[S]tate regulators have approved the sale of five nursing homes in Vermont to a publicly traded company that is broadening its presence in New England.

The Green Mountain Care Board issued a decision in favor of Genesis Healthcare Inc. on Friday, giving a green light for the company to pay $38 million to formally acquire the nursing homes.

Al Gobeille, the chair of the Green Mountain Care Board, declined to comment on the decision.

The five properties are Bennington Health and Rehabilitation Center, Berlin Health and Rehabilitation Center, Burlington Health and Rehabilitation Center, Springfield Health and Rehabilitation Center, and St. Johnsbury Health and Rehabilitation Center. All are limited liability companies.

The five facilities have 579 beds among them, according to the company’s original permit application, and almost all are in semi-private rooms with more than one bed. The company is planning to eliminate 52 beds among the five nursing homes and convert some rooms to private care.

The company appeared to be managing the nursing homes already, according to its website and signs at the location in Berlin. But the approval gives the company formal control of about one-third of Vermont’s nursing home beds and one-quarter of all nursing homes in the state, and brings it further into the New England market.

The company has been accused of fraud and elder abuse, according to news reports. On Jan. 15 the company settled with the U.S. Department of Justice]over alleged disability discrimination. On Monday the company agreed to pay $52.7 million to the Department of Justice to settle allegations of violating fraud and abuse laws.

The company’s spokesperson has not responded to two inquiries for comment made Tuesday.

Genesis applied for approval to buy the nursing homes in October, and the Green Mountain Care Board held its final hearing June 3. At the hearing, board member Con Hogan questioned the conditions at the nursing homes, but the company’s lawyer pressed the board not to add any conditions to the pending permit, called a certificate of need.

In the Friday decision, the board wrote that two out of the five nursing homes Genesis is buying had had one-star ratings in August 2014, and the other three were rated with three stars out of a possible five. In May, the ratings at four homes improved, and only the facility in Berlin still had its one-star rating, according to the decision.

The board acknowledged the improvement under Genesis’ leadership but wrote: “There is undeniably room for improvement (in health care) at the facilities Genesis currently owns in Vermont.” The board also said the Genesis nursing homes are not doing a good enough job of referring patients to hospice care.

“We do not find credible the applicant’s assertion that hospice services are unavailable in Vermont, nor that the claimed lack of such services erects a barrier to improving the quality of care for the applicant’s hospice-eligible residents,” the decision said.

Despite the criticism, the board found that the purchase of the nursing homes would increase the quality of health care under Vermont law. The board reasoned, in part, that the certificate of need process “is an imprecise and inappropriate tool for determining whether quality at nursing facilities will improve with a new owner.”

The board also wrote that, even though Genesis satisfied the quality criterion, “we do so with the expectation that Genesis will improve the quality of care at all of its Vermont facilities, which we anticipate will be reflected in (federal regulatory) ratings and quality measures.”

The full decision is available here.