Ten more residents of the Spokane Veterans Home tested positive for COVID-19 on Saturday, for a total of 12 cases and one death.

The Spokane Veterans Home is now considered Spokane’s largest outbreak of COVID-19 in a long-term care facility for elders, which range from nursing homes to assisted living.

“It’s the largest cluster of cases we’ve seen in one facility,” said Heidi Iyall, a Spokane Regional Health District public information officer.

The health district has identified COVID-19 cases in five long-term care and retirement communities, in addition to three adult family homes, according to Iyall. Five of those facilities had more than one case.

There were at least 221 deaths in 137 Washington long-term care facilities, including employees, as of Friday, NBC News reported. More than 2,200 COVID-19 deaths are associated with long-term care facilities nationwide.

Iyall said she was not aware of large outbreaks at other types of facilities in Spokane but could not say whether the cluster at the Spokane Veterans Home is the largest in the county overall.

The new cases reported at the veterans home Saturday made up all but two of the county’s 12 new cases overall.

The cases were located in one area of the facility, and staff are working to prevent the novel coronavirus from spreading to other parts of the home, according to the Washington Department of Veterans Affairs.

No residents were hospitalized Saturday, according to Heidi Audette, a Department of Veterans Affairs spokesperson.

One person at the facility, which has 85 residents, died Wednesday after two roommates tested positive on Tuesday. Both were cared for by an employee who was awaiting COVID-19 test results but did not have symptoms for three days and returned to work according to state guidelines.

That employee worked in the area where the other residents who tested positive lived.

The employee also worked in another area of the building, but COVID-19 has not been confirmed in residents in that part of the facility.

Audette said the employee was not within 6 feet of residents for more than 10 consecutive minutes, which is the public health definition of close contact.

“But we don’t know for certain whether there is a connection,” Audette said in an email. “It’s possible that any exposure happened prior to the employee being tested while they were asymptomatic or that the virus was introduced to the facility another way.

“Our focus right now is on taking the best course of action moving forward and making sure we do everything we can to prevent the virus from spreading further.”

Five residents were symptomatic on Thursday, and all tested positive Saturday morning, according to the state Department of Veterans Affairs. Another 13 residents without symptoms were sampled for testing between Friday and Saturday, and five of those people were confirmed to have COVID-19.

Test results were pending for one resident and one staff member Saturday, according to the Department of Veterans Affairs. A total of 30 residents and nine staff have been tested.

“We are learning from the experiences of other long-term care facilities and working to defeat this enemy that has come through our door,” said Lourdes E. Alvarado-Ramos, director of the Washington Department of Veterans Affairs, in a statement. “Our team is working around the clock to care for our residents and prevent further spread of the virus.”

A MultiCare consultancy team provided through the state health department recommended the facility test more residents in the affected area of the building, according to the Department of Veteran Affairs.

The MultiCare team also approved the facility’s employee-screening process, and staff demonstrated how they were following public health guidelines for protective equipment and infection control.

Mary Rorie’s 94-year-old father, Willie Rorie, is a Navy veteran and a resident of the Spokane Veterans Home. She said she has seen employees wear gloves and masks while facilitating FaceTime calls with her father but doesn’t know if that is enough protection.

“The nursing homes across the nation are in bad shape,” Rorie said. “The people that are going in and out of there working have got to be exposing the residents.”

Rorie first received notification of the Spokane Veterans Home cases on Tuesday when there were two.

“And here it is Saturday, and now they have 10,” said Rorie, who doesn’t believe her father has been tested. “It’s moving fast.”

Rorie said she would remove her father from the home, but she isn’t equipped to care for him.

“I’m concerned. I’m not going to let my dad die,” Rorie said. “Your hands are tied.”

The Department of Veterans Affairs said residents in the facility continue to be monitored for symptoms of COVID-19 with symptom checks every four hours. Employees are screened before each shift and have been wearing additional protective equipment since March 30.

As of Saturday afternoon, no residents or staff at other Washington Department of Veterans Affairs nursing homes had tested positive for COVID-19. Those locations include facilities in Port Orchard, Orting and Walla Walla.

“I want to say how grateful I am for the staff at the Spokane Veterans Home,” said Patrick McNabb, the Spokane home’s administrator, in a statement. “The commitment and dedication this team shows to each and every resident is truly without parallel and I am proud of how they are performing during this incredibly uncertain time.”