LOUISVILLE, Ky. (WDRB) -- An outbreak of COVID-19 at a nursing home northeast of Indianapolis has left 11 residents dead, Indiana's health chief said Monday. 

State health commissioner Dr. Kristina Box said Bethany Pointe in Madison County first requested state aid March 26, with three residents testing positive for the contagious respiratory illness the next day.

Three of the facility's employees also have tested positive, including two who are in critical condition, she said. 

"This is a heartbreaking situation and illustrates what a brutal toll that COVID-19 can take on our most vulnerable populations," Box said at a briefing in Indianapolis. "Unfortunately, this will not be the last outbreak of this kind." 

She called on long-term care facilities to follow health guidelines and ban residents from sharing meals together or gathering, urging workers to wear masks when preparing food, cleaning rooms or giving medication to residents.

Indiana now has 4,944 confirmed cases of COVID-19 536 new infections were reported Monday. In all, 139 people have died.

Also Monday, Gov. Eric Holcomb said he will extend his stay-at-home order until April 20 and imposed new rules for certain types of retail businesses while closing state park and other campgrounds entirely. 

Under the new executive order, retailers that don't provide "necessities of life" must close the inside of their stores to customers but can provide curbside carryout or deliveries. Pharmacies, grocery stores and hardware stores are among the businesses not affected by the change. 

The order takes effect Wednesday. The newly restricted class of businesses include, for example, florists, bookstores, craft stores and beauty supply shops. 

"These things are not necessities of life," said Joe Hereens, Holcomb's general counsel. "We've created a category that allows them to continue operating under new conditions and restrictions. Specifically, the inside of the store has to be closed to customers." 

Holcomb's order encourages businesses like grocery and big box stores that remain open to foot traffic to limit the number of customers to meet federal social distancing guidelines; reduce operating hours and create special senior shopping times; and properly sanitize their stores. 

Among other actions, the order creates Indiana's Enforcement Response Team to investigate claims of unsafe workplace conditions. Its powers include ordering businesses to close and referring those cases to local prosecutors. 

Reach reporter Marcus Green at 502-585-0825, mgreen@wdrb.com, on Twitter or on Facebook. Copyright 2020 WDRB Media. All rights reserved.