Weight Loss Surgery in Mexico
The complete patient’s guide to bariatric surgery in Mexico. Is Mexico Weight Loss Surgery worth it? What should I know beforehand? Which Mexico surgeons are best
In general, weight loss surgery in Mexico is safe, affordable and effective to those who plan ahead and are aware of any issues that might arise.
Mexico weight loss surgery is an option for those who lack healthcare insurance, or those looking to undergo the surgery quickly. Although there is a possibility you can undergo surgery within a few weeks, it’s important to be mental and emotional prepared for bariatric surgery. This guide is an attempt to help you decide if Mexico is right for you, and how to go about booking your surgery.
We recommend that you read this entire guide. But you’d like we created a list of the quick tips below.
- Never book your surgery on Facebook Groups or Discussion Forms – or from people you’ve met on those sites.
- Most are blatant advertisements, sometimes from people in India or the Philippines, where individuals get a commission for booking your surgery.
- Most of the ‘patient coordinators’ on those groups are people who have never even meet the surgeon, let alone come to Mexico.
- Beware, low-cost providers.
- You can’t get the price too low, without sacrificing on experience, equipment, or facility.
- Consider medical travel insurance.
- Consider companies with medical travel coverage.
- Research your surgeon.
- Read reviews on a variety of sources.
- Check certifications and diplomas.
- Research your hospital.
- Aim to research your hospital and hospital staff.
- Never pay anybody in Mexico directly.
- Always, pay a 3rd party provider to have recourse in case something happens.
- Have realistic expectations.
- Bring somebody, if they’re supportive of your decision.
Bariatric Surgery in Mexico – A Candid Look
Most people would love to have their weight loss surgery done in the comfort of their home city with a surgeon they know and fully trust. Moreover, most insurance companies offer insurance policies that have exclusions when it comes to bariatric surgery coverage, leaving you to pay cash for this life-saving procedure. Indeed, it’s ironic, hence the need for cheaper alternatives.
Fortunately, we live in different times now; the internet has brought with it the advent of social media, online forums, email, and Skype, it’s as easy as ABC to find respected and well-documented surgeons or even patients who’ve had similar experiences.
However, traveling to a foreign country to undergo a significant surgery inclusive of real risks, a surgeon you are unfamiliar with, foreign medical laws and hospital regulations. It’s just plain scary.
In Mexico, as mentioned earlier, the cost of such a delicate surgery is still less than $7,500 on average. However, it may take you sometimes to narrow down on the best options; you’ll have to research more to ensure you receive the best medical care before, during and after your surgery.
The best and appropriate surgeon and hospital in Mexico are always specific to each patient. Thus, ensure you chose the most experienced surgeon with the best experience and a facility with access to latest technology. Most importantly, you must also feel comfortable with them.
More Information you need to Know
Since there is a substantial amount of trepidation as you travel to Mexico for bariatric surgery, it is recommended that you start by finding other patients who’ve undergone similar surgery in Mexico. You can see them on social media or do a simple internet search to find a few groups associated with Mexico Bariatric Surgery. One group, The Bariatric Social group. Is active with many members who have had similar experiences with surgery in Mexico.
You can also read more on the stories posted by people about their surgical experience in Mexico, and you can reach out to them and ask questions. Don’t be shy, questions like ‘Weren’t you scared going off to a foreign country for surgery?’ And, ‘What happens next once you develop a complication?’ should be top of the list of questions asked. You’ll discover that most people will be happy to answer truthfully and are friendly enough to guide you.
Furthermore, you can initiate discussions in a forum or with a couple of primary contacts at the surgeon’s office) and find out more about the process and ensure you feel comfortable going through with the process.
Remember, cheap is always expensive. Having a bariatric surgery is a delicate surgery that demands experience and skills, don’t merely go for the most affordable price or revel in a price discount. You’ll most likely see such instances, however, be cool and calm and make decisions based on critical factors like skills and experience of the surgeon.
Most weight loss surgery procedures in Mexico are cheap (falling in the $5k to $9k range). Ultimately, you’ll be saving more cash compared to staying and having the surgery done in the US or Canada.
General Safety in Mexico
I’d like to dissuade you from the notion that “Mexico is dangerous,” Mexico is a country just like any country with safe cities and regions and also unsafe areas. Therefore, feel free to visit and explore safely. There are significant areas to avoid, and we will list them here
Cost of Weight Loss Surgery Mexico
Weight Loss Surgery and Insurance
As with dental surgery, weight loss surgery isn’t always covered by insurance, and this makes it an expensive procedure to undertake. The weight loss surgery costs in Mexico is much lower than in the U.S. or Canada.
Weight loss surgery in Mexico is the most popular surgery for Americans outside the US. Americans and Canadians, for many years, have been traveling to Mexico for safe bariatric operation and the number is not going down anytime soon.
Mexico is among the best for weight loss surgery for traveling patients because:
- Flights to Mexico are far less expensive than other popular international destinations.
- Many cities in Mexico do offer a relaxing environment that eases the mind stressors that initiate surgery anxiety. Ergo, other patients travel early to enjoy the air merely and sightsee before surgery or choose to remain on vacation healing after surgery.
- Going to Mexico can also provide privacy and discretion. For instance, away from your co-workers and friends if you are uncomfortable and want to avoid the subject of having weight loss surgery performed on you. You can only tell them you are going on a vacation, considering you’ll have the pictures back to show.
Read on below to discover everything about having bariatric surgery in Mexico, the general safety precautions to minimize risk associated with emergency travel.
Average Cost of Bariatric Surgery in Mexico
In Mexico, compared to the US, bariatric surgery is less expensive and healthcare, in general, is less regulated. Moreover, the wages are lower, and the equipment cost is low as well. All of these features tend to lower the cost of surgery altogether. Having a less regulated healthcare system sounds scary. However, the surgeon skills and experiences are not regulated, and it is the surgeon who is responsible for your well-being.
By procedure, the average cost of weight loss surgery in Mexico is listed below.
- Gastric Balloon Surgery– $3,000 to $9,000
- Gastric Bypass Surgery– $6,500 to $11,000
- Mini-Gastric Bypass Surgery – $6,500 to $11,000
- Duodenal Switch Surgery – $6,500 to $11,000
- Gastric Sleeve Surgery – $3,400 to $9,000
What Is Included In The Cost?
Most packages do include certain costs. However, your flight cost to and from Mexico Initially. Transportation within Mexico is included in the package since you are having surgery in a foreign land, finding appropriate accommodation and transport system should be the last thing you need to worry about.
Most patients often arrive two days before the scheduled surgery day. This is enough time for you to adjust and settle in, meet the medical team, have initial tests done, i.e., blood work and most importantly, relax.
Typically, the fee included the following:
- Pre-op evaluations, i.e., preliminary medical tests (blood work, physical examinations, etc.)
- Anesthesiologist
- Two Surgeons or one surgeon and an experienced First Assist in the operating room with you
- Pre and post-op medication
- Theatre (Operating room) costs
- Diet guidelines (before and after the operation)
- Transportation (from the airport and place of temporary residence to the medical facility)
- Your accommodation arrangements at a local 5-star hotel – or something similar
Paying for the Surgery
As mentioned earlier, the first option is using cash, since insurance doesn’t cover for such kind of surgery. It is even better if you’ve had some money saved and there is no better way to spend it than using it to lose weight and live healthy and more prolonged. If you haven’t started collecting, then start right away, put aside about $200 per month, and you’ll have achieved the target in about 2-3 years.
If you don’t have money saved, then consider external financing. Many medical facilities are generous enough to offer financing options via significant banks. Call these bariatric centers and inquire more about the matter and discover how their rates are. However, when it comes to financial institutions, it is prudent to have a good credit score before attempting to engage with them.
Furthermore, with increased competition and thousands of patients flying to Mexico for surgery every year, the package prices are sure to reduce. Thus, ensure you have enough cash, or you can also involve a financial institution and book yourself a ticket to a happier, healthier, and longer life.
Furthermore, with increased competition and thousands of patients flying to Mexico for surgery every year, the package prices are sure to reduce. Thus, ensure you have enough cash, or you can also involve a financial institution and book yourself a ticket to a happier, healthier, and longer life
Risks of Mexico Medical Travel
Minimizing Risks Associated with Surgery and Travelling
Having weight loss surgery in Mexico should always be accompanied by constant care and caution.
To minimize the risk of developing travel-related complications and issues:
- Ensure you make the standard weight loss surgery preparations, similarly if you were having the same procedure at home. i.e., pack all your necessities in a separate case and also lias with your chosen surgeon both at home and abroad before traveling.
- Ensure you have your passport ready! This is for those applying for a visa. They should comprehend that it can take up to 8 weeks, to process and have their passport sent to them.
- Enquire about vaccines from your doctor. According to the CDC, travelers to Mexico are required to have Typhoid and Hepatitis A shots. The Center for Disease Control’s (CDC) website has further information on the matter.
- Tap water is a no, no while in Mexico, ensure you only take bottled or distilled water. This is an effort to reduce the risk of developing stomach problems during the period of your surgery.
- Once you reach your destination, plan a day or two of rest. Don’t go straight into surgery, having time to relax makes the overall experience less stressful and also give you a chance to prepare mentally and most importantly, get over the culture shock and jet lag often experienced with tourists.
- After surgery, you should plan to stay put for at least two weeks. Do not travel as soon as the surgery is done, proper recovery and surgeon evaluation of your condition before traveling home are necessary. Also, in the event of secondary complications, follow up treatments should be possible during this time.
- Be cautious of Deep Vein Thrombosis (DVT). Take the necessary steps to minimize DVT risk. It is the most significant risk of traveling for surgery. Deep vein thrombosis (DVT) is the formation of a blood clot(s) in one of the deep veins in the lower leg. Moreover, DVT risk increases after all significant surgeries, more so when the patient remains immobile for long.
Minimize DVT risk before traveling:
- Put off smoking for a while. Studies have shown that tobacco causes increased the risk of blood clots that lasts for six weeks or more. Having your last puff days before traveling can minimize DVT risk.
- Before wearing elastic clothing, i.e., flight socks or graduated compression stockings, consult your physician and determine the dangers it poses.
- Before you travel, it is also ideal that you are already on a weight loss regimen. Lose as much weight as possible to lower your body mass index (BMI). A low BMI reduces the risk of developing DVT and having bariatric surgery complications in general
- Exercise enough to be considered fit to undertake any medical procedure.
- You should discuss with your doctor about stopping contraceptive methods, i.e., birth control pills and hormone replacement therapy. These tend to thicken your blood and further increase the risk of developing DVT.
- Put on loose clothing
- Ensure you choose a passenger class with enough leg room to stretch your lower limbs occasionally and do some leg exercises at your leisure.
- Inquire further to surgeons on using pneumatic compression devices during and after the surgery.
- Be cautious when taking anticoagulants (blood thinners) while traveling, if necessary ask your doctor about the possible dangers associated with taking them.
- You can walk for a short while, at least half an hour before takeoff
Minimizing Deep Vein Thrombosis risk during flight:
- Ensure you create some room to stretch your legs. Don’t stow baggage under your seat.
- During the flight, take in deep breaths frequently to stabilize internal body pressure.
- Perform calf and ankle stretching exercise every 20-30 minutes.
- You can decide to walk up and down and stretch your leg muscles every 2 hours.
- Do not consume sleeping pills to help you sleep, only sleep for short periods during the flight.
- To avoid dehydration, drink lots of water and fluids in general
- If you can, avoid diet soda and other caffeinated drinks and most importantly, alcohol
- Don’t wear stockings or have your pants rolled up to prevent constricting your legs
Post-Op Weight Loss Surgery Complications
Just like with any surgery, weight loss surgery isn’t devoid of complications. Albeit, these complications are a rarity. However, it is prudent that we mentioned some of the downsides related to weight loss surgery.
As mentioned earlier, gastric sleeve surgery has fewer risks that can trigger secondary complications, and such cases are rare. However, if any complications arise, the surgeon is sure to handle the matter intricately and efficiently.
Complications after weight loss surgery include:
- Wound infections
- Digestive problems
- Ulcers
- Bleeding
To be precise, most life-threatening complications tend to occur within the first-week post-op. These complications usually are infections, leaks, and more.
Since you’ll also need constant support, finding support groups is critical to help you with your recovery by ensuring you remain on track post-op. While still on the support, you’ll also require eliciting the services of a local dietician. Changing your diet is part of the recovery process and part of the adjustments in life you’ll have to undertake post-op. A dietician will then help you make an important decision on what you eat and furthermore, act as a support beam to ensure you don’t fall back to poor eating habits.
Other serious health concerns should also not be overlooked like not absorbing nutrients as much like iron and calcium which can lead to anemia and osteoporosis. But this can be countered by taking nutritional supplements and going for regular blood screening tests.
If you have a local physician looking after your progress, they will tell you what to look out for and advise you further on the matter.
Cities for Mexico Bariatric Surgery
Weight Loss Surgery in Tijuana
Tijuana has an infamous reputation for being rowdy, and unpredictable. However, this doesn’t mean the whole city is dangerous. As mentioned earlier, all cities have their ugly scars beneath. A significant portion of the city is relatively safe, and you can rest assured.
To minimize security risks, keep these tips in mind:
- Always stick to the tourist designated areas when possible. These locations tend to be safer and more so, you can quickly get assistance if you get lost or are confused on where to go. Furthermore, these areas have many English-speakers available.
- Avoid “Calle Coahuila,” a zone considered Tijuana’s Red Light District. Despite being popular among tourists, you shouldn’t travel there lest you endanger yourself. Since your there to get medical services and not to tour leisurely, you should just avoid stressful situations by not visiting this area.
- If you have a vehicle or rented a car, ensure you have some comprehensive coverage on them. Most importantly, take note of erratic drivers. Tijuana drivers are sometimes known to be aggressive and less mindful of traffic lights and stop signs.
- Always keep your money safe. When in public, keep a few dollars with you while you can safely tuck the rest away in inconspicuous locations or the sole of your shoes.
- It is safer traveling in pairs, so you can elicit a companion to travel with you on your quest. Going with a companion is an ideal tip for all international travels, not only to Mexico. Moreover, you’ll need someone around you once you’ve done the surgery.
Accreditation for Mexico Weight Loss Surgery
The US Joint Commission accredits hospitals in Mexico through its international division, the Joint Commission International (JCI). It is the most respected and demanding hospital accreditation agency in the US.
For a hospital to be accredited, it must pass JCI intricate testing for about 300 standards with 1200 data points. After it passes these tests, it automatically receives the certification. A general overview of what’s reviewed includes:
- Patient Assessment
- Ease of access to care (new or continuing)
- Upholding of patient and family rights
- Use of Anesthesia in surgical processes
- Surgical pre- and post-care
- Medical use and management
- Patient and family pre- and post-education
- Quality improvement and overall patient safety
- Prevention and control of secondary infections
- Management and Staff
- Governance, leadership, and direction
- Qualification and Education of Staff
- Transfer of Communication and information
For more information on the accreditation standards, you can visit JCI website.
Acing these accreditation standards means the medical facility puts a premium on safe medical/clinical practices. Mexico is fortunate to have hospitals accredited by the JCI that perform weight loss surgery.
Other Reputable Accreditation Bodies
Since it is time-consuming, expensive and an arduous task to achieve JCI accreditation, most hospitals only don’t have the means to get JCI accreditation. Fortunately, The Mexican Ministry of Health offers CSG accreditation. CSG is modeled after JCI accreditation with a set of standards regarding international patient safety. If you discover a medical facility with CSG accreditation, it should be an indicator that you’re going to be taken care off very well.
Many hospitals in Mexico performing bariatric surgery are CSG accredited, and this should give you relief in finding the best medical care for you.
Non-Accredited Options for Weight Loss Surgery
It should be noted that there are some excellent hospitals providing quality health services including surgery that lack certification from either accreditation body (the JCI or CSG). Some hospitals and clinics do so well that they don’t require accreditation. However, adequate background checks are necessary before selecting a non-accredited health facility.
To ensure their health and clinical practices are safe:
- You should contact the hospital directly and question their quality service provisions, share your safety concerns with them and ask how safe their practices are and why you should choose them. Do not shy away from prodding earnestly; your safety is your primary concern. You can also search online forums and look at reviews on that clinic or hospital website.
- You can also ask for or get at least three patient references. Call each of them and let them discuss their experience with the doctor and medical facility you’ll select.
- You can search online forums for reviews from similar patients of surgeons and facilities you’re considering to visit.
Hospitals vs. Clinics
In Mexico, weight loss surgery clinics separate from the hospital setting are common. Moreover, some clinics are fully equipped with resources to perform successful bariatric surgeries. However, they are not efficient enough to deal with post-surgical complications.
On the other hand, hospitals, are much better equipped with anything arising from the surgery, in addition to an emergency room, intensive care unit, X-rays, pharmacy and any other specializations unit.
Weight loss surgery often concludes with nearly 100% survival rate. However, complications may arise, and a clinic may handle it by sending you to a hospital you are unfamiliar with or even worse, ill-equipped to handle your situation. Hence the need for proper research, you can also do secondary research on ‘plan B’ hospitals should anything go out of the ordinary, which is highly unlikely.
Despite what you choose, a hospital or clinic is just a matter of personal preference but at the end of the day, selecting a hospital gives you a full advantage and a back-up.
Fortunately, this feature also includes not only some of the best hospitals for the procedure but even revered physicians.
Screening and Selecting your Mexican Surgeon
South of the border presents the best and top-most qualified and talented surgeons. When it comes to having weight loss surgery done abroad, a surgeon’s skill and experience is often the biggest concern for most patients. Since you’ll be meeting your surgeon for the first time after you land in Mexico, it is prudent that you ‘vet’ your surgeon incessantly.
Additionally, you can set up a video conference with your surgeon through Skype or Ekiga. This provides assurance, confers confidence and also enables you to talk face to face with the surgeon. If you feel squeamish about him/her, you are free to set up another video conference call with another surgeon.
It is prudent that you learn on how to interview your potential surgeons. Here is a comprehensive list of queries you can shoot at your prospective surgeon.
Partner with a Local Doctor
You can see lias with a local doctor to help you prepare for the weight loss surgery. You are ensuring the best possible outcome, with minimal risk whatsoever by introducing a relationship between your local medical staff at home and your potential surgeon and medical facility in Mexico.
Find a physician who will agree to handle your post-op care before leaving for surgery. Albeit, this may be an arduous task since most doctors choose not to assume medical liability for any issues or complications that may arise caused by a health provider outside the US or Canada.
You can also choose to return home and work with a primary health care doctor instead of seeking the expertise of a local surgeon. If a principal healthcare physician feels comfortable providing the necessary post-op follow-up care, it may be your best option and moreover, cost-effective, considering how expensive a surgeon is.
Don’t despair if you cannot find someone to aid you in your journey; chances are, the Mexico facility has an esteemed relationship with similar providers in the US or Canada. You can ask them for help. Usually, surgeons abroad can provide detailed medical information to your local doctor; this information is accurate and official. It may be digital media or physical files that include your medical summary, doctor notes, vitals, sonograms, x-rays, etc. This information is enough for your doctor back home to pick on and continue with your remediation.
Gastric Sleeve Surgery
Gastric Sleeve Surgery is the most popular form of bariatric surgery in Mexico; it is also popular among weight loss surgery patients as it is a restrictive surgery that limits the amount of food you can eat. Gastric Sleeve Surgery is often done in Tijuana Mexico and here’s what you need to know:
The city of Tijuana is on the US-Mexico border making travel time to the city very short, about 25 minutes (not inclusive of the border waiting times). Moreover, Tijuana’s proximity to another city in the US-Mexico border, San Diego should calm down nervous patients on international travel. Furthermore, Tijuana’s proximity to San Diego adds another layer of comfort, in case of post-op complications; you can easily access many hospitals in the region.
You can also choose to fly directly to San Diego, for a more comfortable and enhanced flight and luggage handling experience.
Fortunately, some Tijuana gastric sleeve surgery providers also make accommodations plans for the patient inclusive of airport travel to and from, hotel, and hospital accommodations. Furthermore, Uber and other taxi services are available in both cities.
Once the gastric sleeve surgery is done, the surgeon will issue out recommendations on what to do next, most importantly if you’ll be traveling via airplane and will approve on the matter. Medical tourism in the city of Tijuana is growing steadily, and the area boasts top surgeons who can either connect you with a medical travel agency or even coordinate the travel themselves. All in all, it’s all about your safety concerns and be assured that the selected medical team will work with you on that.
Gastric Balloon Surgery Procedure
Some weight loss surgery procedures, on the other hand, are easy to do that other, e.g., a gastric sleeve surgery is a straightforward procedure to undertake than a gastric bypass. Moreover, it has a far less long-term complication and confers more weight loss benefits.
The procedure is relatively simple; a soft expandable silicone balloon is inserted into the stomach via the mouth, down the esophagus and filled with sterile water. It then takes up space in your stomach where it temporarily stays there (about 6 months). This procedure takes about 10 minutes, and recovery is well made at home. Albeit you’ll be experiencing nausea in the first week, it is not alarming as you are getting used to the pressure.
Furthermore, the Gastric Balloon is recommended for individuals who have a BMI 27 or higher, indicating its effectiveness in overweight people.
Gastric balloon surgery helps you control your hunger and manage your weight by creating a feeling of fullness and make you eat less by reducing your portion size. Reduced consumption further leads which leads to fewer calories consumed, and ultimately weight loss.
The cost of gastric balloon surgery is relatively low in Mexico, compared to the US and Canada.
Gastric Bypass Surgery
Gаѕtriс bураѕѕ ѕurgеrу is another weight loss surgical procedure that involves making the stomach smaller. Making the stomach smaller reduces an individual’s calorie intake, further promoting weight loss.
The ѕurgеrу еnаblеѕ food particles to bураѕѕ a section оf the ѕmаll intestine; making the individual fееl full quickly after eating smaller portions of food. This means, fewer calories will be consumed and the individual will experience a significant drop in body weight.
Roux-en-Y, the most common type of gastric bypass surgery, involves using surgical ѕtарlеѕ or a plastic band to сrеаtе a ѕmаll роuсh in the ѕtоmасh, which is then linkеd to the small intеѕtine. This аllоws food to bураѕѕ the rеѕt оf the ѕtоmасh and the upper section оf the ѕmаll intestine.
Another type саllеd, Lараrоѕсорiс ѕurgеrу is a gаѕtriс bураѕѕ рrосеdurе where a ѕmаll inсiѕiоn is mаdе in the abdomen, and a саmеrа is used to ѕеаl part оf the stomach.
The cost of a gastric bypass in Mexico is relatively low, almost reduced by half, compared to the US and Canada.
Mini-Gastric Bypass Surgery
Traditional gastric bypass surgery may result in excellent weight loss. However, the procedure is challenging and moreover, carries a 7% complication risk. Within this risk, mortality (death) is very low, about 0.5%.
Thus, a quicker and less risky procedure has gained popularity, the mini-gastric bypass procedure has gained popularity in recent years. Originally developed by Dr. Robert Rutledge in 1997, this technically easier compared to traditional gastric bypass surgery and carries a complication risk of 2.9% (2012 MGB study).
The mini-gastric bypass procedure restricts the amount of food you can eat as the stomach is reduced. However, this method is malabsorptive. It reduces the average absorption of food by bypassing at most, 6 feet of intestines.
Both the Gastric bypass and the mini-gastric bypass are restrictive and malabsorptive and restrictive procedures. Additional risks associated with Mini-Gastric Bypass over Gastric Bypass involves severe acid-reflux. As the distance is reduced and the stomach remainder is connected to the intestines, it is possible for gastric juices to travel down the small intestines causing discomfort.
The Final Decision
Ultimately, selecting the facility and the best doctor for your bariatric surgery should be weighed upon the following factors: the experience and accomplishments of a surgeon, a well-funded facility with additional specialists, expenditure (travel, and accommodation), and the cost of surgery. Just trust your intuition and pick a place you feel safe doing the surgery. Despite the choice you make, what matters is your road to health and improved wellness in a post-op life. Moreover, it’s cheaper to travel from the US to Mexico.
TRAVEL WARNING
Mexico travel is safe, however, there are cities you should avoid traveling to according to the State Department. Cities that are generally safe to travel for medical tourism are Tijuana, Cancun, Puerto Vallarta, Guadalajara, and Mexico City.
* Cities to Avoid
- Ciudad Juárez or Juarez
- Piedras Negras
- Nuevo Laredo
- Acapulco
- Monterrey
- Reynosa
*This is not an exhaustive list and changes weekly. Please visit the State Department travel warnings for more information.
Which Surgeon to Choose?
There are over 100 Mexican bariatric surgeons catering to patients from the United States, Canada, and elsewhere. The choice of which bariatric surgery in Mexico to choose is tough, as some surgeons are practitioners of aggressive digital marketing making it hard to distinguish from the noise. Here is a list of prominent surgeons in Mexico (please do your own research):
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Top Bariatric Practices in Mexico
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Notable Bariatric Hospitals / Facilities
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