I had to place my mom in an approved medicaid/medicare facility 4 months ago. Since she has been there I have had to address the lack of cleanliness of the bathroom, aides addressing her toileting needs. The nurses overall don't seem involved in the day to day care of the residents other than administering medicine whenever I go in the nurses are hovering over the medicine carts writing or counting pills. They don't even acknowledge when I walk in with a "hello" and let me know how things are going with my mom. Last Saturday when I arrived around 4 p.m. my mom was in the bed with her gown on, I asked the nurse why mom was still in bed and no one had an answer other than we just came on duty. They had no notes from previous shift to let them know why mom was still in bed or if she had been up at all that day. Last week when her blood pressure dropped very low, I was called and they told me what happen and that the doctor had been called and blood pressure had come back up. When I called back in an hour the nurse said the doctor said she probably had "orthostatic hypotension." When I got to the nursing home later that day I asked the nurse if mom's blood pressure had been checked in the last couple of hours. The nurse responded she did not have orders to check her blood pressure but if I wanted her to she would check it after mom ate dinner. I have sent numerous letters to the charge nurse and LPN in charge of aides concerning issues and they tell me they will follow up. Is this the norm in most facilities that accept medicaid/medicare? I can't bring mom back home with me because I am having health problems at this time. Do I need to look for another facility? My mom suffers from dementia and is wheel chair bound. Also, the room she is in has 2 other ladies and during most of the day I found they just push the residents in the hallway no activities and there is not a common room to visit. Has anyone else encountered a situation such as this and what did you do? Money is limited for us can't afford those private facilities that start at $5,000.