This article examines the Reglamento para el gobierno interior, político y económico de los hospitales reales de Cuba (Regulations for the Political, Economic, and Internal Governance of Royal Hospitals of Cuba). These regulations were established by the Spanish Crown in 1776, first for Cuba and later for all of Spanish America. The document is key to understanding some of the projects that the Crown undertook in its hospitals in the Indies. It sought to provide a general structure within which hospitals were to be administered, and medical, nutritional, and spiritual care were to be provided. The new standards reaffirmed, but also strengthened and intensified, existing policies. In addition, they sought to resolve a series of debates and disputes among different social groups about how the hospitals should be run.