﻿<?xml version="1.0" encoding="utf-8"?>
<Return returnVersion="2024v5.0" xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-11-04T13:49:47-07:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>660755792</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Rodriguez Rivera &amp; Toro PSC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>PO Box 1080</AddressLine1Txt>
        <CityNm>Mayaguez</CityNm>
        <StateAbbreviationCd>PR</StateAbbreviationCd>
        <ZIPCd>00681</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>660292961</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MED CENTRO INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>MEDC</BusinessNameControlTxt>
      <PhoneNum>7878439393</PhoneNum>
      <USAddress>
        <AddressLine1Txt>PO Box 220</AddressLine1Txt>
        <CityNm>Mercedita</CityNm>
        <StateAbbreviationCd>PR</StateAbbreviationCd>
        <ZIPCd>007150220</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Lcdo Allan Cintron Salichs</PersonNm>
      <PersonTitleTxt>Executive Director</PersonTitleTxt>
      <PhoneNum>7878439393</PhoneNum>
      <SignatureDt>2025-10-15</SignatureDt>
      <DiscussWithPaidPreparerInd>0</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Cristian Vera Mercado CPA</PreparerPersonNm>
      <PTIN>P00856276</PTIN>
      <PhoneNum>7878343100</PhoneNum>
      <PreparationDt>2025-10-15</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="R000001" referenceDocumentId="R000005 R000006" softwareId="24021167" softwareVersionNum="v1.00">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>Med Centro</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>Lcdo Allan Cintron Salichs</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>PO Box 220</AddressLine1Txt>
        <CityNm>Mercedita</CityNm>
        <StateAbbreviationCd>PR</StateAbbreviationCd>
        <ZIPCd>007150220</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>161650122</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>https://www.medcentro.org/</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1971</FormationYr>
      <LegalDomicileStateCd>PR</LegalDomicileStateCd>
      <ActivityOrMissionDesc>To provide primary health care services, specially to low income individuals and families, including agricultural workers in the Municipalities of Ponce, Peñuelas, Juana Diaz, Villalba and other adjacent areas.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>14</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>14</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>541</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>14535690</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>13534994</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>152395366</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>145411631</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>378867</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>2354109</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>374398</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>349388</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>167684321</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>161650122</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>28119359</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>32346328</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>113604575</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>118672614</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>141723934</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>151018942</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>25960387</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>10631180</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>143928875</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>156153146</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>8089564</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>9682655</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>135839311</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>146470491</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>To provide primary health care services, specially to low income individuals and families, including agricultural workers in the Municipalities of Ponce, Peñuelas, Juana Diaz, Villalba and other adjacent areas.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>123477175</ExpenseAmt>
      <GrantAmt>13534994</GrantAmt>
      <RevenueAmt>145576973</RevenueAmt>
      <Desc>Primary Health Care Program. The activity consists in providing health care services, specially to low income individuals and families, including agricultural workers in the municipalities of Ponce, Peñuelas, Juana Diaz, Villalba and other adjacent areas.</Desc>
      <TotalOtherProgSrvcExpenseAmt>0</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>0</TotalOtherProgSrvcGrantAmt>
      <TotalOtherProgSrvcRevenueAmt>0</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>123477175</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="R000002">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd>0</DonorAdvisedFundInd>
      <ConservationEasementsInd>0</ConservationEasementsInd>
      <CollectionsOfArtInd>0</CollectionsOfArtInd>
      <CreditCounselingInd>0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="R000003">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd>0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="R000003">1</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd>0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="R000003">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd>0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="R000003">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="R000003">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="R000004">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>0</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>541</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>14</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>14</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Consejo de Salud de Puerto Rico Inc Med Centro</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>Med Centro</BusinessNameLine2Txt>
        </BusinessName>
        <PhoneNum>7878439393</PhoneNum>
        <USAddress>
          <AddressLine1Txt>PO Box 220</AddressLine1Txt>
          <CityNm>Mercedita</CityNm>
          <StateAbbreviationCd>PR</StateAbbreviationCd>
          <ZIPCd>007150220</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mrs Awilda Garcia Rodriguez MD</PersonNm>
        <TitleTxt>Medical Director Mentor</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1285031</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lcdo Allan Cintron Salichs</PersonNm>
        <TitleTxt>Executive Director CEO</TitleTxt>
        <AverageHoursPerWeekRt>40</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1135613</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Antonio R Alvarez Rodriguez</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>320885</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Felix E Maldonado Santos</PersonNm>
        <TitleTxt>Psychiatrist</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>273589</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Ricardo Cedeno Rivera</PersonNm>
        <TitleTxt>Clinical Specialized Director</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>224896</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Carlos F Garcia Borrero</PersonNm>
        <TitleTxt>Family Physician</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>204331</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dra Karen Berrios Vazquez</PersonNm>
        <TitleTxt>General Practitioner</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>198243</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Javier A Caraballo Velez</PersonNm>
        <TitleTxt>Medial Director ER UR</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>194877</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CPA Javier Ruberte Rosado</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>193307</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>4030772</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>70</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Bufete Fernandez &amp; Alcaraz</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>Capital Center Building South Tower</AddressLine1Txt>
            <AddressLine2Txt>239 Arterial Hostos</AddressLine2Txt>
            <CityNm>San Juan</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00918</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Legal Services</ServicesDesc>
        <CompensationAmt>1571501</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Serralles Construction</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>Urb Mansion Real</AddressLine1Txt>
            <AddressLine2Txt>Calle Andalucia 706</AddressLine2Txt>
            <CityNm>Ponce</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00780</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Construction</ServicesDesc>
        <CompensationAmt>6813486</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AEM Construction LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>Urb Villas del Prado</AddressLine1Txt>
            <AddressLine2Txt>47 Calle Imperial</AddressLine2Txt>
            <CityNm>Juana Diaz</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00795</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Consulting Services</ServicesDesc>
        <CompensationAmt>412112</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Guardian Security Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1004 Ave RH Todd</AddressLine1Txt>
            <CityNm>San Juan</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00907</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Security</ServicesDesc>
        <CompensationAmt>794546</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>DLA Imaging LLC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>Urb Senderos En Montehiedra</AddressLine1Txt>
            <AddressLine2Txt>70 Calle Aquamarina</AddressLine2Txt>
            <CityNm>San Juan</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00907</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Radiology Services</ServicesDesc>
        <CompensationAmt>486950</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>16</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>13534994</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>0</AllOtherContributionsAmt>
      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>13534994</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Premium Revenue - PR Health Reform</Desc>
        <BusinessCd>524114</BusinessCd>
        <TotalRevenueColumnAmt>102443543</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>102443543</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Net Patient Service Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>9765869</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9765869</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Net Pharmacy Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>10254992</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10254992</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Wraparound Reimbursement</Desc>
        <BusinessCd>524114</BusinessCd>
        <TotalRevenueColumnAmt>21276954</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>21276954</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>1670273</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1670273</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>145411631</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>165142</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>165142</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>2188967</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2188967</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>349388</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>349388</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>349388</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>349388</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>161650122</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>148115128</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2934836</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2934836</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>20761576</TotalAmt>
        <ProgramServicesAmt>15803411</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4958165</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>6039585</TotalAmt>
        <ProgramServicesAmt>4482375</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1557210</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>2610331</TotalAmt>
        <ProgramServicesAmt>1740860</ProgramServicesAmt>
        <ManagementAndGeneralAmt>869471</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>2302422</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2302422</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>93220</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>93220</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>4680978</TotalAmt>
        <ProgramServicesAmt>2361926</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2319052</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>1955004</TotalAmt>
        <ProgramServicesAmt>293</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1954711</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>211901</TotalAmt>
        <ProgramServicesAmt>36623</ProgramServicesAmt>
        <ManagementAndGeneralAmt>175278</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>146</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>146</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>4251677</TotalAmt>
        <ProgramServicesAmt>692250</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3559427</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>931258</TotalAmt>
        <ProgramServicesAmt>52005</ProgramServicesAmt>
        <ManagementAndGeneralAmt>879253</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Claims Paid and IBNR Reserve</Desc>
        <TotalAmt>93375830</TotalAmt>
        <ProgramServicesAmt>93375830</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Equipment</Desc>
        <TotalAmt>592014</TotalAmt>
        <ProgramServicesAmt>127427</ProgramServicesAmt>
        <ManagementAndGeneralAmt>464587</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Consumable Supplies</Desc>
        <TotalAmt>4638765</TotalAmt>
        <ProgramServicesAmt>4340053</ProgramServicesAmt>
        <ManagementAndGeneralAmt>298712</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Repair and Maintenance</Desc>
        <TotalAmt>1746026</TotalAmt>
        <ProgramServicesAmt>311567</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1434459</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>3893373</TotalAmt>
        <ProgramServicesAmt>152555</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3740818</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>151018942</TotalAmt>
        <ProgramServicesAmt>123477175</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27541767</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>61236620</BOYAmt>
        <EOYAmt>13588853</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>9622046</BOYAmt>
        <EOYAmt>7873181</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>813291</BOYAmt>
        <EOYAmt>935941</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>685791</BOYAmt>
        <EOYAmt>1531504</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>106641097</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>31143636</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>69129916</BOYAmt>
        <EOYAmt>75497461</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>52185545</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>2441211</BOYAmt>
        <EOYAmt>4540661</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>143928875</BOYAmt>
        <EOYAmt>156153146</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>5536284</BOYAmt>
        <EOYAmt>6485147</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>0</BOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>0</BOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>0</BOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>2553280</BOYAmt>
        <EOYAmt>3197508</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>8089564</BOYAmt>
        <EOYAmt>9682655</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>134017522</BOYAmt>
        <EOYAmt>2257808</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>1821789</BOYAmt>
        <EOYAmt>144212683</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>135839311</BOYAmt>
        <EOYAmt>146470491</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>143928875</BOYAmt>
        <EOYAmt>156153146</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>10631180</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>0</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <InvestmentExpenseAmt>0</InvestmentExpenseAmt>
      <PriorPeriodAdjustmentsAmt>0</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <AuditCommitteeInd>0</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="R000002" softwareId="24021167" softwareVersionNum="v1.00">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>75208434</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>97623516</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>122991742</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>152395366</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>145576973</CurrentTaxYearAmt>
        <TotalAmt>593796031</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>75208434</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>97623516</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>122991742</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>152395366</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>145576973</CurrentTaxYearAmt>
        <TotalAmt>593796031</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>593796031</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>65839</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>61321</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>79639</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>378867</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2188967</CurrentTaxYearAmt>
        <TotalAmt>2774633</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>596570664</TotalSupportAmt>
      <PublicSupportCY170Pct>0.99535</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99875</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsPY170Ind>X</ThirtyThrPctSuprtTestsPY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="R000003" softwareId="24021167" softwareVersionNum="v1.00">
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>16667645</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <BookValueAmt>16667645</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>55650083</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>16122287</DepreciationAmt>
        <BookValueAmt>39527796</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <InvestmentCostOrOtherBasisAmt>1829259</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>585139</DepreciationAmt>
        <BookValueAmt>1244120</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>13043001</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>8016265</DepreciationAmt>
        <BookValueAmt>5026736</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>19451109</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>6419945</DepreciationAmt>
        <BookValueAmt>13031164</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>75497461</TotalBookValueLandBuildingsAmt>
      <InvstProgramRelatedOrgGrp>
        <Desc>US Treasury Bills</Desc>
        <BookValueAmt>52185545</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </InvstProgramRelatedOrgGrp>
      <TotalBookValueProgramRltdAmt>52185545</TotalBookValueProgramRltdAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred Compensation Plan Obligation</Desc>
        <Amt>3197508</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>3197508</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>161650122</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>0</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <RecoveriesPriorYearGrantsAmt>0</RecoveriesPriorYearGrantsAmt>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>161650122</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>0</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>161650122</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>151018942</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>0</DonatedServicesUseFcltsAmt>
      <PriorYearAdjustmentsAmt>0</PriorYearAdjustmentsAmt>
      <LossesReportedAmt>0</LossesReportedAmt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>151018942</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>0</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>151018942</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="R000004" softwareId="24021167" softwareVersionNum="v1.00">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>1</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Lcdo Allan Cintron Salichs</PersonNm>
        <TitleTxt>Executive Director CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>1135613</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1135613</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mrs Awilda Garcia Rodriguez MD</PersonNm>
        <TitleTxt>Medical Director Mentor</TitleTxt>
        <BaseCompensationFilingOrgAmt>1285031</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1285031</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Antonio R Alvarez Rodriguez</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>320885</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>320885</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CPA Javier Ruberte Rosado</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>193307</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>193307</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Felix E Maldonado Santos</PersonNm>
        <TitleTxt>Psychiatrist</TitleTxt>
        <BaseCompensationFilingOrgAmt>273589</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>273589</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Ricardo Cedeno Rivera</PersonNm>
        <TitleTxt>Clinical Specialized Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>224896</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>224896</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Javier A Caraballo Velez</PersonNm>
        <TitleTxt>Medial Director ER UR</TitleTxt>
        <BaseCompensationFilingOrgAmt>194877</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>194877</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dra Karen Berrios Vazquez</PersonNm>
        <TitleTxt>General Practitioner</TitleTxt>
        <BaseCompensationFilingOrgAmt>198243</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>198243</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Carlos F Garcia Borrero</PersonNm>
        <TitleTxt>Family Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>204331</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>204331</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the Executive Director is determined and approved by the government Board. The compensation is established based on experience, qualifications and performance, in addition it is compared with the compensation of other executives in similar positions in Puerto Rico.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Effective November 1st, 2013 the Organization established an Executive Deferred Compensation Plan, a non-qualified deferred compensation plan covering eligible senior management as defined in the Plan Adoption Agreement. The Plan is designed and operates in accordance with regulations under the Puerto Rico Internal Revenue Code, as amended and is not subject to the provisions of the Employee Retirement Income Security Act of 1974 (ERISA).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Executive deferred compensation plan is accrued based on the institution's excess program income as stated in the adoption plan agreement.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="R000005" softwareId="24021167" softwareVersionNum="v1.00">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is prepared by personnel of tax department by the external audit firm from the accounting records, other tax information and data used to prepare the audited financial statements. Once it is prepared, the Form is submitted to the top management (including personnel of Finance Department with suitable knowledge and skills to review and evaluate the form) for review and discussion of doubts with audit's firm personnel. Once discussed and all doubts cleared with the audit firm, the Executive Director present and discuss the form with the Governing Board for approval. Once approved by the Board the firm electronically submit it to the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization has a conflict of interest policy which is monitored by the top management and the Governing Board. An annual conflict of interest declaration is required by the members of the board as well as every employee of the Organization. Top management and Governing Board monitor the conflict of interest policy by analyzing sensitive transactions and contractual information and by requiring employees to disclose their relationship with third parties. The policy is also enforced through seminars and conferences to officers and key personnel.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation of Directors and Officers are primarily determined by the Executive Director based on experience, qualifications, performance and by using comparable statistically data from job positions in Puerto Rico. Once the compensation is determined it is presented to the Governing Board for approval.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing documents such as the conflict of interest policy and audited financial statements might be available for public inspection at the administrative office of the Organization under the supervision of an Official of the Organization. The availability of such documents may depend on the purpose of requesting such information.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <ReasonableCauseExplanation documentId="R000006" softwareId="24021167" softwareVersionNum="v1.00">
      <ExplanationTxt>A timely extension request was filed before the original due date of the return; therefore, no late-filing penalties should apply.</ExplanationTxt>
    </ReasonableCauseExplanation>
  </ReturnData>
</Return>