Marian Grunwald (from left), Earl Elfstrom and Verna Matheson bounced a balloon back and forth with nursing assistant Rick Pavlisich on Dec. 13, 2013, at an Ecumen nursing home in Chisago City, Minn. Glen Stubbe/Star Tribune, Minneapolis St. Paul hide caption

itoggle caption Glen Stubbe/Star Tribune, Minneapolis St. Paul

NPR's analysis of government data found that harsh penalties are almost never used when nursing home residents get unnecessary drugs of any kind. Owen Franken/Corbis hide caption

itoggle caption Owen Franken/Corbis

Antipsychotic drugs aren't necessary in the vast majority of dementia cases, gerontologists say. The pills can be stupefying and greatly raise the risk of falls — and hip fracture. iStockphoto hide caption

itoggle caption iStockphoto

Jim Justice owns Southern Coal Corp., which has 71 mines that have racked up thousands of violations and millions of dollars in fines. Scott Halleran/Getty Images hide caption

itoggle caption Scott Halleran/Getty Images

This photo of Roy Middleton working underground at the Kentucky Darby mine now sits on the mantel in the Middleton home in Harlan County, Ky. He was killed after an explosion in 2006. Anna Boiko-Weyrauch/NPR/Original photo courtesy of the Middleton family hide caption

itoggle caption Anna Boiko-Weyrauch/NPR/Original photo courtesy of the Middleton family

A view of the Tonawanda Coke plant in Tonawanda, N.Y., which was found to have emitted carcinogens at levels many times higher than the state's limit. John W. Poole/NPR hide caption

itoggle caption John W. Poole/NPR

The local playground's design doesn't work for Emmanuel, shown here with his family. The loose surface hampers his wheelchair, and there are no ramps to help him get onto the play structures. Julie Caine for NPR hide caption

itoggle caption Julie Caine for NPR