Hiqa requires additional powers to regulate corporate nursing home companies

The Health Information and Quality Authority (Hiqa) would require additional powers to regulate parent companies of nursing homes, the Health Committee has been told.
The committee also heard that more than 15 per cent of the country's nursing homes are currently under some form of restrictive condition by Hiqa.
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It comes after RTÉ Investigates examined standards of care at two nursing homes operated by Emeis Ireland, formerly known as Orpea.
The programme highlighted serious issues at two centres, The Residence Portlaoise and Beneavin Manor in Glasnevin, Dublin, which have been acknowledged as 'wholly unjustifiable' by Emeis Ireland.
Hiqa, which is responsible for inspecting nursing homes, said it had notified gardai about its concerns arising from the programme.
It also issued an official warning of cancellation of registration to the providers of the two nursing homes should they fail to implement significant improvements in the centres.
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Hiqa chief executive Angela Fitzgerald told the Health Committee on Wednesday that the behaviour in the programme constituted a breach of 'basic human rights which can never be condoned'.
She said the inspection agency was 'really sorry to the families directly impacted and the wider community'.
A general view of Beneavin Manor nursing home in Dublin, Ireland (Niall Carson/PA)
An interim report on Tuesday evening revealed that there had been 198 allegations of abuse to a resident at Beneavin Manor from January 1st, 2022 to June 5th, 2025, with 40 such allegations at The Residence Portlaoise between December 14th, 2023 and June 6th, 2025.
Hiqa said it had also sought immediate assurances on the other 23 homes that Emeis Ireland owns, adding that it is clear it has significant work to do.
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At committee, Sinn Féin health spokesman David Cullinane said what was shown in the programme was 'cost-cutting by a corporate body leading to neglect of residents' and 'substandard' care.
Asked if Hiqa had any powers to provide financial penalties against that corporate entity, Ms Fitzgerald said the authority that was not provided for under its legal framework.
Ms Fitzgerald said the authority has power to regulate individual providers but said it does not 'currently have any powers' in terms of requiring large corporate entities overseeing several providers to take action.
She said it was 'important that we have additional powers' for circumstances where it needs to act with such corporate entities.
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She told the committee that there had been a shift towards large corporate entities in the nursing home space and said: 'We don't currently have powers to direct or require them to do anything – we work on the basis of cooperation.'
Ms Fitzgerald added: 'I do want to put on record today that the vast majority of those corporate entities as well as individual providers cooperate and work with us – but regulation is there to provide both action and a deterrent.
'And I think it is important that when there's a changing landscape, that we pause and look at whether we need additional regulatory powers to deal with circumstances such as this.'
Responding to a follow-up question from committee chairman and Social Democrat TD Padraig Rice, Deputy Chief Inspector Susan Cliffe said the approach taken by the authority begins with engaging with the provider and escalating through a process that includes advisories, cautions, and additional restrictive conditions on its operations.
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She added that it ends with cancellation of service or forced closure as a 'nuclear option'.
Pressed on what additional measure could be taken against companies following cancellation that would prevent them from opening a different nursing home, Ms Cliffe said: 'I think we have the powers at the moment to regulate each individual nursing home, vis a vis the company that runs that nursing home.
'What we're talking about at a higher level is, if you would have the powers to go above that to the company that owns all of these companies, that's what doesn't currently exist.'
Ms Cliffe said the minister has discussed that potential with the authority.
Hiqa also told the committee that 95 of the country's 548 nursing homes are under 'additional restrictive conditions', 53 of which are HSE operated or funded.
The RTÉ Investigates documentary highlighted vulnerable people being left unsupervised, large amounts of residents congregated together being supervised by one member of staff, and requests for the use of toilets being unanswered for lengthy periods of time.
It also showed some staff not using proper hoisting equipment and shortages in necessary items like incontinence pads.
Mr Rice, the chairman of the committee, said the programme was 'very difficult and disturbing viewing'.
Emeis Ireland issued an apology to to all residents and their families for 'the suffering and distress experienced as a result of failures identified in the care provided'.
It said it recognised and deeply regrets the 'breach of trust' and 'any failure to uphold the dignity of some residents at all times'.
Emeis Ireland said it has commenced a comprehensive review across both nursing homes.

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