Please enter your birthday and welcome to Max Healthcare Institute Limited's Earnings Conference Call. As a reminder, all participant lines will be in the listen-only mode, and there will be an opportunity for you to ask questions after the presentation concludes. Should you need assistance during this conference call, please signal an operator by pressing star, then zero on your touch-tone phone. Please note that this conference is being recorded. I now hand the conference over to Mr. Suraj from CDR India. Thank you, and over to you, sir.
Thank you, Meera. Good afternoon, everyone, and thank you for joining us from Max Healthcare Institute Limited's Q1 FY 2025 earnings conference call. We have with us Mr. Abhay Soi, Chairman and Managing Director; Mr. Yogesh Sareen, Chief Financial Officer; and Mr. Keshav Gupta, Senior Director, Growth, M&A, and Business Planning. We will begin the call with opening remarks from the management, following which we will have the forum open for an interactive Q&A session. Before we begin, I would like to point out that some statements made in today's discussion may be forward-looking in nature, and a disclaimer to this effect has been included in the earnings presentation shared with you earlier. I would now like to invite Abhay to make his opening remark. Thank you, and over to you, Abhay.
Good morning, everyone, and thank you for joining us on Max Healthcare Institute Limited's first quarter FY 2026 earnings call. We are pleased to report a strong start to the financial year, with a year-on-year growth of 27% in revenue and 23% in operating EBITDA for the network. This marks the 19th transaction quarter of year-on-year growth, underscoring the success of our strategy and strong execution capabilities of the team. This performance is driven in part by the successful integration of the hospital acquisition made in recent years, which has significantly bolstered both our top and bottom line results. Looking ahead, our focus remains on committing the new bed capacity scheduled to come on scene during the course of the year. We expect to add approximately 1,000 brownfield beds and 500 greenfield beds. Trial runs have already been initiated at the new 160-bed brownfield tower at Max Mohali.
In addition, our board has recently approved the execution of an agreement to meet for a build-to-suit 130-bed hospital in Dehradun. The site is located approximately 100 meters from our existing 220-bed Max Dehradun facility, which reported over 80% occupancy in the first quarter FY 2026. The new facility is expected to be commissioned by the end of 2028, and will primarily focus on advanced oncology services, including radiation therapy, which is presently missing at our Max Dehradun facility. As part of our strategy to focus on specialty care in selected geographies, we have executed a binding term sheet to divest Sita and Anup Sare Hospital for INR 40 crore, with completion expected by September 2025. Of the two, only Sita Hospital was operational and reported approximately INR 5 crore in revenue and INR 1 crore of EBITDA loss in the first quarter FY 2026.
These assets were part of the overall Jaypee Healthcare acquisition and had limited strategic alignment. Now coming to the performance highlights of the first quarter, please note that the term "existing units" hereafter refers to the network facilities that were operational prior to Q1 FY 2025, while Max Noida and Max Dwarka are categorized as the new units. Average occupancy for the network stood at 76% compared to 75% in both Q1 last year and the trailing quarter. However, existing units achieved occupancy levels of over 78%. Occupied beds increased by 26% year-on-year and 4% quarter-on-quarter. Average revenue per occupied bed for the quarter was INR 78,000, growing nominally by 1% year-on-year as well as quarter-on-quarter. For the existing units, like-for-like RPOB grew by 5% year-on-year and 2% quarter-on-quarter.
Network gross revenue was INR 2,574 crore, up from INR 2,028 crore in Q1 last year and INR 2,429 crore in the previous quarter. This reflects an increase of 27% year-on-year and 6% versus the trailing quarter. Of this, new units reported a gross revenue of INR 231 crore. Like-for-like, revenue growth in existing units was 15%, driven by an increase of 10% in occupied beds and 5% in RPOB. Digital revenue from online marketing activities, web-based appointments, and digital lead management was INR 744 crore, accounting for approximately 29% of the overall revenue. Website traffic witnessed over 69 lakh sessions during the quarter, growing by 61% year-on-year and 7% quarter-on-quarter. International patient revenue reached INR 208 crore, registering a growth of 32% year-on-year and 3% quarter-on-quarter despite SH restrictions and geopolitical volatility in certain regions.
Network operating EBITDA stood at INR 613 crore, reflecting a growth of 23% year-on-year and a 3% dip quarter-on-quarter, primarily due to the impact of annual increments and additional manpower hires for new capacities. New units contributed INR 27 crore to the network EBITDA, representing a growth of 19% compared to the trailing quarter. Network operating EBITDA margin was 24.9% for the quarter. Existing units reported an EBITDA margin of 26.2%, which is 44 basis points higher than Q1 last year. Also, adjusted for the one-time donation of INR 12 crore, the margin increased to 26.7% for existing units. Annualized EBITDA per bed for the network stood at INR 68 lakh. Like-for-like EBITDA per bed for existing units was INR 75 lakh, reflecting a 7% growth year-on-year.
Profit after tax for the network was INR 345 crore versus INR 295 crore in Q1 last year and INR 376 crore in the previous quarter, reflecting a growth of 17% year-on-year. Free cash flows for the quarter were INR 389 crore. We deployed INR 435 crore towards ongoing capacity expansion projects and facility upgrades at newer units, while INR 131 crore was spent towards land purchase for brownfield expansion at Max Noida. As a result, net debt for the network stood at INR 1,755 crore compared to INR 1,576 crore at the end of March 2025. Continuing our efforts to support the local communities, we provided free treatments to approximately 40,000 patients from economically weak affected sections of the society, worth INR 62 crore at Hospital Palace. Both our strategic business units continued to report steady growth in their revenue and profitability.
Max@Home reported a top line of INR 50 crore, reflecting a robust growth of 22% year-on-year. It offers 15 specialized service lines across 15 cities, with over 50% repeat transactions. On the other hand, Max Lab reported a revenue of INR 48 crore, reflecting a growth of 19% year-on-year. It provides services in over 55 cities through its network of more than 1,300 collection centers and active partners. Now coming to the status of our expansion projects. Firstly, the 268 beds in Nanavati in phase one. We are in the advanced stages of commissioning three basements, ground to third floor, along with the seventh floor over the next few weeks. 400 beds of Max Smart and Satya Complex. The interior and NEB fit-out works are progressing as planned, with phase commissioning expected to start towards the end of Q2 FY 2026.
Max Lucknow, the current capacity of the hospital stands at 413 beds, and we expect this to increase to 520 beds by the end of the financial year. Of the 107 additional beds, 32 beds are ready for commissioning. The on-call bunkers are also, this is the oncology bunker, are also in advanced stages of completion, with LINAC installation expected to start in early September this year. The 500 beds at Sector 56 Gurgaon, structural and energy work is currently in progress, with high-tech equipment under installation. We expect to commission the facility by the end of this financial year. 100 beds at Max Nagpur, we are currently awaiting formal environmental clearance. While the project has been otherwise approved, civil contract has been awarded. We expect completion within 24 months. 397 beds at Pathpagan, post receipt of environmental clearance, barricading and tendering work is in progress.
The dewatering design, etc., has been done, and work is now being awarded accordingly. This is also in line with what we had projected. 550 beds at Max Vikram, Kakhek. We are still awaiting clearance from the Quality Department for STP tanks plantation. A first application has been submitted in line with discussions with the department. Any which way, this project is to start upon commissioning of the 400 beds at Max Kakhek by the end of this year. The 400 beds at Jirakpur, Mohali. The partner has received approval for the drawings and construction, and site work is progressing at a very fast pace. The project is expected to be completed within the next 24 months. 140 beds at Land are joining Max Noida. Demolition of the existing structure is underway, and the building plans are being filed with the authorities.
We expect to complete this project within the next 30 months. 500 beds at Thane, partner is in the process of finalizing the master plan for the larger site. Detailed drawings for the hospital are being prepared, and we expect commissions to begin by the end of this quarter. The 250 beds at Shalimar Bagh, Delhi, partner has submitted the drawing for approval. Site cleanup and barricading works have been completed, with construction work to commence upon receipt of necessary approval. With this, we open the floor for any questions you may have.
Thank you very much. We will now begin with the question and answer session. Anyone who wishes to ask a question may press star and one on their touch-tone telephone. If you wish to remove yourself from the question queue, you may press star and two. Participants are requested to use handsets while asking a question. Ladies and gentlemen, we will wait for a moment while the question queue assembles. Participants, you may press star and one to ask a question. The first question is from Tushar Manudhane from Motiwal Oswal. Please go ahead.
Thank you for the opportunity. In terms of the operational beds, it has increased by almost 25%. That is also revenue growth, it seems to be, with even the stable RPOB at the headline level. If I exclude this additional operational bed, it would have happened over the last one year. The remaining beds of, you know, performance, how it has been, if you could, you know, show some light.
Like I mentioned, the existing beds is what we are calling what opened in the last 12 months. Max Dwarka opened in July, and Jaypee Noida was acquired in October, November. If I just take these two facilities out, then the growth in revenue has been 16%.
Is that driven again by further optimizing share mix, or is it a combination of both?
Let me just say this. That means including the, including the Lucknow and Nagpur, the growth has been 15% and 18% as I mentioned. If we take out these two new hospitals that we added in this, basically the, you know, the Lucknow and Nagpur, which the acquisition happened in the quarter four of the FY 2024, in that case, the growth will be, if I take that out, then the growth will be around 30% in the revenue and around, you know, 15% in the EBITDA. That means even the base level existing hospital, even taking out Lucknow and Nagpur, the revenue is quite over, so it's just.
Got it, sir. Subsequently, extending to this, you know, now.
I want to mention that in that case, the growth in RPOB will be 7% instead of 5% that I mentioned over the existing hospitals. That means the base level existing hospital growth would be, you know, RPOB is 7%, 5% in the OBD, and overall growth in the revenue will be 30%.
Of course, the occupancy would be any which case going sort of 80% plus, right? I mean, because the headline occupancy itself is at 70%.
No, I think when you said occupancy, the base level of occupancy would be around 79.9% in this quarter.
Yeah, 79.9% is almost 80% on the quarter based on occupancy. If you add Lucknow and Nagpur to it, then it comes to 78%. If you add the other two, which we did last year, then it comes down to 76%, which is similar to what it was last year.
Got it. That's us. Yeah, yeah, fair, fair. I mean, the further extension to this is that if I exclude these new, whatever that got added lower last year, then the base hospitals may, given that we've already grown in this year as well, and we are already at 80% occupancy.
That's right. I just want to tell you, we are calling existing hospitals the two hospitals which were added in the last 12 months, right? If I extend this argument to 15 months, then it becomes four hospitals. Therefore, I'm just telling you, from the existing hospitals, we are only counting the 12 months. In spite of that, the occupancy has gone up from 75%- 78%. If I take out the two which were added in the month 13th, 14th, 15th, last March, it goes to about 80%.
Got it. No, no, subsequently, new growth because of these new additions is very much intact.
Of course.
Before FY 2026, to 2028 or 2029, just trying to understand, if I exclude all these and only on the base hospitals, probably now, the base is, it's being dynamic in nature, so I can't do much about it. If I exclude last 12 months addition, then subsequently whatever the recent comment, and we're reaching at 80% occupancy, in the next two to three years, is it still scoped to grow and further increase the occupancy or that becomes more or less the base, and the addition of base is what is going to drive the growth going forward?
Your base hospital itself, the nomenclature changes. You see, whatever's been added really over the last 12 months or the 15 months has been acquisition and re-increase, right?
Yeah.
For example, what we are going to be growing in the next 30, 60 days, the three brownfields which are coming through in the next, let's say, 30 odd days, is going to be brownfields. They add on to the existing facilities. Then it's difficult to say that, look, in a brownfield, the earlier beds are growing by this much and the newer beds are growing that much.
Fair, fair.
I think, yeah, the take-up of this should be, although it's brownfield, the take-up should be very quick.
Understood. Secondly, on this international patient flow, which are on other geographies, we've been sort of engaged with to get this first kind of high growth.
I don't want to actually go into details of other countries, etc., because I don't want all the tears going into the two countries as well. There have been newer geographies in some of the developing countries as well, developed countries as well, right? Of course, some time back, we had, largely due to the fact that we were opening direct-to-fly offices, right? You know, in other countries and so on and so forth, that's, you know, there was a focus towards international marketing and business is something we had called out much earlier, even a few years back. I think what has led is, we've got increased traction through that strategy. We've been doing more of that and being able to drive more and more patients.
Got it. Lastly, from my side, in terms of MedBed, given the projects at hand, without considering any inorganic opportunity at this point of time, because that will be as and when it comes, how MedBed one should sort of think of at the end of FY 2026?
Yeah, I think the MedBed will go up to some extent because we have set up some funds for the projects underway. If I really say by the end of FY 2026, we may have probably reached the MedBed to the extent of [$240 billion]. Four to four to 500. It will become MedBed to EBITDA of maybe then distinguished in one or two.
Sure, sure. Thanks, thanks. Thank you.
Thank you. Next question is from D amayanti Kerai from HSBC. Please go ahead.
Hi. Thank you for the opportunity. My first question is on your focus on the oncology segment. This is largest for you, and year on year also, I think it has gone up. It is already 25% to 26% of your total hospital revenue. I understand in newer hospitals also you are trying to offer these services. In terms of further growth from the current level, what kind of headroom do you think is available here?
I think first and foremost, some of the newer hospitals, particularly Max Dwarka and Lucknow, both don't offer related oncology at this point of time, right? Because the bunkers are not there. In the third quarter, we're expecting the bunkers to sort of come through in both these hospitals. Therefore, you see a larger share of oncology certainly in these, and that will make an overall sort of this thing as well. We don't believe that there is any sort of reason for the growth in oncology to abate. These are structured, and we are essentially catering to the market. Essentially, the market is growing at what it is, and that is what is leading to increase in our share of oncology.
Okay. Do you think the kind of demand out there in the market and your leading position here, this therapy could be upwards of 30% in, say, a few years from now? Why I'm asking is because I guess what we are hearing from your peers also, they are focusing a lot more on oncology compared to a few years back. From that perspective.
I think to a large extent, you can say we are focusing on it, but we are also all reacting to what is happening in the marketplace, right? Yes, we've seen growth in numbers in oncology, perhaps more than other specialties. If you compound it at that, then certainly you will start increasing the market share of oncology, and it will be a higher sort of market share has been growing. It's not necessarily that the new facilities that we acquired have led to growth in oncology alone, because the newer facilities, like I mentioned, have a lower component at this point of time because of radiation oncology not being there. For example, Nagpur does not have radiation oncology. Lucknow did not have radiation oncology. Dwarka does not have radiation oncology. Okay, Jaypee has, but, you know, that's really one out of the four.
I think as and when, and like I said, when we are able to expand our field for services, which is in Q3, in at least two out of those four hospitals, then the share should go up.
Got your sense. My second question is on your newer hospitals, which will open soon. Nanavati will start in the next few weeks or so, and then Smart is also coming up by the end of this current quarter. What is the status right now on the doctor hiring part? When do you onboard most of the doctors? Before the start of the unit, or will you add on gradually as you offer more and more services? What kind of numbers are you looking at?
All the brownfield expansions pretty much offer the entire suite of services. Like I mentioned in my speech also, some amount of whatever was required for augmentation of these has already happened, particularly with both Nanavati as well as Nanavati, Mohali, and Satya, all three. Incrementally, as and when you open more beds, we definitely have whatever we believe, because, again, we're opening 400 beds. We're not opening 400 beds on day one. As and when you get the close, you kind of open it up. We have more than adequate sort of clinicians who are already onboarded to be able to support what it is. Then incrementally, you'll keep growing thereafter as well. That'll be incremental. You won't see this. Whatever's being absorbed is absorbed. You will not see any impact because of that.
Got it. Okay. That's helpful. Thank you. I'll get back in touch with them.
Yeah.
Thank you. Next question is from Ranath Sharleen from UBS Group. Please go ahead.
Yeah. Hi, guys. Thank you so much for the opportunity. One question I want to understand, you made a comment earlier also that direct cost has gone up, and it's largely because of the new units. Is this going to be stable from here? For example, I can see that your direct cost is INR 1,000 crore right now, from INR 917 crore has gone to INR 1,015 crore. Now the growth of this unit would be inflationary, or there will be more addition, will be that? The subsequent impact on the margin. From Q4 to Q1, I understand this is recently only, but if direct cost shouldn't go up, then one should expect margin to expand from here onwards, meaning for this.
As far as the direct cost is concerned, the significant majority of it is the manpower cost. On 1st of April, we have increased. Yeah. We get that step up because, from 31st March to 1st April, you have that one little bump up because of salary sort of this thing. We also are happy to be at this point of time and always maintain that it's the brownfield, don't really impact. Thirty days before or weeks before when you're doing trial runs, etc., you are staffed. It may not necessarily only be clinicians. It's also people down the line. You staff for those sort of this thing, and you are kind of carrying that cost.
Yes, I think, going forward at present, that cost, that little bit of cost may not be generating extra revenues, but it will do so as and when over the next few weeks these brownfields kick in. Yes, to your point, theoretically, it could increase. Yeah.
On the direct cost specifically going to about 1,000, yes, a bunch of doctors are joining, which is the part of the system that was being built up for the new services coming in. A lot of them will join alongside when the services get commissioned phase by phase. They will go in tandem to the revenues kicking in as well.
Yeah, there's no negative impacts on the commission that will be installed.
Yeah. As we get into the newer quarters, I think as well these hospitals will turn, the share of the PSU beds will come down, right? You know that our strategy is to fill up the beds and then, you know, dip tills. I think as we fill this, this ratio could improve, right? I mean, you know that the PSU share has gone up because of the new beds, etc. As we speak, the occupancies in hospitals like Max Dwarka, which has started only 12 months there, I mean, is 81, 82%, right? It's because we said that's filled up with whatever we had, right? Once that ratio kind of improves, the potential also comes down with direct cost.
Sure. Because typically when you move from Q1 to Q2, there is a sequence of things. For example, 5% or 6% happens on the revenue. It may be more or less depending upon a ramp-up of the new facility. I hope it's more. I don't expect, we should not expect direct cost to also move up in the same line, right? It may not move up, right? Yeah.
Yeah, as a person, this would be moderate, yeah.
That's right. Yeah. Okay.
No, you're right. You're right.
Yes, your hypothesis is correct.
Correct. All right. We should expect a decent margin expansion then. This INR 12 crore thing, is it part of your CSR expense or is it outside of that?
No, CSR expense is generally made by the companies, right? It's not made by the trust. This is the money which is drawn out of the DGF Society, right? This has been on the recommendation of the Board of Governors, etc. There is some benefit that the network cost will get out of this. I think nevertheless, it's a one-time donation that has been made from the PDC Society.
Is this a part of our indirect trust?
It's part of the indirect overhead, yes, at this point of time.
It's a one-time.
Yeah.
It's a one-time. Yeah. Just wanted to ask because it's a CSR, then it's not one-time. If it's X of CSR, then it's a one-time. I think.
It is not CSR in a charitable society. There is no CSR. CSR only applies to companies, right?
Right, right, right.
The money has gone out to the DGF Society. That's the reason why it's changed its donation. It's not.
If I think about it, let's say everything remains the same next quarter, then I should add back this INR 12 crore to the revenues, right? Yes, or to the EBITDA?
That's right. Your INR 12 crore will never happen again. Yeah.
Yeah, that's my INR 12 crore, which I can add back to my EBITDA, right, next quarter?
That's right. That's right. That's right.
Right, sir.
For subsequent quarters.
All subsequent quarters. Absolutely. Absolutely. The last bit, any color if you can give us on the 2Q? How's it been going for you guys right now? How's the season on the vector bond, etc.? Typically, it's a strong season for us.
I'm not going to avoid giving any forward-looking statements.
Okay. The.
I mean, this year, this year normally, as we sort of tell you, normally what happens is that, you know, towards the end of monsoons, the vector season distinct. This year has been a long monsoon. Only at the end of monsoon we start seeing it. You may have to have stagnation of water for vector borne disease to kind of stay, right? It normally happens when your monsoon kind of starts going down, but right now, I mean, it's been continuing.
Sure, sure. I think that's good, thank you so much, guys, and congratulations.
I think the important thing, Sharleen, to look at is existing hospitals, okay, prior to any refuge that we did over the last 15 months, okay? Where there's a 7% growth in RPOB, and there's a, I think, a significant increase in revenue in EBITDA as well. Occupancy has certainly gone up to 80% of those, right? The second thing to look at is the two hospitals which were added 15 months ago. Both those will have obviously a better sort of sense of maturity about them because they've been longer with us. Both of these have also contributed to high increases in their occupancy. In spite of both of them, you still see RPOB move up by maybe 5% and occupancy go up by a couple of percentage points.
If I add the two hospitals which, you know, one we really acquired in October-November, the other was a greenfield, in July, let's say Sita. Those have, in spite of those, we see flat occupancies on an overall basis. It is not any new facilities haven't really dragged down our operations or our numbers by any significant distinct. Yet, you know, they've provided us an opportunity as they mature.
No, got it. Yeah, yeah. Absolutely. Absolutely. I can see that. Great, guys. Thank you so much. I'll go back and touch you.
Thank you, sir.
Thank you. Next question is on Rajat Shah from PGI M India. Please go ahead. Hi, Raj, may I request an unmute and proceed with your question?
Hi. Am I audible?
Your audio is very stable. Can you speak a little louder and through the handset?
Hello. Am I audible?
Yeah, go ahead, please.
Yeah, I just wanted to know regarding the growth trajectory of the acquired hospital on a revenue and EBITDA basis. How has it been post the acquisition?
You're talking about the Nagpur and Lucknow?
Including Lucknow and Nagpur, and also Noida. Go ahead.
Yeah. Lucknow has been doing very well. On a one-on-one basis, the revenue growth is 97%. EBITDA growth is, you know, is 191%. Nagpur will grow on the revenues by 20%, while the EBITDA growth is also in the same range. Noida has been a bit, you know, subdued. The revenue growth is, while steady, and this is based on the numbers that we have updated last year. You know, these are not our numbers, but it's basically the numbers that we look at from the, you know, Israel management. That's around 14% growth, and EBITDA growth is 32%. So that's the numbers.
Okay. Perfect.
Okay. Yeah.
That's it from my side.
Raj, do you have any follow-up question?
No, that's it from my side. Thank you.
Thank you. Next question is from Neha Manpuria from Bank of America. Please go ahead.
Yeah, thanks for taking my question. First question, Abhay, when does Nanavati, the new block, fully become operational? You said that we are currently operationalizing one of the floors and I think the basement. When can we see the units becoming, let's say, fully operational from an EBITDA perspective?
The basement is not just the basement, right? The basement is also used for on-call services and so on, right?
On-call.
Yeah, yeah. We're using the medicine department in the basement. Let me kind of rephrase that. We will be starting over the next few weeks, you know, a couple of floors. During the transition towards October-November, we should be starting the rest of the beds, including OTs, etc.
Okay, understood. My second question is, if I look at the new units, the numbers that you have given for the fourth quarter versus this quarter, it seems like it's broadly similar to what we did in the fourth quarter. Is it because I thought that Max Dwarka had achieved break even last quarter, and that should be positive? Is it just a seasonality thing? I thought the seasonality isn't as stark quarter on quarter from fourth to fifth, and I would have expected that we see, or should I assume till the time we don't see on-call come in in Max Dwarka, you won't really see that big ramp-up happening?
No, I mean, on the contrary, you know, seasonalities, you're right, are there. For a new unit, there are no seasonalities because your growth momentum is still taking care of the seasonality and beyond. We've seen very high ramp-up of occupancies and everything at Max Dwarka. No, I don't think you're waiting for anything to come in. In fact, we are already planning brownfields at Max Dwarka because we are fitting facility down status over there.
Yeah. Dwarka growth on quarter-on-quarter basis is 24%, which means that we drove the revenue from the quarter four FY 2025 to quarter one by 24%. The EBITDA is also seven, eight crores up than quarter one, quarter four, sorry. Dwarka is no, no, no reason for anybody.
Yeah, yeah. This thing has, I think we have way past the breakeven and the seasonality questions over there, etc. We are talking capacity out status.
Okay. In which case, then I'm wondering if, you know, Noida could have done better this quarter, but you know, that really because I would have assumed that, you know, you would see a much larger improvement, you know, given the ramp-up in Dwarka and also, you know, Noida starting to, you know, improve performance. I'm just trying to get a sense, is Noida on track with what we are expecting? Or, you know, should I expect an acceleration as we go through the rest of this year?
You will certainly see acceleration in Noida as well, okay. Like I mentioned, we acquired in October-November, okay? The first couple of quarters are always more distinct because you're kind of integrating HMC, your IT system. We changed the name of the company. We had to re-board it from LCRT. When we did that in this particular case, all the licenses, including transplant licenses, blood bank licenses, etc., we had to reapply for each one of these. Those have been coming through, etc. It's literally we've been operating a little bit with our hands tied behind our back. Even again, this was a company which has been in liquidation for many, many years. The equipment is out of life. We ordered all the equipment. They've been coming in phases. All the building blocks have been put in this particular listing.
Typically what you have is that, look, in any acquisition that you do of this nature, the second year is better than the first year. The first quarter will always be the weaker quarter, right? It will be the weakest quarter because that's perhaps the time you have been able to implement the least amount of changes that you wish to. Whether it's equipment, whether it's management, whether it's doctors, and so on and so forth, that onboarding does take three to six months. Like I said, in this particular case, it's almost like somewhere it was an acquisition that we did, but somewhere it was a greenfield kind of thing because we lost all the licenses. We had to get them all renewed in the new company and so on and so forth and all of that.
Most certainly what's going to happen is that, going forward, you're going to have a snowballing effect. In the quarter to come, you should see significant upside there.
It's fair to assume that all of the grant work that needed to be done for Max Noida in terms of licensing, equipment, etc., will be done. You should start seeing that from the subsequent quarters.
It's already done. Yeah, it's already done. When you order this equipment, the supply chain itself, you know, it comes from overseas. There's a six-month process from the day you indent it for you to get some of the equipment in place.
Understood. Understood. Your question, what did you mention? The Noida EBITDA at? Sorry, I missed that number.
Noida EBITDA growth is 32%, right? The revenue growth is 14%.
Would you have the absolute numbers of the EBITDA? Sorry.
I mean, I have the absolute numbers. It'll be around INR 24 crore for the quarter.
Okay. Thank you so much. That's helpful, sir. Thank you.
Thank you. Participants, you may press star and one to ask a question. Next question is from Kunal Kamesha from Equity Group. Please go ahead.
Hi. Thank you for the opportunity. Just, assuming on the Dwarka and Noida thing, I think the total EBITDA contribution is around INR 23 crore or something or 37. Total contribution, for Dwarka and Noida, which we have mentioned, the new unit is 27, of which we have here 24 is Noida, right?
I think you know also to figure that when the unit EBITDA will be 2.5% higher. We also cross-charge the effort cost when we record numbers to the investors. When you see a unit performance, then it'll be 2% higher in terms of EBITDA margin, 2.5% higher. So 2.5% of the revenues allocated to the unit as the effort cost.
This 27 is on a location.
The 24 is the 24 that I mentioned, is the unit EBITDA, right?
Unit EBITDA.
INR 24 crores. Okay. Which would come down to what, around INR 20 crores?
By INR 24 crore.
Because Max Dwarka, you said 7, 8, right?
Yes.
7 crores.
That's right.
INR 24 crore.
That's right.
Okay. Okay.
This 27 number is after 2.5% lost to INR 31 crores being allocated to these units, right? If you take out this effort cost, you add INR 5 crores to this INR 27 crores, INR 32 crores is the number combined for Max Dwarka and Max Noida, okay?
Got it. Thanks. Yeah, thanks. Second question on the RPOB. You were suggesting that, including Lucknow and Nagpur, the RPOB is around what, the 4.9% growth, right, excluding Noida and Dwarka? We're seeing that the 3,500 beds that we originally had at 7%, that translates to around 7% RPOB degrowth for Lucknow and Nagpur. Is that a correct math?
No, I think I know there's some confusion out there. First of all, let's take the existing hospitals, right? Without taking even the Nagpur and Lucknow, the RPOB growth is 10%, right?
Yes.
These are the hospitals which are in operation, you know, in December 2023, right?
Correct.
If I take out Nagpur and Lucknow, which is the hospital that we acquired in February and March of 2024, then the RPOB growth is 5%, right?
4.1. This is my initial reference.
If I take Max Dwarka as well as Max Noida, see the RPOB growth is 1.2%.
Correct. Correct. I'm saying that for our 3,500 beds, to 2% RPOB growth, the RPOB should have been degrown in Lucknow and Nagpur, right? Only then 7% comes down to 5%.
No, I'm not sure what you're saying because there's no YOY number for the Dwarka RPOB, right? There's no number for Dwarka, right, in Dwarka.
No, no. Just exclude Max Dwarka and Nagpur, Max Dwarka and the thing.
One sec. You have a record, one sec.
Yeah.
Look, there's no degrowth in RPOB in any of the listings. The only increase in RPOB.
The numbers are not basically connecting.
How was that 7%?
For 3,500 beds, you are seeing 7% RPOB, right?
Right.
If we include Lucknow and Nagpur, which is around 600 beds, our presentation says that 4.9% growth or 5% less than, right? 7% is still down to 5% by addition of Lucknow and Nagpur in the mix, which means.
I mean, we've got 85 beds, no?
That means this is the number, right? Just note this down. In the hospitals which were operating till December 2023, the ortho beds were 2,732, right? If we take in the two hospitals, which is Nagpur and Lucknow, the ortho beds were 3,117, right? If we take Dwarka and Noida, the ortho beds were 3,556, right? Now we're moving.
Yeah, I'll maybe connect offline on that.
Sure, no, they are in active workshops.
Please get your formula straight. I've seen your formula, and some of the other thing is, you know, in spite of us saying that occupied bed days have gone up and A loss has gone down, I believe the statements have been made in your formula that our footfalls have gone down for ICD. You know, theoretically, that's not even possible. Please get your cards straight.
Sure, sir. I'll do that.
Thank you.
Yeah, yeah. Second question is, you know, we have seen significant increase in institutional business, right? Even let's say because last year, same quarter, we would not have Noida or Dwarka, right? There's a significant increase, and I assume that Lucknow and Nagpur are not, you know, the center for a lot of institutional patients, right?
We started institutionally in Bombay also. In view of the new beds coming, we've also been Nagpur restarted. It was not there earlier, prior to our takeover. It started last year. So is Lucknow.
Okay. Then existing beds, the 3,500 beds, what would be your, I mean, view? Is it more or less stable in terms of bed days from institutionals or?
For example, let's say Mohali, right? Mohali, we're adding 150 beds. You can't take institutional as that for a time, right? We'll take an institutional in the last quarter, right?
Moment of familiar.
It's gone up, right? We would, we've obviously, you know, we are preparing for the EBITDA.
Those in Mumbai, right? It takes you six months. It takes you six months to implant yourself. Mumbai, for example, as well, there was no institutional business. Now we implanted some institutions.
Sure. Wherever the new expansion is coming, it is more strategic.
That's right.
Very good. Thank you, [Anoop].
Thank you.
Thank you. Next question is from Ranath Mohammed Patel from Edelweiss. Please go ahead.
I have a question on RPOB growth. It has been flat overall. How should we think of overall RPOB in the near term?
It is growing. We think that you've grown by 7%. If you add the two hospitals put up 15 months ago, then it's grown by 5%. If you look at all of the hospitals, then it looks flat. Of course, if you're going to start a new hospital or you acquire a new hospital, the RPOB of that particular hospital is going to be lower, right? You are going to bring the average down. Otherwise, both for existing and the newer hospitals, you know, existing hospitals have gone up RPOB and occupancy significantly.
What do you think about the overall RPOB growth?
Sometimes solutions. Right? Yogesh Sareen, your voice is breaking. Can you please come in? Better reception area?
Is it better? Yeah. When you acquire a new hospital, you acquire it because you lower RPOB. You acquire it at that price. The whole idea is to increase the occupancy and the RPOB of that, right? Going forward, you see RPOB move up.
Okay. Eventually, after a few quarters, the overall RPOB growth will again start inching towards the highest level?
That's right.
Okay. My second question is to.
Having said that, it also depends where you're acquiring. We buy for ROCE. We don't buy for, you know, I may acquire something in a tier two city where the RPOB is, let's say, half the present RPOB. That RPOB of that place may never go up to my existing class of RPOB. The fact is we have to figure out what ROCE are we buying it at. If I'm buying it at a 20% or 25% ROCE, or if I believe I can get it to a 25% ROCE, in spite of it having a lower sort of impact on the overall RPOB, I'd still acquire it, right? I think the cadence you're looking at is incorrect. RPOB by itself or a margin by itself, of any capacity that you're acquiring or you're starting today, is incorrect.
What you have to see is do we have superior return on capital profile over there or not?
Okay. Fair enough. My second.
Let's say if I get an opportunity to buy a chain of hospitals which operates at less than half the RPOB than overall operating at, and I'm able to buy it at a 25% ROCE, should I or shouldn't I? I should, right? What it would do is bring my overall RPOB down. We'll never be able to climb up to sort of my present levels of RPOB. Could we be coming on the same page?
Yes, yes. I get your point. My second question is, should we expect EBITDA margin improvements in FY 2026?
You will expect improvement. Having said that, let me also tell you, and I keep repeating this, EBITDA margin is an incorrect sort of this thing. Because the higher payer mix, your EBITDA margin, my international business is growing by 32%. Supposedly, it's a higher margin business in value term. It's a percentage term, it's a lower margin business. When you do robotics or you do transplants or you do any of the high-end business, surgical business, it gives you less margins in percentage term, but it gives you more in value terms. Please consider EBITDA per bed as the right season and not EBITDA margins. At one end, because of better occupancy, at one end, because of better occupancy, higher utilization, and so on, your margins will increase.
On the other end, because you're going for a superior payer mix and a superior clinical mix as well, your margins should decrease because of that, right? Your EBITDA per bed will increase, and your ROCE will increase.
Mohammed, do you have any follow-up questions?
Mohammed, are you with me on this?
Yes, yes. I'm with you. I'm with you.
Okay.
Thank you.
Thank you.
Thank you.
Next question is from Ranath Suji Shah from SK Enterprises . Please go ahead.
Am I audible?
Yeah, okay.
Yeah. Firstly, I want to appreciate the entire National STRATE team. At this hospital, expanding so rapidly while maintaining profitability is not easy though. All my questions are already asked and answered. I do not have any question to ask.
Thank you.
Thank you.
Thank you very much. Ladies and gentlemen, next question is from Ranath R. Deshra from Informat Media. Please go ahead.
Hello. Can you hear me? Am I audible?
Yes, yes, I can hear you.
Yeah. You, earlier in the call, you mentioned that at the end of FY 2026, the net debt will be, and you gave some figures for that. I was not able to catch that number. Can you please repeat that? The net debt level at the end of FY 2026? Thank you.
What you just mentioned at the end of the year, between now and the end of the year, your total debt for project purposes may go up by another INR 400 - 500 crore. May go up to INR 400 by INR 400 - 500 crore.
Okay. All right. That's it. Thank you very much.
Thank you.
Thank you.
Thank you. As there are no further questions, I'll now hand the conference over to the management for closing comments.
Thank you once again. We appreciate all your time and look forward to connecting with you next quarter. Thank you so much.
Thank you very much. On behalf of Max Healthcare Institute Limited, that concludes this conference. Thank you for joining us, and you may now disconnect your ends. Thank you.