Late Tuesday evening, the future of the Oak Hill  senior living and rehabilitation center in Waterloo was decided – at least for the next five years. 

Despite a spirited effort on behalf of those opposed to a lease of country-owned Oak Hill property and operations to Accolade Health Care, the Illinois Health Facilities and Services Review voted unanimously to issue a certificate of need to Accolade – the final step in the first part of an agreement with Monroe County authorized Aug. 26.

At that special meeting of the Monroe County Board, details were released regarding a plan for two five-year lease agreements with Accolade in addition to an understanding which would put the outright sale of Oak Hill for $14 million on a ballot in 2030 or 2032 if both parties agree to a second lease term within the next five years.

The first lease term began Oct. 1 for just Oak Hill’s buildings and ground, with Accolade granted a “consulting” role with Oak Hill pending Tuesday’s vote – which now has Oak Hill operations to be transferred out of Monroe County control on Dec. 1.

Monroe County State’s Attorney Ryan Webb reported the vote to the Republic-Times early Tuesday evening.

Webb explained this late vote was due to Oak Hill-Accolade placement on the HFSRB’s afternoon agenda. The meeting, scheduled to be finished by 4 p.m., did not adjourn until nearly two hours later.

Webb said about 60 speakers commented publicly about a proposal to discontinue obstetric and intensive care service categories at a St. Elizabeth’s medical center in Ottawa, delaying the final item of the day – the vote to issue Accolade the certificate it needs to begin its turn as the stewards of Oak Hill.

The meeting began 9 a.m. Tuesday at the Bolingbrook Golf Course clubhouse near Chicago.

Monroe County Commissioner George Green was reported to have made the trip up north, as was a small contingent of those opposed to the operational transfer and potential sale.

At all points in the process, local residents took every opportunity to come out in droves to express mostly outrage and disappointment at not only the plan to privatize Oak Hill, but also the way the plan was presented.

Repeated comments revealed skepticism regarding the manner in which county officials developed the lease agreement, that being without any public input. 

Crowds showed up for special Monroe County Board meetings on Aug. 26 and Oct. 1, in addition to a public comment hearing Oct. 8 at the Monroe County Annex.

Dozens of written comment on the matter were also submitted to HFSRB for consideration.

The review board itself took issue with the way the lease was initiated, writing in a Nov. 5 project report that review board members  felt the Oct. 1 lease commencement was a de-facto “change of ownership” prior to HFSRB approval.

On Tuesday, though, the overwhelming amount of oppositional comment and alleged unauthorized action seemed to have little effect on the board’s ultimate vote.

A full transcript should be available on the review board’s website, hfsrb.illinois.gov, within 15 days, a board representative told the Republic-Times. 

Oak Hill was set to be a topic of discussion during Wednesday’s meeting of the Monroe County, Board with an item published Monday on the Nov. 19 meeting agenda.

The meeting had been rescheduled from its typical third Monday of the month date due to a commissioner’s schedule conflict.

Also on the agenda is the final push to have the Fiscal Year 2026 budget ready for approval during the Dec. 1 meeting. 

A draft budget for public review was posted on the county’s website, monroecountyil.gov, earlier this month.

Read more on the Oak Hill vote along with an analysis of the upcoming annual fiscal plan for Monroe County in the Nov. 26 issue of the Republic-Times.