Nacogdoches County Hospital District

What Nacogdoches County Hospital District does

The Nacogdoches County Hospital District is a political subdivision of the State of Texas established in 1967 by the Texas Legislature under Section 9, Article IX, Texas Constitution, governed by an elected Board of Directors representing Nacogdoches County's four commissioner precincts and at-large members. The District's mandate is to provide healthcare access to Nacogdoches County residents regardless of ability to pay, operating through three core service lines: (1) Nacogdoches County EMS, which delivers 911 emergency ambulance response from two strategically placed substations; (2) Non-Emergency Transportation Services, offering wheelchair and medical transport at $50 base plus $3.50/mile per trip to doctor appointments, dialysis, therapy, and dental visits, accepting Medicaid, Medicare, and self-pay; and (3) the Medical Assistance Program (MAP), which administers the County Indigent Health Care Program (CIHCP) under the 1985 Indigent Health Care and Treatment Act as payor of last resort for low-income residents. Support entities include the Nacogdoches Memorial Hospital Auxiliary, the Nacogdoches County Healthcare Foundation, and the Nacogdoches Memorial Hospital Foundation (501(c)(3) nonprofits), plus a gift shop, community health resource directory, outreach programs, and a retirement plan administration function.

Revenue mechanics rely on a dedicated county sales tax, transportation fees, and ancillary gift shop and donation flows. There is no proprietary technology platform; the District operates publicly through its website (nachd.org) with a modest social media presence (Facebook, Instagram, LinkedIn). The District employs a leadership team including CEO Rhonda McCabe (CPA, MS Health Care Administration, 30+ years medical industry experience), CFO James Pool, VP of Clinical Operations/CNO Stacy Garcia, Indigent Program Director José Jesús Rubalcava, and a multi-disciplinary EMS and program staff. Fitch Ratings affirmed the District's credit rating at CC in April 2020.

A defining strategic event is the July 2021 Hospital Facility Lease and Asset Purchase Agreement with Lion Star Nacogdoches Hospital, LLC, which outsourced operations of Nacogdoches Memorial Hospital. Following a Notice of Termination in October 2023, Lion Star filed for bankruptcy in November 2023 with $10M-$50M in unpaid liabilities and 200-999 creditors, prompting service closures (Obstetrics Unit, Garrison Clinic) and layoffs. The District is currently pursuing Federal Bankruptcy Court action to regain direct control of hospital operations and has wired over $2 million to satisfy HHSC recoupment obligations, while continuing to operate EMS, transport, and MAP services uninterrupted.

Name

Nacogdoches County Hospital District

Legal name

Nacogdoches County Hospital District

Website

https://nachd.org

Company type

Private

Founded year

1967

Operating status

Operating

Headcount range

11–50 employees

Short description

The Nacogdoches County Hospital District is a Texas political subdivision providing emergency medical services, non-emergency medical transportation, and indigent healthcare programs to Nacogdoches County residents pursuant to a 1967 constitutional mandate.

Ownership category

akta.pro rank

Product category

Public Healthcare Services

NAICS

General Medical and Surgical Hospitals (62211), Health Care and Social Assistance (62)

SIC

Services-Health Services (8000), Services-General Medical & Surgical Hospitals, Nec (8062)

akta.pro primary industry

County/District/Local Health Departments (HLAJAAAB)

akta.pro secondary industries

Local Public Health & Human Services Administration (BPAIACAK), Community & Regional General Hospitals (HLAFAAAB)

Keywords

• Emergency medical services
• Non-emergency medical transportation
• Indigent healthcare program
• Public hospital district
• Community health services

Headquarters

HQ city

Nacogdoches

HQ country

United States

HQ region

North America

Offices5 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Supply Chain, Others, Marketing or Sales

Revenue model

1. Sales Tax Revenue: The district manages sales tax revenue generated to provide indigent care in the community. As a political subdivision established under Section 9, Article IX, Texas Constitution, the district collects tax revenue from community members to fund healthcare services.
2. Transportation Service Payments: Revenue from transportation services including Medicaid, Medicare, and self-pay payments. Non-emergency transportation charges $50 + $3.50/mile per trip.

Pricing tiers

Distribution channels3 records

Marketing channels5 records

Core offering

The Nacogdoches County Hospital District is a Texas political subdivision that provides emergency medical services through Nacogdoches County EMS, non-emergency medical transportation for county residents and contracted healthcare facilities, and the Medical Assistance Program (MAP) indigent healthcare program funded by sales tax. It also administers supporting foundations, volunteer auxiliary services, community health resources, and outreach programs serving Nacogdoches County, Texas.

Product overview

Nacogdoches County Hospital District operates as a unified healthcare services organization offering emergency and non-emergency medical transportation, indigent healthcare assistance, and community health support programs. The portfolio consists of Nacogdoches County EMS (emergency ambulance services), Non-Emergency Transportation Services, Medical Assistance Program (indigent care), and auxiliary/foundation support services including the Nacogdoches Memorial Hospital Auxiliary, Nacogdoches County Healthcare Foundation, Nacogdoches Memorial Hospital Foundation, Gift Shop, Community Health Resources directory, Outreach Programs, and Retirement Plan Administration. These services work together to provide comprehensive healthcare access regardless of ability to pay for Nacogdoches County residents.

Differentiator

Problem solved

Functional benefit

Products and services

• Nacogdoches County EMS

Named customers5 records

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

Five partnerships are on record, tiered core and minor.

• County Indigent Health Care Program (CIHCP)coreStrategic or Co-development Partner · 1 January 1985The Hospital District administers a Medical Assistance Program which fulfills Nacogdoches County's obligation to meet the provisions of the County Indigent Health Care Program (CIHCP) which was established by the Indigent Health Care and Treatment Act in 1985. This program provides covered medical services to low income residents through local physicians, hospitals, and other facilities.
• Westward Trails Nursing and RehabilitationminorOthersContracted local facility for non-emergency wheelchair transportation services since 2021.
• Stallings Court Nursing and RehabilitationminorOthersContracted local facility for non-emergency wheelchair transportation services since 2021.
• Willowbrook Nursing CenterminorOthersContracted local facility for non-emergency wheelchair transportation services since 2021.
• Magnolia Court Assisted LivingminorOthersContracted local facility for non-emergency wheelchair transportation services since 2021.

Scale indicators2 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Ector County Hospital District (Medical Center Hospital): Texas county hospital district running a community general hospital funded by tax revenue; directly comparable governance, funding model, and acute-care service mix.
• Titus County Hospital District: A small Texas county hospital district operating Titus Regional Medical Center; comparable in scale and rural-East Texas operating profile to Nacogdoches County Hospital District.
• Smith County Hospital District (UT Health East Texas): Another East Texas county hospital district operating a hospital and ancillary community health services, with a similar mix of acute care, EMS-adjacent services, and indigent-care obligations — making it the closest geographic and structural analogue.
• Midland County Hospital District (Midland Memorial Hospital): County hospital district in West Texas operating a community hospital with similar tax-supported funding structure and indigent-care responsibilities.

Emerging players

• MTM (Medical Transportation Management): NEMT broker serving Medicaid and managed-care populations with comparable wheelchair/medical transport focus; useful comparator for the District's non-emergency transportation arm.

Broad incumbents

• American Medical Response (AMR): Largest private EMS provider in the U.S., operating 911 and interfacility transport services; relevant comparison for Nacogdoches County EMS's scale and operating model.
• Modivcare: Major non-emergency medical transportation broker and Medicaid managed-care transportation provider; broadly comparable NEMT service model and payer mix (Medicaid/Medicare/self-pay).
• Parkland Health (Dallas County Hospital District): Much larger urban Texas county hospital district operating a major safety-net hospital; provides a useful scale-up benchmark for the same governance and payer-of-last-resort model.
• JPS Health Network (Tarrant County Hospital District): Large Texas county hospital district operating a full health system including hospital, EMS, and outpatient services — comparable governance structure at significantly larger scale.

Regional players

• Acadian Ambulance Service: Large private EMS and NEMT provider across the Gulf South including Texas; comparable EMS and medical transportation operations, though privately held and broader in scope.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/NacogdochesCountyHospitalDistrict
• LinkedInlinkedin.com/company/nacogdoches-county-hospital-district
• Instagraminstagram.com/healthynacogdoches

Revenue estimate

Valuation estimate

Number of profiles

Profiles12 records

Subsidiaries6 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Nacogdoches County Hospital District