On With Life was the Business Record’s Best Kept Secret winner in 2017, but the nonprofit rehabilitation organization is a secret no more.

The need for rehabilitation services for people who have suffered brain injuries, neurological disorders and spinal cord injuries is growing. On With Life, based in Ankeny, is rapidly expanding to meet that need. Corey Morrison, chief strategy officer, said part of the mission now is ensuring that people know where to find help.

“That’s why we continue to sing from the mountaintops, if you need us we’re here,” Morrison said.

On With Life was incorporated in 1987 after a small group of founding families came together to bring Central Iowa a much-needed service. Aside from their passion to help, the families shared one thing in common. They each had loved ones that had suffered brain injuries.

“They were really told to give up. That there wasn’t anything local,” said CEO Jean Shelton. “They didn’t believe that. They came back here and said Iowa needs better than that.”

In 1991, the organization opened a 22-bed rehabilitation center in Ankeny. Then it expanded to Glenwood, Coralville and Des Moines. 

Along with the growth into new locations, and expanding its footprint in Ankeny, the services have grown to meet the needs of patients. This has happened alongside more and more people needing rehabilitation services after suffering a brain injury, stroke, Parkinson’s and spinal cord injuries. 

Currently On With Life is in the midst of intense growth. It has opened a state-of-the-art 25,000-square-foot outpatient facility in Ankeny, where it also has an “extreme home build” in the works on campus. The home build will create family housing for people who travel great distances for care, free of charge. It is also opening a new facility in Polk City next year.

On With Life serves more than 1,000 people annually and is growing quickly. It receives referrals throughout the country on top of the large base it serves locally. It also employs about 300 people across its facilities. 

The rapid expansion is being done thoughtfully to match an ever-growing need, according to Jeb Lee, chair of the board of directors. Future growth is expected as well, particularly in outpatient care.

“On With Life’s vision is to be the provider of choice in brain injury rehabilitation,” Lee said. “We want to look for opportunities where we can grow but in ways that make sense while supporting that vision.”

Supporting families and catering care

When touring the Ankeny campus it is clear that On With Life is keeping the needs of its patients front and center. The new outpatient facility features much of what would be expected in a rehabilitation facility, such as modern physical therapy spaces. 

Yet it is also unlike almost any health care facility imaginable. It is home to training spaces that replicate the homes and workplaces that patients navigate in their everyday lives. This includes a garage filled with tools, workbenches and materials for woodworkers and mechanics. There is gardening space, a kitchen, bedroom and living area.

A brief look at any of these spaces does not do them justice. There are features that are easy to miss, such as adjustable doorways that can mimic the size of someone’s doorway at home so they can get used to navigating through the space. It is all a part of preparing people to live their everyday lives and do the things they love.

Helping a loved one who has suffered a traumatic brain injury or is overcoming a neurological disease is a taxing experience for families as well. On With Life understands that family members are often thrust into the role of caretaker in these scenarios.

Morrison said the staff within the organization emphasizes getting the family involved with care so they know what needs to be done when their loved one goes home. 

“They pick up on things the team does here. They learn ‘what motivates my loved one,’” Morrison said.

About 85% of On With Life’s patients ultimately return home. While insurance companies focus on the symptoms that are more apparent on the outside, the need for care continues for a lifetime.

Ankeny’s outpatient facility was designed with families in mind, creating space for them to work, eat and relax while their loved ones receive treatment.

“Making the families comfortable is extremely important,” Shelton said. “Imagine coming straight out of ICU and then you’re here. Families haven’t even had the chance to decompress yet. 

“They’re so thrilled their loved one is alive and at the same time there’s a lot going on and a lot of demand on the families.”

This is where the outpatient center and the expanding family homes come in to offer respite. Families that have traveled long distances, some from as far as Arizona and Texas, do not have the extra worry of finding and paying for hotels or short-term housing. On With Life is making room for them to be close.

Success stories

On With Life is a homegrown success story. What is unique about this success story is that it is creating the opportunity for other homegrown success stories.

Shelton said all of On With Life’s success stories are unique. They are based on the goals of the patients. Some goals may seem small to some, like a mother who wants to hold her baby again. Others may sound unattainable after suffering a traumatic event, like returning to work or recreation. On With Life caters therapy to those individual goals.

“Success is so variable here because we’re honing in on what you want, not what we want,” Shelton said. “That’s our secret sauce.”

One patient of the in-patient facility hoped to kayak again. Shelton said he requires at least two people to assist him with any type of movement. But through adaptive therapy his goal was met. It progressed from putting him in a kayak in a pool to getting out in a river surrounded by about 10 volunteer kayakers.

“You can’t get that kind of smile and that kind of quality of life without going way above and beyond,” Shelton said.

For Megan Schmelzer of Ankeny, On With Life brought hope and light to her darkest moment. On Feb. 7, 2020, she fell on ice in the parking lot at the school where she taught fourth grade. She suffered a traumatic brain injury and continues to struggle with short-term memory loss and vision problems.

Compounded with the injury, she had to go through a weekslong workers’ compensation fight before receiving care and was terminated from her job that she worked for 13 years.

Through months of rehabilitation, Schmelzer maintained the goals of regaining independence, being able to enjoy time with her children and getting back in the classroom.

She needed outpatient speech, occupational, vision and physical therapy. Her typical day of rehab started at about 8 a.m. and lasted until 1 p.m. During that time she would meet with each individual therapist, each of whom helped her regain the functions she would need to teach a classroom of 30 students.

One example of the specially catered exercises she did is walking on a treadmill while answering math questions, and remembering the names of up to 30 students. These were activities that would have been effortless before her injury, but the foundation needed to be rebuilt.

She also did driving simulations to relieve her anxiety about getting behind the wheel.

However, it became apparent that Schmelzer would not be able to return to the classroom. At least not in the way she was accustomed to.

While Schmelzer was unable to return to her old classroom, she achieved a much larger and more difficult milestone. She started her own business, the Little White Schoolhouse, a nonprofit tutoring and learning center in Ankeny. The center opened in October 2021.

“They have been incredibly supportive, from when it was apparent that I wasn’t going to be going back to the classroom to my idea about starting a business,” Schmelzer said of On With Life. “They helped interview me and promote me. They were wonderful in making my therapy represent what I would have expected to do in the classroom as a teacher.”

The Little White Schoolhouse has programs for preschool-aged children to adults. It has far exceeded Schmelzer’s initial expectations, now serving about 200 people and employing 65 licensed teachers.

“It’s not just me, like I thought it would be,” she said. “It turned into something really beautiful that I wouldn’t have been brave enough to do if I hadn’t gotten injured. We’re helping a lot of kids. A lot of them are neuro-deficient. So when they are struggling with dyslexia and ADHD I can say, ‘I get you.’ That’s really powerful.”

On With Life met and exceeded Schmelzer’s hopes for rehabilitation. What she may not have expected was what the organization did for her beyond therapy.

“On With Life was there for the darkest moments of my life and made me feel like a person,” Schmelzer said. “They made me feel like I can get back to where I was and even if it looked different, I still have value, while workers’ comp and the school district were saying the opposite.”