Updated 9:30 a.m. May 5: Brookdale Salem spokeswoman Heather Hunter said in an email Monday evening that she could not “share the same details of information that we share with our residents, their families and our associates,” but could provide a statement.

In it, she said more than one person had tested positive.

“We have informed residents, their family members, and associates of Brookdale Salem of this matter. We are diligently monitoring our residents and associates for signs and symptoms, and we continue to work directly with local health officials to help ensure our residents and associates have the appropriate and necessary medical support. We will continue to follow the guidance of the health department throughout this situation,” she said.

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The South Roanoke Nursing Home on Monday reported the deaths of three more residents who tested positive for COVID-19, and a Salem assisted living facility is testing all residents for the virus after at least three were hospitalized.

“The team at South Roanoke is saddened to report that we have now lost a total of 10 residents who were known to have tested positive for COVID-19,” spokeswoman Jennifer Eddy said.

The Franklin Road skilled nursing home had reported Saturday that seven residents had died and three were in the hospital, and that 33 residents who had tested positive were being cared for at the facility. Eddy has said all of the residents have underlying health issues.

“While passing with COVID-19 is not the same as passing from COVID-19, we are deeply troubled by this evolving situation. As reported this weekend, the vast majority of COVID-19 positive residents in our care remain completely asymptomatic,” she said.

The Virginia Department of Health on Monday reported 684 deaths from the virus, an increase of 24 from Sunday. Of those who have died, 382 people, or 56%, were associated with long-term care facilities.

The department is still reporting only three deaths in the Alleghany Health District and none for Roanoke, although Dr. Molly O’Dell, who is overseeing the pandemic response for the districts, said last week that five deaths have occurred.

It is not known whether any of the 10 deaths from South Roanoke will be counted in the state total.

Tim Powell, director of the department’s information systems, said Monday that early on there was not a code for the disease so clinicians couldn’t list it on death certificates.

Now it depends on whether the attending physician identifies COVID-19 as the cause or an underlying cause of death, he said.

More than half of Virginia’s deaths have been people 80 and older, and nearly a quarter of them have been 70 to 79 years old.

The department reported 140 outbreaks in nursing homes and assisted living facilities that account for 2,766 infections.

The department plans on Tuesday to add more information to its website that will include when deaths are reported and when they occur. It also plans to provide information on hospital capacity.

The health department does not release the names of long-term care facilities that report cases. It also does not identify them by locality, instead using multi-jurisdictional health districts. State code bars public health officials from identifying people with infections, and the code also considers businesses to be people.

Brookdale Salem Senior Living is also reportedly experiencing an outbreak that has sent three residents to the hospital, according to emails sent to families. One of the emails said it would test all residents.

Diane Ross said she had already received emails from Brookdale Salem reporting that two residents were in the hospital and two in isolation, when she received a call about 11 a.m. Saturday informing her that her mother had fallen and hit her head and was being taken to LewisGale Medical Center.

Later that night, she said the hospital told her that her 87-year-old mother, Phylis Ross, tested positive for COVID-19 and was in the intensive care unit being given low doses of oxygen.

“She lives in a place that I don’t know what they could have done to prevent it. They live there so someone can look at them. Also, they are very social there. They have friends, they eat together. I can’t really blame the home so much for any of this,” Ross said.

Ross, who lives in Charlotte, North Carolina, hadn’t seen her mother since February. She said Brookdale stopped allowing visitors in mid-March, and then a couple of weeks ago told residents they had to stay in their apartments and could no longer socialize.

She has received several emails from Brookdale Salem. The first, on April 24, said one resident had the virus and was in the hospital. Then on April 29, she was notified that three additional residents were infected. Two were in isolation at the facility, and the third was in the hospital.

The following day, she received an email saying all residents would be tested. Ross said she was not informed of that result, and is not sure whether it had come back when her mother fell in her room May 2.

Heather Hunter, a spokeswoman for Brookdale Senior Living’s corporate office, said that they were not giving interviews and that the company would provide a statement. It had yet to do so by Monday evening.

Ross said she has not been able to talk with her mother while she is in the ICU but has been told by the hospital that she ate her breakfast Monday and wants to leave the hospital. She could be discharged as early as the end of the week but would need to have two negative tests 24 hours apart, and she will need to go to a skilled nursing home, Ross said.

Brookdale Salem is the fourth senior facility in the Roanoke region to report cases of COVID-19.

As of Monday, the health department website reported three outbreaks in long-term care facilities in the Roanoke Valley and none in the New River Valley. An outbreak is when a second case is linked to an initial case without any other way of contracting the disease.

Richfield Living reported in April that four residents had tested positive. One lives in independent living, and three are in the hospital. Two staff members had tested positive.

Richfield said Monday that 88 residents in the Recovery Care Center were tested and all results were negative. Testing for 15 team members has also come back as negative, and other staff are being tested.

Friendship Living on Hershberger Road in Roanoke said it was notified Friday that a non-direct care employee tested positive and was quarantining at home. Friendship said that it was doing contact tracing with the health department and that no other cases have been identified.

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