In our opinion we have great medical services in Nicaragua, Here is an article was written by an expat experience at a local hospital in Masaya. We have a similar story, where Ghislaine had to go for surgery in Managua at Salud Integral. We were able to plan our medical visit and get all the required lab tests done prior to the operation.
The Salud Integral Hospital is in a somewhat modern building and slightly dark halls. But the services was an A+ in our personal opinion. We also paid via credit card since health insurance is still expensive and doesn't cover items we need as we get older. So we keep cash in reserve as we save money from no monthly bill for medical insurance. Ghislaine had a private room for one night, and in the evening we were able to hire a private nurse in case she needed anything while I went home to attend to our fur-babies and business. The total cost for her surgery, hospital, private nurse and blood work was approx. US$4,400 vs in the US we would have paid over US$12,000. That's a real savings for excellent care. And for the people waiting, we can order room service and have it delivered to the room while we wait. That was a great service, not bad for hospital food, but again the service was excellent. The surgeon only works at Pellas Hospital and Salud Integral. He does have his own office in Managua.