I got a reply about the visiting nurses thing:

Dear Mr. Hosier,

Thank you so much for taking the time and effort to inquire about our billboard campaign, "Insist on Visiting Nurses in Their 90's". 

This statement refers to the second line on the billboard,  "95% client satisfaction", meaning our visiting nurses deliver compassionate care that achieves top "grades" -- currently at 95% satisfaction. 

This grading of satisfaction is determined by random telephone surveys conducted periodically by a private firm on behalf of our agency. 

Visiting Nurse Association of Northern New Jersey (VNANNJ) is the premier non-profit healthcare agency serving the greater Morris area, so I'm very pleased to say that our overall client satisfaction ratings have always received top marks "in the "90's". 

One of the most difficult things to achieve in outdoor advertising is attracting attention to the message.  We clearly attracted your attention, but I'm sorry that our intent was not readily apparent to you.  I sincerely appreciate the effort you took to contact us. This is very helpful in our ongoing efforts to communicate the quality of our service to those in need of home health care.

So it appears that Mike and Britt are right.  I still don't get it.  I've read it about 600 times, and it still doesn't make sense.  As Britt said, it's spectacularly poorly phrased.  I'm gonna email the lady back and ask her about it.