At the same time that teams of therapists work with people with brain injuries at On With Life Inc.’s campus in Ankeny, construction crews are busy on the outside on a $5 million construction project that will significantly increase its size.

Miracles are everyday occurrences at On With Life Inc.

The 26-bed brain injury rehabilitation center in Ankeny serves as a regional referral resource for hospitals statewide and regionally, and is one of just a handful of accredited brain injury rehabilitation centers in the world that operates outside a major medical center. 

Now, the center is undergoing a $5 million expansion that will enable it to provide enhanced inpatient services as well as create a permanent space for its outpatient rehabilitation programs. The expansion is to be completed this summer. 

Founded in 1987, the nonprofit organization opened the Ankeny center in 1991. On With Life has the distinction of operating the only brain injury center in the United States that’s independent of any hospital or nursing home group, says its executive director, Julie Fidler Dixon. The nonprofit was formed by eight families who each had a loved one with a brain injury. 

“I think one of the things that’s made us as good as we are is that we are not-for-profit, and we don’t answer to anyone else,” Fidler Dixon said. “So we can focus on that mission: What will be best for the person served and the family members?” 

The project is the first major expansion for the organization since the center opened. To fund the project, the nonprofit launched its first-ever capital campaign, called Life Forward. In a little more than 18 months, the campaign has raised more than $2 million. 

“We’ve never gone to the community for money before, and finally about three years ago, we decided this was the time,” Fidler Dixon said.  

Overall, the inpatient rehabilitation program serves approximately 100 individuals a year from all over the state and the Midwest, said Pat Stilwill, On With Life’s administrator. “At any time, we have a waiting list of about five to 10 individuals,” he said. 

The addition of two more inpatient rooms, which  is expected to be complete by mid-April, will enable On With Life to significantly address that waiting list, he said.

On With Life also operates a long-term skilled care facility in Glenwood, Iowa, and provides 14 independent living apartments for people with brain injuries adjacent to its Ankeny campus. The nonprofit also coordinates supported community living services for people with brain injuries in conjunction with the Neveln Center Inc., a community services center in Ankeny.  

Intensive therapy

On With Life’s inpatient rehabilitation services can be categorized into two major programs: a conventional rehabilitation regimen and its Disorders of Consciousness program. 

The Disorders of Consciousness program is one of only a handful of programs in the country that can provide rehabilitation services for individuals in a coma. A specially trained multidisciplinary team provides environmental stimuli, monitors the patient for signs of awareness and adjusts the stimuli in order to maximize the survivor’s improvement. 

“With disorders of consciousness, you want to do sensory stimulation, but you don’t want to overstimulate that person,” Fidler Dixon said. “It takes a lot of expertise. Most of all, you want to keep that body functioning. If you don’t have any therapy and then they begin to emerge from that coma, now you’ve got a body locked up that you can’t ever overcome.” 

A majority – 76 percent – of the more than 250 individuals who have been admitted into the DOC program have emerged from their coma. 

The length of stay for people in the Disorders of Consciousness program is about 180 days, and less than 90 days for the conventional brain injury rehabilitation program. 

A decade ago, someone with a brain injury might have spent six months in the hospital at Younkers Rehabilitation Center in Des Moines before coming to On With Life for rehabilitation, Fidler Dixon said. “Now they might be there three weeks before they’re discharged and come here,” she said. “So we’ve had to change to meet the market needs because people can’t stay as long in the hospital.” 

The inpatient rehabilitation center provides an intensive therapy schedule that’s individualized to each person’s needs. The level of care is the most intensive of any skilled nursing facility in the state, according to Fidler Dixon. 

On average, the cost to provide inpatient care is somewhere between $800 to $1,000 per individual per day, “which is much, much less than hospitals,” she  said. 

“We feel like we’re a really efficient way to deliver this service, as soon as someone is medically stable,” she said. “The condition of people coming out of the hospital today is far different than five or 10 years ago – that’s why we’ve geared up our medical aspect.” 

More space, less waiting

On With Life’s expansion project includes the addition of an aquatic therapy pool, a new wellness center with expanded inpatient therapy areas, added outpatient therapy areas and an expanded dining room. 

“I came to this program when it was 3 years old, and the dream was to have a pool. That’s been the biggest dream – to have a pool and a family house,” Fidler Dixon said. “And we really need to be able to do outpatient services. For 20 years, our families have asked us to do outpatient services.”

Using a 2,700-square-foot modular home that was purchased nearby and moved a few blocks onto the campus, One With Life has been serving about 150 people in its outpatient program. The expansion project creates a permanent space for outpatient programs.

The expansion will also add landscaped therapeutic outdoor grounds with varied walking surfaces for rehabilitation. Two additional inpatient rooms will be added that will be specially equipped to handle obese patients. 

“With the new additional beds, we’ll obviously be able to pare down that waiting list a bit and get some people out of the hospital,” Stilwill said. “The only option really in the state of Iowa, if they’re not going to remain hospitalized, is to go out of state. Hopefully this will allow more people to stay in state.” 

How it started 

The nonprofit organization began with eight families who met each other at Younkers Rehabilitation Center in the early 1980s. 

“They were eight young men – all who had been injured in different ways – one had an aneurysm, one was a motocross racer, one had a horrible auto accident a mile from here,” Fidler Dixon said. “But it was like jumping off a cliff when they got out of the hospital; they needed holistic, specialty services (that weren’t available). Those families spent the next eight years talking to hospitals, nursing homes, insurance companies and foundations, all of whom said, ‘It can’t be done.’ ” After it appeared it would not be possible to fund a facility,   the city of Ankeny offered to issue $4 million in municipal bonds if the families could match 20 percent of that, or $800,000. 

Polk County Supervisor Richard “Red” Brannan reportedly said, “Boys, this is too good of an idea to let die. Who’s going to help these people?” Don Lamberti and other leaders and organizations came on board to help buy the down the municipal bonds and get the program started.