Nursing homes, assisted living residential areas and long-term health care facilities in Kentucky and around the country have been hit hard during the COVID-19 pandemic.

As of Monday, only two of Hardin County’s 82 confirmed COVID-19 cases have come from nursing home and long-term health care facilities — one a resident and one a staff member, according to the Kentucky Cabinet for Health and Family Services.

Signature Healthcare of North Hardin in Rad­cliff has had one positive COVID-19 test for a resident and Presbyterian Homes-Helmwood has had a positive test for a staff member.

The two positive tests were self-reported, according to the cabinet. No dates of confirmation were available. Phone calls to both facilities seeking comment were not returned Tuesday and neither was a message left at Signature Healthcare corporate offices in Massachusetts.

According to state data as of Monday afternoon, 200 of the 346 reported deaths attributed to COVID-19 were residents or staff at elderly care facilities around the state.

Neither of the positive tests at the Hardin County facilities have resulted in death, according to the Kentucky Cabinet for Health and Family Services.

John Godfrey, M.D., Baptist Health Hardin vice president and chief medical officer, said the Centers for Disease Control has pointed to the elderly “among those most at risk of severe illness from COVID-19.”

Once there has been exposure introduced inside a facility, the virus has the potential to run rampant.

“They also live in close proximity with many other residents, and they are cared for by the same caregivers, so the virus is susceptible to spreading by being in such close proximity to this community of people,” he said. “We have seen this happen nationwide and in Kentucky with very difficult outcomes.”

The Cabinet for Health and Family Services said in a news release “facilities included on this list have responded to the state’s plan and mechanism for communicating regularly with residents, family members, local health departments and other partners, disclosing when someone who has tested positive for COVID-19 has been inside the facility within 14 days prior to the date of the COVID-19 test.”

Facilities closed their doors to family and visitors in March in attempt to thwart the virus.

“By taking every precaution to prevent the virus from entering the nursing homes and long-term health care facilities, we are protecting the most vulnerable,” Godfrey said.

“Every precaution must be taken to prevent the spread of this virus within these facilities,” said Terrie Burgan, health promotion manager and public information officer for the Lincoln Trail District Health Department.

Some areas of the state have been hit particularly hard from the virus being exposed in facilities. For instance, Grayson Nursing and Rehabilitation in Leitchfield has had seven deaths of residents of their 46 confirmed cases among resident. There also has been 16 positive tests for staff.

Sandy Peace, director of nursing with the Baptist Health Hardin Nursing Facility, said Hardin Memorial has worked “closely” with nursing homes and long-term health care facilities.

“We continue to have regular standing calls to communicate during the COVID crisis, we offer prioritized COVID-19 testing for residents and staff that are experiencing COVID-19 related symptoms, and are regularly gauging our ability to respond to a surge of patients in the event that a facility experiences a large number of diagnoses,” she said.

While the ability for families to visit face-to-face has been halted, Sara Prewitt, manager of Baptist Health Hardin Nursing Facility, said keeping interaction in other ways with residents is needed and impactful.

“The lack of visitors can be very difficult for residents in nursing homes and long-term healthcare facilities,” she said. “This is compounded for memory-care residents … I encourage the families and friends of these residents to be very intentional about staying connected with their loved ones via technology or creative forms of social distancing. It is difficult, but our precautions can prevent unnecessary tragedy.”