For instance is she eating, sleeping? The nurses are busy, the aides just give quick response, not sure what is going on with her. She says she is hungry and food is cold so she can't eat it.

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The rehab facility I've used since 2012 has a chef, a real live chef. Meals are prepared fresh, and to order, including for dysphagia patients. Menus are published in advance but there's also an a la carte or ("always" menu as the staff calls it). Food is good, really good. I bought some top notch really fresh chef salads for myself.

If I had to choose another place, I'd go for a tour/visit at mealtime, not only to gauge the expression on the residents' faces but to check out the food. If you see hospital sized meal carts, you can pretty much guess that everyone gets the same meal (except for those on special diets).

Individually chosen meals have become standard in the hospital we use. The food is really quite good.

Montana, it also helps to introduce yourself to the staff so they remember you. And do plan to bring food - in addition to chocolates, bagels and donuts are welcome. Individual staff have said they can't accept gifts, so I suggest putting the food in the break room for all to share.

As to getting answers, I've found that trying to catch staff while I'm there isn't easy, so I write notes with my home contact information and either tack them to the room's bulletin board or deliver them to the nurse for the day and ask to either meet with her or speak by phone when she has a break.

Giving her a list of concerns allows her time to research the answers. Then when we do get together, the discussion passes much quicker and minimizes time for both of us.
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This is such a common concern..and from sad experience, I know that there are great NH's out there and a lot of not-so-great.

Try the food yourself. It's probably pretty bland, and anything cooked in mass quantities usually isn't too great. If she is getting meals in her room, they will be cold, that's just what happens.

They well may be over-filled and understaffed. Most NH's do not pay really well, and the turnover is high.

They SHOULD be keeping some kind of charting system, though. I'd inquire.

One thing I did, at one place mother was in for rehab, was take a HUGE box of candy for the staff and put a note on it saying it was from "Mrs. So and so" in thanks for the great care! You betcha I'll stoop that low to get mother the care she needs. it also cuts down on the whining from her, to be honest.

If the place is simply unsatisfactory, you can move your loved one. No law says they are stuck in a substandard place. A LOT of NH's put out a lovely color brochure showing a beautiful place and the BEST room (which may not even exist in their facility) The "representative" will move heaven and earth to get more patients. Mother bought the story from the rep and went to the nastiest place--right near my home. I saw the brochure and said "Mother, it looks NOTHING like that!!" Long story short, she stayed a weekend, was combative and hostile to everyone and wound up in a much more expensive and nicer facility with sister paying the extra bucks for the stay.

Go there and physically check the place out. Eat the food, Talk to the staff. If you are not happy there, mom won't be either. If she wants a better meal, take her out, or bring her a hot meal from a local restaurant once in a while.

Kind of a hint: the bigger the NH, the worse the food. IMHO. Smaller places pay more attention to this kind of thing. They are also more expensive.
Good Luck.
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I agree with cwillie. Patients AND families have rights when it comes to nursing home care. In fact, there should be a "bill of rights" similar to what you see posted (and often handed out) in hospitals available to you. This will state who you should speak to if you have a concern.

On a day-to-day basis, there should be some sort of unit or floor secretary...or someone somewhere who can tell you who is/was assigned to your Mom for each shift (CNA/LPN/RN/etc). While of course it varies, the few I've worked in or spent time in the same aides generally stay in the same room "areas" with minimal rotation, so while it would be beneficial to learn the names/faces of as many as you can in case of an emergency (and just because that's a great thing to do!!), for the purpose of who is with your mom you would likely only need to learn maybe 5 or 6 people max depending on the size of the home. Then when you find out who is assigned that day you don't need to worry about chasing everyone down and them saying "not my patient, not my problem."

As far as the bigger issue though, again as cwillie suggested, depending how long it has been going on it may be time to bring this to the DON and/or request a care conference. If it continues to go unnoticed, or god forbid the issue becomes larger or more out of hand, don't hesitate to contact an administrator. Again, you have rights too.
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This is something I struggle with as well. It seems most natural to ask the aides that are doing hands on care, but they only know what they themselves have done and have no clue what those on other shifts or nursing is doing. I made sure to ask what the protocol was when I needed something addressed immediately and was told to speak to the nurses, specifically the RN, because she can check the chart to find the answers. If it is something that doesn't need an immediate response you should make an appointment to speak with the DON, perhaps even ask for a care conference if you have multiple areas of concern.
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