Upstream Rehabilitation Executive and Leadership Team

October, 2026

Leadership Overview

Upstream Rehabilitation has 5 executives leading key functions including operations, financial strategy, legal compliance, organizational leadership, and market expansion.

Focused on delivering high-quality outpatient care, Upstream Rehabilitation advances the standard of physical therapy through a robust national network of clinics and management services designed to improve patient outcomes.

Leadership Roles at Upstream Rehabilitation

  • Chief Financial Officer - Karl Hagedorn
  • Chief Operating Officer - Casey Kalb
  • President - Cindy Butierez
  • President, Growth & Development - Chad Barker
  • General Counsel & Chief Legal Officer - Hugh Middlebrooks
  • Karl Hagedorn - Chief Financial Officer

    Karl Hagedorn, the Chief Financial Officer at Upstream Rehabilitation, manages the fiscal health and long-term capital strategy of the organization. Overseeing financial planning, budgeting, and revenue cycle management, the Chief Financial Officer ensures that the company maintains the resources required to expand the national footprint of outpatient rehabilitation services. This leadership role involves analyzing market trends to guide investment decisions in new clinic locations and service lines. By monitoring financial performance metrics, Karl Hagedorn directly impacts the profitability and stability of the enterprise. The Chief Financial Officer also collaborates with the executive team to align fiscal objectives with the overarching mission of delivering high-quality physical therapy. Through rigorous financial oversight and risk management, the Chief Financial Officer supports the sustainable growth of the entire member network. Ultimately, Hagedorn secures the financial integrity needed to navigate the complexities of the healthcare industry.

    Casey Kalb - Chief Operating Officer

    Casey Kalb, the Chief Operating Officer at Upstream Rehabilitation, directs all daily clinical operations across the national network of physical therapy clinics. Overseeing the efficiency of outpatient rehabilitation management services, the Chief Operating Officer ensures that every facility maintains rigorous standards of patient care and operational excellence. This leadership role involves optimizing clinic workflows to support the broader mission of providing accessible rehabilitation services. By streamlining administrative processes and clinical resource allocation, Casey Kalb directly impacts the scalability of the organization. The Chief Operating Officer also coordinates with regional directors to ensure consistent service delivery across diverse geographic markets. Through the implementation of standardized operational protocols, the Chief Operating Officer drives significant improvements in clinic productivity and patient satisfaction metrics. Ultimately, Kalb secures the operational foundation necessary for sustained growth within the competitive outpatient rehabilitation sector.

    Cindy Butierez - President

    Cindy Butierez, the President at Upstream Rehabilitation, leads the overall strategic direction and organizational culture of the national outpatient rehabilitation provider. Overseeing the integration of clinical services and management functions, the President ensures that the company remains committed to excellence in physical therapy. This leadership role involves fostering collaboration across the entire member network to drive consistent patient outcomes. By championing initiatives that enhance service quality, Cindy Butierez directly impacts the market reputation of the organization. The President also coordinates with other C-suite leaders to execute long-term growth strategies and maintain competitive positioning. Through the promotion of a patient-centered philosophy, the President aligns the workforce with the core mission of the company. Ultimately, Butierez secures the organizational alignment necessary to thrive in the evolving healthcare landscape, ensuring that the company continues to provide comprehensive rehabilitation services to communities across the nation.

    Chad Barker - President, Growth & Development

    Chad Barker, the President, Growth & Development at Upstream Rehabilitation, architects the expansion strategy for the national network of physical therapy clinics. Overseeing business development and the acquisition of new rehabilitation service providers, the President, Growth & Development ensures that the company successfully enters new geographic markets. This leadership role involves identifying strategic partnerships and opportunities to scale the outpatient rehabilitation management services. By driving initiatives that increase the reach of the organization, Chad Barker directly impacts the growth trajectory of the enterprise. The President, Growth & Development also collaborates with the executive team to integrate new clinics into the existing network while maintaining service quality. Through the execution of targeted expansion plans, the President, Growth & Development strengthens the market presence of the company. Ultimately, Barker secures the future of the organization by continuously identifying and capturing new opportunities for development and service delivery.
    Chad Barker
    Hugh Middlebrooks, the General Counsel & Chief Legal Officer at Upstream Rehabilitation, directs all legal affairs and regulatory compliance initiatives for the national provider network. Overseeing corporate governance and risk mitigation, the General Counsel & Chief Legal Officer ensures that all outpatient rehabilitation services adhere to complex healthcare laws and industry standards. This leadership role involves managing contractual obligations and protecting the intellectual property of the organization. By providing strategic legal guidance, Hugh Middlebrooks directly impacts the operational security of the company. The General Counsel & Chief Legal Officer also works closely with the Board to address emerging regulatory challenges in the physical therapy sector. Through the development of robust compliance frameworks, the General Counsel & Chief Legal Officer minimizes legal exposure while facilitating business expansion. Ultimately, Middlebrooks secures the legal foundation that allows the organization to focus on delivering exceptional patient care.
    Hugh Middlebrooks

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    Frequently Asked Questions Regarding Upstream Rehabilitation Top Executives and Leadership Team

    Who leads Upstream Rehabilitation?
    Upstream Rehabilitation is led by Karl Hagedorn (Chief Financial Officer), along with executives such as Casey Kalb (Chief Operating Officer) and Cindy Butierez (President).
    Who is part of Upstream Rehabilitation’s executive team?
    The executive team of Upstream Rehabilitation includes leaders such as Karl Hagedorn (Chief Financial Officer), Casey Kalb (Chief Operating Officer), Cindy Butierez (President) and other senior executives.
    How many executives does Upstream Rehabilitation have?
    Upstream Rehabilitation has 5 executives leading key business areas.
    What roles are included in Upstream Rehabilitation’s leadership team?
    The leadership team of Upstream Rehabilitation includes roles such as Chief Financial Officer, Chief Operating Officer, President, President, Growth & Development, General Counsel & Chief Legal Officer.