A former patient accused of stabbing a Hawaii State Hospital nurse to death on Monday has been indicted on a second-degree murder charge. 

Tommy Kekoa Carvalho, 25, is being held without bail at the Oahu Community Correctional Center and is scheduled to be arraigned on Monday, according to Dave Day, special assistant to Attorney General Anne Lopez.

Carvalho was indicted by a grand jury of at least eight people, Day said. Grand jury proceedings are confidential, but at least eight grand jurors must vote to indict before an indictment can be returned, he said. 

Carvalho will have the opportunity to enter a plea on Monday. He does not yet have a court-appointed attorney, Day said. 

Carvalho, who was discharged from the Hawaii State Hospital in August and living in a transitional residential program, is accused of killing Justin Bautista, a 29-year-old licensed professional nurse who had worked at the hospital for four years. 

Hawaii State Hospital Administrator Kenneth Luke said Tuesday that the hospital would be in a “safety stand down” for at least 48 hours after the killing. About five patients were moved from the residential area where Carvalho was living into other supervised programs on campus, he said. 

The hospital was also working to increase its staffing levels in the transitional housing program to seven employees during the day and five at night, Luke said. Recently, there were five employees working during the day shift on average and three at night.

Three psychiatric technicians, one registered nurse and Bautista were working at the time of the stabbing Monday evening, according to Rosemarie Bernardo, spokeswoman for the Department of Health.