Almost $29 million in funds — collected from North Carolina nursing homes through civil monetary penalties — has sat mostly untouched for years.

That’s according to a “startling” new report, issued by North Carolina Health News on Wednesday. The money is supposed to be used to improve nursing home care and the lives of residents, but just $406,000, or 1.4%, has been expended the past three years. The state has collected about $13 million from providers during that time alone, from fines as large as $1.6 million.

Not enough institutions are applying for grants, the state says. In the past two fiscal years, North Carolina received 24 requests from nursing homes and other institutions to make use of the funds and approved 22 of them, for mostly small-scale projects. Those have included requests such as $15,932 for iPads at Trinity Ridge senior living community, while other projects have floated in the $20,000 to $30,000 range.

North Carolina Health News writers claim that the dormant $29 million could be put to better use. Almost two-thirds of the state’s nursing facilities have received 2 stars or less in the government’s Five-Star rating system. The money pot is equal to about two-thirds of the state’s $44 million annual allocation for the Division of Aging and Adult Services, which has seen cuts to funding and a waiting list of recipients.

“The philosophy and orientation of the state has been to fund nursing-home-level projects that generate from the bottom up,”  Bill Lamb, executive director of the nonprofit advocacy organization Friends of Residents in Long-Term Care, told the website. “You can never spend $28 million that way.”

The executive VP of the North Carolina Health Care Facilities Association said providers are working to pursue new ideas for the money’s use, including telehealth and workforce development initiatives with local universities.