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      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>L&amp;R ENGINEERING GROUP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1519 AVE PONCE DE LEON</AddressLine1Txt>
            <CityNm>San Juan</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00909</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ENGINEERING SERVICES</ServicesDesc>
        <CompensationAmt>3046281</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HEALTH PREVENTIVE AND EMER</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 622</AddressLine1Txt>
            <CityNm>BAYAMON</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00960</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDIC SERVICES</ServicesDesc>
        <CompensationAmt>2476498</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PLATINUM EMERGENCY CARE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>SOLUTION PSC 1300 WINSTON CHURCHILL</AddressLine1Txt>
            <CityNm>TRUJILLO ALTO</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00976</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDIC SERVICES</ServicesDesc>
        <CompensationAmt>1374322</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ADVANCED INVESTIGATION GRO</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 783</AddressLine1Txt>
            <CityNm>BAYAMON</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00960</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SECURITY</ServicesDesc>
        <CompensationAmt>1181360</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SG CONSTRCTION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 190410</AddressLine1Txt>
            <CityNm>SAN JUAN</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00919</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRUCTION</ServicesDesc>
        <CompensationAmt>1134033</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>37</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>12096892</GovernmentGrantsAmt>
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      <TotalContributionsAmt>12323447</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>All other Outpatient</Desc>
        <BusinessCd>621110</BusinessCd>
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        <ExclusionAmt>109978855</ExclusionAmt>
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      <TotalProgramServiceRevenueAmt>109978855</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
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        <ExclusionAmt>1538813</ExclusionAmt>
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      <NetIncmFromFundraisingEvtGrp>
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      <OtherRevenueMiscGrp>
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        <BusinessCd>621400</BusinessCd>
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        <ExclusionAmt>2245318</ExclusionAmt>
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      <OtherRevenueTotalAmt>2245318</OtherRevenueTotalAmt>
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        <ExclusionAmt>113762986</ExclusionAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
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        <ProgramServicesAmt>24335192</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7742842</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>654383</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
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        <ProgramServicesAmt>12855220</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1993942</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
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        <ManagementAndGeneralAmt>568962</ManagementAndGeneralAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>46973</ProgramServicesAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>3842637</ProgramServicesAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>830209</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2282</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <TotalAmt>21541279</TotalAmt>
        <ProgramServicesAmt>21541279</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
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        <ProgramServicesAmt>12371199</ProgramServicesAmt>
        <ManagementAndGeneralAmt>445207</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ManagementAndGeneralAmt>126689</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>152837240</EOYAmt>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
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      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
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      <OtherAssetsOrgGrp>
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      <OtherAssetsOrgGrp>
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      <RevenueSubtotalAmt>126086433</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>126086433</TotalRevenuePerForm990Amt>
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      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
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        <TitleTxt>President</TitleTxt>
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        <TotalCompensationFilingOrgAmt>283090</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <TotalCompensationFilingOrgAmt>191615</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ADA T TORRES</PersonNm>
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        <TotalCompensationFilingOrgAmt>240562</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANABELLE TORRES</PersonNm>
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        <TotalCompensationFilingOrgAmt>265061</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <TotalCompensationFilingOrgAmt>119572</TotalCompensationFilingOrgAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>See Schedule O</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>See Schedule O</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>See Schedule O</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IX Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Biomedical Total expenses - $87510.00 Program service expenses - $87510.00 Mgmt and general expenses - $0.00 Fundraising expenses - $0.00</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IX Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Other professional Total expenses - $14761652.00 Program service expenses - $12767710.00 Mgmt and general expenses - $1993942.00 Fundraising expenses - $0.00</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>Finance Committee of the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Provide excellent ambulatory and home care services</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>in a save environment to procure the physical, mental and social</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>well being of the residents of our communities. SIM provides</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>preventive primary and home health services that includes</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>many medical services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Provide excellent ambulatory and home care services</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>in a save environment to procure the physical, mental and social</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>well being of the residents of our communities. SIM provides</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>preventive primary and home health services that includes</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>many medical services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Once 990 Form is completed, draft is reviewed by management</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>and copy is handed to the governing body.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>In a Board of Directors meeting, the Directors discuss</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>the compensation for the key employees. The Board evaluates</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>the compensation criteria, compare to similar orgainzations</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>and determines (based performance) any salary increase.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Goverment documents, conflict of interest policy and</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>financial statements is available to the public upon</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VII Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing Body do not received compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>