
During the due diligence process, Upstream will audit the history and structure of your practice, including the financial, compliance and employee (HR) components of your practice. This process typically takes between 60 and 90 days depending on the details and complexity of the transaction.

14. What does Upstream’s Employee Benefits program include?
Upstream offers a competitive and comprehensive benefits program to all of its associates, including standard health benefits (i.e., medical, dental and vision options), ancillary health options (i.e., short-term and long-term disability, company-paid life insurance, etc.), health savings account, flexible spending account, 401(k) and more. In addition, Upstream provides all of its associates with paid time off, company-paid holidays, a company-paid volunteer day, annual continuing education allotments for clinical staff, adoption assistance, employee assistance programs and access to a MedBridge learning management account.

15. What professional development opportunities are there with Upstream?
Upstream Rehabilitation and its professional development organization, Upstream Rehab Institute (URI), provide high-quality and innovative post-professional education for all clinical associates. URI, recognizes the difference between average and exceptional care, and exceptional care requires the highest levels of clinical education and training. For this reason, URI is dedicated to leveraging its expert faculty and innovative delivery methods to offer the ultimate in post-professional clinical education via residency, fellowship, and continuing education programs. In addition, all Upstream associates are provided with a subscription to MedBridge for unlimited CEU opportunities.

Thinking about selling your physical therapy practice or exploring a partnership?

Whether a complete sale of your practice or retaining equity through a partnership, Upstream will help you decide the best path forward while ensuring the highest valuation for your practice. Learn more about selling your practice.

Share this article

Schedule an Appointment

You might also like

Range of Motion Exercises

Range of Motion Exercises

Range of motion is how far you can move and extend a joint or muscle independently or with assistance. Injury or disease can affect range...

Physical Therapy treatment for muscle weakness

Physical Therapy Treatment for Muscle Weakness

Do you notice your muscles feeling weaker than usual, even when you exert maximum effort? Is it challenging to do the tasks you used to...

Preventative Physical Therapy

Benefits of Preventative Physical Therapy

Musculoskeletal disorders are among the most debilitating and costly to treat. An estimated half of Americans over 18 will develop a long-term injury of the...

Find a