At least 45 residents of a Richmond, Va., nursing home have died from the novel coronavirus, officials said.

The number of fatalities at the Canterbury Rehabilitation & Healthcare Center exceeds the death toll at Seattle’s Life Care Center, where 43 people have died, according to The Associated Press.

The vast majority of the Virginia facility’s residents rely on Medicaid funding, the AP noted, and its layout complicates implementing the social distancing measures recommended by the Centers for Disease Control and Prevention. Other facilities with similar dependence on Medicaid have also seen outbreaks, including homes in Crown Heights, Brooklyn, and Wayne, W.Va., according to the news service.

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Canterbury saw its first confirmed case on March 18, with numerous staffers quitting in the aftermath and others taking ill themselves.

James Wright, Canterbury’s medical director, told the AP weeks ago that a second doctor who typically treated patients stopped showing up, leaving the remaining staff to take on duties with which they were unfamiliar.

“I was changing patients, cleaning beds. My administrator was delivering meal trays,” Wright told the AP. “You pick any element, or any arena in our facility that needed to be up and running at its best and nothing was.”

The facility was not initially able to test all residents and staff due to guidance from state and national officials requiring long-term care residents to first be tested for the flu to rule it out.

Tests for the coronavirus were not conducted on everyone at the facility until about two weeks after the first case was confirmed, by which point 53 of 92 infected residents showed no symptoms of the disease.

“A publicly funded nursing home is a virus’s dream,” Wright told the AP. “It is the best place for a virus to be. People are close together. Their immune systems are compromised. It is just a tinderbox for that match.”