Doctor unhappy with ALF and I agree

My niece and sister-in-law visited the Doctor's office with my mother last week. His news was a shock: he feels that mom is not getting the individual assistance she needs at her ALF and he wants us to move her someplace smaller. I think I agree but hate the idea of going through it all again. I am concerned about Mom's state since she is getting regular healthy meals and her meds on time each day - which didn't happen at home. Why - after 3 months - has her condition deteriorated so much? She's lost more strength in the past 3 months than she had the prior year!

Before I go into much detail I must say that her doctor is great. He's been her physicial for 30+ years and is very thorough. I trust him and his judgement; he's kept Mom well and knows what he is doing. He has numerous small examples that amount to a very large issue for me - the ALF is not communicating, not with him and not with the family. Apparently he's made numerous times at various times trying to reach a nurse. He's been told that no nurse is available to discuss Mom's meds or condition. He's faxed her meds to them and received no confirmation. He's left messages but has not heard back from them after trying to reach them for three weeks.

I am also concerned and plan to raise hell. I've had a hard time getting mom on the phone - I call, she doesn't answer. I believe she can't hear it ringing. I hoped that she was out doing something but, it's not that good I fear. I came to town last night after being away for 6 weeks and found Mom asleep in her chair. During my visit, I learned from an aid that Mom had 6 falls in the week before my visit. SIX!!! I got a voice mail about one fall two days ago but not the other 5!

When I arrived I found Mom asleep in her chair at 130pm in the afternoon. We woke her up and she seemed groggy and very weak- much weaker than she was when I left 6 weeks ago. There is only one thing that it drastically different than her conditions at home - she is getting her medications on a regular basis. I fear that one of them is causing problems - plaquenil. Before moving into the ALF, Mom had used only one full, 30-day, plaquenil prescription during the prior 12 months. I was concerned that her arthritis was getting worse because she failed to take the plaquenil now I am worried that it's causing her decline! Possible side effects are:

• hearing loss - Mom's has worsened in the past 3 months
  
• muscle weakness - she is definitely weaker in spite of physical therapy
  
• ringing in the ears - Mom's complained of this for 3 months

I hope that it's as simple as this because I want what ever time Mom has left to be good and her state is not good right now. She's totally dependent on others and I know she'd hate that. It makes me feel all the more guilty for moving her.