Wrong - medicaid only funds a small portion of the patients in long term care facilities. Most are covered by a combination of medicare and private, supplemental insurance. And, some pay the difference in cost directly to the facility from their savings and retirement accounts.

In my part of the world, as I believe in most areas of the US, musical entertainment is mandated. Now, I'm not sure about the constraints of this mandate, and what the ADs are required to do. Most have a specific budget just for activities, and it is usually left up to the AD as to how those funds are distributed.

Personally, I would worry too much about it. If I had my health back and were 20 years younger, I could easily perform 500 jobs a year here and never travel more than 30 miles from home to get to the most distant of them. Assisted Living Centers, Retirement Communities, and Long Term Care facilities are a huge, highly profitable business in the United States. New facilities are opening constantly in my area, many of which would easily house 500 or more residents. Some, are huge campuses, and I know of one complex that has Independent Living, Assisted Living and Long Term Care all on the same 125-acre campus. It also has a huge church, funeral parlor, a couple dozen staff physicians and huge nursing staff. All of the buildings are connected through underground corridors so you never have to go outdoors when the weather is bad. It also has a huge pond that is stocked with largemouth bass, channel catfish, bluegill, and pickerel where residents can just sit on a bench and watch the world go by in good weather, or pick up their fly rod and cast to a variety of exceptionally large, freshwater gamefish.

Of course, all of this comes at a price, which ranges from $4,000 to $7,500 a month, including all meals and housekeeping. Some services, such as laundry, are extra. Now, there will always be budget cuts, which are usually the result of some pencil pushing geek at the corporate level that thinks he or she will make points with the CEO or Chief Administrator and get a raise for saving them a few bucks by slicing the budget where they think they can get away with it. When this happens, which is usually every couple years, one of the first things to get the budget axe is the activities department. It has happened to all of us at one time or another.

The secret to success is knowing how to handle it. In most instances, I was usually not effected at all, while some performers who charged less than half what I made were the first to go. Of course, the old say holds true "You only get what you paid for!" If you could provide the goods, as DNJ always said, you usually kept your job at the same rate of pay.

When some told me they could no longer pay my rate, I told them that I would not play for less than that amount, however, we could offset this by just cutting back the number of performance dates from monthly to bi-monthly. After a while, the bi-monthly schedule usually reverted back to monthly. Additionally, during the cut back schedule, I was always the first person that was called for special events, mainly corporate open house parties at that particular facility. Those parties were usually 2 to 3 hours, which meant I was able to pick up a fairly hefty paycheck for that job. And, more often than not, it was the corporate folks that put me back on the monthly schedule, and still insisted that I perform for the corporate parties, both at that facility and many others within an hour or less drive time.

Like I said, I wouldn't worry too much about it.

All the best,

Gary