ST. PETERSBURG -- Beverly Ventura is in the business of breathing. The 47-year-old respiratory therapist has helped hundreds of people learn to do the one thing we take for granted every second of the day.

Ventura is part of a team of specialists working in a new program offered at the Laurels Nursing and Rehabilitation Center at 550 Ninth Ave. S. across from Bayfront Medical Center. When the center came under new management 18 months ago it became one of a handful of long-term care facilities in the state with a 24-hour ventilator care unit.

The unit has 18 beds for patients who suffer from everything from severe neurological disorders to pulmonary disease and need the assistance of specialized technology to breathe. Though the majority of the unit's patients are elderly, Ventura said it's not unusual for younger victims of serious heart attacks or car accidents to need the specialized care.

"It can happen to you. When you're 35 or 38 you could have a massive heart attack. We usually don't think about it, but you suddenly need the ventilator," Ventura said.

High operating costs and low reimbursement rates have caused a number of nursing home units to close down similar programs. There are now only 41 long-term ventilator care units in Florida.

The limited number of programs frequently forces patients to travel long distances once they are released from the hospital. According to Ventura, some of the unit's current patients live as far away as 200 miles from St. Petersburg. Long distance travel sometimes adds extra time to the recovery process for patients who desperately need family support.

"It becomes a hardship for the patient and for the family. You know, for the family it means the only time they have to come down is during the weekends," Ventura said.

Though startup costs for ventilator equipment and staff can run up to about $200,000, Florida Health Care Association spokesman Ed Towey said additional liability insurance for the treatment has skyrocketed well above that in recent years.

"It's high exposure to liability because if you're on a ventilator you are constantly at risk for things like pneumonia and bed sores, which are the No. 1 cause of malpractice suits at nursing homes," Towey said.

The average per patient cost of ventilator treatment is $500 a day. Laurels CEO Bill DeTellis said many of the patients in the ventilator unit are on Medicaid or Medicare. Medicare typically reimburses the treatment center for only about $350 of that cost and Medicaid pays out only $134.

Nursing homes and patients who need the units' 24-hour respiratory therapy frequently find themselves scrambling to make up the difference. "If we were to take Medicaid patients alone, then the ventilator program would implode from the cost of running it versus what we take in," DeTellis said. But DeTellis said Laurels Medicaid and Medicare patients who need the therapy are usually able to work out private payment arrangements with the home's finance department.

Laurels staff hopes the ventilator unit will make the center stand out in the county's crowded market for assisted living facilities. Pinellas County accounts for roughly 18 percent of the state's 674 nursing homes. Only about 6 percent of the state's nursing homes have ventilators units. "In order to survive in that market you have to be creative and take risks," DeTellis said. "That's why we got into ventilator care. "