MONTGOMERY — Huntsville Hospital has received the go-ahead to build a 60-bed, not-for-profit hospital in Madison.

The state Certificate of Need Review Board voted 5-3 Wednesday to award construction to Huntsville Hospital. It overruled a judge’s recommendation to award the certificate to Crestwood Medical Center’s parent company, Community Health Systems Inc. of Franklin, Tenn., which had hoped to build a for-profit hospital in Madison.

“That is the best case scenario for us since Athens-Limestone Hospital is now partnered with Huntsville Hospital,” said Limestone County Commission Chairman David Seibert, who along with Athens Mayor Dan Williams and other city and county leaders attended the meeting.

In awarding the new hospital to Huntsville, the board overruled the recommendation of a state administrative law judge who heard evidence in the case in early 2007. Judge Randy Reaves had recommended then that Community Health Systems Inc. of Franklin, Tenn., receive the certificate of need. The Alabama Court of Civil Appeals last year ruled against Athens-Limestone Hospital which opposed the new hospital, clearing the way for it to be built along U.S. 72 East in Madison.

“We can live with this decision because Huntsville Hospital wants to build a not-for-profit hospital,” Williams said. “We wanted Huntsville because we feel like it would hurt our hospital less since we are now in partnership with them.

“If Crestwood had gotten it, they would have built a for-profit hospital. Madison city officials wanted Crestwood because they wanted the tax money generated from a for-profit hospital.”

Athens-Limestone Hospital officials earlier contended in a lawsuit filed against the Madison hospital that, in the past, hospital beds in Alabama have always been awarded to counties and not cities.

Athens officials worry that a new hospital in Madison would draw patients from the East Limestone area and cause financial problems for the local hospital, which is also not-for-profit.

In late December of last year, Athens-Limestone and Huntsville Hospital officials announced a formal affiliation in light of cooperative efforts over the past five years.

Both not-for-profit hospitals acknowledged that the affiliation is a compromise to a four-and-a-half-year fight by Athens against both Huntsville Hospital’s and Crestwood’s efforts to build in Madison and a way to improve local health care by sharing resources.