Old tank syndrome is when a tank has had insufficient water changes over a period of years (4-5 years is plenty of time to meet that requirement), and nitrates and other "nasties" start to build up in the tank. New fish being placed into a tank like this have very little chance of acclimating to the water - but the fish in the tank have grown accustomed to it and manage to live, but are weakened by it, so that any minor disturbance (like ich) that they may have been capable of handling previously becomes that much more serious.
50% monthly is not a sufficient water change schedule, imho. I don't know exactly what your water stats are, as you haven't been able to provide them, but I'd be willing to wager that the pH is a good bit lower than your tap water, and your nitrates are elevated.
Personally, I like 20-30% weekly, in addition to 50% monthly and even a 75+% change every 6 months. The only "cure" for old tank syndrome is a LOT of very small water changes very frequently. I'm talking about 10% daily or every other day for about two weeks. Then, increase that to 20% daily or every other day. Ultimately, the goal for fishkeepers is to try to keep the water in the tank as close to the tap conditions as possible so that you can do a massive water change whenever something goes wrong. However, if the tank has been under changed for a period, large water changes can actually be more dangerous than they are beneficial - as the new water is so different from the old tank.
That's my assessment of what I've been able to glean. I am assuming as well, that the LFS that is testing the water is using "strips" rather than a liquid kit. Generally when a LFS is testing your water, they use the cheapest alternative - which would be strips - and they nearly never share the actual values with the customer, but just use general terms like "normal" or "ok" which is actually meaningless. It is far more important to know the levels of you water so that you know how close it is to your tap. "Normal" and "ok" don't mean a thing in terms of determining if your tank water and tap water are still very close. "Normal" is a broad term, because most fish can survive (and even thrive) in a wide array of water chemistries, if given time to acclimate (weeks or months) but not if forced to do so quickly (hours/weeks).