Nursing home operator Next Step Healthcare reached a $4 million settlement with the Massachusetts Attorney General Andrea Joy Campbell, in what is the largest nursing home settlement ever reached in the state.

As part of the settlement, Next Step will pay $4 million to resolve allegations, improve staffing levels and agree to independent compliance monitors. The 16-facility operator allegedly failed to properly staff its nursing homes as early as April 2019, resulting in resident harm and neglect.

These staffing reductions included reductions of certified nursing assistants (CNAs) and non-CNA positions, and Next Step continued to understaff its facilities even after state regulations went into effect in April 2021, the AG’s office alleged. As a result, some of Next Step’s facilities had staffing levels that ranked in the bottom 10% of their counties.

The settlement follows a multi-year investigation by the state Attorney General’s office, reviewing reports of substandard care and complaints and violations received from the state Department of Public Health (DPH).

“For years, Next Step prioritized profit over care by failing to adequately staff its nursing homes,” said Campbell. She hopes the move will send a message to other operators in the state that such action won’t be tolerated and ensure Next Step’s facilities comply with staffing requirements moving forward.

Next Step will budget staffing at state-mandated level and pay an additional $4 million to resolve allegations, according to terms of the settlement agreement. About $750,000 of those settlement funds will be paid to the Commonwealth, which will then evenly distribute funding to MassHealth and the Long-Term Care Facility Quality Improvement Fund.

The latter organization is operated by the state DPH and focuses on improving the quality of care delivered to residents by long-term care facilities.

The independent compliance monitor will use the remaining $3.25 million for additional staffing improvements, recruitment, retention, additional benefit costs, bonuses, overtime, wage increases, and other staffing-related initiatives over the next three years, Campbell’s office said in a statement.