(CNN) Nursing homes in Washingto state have been instructed to limit visitors as coronavirus cases spread across 11 facilities -- with Life Care Center in Kirkland at the epicenter of the outbreak.

The mandate echoes even stricter new guidance to eliminate visits entirely to nursing and assisted living centers, the head of the nation's largest association of long-term and post-acute care providers told CNN.

"We are encouraging all people, including family members and loved ones, to not visit nursing homes and assisted living facilities," American Health Care Association President Mark Parkinson said Tuesday.

"Until we get this under control, our new guidance, as of today, is to family members, to loved ones: Don't visit the facilities; instead, come up with an alternate way to communicate," he said, including phone, text, FaceTime or Snapchat.

"The grim reality is that, for the elderly, Covid-19 is almost a perfect killing machine," Parkinson said.