The number of long-term care facilities reporting COVID-19 activity in Washington has increased steadily since June, and 11 facilities in Spokane County now have cases in staff or residents.

Royal Park Health and Rehabilitation in the Nevada Heights neighborhood has 32 positive cases among residents and staff members, Kelli Hawkins, public information officer at the Spokane Regional Health District, confirmed Tuesday. These numbers reflect cases recorded since July 15, she said.

Department of Social and Health Services data show 242 long-term care facilities, including adult family homes, across the state have at least one positive case of COVID-19.

The Grant County Health District announced two outbreaks in Moses Lake long-term care facilities on Tuesday, which account for 34 cases but no hospitalizations among residents and staff.

While cases have been confirmed at facilities in Spokane County throughout the pandemic, Hawkins said such outbreaks usually result in an average of five or six people testing positive, if the facility can control an outbreak before it spreads.

The health district considers a long-term facility with two cases to have an outbreak.

“Our long-term care facilities are doing a great job, and they are trying hard to maintain all the health measures in place,” she said.

The health district assists facilities in need of personal protective equipment and can provide a rapid-response “drop team” and infection-prevention specialists who can assist facilities with quarantining residents and box in the virus to prevent it from spreading among often highly-vulnerable populations.

COVID-19 can lead to severe symptoms for people over the age of 65 and those with underlying health conditions.

As of July 21, 171 COVID-19 cases and 23 deaths were associated with long-term care facilities in Spokane County, according to state data .

The Spokane Regional Health District confirmed five new deaths from COVID-19 in county residents on Tuesday, bringing the total to 52.

The health district also confirmed 83 new cases on Tuesday, for a total of 3,507.

Hospitalizations are on the rise, too. Sixty-three patients are being treated for COVID-19 in Spokane hospitals, and 41 of them are county residents.

While people in their 20s continue to drive local case counts, that trend has spread to other age groups, with those in their 30s and 40s now disproportionately represented in Spokane County’s cases.

COVID-19 cases and deaths also continue to rise in North Idaho.

The Panhandle Health District reported 49 new cases Tuesday, for a total of 1,625, and two more deaths, for a total of eight, in the five-county region it covers. Thirty-two North Idaho residents are hospitalized with the virus.

As in Spokane County, the Panhandle Health District has been responding to COVID-19 outbreaks in long-term care facilities for months, providing guidance and PPE to facilities in need.

The Panhandle Health District can also conduct testing on behalf of facilities, though Katherine Hoyer, the district’s public information officer, said that is uncommon. If facilities are able to do their own testing, they are encouraged to do so, while staff members are encouraged to go to community testing sites if they’ve been exposed.

Ivy Court, an 85-bed skilled nursing and rehabilitation center in Coeur d’Alene, has confirmed COVID-19 activity in the facility and conducted sitewide testing of residents and staff on July 9.

Facility leaders declined, however, to give exact numbers of cases, citing constantly changing test results. Instead, they referred The Spokesman-Review to data reported to the Centers for Disease Control and Prevention and the Idaho Department of Health and Welfare, which are expected to be available Friday.