BISMARCK — Before last week, the Good Samaritan nursing home in rural Bottineau, N.D., had not experienced any deaths related to the coronavirus pandemic. Now, eight people in the facility have died, including a staff member.

The Bottineau County nursing home, which has a total of 35 residents, about 75 staffers and 48 licensed beds, is reporting COVID-19 cases in more than half of its residents and in nearly a third of its staff, according to the facility's administrator. The outbreak comes as rural virus spread has escalated in other parts of North Dakota, and nursing homes have shouldered the brunt of the state's recent surge.

And while the North Dakota Department of Health said it cannot address the occupations of people who have died from the coronavirus, the death of a staff member at Good Samaritan may be the first confirmed death of a North Dakota health care worker as a result of the virus.

Mitch Leupp, Good Samaritan's administrator, said he could not speak to any specifics about the death of their staff member but said that he hopes the worst is behind his facility. "We're very hopeful that we're over the hump and we're starting to see things slow down," he said, noting that many of the staff positives are nearing the end of their quarantines and should return to work soon.

So far, Good Samaritan has been able to stay fully-staffed thanks to help from the state's emergency medical response corps, which dispatches health care workers to facilities around the state in need of reinforcements, as well as extra hands from the statewide Good Samaritan Society.

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Good Samaritan had managed to stay mostly insulated from the virus for much of the pandemic, but the recent spike in virus cases has overtaken the facility. In the last week and a half, seven residents and one staff member have all died.

Leupp reported that the nursing home has seen a total of 37 positive residents since March, but the majority of those cases have come in just the last few weeks. Twenty residents and 24 staff members are currently reporting active positives.

"We had very few asymptomatic cases," Leupp added. "Almost all of our cases have been symptomatic."

The extreme circumstances in Bottineau, a small town in north-central North Dakota, are just one instance in what's been a devastating last month of the pandemic in the state's nursing homes. Since the first day of September, 79 nursing home residents have died of COVID-related complications in the state's long-term care facilities, according to Department of Health spokesperson Nicole Peske, half of the total number since the start of the pandemic. And 12 of those deaths were reported just in the first two days of October.

"At this point it seems everyone is having their turn," said Shelly Peterson, president of the North Dakota Long Term Care Association, which represents and lobbies on behalf of long-term care facilities around the state. "It's not if you're going to get it. It's when you get it."

Neither North Dakota's Department of Health nor its Department of Human Services, which oversees long-term care, will comment on specific facilities, so it's unclear how the death toll at Good Samaritan compares to other nursing homes around the state. Last month, The Forum reported eight deaths in a single facility over the course of several weeks, a number equal to the death count at Good Samaritan but spread over a longer stretch of time.

Good Samaritan has issued personal protective equipment to all of its employees and isolated COVID-19 positive residents in a wing of its facility, where some residents have been sharing rooms with other coronavirus patients.

But the facility has also had to send some residents experiencing severe symptoms to hospitals for more intensive treatment. Four Good Samaritan residents are currently hospitalized, though Leupp said several of them are on the mend and expected to return to Good Samaritan soon.

Peterson stressed that nursing home staffers and the state have done everything in their power to stem the spread in these facilities. "They're doing everything right. They're working night and day. They have good infection control practices," she said. She added that spikes of COVID-19 cases in nursing homes have directly correlated with community spread outside of the facility.

The Department of Health was reporting 46 active COVID-19 cases in Bottineau County, but it listed a total of 45 cases within the Good Samaritan facility alone. Peske said the disproportionate numbers within the nursing home may be skewed by staff members who live in neighboring counties whose positive tests do not contribute to the Bottineau County figures.

The Department of Health has reported a total of 153 COVID-related deaths in nursing homes since the start of the pandemic, more than half of the total 264 people who have died from the virus in North Dakota.

Peterson said nursing homes still have many unanswered questions about how the virus is getting into their facilities.

"We don't know," she said. "We're all doing our best to identify the source and eradicate it."

Readers can reach Forum reporter Adam Willis, a Report for America corps member, at awillis@forumcomm.com.