How bad is the Covid crisis in US care homes?

When Michael Colwell received the call that his mother-in-law Helen Osucha had passed away at her nursing home in Geneva, Illinois, he says they told his family the 97-year-old died peacefully in her sleep.

A day later, the funeral home that had received Helen's body told them she had Covid-19.

Mr Colwell says the home informed them that there were "a case or two" of Covid-19, but they had no idea of the full extent.

A spokeswoman for the home told the BBC: "We mourn the loss of our patients, for many of whom we cared for many years, and we share the anguish of their loved ones.".

Bria of Geneva has reported 16 Covid-19 deaths to CMS.

Johns Hopkins University puts the US death toll at over 133,000 as of 10 July - which means that by current federal figures, care homes account for a quarter of all US coronavirus deaths.

An analysis by the non-partisan Foundation for Research on Equal Opportunity found 45% of US Covid-19 deaths came from nursing homes - a group that makes up just 0.6% of the US population.

The lack of testing early on "was bad in hospitals [and] was worse in nursing homes", she says, though it has since been improving.

"But nobody was paying attention to what was happening in nursing homes, who were a much higher risk population," Prof Bakerjian says.

"It was going to be an even bigger problem because they don't have the resources a hospital has - in terms of nursing resources as well as having the supply of appropriate personal protective equipment.".

A clearer federal response may have also helped avoid the contentious policy decision by some states to have nursing homes take in Covid-19 patients from hospitals.

In its care homes, the state has seen over 10,500 confirmed cases of the virus and has lost at least 4,092 residents to Covid-19, according to CMS data, from a population of nearly 90,000.

In New Jersey, the state with the highest average case count in care homes, 15 families are suing a facility that made national headlines when nearly 20 bodies were found stacked in a morgue built to handle just a few.

Several families in Kentucky are suing a home for not properly educating staff about wearing protective equipment in Covid-19 patient rooms amid over a dozen deaths.

It isn't just patients and families taking issue with how care homes have handled the pandemic.

There are reports of staff being told to work despite having Covid-19 symptoms, not having access to testing, not receiving proper training regarding Covid-19 or the need for personal protective equipment

A group of House Republicans on the same virus subcommittee have requested information from five Democratic state governors - Tom Wolf of Pennsylvania, New Jersey's Phil Murphy, Michigan's Gretchen Whitmer, California's Gavin Newsom and Mr Cuomo - over their policies to have homes take in Covid-19 patients

"Our numbers are still going the wrong direction, though I think there's a much more concerted effort now to try to make sure that nursing homes at least have the resources that they need."