At least 26,000 elderly residents died and more than 60,000 were sickened as the unrelenting coronavirus swept America’s nursing homes in recent months, particularly those with a history of violating federal standards meant to control the spread of infections, the Centers for Medicare and Medicaid Services announced late Monday.

The numbers represent the first official national accounting of fatalities in the 15,000 nursing homes that receive Medicare and Medicaid funding. The tally, however, is incomplete. About 20% of the nation’s nursing homes did not report required case and death data to the federal government, which began collecting the information last month.

Of those that reported, one in five saw at least one death from covid-19 and one in four had at least positive case.

An early analysis by CMS showed that homes with a history health deficiencies — including the failure to prevent and control the spread of infections — were more likely to see outbreaks than those with stronger track records. On Monday, CMS announced that it would ramp up enforcement, including civil penalties, of nursing homes with a history of violating infection-control standards.

For weeks, some states and facilities have declined to release case and death counts to the public, citing privacy concerns. The new federal data, while limited, comes after months of criticism from watchdog groups and patients’ families, who argued that tracking cases is critical to public health.

Since the first known outbreak at a nursing home in the state of Washington in February, some states have repeatedly declined to name impacted facilities or describe the scale of the problem, forcing families to plead for information from homes that were often reluctant to release details.

“I think people have a right to know what’s going on – and not all this hiding,” said Toby Edelman, a senior policy attorney at the nonprofit Center for Medicare Advocacy. “If the nursing homes would just tell the truth, people would respect them a lot more than this language about ‘we love our residents.'”

With a patchwork of reports from states, media accounts have previously placed the death toll at nursing homes in the tens of thousands. The estimates included all types of long-term care facilities, such as assisted living centers and group homes.

A Washington Post accounting of deaths in the nursing homes, based on state reports since the beginning of the pandemic, shows that more than 27,000 residents have died.

In April, CMS announced that all nursing homes would be required to report case information to the Centers for Disease Control and Prevention on a weekly basis. CMS requested data by May 17 but gave nursing homes a two-week grace period to report.

CMS administrator Seema Verma on Monday said the agency will distribute $80 million to states to increase infection-control inspections of nursing homes during the pandemic. States that have not inspected all Medicare-certified homes by July 31 will lose some of the money and will be required to submit a corrective plan to the government.