Upstream Rehabilitation Executive and Leadership Team

September, 2026

Leadership Overview

Upstream Rehabilitation has 5 executives leading key functions including financial strategy, operational management, legal compliance, organizational leadership, and growth development.

Focused on delivering high-quality outpatient physical therapy, Upstream Rehabilitation maintains a commitment to clinical excellence and expanding access to rehabilitation services across the national healthcare landscape.

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, directs all fiscal planning and capital allocation strategies for the organization. Managing the financial health of a national provider of outpatient rehabilitation services requires rigorous oversight of revenue cycles and cost structures. Hagedorn architects robust financial models to support the expansion of free-standing physical therapy clinics while ensuring long-term fiscal sustainability. By analyzing market trends and operational expenditures, the Chief Financial Officer optimizes resource distribution across the member network of rehabilitation service providers. This leadership role involves close collaboration with the Board to maintain transparency and drive shareholder value. Karl Hagedorn monitors economic indicators to mitigate risks associated with healthcare reimbursement shifts. Through precise budgeting and strategic investment, the Chief Financial Officer secures the necessary capital to fuel the company's mission of providing comprehensive outpatient care across diverse regional markets.

    Casey Kalb - Chief Operating Officer

    Casey Kalb, the Chief Operating Officer at Upstream Rehabilitation, oversees the daily operational efficiency of the entire outpatient rehabilitation network. Managing the complex logistics of free-standing physical therapy clinics, the Chief Operating Officer ensures that clinical workflows remain optimized for patient care delivery. Kalb drives operational excellence by standardizing management services across the national footprint, ensuring consistent quality standards in every facility. By implementing scalable administrative processes, the Chief Operating Officer supports the seamless integration of new member network providers. Casey Kalb coordinates with regional leadership to streamline patient intake and treatment scheduling, directly impacting the overall throughput of the organization. This role requires constant evaluation of operational metrics to identify bottlenecks and improve service delivery speed. Through rigorous process improvement and resource management, the Chief Operating Officer maintains the high standards of care expected from a national leader in the rehabilitation industry.

    Cindy Butierez - President

    Cindy Butierez, the President at Upstream Rehabilitation, provides executive leadership for the entire organization, guiding the strategic vision and mission. Overseeing the alignment of clinical services with business objectives, the President ensures that the company remains a premier provider of outpatient rehabilitation. Butierez directs the executive team to foster a culture of excellence and patient-centered care across all free-standing physical therapy clinics. By championing innovation in rehabilitation management services, the President drives the company's competitive position in the national market. Cindy Butierez collaborates with the Board to define long-term goals and execute high-level initiatives that expand the reach of the member network. This leadership role involves balancing operational demands with the need for sustainable growth. Through decisive action and strategic oversight, the President maintains the company's reputation for quality and reliability, ensuring that the organization continues to meet the evolving needs of patients and healthcare partners nationwide.

    Chad Barker - President, Growth & Development

    Chad Barker, the President, Growth & Development at Upstream Rehabilitation, spearheads the expansion strategy and market penetration efforts for the organization. Identifying new opportunities for free-standing physical therapy clinics, the President, Growth & Development architects partnerships that broaden the company's national footprint. Barker manages the integration of new rehabilitation service providers into the existing member network, ensuring that growth aligns with the company's core mission. By analyzing regional market demand and competitive landscapes, the President, Growth & Development drives the acquisition of new facilities and the development of outpatient management services. Chad Barker coordinates with regional leaders to execute expansion plans that increase access to care. This leadership role involves building relationships with healthcare systems and independent providers to foster collaborative growth. Through strategic planning and aggressive market development, the President, Growth & Development ensures the company continues to scale its operations effectively across the United States.
    Chad Barker
    Hugh Middlebrooks, the General Counsel & Chief Legal Officer at Upstream Rehabilitation, manages all legal affairs and regulatory compliance for the national provider. Navigating the intricate landscape of healthcare law, the General Counsel & Chief Legal Officer protects the organization against liability while ensuring adherence to state and federal mandates. Middlebrooks architects legal frameworks for the acquisition and management of outpatient rehabilitation service providers, safeguarding the company's interests during expansion. By providing counsel on corporate governance and contract negotiations, the General Counsel & Chief Legal Officer maintains the integrity of the member network. Hugh Middlebrooks oversees internal audits and risk management protocols to prevent regulatory infractions. This leadership role involves constant monitoring of legislative changes that impact the physical therapy sector. Through proactive legal strategy and diligent oversight, the General Counsel & Chief Legal Officer ensures that the company operates within the highest ethical and legal standards.
    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.