By CHET YARBROUGH

In the last century, we have received the mixed blessing of living longer. Mark Twain said, "It is sad to go to pieces like this but we all have to do it."

Rehabilitation protects the health of young and old by improving the quality of life. It offers many service and employment opportunities. Big and small Las Vegas Valley businesses serve the rehabilitative needs of a growing population.

The biggest medical rehabilitation company in the area is HealthSouth Corp.

"HealthSouth has 20,000 employees nationwide," said Tovah D'Ambrosio, director of human resources. "They employ 700 people in the Las Vegas Valley at four HealthSouth rehabilitation hospitals and one outpatient facility. The Desert Canyon Rehabilitation Center alone employs 140 people."

Ed Hladek is one of six resident physical therapists at Desert Canyon Rehabilitation Center, 9175 W. Oquendo Road. He outlined a typical workweek and what a patient would experience at Desert Canyon.

"Every day is different, cases are different, and personalities are different. Patient maturity ranges from youthful to aged," he said. "Once a week, our therapy team meets to evaluate new patients and the progress of current patients."

At this evaluation meeting, Hladek explained, "We divide patient service based on their needs and our skill and experience. We schedule therapeutic service for the week and begin work on our first patient of the day."

HealthSouth's therapists serve stroke victims who have lost motor skills because of blood flow interruption to parts of their brain. Therapists help convalescents relearn simple things like how to pour a glass of water. The hospitals offer rehabilitation for hip replacements, spinal cord injury, traumatic brain injury and degenerative orthopedic disease. HealthSouth's goal is to get patients back home and back to work.

"I recently treated a paralyzed patient that could not lift his head when he was wheeled into the hospital. I began working with him for three hours a day. At the end of his stay, he used a walker to walk out of the hospital," Hladek said.

HealthSouth is a one-stop service for rehabilitation. Staff members come to patients' homes, if necessary, to evaluate their conditions and determine whether rehabilitative therapy will help. They will contact a patient's regular physician to help with a referral and can begin the admission process from the home.

When admittance is required, the average stay at HealthSouth is two weeks and most patients go home rather than to another facility.

"In some circumstances, a patient will continue therapy in their home or with visits to the HealthSouth outpatient clinic for further treatment," Hladek said.

HealthSouth is always looking for good employees. Its website (www.health
south.com) has posted job openings and a job search application.

"Job openings in physical, occupational and speech therapy require worldwide employee searches because it is difficult to find enough qualified candidates locally," D'Ambrosio said,

"HealthSouth is a great place to work because a physical therapy team creates a family atmosphere in their treatment of patients," she added.

Job satisfaction is buoyed by a therapeutic team's success in returning patients to their homes, to their families and to the routine of independent life.

A specialized category of care is provided at intensive care rehabilitation facilities called long-term acute care hospitals. An LTAC facility is staffed and equipped to offer rehabilitation to patients with acute, often multiple medical issues that require 24/7 attention by physicians, nurses and rehabilitative staff who care for patients with life-threatening disabling injuries or illnesses.

Las Vegas has six hospitals classified as LTAC facilities: HealthSouth, 2500 N. Tenaya Way; Horizon Specialty Hospital, 640 Desert Lane; Vegas Valley Rehabilitation, 2945 Casa Vegas St.; Progressive Hospital, 4015 S, McLeod Drive; and Kindred Hospitals, 5110 Sahara Ave., and its satellite facility, 2250 E. Flamingo Road inside Desert Springs Hospital.

The two Kindred Hospitals offer 92 LTAC beds, 40 on the fifth floor at Desert Springs Hospital and 52 at Kindred Hospital on Sahara Avenue.

A significant part of the Kindred group policy is its continuation of care after patient discharge. Often rehabilitation must continue on an outpatient basis; in some cases transition may be to another care center that offers a less expensive but more appropriate level of care. Kindred assists the patient in that transition. Its rehabilitation goal is to return patients to live and work as normally as possible after a disabling injury or illness.

The Kindred hospital group publicly announced in February 2011 an expansion of its service area and capability with the acquisition of publicly held RehabCare Group for $1.3 billion. The acquisition will make Kindred the largest long-term acute care company in the United States.

Kindred's website offers insight to its personnel management philosophy. It offers job-related education incentives to full-time employees that have completed at least 90 days of employment. Parent company Kindred Healthcare publishes an annual nurses' report that summarizes employee surveys showing job satisfaction. Also, like HealthSouth, Kindred's website, www.kindredhealth
care.com, offers a job search application for interested job seekers with access to job openings throughout its network of hospitals.

While HealthSouth and Kindred are large corporations, Chrysalis is one of the smaller rehabilitation services in Las Vegas. Chrysalis opened its business in 1985 with 14 people in Heber City, Utah; its Las Vegas Valley office is at 3011 N. Coleman St. in North Las Vegas.

Chrysalis is a unique rehabilitative business that serves approximately 500 patients with cognitive disabilities in various three- and four-bedroom group homes throughout Utah and Nevada. It contracts with various state agencies and private paying families to provide rehabilitative service, i.e., from creating a specialized diet to integration or reintegration of mentally or physically impaired patients into society. Chrysalis works closely with organizations like Opportunity Village.

Employees work in individual group homes that have three to four clients in each home. The homes are staffed at all times that clients are present (clients often have jobs outside the home). There are approximately 150 employees in the Las Vegas Valley.

"New employees have a minimum high school education and, after submitting to a background check, are entered into a training program to understand how to manage situations that may occur in a group home," said Ryan Giles, managing director of the Las Vegas office.

Giles said training includes CPR, first aid, human rights, diversity and medication management; it takes between 50 and 60 hours prior to working in a home. Training may involve role playing with explanations of how to handle confrontation through a range of conflict-resolution strategies to, in extreme cases, restraint. While entry-level positions do have high turnover because of the labor intensity of the work, Giles notes that he started out in an entry-level position 17 years ago.

Chrysalis advertises for employees by saying it is looking for people who care. In going to its website, www.gochrysalis.com, job seekers can learn about the company. The website has the additional feature of job listings that are available in the Las Vegas Valley.

"Chrysalis is always looking for entry-level employees and, right now, we are looking for a professional behaviorist," Giles said.

A new rehabilitation facility, Advanced Health Care of Las Vegas, is opening its doors this month at 5840 W. Sunset Road. Brigham Church, nursing facility administrator, and Travis Winward, admissions director, will welcome their first clients to the 38-bed, first-class facility. Advanced Health Care is not an LTAC facility but it does provide short-term care that may be prescribed by a patient's personal physician. Customized rehabilitation may include wound care, IV therapy, medication administration and assistance with dressing, bathing, walking and dining.

The average patient stay is two to three weeks. The objective of Advanced Health Care is to return residents to independent living as soon as possible.

To that end Church explained, "Every patient has a private room, microwave, refrigerator, bathroom and amenities like cable TV and Internet services."

Common areas include a reception area, spa, beauty salon, small outdoor park with benches, dining room, library and fully equipped physical therapy room.

In the Mesa, Ariz., facility, which is a mirror image of the Las Vegas center, 95 percent of Advanced Health Care's patients are Medicare recipients. "I expect similar Medicare patient percentages at this new Las Vegas Valley facility," Church said.

"That, unlike nursing homes with nursing assistance staffing ratios of 1 to 12 or 15 patients, Advanced Health Care of Las Vegas will have a ratio of 1 to 8," he said.

Cost of rehabilitation is often covered, at least in part, by private insurance or Medicare. Patients need to discuss their coverage with their insurance carrier when a plan for rehabilitation is determined. Companies like HealthSouth, Kindred, Chrysalis and Advanced Health Care of Las Vegas are staffed to help patients understand their financing alternatives.

As of April 12, Church had hired 12 employees with plans to hire 68 more, ranging from physical and occupational therapists to building maintenance and kitchen help. Some jobs are more difficult to fill than others because of education and licensing requirements but Advanced Health Care plans to hire licensed therapists as full-time employees to ensure quality of care.

Church said, "Employee turnover is low because it is a great place to work."

Another service of the rehabilitation industry is to treat addiction. Las Vegas Recovery Center offers a three-phase, three-month addiction program that involves the client and his or her family. Mel Pohl, a general practitioner, is the medical director of Las Vegas Recovery Center. He is joined by psychologist Rob Hunter, Ph.D., and Dr. Claudia Black, a published author, trainer and speaker about addiction.

There are many facets of addiction -- the guilt associated with it, its appeal to the fundamental nature of man and its devastating impact on families and society. Treatment is rehabilitative for one person but its import spreads throughout a community.

The National Institute of Drug Abuse reports that "for most patients, the threshold of significant improvement is reached at about three months in treatment. After this threshold is reached, additional treatment can produce further progress toward recovery."

There are many jobs needed in the rehabilitation industry, from doctors, nurses, dieticians, therapists to nursing assistants, therapist assistants, food servers and building maintenance personnel. While some rehabilitation employees do not need advanced degrees, jobs like occupational, physical and speech therapy require postgraduate education for licensing in the state of Nevada.

To be a licensed speech therapist, a student must have a postbaccalaureate degree in speech pathology. Nevada State College in Henderson offers a bachelor's degree in speech pathology but no advanced degrees in the subject.

The state of Nevada, through the Department of Education Teacher Licensure, offers a restricted speech therapy license to Nevada State College speech therapy graduates but only to work in the Nevada school districts for kindergarten through grade 12. No speech therapy postgraduate programs are presently available in the Las Vegas Valley. Consequently, hiring a speech therapist requires a national search for candidates.

The College of Southern Nevada can be a good starting point for a professional position in rehabilitation. The college offers students an Associate of Applied Science degree in physical therapy and occupational therapy for employment as a physical or occupational therapist assistant.

However, to become a licensed therapist, students have to complete a bachelor's degree with stipulated prerequisite classes to be able to apply for a postgraduate degree in physical therapy at the University of Nevada, Las Vegas or Touro University Nevada. The degree virtually guarantees employment

"One-hundred percent of our students find a job after graduating and some have jobs before graduation," said Dr. Sue Schuerman, director of clinical education at UNLV.

But getting accepted into those classes can be difficult. "Out of 500 applications to the graduate school of physical therapy this year (250 had nearly perfect applications), 80 interviews were given and only 30 student applications were accepted," she said.

"We just do not have the staff or facilities to accommodate more students," said Dr. Daniel Young, assistant professor of the department of physical therapy.

A big part of UNLV's physical therapy graduate program is its clinical affiliation training. Dr. Harvey Wallmann, the current chair of the UNLV physical therapy department, trailblazed UNLV's clinical affiliation program. The physical therapy department contracts with local rehabilitation hospitals, acute care hospitals and outpatient facilities to give UNLV students an opportunity to learn and train with licensed physical and occupational therapists in a clinical environment.

According to Schuerman and Young, UNLV is in the 90th percentile of schools whose graduates pass the national exam for physical therapy on the first try. This puts UNLV in a select group of schools that offer this kind of graduate education, which explains the popularity of the program.

"Eighty percent of this year's students admitted to the physical therapy graduate school are from out of state. In spite of doubling tuition prices, the demand for education in graduate physical therapy is unabated," said Young, who noted that, in past years, half of the students came from Nevada.

Touro University, which started in New York, now has campuses in San Francisco and Henderson.

"Touro's postgraduate rehabilitation program is in its inaugural season," said Dr. Mindy Renfro, a faculty member in the school of physical therapy.

"After graduating its first graduate students, Touro University will have an accredited postgraduate school of physical and occupational therapy," which can lead to licensing by the state of Nevada.

A major part of Touro University's philosophy of education is to be a service to its community. Curriculum characteristics of the school include a requirement to intern with Las Vegas Valley rehabilitation companies and to volunteer a minimum 18 hours in the community.

Touro University conducts a Henderson Health Fair every year that includes free screening for balance, cholesterol, diabetes and blood pressure.

"When they started the Health Fair in 2007, 30 to 35 people showed up; last year, more than 300 attended," Renfro said.