A nursing and rehabilitation facility chain is paying $38 million to settle claims that it defrauded Medicare and Medicaid programs by billing for substandard care in what the U.S. Department of Justice is calling the largest failure-of-care settlement with a chain of this type yet.

Extendicare Health Services Inc. has admitted to no wrongdoing in the settlement and denies the allegations against it, according to the agreement released Oct. 10.

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