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Avalon Health Care Group announced Monday that a 13th veteran who tested positive for COVID-19 has died at the Yukio Okutsu State Veterans Home, and Hawaii News Now reported Tuesday that a 14th veteran or family member at Okutsu has died.

Avalon, which manages the skilled nursing facility in Hilo, gave no further details about the deaths. “We are heartbroken over this and express our condolences to the family and friends of these residents,” according to a statement from the company.

The fatalities at the care home have triggered a review of the operation by staff from the Department of Veterans Affairs and the Hawaii Emergency Management Agency.

The deaths at Okutsu also prompted Hawaii County Mayor Kim last weekend to call a press conference to urge the state to replace Avalon as the care home operator.

In a statement posted on the company website on Monday, Avalon said the company has been following the guidance and directives of the Centers for Disease Prevention and Control and Prevention, the Centers for Medicare and Medicaid Services, as well as guidance from state and county officials.

“Please know that our staff has been working tirelessly to care for our residents,” Avalon said in the statement. “Being in the spotlight and so heavily criticized by the media and public officials has certainly been tough on all of us. We greatly appreciate the love and Aloha we have received from many of our family members and friends.”

So far the company has reported 68 Okutsu residents have tested positive, and 30 staff have been infected. Avalon reports that 17 residents have recovered, along with five staff.

“Based upon our contact tracing, we believe the virus entered the facility through an asymptomatic staff member who was exposed in the community and through a resident who was exposed at an outside dialysis appointment, which exposure we were not informed about,” .