Challenge
Before Athelas
Rock Valley wasn't a practice that needed to be rescued. It was operationally sophisticated, deeply respected in the PT community, and had always handled billing in-house. So well that other practices started asking them for help, which is how Slate was born.
But even a well-run practice can hit a ceiling. And Rock Valley had been bumping against the same ceiling for years.
Payment had been flatlining. Medicare reimbursements had declined year-over-year for the better part of a decade. As Randy Boldt put it in a presentation to University of Iowa PT students: if a small clinic's revenue hadn't changed in five years, what looked like a $100,000 profit could quietly become a $131,000 loss, just from inflation. For Rock Valley, Medicare represented approximately 45% of their business. That wasn't a niche concern, it was an existential one.
Data existed. Access didn't. Rock Valley had the numbers. What they didn't have was a way to get those numbers to the right people, in the right format, at the right time. Reports lived in Excel. Business intelligence tools had been piloted and abandoned when dashboards never materialized. Clinic leaders were making decisions without the real-time visibility they needed to act on them.
Administrative burden was consuming clinical capacity. Documentation, prior authorizations, compliance requirements — the back-office work kept piling up on the people who went to school to do something else entirely. Therapists who might have said yes to one more patient were saying no because a new evaluation meant another 15 minutes of paperwork. At scale, that math mattered.
And the structural problem was about to get harder. The state of Iowa had cut payments for speech services, directly affecting Rock Valley's two pediatric practices. Within the same week that leadership met to assess the financial impact, state auditors arrived unannounced for a compliance review. The pressure on margins, staffing, and operations was real and immediate.
Solution
After Athelas
Rock Valley selected Athelas as their partner; not because they needed a vendor, but because they needed a platform that could match the scale and complexity of where they're going.
The engagement is built around two parallel tracks: rolling out Athelas EHR across Rock Valley's PT and therapy clinics, and simultaneously standing up Slate on the Athelas RCM platform. Every efficiency, every workflow, every reporting standard can be packaged and extended to Slate's growing roster of private practice clients.
AI-powered documentation that gives time back. The Athelas ambient scribe sits at the center of the clinical value proposition. Therapists can move through a session focused entirely on the patient, and the chart note is built in the background. By the time the visit ends, documentation is largely complete. For a practice where clinicians were finishing notes on evenings and weekends, that's not a convenience, but a fundamental change in how a day feels.
Integrated compliance checks built into the workflow. Rather than relying on therapists to remember every documentation requirement, Athelas surfaces compliance scoring at the note level and aggregates it across the practice. New clinicians can track their own progress. Leadership can spot patterns before they become audit findings. The state auditor who showed up unannounced is exactly the kind of risk this is designed to reduce.
One platform, not fifteen. Scheduling, clinical documentation, billing, and RCM all operate inside a single connected system. No separate logins. No data hand-offs between disconnected tools. What a front desk coordinator schedules flows directly into what a clinician documents, which flows directly into what a biller submits. It’s cleaner and faster, with fewer places for claims to get lost or rejected.
Standardization built for scale. Kavan Zommers, VP of Launch Operations at Athelas, framed the implementation goal clearly: this isn't just a go-live. It's building a reference package: configurations, templates, rule sets, training materials, that Rock Valley and Slate can deploy on a moment's notice as they bring on new practices. Every implementation decision made today becomes infrastructure for growth tomorrow.
White-glove implementation, on the ground. Jonathan Thompson, Senior Implementation Manager on the Athelas strategic launch team, described the approach: learn how Rock Valley trains people, how they manage change, how their teams absorb new information, then build the implementation around that. Virtual sessions, in-person site visits, train-the-trainer programs. The goal is a network of internal super users at Rock Valley before the first clinic goes live.
Result
Key Improvements
Rock Valley's calculus is straightforward: AI documentation frees up therapist time, which turns directly into added patient capacity and helps offset years of margin pressure from declining reimbursements. For Slate, the impact scales further: turning Rock Valley's own billing and compliance expertise into infrastructure other therapist-owned practices can lean on to stay independent.
- 15 minutes saved per evaluation with AI documentation
- 1–2 additional patients seen per therapist, per week
- Margins recover through added capacity, not rate increases
- ~45% of Rock Valley's business tied to Medicare reimbursement
- Slate extends billing expertise, compliance infrastructure, and technology to other small private practices at scale
- Helps therapist-owned practices stay independent instead of being pushed toward consolidation or exit
- 2 mornings/week: Wendy Bloomhuff, VP of Slate, still sees patients herself
"Our therapists went to school to take care of people, and compliance, the administrative burden, and the authorization requirements are taking too much time away from the patients. If our system is efficient and automated, if it allows therapists to get back to doing what they do best — that would be a great outcome."
— Eric Sacia, COO, Rock Valley Physical Therapy
Rock Valley Physical Therapy has spent 30 years proving that therapist-owned, patient-first care is not only possible, but a competitive advantage. Athelas is here to make sure the business infrastructure around that care is strong enough to carry it forward.
Ready to see what this could look like for your practice? Schedule a demo with Athelas, powered by Commure, today.
