Coronavirus cases are increasing in nursing homes across the country coinciding with a national surge in the pandemic, a report from a health care group released on Tuesday found. 

The report from the American Health Care Association and National Center for Assisted Living found the largest increase in nursing home coronavirus cases has been centered in midwest states since mid-September. 

Nursing homes are considered especially vulnerable to the virus, which so far has killed more than 240,000 Americans. At the same time, health experts have found an increasing link between the virus's spread among the community members eventually reaching a nearby nursing home or long-term care facility. 

“As we feared, the sheer volume of rising cases in communities across the U.S., combined with the asymptomatic and pre-symptomatic spread of this virus, has unfortunately led to an increase in new COVID cases in nursing homes.” said Mark Parkinson, the president and CEO of AHCA/NCAL.

“It is incredibly frustrating as we had made tremendous progress to reduce COVID rates in nursing homes after the spike this summer in Sun Belt states. If everybody would wear a mask and social distance to reduce the level of COVID in the community, we know we would dramatically reduce these rates in long term care facilities.”

Midwest states have seen a 41% increase in weekly COVID-19 cases in nursing homes since the end of May. In northeastern states, the increase has been 8%, the report found. 

In New York, at least 6,400 nursing home residents have died of the virus or have died with factors tracing back to COVID-19 since March. 

The death toll in New York nursing homes is likely higher, given the state does not count those residents who contracted the virus in nursing homes, but died elsewhere. 

New York health officials have pointed to asymptomatic staff and visitors for spreading the virus unknowingly in nursing homes in March and April, pushing back on criticism that a controversial March 25 order requiring nursing homes to take COVID-19 positive patients from hospitals played a role. 

COVID-19 cases in a surrounding community may also play a strong role in the vulnerability for individual facilities and people living in congregate settings. Health experts have found there is a strong correlation between spread of the virus among the general population and the increasing risk that would pose to a nearby nursing home. 

New York has seen an increase in coronavirus cases overall in recent weeks, with parts of upsate New York seeing rising positive rates, while hospitalizations overall have steadily increased to more than 1,000 COVID-19 patients once again. 

The state on Tuesday reported the highest positive rate for new COVID-19 cases since the end of May.