We are very unhappy with the level of care at dad's current nursing home, what should our next steps be?

Call you local Ombudsman, every county in the U.S. has an Ombudsman. These are the liaison between nursing homes and their residents. A bad report from the Ombudsman can hurt See also:
What do I need to know before I sign a nursing home contract? the reimbursement rate from Medicare, so nursing homes staff are careful not to have an bad report. http://www.ltcombudsman.org/ombudsman This site will help you locate your local office.

Meanwhile, you can ask for an appointment with the administrator (insist on it) and discuss the oversight with him. Tell him you have contacted the Ombudsman and you want to know what measures he will take to improve the nursing staff, and to ensure that medications are given as ordered. Get it in writing.

You can also contact the physician following your father in the nursing home, and let him know that the medication was not given as you thought it was ordered. Ask him to clarify the instructions if you misunderstood, and or talk to the nurses if you are correct and they missed several doses.

Unfortunately, studies show that patients who have family or representatives in the nursing home often do better than families who cannot be present frequently. You must make it your business to check his medications daily; try to do this politely, without being offensive. Explain that you monitoring his medications, bathing, oral hygiene and nutrition to make sure that his health improves while he is in the facility. In this way you make yourself part of the nursing team, rather than an adversary.

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