﻿<?xml version="1.0" encoding="utf-8"?>
<Return returnVersion="2020v4.0" xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2021-12-23T09:25:30-07:00</ReturnTs>
    <TaxPeriodEndDt>2021-03-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>660561068</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>DIAZ &amp; CANDELARIA CPA PSC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerForeignAddress>
        <AddressLine1Txt>PMB 294</AddressLine1Txt>
        <AddressLine2Txt>100 GRAND PASEO BLVD STE 112</AddressLine2Txt>
        <CityNm>SAN JUAN</CityNm>
        <ProvinceOrStateNm>PR</ProvinceOrStateNm>
        <CountryCd>RQ</CountryCd>
        <ForeignPostalCd>00926-5955</ForeignPostalCd>
      </PreparerForeignAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2020-04-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>660437924</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>HPM FOUNDATION INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>HPMF</BusinessNameControlTxt>
      <PhoneNum>7872684171</PhoneNum>
      <ForeignAddress>
        <AddressLine1Txt>PO BOX 14457</AddressLine1Txt>
        <CityNm>SAN JUAN</CityNm>
        <ProvinceOrStateNm>PR</ProvinceOrStateNm>
        <CountryCd>RQ</CountryCd>
        <ForeignPostalCd>00916-4457</ForeignPostalCd>
      </ForeignAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>IVONNE RIVERA HERNANDEZ</PersonNm>
      <PersonTitleTxt>EXECUTIVE DIRECTOR</PersonTitleTxt>
      <PhoneNum>7872684171</PhoneNum>
      <SignatureDt>2021-12-23</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>JOSE G CANDELARIA CASTRO</PreparerPersonNm>
      <PTIN>P01448309</PTIN>
      <PhoneNum>7877606263</PhoneNum>
      <PreparationDt>2021-12-22</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>1</TrustedCustomerCd>
        <OOBSecurityVerificationCd>11</OOBSecurityVerificationCd>
        <LastSubmissionRqrOOBCd>1</LastSubmissionRqrOOBCd>
        <AuthenticationAssuranceLevelCd>AAL2</AuthenticationAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2020</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="5">
    <IRS990 documentId="R000001" referenceDocumentId="R000005" softwareId="20012124" softwareVersionNum="v1.00">
      <PrincipalOfficerNm>IVONNE RIVERA HERNANDEZ</PrincipalOfficerNm>
      <ForeignAddress>
        <AddressLine1Txt>PO BOX 14457</AddressLine1Txt>
        <CityNm>SAN JUAN</CityNm>
        <ProvinceOrStateNm>PR</ProvinceOrStateNm>
        <CountryCd>RQ</CountryCd>
        <ForeignPostalCd>00916-4457</ForeignPostalCd>
      </ForeignAddress>
      <GrossReceiptsAmt>53248661</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.healthpromed.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1987</FormationYr>
      <LegalDomicileStateCd>PR</LegalDomicileStateCd>
      <ActivityOrMissionDesc>Provide primary ambulatory, supplemental and environmental health services to the medically underserved residents in the Santurce Ward.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>11</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>11</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>219</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>6490777</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>8285666</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>29532253</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>41531823</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>13256</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>12063</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>3334033</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>3419109</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>39370319</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>53248661</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>8623685</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>9016441</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>29956184</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>40372385</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>38579869</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>49388826</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>790450</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>3859835</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>22146665</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>26018115</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>2607658</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>2619273</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>19539007</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>23398842</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>Provide primary ambulatory, supplemental and environmental health services to the medically underserved residents in the Santurce Ward of the Municipality of San Juan, Carolina and the Municipal island, Vieques and Culebra.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>44261856</ExpenseAmt>
      <GrantAmt>0</GrantAmt>
      <RevenueAmt>0</RevenueAmt>
      <Desc>Provide primary ambulatory, supplemental and environmental health services to the medically underserved residents in the Santurce Ward of the Municipality of San Juan, Carolina and the Municipal island, Vieques and Culebra. Our patients/clients received services in the following areas: general medicine, ginecology pediatry, dental, vision, clinical phychology and patient/community education.</Desc>
      <TotalOtherProgSrvcExpenseAmt>0</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>0</TotalOtherProgSrvcGrantAmt>
      <TotalOtherProgSrvcRevenueAmt>0</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>44261856</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>0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd>0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd>0</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>0</BackupWthldComplianceInd>
      <EmployeeCnt>219</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>0</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>11</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>11</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>1</OfficerMailingAddressInd>
      <LocalChaptersInd>1</LocalChaptersInd>
      <PoliciesReferenceChaptersInd>1</PoliciesReferenceChaptersInd>
      <Form990ProvidedToGvrnBodyInd>0</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>
        <PersonNm>ALEX GUERRERO IRIZARRI</PersonNm>
        <PhoneNum>7872684171</PhoneNum>
        <ForeignAddress>
          <AddressLine1Txt>PO BOX 14457</AddressLine1Txt>
          <CityNm>SAN JUAN</CityNm>
          <ProvinceOrStateNm>PR</ProvinceOrStateNm>
          <CountryCd>RQ</CountryCd>
          <ForeignPostalCd>00916-4457</ForeignPostalCd>
        </ForeignAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>IVONNE RIVERA HERNANDEZ</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>155805</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HECTOR L VILLANUEVA RODRIGUEZ</PersonNm>
        <TitleTxt>SENIOR MEDICAL CONSULTANT</TitleTxt>
        <AverageHoursPerWeekRt>40</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>135350</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JORGE F VAZQUEZ PEREZ</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>135248</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALWIN L TORRES ORTIZ</PersonNm>
        <TitleTxt>GENERAL PRACTITIONER</TitleTxt>
        <AverageHoursPerWeekRt>35</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>108617</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ZIDNIA M COLON BLANCO</PersonNm>
        <TitleTxt>FAMILY DOCTOR</TitleTxt>
        <AverageHoursPerWeekRt>35</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>105182</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL SERRANO CHERVONY</PersonNm>
        <TitleTxt>GENERAL PRACTITIONER</TitleTxt>
        <AverageHoursPerWeekRt>35</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>104014</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MIGUEL A RIVERA VIERA</PersonNm>
        <TitleTxt>FAMILY DOCTOR</TitleTxt>
        <AverageHoursPerWeekRt>35</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>101740</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAVIER MATOS VALENZUELA</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NELSON CORDERO GONZALEZ</PersonNm>
        <TitleTxt>VICEPRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CARMEN TORRES ESCUTE</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARITZA ESPINOSA RAMON</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELBA MARIN ENCARNACION</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>OSCAR REINOSA CEDO</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MONICA DE JESUS FIGUEROA</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VERONICA MELENDEZ GONZALEZ</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ZAIDA I TORRES RODRIGUEZ</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROSE MARIE CISNEROS CALDERON</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHARLIE ORTOLAZA MARTINEZ</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>845956</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>7</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Gonzalez Torres CPA Group PSC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <ForeignAddress>
            <AddressLine1Txt>1250 Ponce de Leon Ave</AddressLine1Txt>
            <AddressLine2Txt>Suite 801</AddressLine2Txt>
            <CityNm>San Juan</CityNm>
            <ProvinceOrStateNm>PR</ProvinceOrStateNm>
            <CountryCd>RQ</CountryCd>
            <ForeignPostalCd>00907-3912</ForeignPostalCd>
          </ForeignAddress>
        </ContractorAddress>
        <ServicesDesc>Fiscal Consultants</ServicesDesc>
        <CompensationAmt>289965</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Immuno Reference Lab</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <ForeignAddress>
            <AddressLine1Txt>Ave Munoz Rivera</AddressLine1Txt>
            <AddressLine2Txt>562</AddressLine2Txt>
            <CityNm>Hato Rey</CityNm>
            <ProvinceOrStateNm>PR</ProvinceOrStateNm>
            <CountryCd>RQ</CountryCd>
            <ForeignPostalCd>00918</ForeignPostalCd>
          </ForeignAddress>
        </ContractorAddress>
        <ServicesDesc>Laboratories</ServicesDesc>
        <CompensationAmt>225957</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Excel Professional Services Corporation</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <ForeignAddress>
            <AddressLine1Txt>Plaza 273 Suite 700</AddressLine1Txt>
            <AddressLine2Txt>273 Ave Ponce de Leon</AddressLine2Txt>
            <CityNm>San Juan</CityNm>
            <ProvinceOrStateNm>PR</ProvinceOrStateNm>
            <CountryCd>RQ</CountryCd>
            <ForeignPostalCd>00917-1934</ForeignPostalCd>
          </ForeignAddress>
        </ContractorAddress>
        <ServicesDesc>Radiology Services</ServicesDesc>
        <CompensationAmt>182694</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Quest Diagnostics</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <ForeignAddress>
            <AddressLine1Txt>PO Box 14457</AddressLine1Txt>
            <CityNm>San Juan</CityNm>
            <ProvinceOrStateNm>PR</ProvinceOrStateNm>
            <CountryCd>RQ</CountryCd>
            <ForeignPostalCd>00916</ForeignPostalCd>
          </ForeignAddress>
        </ContractorAddress>
        <ServicesDesc>LABORATORY</ServicesDesc>
        <CompensationAmt>159450</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Reno and Cavanaugh PLLC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <ForeignAddress>
            <AddressLine1Txt>PO BOX 14457</AddressLine1Txt>
            <CityNm>SAN JUAN</CityNm>
            <ProvinceOrStateNm>PR</ProvinceOrStateNm>
            <CountryCd>RQ</CountryCd>
            <ForeignPostalCd>00916-4457</ForeignPostalCd>
          </ForeignAddress>
        </ContractorAddress>
        <ServicesDesc>LEGAL SERVICES</ServicesDesc>
        <CompensationAmt>150960</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>9</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>7792807</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>492859</AllOtherContributionsAmt>
      <NoncashContributionsAmt>211405</NoncashContributionsAmt>
      <TotalContributionsAmt>8285666</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Premium Revenues (Capitation)</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>36316173</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>36316173</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Program Income</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>5215650</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5215650</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>41531823</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>12063</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>12063</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <OtherRevenueMiscGrp>
        <Desc>Wrap-around Reimbursement</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>3205660</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3205660</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>213449</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>213449</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>3419109</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>53248661</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>44962995</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>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>7091973</TotalAmt>
        <ProgramServicesAmt>5495206</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1596767</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1311336</TotalAmt>
        <ProgramServicesAmt>754051</ProgramServicesAmt>
        <ManagementAndGeneralAmt>557285</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>613132</TotalAmt>
        <ProgramServicesAmt>440101</ProgramServicesAmt>
        <ManagementAndGeneralAmt>173031</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>276427</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>276427</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>318797</TotalAmt>
        <ProgramServicesAmt>191278</ProgramServicesAmt>
        <ManagementAndGeneralAmt>127519</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>1953218</TotalAmt>
        <ProgramServicesAmt>1715447</ProgramServicesAmt>
        <ManagementAndGeneralAmt>237771</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>10275</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10275</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>538942</TotalAmt>
        <ProgramServicesAmt>328619</ProgramServicesAmt>
        <ManagementAndGeneralAmt>210323</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>861823</TotalAmt>
        <ProgramServicesAmt>228705</ProgramServicesAmt>
        <ManagementAndGeneralAmt>633118</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>164845</TotalAmt>
        <ProgramServicesAmt>98907</ProgramServicesAmt>
        <ManagementAndGeneralAmt>65938</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>126129</TotalAmt>
        <ProgramServicesAmt>31329</ProgramServicesAmt>
        <ManagementAndGeneralAmt>94800</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>53630</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>53630</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>40655</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>40655</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>861558</TotalAmt>
        <ProgramServicesAmt>533114</ProgramServicesAmt>
        <ManagementAndGeneralAmt>328444</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>223343</TotalAmt>
        <ProgramServicesAmt>134006</ProgramServicesAmt>
        <ManagementAndGeneralAmt>89337</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Claims Paid &amp; IBNR Retention</Desc>
        <TotalAmt>33171968</TotalAmt>
        <ProgramServicesAmt>33171968</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Drugs &amp; Medications</Desc>
        <TotalAmt>950698</TotalAmt>
        <ProgramServicesAmt>950698</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Reparirs &amp; Maintenance</Desc>
        <TotalAmt>316405</TotalAmt>
        <ProgramServicesAmt>10077</ProgramServicesAmt>
        <ManagementAndGeneralAmt>306328</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Utilities</Desc>
        <TotalAmt>269711</TotalAmt>
        <ProgramServicesAmt>161826</ProgramServicesAmt>
        <ManagementAndGeneralAmt>107885</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>233961</TotalAmt>
        <ProgramServicesAmt>16524</ProgramServicesAmt>
        <ManagementAndGeneralAmt>217437</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>49388826</TotalAmt>
        <ProgramServicesAmt>44261856</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5126970</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2791482</BOYAmt>
        <EOYAmt>5943552</EOYAmt>
      </CashNonInterestBearingGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>197462</BOYAmt>
        <EOYAmt>243282</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1702517</BOYAmt>
        <EOYAmt>2204213</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>76611</BOYAmt>
        <EOYAmt>249835</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <EOYAmt>62623</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>22702104</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>5787494</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>17345157</BOYAmt>
        <EOYAmt>16914610</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>33436</BOYAmt>
        <EOYAmt>400000</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>22146665</BOYAmt>
        <EOYAmt>26018115</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1918746</BOYAmt>
        <EOYAmt>2328928</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>688912</BOYAmt>
        <EOYAmt>290345</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>2607658</BOYAmt>
        <EOYAmt>2619273</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>19252140</BOYAmt>
        <EOYAmt>23286669</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>286867</BOYAmt>
        <EOYAmt>112173</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>19539007</BOYAmt>
        <EOYAmt>23398842</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>22146665</BOYAmt>
        <EOYAmt>26018115</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>3859835</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>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="R000002" softwareId="20012124" softwareVersionNum="v1.00">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="R000003" softwareId="20012124" softwareVersionNum="v1.00">
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>2994000</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <BookValueAmt>2994000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>15142360</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3891004</DepreciationAmt>
        <BookValueAmt>11251356</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <InvestmentCostOrOtherBasisAmt>1081049</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>875929</DepreciationAmt>
        <BookValueAmt>205120</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>948904</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>360912</DepreciationAmt>
        <BookValueAmt>587992</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>2535791</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>659649</DepreciationAmt>
        <BookValueAmt>1876142</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>16914610</TotalBookValueLandBuildingsAmt>
      <TotalRevEtcAuditedFinclStmtAmt>53248661</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>0</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <RecoveriesPriorYearGrantsAmt>0</RecoveriesPriorYearGrantsAmt>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>53248661</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>0</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>53248661</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>49388826</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>0</DonatedServicesUseFcltsAmt>
      <PriorYearAdjustmentsAmt>0</PriorYearAdjustmentsAmt>
      <LossesReportedAmt>0</LossesReportedAmt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>49388826</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>0</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>49388826</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="R000004" softwareId="20012124" softwareVersionNum="v1.00">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>IVONNE RIVERA HERNANDEZ</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>155805</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>155805</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="R000005" softwareId="20012124" softwareVersionNum="v1.00">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Monica De Jesus Figueroa - Villa Palmeras, 355 Calle Palacios, Santurce, PR 00915</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Finance Department review the 990 form versus the Financial Statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Annually, the conflict of interest is sent to all employees. Disclosures are analyzed and those showing signs of fraud or conflicts of interest are investigated.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Members do not receive compensation in a Board of Directors meeting. The Director discuss the compensation for the Key Employees. The Board evaluates the compensation criteria, compare to similar organizations and determines (based performance) any salary increase of charges.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing documents, conflict of interest policy and financial statements are available to the publicupon request.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>