Have a look at the 'Carvin AG100D' at
http://www.carvin.com/cgi-bin/get.exe?PAGE=detail&CFG=2&SearchStr=(I.ItemNumber='AG100D')+AND+(CID2='GA')

Its like a 3 channel mini PA system. With this unit you can have separate effects for a Keyboard and Vocals. Plenty of power for most nursing homes. You can add a second speaker also. A good product for the $.