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CHF and Elderly Father's Meds/Care

I need help. My 88 yr old dad had AV-replaced (porc) 2004. Did very well but yrs later came  afib. He has Pace, rx warf approx 5 yrs then CHF. Lasix was added 1x/day, bp rx-I think, then Carvd, but it seems  rx/care not well managed. No Cardios in town-yes @ hospital & @ an openly limited place- say they stabalize only & get pt back to the primary doc asap. His carvd has not been up titrated as I read (if correct) it should be. My dad is weak (iron ok), has osteo pain, GP said his heart is strong, but pulm HP so now the PA @doc suggs to try digoxin. I can't get my sister to take him a 1/2 hr drive to where there are Cardiologists. Other than vit k stuff, she denys foods can mess w/INR-it spiked after hotdogs w/pork n' beans, supposedly both have tumeric. Finally after 2 hosps for fluid GP sugg taking Lasix 2x/day. (I asked about that months earlier, sister refused to ask dr)  Given his age, multiple rxs & condition I feel strongly a Cardiologist is only one w/ knowledge qualified to oversee his CHF. Am I wrong? However well meaning, I'm concerned
Gp/PA aren't experienced enough. I wonder if Carv could help him more if admintered correctly & if giving digox before that can have any negative side effects. Due to severity of my health & distance- it's difficult. My sister controls everything, gives very little info. She seems content withholding what I think is necessary medical care. I don't kmow what to do.
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