Despite the expected approval of a lease agreement this coming Monday which will make Accolade Healthcare the primary stewards of Oak Hill for at least the next five years, Monroe County officials are still dealing with the aftermath of the facility’s chaotic financial affairs from the first half of the current decade.

Monroe County Treasurer Kevin Koenigstein presented a monthly financial report for the county-owned senior living and rehabilitation center during the Monroe County Board meeting Monday morning showing a six-figure deficit through the first eight months of the fiscal year.

Koenigstein clarified the county is “not losing any money at the nursing home, but (is) not making money” year-to-date.

As of the end of July, the total facility’s operating budget had a reported shortfall of $133,458, although Koenigstein said those losses will be offset by non-operating income – a $350,000 tax levy disbursed during the current fiscal year in addition to payouts from interest-earning accounts established using prior surpluses from Oak Hill.

Koenigstein further explained the Oak Hill operating costs have exceeded revenues for longer than originally reported due to a failure to make necessary adjustments to the facility’s accounts receivable ledgers.

In recent years, income statements from Oak Hill had showed slight profits overall following a $1.1 million deficit during Fiscal Year 2023. 

The December 2024 end-of-year report showed an operating surplus of about $10,000, which has recently been discovered to be a loss of over $1 million in Fiscal Year 2024.

The discrepancies came to light as county officials began a thorough examination of accounting practices at Oak Hill following a grave audit report last month. 

During the July 7 report, auditor James Schmersahl called for
“significant changes” at Oak Hill after he described finding $3.3 million in transactions which had been “misreported,” clarifying he did find evidence of malicious intent as part of the systemic accounting failure.

In examining the Oak Hill books in the past month, county officials learned that charges billed to insurance companies and other entities were recorded as revenue but never adjusted to reflect actual payments received.

Koenigstein gave the Republic-Times a simplified explanation of the “accrual” accounting method as compared to actual money in hand. 

He said accounts which should have been documented and rectified over several years were simply entered as accrued revenue, but in the past few years, the figures were never revisited to show the actual amount of money deposited in Oak Hill’s accounts.

Oak Hill has traditionally practiced a hybrid accounting method which begins as “accrual” but is then adjusted to reflect actual payments rather than expected or invoiced amounts. 

A high degree of disparity exists in the healthcare industry between expected income and what is actually received, he continued. 

Koenigstein’s report on Monday prompted comment from Monroe County Clerk Jonathan McLean, who suggested – and Koenigstein agreed – the accrual numbers “never should have been posted.” 

McLean said Oak Hill is considered in financial terms based on actual assets. 

He continued by saying a consistently high dollar amount of “write-offs” – about $1.3 million in FY24 – do not give officials an accurate picture of the facility’s position, especially when the errors are discovered after the fact.

“When we’re trying to review these financials, and we’re posting revenue we’ll never get, that’s incredibly frustrating,” McLean said. 

Monroe County is still “grasping hold” of the true state of Oak Hill’s finances following the July audit, McLean admitted.

“This is the first report that clearly shows what’s going on” at Oak Hill, he continued, describing the situation as “the challenge of government trying to run a business.”

While Oak Hill has not been a significant moneymaker in the past five years as it was during the several decades prior, Koenigstein posited that minor financial gains or break-even expectations for the facility are not necessarily a negative for the county.

He suggested a lack of notable revenue can be justified if it benefits county residents.

“If we lose a little bit on operating income from the nursing home but make it up in tax revenue, and the people are happy, we employ local people and have local people in the nursing home, I think that’s all for the good,” Koenigstein concluded.

Monday’s discussion of Oak Hill finances may be a moot point following an upcoming special county board meeting scheduled for this Tuesday, Aug. 26.

As previously reported, commissioners are expected to approve a five-year lease agreement with Accolade Healthcare which guarantees annual revenue of at least $750,000 the first year with increases in subsequent years during the lease term.

If Accolade agrees to renew the lease and officials are satisfied with how it has been run during the five-year period, commissioners said they will put a referendum question on a future ballot asking taxpayers whether or not Monroe County should sell Oak Hill and its properties, effectively ending the county’s 75-year run in the senior living business.

The meeting will begin at 6:30 p.m. at the Monroe County Courthouse. 

Monroe County State’s Attorney Ryan Webb is expected to deliver a presentation explaining the lease, which will be followed by time for public comment, input from an Accolade representative and a vote to approve the lease.

In other business Monday, Monroe County Supervisor of Assessments Dawn Goff was on hand with a resolution to modify the county’s re-assessment districts. 

Currently, property tax assessments look at newly-developed or improved properties along with one county region every four years. 

In order to balance the workload during the quadrennial assessment cycle, Goff requested properties in the Columbia and Waterloo regions be rearranged to avoid completing the county’s two largest property volume regions during successive years.

Columbia and the surrounding rural area was assessed in 2024, with Hecker and Maeystown areas being assessed this year. 

Instead of following this year with assessment of properties in Valmeyer, Burksville, Fults and the Bottoms, commissioners approved moving that cycle to 2027 and allowing assessments in and around Waterloo in 2026, a year earlier than the typical cycle.

Assessor Kris Kennedy explained the “main goal is to separate cities,” adding that “Waterloo and Columbia should not be back to back.”

In an update of the current assessment cycle, Goff noted she and her team are close to evaluating properties on this year’s schedule – meaning the trend of earlier-than-normal assessment publication will likely continue in 2026.

Kennedy noted that disbursement of 2024 taxes collected in 2025 began this month – or about 11.5 percent of taxes levied by various entities.

She added this is the first time in the past 11 years disbursements have occurred this early.

Collecting in August is “the plan,” Goff said, adding her goal is to “stay on the new track.”

The first collection date for property taxes in this cycle is Sept. 19, with the second due date of Nov. 14.

Monroe County Engineer Aaron Metzger was also on hand to discuss an ordinance unifying access control on the future Rogers Street extension in Waterloo.

Following an ordinance passed last month to allow an ingress/egress on a five-acre residential property between Covington Drive and Hamacher Street, Metzger brought the topic up for consideration as final plans for the long-awaited extension are nearly complete. 

While Metzger admitted there are still some right-of-way hurdles to clear, he urged commissioners to prepare for official action on the project in the coming years. 

One preliminary step would be to have one ordinance to govern streets and driveways on both the current and future versions of Rogers Street.

Commissioner Vicki Koerber said the board will “mull it over.”

Metzger also reported the first phase of repairs to the Bluff Road bridge over Carr Creek in Columbia is nearing completion.

In other action, commissioners updated the county’s floodplain ordinance, a move similar to several county municipalities following the official implementation of new FEMA flood maps.

Monroe County Probation Chief Managing Officer Courtney Schweikhardt was also on hand to deliver details of her annual probation department plan. 

In what she called an “exciting time,” Schweikhardt reported the long-planned “drug court” may soon be a reality.

She said 24th Judicial Circuit Assistant Chief Judge Chris Hitzemann would soon hold a meeting with stakeholders in the proposed drug court, which is expected to receive grant funding through the state’s “Adult Redeploy Illinois” program which focuses on equipping local jurisdictions for initiatives such as the proposed drug court.

The next regular meeting of the Monroe County Board will be Tuesday, Sept. 2, beginning at 8:15 a.m. at the Monroe County Courthouse.