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National Guard medical workers are responding to four Southern California nursing facilities identified by the state as among the hardest hit by COVID-19.

Nursing facilities have become a focal point of the pandemic as clusters of deaths and infections have appeared across the U.S., with their populations being particularly vulnerable to the virus. In California, the state has identified four facilities in Los Angeles County as being most in need of assistance.

They were selected based on daily calls that state workers make to 1,224 licensed skilled nursing facilities across California, checking on staffing levels and the number of COVID-infections and deaths, Gov. Gavin Newsom said Friday. The facilities getting assistance are not necessarily those with the most cases of the virus.

They include the Gardena Convalescent Center in Gardena, Hollywood Premier Healthcare Center in East Hollywood, Brighton Care Center in Pasadena and Alcott Rehabilitation Hospital in Koreatown, according to National Guard Lt. Col. Jonathan Shiroma.

The help comes as L.A. County announced new efforts to address COVID-19 outbreaks at nursing homes and assisted living facilities — more than 90 have reported at least one death due to the virus, according to health officials. Dozens more have reported infections among residents or staff.

About 43% of all COVID-19 deaths have been linked to institutional settings such as nursing homes, assisted living facilities, shelters and jails, L.A. County Health Director Dr. Barbara Ferrer said Friday. Most of them were residents of nursing facilities, she said.

Beginning Monday, licensed nursing facilities must have all staff and residents tested for the novel coronavirus even if they do not show symptoms, Ferrer said. She said testing will eventually be made available to every facility but the county will first prioritize those with the most severe outbreaks.

The National Guard medical teams sent to four L.A. County facilities each consist of eight members including a physician’s assistant, nurse, five U.S. Army or Air Force medics and an administrative sergeant, according to Shiroma.

“Our soldiers and airmen would fall directly under the direction of civilian staff,” Shiroma said. “We’ll be there as long as we’re needed.”

Newsom said the teams arrived Sunday and Monday and will help facilities with isolation of COVID-19 patients, carrying out tests and other tasks related to managing the outbreak.

With 46 residents and 26 staff members infected, Hollywood Premier Healthcare Center has reported the most cases of the virus among the four facilities as of Thursday, according to data from county and state health officials. Nine people from the facility have died of the virus.

The Alcott Rehabilitation Hospital has also been linked to nine COVID-19 deaths, and 18 residents and 12 workers there have tested positive as of Thursday, according to county data. Another 34 residents and 18 staff members were infected at the Gardena facility, which has been linked to five deaths.

At the Pasadena facility, 57 residents and less than 11 staff members have been infected, according to state data, which does not include death tolls.

In total, at least 522 licensed nursing facilities across California have reported cases of COVID-19 and more than 2,700 residents and staff were infected as of Thursday, according to Newsom.

In addition to 1,224 licensed nursing facilities, Newsom said the state is monitoring more than 7,000 senior assisted living facilities over virus concerns.