CVS Health, the nation’s largest pharmacy chain with more than 9,000 locations, has been fined more than $1.5 million by Ohio regulators over problems connected to understaffing and patient safety, officials said.

The fines are part of a settlement of 27 cases involving various safety concerns that were uncovered during a series of inspections of 22 pharmacies between 2020 and 2023, the State of Ohio Board of Pharmacy said in a statement on Thursday.

The board said that it found, among other things, improper drug security, errors dispensing drugs, prescription delays, lack of general cleanliness, understaffing and failure to report losses of controlled substances.

The settlement comes as pharmacies nationwide have been plagued by labor issues. In November, some pharmacy workers called in sick or walked off the job to call attention to what they say is inadequate staffing and growing work demands.

The Ohio board levied a $1.25 million penalty against CVS. Over the next three years, the company will also pay approximately $250,000 to cover the costs “of enhanced monitoring” by the board.

In addition, eight stores will be placed on probation for three years, the board said.

In a store in Toledo, Ohio, inspectors last year found drug shelves were dusty and cluttered and that pharmacy counters were dirty, according to state records. At the same outlet, inspectors reported finding unlabeled amber vials containing medication.