NEW YORK (AP) — The operators of four New York nursing homes will pay $45 million to settle claims they neglected and abused residents, including some who were forced to sit in their own urine and feces for hours, said State Attorney General Letitia James. announced Thursday.

Democrat filed a civil suit last year that accused the Centers Health Care owners and operators of using Medicaid and Medicare funds to enrich themselves, their relatives and associates instead of using funds to care for residents. James argued that understaffing at the homes contributed to sloppy care. She said residents were living in squalor and were left unattended, leading to injuries.

Under the agreement, the Centers and its owners will direct $35 million toward improving resident and staff care. The Medicaid and Medicare programs will receive $8.75 million in restitution. Independent monitors for operations and finances were appointed by the court shortly after the lawsuit was filed and reforms have already begun, according to the attorney general.

“The owners of the centers were operating the nursing homes understaffed so they could pocket tens of millions of taxpayer dollars earmarked for resident care,” James said in a prepared statement. “Residents suffered tragic injuries and their families were often left in the dark or in despair about their loved ones.”

Centers, in a prepared statement, said it was pleased to settle the litigation, “which dismisses all allegations of wrongdoing against Centers.”

“Over the past three decades, Centers has cared for thousands of residents in dozens of facilities while maintaining the highest standards of resident care and well-being, the statement said. “We are committed to fully implementing the regulatory conditions, including significant investment in resident care.”