In Orange County, two facilities are experiencing such hotspots -- PruittHealth Carolina Point and Signature HealthCARE at Chapel Hill.
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PruittHealth has at least 60 positive cases and the total includes staff and residents.
"It's very easy to see the virus spreading quickly among folks living there and folks working in close proximity with them, and the second is the average age of the people in these facilities is higher, and we know they are more susceptible to the most severe symptoms of the virus," Pruitt spokesperson Graig Meyer said.
Seven residents are at Duke University Hospital. Two have died.
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Signature HealthCARE has seen three positive tests. The patients are being cared for at UNC Hospitals.
More test results are pending for both facilities.
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North Carolina Health Secretary Dr. Mandy Cohen said state officials first became aware of cases at the Orange County nursing home in early April. A news release from the Orange County Health Department on April 2 identified two positive cases of the virus at PruittHealth - Carolina Point. A resident at that facility had to be hospitalized for treatment.
Meanwhile, in Moore County, the county health department identified Pinehurst Healthcare & Rehabilitation Center as a location where 29 positive COVID-19 cases have happened.
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A staff member at the facility tested positive during the weekend. Following that, the 96 residents and 115 staff members were all tested. So far 26 residents and five staff members have tested positive.
All residents at the facility that have tested positive for the virus have been isolated from others. None of the residents has exhibited any severe symptoms or signs of respiratory distress.
Eleven additional positive cases have been reported at Springbrook Rehabilitation and Nursing Center in Clayton. Since the outbreak, there have been two COVID-19 related deaths at the facility.
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The Moore County Health Department said the number of positive cases remains preliminary as not all test results have come back.