We explore the relationship between the spatial distributions of excess deaths and care home facilities during the COVID-19 outbreak in Italy. Using registry-based mortality data (January 1st- March 31st, 2015-2020) for Lombardy, one of the areas hit most severely, we estimate that municipalities with care homes present significantly higher excess death rates among the elderly (+41%). We find that this effect is not driven by the size of care homes and of the vulnerable population that they host. Rather, our results suggest that the excess deaths did not occur only within care homes and these facilities acted as one of the possible catalysts in the diffusion of COVID-19 in the whole elderly population of their surrounding territory.