Nutex Health Inc.; Nutex Health, LLC; And Tyvan, LLC v. Kyle ER, LLC; Kyle Assets, LLC; And Micro Hospital EP, PLLC

Texas Court of Appeals, 3rd District (Austin)·Decided May 8, 2026·No. 03-24-00289-CV·Published

Opinion

TEXAS COURT OF APPEALS, THIRD DISTRICT, AT AUSTIN

NO. 03-24-00289-CV

Nutex Health Inc.; Nutex Health, LLC; and Tyvan, LLC, Appellants v.

Kyle ER, LLC; Kyle Assets, LLC; and Micro Hospital EP, PLLC, Appellees

FROM THE 274TH DISTRICT COURT OF HAYS COUNTY NO. 23-2458, THE HONORABLE JOE POOL, JUDGE PRESIDING

MEMORANDUM OPINION

Appellants Nutex Health Inc.; Nutex Health, LLC; and Tyvan, LLC (collectively, “Administrators”) challenge the trial court’s order denying their motion to compel arbitration. In the underlying lawsuit, appellees Kyle ER, LLC; Kyle Assets, LLC; and Micro Hospital EP, PLLC (collectively, “Hospital Companies”), who own a hospital, assert claims for breach of contract, conversion, and unjust enrichment/money had and received against the Administrators, who formerly performed administrative services for the hospital. Because we conclude that the trial court did not err in denying the motion to compel arbitration, we affirm the trial court’s order.

BACKGROUND

The underlying suit has a complex procedural history. It encompasses two separate disputes involving the Hospital Companies. The dispute underlying this appeal is

between the Administrators and the Hospital Companies over the alleged mismanagement of the hospital’s administrative services. It arose after a prior dispute among the owners of the Hospital Companies over who controls those companies. To provide context for the Hospital Companies’ dispute with the Administrators, we describe the prior dispute over control of the Hospital Companies in the chronology below.

The Service Contracts Between the Hospital Companies and the Administrators The Hospital Companies provide emergency-care services in a hospital facility in Kyle, Texas. The hospital began operations in 2015. Kyle ER operates the hospital facility; Kyle Assets owns the facility and related real estate, and Micro Hospital provides medical services for the facility.

The Hospital Companies employed Nutex Health, LLC (Nutex) and Tyvan, LLC as third-party administrators to handle the day-to-day management and administration of the hospital facility. 1 From Kyle ER’s inception in October 2014 through early December 2023, Nutex provided services for the hospital facility that included marketing, processing payroll for employees and physicians, accounting services and bill paying, maintaining books and records, human-resources management, and regulatory-compliance oversight. According to the Administrators, Nutex provided those services under a management-services agreement between Nutex and Kyle ER (“Nutex Health Service Contract”). Although this service contract is not part

1 Nutex Health, Inc.is the publicly traded parent company of numerous entities, including companies that provide management and administrative services for emergency-care facilities in many states. The Hospital Companies sued it in its capacity as the parent company of Nutex Health, LLC and Tyvan, LLC. It is undisputed that the Hospital Companies have no service contract with Nutex Health, Inc. and that there is no arbitration agreement between those parties.

of the record, it is undisputed that any such contract does not contemplate arbitration of disputes between the parties.

From March 2018 through December 2023, Tyvan provided coding, billing, and collection services for the hospital facility. Kyle ER and Tyvan entered into the Tyvan Facility Coding, Billing, and Collections Agreement (“Tyvan Service Contract”). The Tyvan Service Contract does not contain an arbitration provision or otherwise contemplate arbitration of disputes between the parties. We collectively refer to the Tyvan Service Contract and the Nutex Service Contract as the “Service Contracts.”

A Dispute Arises Between Nutex’s CEO and Other Members of the Hospital Companies Dr. Thomas Vo is the CEO and Chairman of Nutex Health, Inc. In 2021, Vo proposed a merger involving the exchange of shares of Nutex Health, Inc. with the membership interests of Kyle ER. Five of the eight members of Kyle ER agreed to the merger and traded some or all of their membership interests in exchange for Nutex Health, Inc. shares. The transaction was effective on April 1, 2022. As a result, Nutex Health, Inc. acquired 46.32% of Kyle ER, which included the 41.05% interest that Dr. Vo previously individually owned. Nutex Health Inc.’s ownership interest is held by Nutex Health Holdco, LLC. Nutex Health Holdco is a wholly owned subsidiary of Nutex Health, Inc. 2 Dr. Donna Campbell, one of the members of Kyle ER and of the other two Hospital Companies who chose not to participate in the merger and retained her ownership of her membership interest in Kyle ER, sent a demand for the books and records of the three Hospital

2 Although Nutex Health Holdco is a member of Kyle ER, it is not an Administrator and thus, it is not a party to this appeal. In addition, the members who were not transferring their membership interests to Nutex Health Holdco voted to admit Nutex Health Holdco as an assignee but not as a full substituted member with voting rights.

Companies on May 24, 2023. She directed her demand to Vo as CEO of Nutex Health, Inc. and as Operations Manager and Tax Matters Member of the three Hospital Companies. Campbell’s demand invoked various sections of the Kyle ER Company Agreement, the Kyle Assets Company Agreement, and the Micro Hospital Operating Agreement (collectively, “Hospital Company Agreements”), as well as various sections of the Texas Business Organizations Code.

Each Hospital Company Agreement has a dispute-resolution provision that requires all disputes related to the Company Agreement, its construction, or its breach to first be submitted to the LLC members collectively. 3 If a member concludes that the members are unable to resolve the dispute within ten days, the members must seek resolution through mediation under prescribed procedures. If mediation fails to resolve the dispute within forty days of the dispute-submission date, then the matter must be decided by arbitration conducted under the rules of the American Arbitration Association (AAA). 4 On August 16, 2023, Campbell sent a letter to the members of the Hospital Companies, including Vo, informing all members of her document requests and her allegation that Nutex, on behalf of the Hospital Companies, had failed to provide documents in response to certain of her requests. She informed the members that she had no alternative but to submit the

3 Each Company Agreement defines “dispute” or “controversy” slightly differently, but those differences are immaterial for purposes of this opinion.

4 The specifics of the prescribed process slightly differ under the Micro Hospital Company Agreement, but it ultimately requires arbitration under the AAA rules if initial dispute- resolution efforts and mediation fail. Arguably, however, that Company Agreement does not constitute an agreement to arbitrate because that Company Agreement was never signed. Dr. Amanda Dupont, a member of the Hospital Companies, attested that the Micro Hospital Company Agreement has never been used to govern the Company. In addition, in December 2023, a majority of the Micro Hospital members passed a resolution in which they agreed that no governing documents had been executed, and thus, they believed that Texas Business Organizations Code Chapters 100 and 304 control Micro Hospital’s governance.

dispute to the members under the relevant dispute-resolution sections of the Hospital Company Agreements. The record does not reflect that any action was taken to mediate this dispute.

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Nutex Health Inc.; Nutex Health, LLC; And Tyvan, LLC v. Kyle ER, LLC; Kyle Assets, LLC; And Micro Hospital EP, PLLC, (Tex. Ct. App. 2026).

Nutex Health Inc.; Nutex Health, LLC; And Tyvan, LLC v. Kyle ER, LLC; Kyle Assets, LLC; And Micro Hospital EP, PLLC (Nutex Health Inc.; Nutex Health, LLC; And Tyvan, LLC v. Kyle ER, LLC; Kyle Assets, LLC; And Micro Hospital EP, PLLC) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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