Dunlap Specialty Care, a nursing home in Iowa previously considered among the worst in the nation, is cited for failing to adequately respond to fatal injuries sustained by a resident. State inspectors allege that the staff at the facility, run by the Care Initiatives nonprofit, did not inform the resident’s hospice provider promptly after she suffered a serious head injury in a fall. The woman’s injuries included lacerations on her arm, bruising on her head, and a hematoma around her left eye. Despite the severity, the hospice nurse was only notified three hours after the fall. The state has proposed an $11,500 fine, pending a federal penalty assessment. Dunlap Specialty Care has a history of violations, including resident abuse allegations, COVID-19 outbreaks, and infection control issues. In 2022, it received fines totaling $200,489, and it currently holds a one-star rating, the lowest possible, from the Centers for Medicare and Medicaid Services (CMS). The facility has been on the CMS list of homes eligible for special-focus status due to the severity of violations for the past six months.