Extendicare Health Services and its subsidiary Progressive Step Corporation have agreed to pay $38 million to the United States and eight states to resolve allegations that Extendicare billed Medicare and Medicaid for materially substandard nursing services that were so deficient that they were effectively worthless, and billed Medicare for medically unreasonable and unnecessary rehabilitation therapy services, the Justice Department and the U.S. Department of Health and Human Services of Inspector General announced Friday.

This resolution is the largest failure of care settlement with a chain-wide skilled nursing facility in the department's history. The billing took place between 2007 and 2013.Locally, the company operates Slate Belt Nursing & Rehabilitation, Bangor; Broad Mountain Nursing & Rehabilitation, Frackville; Mountain City Nursing & Rehabilitation, Hazle Township; and Tremont Health & Rehabilitation, Tremont.As part of this settlement, Extendicare has also been required to enter into a five year chain-wide Corporate Integrity Agreement with the government. Extendicare is a Delaware corporation that, through its subsidiaries, operates 146 skilled nursing facilities in 11 states. ProStep provides physical, speech, and occupational rehabilitation services.