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            <ZIPCd>00970</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Construction</ServicesDesc>
        <CompensationAmt>457110</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NATIONAL BUILDING MAINTENANCE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <ForeignAddress>
            <AddressLine1Txt>855 AVE HOSTOS</AddressLine1Txt>
            <CityNm>PONCE</CityNm>
            <ProvinceOrStateNm>PR</ProvinceOrStateNm>
            <CountryCd>RQ</CountryCd>
            <ForeignPostalCd>00716-1105</ForeignPostalCd>
          </ForeignAddress>
        </ContractorAddress>
        <ServicesDesc>Maintenance</ServicesDesc>
        <CompensationAmt>185449</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>JORGE RIVERA RIVERA</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <ForeignAddress>
            <AddressLine1Txt>MUNOZ MARIN 20 VILLA BLANCA 166</AddressLine1Txt>
            <CityNm>CAGUAS</CityNm>
            <ProvinceOrStateNm>PR</ProvinceOrStateNm>
            <CountryCd>RQ</CountryCd>
            <ForeignPostalCd>00725</ForeignPostalCd>
          </ForeignAddress>
        </ContractorAddress>
        <ServicesDesc>Services</ServicesDesc>
        <CompensationAmt>145083</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JOM SECURITY SERVICES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <ForeignAddress>
            <AddressLine1Txt>PO BOX 1057</AddressLine1Txt>
            <CityNm>GUAYAMA</CityNm>
            <ProvinceOrStateNm>PR</ProvinceOrStateNm>
            <CountryCd>RQ</CountryCd>
            <ForeignPostalCd>00785</ForeignPostalCd>
          </ForeignAddress>
        </ContractorAddress>
        <ServicesDesc>Security Services</ServicesDesc>
        <CompensationAmt>143037</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>9</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>6061256</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>1721680</AllOtherContributionsAmt>
      <NoncashContributionsAmt>1696930</NoncashContributionsAmt>
      <TotalContributionsAmt>7782936</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>CAPITATION</Desc>
        <BusinessCd>621900</BusinessCd>
        <TotalRevenueColumnAmt>30686854</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>30686854</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAL SERVICES</Desc>
        <BusinessCd>621900</BusinessCd>
        <TotalRevenueColumnAmt>3630613</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3630613</RelatedOrExemptFuncIncomeAmt>
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        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <TotalProgramServiceRevenueAmt>34317467</TotalProgramServiceRevenueAmt>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
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        <ExclusionAmt>0</ExclusionAmt>
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      <RoyaltiesRevenueGrp>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <GrossRentsGrp>
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        <PersonalAmt>0</PersonalAmt>
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      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
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      <RentalIncomeOrLossGrp>
        <RealAmt>111713</RealAmt>
        <PersonalAmt>0</PersonalAmt>
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      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>111713</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>111713</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
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      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>42232338</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>34449402</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>6044351</TotalAmt>
        <ProgramServicesAmt>5748374</ProgramServicesAmt>
        <ManagementAndGeneralAmt>295977</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>790776</TotalAmt>
        <ProgramServicesAmt>738083</ProgramServicesAmt>
        <ManagementAndGeneralAmt>52693</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
        <TotalAmt>26613887</TotalAmt>
        <ProgramServicesAmt>26205122</ProgramServicesAmt>
        <ManagementAndGeneralAmt>408765</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>10039</TotalAmt>
        <ProgramServicesAmt>10039</ProgramServicesAmt>
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      <OfficeExpensesGrp>
        <TotalAmt>217328</TotalAmt>
        <ProgramServicesAmt>89158</ProgramServicesAmt>
        <ManagementAndGeneralAmt>128170</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
        <TotalAmt>73712</TotalAmt>
        <ProgramServicesAmt>60672</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13040</ManagementAndGeneralAmt>
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      <OccupancyGrp>
        <TotalAmt>708266</TotalAmt>
        <ProgramServicesAmt>585609</ProgramServicesAmt>
        <ManagementAndGeneralAmt>122657</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>85349</TotalAmt>
        <ProgramServicesAmt>14860</ProgramServicesAmt>
        <ManagementAndGeneralAmt>70489</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>70100</TotalAmt>
        <ProgramServicesAmt>10477</ProgramServicesAmt>
        <ManagementAndGeneralAmt>59623</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
        <TotalAmt>570025</TotalAmt>
        <ManagementAndGeneralAmt>570025</ManagementAndGeneralAmt>
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      <InsuranceGrp>
        <TotalAmt>124863</TotalAmt>
        <ProgramServicesAmt>77034</ProgramServicesAmt>
        <ManagementAndGeneralAmt>47829</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>VACCINE AND MEDICAL SUPPLIES</Desc>
        <TotalAmt>2943348</TotalAmt>
        <ProgramServicesAmt>2787186</ProgramServicesAmt>
        <ManagementAndGeneralAmt>156162</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OtherExpensesGrp>
        <Desc>COMMUNITY ACTIVITIES</Desc>
        <TotalAmt>67597</TotalAmt>
        <ProgramServicesAmt>67530</ProgramServicesAmt>
        <ManagementAndGeneralAmt>67</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>700183</TotalAmt>
        <ProgramServicesAmt>375138</ProgramServicesAmt>
        <ManagementAndGeneralAmt>325045</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OtherExpensesGrp>
        <Desc>UTILITIES AND TELEPHONE</Desc>
        <TotalAmt>187936</TotalAmt>
        <ProgramServicesAmt>143284</ProgramServicesAmt>
        <ManagementAndGeneralAmt>44652</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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        <ProgramServicesAmt>10249</ProgramServicesAmt>
        <ManagementAndGeneralAmt>215164</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>39433173</TotalAmt>
        <ProgramServicesAmt>36922815</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2510358</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>4324383</EOYAmt>
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        <EOYAmt>101562</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>845070</EOYAmt>
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        <EOYAmt>975978</EOYAmt>
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        <EOYAmt>775125</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>196612</EOYAmt>
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        <EOYAmt>99601</EOYAmt>
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      <LandBldgEquipAccumDeprecAmt>2895082</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>5320868</EOYAmt>
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      <InvestmentsProgramRelatedGrp>
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        <EOYAmt>90000</EOYAmt>
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        <EOYAmt>12729199</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>1602905</EOYAmt>
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      <OtherLiabilitiesGrp>
        <BOYAmt>904915</BOYAmt>
        <EOYAmt>878154</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>1938075</BOYAmt>
        <EOYAmt>2481059</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>7448975</BOYAmt>
        <EOYAmt>10248140</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>7448975</BOYAmt>
        <EOYAmt>10248140</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>9387050</BOYAmt>
        <EOYAmt>12729199</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>2799165</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>0</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <InvestmentExpenseAmt>0</InvestmentExpenseAmt>
      <PriorPeriodAdjustmentsAmt>0</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>1</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
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    <IRS990ScheduleA documentId="R000002" softwareId="23018249" softwareVersionNum="v1.00">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="R000003" softwareId="23018249" softwareVersionNum="v1.00">
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>63756</OtherCostOrOtherBasisAmt>
        <BookValueAmt>63756</BookValueAmt>
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      <BuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>3170114</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>62002</DepreciationAmt>
        <BookValueAmt>3108112</BookValueAmt>
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      <LeaseholdImprovementsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>2156383</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1113179</DepreciationAmt>
        <BookValueAmt>1043204</BookValueAmt>
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      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>2341552</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1447549</DepreciationAmt>
        <BookValueAmt>894003</BookValueAmt>
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      <OtherLandBuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>484145</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>272352</DepreciationAmt>
        <BookValueAmt>211793</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>5320868</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>UNEARNED REVENUES AND LEASE PAYABLE</Desc>
        <Amt>869691</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEPOSITS AND BONDS</Desc>
        <Amt>8463</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>878154</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>42232338</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>0</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <RecoveriesPriorYearGrantsAmt>0</RecoveriesPriorYearGrantsAmt>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>42232338</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>0</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>42232338</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>39433173</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>0</DonatedServicesUseFcltsAmt>
      <PriorYearAdjustmentsAmt>0</PriorYearAdjustmentsAmt>
      <LossesReportedAmt>0</LossesReportedAmt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>39433173</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>0</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>39433173</TotalExpensesPerForm990Amt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A copy of the form 990 is provided to the governing board finance committee after is filled to be reviewed and approved. The form is filled by our accountant consultant firm who also are Certified Public Accountants. They also obtain all the documents and the data from the organization accounting and human resources departments and from the corporate official documents. The executive director sends the form to all members of the finance committee is conducted to approve the form before sending. The approved form is sent mail to all governing members.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>It is required that board of members and key staff sign a document where certify and acknowledge the following: that receive a copy of the organization conflict policy and acknowledge the requirement to disclosure annually interest that could rise a conflict. The signed document is kept in the corporate file. Also, the employee and independent contractor contracts includes a clause in which the parties certify the absence of conflict of interest and family member relationship with any governing board member.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization has human resources consultant who provides technical assistance to the organization to determine the key staff and employee salaries and compensation in compliance with the federal and local department of work and human resources laws and regulations. Comparability data and reasonable market value for key staff position in used. Also, the organization has written salary and compensation policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The general public has the right to inspect the application from for tax exemption, annual information return, governing documents and financial statements at the organization's principal officers during regular business hours. Each information returns are available for a period of three years beginning as of the date the return is required to be filled. The general public has the right to inspect and request a copy with a reasonable and actual postal cost, if apply. Also, this information will be available in public website that might be notify to public when they request the information.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Programmatic Professional Services that include: Doctor's Psychologists, and Social Workers.</ExplanationTxt>
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    </IRS990ScheduleO>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Municipality of Caguas</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <ForeignAddress>
          <AddressLine1Txt>Po Box 907</AddressLine1Txt>
          <CityNm>Caguas</CityNm>
          <ProvinceOrStateNm>PR</ProvinceOrStateNm>
          <CountryCd>RQ</CountryCd>
          <ForeignPostalCd>00726-0907</ForeignPostalCd>
        </ForeignAddress>
        <EIN>660433568</EIN>
        <PrimaryActivitiesTxt>Government Entity</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PR</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>527</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>170 blAv</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>