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MCH began with the privately owned Medina Hospital, which was located at 1705 21st Street in Hondo. In the early 1960's when the elderly owners decided to close the old hospital, a group of community leaders decided that a new hospital facility was needed. The concept was put to the voters of Medina County, and after an initial defeat, Medina Memorial Hospital was approved. The hospital is located on a 6.8 acre site in southeast Hondo. Half of the financing for the original structure was arranged through the federal Hill-Burton Act program, and the other half from county and city funds. The first Board of Managers included John H. Poerner, Chairman, Louis E. Hart, Vice Chairman, William E. Berger, Secretary/Treasurer, Robert Zuberbueler, Hilmar b. Haegelin, Edgar Stiegler and J. Travis Lilly.

Additions in 1983, 1986 and 1989 have increased service in the outpatient and emergency services department. In 1987 the hospital's name was changed from Medina Memorial to Medina Community Hospital to better reflect the hospital's role in serving Medina County and the surrounding area.

In 2001, Medina County and the City of Hondo began discussions for the transfer of ownership to a new Municipal Hospital Authority. On December 1, 2002, the assets of Medina Community Hospital were transferred to the Hondo Hospital Authority. The Authority's nine-member Board of Directors is appointed as the mission of providing quality and convenient healthcare remains the same, and Medina Community Hospital continues to function solely on revenues from operations, state funds and grants and revenue bonds. Volunteers on the Board of Directors are: Rita Vance, President; Carlton "Corky" Young, Vice President; Judy Winkler, Secretary/Treasurer; Steve Hackebeil, Mario Garcia, Tima Barrientes, Lisa Rothe, Arthur Tottie Ilse and Mark Hiler.

Medina Community Hospital is one of the larger employers in the county, and a major contributor to the local economy. MCH employs a total of 190 full and part-time employees with an annual payroll of $4.6 million. The hospital and clinics employ a variety of professionals, from physician assistants, certified health technicians and varying levels of skilled nursing staff, to hospital management, administrative support, billing specialists, clerical staff, dietary, housekeeping and maintenace personnel.