Foothill Ranch-based Skilled Healthcare Group Inc. settled with the California attorney general’s office over complaints about its staffing levels and care at its nursing homes.

Skilled will be required to make improvements to its 20 California nursing homes and those changes will be monitored and enforced by a court if necessary, Attorney General Kamala Harris said in a statement.

The settlement resulted from 76 citations and 209 deficiency notices issued against Skilled’s California nursing homes by the state Department of Public Health between 2008 and 2012. Those covered things such as medication errors, urinary incontinence, dehydration and a failure to prevent pressure ulcers.

Skilled will be paying $700,000 over a two-year period for an independent monitor to make surprise inspections of its nursing homes, the attorney general’s office added.

Shares of Skilled were up about 10% to a market value of $233.2 million in afternoon trading Tuesday.