I agree with Bill's statement above. I too perform for the residents, and I've grown to know many of them over the years. These are wonderful people who happened to outlive their bodies.

As for the Federal Rating, it's, IMO, not a valid measure of the quality of care, or the overall quality of the facility itself. Some of the information is self-reported by the facility, which automatically makes it a bit suspect.

I looked at the ratings for several of the locations where I perform regularly. Some that were rated fairly high were locations that I would not have sent my cat to live out her last days. Others, that were not rated as high, were locations where the level of care and staff are absolutely top drawer.

And, I have a great deal of admiration for the many, many, hard-working individuals who daily have to take care of a large number of individuals that can no longer care for themselves. The vast majority of the staffers are compassionate, caring, people that give 110 percent to every patient they come in contact with.

I have personally witnessed dramatic changes in the Assisted Living/Nursing Home industry in the mid-Atlantic region of the United States. It's a huge, and very competitive industry that continues to grow as the nation's population ages. The competition is so keen that facilities in this part of the world now resemble luxury resorts. Many have spas, hair salons, dining rooms with waiters and waitresses adorned in tuxedos and incredible, ornamental gardens, both indoors and outdoors.

I have relatives that work for the state's Department of Health and Mental Hygiene who make surprise visits to facilities throughout the state on a daily basis. The show up unannounced so there is no dog and pony show for the inspectors. They're very strict, take photos, and in the past, have issued reports that led to facilities being shut down--some for good!

I don't know much about the assisted living/nursing home facilities in Kentucky, but I suspect they may be a bit behind those in this part of the world, especially when it comes to competition. The same is true in some southern states where conditions were found to be deplorable at best. The following is a mission statement from a Florida location that scored high. "Hospice Care is dedicated to acknowledging and preserving the dignity of individuals by providing comprehensive spiritual, psychosocial and medical support for those dealing with end of life challenges." It also states "Hospice Care acknowledges that death is a natural part of life and encourages every individual to live each day to its fullest." My sister in law tells me the only thing her mother received here was total neglect.

Russ, if you wish to donate your time and services for something you believe will improve the NH industry in your area I sincerely applaud your efforts. You are providing a needed service where your only monetary benefit could be a write-off on your tax return as a charitable donation. Those of us who entertain the residents for a living do so for two reasons--we provide a service that benefits the residents, patients and staff of the facility, which in turn improves their quality of life. And we make our living at providing high-quality entertainment for those individuals.

Good Luck,

Gary