At 10:06 p.m. on Tuesday night, Alixandra Handy received a voicemail from the Family of Caring at Montclair Nursing Home: Her 86-year-old mother, a resident of the overnight facility, was low on oxygen.

The next day, Handy said a nurse notified her by phone that two people, a patient and visitor to the facility, had tested positive for coronavirus. The patient has since died, the nursing home confirmed Thursday.

Handy’s mother Lona Erwin was swabbed for testing, Handy said.

But before the results could come back, Handy said her mother died.

Erwin’s death on Wednesday, the cause of which Handy says is still being determined, underscores the challenges nursing homes across the U.S. face in stopping the spread of a fast-moving virus among their vulnerable, elderly populations.

“I don’t know that it was 100 percent COVID-19, but everything is pointing in that direction,” Handy said of her mom, who was admitted to the facility in 2017 and suffered from hypertension and dementia.

Jonathan Mechaly, a spokesman for the center, declined to comment on whether or not Erwin had contracted coronavirus. Officials in Montclair did not immediately respond to a request for comment on Erwin. Essex County officials deferred to Montclair for comment.

Handy said she expects to learn more about her mother’s cause of death Friday.

The virus, Mechaly said, first entered the facility on March 7 through a man who was visiting his spouse, a patient there.

Staff noticed the visitor was coughing, gave him a mask and escorted him outside of the building. He later tested positive for the virus in the hospital. His spouse was discharged from the facility on March 12 and returned home, but is not showing any symptoms, according to a statement from the nursing home.

“He was the initial person to come into our center with it,” Mechaly said.

Six days later, the nursing home sent a patient who was showing symptoms to the hospital and learned on Tuesday that the individual tested positive, he said. That person has since died, he confirmed. In a statement Thursday, Montclair officials said the patient who died was treated at Hackensack Meridian Health Mountainside hospital. The person had “multiple chronic conditions,” the statement said.

Visitors are now restricted from stepping foot inside Family of Care. Staff and physicians are being screened upon entering the building, Mechaly said, including by having their temperatures taken and filling out daily questionnaires regarding their travel.

The nursing home was given swab kits by a lab company and instructed staff to test anyone showing symptoms. Mechaly did not know how many people at the facility were being tested or how many were symptomatic.

The center is a 68-bed facility which provides rehabilitation and long-term care to patients.

“The local Health Department and the DOH were notified and gave directions which the facility has followed. There has been an ongoing dialogue with the facility and these agencies to ensure proper procedures are followed,” a statement from the nursing home said. “Family of Caring is dedicated to the safety and wellbeing of our patients, staff, and physicians.”

On March 14, a week after the man with coronavirus visited the Montclair facility, Gov. Phil Murphy said during a press briefing that no visitors would be allowed into nursing homes, pediatric residential facilities and dementia care homes “except for end-of-life situations.”

“These are the most vulnerable populations in our state, and given that COVID-19 has caused more severe illness in older adults and individuals with underlying medical conditions we feel this action is critical,” Murphy said.

At a press conference Thursday, state officials said there have been positive coronavirus tests in at least six nursing home facilities in the state, and that of the nine people in New Jersey who have died from the virus, three were at long-term care facilities.

It was quiet outside the center on Thursday morning as an employee wearing a face mask wheeled a trash bin full of garbage. Another employee came out quickly to spray down an intercom at the front of the building.

Just after 10 a.m., two Atlantic Ambulance vans arrived at the center. Several EMS workers carried equipment and pushed a gurney inside the building.

“I think we’re going to see more cases popping up in skilled nursing facilities across the state, just given the nature of this virus and the population it’s attacking,” Mechaly said. In the Seattle suburbs, the Life Care Center nursing home saw an outbreak, with at least 70 staff members out sick with coronavirus symptoms and six residents fallen ill.

Family of Caring Healthcare at Montclair, on North Mountain Avenue, is rated highly by the Centers for Medicare & Medicaid Services, receiving five out of five stars. It had already been restricting visitors in the wake of the COVID-19 outbreak.

Its parent company owns a number of nursing facilities in New Jersey.

It’s not the first time concerns about contagious diseases have swirled around such facilities.

In late 2018, a devastating adenovirus outbreak swept through the Wanaque Center for Nursing and Rehabilitation in Haskell, a nursing facility that specializes in pediatric patients, many on ventilators to help them breathe. The outbreak led to the deaths of 11 children and infected 25 other residents, ranging from toddlers to teenagers. One staff member also was diagnosed with adenovirus.

Wanaque Center was later cited for infection control violations.

For those with family inside Family of Caring now, it has been a stressful experience as they remain locked out of the facility. Relatives and friends can only reach their loved ones at the nursing home by phone, Skype or FaceTime for the next several months.

Although Handy said her mother was “not the picture of health,” her death this week was still unexpected. Erwin spent most of her life in Framingham, Massachusetts and was a mother of five children, Handy said.

“There’s nothing that can really undo it at this point,” Handy said. “But I feel like I should have been informed sooner than the night before she died.”

As of Thursday, at least 742 people across the state had tested positive for coronavirus, and nine people had died.

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Staff reporter Rodrigo Torrejon contributed to this report.

Avalon Zoppo may be reached at azoppo2@njadvancemedia.com. Follow her on Twitter @AvalonZoppo. Find NJ.com on Facebook.

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