New York nursing home operator Centers Health Care must pay $45 million to settle civil charges related to Medicaid fraud, patient neglect and mistreatment.

The office of New York Attorney General Letitia James filed a civil lawsuit against owners Kenneth Rozenberg and Daryl Hagler in 2023 alleging fraud and neglect incidents across several facilities, and siphoning more than $83 million in Medicare and Medicaid payments to enrich themselves instead of sufficiently staffing buildings, according to reports in the Times Union and Newsweek.

Shortly after filing the lawsuit, a court granted a preliminary injunction to immediately address ongoing issues at the facilities, including installing independent financial and health care monitors, who have notably increased the number of staff, according to a statement from the state Attorney General’s office.

Centers operates 40 facilities across New York and New Jersey.

Of the $45 million to be paid by Rosenberg and Hagler, $35 million will go toward funding improvements in resident care and staffing; Medicare and Medicaid programs will receive $8.75 million in restitution. Centers will also have a court-appointed monitor to oversee reforms in staffing levels, and work with an independent monitor that has been overseeing Centers’ finances of facilities, the Times Union reported.

The settlement also requires that Centers and its owners can’t close or sell any of the facilities named in the lawsuit for three years, according to the Times Union.

“We are pleased to resolve our litigation, which dismisses all allegations of wrongdoing against Centers,” Maryellen Mooney, a spokeswoman for the company, said in a statement. “Over the last three decades, Centers has cared for thousands of residents across dozens of facilities, while maintaining the highest standards of care and resident welfare. We are committed to fully implementing the settlement terms, including a significant investment in resident care.”

Litigation focused on four Centers facilities: the Beth Abraham Center for Rehabilitation and Nursing in Bronx County, Buffalo Center in Erie County, Holliswood Center in Queens County, and Martine Center in Westchester County.

“Residents at these Centers nursing homes endured years of tragic and devastating mistreatment and neglect, while the owners made millions of dollars in profit,” James said in a statement. “Centers’ owners operated the nursing homes with insufficient staffing so that they could pocket tens of millions of taxpayer dollars meant for resident care.”

Centers was involved in another lawsuit filed in June, in which a former nursing manager at two of its facilities alleged she was fired after her complaints about conditions in the nursing homes landed her with disciplinary scrutiny from Centers executives, the Times Union reported.

Unionized workers at five Centers properties have been working to get new labor contracts approved, which would help with chronic understaffing and high employee turnover, reports found.