With amalgamation, the Hotel Dieu was placed under the governance and management of Niagara Health and renamed the Ontario Street Site.

According to an Ontario Nurses Association press release in June 2007, censuring is ONA's nationwide public reproach of a health agency due to the negative impact on staff and patient care, of poor labour relations and administrative practices.

[8] On May 17, 2010, the Ontario Health Coalition after conducting public hearings in March 2010 issued a report calling on the provincial government to send an investigator to the Niagara Health System, stating the following reasons: Witnesses in Niagara described the poorest access to hospital beds and emergency department care of all the regions we visited.

Cuts have been and are being implemented without any protections for resident access to care and without funding agreements, functional protocols and enablers in place.

[9]During the COVID-19 pandemic in Ontario, Tom Stewart, the CEO of Niagara Health, took an international holiday vacation to the Dominican Republic and other countries from December 18, 2020, until at least January 5, 2021, contrary to public health advice to avoid non-essential international travel.