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

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

Failures in ordinary care are causing widespread harm that's sometimes serious, inspectors say. iStockphoto hide caption

itoggle caption iStockphoto

A firefighter walks past the Residence du Havre after the fire in L'Isle Verte, Quebec. At least three people died in the blaze at the seniors' home. Early reports were that another 30 people were missing. Mathieu Belanger /Reuters/Landov hide caption

itoggle caption Mathieu Belanger /Reuters/Landov

Dorothy Holmes, back home with her new dog, Jack. Martha Bebinger/WBUR hide caption

itoggle caption Martha Bebinger/WBUR

Zach Sayne at age 5, with his mother Nola. Courtesy of Nola Sayne hide caption

itoggle caption Courtesy of Nola Sayne

HHS found that 19 percent of nurse aides who'd been disciplined had a prior conviction that would have shown up on a background check. Matt Rourke/AP hide caption

itoggle caption Matt Rourke/AP