In a move expected to secure hundreds of millions in private and state funds, the DeKalb County Commission approved a lease agreement Tuesday that would shift operational control of Grady Memorial Hospital to a new nonprofit corporation.

The unanimous vote is one of the last hurdles in the management restructuring designed to save the financially crippled hospital.

The lease agreement shifts daily operations of the hospital system from the hospital board of trustees and puts it under control of a nonprofit board of business and community leaders; the Grady board would continue to have broad oversight and would own the real estate.

The power shift would fulfill the demand of state and business leaders who have promised, in exchange, millions in extra funding for the hospital.

Fulton County commissioners approved the lease agreement last week.

Both votes are significant because, for decades, Fulton and DeKalb's elected commissioners have appointed all 10 members of the Grady board.

Under the new agreement, the county commissioners' power would be diminished as Grady shifts control over policies and budget from the Grady board to the proposed nonprofit.

The Grady board is expected to name the members of the nonprofit as early as Monday.