Another hearing concerning the pending lease of county-owned Oak Hill senior living and rehabilitation center to Accolade Healthcare has been scheduled for Oct. 8 at the Monroe County Annex in Waterloo. 

This meeting will be conducted by representatives of the Illinois Health Facilities and Services Review Board. 

The HFSRB mission is to regulate the “planning, construction and operation of healthcare facilities” in Illinois.

The October hearing is intended only to gather public comment to be entered into the official record for consideration by the state board. 

No action will be taken during the hearing apart from accepting public input, and county officials are not required to attend the meeting.

According to documents available on the HFSRB website, hfsrb.illinois.gov, this hearing was scheduled after the board received two requests for an additional public hearing, one submitted by a current Oak Hill employee who lives in Waterloo and the other by a “concerned citizen” in Columbia.

The employee’s hearing request describes the commissioners’ decision to lease Oak Hill “extremely rash, very unfair and unjust,” adding the application process was “completed without any of the Oak Hill employees, Monroe County taxpayers and registered voters’ consent.”

The Columbia resident argues an additional hearing is necessary to ensure “proper consideration” of the project, adding, “The Monroe County Board needs to reconsider the gravity of this five-year lease… before it ruins Oak Hill.”

The HFSRB site also contains information about the proposed lease – much of which was disclosed during an Aug. 26 special meeting of the Monroe County Board – although a few documents offer information which has not yet been discussed at length during any public meetings.

The website contains an application for the pending lease, referred to as HFSRB project name “25-031 Oak Hill Senior Living and Rehabilitation Center, Waterloo.”

The “application for permit” was submitted by Monroe County as current owner of Oak Hill. It was signed by Monroe County Board Chairman George Green and Vice-Chairman Vicki Koerber on Aug. 4 and received by the HFSRB on Aug. 11.

The “purpose of the project” application section states the “Monroe County Board of Commissioners determined it no longer has the required expertise to operate a skilled nursing facility and decided to exit the business so it can focus on public safety and essential services to the residents of Monroe County.”

An “alternatives” section describes four options for Monroe County officials contemplated prior to authorizing execution of the lease.

“Monroe County considered closing the nursing home,” this application states.

That option was rejected because the “other (skilled nursing) facility (in Monroe County) is a Medicare one-star facility and lacks the capacity to accommodate all the Oak Hill residents.”

Selling Oak Hill was a non-starter, as a voter referendum would be required.

County officials did not want to “maintain the status quo” due to “staffing issues” and “costly managers and consultants” required to “address the complex and growing regulations” of the health care industry.  

This section also notes Oak Hill self-reported  “overpayment” to the Center for Medicare and Medicaid Services which “resulted in engaging a D.C. lawyer to settle the overpayment.”

The application also points out increased services Accolade Healthcare would be able to provide as the “new operator” of Oak Hill, which includes admission of “high acuity residents with tracheotomies, requiring dialysis or complex wound care.”

The application provides clarity about “an application for change of ownership of Oak Hill” described in a legal notice published in the Sept. 17 and Sept. 24 issues of the Republic-Times which provide notice of this Oct. 8 meeting.

The “narrative description” application section states Accolade Healthcare of Waterloo LLC needs to become the Illinois Department of Public Health designated “licensee” of the facility in order to assume operational control.

The “ownership” is that of the IDPH license, not the facility or property.

County officials have maintained Oak Hill’s building and real estate will remain county-owned during the initial five-year lease term.

Further on in the application, it is made clear that no new construction or “land acquisition” is involved with the initial lease.

If a second lease term is approved, a referendum question will be placed on a ballot in 2030 or 2032 asking voters if they would support selling Oak Hill business operations and county-owned property outright for $14 million.

The county commissioners’ goal of the eventual sale of Oak Hill is reinforced by a non-binding “Letter of Intent” sent from Accolade President Moe Freedman to Ray Giannini of commercial real estate firm Marcus & Millchap.

Giannini specializes in “selling all types of seniors housing properties, including congregate care, assisted living and skilled nursing facilities,” according to the Marcus & Millichap website. 

The letter of intent, dated April 7 and signed by Freedman and Green, provides more specifics about the proposed lease – such as a lease payment schedule – although final terms of the agreement will not be official until the state review board votes on the project.

As of Aug. 14, the project has been in a “review period,” during which HFSRB staff will “conduct a comprehensive review of the project and prepare a report of findings for submission,” which includes gathering public comment on the matter.

The Oct. 8 hearing has been scheduled for 4 p.m. at the Monroe County Annex in Waterloo.

A report in the Sept. 17 issue of the Republic-Times erroneously listed the venue for this hearing as the Monroe County Courthouse.

Comments may also be submitted in writing for entry into the official record. 

All written public comments must be received by the board by Oct. 29. 

Comments may be mailed to “Illinois Healthcare Facilities and Service Review Board, 525 W. Jefferson Street (2nd Floor), Springfield, IL 62761.

Once all comments are documented, HFSRB staff will then release a report Nov. 5  which will be available online at hfsrb.illinois.gov.

Those wishing to comment on the Nov. 5 report’s findings may do so in writing, although submissions are must be received by Nov. 10. 

The matter is currently scheduled for a vote during the Nov. 18 HFSRB meeting. 

If the operational transfer is approved, Accolade is expected to assume official control of Oak Hill per terms of the lease on Dec. 1.

The application listed a proposed takeover date for Accolade as Oct. 1, but the timing of lease execution has been delayed for a number of reasons, one being the Oct. 8 hearing.