NEXT LEVEL LIVE VIRGINIA
September 25 - 26, 2026
Build a Therapy Business That Lasts: Strong Systems, the Right Team, and Relationships That Drive Growth
This event is for any OT, PT, SLP professional and student who either has a private practice or is interested in starting a private practice.
Running a successful therapy practice takes more than providing great care. It requires strong systems, smart financial decisions, the right team, and relationships that support long-term growth.
Now is the time to learn how to:
▪️ Strengthen the systems that keep your practice running efficiently and compliantly.
▪️ Better understand the numbers that drive profitability and smarter business decisions.
▪️ Recruit, hire, and build a team that can grow with your practice.
▪️ Navigate documentation, billing, audits, and changing payer requirements.
▪️ Explore different revenue models and opportunities for sustainable growth.
▪️ Build stronger professional and community relationships that create new opportunities.
Next Level Live Virginia brings therapy practice owners together for practical education, real-world strategies, and honest conversations about what it takes to build a therapy business that lasts.
Therapy Business Builder (TBB), Home and Community Therapist Network (HCTN) and STUDENTS get an exclusive discount— please message us & we’ll send your special promo code directly to you!
What You'll Learn
Leave with the tools, strategies, and confidence to elevate your practice. Topics include:
▪️Build stronger business systems Identify essential policies, procedures, compliance processes, insurance coverage, technology, communication, scheduling, documentation, and administrative systems needed to protect and operate a therapy practice.
▪️Understand the numbers behind a profitable practice Distinguish revenue, cash flow, and profit; calculate the true cost of services and employees; monitor productivity and labor costs; and use KPIs to make better business decisions.
▪️ Hire and build the right team Improve recruiting, job postings, candidate screening, interviewing, evaluation of cultural fit, and hiring decisions for long-term growth.
▪️ Reduce compliance and reimbursement risk Recognize documentation and billing vulnerabilities, prepare for payer audits, respond to record requests, demonstrate medical necessity, and manage denials and appeals.
▪️ Prepare for upcoming payer and regulatory changes Understand proposed Medicare and insurance changes for 2027 and identify steps practices can begin taking now.
▪️ Streamlining With AI Understand practical AI applications in revenue-cycle management, automation of administrative work, billing and claims workflows, while recognizing privacy, oversight, and other limitations.
▪️ Turn clinical expertise into a sustainable business Learn how to identify unmet needs, evaluate risk, balance mission with financial sustainability, and build systems around highly specialized care.
And more…
From marketing and systems to legal structure and staffing—this event covers the full spectrum of what it takes to build a profitable, future-ready private practice.
Therapy Business Builder (TBB), Home and Community Therapist Network (HCTN) and STUDENTS get an exclusive discount— please message us & we’ll send your special promo code directly to you!
Here is Our Schedule
Thursday, September 24, 2026 AOTA Capitol Hill Day
Please visit the AOTA website to register; this is a separate event.
Friday, September 25, 2026
8:30–8:50 AM — Light Breakfast, Registration, and Networking
This time will provide participants with an opportunity to check in, meet the presenters and other practice owners, and begin developing meaningful professional relationships.
8:50–9:00 AM — Welcome and Introduction of Jesse Graham
Presenter: Tammy Phipps, OTR/L, CDRS
9:00–9:50 AM — Redefining Independence: From Spinal Cord Injury to Advocacy, Entrepreneurship, and Occupational Therapy
Presenter: Jesse Graham
This session will address:
- The experience of rebuilding independence following a spinal cord injury
- The importance of access, mobility, and community participation
- How lived experience can inform advocacy and innovation
- Recognizing unmet needs as opportunities to create change
- Turning personal challenges into purpose and entrepreneurship
- The impact therapists and business owners can have beyond traditional clinical care
9:50–10:00 AM — Break
10:00–10:50 AM — From Walter Reed to DRCE: Turning a Mission Into a Business That Restores Independence
Presenter: Tammy Phipps, OTR/L, CDRS
This session will address:
- Identifying an unmet need in the community
- Turning specialized clinical expertise into a viable business
- Building a mission-driven organization while maintaining financial sustainability
- Developing referral and community partnerships
- Creating systems around highly specialized services
- Recruiting and developing the right team
- Lessons learned while expanding DRCE from one location to three
- Maintaining service quality and professional standards during growth
10:50–11:00 AM — Break
11:00–11:50 AM — Strengthen Your Practice: Audit What Is Working, Identify the Gaps, and Build Your Action Plan
Presenter: Kara Welke, OTD, OTR/L, CLT
This session will address:
- Defining a clear niche and ideal client
- Developing a concise problem-solving statement
- Evaluating compliance and risk-management practices
- Assessing financial clarity and overall business health
- Identifying the KPIs practice owners should monitor
- Evaluating revenue-cycle and billing performance
- Identifying gaps in systems, workflows, and automation
- Assessing leadership, staffing, and hiring readiness
- Identifying the three areas requiring the most immediate attention
- Turning assessment results into a focused action plan
12:00–1:00 PM — Lunch and Facilitated Networking
Facilitator: Kara Welke, OTD, OTR/L, CLT
This session will address:
- Developing meaningful connections with other practice owners
- Sharing challenges, ideas, and helpful resources
- Identifying potential collaboration and referral opportunities
- Learning from owners at different stages of practice development
- Building a professional network that extends beyond the event
1:00–2:00 PM — Beyond the Buzz: How AI and Automation Are Changing Revenue Cycle Management
Presenter: Steve Glukh, MS, OTR/L, CEO and Founder of HelloNote
This session will address:
- Understanding the revenue cycle from intake through payment
- Identifying common revenue leaks and workflow breakdowns
- Using automation to reduce repetitive administrative work
- Improving billing and claims workflows
- Identifying denials, delayed payments, and collection problems
- Using KPIs to monitor revenue-cycle performance
- Supporting staff efficiency while maintaining appropriate oversight
- Protecting patient information when using AI-enabled tools
- Understanding the risks and appropriate boundaries of AI
2:00–2:10 PM — Break
2:10–3:10 PM — Audit-Ready: Documentation, Appeals, and Payment Challenges
Presenter: Melanie Gagnon, PT, CHHi-RP
This session will address:
- Understanding payer audits and medical-record requests
- Recognizing documentation and billing vulnerabilities
- Demonstrating skilled care and medical necessity
- Connecting documentation to the services billed
- Responding appropriately to denials
- Understanding when and how to appeal
- Preparing for an audit before one occurs
- Protecting practice revenue while reducing compliance risk
3:10–3:30 PM — Break
3:30–4:30 PM — Marketing That Builds Your Practice: Messaging, Visibility, and Referral Relationships
Presenters: Tammy Phipps, OTR/L, CDRS, and Trista Windows, COTA/L, CDRS
To be provided by Tammy and Trista.
4:30–4:45 PM — Break
4:45–5:45 PM — Owner Panel: What We Wish We Had Known
Panelists: Kara Welke, OTD, OTR/L, CLT; Tammy Phipps, OTR/L, CDRS; Dr. Christopher Gaskins, PhD, OTR/L, CSRS; and Melanie Gagnon, PT, CHHi-RP
This session will address:
- Common mistakes made during the early stages of practice ownership
- Financial decisions owners wish they had handled differently
- Compliance, documentation, and billing lessons
- Marketing and referral-development challenges
- Hiring and leadership mistakes
- Systems owners waited too long to implement
- Managing growth without sacrificing quality
- What experienced owners would do differently if starting again
- Participant questions about the realities of owning and growing a practice
5:45–6:15 PM — Behind the Business: Tour of the Driver Rehabilitation Center of Excellence
Tour Facilitators: Tammy Phipps, OTR/L, CDRS, and Trista Windows, COTA/L, CDRS
This experience will provide time to:
- Tour the Driver Rehabilitation Center of Excellence
- See how the business, clinical space, and services are structured
- Learn more about driver rehabilitation services
- View specialized equipment and adaptive-driving resources
- Ask questions about training and credentialing
- Discuss referral relationships and potential referral sources
- Learn about safety, liability, documentation, and operational considerations
- Ask Tammy and Trista questions about developing and expanding DRCE
- Explore what may be required to add driver rehabilitation services to an existing practice
7:30 PM — Optional Group Dinner
Participants and presenters are invited to continue connecting during an informal group dinner at a local restaurant.
Dinner and beverages are not included in event registration. Each participant will be responsible for purchasing their own food and drinks.
Saturday, September 26, 2026
9:00–9:15 AM — Light Breakfast and Questions
Facilitator: Kara Welke, OTD, OTR/L, CLT
This time will provide an opportunity to:
- Ask follow-up questions from Friday
- Identify what each participant wants to accomplish during the individual work session
9:15–10:15 AM — From Revenue to Profit: Understanding the Numbers That Drive Your Practice
Presenter: Kara Welke, OTD, OTR/L, CLT
This session will address:
- Understanding the difference between revenue, cash flow, and profit
- Recognizing common financial problems in private practice
- Understanding the practice’s break-even point
- Knowing the true cost of delivering a visit or service
- Monitoring cancellation rates, CPT code utilization, and reimbursement
- Calculating employee costs and labor costs as a percentage of revenue
- Understanding productivity, capacity, and utilization
- Planning for taxes, operating expenses, and cash reserves
- Determining appropriate owner compensation
- Recognizing when growth increases revenue without improving profit
- Determining whether the practice can financially support another employee
- Using financial information to make better business decisions
10:15–10:30 AM — Break
10:30–11:30 AM — Hiring the Right People: Knowing When You Are Ready and Who You Actually Need
Presenters: Tammy Phipps, OTR/L, CDRS, and Trista Windows, COTA/L, CDRS
To be provided by Tammy and Trista.
11:30–11:40 AM — Break
11:40 AM–1:00 PM — Individual Strategy and Implementation Work
Facilitators: Kara Welke, OTD, OTR/L, CLT, and Tammy Phipps, OTR/L, CDRS
This session will address:
- Turning audit findings into specific priorities
- Completing a focused 30- or 90-day action plan
- Working through financial questions and business decisions
- Establishing financial targets and measures of success
- Creating or refining a KPI scorecard
- Developing a marketing and referral plan
- Addressing systems, workflows, or operational gaps
- Identifying the business’s most significant bottleneck
- Creating a staffing plan, job description, or hiring process
Meet Your Presenters
Kara Welke, OTD, OTR/L, CLT
Founder and CEO, Next Level Occupational Therapy and Home Therapy Solutions
Kara Welke is an occupational therapist, private-practice owner, national presenter, and business coach with more than 25 years of experience in occupational therapy. She is the founder and CEO of Next Level Occupational Therapy and Home Therapy Solutions.
In 2018, Kara launched Home Therapy Solutions as a mobile outpatient therapy practice designed to bring occupational and physical therapy into patients’ homes and communities. She has since grown the practice to include a multidisciplinary team, expanded outpatient services, and developed a clinic serving individuals across the lifespan. Home Therapy Solutions has been recognized as an Age-Friendly Health System committed to care excellence.
Through Next Level Occupational Therapy and the Therapy Business Builder Program, Kara helps occupational and physical therapy practice owners start, build, and grow sustainable businesses. Her work extends far beyond marketing and includes financial planning, key performance indicators, compliance, insurance, policies and procedures, hiring, compensation, productivity, documentation, billing, leadership, and long-term growth.
Kara combines real-world business ownership with extensive clinical, teaching, and leadership experience. She previously served as an occupational therapy assistant faculty member and academic fieldwork coordinator and has presented nationally for professional organizations and continuing-education programs. She is also actively involved in advocacy for occupational therapy, older adults, community-based care, and independent therapy practices.
At Next Level Live Virginia, Kara will serve as an event host, featured presenter, owner-panel participant, and closing-session facilitator.
Tammy Phipps, OTR/L, CDRS
CEO and Co-Founder, Driver Rehabilitation Center of Excellence
Tammy Phipps has spent more than 25 years as an occupational therapist and 22 years specializing in driver rehabilitation. In 2008, she developed and launched the first and only comprehensive driving rehabilitation program within the Department of Defense at Walter Reed Army Medical Center.
One of the service members Tammy assisted was Josh, a Marine who sustained a spinal cord injury resulting in quadriplegia while deployed during Operation Enduring Freedom. Tammy guided Josh and his family through the process of selecting a vehicle, identifying adaptive equipment, coordinating modifications, completing paperwork, and providing training and follow-up support. With her help, Josh regained his ability to drive.
Recognizing that many others faced similar barriers, Tammy and Josh co-founded the Driver Rehabilitation Center of Excellence in 2016 with a mission to make driving and community mobility accessible to everyone. Today, DRCE serves Wounded Warriors and individuals with a wide range of adaptive mobility needs.
Outside of work, Tammy celebrates her birthday, half-birthday, and two “birthing days.” She has also met more than 20 celebrities, including a First Lady of the United States.
Trista Windows, COTA/L, CDRS
Director of Driver Rehabilitation Services, Driver Rehabilitation Center of Excellence
Trista Windows has been a certified occupational therapy assistant for more than 18 years. She spent 10 years working at Walter Reed National Military Medical Center, where she first met Tammy Phipps and developed a strong understanding of the complex rehabilitation needs of injured service members.
In 2018, Trista joined the small but dedicated team at the Driver Rehabilitation Center of Excellence. Since then, she has had a front-row seat to DRCE’s growth from a single-site operation into an organization with three driver rehabilitation locations and a growing team of 11 occupational therapy providers.
As Director of Driver Rehabilitation Services, Trista oversees DRCE’s locations and helps ensure that each site provides high-quality care while meeting the professional and clinical standards of the driver rehabilitation field. Her leadership responsibilities include recruiting and interviewing employees, supporting team development, managing difficult employee situations, maintaining consistency across multiple locations, and helping DRCE grow without losing the relationships and quality of care on which it was built.
Outside of work, Trista loves to travel and is on a mission to spend at least one night in all 50 states. She has currently visited 32. She is also a proud book nerd and spends many evenings with her Kindle and the latest trending novel.
Jesse Graham
Sales Associate and Peer Mentor, Driver Rehabilitation Center of Excellence; Occupational Therapy Student, Shenandoah University
Jesse Graham is a 13-year Air Force veteran who sustained a spinal cord injury in a snowboarding accident. During his rehabilitation at Walter Reed, Jesse met Tammy Phipps and realized how essential returning to driving would be to his independence, relationships, and quality of life.
Since DRCE opened in 2016, Jesse has mentored customers with spinal cord injuries and other disabilities and assisted with sales, fittings, and customer feedback. He brings an important patient and peer-mentor perspective to private practice and driver rehabilitation.
Jesse is now an occupational therapy student at Shenandoah University. He is also an entrepreneur with experience in real estate investing, rental-property ownership, and developing an adaptive gym designed to include people with disabilities.
Melanie Gagnon, PT, CHHi-RP
Physical Therapist and Compliance Consultant, Therapy Consulting 8
Melanie Gagnon has been a practicing physical therapist since 1994. Throughout her career, she has worked in outpatient therapy, home health, skilled nursing facilities, inpatient rehabilitation hospitals, and acute care.
In 1999, Melanie opened an outpatient rehabilitation clinic in Harrisburg, Pennsylvania. The clinic operated for 13 years and grew to an average of 10 therapists providing physical, occupational, and speech therapy services.
In 2001, Melanie also established a nonprofit foundation and opened the first private residential group home for young adults with traumatic brain injuries in central Pennsylvania. She later worked for many years as a traveling physical therapist, gaining firsthand experience with a wide variety of clinical settings, operational systems, documentation requirements, and billing practices.
Melanie earned her Certified Harmony Healthcare International Rehabilitation Professional certification in May 2019. She is a member of the American Physical Therapy Association and its Private Practice Section. She regularly attends industry conferences and educational programs to remain current on Medicare and insurance documentation, billing, and compliance requirements.
Through Therapy Consulting 8, Melanie provides documentation auditing, compliance education, and individualized feedback to therapy practices. She helps owners and clinicians identify documentation and billing vulnerabilities before they result in denials, recoupments, or audits.
Steve Glukh, MS, OTR/L
CEO and Founder, HelloNote
Steve Glukh is an occupational therapist, entrepreneur, and technology leader dedicated to changing how healthcare professionals manage documentation and interact with their communities.
As the CEO and founder of HelloNote, Steve combines his clinical experience as an occupational therapist with his knowledge of technology and programming. This combination allows him to understand the daily frustrations therapists experience with documentation, billing, administrative workflows, and revenue cycle management and to develop practical technology solutions designed specifically for therapy practices.
Steve is passionate about creating organization out of chaos. He believes technology should reduce administrative burden, support the clinical team, and give practice owners better visibility into what is happening within their businesses.
Dr. Christopher Gaskins, PhD, OTR/L, CSRS
Founder and CEO, Neurosuite, LLC, Research Coordinator, Howard University Post-Professional OTD Program
Dr. Christopher Gaskins has over 15 years of experience as an occupational therapist. While working at Walter Reed, he became fascinated by how the brain processes cognitive-motor demands, a curiosity that led to his PhD in Neuroscience and Cognitive Science from the University of Maryland, College Park (2023), with a dissertation on mental workload during upper-limb prosthetic training.
He is the Founder and CEO of Neurosuite, LLC, a mobile outpatient neurorehabilitation company serving DC, Maryland, and Virginia, grown from a solo practice into a clinical team with a physical clinic in Rockville, MD. Neurosuite is built to be neuroscience based and tech-forward, helping clients navigate technology decisions in their neurorehab journey, and its research arm, The Suite Lab, is exploring digital therapeutics and assessment tools for clients. He also serves as Research Coordinator for the Post-Professional OTD Program at Howard University, his alma mater.
He holds a B.S. in Exercise Science from the University of South Carolina, an M.S. in Occupational Therapy from Howard University, and is a Certified Stroke Rehabilitation Specialist (CSRS), a credential central to Neurosuite’s neurological caseload. His research appears in the Journal of
Neural Engineering and Experimental Brain Research, and he completed an FDA ORISE Fellowship in the FDA’s Human-Device Interaction Laboratory and the BiteLabs Digital Health, AI & Innovation Fellowship.
A frequent voice in the neurorehab field, Dr. Gaskins developed a national CEU course, “Cognitive Strategies to Improve Upper Limb Motor Performance,” through Medbridge, and has been featured on the OT Potential, No Plateau, The Slow Road to Better, Pull Up with LimbsNThings, and Interconnected with Jourdan podcasts. He is a proud husband and “girl dad” who enjoys biking, cooking, and music.
📍Location
Driver Rehabilitation Center of Excellence
Chantilly, Virginia
14101 Parke Long Ct Ste E, Chantilly, VA 20151
🗓️ Date
Thursday - Saturday
September 25- 26, 2026
⏱️ Time
8:00 AM - 5:00 PM EST
Accommodation details below!
“The Next Level Experience was truly an amazing experience. I’ve never been to a conference where every minute provided value and real life application. Kara and her team truly care and were present the entire time (even after conference time) to answer questions, provide insight and help us all grow to our next level. No matter where you are in your business, this conference provided value and most importantly, inspiration to help you grow based on true knowledge not just flowery expressions. I highly recommend attending and will be going to the next conference”
Are you a TBB member, HCTN member, or student?
Email: admin@nextlevelot.com or Text: (701) 587-9707 us to receive your code.
Why Attend? because you can’t afford not to.
With rising costs, shrinking reimbursements, and shifting regulations, it’s more important than ever to be proactive and take control of your practice’s future.
This event isn’t just about information — it’s about actionable transformation.
▪️2 powerful days of learning, collaboration, and implementation
▪️ Walk away with strategies you can put into place immediately
▪️Connect with experts, coaches, vendors, and fellow practice owners
▪️See what’s working now in successful practices across the country
▪️Position yourself ahead of the curve with legal, profitable, and scalable models
Don’t wait for change to happen to you.
Create the change your practice needs —now.
Are you a TBB member, HCTN member, or student?
Email: admin@nextlevelot.com or Text: (701) 587-9707 us to receive your code.
Registration type
Price
General Registration
$149
Therapy Business Builder members
$75
Home & Community Therapist members
$112
Students
$25
Event Sponsors
Student Registration
The $25 student rate is available to currently enrolled:
Occupational therapy students
Occupational therapy assistant students
Physical therapy students
Physical therapist assistant students
Speech-language pathology students
Speech-language pathology assistant students
Current student identification or enrollment verification may be required.
Registration Includes
▪️Friday and Saturday educational programming
▪️Light breakfast on Friday and Saturday
▪️Friday lunch
▪️Networking opportunities
▪️Event materials
▪️A certificate of attendance for each day completed
Registration fees are the same whether an attendee participates in one day or both days. Fees will not be prorated based on the number of sessions or days attended.
Travel, lodging, AOTA Capitol Hill Day expenses, ground transportation, and optional evening activities are not included.
Are you a TBB member, HCTN member, or student?
Email: admin@nextlevelot.com or Text: (701) 587-9707 us to receive your code.
Reserve Your Spot Below!
Certificates of Attendance and Professional Development Credit
Participants will receive a separate certificate of attendance at the conclusion of each day for which they complete the applicable attendance requirements.
Each certificate or its accompanying documentation will identify:
▪️Participant’s name
▪️Event name and date
▪️Sessions attended
▪️Educational contact hours completed
▪️Event organizer or authorized signature
▪️Relevant session descriptions and learning objectives
Participants must be present for the educational sessions they claim and must complete any required sign-in, session-verification, or evaluation procedures. Meals, breaks, registration periods, networking activities, and other noneducational activities will not be included in reported contact hours.
Each educational session will have a written description and clearly stated learning objectives. The event will maintain the agenda, speaker information, session descriptions, learning objectives, and attendance records to support participants’ professional-development documentation.
Next Level Live Virginia does not guarantee acceptance by any specific state licensing board, credentialing organization, employer, or professional association. Continuing-education and professional-development requirements vary by profession, state, board, and credential.
Each participant is responsible for:
Verifying whether the sessions meet the requirements of the participant’s state licensing board
Verifying whether the sessions qualify for the participant’s professional certification or credentialing requirements
Maintaining certificates of attendance and supporting program materials
Accurately reporting only the sessions and contact hours completed
For NBCOT certificants, eligible educational contact hours may qualify for Professional Development Units under NBCOT’s current certification-renewal requirements. NBCOT currently recognizes one qualifying contact or clock hour, excluding meals and breaks, as one PDU. Participants are responsible for confirming current NBCOT requirements and maintaining the documentation required for renewal.
Questions regarding state licensure credit should be directed to the participant’s applicable occupational therapy, physical therapy, speech-language pathology, or other professional licensing board.
Travel and Hotel Information
Transportation to Northern Virginia from Capital Hill
Take the Silver Line directly from Smithsonian Station to Innovation Center Station.
▪️No train change is required.
▪️Attendees should allow approximately one hour for the Metro ride.
▪️Additional time should be allowed to reach Smithsonian Station and travel from Innovation Center Station to the event.
▪️The event venue is approximately a 15-minute drive from Innovation Center Station.
▪️Event organizers will coordinate shuttle or rideshare transportation based on final attendance.
Nearby Attractions
Steven F. Udvar-Hazy Center
The Smithsonian National Air and Space Museum’s Steven F. Udvar-Hazy Center is located in Chantilly near Dulles International Airport.
Admission is free.
No timed-entry pass is required.
Current hours are 10:00 AM–5:30 PM daily.
Parking is $15.
Thank you to our Sponsors!
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