Private and public nursing homes notified Ireland's health and social care watchdog of more than 4,000 serious incidents that impacted on older residents last year.
According to the Health Information and Quality Authority, 373 notifications were about alleged, suspected or confirmed abuse and almost 300 concerned outbreaks of infectious diseases.
Last year, HIQA inspected all 565 residential centres for older people in mainly unannounced visits and on average one-and-a-half times each.
It said the four years since it took over as regulator from the HSE have seen significant progress, but today’s first annual overview of inspections demonstrates the need for further improvement.
Managements are legally required to promptly notify HIQA of certain adverse or potentially harmful events.
Last year, 4,236 notifications were about serious incidents impacting on residents.
HIQA also received 355 unsolicited tip-offs about over a third of the homes, mostly from concerned relatives of residents.
Almost six out of ten centres were told to put in place practices and policies on ordering, prescribing, storing and administering medicines to residents, and on the handling and disposal of unused or out-of-date drugs.
Overall, inspectors identified more than 8,500 actions required for compliance.
The Health Service Executive has said it welcomes the report and is studying the findings.
The Irish Patients' Association has expressed concern that one in five of the actions HIQA told nursing homes to undertake after inspections last year related to risk management and health and safety issues.
It has also called on the authority to publish a comparative report to show how HSE-operated or HSE-funded centres compared with privately-owned homes.
Stephen McMahon of the association welcomed the HIQA's first annual review of inspections, saying it provides a bird's eye view of the sector's performance during 2013.
The HSE has set up a helpline for those concerned about elder abuse: 1850241850.