Choosing a nursing home for someone can be a daunting task. I had to do it for my father and have visited other nursing homes where friends and a few teenage patients were placed. One of the first criteria I used when chossing a nursing home for my father was how it smelled when I walked in the door. When my children visited their grandfather, they would comment on the smell, although the nursing home was the best one I could find in the area. By keeping in close touch with the staff and visitng frequently, I think the care my father received was the best possible. The medical care could have been better, but many doctors rarely visit nursing homes. Some send their nurses and then bill for their own time.
An article in the New York Times on 8/25/14 provided information about a grading system that is now in place of which I was unaware. The problem with the grading system is that the nursing homes provide much of the information used in the grading. Then when they have inspections, they know when they are going to happen and hire more staff and also do extra work to make the homes pass the inspection. The rating system thus is probably not as good as spending time there, interviewing patients' families and dropping in often.
There are some advocacy groups that try to keep their eyes on nursing homes, but unless there are laws to protect the elderly, I don't see that they have much power. Family members and good friends are the best watch dogs and they should complain if they note inadequate care. I have done that and it has made a difference.