The fate of a proposed operational transfer of the Oak Hill senior living and rehabilitation center in Waterloo will be decided Tuesday morning in Bolingbrook during a meeting of the Illinois Health Facilities and Services Review Board.

Preparations to allow Accolade Healthcare to assume operations at Oak Hill for at least the next five years have not gone as smoothly as county officials would have liked ahead of a vote for final approval of this matter.

In addition to overwhelmingly negative reaction to the proposal during several rounds of public comment, the review board has since noted a perceived violation of protocol due to Accolade’s recent involvement with the county-owned facility.

A project report published on the HFSRB website Nov. 5 alleges an unauthorized “change of control” following a lease of the Oak Hill buildings and property signed Aug. 26.

The lease, along with a “consulting agreement” designed to allow Accolade to assist with Oak Hill operations prior to HFSRB approval, became effective Oct. 1.

Operations at the facility remain under the authority of Monroe County pending issuance of a “certificate of need,” which the state board will consider during its Nov. 18 meeting; however, the project report describes the lease as a de facto transfer of Oak Hill ownership to Accolade.

The report states,  “From documents received by the (HFSRB), it appears that a change of control of (Oak Hill) has occurred before the approval of the State Board.” 

The report seems to take issue with the effective date of the lease more than the consulting agreement, with the “summary” section stating “a change in operational control or ownership of a facility’s physical plant and capital assets is defined as a ‘change of ownership’ and is not permitted” without prior approval of the HFSRB.

One of the documents received was submitted Oct. 13 by a current resident of Oak Hill. 

His submission included a letter inviting the “residents, families and friends” of Oak Hill to an event to “Meet our New Administrator Eli (Kamins) and the Accolade Healthcare Team” on Oct. 9.  

On Tuesday, Monroe County State’s Attorney Ryan Webb offered his opinion on the matter as legal counsel for the county.

Webb told the Republic-Times that county officials “disagree with the interpretation of the agreements and the conclusion that control has been transferred,” noting further clarification will be provided during Tuesday’s HFSRB meeting.  

Webb believes an explanation of “the intricacies of the various agreements (will) demonstrate that no control has been given at this juncture,” adding any transfer of control involving Oak Hill would occur Dec. 1, “and then only after receiving approval from the facilities review board.” 

The Nov. 5 report also  found the Accolade application was “not in conformance” with Illinois statute due to “Type A and Type AA violations” which occurred at other Accolade facilities in Illinois within the past three years not being reported in the original project application.

A list of relevant violations was submitted Oct. 22 by Anne Cooper, an attorney for Accolade.

The list of 10 violations occurred from 2022-2025 at Accolade facilities in Danville and Peoria and at two separate facilities in Paxton.

Among these violations are several falls leading to a skull fracture and other bone fractures and supposed “failures” resulting in the amputation of a fingertip, skin lacerations and other occurrences requiring hospitalization.   

The report also summarized public input, which was accepted through Oct. 29.

A late submission, dated Oct. 28, was submitted by former Oak Hill administrator Kim Keckritz, who served in that role for nearly 20 years. 

The letter was mislabeled as “support,” as  Keckritz rebuts the stated rational given by county officials for no longer being able to effectively operate Oak Hill.

Keckritz repeatedly states the issues of industry regulations, Medicare billing and others may be remedied through hiring of qualified individuals or the use of a management company – which Monroe County did from the late 1990s through the early 2010s.

“The county never had the expertise (to operate Oak Hill), but this expertise is available through hiring a competent administrator or a management company to oversee operations,” her letter states.

She also took issue with the assertion of recent excessive turnover of administrators at Oak Hill.

“Five administrators in five years – I’m not sure how this was calculated.  I was the administrator from 2001-2020, so I don’t believe you can count me as someone who turned over quickly,” the letter reads. “The last administrator was not even initially licensed and did not have the experience necessary to run Oak Hill.  I do not believe an adequate search was made to find a qualified administrator for this position to help Oak Hill succeed. There was not one ad placed on Indeed, which is a major recruitment tool.”

Keckritz also discounted a claim that additional, costly consultants would need to be hired for future county management of Oak Hill.

“I’m not sure why this is the case. When I was the administrator there, we did not have high-priced consultants, and we were profitable and maintained a five-star rating,” the letter continued, once again claiming “proper staff or a management company” would be a suitable solution.

Her letter concludes with an appeal for the HFSRB to “keep our home as the haven it has been for our older adults.”

The previously mentioned resident’s letter also  questions Accolade’s personnel decision. 

“Accolade proposes to place a nursing home administrator with only three years of nursing home experience in charge of Oak Hill,” the letter points out.  “In their own welcoming letter, they state that he is ‘excited to work with the current experienced staff.’ That phrasing alone should give us pause — because it implies that Accolade is depending on the very people they may soon displace or overburden, rather than bringing the depth of experience our residents deserve.”

Public comment on the Nov. 5 HFSRB project was accepted through Nov. 10.

A Nov. 7 submission by Waterloo resident Judy Niemann further alleges that “Accolade has taken over control of Oak Hill operations in a ‘consulting’ capacity.” 

Her submission alleges Accolade staff have already initiated changes to Oak Hill’s “electronic health care system,” “dietary/food” operations and dress code policies.

Niemann also claims one resident asked to meet with Kamins on Oct. 16 “to ask questions and ease his anxiety,” and Kamins had not “attempted to speak with” the resident as of Nov. 7.

The Nov. 5 staff report, along with all written public comment and a transcript of the Oct. 8 HFSRB hearing held in Waterloo, are available online at hfsrb.illinois.gov by searching “25-031 Oak Hill.” 

Oak Hill, which began as Monroe County Nursing Home nearly 75 years ago, remains one of the few county-owned skilled nursing facilities in the state.

A plan to lease the facility’s property and business operations to Accolade Healthcare for five years was approved by the Monroe County Board during a special meeting on Aug. 11.

If approved, and if both parties are satisfied after an initial five-year lease term, the agreement will be renewed for another five years and taxpayers will be asked to vote on a referendum question concerning the outright sale of the Oak Hill property and operations in either 2030 or 2032.

Monroe County officials are expected to be on hand for the Nov. 18 meeting and vote, and a group opposed to the operational transfer is also reportedly planning to attend.