OT Across America: Fort Collins, CO with Krista Covell-Pierson, OTR/L

For this “OT Across America: Fort Collins, Colorado” edition, I’m really excited to share this interview with Krista Covell-Pierson, OTR/L, who is a practicing OT in Fort Collins, CO and the founder of Covell Care and Rehabilitation.


This is an awesome interview especially for anyone interested in starting their own therapy practice, since Krista has been growing and expanding her mobile outpatient practice in Colorado. In this interview, she shares her background, what her business is all about, and what it’s been like starting her own practice from the ground up.

Tell us a bit about your background. What drew you to OT?

Krista-Covell-PiersonI’m Colorado-born and raised and went to social work school at Colorado State University. At the time, CSU was a random lottery, so as long as you had a minimum GPA, volunteer hours and so on, you’d get placed into a random lottery system. I knew I wanted to be an occupational therapist because my aunt, who lives in North Carolina, is an OT. I initially always thought I wanted to be a teacher, but when I went to see her, I got exposed to OT in the schools.

I thought “That’s totally what I want to do,” even though I’ve never worked in schools or in peds, but that’s how it goes.

I applied to OT school three different times and didn’t get in the first two times, so then on the third time I was actually graduating that year. At that point, I was like “Well, I guess I’ll stay in Fort Collins” and went to OT school at CSU.

I started out an as OT when PPS first came out so a huge percentage of OTs lost their jobs, so it was super competitive to get a job. It was 2001, and I took a job as a Director of Social Services at a nursing home and loved it.

I then became the Director of Marketing, then met a doctor who was medical director there and he said, “Maybe you should start your own business,” because I was really into working with people with dementia. He said “There’s a lot of people in the community that could benefit from what you’re doing.” That was where the seed to start the business was planted (I was 23 at the time).

What occupational therapy setting do you practice in?

I’m in private practice, and we work with mostly older adults and adults with chronic disabilities and illnesses. We are mobile outpatient practice so we see people mostly in their home, but we can see also people in coffee shops, the bank, on the bus, etc.

We started out as just doing occupational therapy and then added physical therapy and speech therapy because nobody was doing the model we were, so if we referred to outpatient practices for our clients, we felt that they just weren’t getting the same level of support as what we were able to provide in their homes.

That’s why I also added PT and Speech. We also added geriatric care management, senior fitness trainers, and a certified driving rehab specialist who is an OT that can take you out on the road with an adapted car.

I’m certified in Pelvic Muscle Dysfunction so we do a lot of incontinence training, which is huge for our people at home. [Be sure to listen to Krista discuss this specialty on the Seniors Flourish podcast!]

We also do licensed clinical social work and massage. Everyone working for us is mobile and we practice across five different counties. We’ve grown from just being a one-man band to now, we have 45 practitioners and an administrative staff of six.

So the practice has grown but our job as occupational therapists is to live the best, most functional life we can, so we try to be more like a lifestyle place for practitioners too and support their growth in all different ways so they can be the best person they can be. That way they can go out and help people do the same when they’re sick or have had an injury.


What does your typical day look like?

I don’t have a typical day at all, especially as a business owner.

An example of a “typical” day would be today I started with rounds with the nurse practitioner then I went and did some marketing for about 30 minutes, then I came to meet with you.

Afterwards, I’ll go to my office and do some emails and work on some projects that we’ve got going. Then I’ll meet with an attorney at 3:00 to discuss a possible business acquisition for a business out in Boulder that we might want to purchase. So we’ll look at those financials and then I’ll go do more marketing until about 5:00, and then I’ll go home and take care of 6 month old twins! Then tomorrow I have meetings all day and a lot of marketing.

I also see a small caseload of patients, so my day really just depends on what I have going on.

When I first started the business for the first 5 years, I would work 80-100 hours a week. That’s just what it took to get it off the ground.

What is your team approach like? Do the therapists have a productivity standard?

I knew when I created my own team I wanted to create a place that we knew each other like family and that we could all truly support each other. Our practitioners are all in private practice of some sort and we’ve taught them that they have to manage their own productivity. So if somebody’s slower placed, that’s on them, and if somebody’s a machine, good for them.

We don’t have a productivity standard. Whoever’s working has to match it with what their internal barometer is. I’ve met therapists that will go out and do 11 visits in a day and I know that that’s not possible when you’re driving from town to town, so that’s not the right practitioner for Covell Care.

We want somebody that performs good, solid treatments. And maybe they work hard and can get 6 or 7 visits in a day, but some therapists would be exhausted with that amount at the end of the day with that. So, it just depends on what feels right and ethical for that clinician.

My business philosophy is, “If you always do the right thing, the money will follow.

It has been an expensive thought process at times because it has cost us, but it does come back because people remember that you make good, honest decisions and that you have a moral compass.

We don’t want to fight (with other businesses) over referrals. I used to preach at my administrators those things, so when I had to call the shots in my own business I thought, “If I’ve spent that many years preaching to administrators that this is the way ethically you need to operate, then you need to do that.” But there are times as a business owner it can be hard.

For example, we’ve never said no to Medicaid clients when they weren’t covered. Last year, we ended up giving away $100,000 of free services, but now Medicaid is reimbursing for what we’re doing. That’s great because people have been sending us Medicaid referrals for 10 years and now all of the sudden, we’re going to get paid for the services we provide. Now other companies want a piece of that pie but it’s like, “Where were you helping these people [when they weren’t covered]?”

I do also ask my clinicians to give away at least one service a year for somebody that can’t afford it.


What is your favorite thing about owning your own business?

My favorite thing about owning my own business hands-down is helping other people create their dream job, 100%. I never thought I would be able to do that, but that’s my favorite thing.

What are the biggest challenges with your business?

One thing that’s hard is when you’re out helping somebody create their dream job, they might not enjoy the challenges and they might have unrealistic expectations sometimes. So then when I have to tell them “This is the crappy part of this, can you deal with that in order to do the other stuff?” I don’t enjoy that because sometimes I feel like people can get stuck in that.

I also don’t enjoy dealing with unethical people. Those are my two big ones.

And the mass chaos that comes with healthcare can get frustrating. Like the right hand doesn’t know what the left hand’s doing half the time, so you can have somebody with cardiac problems and they also have cancer, and the cardiologist and oncologist don’t communicate. So those things are hard.

Is there anything unique to OT in the Fort Collins area?

In Northern Colorado, because we have so many older adults and older-adult-friendly community, I feel like we have a lot of resources. We don’t just have one home health company, we have many home health companies. We have a lot of resources but that also can be challenging, so it depends how you look at it.

We have a strong sense of community, although we don’t have the best public transit options for older adults. In theory, the options are fine but they’re not really practical. But overall we have a good support system for the older adult community.

Do you feel like you have to advocate for occupational therapy in your area?

All the time, every day. I think it’s a daily education even for people I’ve known and worked with for years. Sometimes it takes practical applications with the client for other people to see what all we can do. The more people talk about it, the better it gets.

What are your future plans for your business?

We would like to develop telehealth on our pelvic health side, so other people can have access to information about incontinence, pelvic pain, etc.

We’d also like to grow outside of Colorado and start helping people start their private practices outside of Colorado. And just continue doing what we’re doing, one client at a time.


We want to extend huge thanks to Krista for taking the time to interview with us for our OT Across America series. We had a blast exploring Fort Collins and want to also thank the occupational therapy students of Colorado State University for hosting a meet and greet for us! We loved Fort Collins and hope to make it back to visit the awesome Fort Collins OT community again soon.


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