Dale it has been many years since I have lived in PR, but you may want to investigate hospital options in Mayaguez. There was a hospital that had a very good reputation back in the day. (Bella Vista was the name of the facility) I say that because I am fan of the beaches on the west coast of PR. I have no background in medicine so I am just throwing this out to you as info.
There is a website called US Hospital Finder (
http://www.ushospitalfinder.com/hospitals-in/Puerto-Rico ) that will show you what hospitals are available in throughout the US and Puerto Rico. It also gives at a high level what they specialize in, which may drive your choice of locations. The site also provides all sorts of statistics so you could compare your current hospital to the one you may have to rely on.
I would say that your starting point is to insure that the hospital is JCAHO accredited that will give you a baseline and from there start researching which facility best meets your needs. Best of luck to you.