Nearly 75 years after building the first county-owned nursing home in Illinois, Monroe County may soon be out of the senior living and rehabilitation business altogether.

Commissioners are expected to approve a five-year lease agreement with Accolade Healthcare following a public meeting at the courthouse this coming Monday night, Aug. 11, beginning at 6:30 p.m.

Monroe County Clerk Jonathan McLean was  notified about the decision and was asked to set a public meeting.

McLean spoke with the Republic-Times on Monday and described terms along with the rationale behind this decision.

According to Monroe County Board Chairman George Green, the lease will give Accolade complete control of Oak Hill although none of the internal operations would change during the transition or the duration of the lease.

Green pointed out that current residents of Oak Hill, located at 623 Hamacher Street in Waterloo, should not notice any changes during this changeover.

He added all current employees are to be retained, as is the current collective bargaining agreement and the role of the Monroe County Nursing Home Endowment Board.

Also as part of the lease, Monroe County will receive $750,000 for the first year with an additional 2 percent added each consecutive year until the initial term expires for a total revenue of around $4 million for Monroe County. 

The lease is expected to begin Oct. 1, pending approval of the Illinois Department of Public Health and other relevant agencies.

Should the county and Accolade agree to renew the lease after five years, a referendum would be placed on the next available ballot which would ask voters if the county should sell Oak Hill to Accolade for $14 million.

The details of the lease and possible referendum will be explained during Monday’s meeting. 

Monroe County State’s Attorney Ryan Webb will begin this meeting by presenting a detailed explanation of the lease terms, potential for a sale referendum question, the future of Oak Hill and the leasee’s responsibilities.  

The presentation will be followed by public comment, with each speaker allowed three minutes to express an opinion about the proposed lease and potential sale of Oak Hill.

An Accolade representative will also be on hand to provide additional information or clarify any issues raised during public comment.

Commissioners will then vote to authorize Green to sign the lease agreement.

Oak Hill has been in a state of flux recently with former director Alicia Emmerich resigning last month following an audit of county finances which discovered major issues with Oak Hill accounting practices.

During the July 21 board meeting, commissioners authorized Health Dimensions Group to take control of administrative personnel.

During that meeting, Michael Moore was announced as the latest Oak Hill administrator, making him the fifth executive leader at the facility in as many years. 

With the frequent changes in leadership, Oak Hill has lost money in recent years following decades of being a consistent money maker. 

Despite the revolving door for administrators at Oak Hill lately, Green said the decision to lease and possibly sell the senior living and rehabilitation center is based less on recent issues and more on the changing nature of the industry – especially following regulations imposed on skilled nursing facilities during COVID-19.

Green pointed to an industry-wide shortage of nursing staff, recent difficulty in properly submitting Medicare paperwork, and a number of other issues which Accolade is in a better position to oversee.

With Accolade owning several locations in East Peoria, Peoria, Danville, Pontiac, Paxton, and Savoy, Green said the company has resources that make it better equipped to deal with the challenges of the changing landscape of senior care.

Green also said the county has been looking for a solution to improve Oak Hill for some time, but most companies were not interested in leasing the facility as many are looking for property acquisition in order to collateralize assets.

The county “picked (Accolade) for a reason,” Green continued, saying both have a shared interest in its success. 

In addition to Accolade’s Peoria location attaining the CMS five-star facility rating, the five-year lease term gives both parties an opportunity to see results prior to a potential outright sale.

Green said Accolade is also in a better position to provide increased services at Oak Hill such as on-site dialysis treatment.

The next five years will decide the direction and future of Oak Hill, and county residents will be able to have their say on what that future should look like on Monday night.