Thank you for your review. You have raised many questions and we definitely would like to provide answers. First and foremost it is our goal to provide quality care to our patients and do so in a compassionate manner and a clean environment. We provide numerous activities on a daily basis to keep residents engaged such as ice cream socials, birthday parties, bingo, card games, crafts, current events, coffee groups and much more during their stay. These are all part of our routine services and there are no additional fees associated. We also provide snacks and other goodies to residents in between meals again with no additional fees associated. There are times throughout the year that we conduct fundraisers that mostly staff and families participate in for good causes. We then donate the proceeds to charities such as the Alzheimer’s Association or the Heart Association. We did have a fundraiser back in the summer for one of these wonderful organizations and it was ice cream for $1. Many families and staff purchase during those times and give to residents. I am sorry to hear that we failed to extend that courtesy to the resident you encountered. We will make sure staff are more aware of this and if by chance a resident’s diet does not allow the item that an alternative is offered. I apologize that you were given the impression that we charge for activities and/or supplements. In regards to pest, we are required to have an effective pest control program and contract services. We do need to evaluate those services frequently to make sure they are effective. There may have been times we felt that service was not up to standard at which time we have increased the services provided to assure any issues were resolved. We also have routine inspections by the local health department as well as internal audits for cleanliness. We have a good long-standing record with our inspections. Thank you again for making us aware of this issue as well as assisting us in clearing up the misconception of the additional expenses.