Taoiseach Micheál Martin has said he has "no issue" with "larger fines" being levelled on nursing homes which are repeatedly failing to meet set standards.
Speaking during Leaders' Questions in the Dáil, he said he also believes that closure "has to be there" as a real possible consequence.
He said if there is a series of incidents of non-compliance, then "that option has to be on the table."
Describing what was revealed in the RTÉ Investigates programme as "scandalous", he said that adult safeguarding legislation would be delivered under this Government.
He was replying to Labour leader Ivana Bacik who said that it was "no exaggeration to say that confidence has been shattered" in the management of nursing homes.
She added that "faith in the system of inspection has been also greatly damaged."
Ms Bacik said the performance of the Health Information and Quality Authority (HIQA) executives at the Oireachtas Committee on Health this morning "raised more questions than answers."
She said complaints about nursing care have to be "taken seriously" and there has to be "consequences" for nursing homes.
Ms Bacik said HIQA's sole enforcement measure was restricting admissions to nursing homes but, she asked, "what help is that for those already resident in the home?"
She maintained "serious questions" remain about HIQA's ability to keep citizens in nursing homes safe.
The Taoiseach said that eight nursing homes lost their registrations last year, but more needed to be done.
Sinn Féin's health spokesperson David Cullinane, who is a member of the Dáil Health Committee, said that "older people are being failed".
"What we've seen is a corporate takeover of many of our nursing homes," he said.
Speaking on RTÉ's News at One, he said 75% of Ireland's nursing homes are now "private".
He said many are managed by "big multi-nationals", and referred to HIQA's acknowledgement that it does not have the "far-reaching powers" that it needs to deal with the parent companies.
Mr Cullinane said the interim report published yesterday is "damning" and "raises questions" for HIQA but also for the Government, "because all of this has happened on their watch".
He said the reason that three quarters of nursing homes are privately-owned is because "the state stopped building" community and public nursing homes and "allowed the private sector to fill the gap".
Mr Cullinane said adult safe-guarding legislation and mandatory reporting of instances of abuse and neglect are needed.
HIQA notify gardaí of concerns
HIQA has notified gardaí about its concerns on the care deficits identified at two nursing homes which recently featured in an RTÉ Investigates programme.
The information was contained in an opening statement submitted by HIQA Chief Executive Angela Fitzgerald to the Oireachtas Committee on Health ahead of her appearance before it this morning.
HIQA said the two nursing homes - Firstcare Beneavin Manor in Glasnevin and The Residence in Portlaoise - were issued with an official warning of cancellation of registration, should they fail to implement significant improvements in the centres.
Ms Fitzgerald said she wants to once again express her "deepest concerns" about what was filmed at the two facilities, adding: "The conduct of staff and the behaviours witnessed were wholly unacceptable in any circumstance."
HIQA's Chief Inspector is said to be "addressing these fundamental issues directly with the nursing homes and its parent company, Emeis Ireland, and is engaging in additional escalatory actions".
Ms Fitzgerald told TDs and Senators: "As CEO of HIQA, I met with Emeis Ireland this week with the Chief Inspector and I welcome the immediate actions that they are taking.
"We have sought immediate assurances on the other 23 homes that Emeis Ireland own."
On the two nursing homes which featured in RTÉ Investigates, there were four HIQA inspections in Firstcare Beneavin Manor and three in The Residence Portlaoise over an 18-month period which raised concerns.
The concerns raised include inadequate staffing and competence of staff; supervision and management of staff; governance and management issues; recording of key information; inadequate arrangements for meaningful activities for residents.
The HIQA Chief Executive said there will also be reform at her authority.
"HIQA fully accepts that we also have work to do in relation to reviewing our regulatory process," she said.
"We are fully committed to examining what we can learn from recent revelations, and we have commenced work in this regard."
Ms Fitzgerald concluded her statement by saying: "The recent RTÉ Investigates was incredibly distressing and I want to apologise to anyone who feels let down by HIQA as the regulator."
She added: "What we witnessed in the programme should never have happened and I hope that this can be a catalyst for change at a number of levels.
"I want to assure you that we have taken a number of steps to ensure the safety of residents and will continue to do so."
More: Serious care concerns found at leading private nursing home group
An interim report from HIQA into the two nursing homes revealed one of the residences had almost 200 notifications of allegations of abuse of patients since January 2022.
There were 198 notifications of an "allegation, suspected or confirmed of abuse to a resident" in the Firstcare Beneavin Manor, according to the report.
There were 40 notifications of allegations of abuse at The Residence Portlaoise since December 2023.
