Jeff Samz, president and CEO of the Huntsville Hospital Health System, delivered a presentation to the Huntsville City Council regarding its recent acquisition of Crestwood Medical Center. (CMC)

During the council’s regularly scheduled meeting on Thursday, April 24, he outlined the hospital system’s large footprint across North Alabama, its role as a major employer and economic driver, and its commitment to community health initiatives.

According to Samz, Huntsville Hospital has a $7.4 billion economic impact on the region and nearly 22,000 employees, making it the largest employer after Redstone Arsenal.

During his presentation, the CEO explained that the acquisition of Crestwood was a strategic decision to keep a vital community asset under local, nonprofit governance after its for-profit parent company, Community Health Systems, decided to sell.

Samz said Huntsville Hospital learned just before Thanksgiving that Crestwood was on the market.

“When they approached us about the possibility of maintaining over local governance, we worked with that board you saw and made a challenging decision that we felt like local governance over something as important as health care was the right thing to do,” he said.

Huntsville Hospital’s acquisition of Crestwood was officially completed on March 31, 2026.

“Until we closed the transaction, they didn’t want me and the media talking about their company. That’s why I couldn’t talk about this until tonight,” Samz said.

Samz detailed plans for significant capital investment in Crestwood and addressed public concerns regarding the merger’s potential impact on health care costs, nursing wages, and CMC’s operations.

“In the first 90 days we’ve been there, we’ve already committed $4 billion of capital investment in Crestwood,” he said.

BRYBNK Hville HereToday Digital 780x130 2

According to Samz, Crestwood is and has been financially successful, and prior to the acquisition, most of the money earned from its operation was not staying in the Huntsville area.

“Of the cash generated from the operation of Crestwood, well over 90% was leaving our community to go to shareholders or retire their debt. That changes going forward. All of those dollars will stay in our community and every dollar will get reinvested in the hospital,” Samz said.

Samz addressed comments from community members who were concerned that Huntsville Hospital would start charging higher rates for health care and that hospital leadership would personally profit from the acquisition.

Samz said that no one on his team, including himself, receives extra compensation due to the acquisition.

“Our compensation is completely disconnected from how we perform at Crestwood or the acquisition itself,” Samz said.

Samz said that while the hospital system does not have the ability to dictate health care prices, over half of its reimbursement comes from Medicare and Medicaid at below-cost rates.

He said that the remainder is negotiated with a single commercial insurer (Blue Cross Blue Shield of Alabama) that dominates over 90% of the market in the state.

“I assure you I cannot dictate what they pay us for care. We are a larger regional health care system. We feel like we’ve leveled the playing field a little bit, but I assure you I have no ability to dictate what people pay for health care,” Samz said.

Samz’s presentation was followed by a question-and-answer session with council members.

Huntsville City Council President Pro Tem Bill Kling, District 4 asked Samz if the Crestwood brand and operations would remain unchanged.

Samz replied and explained to Kling that Crestwood will keep its existing brand and name after the acquisition.

“Crestwood going to stay Crestwood. There’s an incredible culture there. It’s a little smaller hospital. Parking’s a little easier. We respect the history. We’re going to keep that hospital the same,” Samz said.

Samz added that the hospital’s staff were absorbed into the Huntsville Hospital System and that their compensation would not change.

Regarding pay for nurses, Samz stated that the Huntsville Hospital system had invested $65 million in nursing compensation adjustments since 2021, with another $30 million planned for July. He insisted that despite community pushback, Huntsville Hospital remains competitive in its pay for medical professionals.

“We don’t control the market for nursing. We’re trying our best to support nursing, to support training for nursing, and make sure they’re compensated fairly for the amazing work they do,” Samz said.

At the end of the discussion period with council members, a tense exchange unfolded between Samz and Huntsville City Council member Michelle Watkins, District 1 over transparency and board representation.

Watkins strongly criticized Samz for failing to communicate with the public and elected officials about the merger.

“As an elected official and as a representative from my district, operating in transparency at all times, even when it’s difficult, even when it’s controversial, you have to stand in your truth. I’m disappointed because Huntsville Hospital did not offer that to the citizens and they wanted those questions answered,” Watkins said.

Samz reiterated that legal agreements prevented him from speaking about the merger sooner.

“Regarding the transparency, we signed nondisclosure agreements. CHS is a publicly traded company. I was not allowed to answer questions. I would have been violating a contract I signed,” Samz said.

Watkins expressed strong feelings about a lack of representation for District 1 on Huntsville Hospital’s board.

“With this new merger, I would like to know, is District 1 going to be considered to have someone, a resident, not someone that works in District 1, but a resident of District 1 on the board?,” Watkins said.

Samz said that other areas, such as Decatur, which is part of the Huntsville Hospital system, would like board representation, highlighting the challenge of geographic representation across their large service area.

When Watkins pressed him on this issue, he reiterated his willingness to work with her on board representation for District 1 residents.

“I’m certain there are qualified people in District 1 who would be great board members. We would be happy to build a relationship with you going forward,” Samz said.

The exchange created significant tension, not only with Samz, but also between Watkins and Huntsville City Council President Jennie Robinsion, District 3. The heated discussion led to a brief recess.

While Samz provided a comprehensive update to the council, it remained clear that both council members, and the public are closely watching Huntsville Hospital’s control of the area’s healthcare.

After his presentation, Samz stepped out into the hallway to talk privately with residents who had questions and concerns regarding their experience with the Huntsville Hospital System.