County residents eager to speak during the much anticipated special meeting of the Monroe County Board were forced to wait a few more weeks as Monday night’s meeting was postponed.

This meeting was to present information about a pending lease and possible future sale of the Oak Hill senior living and rehabilitation center in Waterloo to Accolade Healthcare. 

Unfortunately, Monroe County State’s Attorney Ryan Webb, who was to give an informational presentation about the lease, was not able to attend Monday night due to a medical emergency in his family. 

“We will not be making any further comment with respect to those private matters and ask that you keep the family in your prayers,” county officials stated in a press release.

The meeting has been rescheduled for Tuesday, Aug. 26, beginning at 6:30 p.m. at the Monroe County Courthouse.

Besides Webb being the presenter, he is also the county’s legal counsel.

Commissioners considered holding the meeting without Webb but did not feel comfortable proceeding without the presence of legal representation, Monroe County Clerk Jonathan McLean told the Republic-Times. 

Due to scheduling conflicts, Aug. 26 was the earliest date to reschedule this meeting. 

Commissioners are expected to approve the lease to Accolade during the meeting, following the presentation and public comment. 

Oak Hill has been the subject of much board discussion in recent years, with several lawsuits filed against Monroe County by employees and family members of Oak Hill residents in addition to a revolving door of administrators.

In July, commissioners approved Health Dimensions Group as an authorized agency to handle administrative staffing at Oak Hill following a tumultuous past five years which saw five different administrators overseeing the facility.

The most recent administrative exit was that of Alicia Emmerich, who resigned last month following a county audit report which found severe deficiencies in Oak Hill’s accounting practices, although no signs of “malfeasance.”

It was announced July 21 that Health Dimensions had installed Michael Moore as the newest Oak Hill administrator, although his tenure is likely to be short-lived.

If the lease with Accolade is approved as anticipated, the company will presumably appoint its own administrator in the near future. 

Monroe County Board Chairman George Green told the Republic-Times on Tuesday the agreement with Health Dimensions for its services may be ended at any time – meaning the pending lease would not violate any terms of the contract signed last month.

In an email sent by Green on Monday, he clarified the Health Dimensions  contract will “continue during the transition until Accolade places their administrator.”

Although fired in late September last year, former Oak Hill administrator Shari Kruep is at least in part responsible for a recent Center for Medicaid & Medicare Services rating downgrade.

Last week, it was learned Oak Hill was downgraded to a 4-Star facility according to the annual CMS provider information published July 31 at data.cms.gov. and medicare.gov.

The CMS rating designations for “nursing homes” are issued in July and are based on performance indicators and other factors from the prior year.

Oak Hill, which has for the most part maintained a prestigious 5-Star “overall” rating from CMS since 2010, regained 5-Star status in 2023 following a 4-Star rating in the 2022 CMS report.

A large component of the recent downgrade stems from an Aug. 23, 2024, state health inspection report which found “allegations of physical and sexual abuse” involving four different Oak Hill residents which occurred in January, July and August 2024.

The detailed report –  available at medicare.gov –  states the Oak Hill director of nursing “presented a stack of abuse allegations and stated that they were not reported to (the Illinois Department of Public Health)” during an Aug. 13, 2024, state inspection tour of the facility.

While many were not reported “because (Oak Hill staff) determined within two hours of the allegations that they were not abuse,” according to the inspection report, an employee only identified as “V1 Administrator” told the inspection team she did “not know why (three) allegations were not investigated.”

The administrator also told investigators Oak Hill “does not have a designated abuse coordinator,” but she and two other employees “look at each allegation and decide from there if it should be investigated or not.”

Commissioners terminated the employment of Kruep a little over a month after the inspection revealed her failure to have allegations submitted to IDPH per state and CMS guidelines.

While Kruep was already out as facility director when Monroe County was sued in October by a family member of an Oak Hill resident who died Oct. 29, 2023, the incident occurred about a year and a half into Kruep’s tenure as administrator.

In a May 10, 2023, Republic-Times article, a family member of a man who was admitted to Oak Hill shortly after Kruep’s hiring voiced allegations of repeated abuse and neglect with little to no communication from the facility about how to remedy the issues.

At the time, then-commissioner Dennis Knobloch said an investigation had been launched in response to those allegations.

Another likely cause of the CMS rating downgrade is also detailed in the August 2024 inspection report regarding Kruep’s handling of COVID-19 protocols at Oak Hill.

“Based on observation, interview and record review, the facility failed to ensure infection control procedures were in accordance with current standards of practice for COVID-19,” the report stated. “This failure has the potential to affect all 133 residents residing in the facility.”

One incident detailed in the report describes an Aug. 20, 2024, incident involving a resident who shared a room with another resident who had recently tested positive for COVID.

Kruep’s own failure to personally follow protocol was also noted in her letter of termination obtained by FOIA request.

While COVID-positive, Kruep “repeatedly presented at Oak Hill” even though she was instructed to remain off-property, the termination letter stated.

In addition to Kruep’s indiscretions, Monroe County officials have dealt with several lawsuits filed by former employees. 

The county settled a wrongful termination lawsuit with former Oak Hill director of nursing Susan Nordhaus in 2023. 

Nordhaus was awarded $125,000 with the stipulation the suit be dismissed with prejudice and Nordhaus’ personnel employment file indicate “voluntary resignation” as the designation for her separation of employment from Oak Hill in October 2021.

Monroe County is still in litigation with another former employee, Jennifer Morgan, who sued the county in June 2023 following what she described as a “violation of the Illinois  Human Rights Act” which led to her termination.

Morgan alleges Oak Hill administration engaged in “retaliation” for reporting allegations of sexual harassment by another recent former administrator, Brian Koontz, which ultimately led to the end of her employment in late 2021.

Koontz resigned as Oak Hill administrator in October 2021 after being placed on administrative leave a little over one year into his tenure.

While the personnel lawsuits did not affect the recent CMS rating, they serve as more recent examples of the business Monroe County officials hope to avoid for at least the next five years if the lease to Accolade is approved later this month – although commissioners will likely receive an earful from county residents prior to that vote on Aug. 26.