Do you want to help your aunt or your mom? Two very different things here - the first an ill person, the latter a bereaved.
1.Does your aunt have any family in Sacramento, or the area, who can be asked to contribute to her care? It is a stretch to assume that you can do this from over here. It is also a stretch to think that someone might step up to the plate now, since your aunt has lived in a retirement home for some time. Caregiving is often costly, as you yourself have seen with your mom. It takes a toll on one's energy, emotions, as well as finances, exactly like you said, and even more than that.
2. If there is no one, and you decide to take it upon yourself to find a good solution for your aunt, it can be doable - with lots and lots of phone calls (9h difference plus a good US phone plan). Does she have a power of attorney on file? Or something else...like a power of attorney?
3. I am guessing - not sure here - but you might have to prove that you are the next of kin or the one to ask medical info/make decisions about this person before you can do anything else. After which:
4. Before you find a ombudsperson, why not call the hospital she is in right now and have a talk with the people who care for her? Start from there. You have to be outspoken, ask the hard questions and get the hard answers. If you forgot to ask something, call back, don't take no for an answer. Speaking out for an ill person takes perseverance, perseverance, and perseverance in order to get what you want.
5. Answers regarding proper care of a sick elderly person - Google is your best friend here - look up as many organizations that might provide you with leads and answers - i.e. Stroke Foundation Sacramento(link under), vaguely helpful I assume, but eventually you will zero in on the right people you need to talk with. https://www.dignityhealth.org/sacram...stroke-centers
6. Who is her insurer? All her coverages can be found out if you are THE ONE - power of atty.
7. In order to start pointing fingers at who's at fault for your aunt's bedsores, you have to have her medical file. I am sure that when she was admitted, say, to the current facility, there was a report of her wellbeing, which would have mentioned the sores.
Unfortunately, bedsore means bad news - depending on how advanced they are, they are very hard to get rid of, and since she is immobile, well, the odds are against her.
1. Maybe your mom isn't only exhausted, but also depressed by the state her relative (sister?) is in. Caring for an ill person has a way of altering one's life perspective. Big time! So, I would say she should give herself some time to recover physically and financially before seeking counselling, unless she has a few very close friends to do the counselling for free.
If she has a good network, she will be OK, deeply affected, but OK.
Both you and your mom have to understand that the distance limits greatly what you are able to do, and you both have to come to terms with it.