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

Mountains of "little blue pills" and their chemical kin have transformed the way many people think about sex and aging. Raphael Gaillarde/Gamma-Rapho/Getty Images hide caption

itoggle caption Raphael Gaillarde/Gamma-Rapho/Getty Images

Federal prosecutors allege two nursing homes in California have "persistently and severely overmedicated elderly and vulnerable residents." Antipsychotic drugs like risperidone, also known as Risperdal, can be dangerous for elderly people, but are frequently prescribed to nursing home patients. JB Reed/Bloomberg via Getty Images hide caption

itoggle caption JB Reed/Bloomberg via Getty Images

Lively is a sensor that can be attached to a pill box, keys or doors. It lets people know whether aging parents are taking their medicines or sticking to their routines. Courtesy of Lively hide caption

itoggle caption Courtesy of Lively

Minnesota, Washington and Oregon topped the ranking, which looked at 26 variables, including affordability and whether patients could get good paid care at home. Alabama and Kentucky came in last. Fred Froese/iStockphoto hide caption

itoggle caption Fred Froese/iStockphoto