While the operational takeover of Oak Hill will not be finalized until the beginning of December, the lease of the county-owned senior living and rehabilitation center to Accolade Healthcare began Wednesday.

A special meeting of the Monroe County Board was scheduled Monday afternoon.

The meeting, held at 3 p.m. Oct. 1 at the Monroe County Courthouse, began with public comment before adjourning to a closed session. 

Following the closed session, commissioners approved commencement of a five-year lease and a consulting agreement with Accolade from Oct. 1 through Nov. 30.

Comments from the public varied, with most individuals – among them some former Oak Hill employees – lobbing criticism at the board for, as they said, withholding information from the public or not seeking out alternatives to leasing the facility.

Further critique honed in on the board’s agreement with Accolade, with some members of the public taking issue with Accolade’s management of some low-rated facilities compared to Oak Hill which rates between four and five stars.

Among the last to speak was Anna Johnson, who has been serving as a contracted interim director of Oak Hill in recent weeks.

She emphasized her place as a neutral party separate from the board and Accolade, speaking in their defense.

Johnson spoke in favor of the board’s recent behavior surrounding the Oak Hill situation, saying that they seem to be striving to maintain the facility and arguing that a board of commissioners with many other responsibilities simply isn’t able to properly manage or oversee a care facility nowadays given the tremendous amount of nursing facility regulations that have been added over the years, especially in the years since the start of the COVID-19 pandemic.

She further spoke to the dire situation care facilities like Oak Hill have found themselves in since the start of the pandemic, with the relevant work force being drastically reduced.

Further, Johnson defended those Accolade facilities with poor ratings, arguing that such facilities with a low rating have still seen improvement, suggesting that Accolade has taken no-star facilities and built them up.

Referencing her experience in the field, she also argued that such ratings don’t paint a full picture of a facility’s capability. Though some facilities can receive glowing assessments, she said, any mistake or infraction can heavily impact their rating, even if the issue has been addressed and amended.

Ultimately, Johnson urged those present to “shift your thinking on this to the big picture,” reiterating her view that the board is striving to maintain Oak Hill.

Board Chairman George Green confirmed Monday the consulting agreement will allow Accolade to assist Monroe County with Oak Hill operations while approval of a required “certificate of need” is pending through the Illinois Health Facilities and Services Review Board.

The state board is scheduled to vote on Accolade’s certificate of need during its Nov. 18 meeting.

Green also confirmed on Monday that the lease agreement is required by the HFSRB as part of its issuance of a certificate of need.

A motion to authorize Green to execute the lease was approved during an Aug. 26 special meeting.

At the time, county officials anticipated the lease being enacted Oct. 1, although several setbacks since then led the involved parties to believe lease authorization would not be possible until November or December.

However, Monroe County Clerk Jonathan McLean told the Republic-Times he received word about 1 p.m. Monday afternoon that all issues had been resolved, clearing a path for execution of the lease.

McLean previously explained that any changes at Oak Hill would need to begin on the first of the month due to payroll, billing and other considerations.

The unusual meeting time was due to a desire to begin the lease term on Oct. 1 while also satisfying requirements of the Illinois Open Meetings Act.

A public body that has a website must post any meeting agenda online at least 48 hours in advance. Since the agenda for Wednesday’s meeting was posted on monroecountyil.gov shortly before 3 p.m. Monday, the earliest the meeting could begin was 3 p.m. Wednesday.

With the lease is authorized, Accolade will still need to be issued a certificate of need to officially assume operations at Oak Hill.

As previously reported, a hearing to gather further public input on Accolade’s certificate of need application will be held from 4-7 p.m. next Wednesday, Oct. 8, at the Monroe County Annex in Waterloo.

HFSRB representatives will be on hand during the Oct. 8 hearing for the sole purpose of officially recording public comment to be considered during the Nov. 18 meeting. 

Monroe County and Oak Hill officials are not required to attend the meeting.  

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 about that report must be received by Nov. 10. 

If the certificate is issued, the operational transfer of Oak Hill to Accolade is expected to begin Dec. 1.

During the five-year lease, county officials are planning to conduct periodic reviews of the state of business and quality of service at Oak Hill, although Accolade will then be responsible for all operational aspects of the facility.

Monroe County will retain its ownership of Oak Hill’s “real property” – namely the buildings and land – for the duration of the initial lease.

Accolade will pay $750,000 for use of the property and business operations with a 2 percent “rent escalator” increase for each of the four remaining years.

If all parties agree to enter into a second lease agreement, commissioners have stated a referendum would be placed on a ballot in 2030 or 2032 asking Monroe County voters if the Oak Hill facilities and land should be sold to Accolade for $14 million.