Should I not be notified when changes in meds for my mom are made in a skilled nursing facility?

I will apologize upfront for this being long, but I am new here. I am an only child who has been caring for my 77 year old mother, in my home for over a decade. In the last four years, she has declined from a walker to a wheelchair. I am fortunate to be able to stay home with her. We have had a few stints in and out of skilled nursing facilities but she has mainly been cared for by me alone at home.

She fell quite a few times recently and ended up with pneumonia and in the hospital two weeks ago. Thankfully, it was caught early, and as of last week, is back in skilled nursing. Unfortunately, she is not in the same facility she has been in before, because they no longer take her insurance. We were very comfortable there and it was very close to my home. Also, it was next door to her primary physician and he made rounds at the nursing facility as well, but where she is now, is a different county and he does not go there. So we are dealing with a new doctor.

I had been pleased, so far, with her care at the new facility, but tonight I found out from talking to the nurse that the doctor took her off many of her medications. Some she had been taking for years. On 3/16 she had blood-work done at the hospital and it was fine. My mother is severely anemic, and MUST take two iron pills a day, along with folic acid. Both of these were discontinued by the new doctor. She has been anemic all my life and, her count has gotten so low that she needed transfusions, but she has never been removed from iron pills since we found out how serious her anemia was back in 2009. I find it confusing that she was removed from the medications because “her blood work was all off” (those were the words the nurse used. Her blood-work has been fine for over a year, and on 3/16 when done at the hospital, then one week later they are all the sudden off?

Also my mother has severe osteoarthritis and osteoporosis, for many years she has been on hydrocodone every six hours and it does a great job of easing her pain. Both her hips and shoulders are bone on bone, because she is not a candidate for surgery. After being told in confidence by the nurse about her medicine changes, she gave me a copy of her list of medications. I had gotten a copy the first day she was admitted on 3/20, because I keep on top of things like this and the orders from the hospital were the same meds she had been on, at home. Now I see that not only have they discontinued seven of her prescriptions but they have her pain meds listed as PRN and she has not been given one since 3/27 (two days ago.) With her dementia she is not able to tell them she needs pain meds. This means she is getting nothing for pain. How is she supposed to function in skilled nursing on no pain medications?

I plan on talking to the Administrator on Monday but I wondered, is the facility not supposed to advise me when changes are made in her medications? Also, do I have a right to ask for copies of her blood work? The nurse tonight told me they were not supposed to give our things like that but gave me the prescription list in confidence, saying that things like that had to go through the front office. At the prior facility she was in, and the only one I have ever dealt with, I was called every time a change was made or something was going on with her blood-work, and I just had to ask the nurse on duty for a copy of things such as this, and got it on the spot.

Obviously, this all makes me very concerned, because now I am afraid that I won’t be told if other changes are made. We live in a very rural area of TN and there are not many options of places I can place her, and I have heard the skilled nursing section is excellent and from what I have seen, and the people I have met it is. It is just learning this new info that really has me very troubled. Thanks so much if you have read so far and any advice you have.

These are the medications that the new doctor removed. All had been prescribed by her primary doctor

Elavil/Amitriptyline 50 MG 1 at Bedtime
Calcium Carbonate 600 MG 1 in the AM
Vitamin C 500 IU 1 in the AM and PM
Vitamin D 2000 IU 1 in the AM
Magnesium Oxide 400mg 1 in the AM and PM
Iron Ferrous Sulfate 325 1 in the AM and PM
Folic Acid 1000MG 1 in the AM
Hydrocodone Lortab 5-325mg 1 every 4 hours NOW PRN