Review cadence
- Source date
- 2026-07-16
- Claim review
- 2026-07-17 · 20/20
- Proven sweep
- 2026-07-15
- Target
- T2 · biweekly
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Puerto Rico has 22 community health centers across 170 sites serving 474,356 patients — the #19 FQHC state by patients in the national-breadth layer. Its community health centers depend on the federal Community Health Center Fund, authorized only through December 2026.
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We keep source date, claim review, and a completed source sweep separate. None of these clocks substitutes for another.
70,162 reported patients
Actual values: 10/12 · source-backed: 8/12
Visible gaps: reported financials, NPPES operator identity, EHR, history.
Hash-pinned review: 2026-07-19 · next 2026-10-17
This public log starts July 14, 2026. Zero logged changes does not mean a page or claim never changed before that date.
2026-07-17 · addition
New tracked PR development added to the state intelligence feed.
2026-07-17 · addition
New tracked PR development added to the state intelligence feed.
2026-07-16 · addition
New tracked PR development added to the state intelligence feed.
2026-07-16 · addition
New tracked PR development added to the state intelligence feed.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this PR record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
Send a correction or new source to improve this state page.
As of July 15, 2026, HRSA's official 2024 UDS record shows 21 Puerto Rico Health Center Program awardees serving 474,356 patients, including 291,406 Medicaid/CHIP patients and 46,392 uninsured patients. CMS separately reports 1.3 million people enrolled in Puerto Rico Medicaid and CHIP as of January 2026 and confirms that the 76% FMAP runs only through September 30, 2027 under a territorial financing structure capped by an annual federal ceiling. The timing of congressional action remains uncertain: Resident Commissioner Pablo José Hernández told El Nuevo Día that reauthorization may wait until 2027, while MMAPA described preliminary congressional-staff interest in drafting—not an introduced bill. The Financial Oversight and Management Board calls Medicaid a material FY2027 budget risk because Puerto Rico must finance spending above the cap and MCO contract costs remain unsettled. Nearer-term, the national $4.6 billion Community Health Center Fund expires December 31, 2026, and ASES data obtained by CPI show five First Medical sanctions totaling nearly $4.8 million, with only $300,000 paid and three sanctions still in administrative review.
Patient-weighted across the 21 centers with UDS 2024 data.
Puerto Rico's nursing statute creates a mixed scope rather than a blanket 'reduced-practice' rule. Act 254-2015 recognizes private and independent nursing practice and says an advanced-practice nurse may function independently within nursing functions. But it conditions the nurse practitioner's primary-provider role on physician-approved protocols and collaborative agreements; diagnostic testing, treatment plans, and medication orders are also tied to prior physician discussion or approval. Health centers should distinguish independent nursing practice from the collaboration conditions attached to specific NP medical-management functions when designing teams and privileges.
Puerto Rico operates Medicaid under a federal block-grant cap (not standard FFP); the headline risk is the hard funding ceiling plus reduced federal match and the end of pandemic-era enhanced territory allotments.
Jurisdiction operating analog
This framework does not force territorial Medicaid or Compact assistance into state-only fields. Every lane preserves its own authority and source.
Puerto Rico delivers Medicaid through its island-wide managed-care system, but federal financing remains subject to the territorial section 1108 ceiling. Its 76% FMAP applies through September 30, 2027 only while federal allotment remains; neither feature is equivalent to open-ended state financing.
Centers for Medicare & Medicaid Servicesreviewed 2026-07-14The live statutory checkpoint is September 30, 2027, when the temporary 76% FMAP ends under current law. Planning should model the current authority and an expiration scenario separately; it should not present a congressional extension, parity rate, or future allotment as enacted before it is.
Centers for Medicare & Medicaid Servicesreviewed 2026-07-14Puerto Rico's Board of Nurse Examiners regulates nursing under Act 254-2015 and publishes advanced-practice renewal requirements and forms. Workforce records should cite the Puerto Rico credential and current board requirements, including when a mainland license is also held.
Puerto Rico Department of Health, Board of Nurse Examinersreviewed 2026-07-14Puerto Rico's government reported FEMA approval of $1.18 billion for 176 reconstruction projects, including Department of Health and health-care facilities. Treat approvals as a reconstruction pipeline and track obligation, drawdown, construction, and service restoration separately; an approved amount is not the same as completed clinical capacity.
Puerto Rico Federal Affairs Administrationreviewed 2026-07-14Salud Integral en la Montaña's employer page publishes primary-care vacancies and role-specific licensing requirements. Use the employer's dated list as observed FQHC demand and preserve salary only when the employer publishes it; disappearance of a posting means closed or unknown, not a verified zero-demand market.
Salud Integral en la Montaña, Inc.reviewed 2026-07-14Puerto Rico is expressly excluded from direct RHTP eligibility by the CMS funding notice, despite operating a Medicaid program. Keep RHTP ineligible/not applicable and do not infer that a territory Medicaid cliff is offset by a state-only rural award.
Centers for Medicare & Medicaid Servicesreviewed 2026-07-14Role implications
Pick the right lens and open a personalized daily brief. Links carry only state, role, and audience in the URL.
Puerto Rico ranks #19 by FQHC patients, with 22 organizations and 170 sites tied to federal grant exposure.
Use this as the board agenda frame: exposure, owner, decision date, and the first source to recheck.
61.4% Medicaid/CHIP, 9.8% uninsured, and uninsured share is 9.8%.
Turn the payer mix into scenarios for PPS, 340B, grants, and patient-volume stress.
HRSA organization data while public job-source coverage expands; largest systems and directory links show where hiring capacity may need verification.
Use the state read to pick roles to watch, openings to save, and retention risks to discuss with managers.
Puerto Rico combines 474,356 FQHC patients with reduced NP practice context and access pressure from payer mix.
Map the signal to panel access, team-based care, top-of-license planning, and patient-impact follow-up.
ASPPR, state policy context, and the December 31, 2026 CHC Fund cliff define the sources to keep current.
Assign one source owner for state policy, one for federal deadlines, and one for billing/audit implications.
Puerto Rico has 22 FQHC employers in the directory and HRSA organization data while public job-source coverage expands to compare before applying.
Use the state context to choose target employers, tailor proof, and save the next job or resource in My Progress.
Browse FQHC jobs in Puerto Rico and nationwide.
The official Puerto Rico Department of Economic Development and Commerce, Workforce Development Program / State Unit for Dislocated Workers and Employers source was checked 2026-07-15, and the artifact contained 20 official rows. We publish only human-confirmed FQHC directory matches: 0 confirmed and 0 pending.
The row count describes the official artifact, not a count of FQHC layoffs. · Official source
Puerto Rico's defining fiscal clock is federal: the enhanced 76% FMAP and block-grant allotments expire September 30, 2027, and reauthorization is expected to slip to 2027.
Primary source · as of 2026-07-14
20 primary-sourced findings on Puerto Rico FQHC policy and financing.Newest item: 2026-07-16
Observed July 16, 2026, NeoMed Center's current Juncos page lists regular hours Monday–Friday from 6 a.m.–5 p.m. and extended hours Monday–Friday from 4–9 p.m.; the schedules overlap for one hour and are not additive. It separately lists general medicine, family medicine, pediatrics, gynecology and obstetrics, vaccination, and hepatitis C treatment from 6 a.m.–5 p.m. Other listed services include behavioral health, health education and outreach, case management, home medication delivery, patient navigation, and telemedicine.
This is a standing operator schedule, not a dated opening or expansion. The page does not identify which services operate from 5–9 p.m., guarantee same-day or virtual appointments, establish emergency or hospital care, or report staffing or FTE, appointment capacity, visits, utilization, wait times, costs or outcomes.
Observed July 16, 2026, Costa Salud Community Health Centers' current Spanish access page lists Rincón general hours Monday–Friday from 8 a.m.–4:30 p.m. and extended medical/pharmacy hours Monday and Wednesday–Friday from 4:30–9 p.m. It lists the Rincón laboratory through 11 p.m. weekdays and 8 a.m.–4 p.m. weekends, X-ray through 11 p.m. weekdays and 8 a.m.–4 p.m. weekends, and an operator-labeled emergency room Monday–Sunday from 7 a.m.–11 p.m. At Aguada, medical/pharmacy extended hours run Monday–Friday from 4:30–9 p.m. after the general schedule, and a clinic at Dr. Carlos González School is listed Monday–Friday from 7:30–11 a.m. and noon–4 p.m. This is a standing operator schedule, not a dated expansion.
It does not guarantee appointments or continuous staffing, define the emergency room's clinical scope or acuity, establish 24-hour emergency or hospital care, or report staffing or FTE, capacity, visits, utilization, wait times, costs or outcomes.
In a July 13 interview, Resident Commissioner Pablo José Hernández said congressional reauthorization of Puerto Rico's Medicaid financing may be left until 2027, after the 2026 midterm elections. The report describes his forecast and advocacy strategy; it is not a congressional schedule, introduced bill, or enacted extension.
CMS independently confirms that the current 76% FMAP ends September 30, 2027. The operational signal for health centers is therefore uncertainty, not a quantified loss: FY2027 and FY2028 budgets should distinguish the date fixed in current law from the still-unresolved timing and terms of any replacement.
MMAPA president Solange De Lahongrais told El Diario on July 7 that association and business-sector representatives met with staff for Rep. Gus Bilirakis on the House Energy and Commerce Committee. She said the staff intended to have a draft by the end of 2026 to begin discussion before the September 2027 cliff.
MMAPA's preferred outcome is parity with state financing; its fallback is an adequate capped allotment plus a permanent 83% FMAP. Those are advocacy positions, and the source identifies no bill number, introduced text, sponsor commitment, score, or committee timetable.
Health centers have a concrete office and policy range to monitor, but not yet a legislative vehicle to budget against.
Salud Integral en la Montaña announced June 30 that it had implemented vaginal self-sampling for HPV detection with Puerto Rico molecular-testing company LifeGene Biomarks. SIM says the initiative began February 4 and that 101 women voluntarily participated in the first clinical self-sampling tests; participants received confidential results through the MisResultados digital platform, and testing was offered at no cost during this initial phase.
SIM describes self-sampling as a complement to traditional cervical screening and says it provides clinical management, follow-up and referral under current guidelines. This is a first-party implementation report, not an independent evaluation.
The 101 participants are not a prevalence, positivity, diagnosis, treatment or outcome count, and free testing in the initial phase does not establish current or permanent no-cost access. The source does not report the number invited or eligible, participating clinic sites, participant demographics, completed follow-up or referrals, test performance, comparison with Pap screening, staffing or training, appointment capacity, wait times, program funding, reimbursement, per-test cost or clinical outcomes.
When certifying Puerto Rico's $33.6 billion FY2027 consolidated budget on June 29, the Financial Oversight and Management Board identified Medicaid as one of the Commonwealth's most material fiscal risks. Its official release says spending above the statutory federal ceiling must be financed entirely by Puerto Rico, while the fiscal effect of ongoing MCO contract negotiations was not yet incorporated.
The budget resolution therefore requires ASES to submit proposed Medicaid benefit or service changes for review by OMB and the Oversight Board. The source does not forecast a specific federal-funding loss or benefit cut, so health centers should monitor contract and benefit decisions rather than repeat speculative cliff amounts as settled outcomes.
CPI reports, from data supplied by ASES, that First Medical received five sanctions totaling nearly $4.8 million in less than two and a half years. Two 2024 provider-payment fines totaling $300,000 were paid.
A separate $1.2 million 2024 provider-payment sanction and two 2026 sanctions—$1.8 million for provider-payment noncompliance and $1.4 million for missing call-center metrics—remained in administrative proceedings and were not final. The source also reports $170.7 million in unpaid claims in First Medical's 2025 filing to the Insurance Commissioner, but ASES did not answer CPI's questions about current provider-payment status.
Health centers should treat sanctions, collections, and outstanding claims as distinct measures and document their own receivables.
A delegation organized by Puerto Rico House Speaker Carlos 'Johnny' Méndez traveled to Washington to advocate for continuation of the island's Medicaid financing beyond September 30, 2027, coordinating its effort with PRFAA. The reported request was to preserve at least the current 76% FMAP and pursue more equal treatment with states.
This was an advocacy trip, not enactment or introduction of a federal bill. CMS confirms that current law set the 76% rate in the Consolidated Appropriations Act, 2023—not in 2021—and that the territorial program remains subject to an annual federal ceiling.
Health centers should track subsequent bill text and committee action before assigning probability to an extension.
NotiCel reports that House Democratic Leader Hakeem Jeffries and Resident Commissioner Pablo José Hernández visited HealthproMed's Barrio Obrero community health center during a Puerto Rico health-policy visit. Speakers cited an approximately 4% Puerto Rico Medicare Advantage payment increase versus about 2.5% nationally; that comparison concerns Medicare Advantage, not Puerto Rico's Medicaid allotment.
The article does not document a new award, introduced legislation, or a quantified operating commitment, so the entry treats the visit as an advocacy signal only and omits operational details not stated in the cited report.
In an official May 14 release, the Puerto Rico Department of Health, ASES, and PRFAA described the Puerto Rico Health Policy Conference 2026 as part of the work of the multisector task force created by Executive Order 2026-006. The agencies said they were collecting memoranda, proposals, and recommendations for a master plan to be presented to the governor and then defended before Congress and federal agencies.
The conference includes government, insurers, hospitals, primary health centers, professional groups, and federal participants. It is a policy-development and advocacy process; the release does not establish an enacted extension, dollar award, or guarantee that Plan Vital financing continues beyond 2027.
Corporación SANOS reported April 9 that Fundación Triple-S had certified it as Puerto Rico's first Section 330 community health center in the Dementia Friends initiative. The release says SANOS personnel participated in specialized education covering dementia, humanized patient support and institutional awareness.
It separately reports that the organization grew from three employees two decades ago to 166 health professionals serving more than 22,000 patients annually. The first-in-Puerto-Rico status and scale figures are first-party claims; the page does not link an external certification registry or an audited workforce or patient report.
It does not state how many or which personnel completed training, whether all 166 participated, training hours, competency testing, certification requirements or renewal terms. The 166 professionals are not an FTE total, net-new hire count or retention measure, and the 22,000-plus patient figure has no stated measurement year or definition distinguishing unique patients from visits.
Certification documents education and recognition, not dementia-specialty designation, added appointment capacity, screening, diagnoses, referrals, wait-time improvement, funding, cost or patient and caregiver outcomes.
At a March 24, 2026 Puerto Rico House hearing, Health Secretary Víctor Ramos Otero supported Senate Bill 15 as one tool for physician retention and recruitment while expressly saying it would not solve the workforce crisis by itself and required fiscal and operational review. The proposal would amend Act 60 incentives, require qualified physicians with decrees to serve Plan Vital patients, and impose specified hospital-practice conditions, with a 15-year 12% income-tax rate.
The source documents testimony and continued legislative evaluation, not enactment. Health centers should not treat the Plan Vital service condition, tax rate, eligibility rules, or effective date as operative until final text is enacted.
Banco de Alimentos de Puerto Rico and ASPPR opened 'Comida es Medicina' food pharmacies at MEDX Medical Experience by Migrant, Camuy Health Services, and Centro de Servicios Integrados de Salud. The program integrates food-insecurity screening, clinician food prescriptions, nutrition planning, food distribution, and outcome monitoring for patients with chronic conditions such as diabetes, hypertension, and obesity.
AbbVie separately confirms that its Foundation accelerator provided Banco de Alimentos a $50,000 unrestricted grant and support to scale the model. The source does not publish enrollment, outcome, duration, or reimbursement results, so the three-site launch should be tracked as an implemented care model, not yet as proven population impact.
PRFAA reported that FEMA approved $1,183,611,623 for 176 reconstruction projects across Puerto Rico in February 2026. The official release names the Department of Health, health-care centers, schools, public-safety facilities, universities, ports, water systems, and municipalities among the covered sectors and recipients.
The announcement is an aggregate obligation, not a health-center-only award list, disbursement schedule, construction-completion report, cumulative FEMA-obligation total, or proof that Section 330 sites received a specified share. Health centers should match any project they rely on to its FEMA project worksheet and obligation status.
The current NACHC funding page states that community health centers recently received $4.6 billion in mandatory Community Health Center Fund support and that the authority expires December 31, 2026. NACHC identifies the fund as about 70% of federal health-center funding; annual discretionary funding is a separate stream and totaled $1.858 billion for FY2026.
This replaces the stale September 2025 lapse-and-January-stopgap framing. Puerto Rico's 21 UDS-reporting awardees face the same national reauthorization deadline while also operating under the separate September 2027 Medicaid deadline.
The two clocks, funding streams, and congressional committees should be tracked independently.
HRSA's official FY2025 Ryan White Part C Early Intervention Services award list, published in February 2026, identifies $170,770 for Concilio de Salud Integral de Loíza and $548,064 for Healthcare Integrated Program Services in Puerto Rico. The same federal list includes other Puerto Rico recipients, including Centro de Salud de Lares, Migrant Health Center, Med Centro, Centro Ararat, and PRCONCRA.
These are named Part C outpatient HIV awards, not unrestricted operating grants and not proof that any recipient can offset a Medicaid shortfall dollar for dollar. Health centers should map each award to its HIV service, reporting, and grant-period restrictions.
CMS explains that Puerto Rico, unlike states and the District of Columbia, receives federal Medicaid matching only until its annual federal ceiling and supplemental funds are exhausted. Under P.L.
117-328, the FMAP is 76% from December 29, 2022 through September 30, 2027; CRS reports that current law returns Puerto Rico to the regular 55% rate in FY2028. CMS also reports 1.3 million Medicaid and CHIP enrollees as of January 2026.
The official page does not forecast how many people would lose coverage, which benefits would change, or the post-2027 dollar shortfall. Those outcomes depend on future congressional action and Puerto Rico budget and program decisions.
A December 2025 Congressional Research Service comparison states that P.L. 119-21's new Medicaid community-engagement requirement applies to specified people in the 50 states and District of Columbia and does not apply to Puerto Rico or the other territories.
The exemption is provision-specific: it does not mean Puerto Rico is outside every health, Medicaid, Medicare, tax, or nutrition provision in the reconciliation law. It also should not be confused with Puerto Rico's separate capped-financing structure or the September 2027 FMAP deadline.
Health-center enrollment teams can exclude this federal Medicaid work-reporting rule from Puerto Rico workflows while still tracking other applicable federal and local eligibility changes.
AAMC reports a published estimate of 120.7 primary-care physicians per 100,000 people in Puerto Rico versus 156.7 on the mainland and an estimate that 5,000 physicians moved practices off-island from 2006 to 2016. Its 2022 survey of 113 Puerto Rico medical students found 51.4% reported an application denial after being treated as international, 43.1% were asked for citizenship proof, and 61.3% received offensive questions or comments.
The article says local residency positions are available for fewer than half of local applicants; it does not say half of graduates match to mainland residencies. It also reports a 75.6% retention rate among physicians who complete residency in Puerto Rico, underscoring the value of local training capacity.
HRSA's official 2024 UDS summary reports 21 Puerto Rico Health Center Program awardees and 474,356 total patients. Of those patients, 291,406 (61.43%) had Medicaid/CHIP, 46,392 (9.78%) were uninsured, 66,008 had Medicare, and 17,175 were dually eligible for Medicare and Medicaid.
The source also reports 474,356 patients—not '474,000+'—and does not support the prior count of 22 organizations. NACHC separately describes the same network as 21 community health centers operating nearly 150 delivery sites.
For planning, boards should keep awardee, delivery-site, patient, and payer counts distinct rather than treating them as interchangeable employer counts.
By patients (HRSA UDS 2024). Tap for the full profile.
| Organization | Patients | Sites | Uninsured | Revenue (990) | Resilience | District |
|---|---|---|---|---|---|---|
| Salud Integral En la Montana Inc. Cedro Arriba | 70,162 | 17 | 16.8% | $126M | Stable | PR-98 |
| Med Centro, Inc. Ponce | 49,602 | 15 | 3.94% | $168M | Stable | PR-98 |
| Neomed Center, Inc. Caguas | 47,466 | 10 | 8.77% | $80M | Stable | PR-98 |
| Migrant Health Center Western Region Inc. Mayagüez | 38,728 | 27 | 11.24% | — | Stable | PR-98 |
| Cossma, Inc. Bayamón | 38,122 | 12 | 11.48% | $91M | Stable | PR-98 |
| Sanos Corp Caguas | 19,710 | 5 | 10.78% | — | Watch | PR-98 |
| Corporacion de Servicios Medicos y Prevencion Hatillo | 19,369 | 11 | 9.38% | — | Watch | PR-98 |
| Centro de Servicios Primarios de Salud de Patillas Inc. Patillas | 18,369 | 8 | 9.85% | $34M | Stable | PR-98 |
| Hpm Foundation, Inc. San Juan | 17,959 | 12 | 21.91% | $61M | Watch | PR-98 |
| Camuy Health Services Camuy | 17,825 | 4 | 4.99% | $40M | Stable | PR-98 |
1 hospital/university/county-operated: 1 hospital.
| District | Representative | Sites |
|---|---|---|
| PR-98 | Pablo Jose Hernandez | 168 |
Puerto Rico ranks #19 by FQHC patients and #24 by organization count among the 57 national-breadth jurisdictions. All 22 centers depend on the federal Community Health Center Fund, authorized only through December 31, 2026.
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FQHC data from the HRSA bulk-sites file + UDS 2024 + IRS 990. State policy profile via NACHC/KFF/AANP. Intelligence items cite primary sources. Federal items apply to all states; state items are Puerto Rico-only. Updated 2026-06-30.