Despite last Tuesday’s vote to approve an operational transfer of Oak Hill to Accolade Healthcare, there was relatively little talk of the senior living and rehabilitation center during last Wednesday’s Monroe County Board meeting.

While the transition was mentioned during a non-financial Oak Hill report, a majority of discussion about the pending takeover by Accolade occurred during public comment.

Coincidentally, both speakers last Wednesday are also candidates for Monroe County Commissioner. 

The first to speak was Marvin Wittenauer, who will be on the Republican primary ballot March 17 along with incumbent George Green, both seeking to be part of the Nov. 3 general election.

With the Illinois Health Facilities Review Board approving Accolade’s “certificate of need” required to assume operations Dec. 1, Wittenauer posed questions Nov. 19 regarding details of the lease agreement. 

With Accolade set to begin the first of two five-year lease terms, Wittenauer asked commissioners what happens at the end of 2030.

With outright sale of Oak Hill not possible without voter approval, the county’s agreement with Accolade will place a referendum question about the sale on a ballot in 2030 or 2032 if both parties are satisfied with conditions at Oak Hill following the first lease term. 

Wittenauer later told the Republic-Times he was simply asking how the second five-year lease would be carried out.

“The way I understand it is, this is catered to Accolade pretty heavily,” Wittenauer said, adding he believes the agreement would allow Accolade to continue leasing past the first two terms, or 10 years, should voters block the outright sale of Oak Hill.

Also speaking was Pat Kelly, frequent board meeting attendee and candidate for Green’s seat. Kelly is running unopposed this November as a Democrat.

Last Wednesday, Kelly sought clarification on a Republic-Times report which stated the HFSRB took issue with the way the lease of Oak Hill property came to be.

Monroe County State’s Attorney Ryan Webb explained the HFSRB project report did contain language about the nature of an Oct. 1 board action, adding he believed it was based on a simple misunderstanding of what was approved during the special meeting last month.

Webb explained the lease was executed Oct. 1 with a “commencement” date of Dec. 1 – when the actual operational transfer will take place.

He also noted any misconduct on behalf of Accolade or Monroe County prior to Dec. 1 would have resulted in explicit intervention by state officials.

Later in the meeting, Oak Hill Director of Nursing Mindy Hanna was joined by Oak Hill Administrator Eli Kamins during an update of current goings-on at the facility. 

Kamins said he wants Oak Hill to be a  “place to be proud of,” adding Accolade is “here for the community.”

He then noted that census is up in the skilled nursing wings at Oak Hill, with some residents taking spots in the semi-skilled wing “just to get in” due to a waiting list for admission.   

Kamins also provided an overview of the transition process, noting a change in several computer systems involving billing reports and other administrative tasks.

He also noted a change in dietary operations at Oak Hill, with a new focus on “fresh food options.”

Monroe County Clerk Jonathan McLean expressed appreciation of timely financial reports – one function of the software change.

Hanna, while admitting the last few months have “been a lot,” describing parts of the transition as “rough,” she also said morale is improving as the changes become more routine and familiar.

Hanna also said Oak Hill staff “loves the new software,” referring to the system used more by the nursing crew.

She did attribute recent difficulty to the shutdown of the federal government, which ended Nov. 12 after over a month.

The shutdown affected required reporting through the Centers for Medicare and Medicaid Services, with operations hampered by the absence of CMS staff.

Green then noted Kamins and other Oak Hill staff would deliver quarterly reports to Monroe County, also stating commissioners would visit the facility once per month during the lease period.

In other Accolade news, the Accolade Paxton Senior Living facility recently earned the prestigious CMS five-star overall facility rating.

Oak Hill had maintained the five-star rating until earlier this year, when it was demoted to four stars due to “allegations of physical and sexual abuse” and failure to report abuse allegations by former administrator Shari Kruep, who was fired shortly after the 2024 inspection was completed.

In other business last Wednesday, Monroe County Treasurer Kevin Koenigstein offered several financial updates, one concerning the county budget, which he said was “99 percent complete.”

Prior to budget talks, Koenigstein briefly discussed Oak Hill finances, which he described as “treading water.”

Oak Hill is not expected to lose money during what may be the last month being under Monroe County control, although Koenigstein pointed out the county will still conduct repairs and maintain the facility during its lease to Accolade.

Once such project, a roof repair, will be paid using a fund established by commissioners in the 2010s.

Oak Hill will have a positive effect on the county budget in the upcoming fiscal year due to construction bonds issued in the early 2000s being paid in full earlier this year.

Koenigstein pointed out the county would not levy a tax for Oak Hill in Fiscal Year 2026, and by doing so the county will reduce not only its tax rate but actual amount of property tax monies collected for the second year in a row.

Overall, Monroe County will collect almost $40,000 less than it did in FY2025.

The budget itself is “balanced,” Koenigstein reported.

Although the county’s $12.87 million in expected expenses is more than the $12.5 million in expected revenue, Koenigstein pointed to county sales tax receipts continuing to break records.

He also noted he does not expect the $600,000 allotted in the commissioners’ “contingency” fund to be completely spent, estimating the county will have about $400,000 left in that fund at the end of FY26 – just enough to cover the $370,000 calculated shortfall.

He called the budget “typical,” with the county’s $8,964,000 total budget a result of a 2.9 percent increase based on the Property Tax Extension Limitation Law and 1.2 percent expected growth in the county.

The Monroe County Sheriff’s Department accounts for $4.5 million of the budget despite dispatch personnel now being included as part of the county’s 9-1-1 department budget.

The Monroe County Highway Department accounts for $2.1 million of the budget.

Monroe County Engineer Aaron Metzger spoke during the meeting, noting recent legislation which grabbed his attention in regard to state funding.

The $1.5 billion package redirects $860 million from motor fuel tax revenue – a major funding mechanism for county highway departments – to the Chicago Transit Authority.

Metzger was skeptical of the move, and advised commissioners to be aware of possible changes in how projects are pursued and funded as a result of the move.

The draft budget is currently available online at monroecountyil.gov.

The budget is expected to be officially adopted during the next regular board meeting this Monday, Dec. 1, which is also the beginning of the fiscal year for Monroe County government. 

Also during the meeting, commissioners approved an ordinance which officially adopts the county’s comprehensive plan, which was detailed in the Oct. 29 issue of the Republic-Times.