The day before a primary election, a hot topic for the contested Republican ballot for county commissioner was discussed during Monday’s meeting of the Monroe County Board.

The current board has faced criticism for its decision last year to lease Oak Hill, the county-owned senior living and rehabilitation center, to regional firm Accolade Healthcare.

Monroe County Board Chairman George Green is facing opposition in the March 17 primary from Marvin Wittenauer, who listed Oak Hill as one main reason for challenging the incumbent.

Monday’s discussion featured public comment on the senior care facility, followed by a mention of the Oak Hill Endowment Board and Accolade Healthcare during a financial report.

First to speak on Monday was Monroe County Democratic Central Committee member Scot Luchtefeld. He asked whether a report would be available following a forensic audit of the senior living facility from 2016 through 2022.

Monroe County State’s Attorney Ryan Webb explained this audit will remain in “draft form” and is therefore not subject to Freedom of Information Act requests.

Webb added that information given to the Republic-Times last week contained all the pertinent information from the audit – the main difference being that it was not on Armanino LLP letterhead – the company that performed the audit.

Next to speak was Nancy Gilbert, who had questions about a reported decline in service at this facility. She cited “many changes” since Accolade took over – including “no choice” regarding food options and Accolade having severed ties with local businesses.

“It looks like an institution,” Gilbert added, speaking to her recent visits to the facility while saying residents are upset and rates have already been raised.

“Is that how (Accolade) is going to make money to pay the county?” Gilbert asked of the supposed rate hikes.

She also asked about terms of the lease, specifically the purchase option.

Green explained that Accolade has the option to purchase the facility in Waterloo outright should it decide to renew the first lease term.

Accolade has “five years to prove themselves,” Green added.

Webb added that no sale of the facility would occur “unless and until” this move receives voter approval.

“I don’t understand. Do you think (voters) are really going to pass that?” Gilbert said, referring to the potential sale referendum.

Next to speak was Pat Kelly, a Democrat running unopposed for the county board seat currently held by Green this November.

Kelly asked why previous audits did not reveal any potential wrongdoing.

Webb responded by saying Armanino auditors looked at “every single document” from 2016-2022 available for review, explaining typical audits would not have revealed billing issues.

Webb continued by saying Armanino was brought in following a “whistleblower” report in February 2023.

In reviewing documents from the beginning of 2023, the auditors found “pervasive” billing issues and recommended an exhaustive audit beginning in 2106, Webb said.

Speaking to “blank” entries that resulted in payment from Medicare, Webb said, “for lack of a better term, it’s fraud.”

Webb later said documentation would be available once the county submits a self-disclosure notice to Medicare.

During a quarterly financial report, Monroe County Treasurer Kevin Koenigstein mentioned the county’s “rental” line being funded at more than 180 percent already for the year, due in part to Accolade submitting lease payments in December, January and February. Per the lease agreement, Accolade will pay $750,000 in the first year of the lease with incremental increases in subsequent years.

Commissioner Vicki Koerber said she believed any Accolade lease payments would be placed in a separate account.

After a bit of discussion, action on the matter was delayed to a future meeting.

Koenigstein also noted the March 1 payment from Accolade in the amount of $62,500 “failed to clear” the local financial institution. He said the check was deposited March 2 and returned March 6.

Koenigstein also added Accolade issued another payment check on March 9 that thus far has not been returned.

Read more on Oak Hill and other county matters in the March 18 issue of the Republic-Times.

For last week’s article on past Medicare billing issues at Oak Hill, click here.