Our Administration

Virgil Underwood

Chief Executive Officer & President 

Virgil Underwood, a West Virginia native, was born in Fayette County. He moved to Kanawha County after graduating from college and has lived in Boone County for over 20 years.

Virgil has a B.S. Degree in Business from the West Virginia Institute of Technology, became a Certified Public Accountant in 1982, and received a post-graduate certificate from the Bank Administration Institute Controllership Program at the University of Wisconsin. Additionally, he has held licenses as a General Securities Representative, a Uniform Investment Advisor, an Accredited ACH Professional, a Property & Casualty Insurance Advisor, a Retirement Planner, and obtained his private pilot’s license.

Virgil worked as Vice-President of One Valley Bank for eleven years, was a Financial Consultant and Coach for Merrill Lynch for seven years, and Co-Owner of Allstate Insurance Agencies in Southern WV for fourteen years before working with Boone Memorial Hospital as a Board Member and Consultant.

Virgil has been deeply involved in his community serving on various boards including the American Lung Association, Junior Achievement of WV, Madison Buddy League Basketball, Madison Little League Baseball, Boone County Community Foundation Distribution Committee, and Driven Knights.

Virgil currently resides in Madison with his wife, Liz, and their two children Patrick and Katie. Virgil also has two older sons, Jason and Adam, and four grandchildren.

Angela Christian, MHA, BSN, RN, CRNI

Chief Operating Officer

Angie joined the Administrative Team at Boone Memorial Health in March 2019. As Chief Operating Officer, she provides strategic leadership, steering hospital operations toward excellence and innovation.

Before joining Boone Memorial Health, Angie served as Vice President of Nursing for a national infusion company, where she played a key role in shaping the direction of the organization. Prior to that, she served as a Regional General Manager overseeing pharmacies and infusion suites. Angie’s diverse experience also includes working as a private nurse for a cardiology practice, and as a hospital staff nurse, with roles in the emergency room, surgery, and post cardiac catheterization unit.

Angie received her Associate Degree in Nursing from Southern West Virginia Community & Technical College. Graduating summa cum laude from South University, she holds a Bachelor of Science Degree in Nursing and a Master of Healthcare Administration. Additionally, she is a Certified Registered Nurse Infusion (CRNI), which is a nationally recognized and accredited credential for nurses specializing in infusion therapy. She resides in Alum Creek with her husband, Derek. They are proud parents to four children and doting grandparents to a grandson.

D. Cole Malcolm, CPA

Chief Financial Officer

Cole joined Boone Memorial Health in October 2022 as its Chief Financial Officer. As CFO, Cole provides strategic leadership for BMH’s business and finance functions and is responsible for the management of its financial and capital resources. This responsibility includes financial reporting, accounts receivable and payable, sponsored projects accounting, financial systems, audit, treasury, special projects, and corporate finance.

Prior to joining BMH, Cole was a Senior Manager within the FORVIS Healthcare (previously Dixon Hughes Goodman) assurance and advisory practice and a manager with Ernst & Young in Charleston, West Virginia.

With nearly 20 years of experience, Cole has maintained a strategic focus on healthcare for the majority of his professional career. His prior experience includes serving clients that provided care throughout the continuum of a patient’s life. Cole’s financial statement audit and consulting portfolio consisted of a wide range of acute care facilities that ranged from small community and critical access facilities to large, multi-state academic medical centers. His post-acute experience included skilled nursing facilities, rehabilitation hospitals, and other long-term care organizations that specialized in independent living, assisted living, and memory care. He also served clients in the non-acute space, which included physician practices, ambulatory surgery centers, drug treatment facilities, and other non-acute providers.

Cole graduated Magna Cum Laude with a Bachelor of Science in Business Administration (Accounting & Finance) from Concord University. He also earned a Master of Business Administration from Morehead State University.

Cole lives in Saint Albans, West Virginia and is very active in the local community, including volunteering at his local church, Bible Center (Charleston, WV). He and his wife, Mary Beth, have twin children that bless their home on a daily basis.

Terri Castle, RN

Chief Nursing Officer

Terri started her nursing career in 1992 as a Nursing graduate from Southern WV Community College. Her inspiration to pursue a nursing degree started after her completion of a Pre-med course and additional Secondary Educational studies in Math and Biology at Marshall University. She began her employment at Boone Memorial Health in 2002 as an ER nurse. Her overall career experience includes Emergency Nursing, Home Health, Cardiology, and Psychiatric nursing.

Her current and previous certifications include ACLS, PALS, BTLS, CPR, TCI, and NIMS. She has been a member of the Stroke Pilot Project of WV, Advisory Council Representative of CORE, and an Advisory Committee Member at Southern WV Community and Technical College. In 2007, she became Assistant Director of Emergency Services and Education Coordinator at BMH. Her position advanced to Assistant Director of Nursing in 2011. Terri was named Chief Nursing Officer in 2015.

Terri graduated from the University of Louisiana Lafayette with a BSN Degree. She is a resident of Boone County and lives with her husband David Castle. Together, Terri and David have six children; Brooke, Levi, Garrett, Chandler, Jagger, and Maddiex.

David Gresham

Chief Development Officer

David joined Boone Memorial Health in 2008 as Revenue Cycle Manager and was promoted to Chief Development Officer in 2015. He previously served as CFO and Assistant Administrator of several Southern West Virginia hospitals including Logan General, Williamson ARH, Welch Emergency Hospital, and Cabell Huntington Hospital. David graduated from Morris Harvey College in 1978 and attended The Ohio State University’s Graduate Executive Program in HealthCare Administration in 1982. David brings over 40 years of healthcare experience to Boone in the areas of Finance, Billing, Administration, Recruitment, and Business Development.

David is an SSAC Registered Umpire and has coached various community sports teams such as Little League and Buddy League basketball. He is an avid golfer and gun enthusiast.

David resides in Chapmanville with his wife Marsha. They have three children: Ryan, Zac, and Makayla.

Ray Harrell, Jr., Esq.

General Counsel & Chief External Affairs Officer

Ray serves as General Counsel and Chief External Affairs Officer for Boone Memorial Health. As General Counsel, Ray oversees the legal affairs of the company and provides legal advice and counsel to the Chief Executive Officer, Administration, and management teams, and the BMH Board of Directors. As Chief External Affairs Officer, Ray manages the BMH Foundation for Community Health and is also responsible for public relations and marketing, fundraising, grant funding strategy, and government affairs.

Prior to joining BMH, Ray practiced in the Labor & Employment and Government Relations groups of Dinsmore & Shohl LLP; an AmLaw 200 U.S. law firm headquartered in Cincinnati, Ohio. Ray was named to the 2020 West Virginia Rising Stars list by Super Lawyers, and was one of ten attorneys selected to participate in the 2019 West Virginia Bar Foundation Lawyer Leadership Institute.

Ray serves on the West Virginia Hospital Association Legislative Committee and the HOSPAC Board of Trustees. He is an active member of the West Virginia State Bar and the American College of Healthcare Executives, and also serves on the Board of Directors for Capitol Market, and The Greater Kanawha Valley Foundation Economic Development Task Force. Ray previously served on the Marshall University Alumni Association Board of Directors and the West Virginia Bar Association Executive Council.

Ray is a cum laude graduate of the University of Florida Levin College of Law, where he earned his Juris Doctor degree and served as President of the Florida Moot Court Team. He received his Bachelor of Arts in Political Science, cum laude, from Marshall University, where he served as Student Body President. He resides in Charleston with his wife, Ashton, and their three daughters.

Amy Parker Sayre, MD

Chief Medical Officer

Dr. Sayre has been part of the Boone Memorial Health family on a full-time basis since 2017. She grew up in Madison, WV and graduated Valedictorian of Scott High School in 1993. She attended West Virginia University and graduated with a BS in Exercise Physiology. At WVU she was a member of the Pride of WV, playing trumpet in the WVU Marching Band from 1993-1996 and remains an avid Mountaineer fan. She went on to WVU School of Medicine graduating in 2002. Dr. Sayre furthered her medical education at the Washington Hospital, completing a three-year family medicine residency, and is board-certified in family medicine.

In 2005, Dr. Sayre returned to serve her hometown as a family physician with Madison Medical Group, and cared for coal miners and their families at the WV Family Wellness Center. She then spent nine years caring for patients in Chapmanville, WV. In 2017, she returned to her roots in Madison and started a family medicine practice in conjunction with Boone Memorial Hospital. In her family practice, Dr. Sayre cares for men, women, and children of all ages. She has a special interest in preventative medicine, health education, and women’s health. She also served as Chief of the Medical Staff from 2020-2021.

Amy currently resides in Madison with her husband Jeremy, who is a personal fitness trainer. They have one daughter, Callie, who is an honor student at West Virginia University. They enjoy running, biking, Disney, and spending time on Hilton Head Island.

Crystal Smarr, MHA

Chief Human Resources Officer

Crystal Smarr joined Boone Memorial Health in August 2023 as its Chief Human Resources Officer (CHRO). In her role, Crystal is responsible for leading BMH’s overall human resources strategy, talent acquisition, leadership development, diversity and inclusion, organizational design and cultural development, employee education and development, compensation and benefits, HR operations and technology, and employee relations.

Before joining the administration team at Boone Memorial Health, Crystal served as Vice President of Human Resources for Commercial Holdings/AMFM, LLC for over 20 years. In this position, she had responsibility for all human resources-related services for 25 companies with over 2000 employees, including: employee/labor relations, diversity and inclusion, compliance, recruitment, talent planning, learning and development, organizational development, compensation, benefits, and workforce planning.

Crystal holds a Master of Science in Health Care Administration from Marshall University and a Bachelor of Science in Strategic Leadership from the University of Charleston.

Crystal serves as a Board Member with Applied Behavior Learning Center, LLC (ABLC) and is also an active volunteer at Charleston Catholic High School.

Outside of work, Crystal enjoys traveling, cooking, and spending time with her family and friends. She currently resides in South Charleston with her husband David and son, Clayton.