I guess it depends where you are in the states.... out here in AZ, there are a great many facilities, VA had many facilities too.
In all honesty, you have to be a 24/7 advocate in ANY medical facility....even a hospital, because of the volume of patients cared for. Personally I feel that until the feds mandate staffing ratios for nursing home facilities, you will continue to see substandard care. I've been working in this environment for 16+ years now, and it's really hard to provide quality care when you don't have enough staff to provide that care. Also nursing home wages are not even close to hospital wages.... I could be making $10-$20 more an hour in a hospital /base pay, but I choose to work in a SNF/LTC facility because I feel this is where I make a difference. It always saddens me to hear of people having poor experiences in nursing homes.... because I know there are good places out there...