Ohio officials are worried that the Carlyle Group’s proposed takeover of a troubled nursing home company will condemn them to further problems.

Carlyle has agreed to pay $6.3 billion for HCR Manor Care, which runs 44 nursing homes in Ohio. HCR shareholders are set to vote on the deal on Wednesday. It would be the private equity giant’s first nursing home purchase.

“These are not the kind of nursing homes that they can just take over and keep the status quo,” Beverly Laubert of the Ohio Department of Aging told the Akron Beacon Journal. “When you have facilities with such quality problems, someone is going to have to fix them.”

HCR has been accused of failing to provide adequate care and understaffing, although the firm disputes claims that the problems are widespread. Further, HCR said staffing levels would not be cut under Carlyle’s leadership.

“We provide quality care, and we will continue to provide excellent care,” Carlyle spokesman Chris Ullman said.