Although Monday’s Monroe County Board meeting adjourned within 20 minutes of being called to order, it was enough time for local residents to voice a number of lingering concerns – “transparency” being the word of the day.

Accolade Healthcare of Waterloo, formerly known as Oak Hill, dominated a majority of discussion.

Commissioners were scheduled to address billing discrepancies with the Center for Medicare and Medicaid Services which, in part, led to commissioners approving a five-year lease and possible sale of the county-owned senior living and rehabilitation center.

While Monroe County still owns the property at 623 Hamacher Street in Waterloo, Accolade Healthcare officially assumed business operations Dec. 1 following the Illinois Health Facilities and Services Review Board issuing a required “certificate of need” during its November meeting.

During public comment Monday morning, former Oak Hill Director of Nursing Zoe Weakly called on commissioners to fulfill their duties as described by the HFSRB.

In a “permit approval letter” to commissioners dated Nov. 25, 2025, the HFSRB listed two conditions of the county board moving forward.

As of Monday, at least one of those conditions has not been satisfied. 

As part of the permit being issued, commissioners must “provide all available documentation regarding the process of selecting viable candidates to lease and/or operate Oak Hill.” 

Those documents include anything that describes “the ultimate decision-making process leading to the selection of Accolade Ventures LLC, including, without limitation, (Monroe) County Board meeting minutes, public notices, requests for proposals (RFPs), memorandums, communications to candidates, residents and community members, etc.”

On Monday, Weakly asked commissioners why RFP reports were still unavailable to the taxpaying public.

RFPs are official documents issued by governing bodies or businesses that announce a project or initiative which involve entities separate from the primary organization.

When the plan to lease Oak Hill was announced in early August, Chairman George Green said county officials had been seeking a solution to improve Oak Hill for some time, adding most companies were not interested in leasing the facility because it would not allow them to collateralize assets. 

With the search for potential lessees seeming to include multiple candidates, Weakly and the HFSRB assume the RFP method was used to identify organizations qualified to take over Oak Hill operations.

Even if commissioners never drafted such proposals, the county board is still be responsible for collecting and sharing any documents and communications that describe the selection process.

Weakly said she has submitted a Freedom of Information Act request to obtain any RFPs which may have been issued, although she said she has still not received a response from the county.

As of press time, the only documents available on Monroe County’s website are the information used in a presentation given during an Aug. 26 special meeting, an “operations transfer agreement,” “consulting agreement” and a copy of the official lease agreement.

The HFSRB also lists meeting minutes as one medium used to communicate the decision making process.

Monroe County Democratic Central Committee Vice-Chair Scot Luchtefeld asked about meeting minutes during public comment Monday.

Luchtefeld was not asking for the minutes specifically for Oak Hill purposes, but he did question why closed-session minutes have not been released or made available through the county’s website. 

Although meeting agendas and minutes are available as far back as 2016 at monroecountyil.gov, it does not appear as if any of the minutes have been updated to include closed session minutes.

Many times, closed sessions involve personnel matters or pending litigation and prevent them from being shared as long as the respective issue is still under consideration; however, Luchtefeld pointed out that the absence of any closed session minutes from the past 10 years points to a lack of transparency by commissioners past and present. 

Organizations that do release closed-session minutes also have the option to redact any sensitive or ongoing matters.

Luchtefeld also suggested a lack of transparency when he asked commissioners why the bids for Oak Hill roof repairs approved in October were similarly not available.

He elaborated by pointing to a number of other financial matters he believed were not properly documented for public review.

Board meeting agendas posted on the county’s website have traditionally only included agenda items but no accompanying documents.

For the Feb. 2 meeting, the online agenda includes a description of pending approvals exceeding $10,000 and documents related to a special use permit request.

The documents attached to Monday’s meeting agenda are the exception, with almost all other agendas from 2014 to the present only containing agenda items or meeting schedules.

During her comments, Weakly also referred to the “strong recommendation” of the HFSRB to closely monitor conditions at the Accolade facility in Waterloo due to a number of issues found at other Accolade facilities.

Weakly conceded commissioners would provide financial oversight, but she urged the board to monitor quality of care at the facility, as well. 

In its Nov. 25 letter to commissioners, the HFSRB also noted Monroe County must also produce “quarterly reports about the performance, financial and safety metrics provided by Accolade Ventures, LLC for a period of 12 months following the approval” that went into effect Dec. 1.

March 1 of this year will mark the first quarter of Accolade operations at the former Oak Hill site.

Also speaking Monday morning was former Oak Hill nursing director Donna DeWilde.

She credited Green for being the only Monroe County official to attend the November HFSRB meeting near Chicago.

DeWilde also thanked the board as a whole for its public handling of suspected billing irregularities and “not sweeping it under the carpet.”

She had expected a report on the financial audit of Oak Hill finances from 2016 through 2022, but said she understood the “timing was bad,” adding that “Oak Hill should still be important to county leadership.

Green apologized for not having the audit report available as stated on the agenda, explaining it is “still undergoing final review.”

The audit is expected to be addressed during the next regular board meeting to be held Tuesday, Feb. 17.

The meeting will not be held on Monday, Feb. 16, for observance of President’s Day.

There is also a special meeting scheduled to begin at 8:30 a.m. this Monday, Feb. 9, although a closed session is the only agenda item.

All county board meetings are held at the Monroe County Courthouse in Waterloo.