A western Sydney aged care home at the centre of a COVID-19 outbreak has suffered a 12th death, with the facility now running as a "pseudo" hospital as it attempts to manage infections.
The Anglicare-run Newmarch House reported an additional death on Wednesday after four were reported on Tuesday.
Anglicare chief executive Grant Millard earlier on Wednesday said the facility was anticipating more deaths.
About 80 residents are still living at the home near Penrith.
Twenty registered nurses, 25 carers, 11 cleaners and a GP are working daily at the nursing home where 34 residents and 22 staff members have tested positive to COVID-19.
"(It's) really running as a pseudo hospital at the moment," Mr Millard said.
Residents have been isolated since the outbreak on April 11, with Anglicare working to connect them with family members via mobile phones.
Employees are helping residents who cannot use mobile phones to connect.
But family members of Newmarch residents told reporters on Wednesday the lack of communication from Anglicare was disappointing.
Mary Watson says her mother is suffering more from the "mental anguish" of isolation after she was diagnosed on April 24.
"She told my son this morning she'd rather die because she's living in hell and if she's gone she won't be in hell any more," Ms Watson told reporters.
"I know this is uncharted territory and we're playing catch-up with this virus but we've been doing this for two-and-a-half weeks now."
Louise Payne said families such as hers wanted a direct line of communication with residents.
"It's like a nightmare we can't wake up from - you just can't help but feel that they're all going to be lost," she said.
NSW Premier Gladys Berejiklian acknowledged it was "distressing" that communication between relatives and residents and Anglicare was lax.
"We say to the operators of that aged care home, you need to lift your game in communicating to loved ones," Ms Berejiklian said.
"It's not acceptable to keep people in the dark. Just put yourself in the shoes of those people - it's horrific to be fearful about firstly, potentially losing a loved one but then not knowing what's going on and not being able to offer that care."
Anthony Bowe - a resident's son - said no one from the Berejiklian government had visited the facility since the isolation began almost 20 days ago.
"I say to the premier, as much as we respect that she is passing on her love and prayers, we don't need that, we need her presence, we need her here to sort out some issues and to do it quickly," he told reporters.
NSW Labor leader Jodi McKay said families needed more support from Anglicare too.
"We keep on hearing from the premier that we have ICU capacity, that we have ventilators. Why aren't these facilities being offered to residents?" she said.
Earlier on Wednesday, the state's chief health officer said any patient could be transported to hospital but their wishes had to be taken into account.
"The death rate in elderly as a consequence of COVID-19 is extremely high," Dr Kerry Chant said.
"So generally our approach is that we would have a discussion with the individual and their family. People may want to stay at home and be supported.
Infectious disease clinicians are assessing the situation at the facility daily, while staff who helped manage a coronavirus outbreak at Dorothy Henderson Lodge aged care home in Macquarie Park have also been called in to help.
Australian Associated Press