Good morning, everyone. This presentation will highlight the main information from Mater Dei S.A. about the first quarter, which finished on 31st of March , 2022. This presentation will summarize, and is not intended to be a complete presentation, just the main highlights. Investors and shareholders should understand this presentation along with the quarterly disclosure results. This presentation was prepared for informative purposes and should not be interpreted for proposition of purchase or any other intention, and it's not a recommendation for investments. None of the statements here are provided with precision, certainty, or comprehensiveness of all the information in the presentation. The performance of the company is not an indication of future earnings or results. This presentation should not be used as a base for any decision or contract.
Information about Mater Dei, its activities, its financial economic situation, and the risks inherent to its activities, as well as its financial statements, may be obtained in the Mater Dei website for investor relations.
Good morning, everyone. I'm Henrique Salvador, and I'm the CEO of Mater Dei. I'm here with the company of Rafael Cordeiro. He's our CFO of Mater Dei. Today we're going to be presenting the earnings for the first quarter of 2022. At this moment, the company has the capacity to receive over 2,500 hospital beds in its units located in many different hubs where we're operating. In November 2021, we performed the acquisition of the Hospital Santa Genoveva in Uberlândia, and now in the first quarter of 2022, as disclosed to the market, the transaction was confirmed. Now this unit already operates, and it's integrated with Mater Dei.
On January 11th, 2022, we announced the Hospital Premium in Goiânia, which sets the entrance of the company into the Midwest region of Brazil, which is a very promising region, the agribusiness hub of the country, with strong potential for development growth. This Hospital Premium has the capacity for 156 beds with the possibility for expansion through brownfield, as we've also acquired a 5,000 sq m land that's next to the existing operation. After, in February 2022, we announced the acquisition of Hospital EMEC, the first private hospital in the city of Feira de Santana with a capacity for 150 operational beds, and this acquisition was completed also just recently. After, on March 2nd, 2022, we announced the acquisition of Hospital Santa Clara, which reinforces our position in our network in the Minas Gerais region, in the Uberlândia region, one of the three most traditional hospitals in that region.
This transaction still has a preceding condition with the antitrust bodies analysis, CADE, and we're waiting on this decision. Once this is integrated, the operation of Mater Dei in the Minas region is going to become even stronger and even more capable of generating value and results for the Mater Dei network. Another important step was just recently with the launch of Mater Dei Salvador. As we had mentioned and planned previously, we should be launching this greenfield project in the first semester of 2022, and this is what we've done. Just 10 days ago, on 1st of May , this hospital was inaugurated. It's already operating. It's the first greenfield project the company has launched out of Minas Gerais. It's a project that has a modern infrastructure. It's complete for the full service of our patients.
It's strategically located in the region of Rio Vermelho, right on the corner of two important avenues. It's in development with 61,000 sq m of built area, and we have 24 different floors with a helipad, which allows you to connect with more remote locations in the state of Bahia, which is a really big state. Those neighboring states and a capacity for 369 beds with 40 for pediatric ICUs and 40 ICUs for adults, so it's also a very robust emergency region. We have really the most modern technology available, along with 21 surgery rooms, a robotic surgery room, a CT scan center inside the surgical center, which will allow us to have complex procedures that are radio-guided. A hospital facility that's definitely one of the most modern in the country.
At this moment, the hospital already has 600 employees hired in a clinical team that's complete with almost 400 physicians registered and over 40 specialties. An important unit also that we should mention, which is the accreditation of other insurance companies, where we already have over 400,000 lives hired with a possibility for expanding from scratch the number of services provided, and also generate a lot more value for the Mater Dei network as a whole. It's important to mention that this integration concept, this hospital will also have a building with 10,000 sq m of built area, which is close to where we'll have a physician center, where we'll have other 70 additional medical offices, an administrative office, and a convention center, which will allow Mater Dei to have a strong interaction relationship with the scientific community and physician community.
It's a moment when we're really searching for opportunities to integrate these operations so that we can have the best use of these M&As that were performed. Some opportunities as well really catch our attention at this moment. Hospital Porto Dias, for example, where we just launched the maternity. It's a very modern maternity and certainly will be a relevant process for the medical services in Pará. With 18 rooms initially, three PPP, which is this modern concept for maternities and pediatric services. We can even expand this model so that we can absorb the demand that will certainly arrive as this takes place. This is the first expansion we have that's very synergetic ever since the acquisition of Hospital Porto Dias, considering the tradition that Mater Dei has in its maternal and pediatrics areas.
This is going to be an important initiative in the Pará region for our northern hub of hospitals. In the first quarter of 2022, we also set up and registered with Bradesco Saúde, this insurance company, for Hospital Porto Dias, and I think this is going to be an important registration process as we have this partnership with this insurance and payer, to be able to really strengthen the Hospital Porto Dias quality service, which is due to a historical partnership that the Bradesco insurance company has with Mater Dei. It's also important to highlight some new registrations and agreements signed with payers. We were able to be registered also with IPSEMG, The Institute for Public Employees in the State of Minas Gerais, in two of our units, Mater Dei Betim-Contagem, and Hospital Santa Genoveva.
There are 800,000 lives in Minas Gerais, with about 160,000 in the Belo Horizonte macro region and 21 in Uberlândia. The experience we've acquired with the Hospital Porto Dias integration with IASEP, the Institute for Pension Services in Pará, really helped us to consider some specificities that we have in this health plan model. Also in Hospital Porto Dias, we signed an agreement with Leader Saúde, with 7,000 lives that will leverage and potentialize even more of the services and movement in that region. Now I'll pass on the word to Rafael Cordeiro as he gets into some of the details of our numbers in the first quarter of this year.
Thank you, Henrique. Thank you, and good morning, everyone. This first quarter was really very challenging. We have been going through some structural processes in our sector.
Mater Dei has many levers to be able to really make this year promising. The first quarter is not going to reflect what we're going to be doing during the year. We have many effects in this quarter, which is due to our sector and also the moment we're going through with new acquisitions, opening up a very important greenfield operation. Salvador is bringing in even better perspective than our business plan originally imagined. We're super excited for the rest of the year, and we're going to show you some of the highlights in this quarter. Some information about the controlling company in the metropolitan region of Belo Horizonte. We had an increase of COVID-19 patients hospitalized in the fourth quarter. Now we went up to 56 patients hospitalized.
On the bottom part of the slide, you can see that we show you the growth of the beds that will really become a legacy after COVID. We've been growing the amount of beds systemically. We've been also working on some initiatives that won't be reflected in the short term, but some efforts with operators, payers, and IPSEMG was just mentioned by Dr. Henrique. We started off in the month of April with them. We have expertise coming from Hospital Porto Dias also, where we learned how to handle and work with these kind of plans. We can work with the main procedures and really be a reference for high complexity in the state, so we can open up even more beds, which is our objective at the end of the day when it comes to the metropolitan region.
Moving on to the next slide, as we talk about this in a more consolidated way, we had growth that was very significant. 20% with 1,078 beds in our network. It's double what we've done in the IPO, so we already have about 100% growth in the number of operational beds, and more will come with the consolidation of this process. The occupancy rate is one of the best that we've ever had in the last quarters, 74.3%, where we've had strong work to increase productivity and improve and search for ways to improve our margins, although we have this very challenging high inflation scenario. When it comes to the amount of patients per day, we've been growing 70.6% compared to the first quarter of 2021. An important acceleration compared to the fourth quarter of 2021. The average ticket is a trend we've been noticing and discussing with you.
Some operations we acquired are lower average ticket operations, which does not mean, we have been talking about this actually constantly, that this does not mean lower profitability. At the moment, we are having an occasional reduction in this because of the integration synergy work being done, but the average ticket has MatMed costs that we do not look at as a cause for reduction in margins. So we have this reduction to BRL 2 million per bed at this moment. When it comes to the net revenue, the growth of quarter-over-quarter was 51%, and a growth of 20% compared to the past quarter, reaching BRL 343 million of net revenue. What is important to mention is that we also had, in this quarter, a situation where you see we have a non-payment, and it is a seasonal period.
We have already been working on this actually internally to be able to get back to the levels we had last year, which we want to reach this year as well, which are non-payment rates that are close to about 3.5%. So we have 2 - 2.5 points in the EBITDA that have been harmed by this quarter, but these are issues that will be recovered over time. We have already seen where these main points have occurred, and this has an occasional effect in the first quarter only. Moving on to slide eight, the cost of services provided. We have an increase to 65%, and here we are going to show you some of these adjustments that was actually requested by you guys in the call in the last quarter, so we can disclose what the costs were related to Salvador.
Salvador had this effect of BRL 3.8 million with BRL 2.1 million in costs and BRL 1.7 million in expenses. So if we adjust this according to Salvador, which was not a revenue generation source, we are going to go to 64.4%. There is a change that is structural in our P&L when it comes to cost, because the hospitals were integrated go through the revenue and cost with zero margins with the medical fees. So we have a percentage increase of this line due to this point, and we also have the entrance of MatMed and Personnel with the new personnel. Sorry, with the new hospitals where we still have not seen the effects of the synergies.
We have been starting this work for about a month with Hospital Santa Genoveva . We have been going in with Premium, and we are going to start with EMEC next month as well.
These are hospitals that used to operate at levels that were actually a little lower than what we have at the National Association of Private Hospitals. So there is an improvement for operational gains. On the bottom part, we already have a reduction in the operational expenses. This is something where we have a trend of dropping this number throughout the year because we have a new hospital, the new revenue. We have a good structured back office, so expenses actually come before the dilution. Here we have BRL 6.8 million in adjustments, which is M&A, stock options, and that part of Salvador I mentioned just recently. So we have a reduction to about 14%. Then we have other costs we do not adjust for, which are occasional expenses that are not ongoing. So we have some costs with licenses for IT work as well, and services related.
Then we also have part of the integration that we've hired a third party to work on, and now we're already operating with our own internal team. But this is an expense we had in the third quarter. These are effects that we don't highlight, but they somehow harm a bit of the results. The trend throughout the year is for a reduction overall. We consider that there will be better results in the cost of expenses in the next quarters in the year. As a consequence of what was mentioned before, we did have margins below the first quarter of last year and a little lower than the fourth quarter, but this is just because of the non-payment issue. We would already maybe have margins that are higher than this.
These are points that administration's really focused on, and we've been identifying these main points and the synergy and integration work will be fundamental to maximize the results in the next quarters of the company. We reached BRL 90 million EBITDA in the quarter with a growth of 11% compared to the previous quarter, and a growth of 45% compared to the first quarter of 2021. We really have our eyes open when it comes to margins, and we've been increasing, when it comes to absolute terms as well, due to the integration and acquisition of new assets, considering quicker speed than what we had expected and promised to the market. This brings some challenges for the year, but we understand that we have the tools, the people, and the processes that we need to be able to go through this year of integration.
Now, moving on to slide 10, we have an important point that we need to highlight as well, which is we had BRL 37 million of net income. It's a margin of 10.7%. It's lower than the fourth quarter and the first quarter of 2022. But we also have the goodwill of the Bortolotto acquisition, which has a cash effect. We haven't paid income tax on this quarter at the controlling company, and we have a provision for BRL 18 million. From an accounting perspective, we have the goodwill in a stable position on side of the asset, and we have a deferred liability in the long term of BRL 18 million.
You won't find the liability because it's net with the deferred asset, but you'll notice over time that there's a reduction of the deferred asset, and up until the end of the year, we'll have the creation of this deferred liability. This is money that the company has. These are resources that are not cash outputs, and this is just an accounting perspective, really. As a fruit of the acquisition, we have this benefit when it comes to cash flows. Then we've had many payments for acquisitions in this quarter. We had BRL 460 million for investments. Part of this is Salvador, where we had almost BRL 100 million in investments, among which we'll have now in the month of May and June, the repayment of this investment in Salvador. BNB is a bank that operates as, they have a reimbursement process.
They have a rate that is really good, which is IPCA plus 1.05. The recovery of this cash position will be important for our liquidity. We went from BRL 1 billion 278 at the end of the quarter of 2021. With the investment for operational generation and financial aspects, we had a cash consolidated position. Now moving on to the next slide, on slide 11. We have this cash with our debt of BRL 1 ,159,000,000 , takes us to an indicator of a net debt to EBITDA ratio in the last 12 months of 1.1. We have almost all of the investments made with the payment of EMEC that took place in April and Santa Clara. When we have approval from the goodwill entity, which we are estimating will occur in 2022, we will have these two exits.
We understand that the cash part is up to date and we will have a really comfortable debt position for the company to be able to have an equity structure, and a debt structure as well, if necessary, to have a future acquisition or another acquisition that is more structuring due to the moment we are going on in our sector. Going on to the schedule of this debt, it is a really long-term debt. 77% of our debt is going to be reaching maturity over five years, with an average term of 6.4 years. There is a really good structure, but the company is always looking on to new opportunities for reduction of its cost of debt and extension of the debt payment. We have no concrete actions being done, but we are working on many internal studies. These are the main points about our earnings.
Now, we will start Q&A, and we are available, me and Dr. Henrique, to answer your questions. Thank you so much for your presence today.
Moving on to Q&A. The first Q&A comes from Samuel from BTG Pactual. Good morning, Samuel.
Good morning, Dr. Henrique and Rafael. We have two questions on my side. The first one is about the ticket, which dropped about 12% year-over-year. I think we had a bit of the impression that this becomes a new level. But I wanted to understand if there was some occasional effect that is a lower complexity in the network in the first quarter. That is the first question. The second question is about operational beds in Belo Horizonte. Should we know that including COVID, we even have a drop quarter-over-quarter when we exclude the COVID beds.
I wanted to understand if this is like an occasional effect or temporary effect, or if you think that the bed ramp-up in the market overall could be maybe a little slower than what you had imagined previously.
Well, let me mention the ticket first. As you read your reports on the sector as a whole, we did have Omicron in the beginning of the year, which led to an important movement that was really high in our emergency rooms and outpatient centers, generating less hospitalizations, which reduced the tickets of all of the hospitals in the entire sector. The controlling company, which is in Belo Horizonte, which is going to be in Salvador as well. But now only those three hospitals had a reduction, which is the fruit of Omicron, but now we have already seen a recovery in this ticket in March and April.
It was really just an occasional issue. Structurally, our ticket will be lower than the ticket of the controlling company, which is what we've always reported, which is the fruit of these new hospitals. Then you have another issue that's more factual because there's a lower ticket, but there's also an opportunity. In Dr. Henrique's presentation, he mentioned, for example, the accreditation and registration of Porto Dias with Bradesco as a payer for an insurance plan. We are very confident in the increase of the ticket with new payers being registered. We also have the opportunity to bring in more complexity to the hospital. EMEC is coming in in April.
They're right next to Hospital Salvador, which maybe has one of the best hospital equipments in Brazil, with the opportunity to bring in new procedures as well, new exams, and taking on new conditions for the population in Feira de Santana. As well as Uberlândia, which is a hospital that was really, for quite a while, leaving a lot of physicians aside, postponing some investments. We see opportunities for the clinical team and new procedures and surgeries that are more complex. Occasionally, at some point here, just to end my presentation on the ticket, there was a general reduction due to Omicron, but we've noticed a recovery. Structurally, our ticket will be lower than the Belo Horizonte one due to the structure of the entrances. This does not mean lower margin.
We're going to work to have the historical margins in Grupo Mater Dei that we've disclosed in the past, and the opportunities are huge for the growth of the tickets in new operations. Now, when it comes to the revenue and synergies, that's what comes afterwards. First, you have the capturing of improvements in the cost or reduction of expenses with new plans, new procedures, and new positions in a better mix. This is an improvement over time, despite the two points I mentioned in the beginning. Now I'll pass this on to Dr. Henrique.
Good morning, Samuel, and thank you for participating. Samuel, to be very objective about your question on Belo Horizonte, which includes the three hospitals, Mater Dei Contorno, Santo Agostinho, and Betim -Contagem.
If we compare the number of beds that are non-COVID with the first quarter of 2021 and the first quarter of 2022, we went from 284 non-COVID beds to 365 in the first quarter of 2022. If we compare the fourth quarter of 2021 with the first quarter of 2022, we went from 349 non-COVID beds to 336 non-COVID beds. I think the main celebration of this agreement is going to bring in this movement that's really accelerated, especially for the Betim -Contagem unit. The expectation is that there should really be the opening of new beds in the next weeks and months, which will make us have an opening of the non-COVID beds that's even more significant now in the second quarter of 2022.
Great. Thank you very much, Rafael. Thank you very much, Dr. Henrique.
And just to explain myself here, we are mentioning the total number of beds, excluding just the COVID beds. You even say that they are the non-COVID beds, but there is also the ones that are the fruit of the occupancy rates. But it was quite clear due to the response that you had about the accreditation. And this also helps with those 74.3% where we have better productivity. The less beds we have due to the occupancy rate, with more beds with the team, we will be generating revenue. So from a total revenue perspective, you are correct. But when it comes to the company's vision on what generates revenue and what is productivity, the green part of our graph here is the number that we need to consider when we are growing.
Okay, perfect. Thank you very much.
No problem.
Now I will pass on the word to Gustavo Miele from Goldman Sachs for his question. Good morning, Miele.
Good morning, Rafael, Dr. Henrique. Thank you for the presentation. We have two questions here on our side. The first one is, I wanted to recover the ticket discussion a bit and explore another angle. I wanted you guys to help us kind of eliminate a bit of the sausages effect in the company's ticket. Do you have any expectation? Or what would be the ticket if we were to take a photograph of the metropolitan region in Belo Horizonte? And also, what would be the main triggers you look at for prices? So are you looking at a recovery in the mix? What is the profile of the elective surgeries coming into your base, and what is the negotiation with the payer?
We have also seen that there is a bit of a challenging scenario for the first quarter, but I wanted to know if in some way you are having some kind of a negotiation for prices with these payers, just so we can try to monitor a bit of what would be the ticket for the rest of the year. And a second question, if possible. I wanted to understand what is in between the lines in the cost structure of the company in the quarter. When we look at the COGS, we can see that in the second quarter, there is performance that is really interesting in the dilution of material and medical expenses. But then we also see a personnel structure that is maybe a little more challenging even.
So I wanted to understand if this is a temporary effect with synergy gain, maybe the personnel synergy here for the integration of the new deals is coming in a bit later, or if maybe the personnel level is something similar to what we have seen this quarter. So these are the two points, more of an outlook on the tickets and the cost structure of the company. Thank you very much.
About the tickets, Miele, we are not going to disclose the ticket per hospital, but we do not see anything structuring that will change the ticket of the controlling company, which was your first question. There really was a challenge initially in this quarter. Omicron is a national issue, so you will notice this in all of the hospitals.
You do have an outpatient service that reached a record of all the numbers in 2019 even, and hospitalizations were a lot less than the first wave that reached the first hospital. Occasionally in this quarter, we're going to continue to work on the tickets and the growth and the recovery of these tickets following that challenge. We don't see any structuring changes from the past to the future. The new network do have smaller tickets. They have tickets at the level of the Porto Dias, but what we see is within our studies and one of the fronts with the integration work is the growth of the revenue and the tickets of the new units. As I mentioned, this is a process. Let's show you a clear example about this. Goiânia, for example.
It's like wine to water, a real change, and it was a hospital that was really well-structured for what it was planning to do. Now it's a new hospital with capacity for growth, with a piece of land that we acquired next to it, but with a plastic surgery, eye surgery, and dermatological surgeries with a more restricted network. In this region, you have some limitation with some procedures, so we're working on guaranteeing that we can kind of launch this new Hospital Premium with all of the specialties that can really be in line with the network standard. There's an issue related to the ticket, the mix, and then we're going to talk about operators as well. We have some work with the national operators so that they can start. They actually requested this before acquisition.
Many of the national operators were saying, "Hey, Goiânia seems to be a good place for you guys to go to, where it's difficult for us to come in because of a lack of a partner." Now that we're going in and structuring this, they're also structuring plans, their commercial structure. All of these are important steps that don't come from night to day, such as a cost that you can cut off, for example. There's an important point there. About personnel, before we move on, personnel involve a change. Some of the hospitals we consolidate do have some fixed costs related to production. You have some shifts that have extra payments. These are some of the regional characteristics, but we're going to monitor this and bring in a bit of our own concept. There's a strong reduction of people in these units.
For Hospital Santa Genoveva, we've already cut off over 100 people. This movement was in March and April, and it brings in costs initially, but then there's quick returns of about four or five months, and you already start working at a whole other level. There is an occasional increase. These are movements that we are in the beginning of the synergy process. We've identified them, but they're going to happen over time. When it comes to the revenue, it's a little bit longer. That's why we say that our margins, because this is adding up some of the costs and expenses, but also the structuring aspect when it comes to the revenue.
Well, Miele, as we try to answer the first question you made about negotiations with the operators, they are underway, and I think this is an important point, especially in the current scenario we are in. There is another point as well, which is something we have been working on as well that will impact our margins. This is the renegotiation with the suppliers, expanding our spectrum for use of some of these inputs so that we have a capacity to negotiate this better. We have been working on this with our clinical teams and with our suppliers to be able to achieve this. The Mater Dei Hospital in Salvador, for example, has the possibility to really take on a lot of high complexity in some operators that we have been registering. Structurally, this allows for this.
This robot we took there has ultrasound that is connected, and it allows for very unique procedures as we performed this week in the city of Salvador. The CT scan system in the surgical center allows for high-complexity surgeries with high added value when it comes to the average ticket. There used to be some pressure on behalf of the operators for us to move on to Goiânia and Uberlândia as well, which are regions where we have a lack of qualified access to be able to take on this high complexity. Another important fact as well that will lead to an expansion of the spectrum and the complexity of our work is how some of the hospitals we work at had clinical teams that were closed. They were really like a feudal system.
At the moment when we come in, we started attracting other teams from these cities that did not have access to our hospitals. This allows us to also, as we improve structure and processes and management, we can create more of an attractive approach for these positions that are referenced in the city, and with this, we can attract more complexity. This integration has really focused on this and this work with suppliers, this work with improving the attractiveness of this clinical team, and really embedding more technology in a better structure for our units will impact our improvement in the complexity of our hospitals.
Thank you. That is very clear, Dr. Henrique and Rafael. Thank you very much.
Now, moving on to our next question. We have Luca from-
Good day, Dr. Henrique and Rafael. Thank you for taking our questions. First, I think it is more of a follow-up question on this issue of costs and expenses. You mentioned there was a shift in the model of the hospital acquired. My question is, do you think there is a normalization in the second quarter, or when do you think it happens? The second point, it is not related to the costs that much, but if you can maybe talk about how you have been evolving with the new accreditation processes in greenfield and Salvador, I think that would help a lot on our side.
I am going to talk about the first part with Dr. Henrique when it comes to Salvador. In this point with expenses, we are going to be coming in with EMEC. Our balance sheet will be consolidated. We are certainly going to have Santa Genoveva better than what we had in the first month. We also have the completion of these investments with this restructuring of the Hospital Premium, and slowly but surely, we will notice this improvement. If everything is going to be captured in the second quarter? No. It is going to happen throughout the year. We are going to capture this over time, but we want to have a drop quarter-over-quarter. This is our objective. We are starting to mention this issue with the cost of integration with third parties. In the second quarter, we are already bringing in technology and our process developed together with integration.
We will continue to have M&A costs in the second quarter as well, but we need to exclude these effects as they are occasional. We had the payment of some fees and expenses with lawyers as well, due to the completion of these transactions. There is still this effect in the second quarter. Now when we think about the clean operations without these effects, we would like to have a reduction quarter-over-quarter. This is our target throughout the year, and gradually, it should be dropping until the end of the year.
Good morning, Luca. When it comes to the Salvador greenfield point, there is an important pathway we need to go through, to be able to have the accreditations for the units.
The first thing is receiving the partial approval for the development and the authorization from the health agency and inspection agency, and then the registration together with Conest, so we can sign contracts with the payer. We have already been able to fulfill this process with many of them. Others have some negotiations from a commercial perspective that have also been very advanced, and they only really depend on the contract, which is more of a bureaucratic process, so that we can operate and start working. This week, we already opened up, actually, this operation, one of the most relevant ones with Bradesco, which we are already working with ever since the opening of the hospital, but others as well. Many of these big ones also, and this leads to a total of 400,000 lives.
400,000 lives connected to the operators, the payers, with whom we have already signed commercial agreements. This accreditation process with Mater Dei in Salvador is in line with what we mentioned in our roadshow back then. I do not know if you guys remember, but we presented some letters from payers asking if they would be interested in our hospitals and registering with them because we have this phenomenon in Salvador with the concentration of a big number of hospitals in a single network, and the operators were searching for alternatives for service providers to be able to balance out the ratio between suppliers and local operators. I could say that we have some experience with some greenfield processes with Mater Dei Santo Agostinho and Contorno, Betim-Contagem, and now Salvador as well.
To our surprise, Mater Dei Salvador has been one of the operations that has most easily been able to have these accreditation processes complete.
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Thank you, Dr. Henrique and Rafael. Thank you very much.
You were there, Luca? You saw how this equipment is very different and what we've prepared. We're already operating this, we're already billing this, we already have patients, and it's really a scaling-up process. The project is super well-structured. There's a desire from all stakeholders. It's really a project that we're going to be working on, and it's one of the points you always mentioned, and that we think we're actually overcoming any of the questions about the project. Just from now on, we're going to have this growth and be able to structure all of these points that are really more challenging for greenfield openings.
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Great. Perfect. Thank you, Rafael.
No problem. Good morning. Now I'll pass on the word to Joseph from JP Morgan.
Good morning, Rafael. Good morning, Dr. Henrique. Thank you for the question. I would like to explore this issue with the opening of beds in Belo Horizonte and how you've been looking at more opportunities for growth and expansion of the network. We've seen a strong accelerated movement in M&A, and I wanted to understand from you guys, from an organic perspective, we have that building you bought in Nova Lima, and I wanted to understand if by any chance there is a project for some hospital or some Mater Dei in the region. The second point is how you're looking at the environment for M&A.
I know you've bought a lot of things, so we wanted to know if we're at a moment where we should be digesting a bit of these acquisitions, or if we can still consider maybe accelerated growth because maybe this moment would facilitate this process. Thank you very much.
Well, good morning, Joseph, and thank you for the question. The Mater Dei DNA was always this growth. It was organic. In 2000, we also had the expansion of Mater Dei in Santo Agostinho. In 2014, we also had a greenfield that was bigger in our network till then, which is Mater Dei Contorno. In 2019, we also opened up the Mater Dei in Betim-Contagem with a greenfield project as well. We identified in the Nova Lima region an opportunity, where we have other developments as well.
According to the FGV Institute, this is one of the regions with the biggest income per capita in Brazil, and we had the opportunity for a very unique, differentiated hospital. We're at the moment with the demolition of the building for renovation purposes, so we should, in the second semester of next year, launch this operation. This would strengthen our hub in the region of Belo Horizonte within Class AA public, and according to the processes and information we gathered in our roadshow, they don't use much of our hospitals in the center southern regions because of a difficulty for logistics and this is something that happens in any other big central region. We are also considering the launch of the Porto Dias Republic of Quality Health.
That should happen till the end of this year with another 120 beds, a very unique position as well in the Belém region, in a very rich neighborhood, which will bring in complementarity that's really important with Porto Dias, which already exists and is operating in that region. Obviously, Joseph, we're always keeping our eyes open for new opportunities. We normally say that what's important for greenfield is you should identify opportunities and create local conditions for that to happen. Today I'm not even counting on Salvador, but the success of the other two projects we worked on, we had two in Santo Agostinho, is really due to the capacity to identify this and really work towards making this a reality. When it comes to expansion through M&A growth, we always have our eyes open. Rafael just presented the debt profile of what we have today.
We still have the capacity for debt and the capacity also for utilizing some of our stock as well for some M&A that could be transformational as well, to give even more robustness to the Mater Dei network. The biggest challenge for 2022 is identifying these opportunities and integrating them. Integrating them in the best way possible with what is already in-house. This is something we have been doing with a lot of capacity together with our integration team, we are really having strong expectations that this will generate a whole another level of standards when it comes to growth, revenue, and margins for the Mater Dei network.
Okay, Joseph. All right, Joseph. Thank you very much. That region in Nova Lima is really an important growth in our city, it is a target audience with the Mater Dei network that we have been monitoring with research and movement.
It is creating a process or even as a metaphor, kind of comparing with Rio. It would be similar to what they did in Rio with Barra da Tijuca when it comes to really being the same city, but with different hubs, right? You can see there are schools, there is an increase in the amount of schools, an important school is going to be built there. There are a lot of people working there, a lot of offices there, restaurants that are opening up there, that are moving on to that region in the southern part of the city. Structurally, this Nova Lima region is kind of duplicating or replicating Belo Horizonte with high standards and premium life standards. It is only about 4% of our revenue coming from there.
At the moment, there is not this standard of Mater Dei. Our objective is to really add something that is not too big, but that we really do not want to lose these families and this possibility for GDP growth that we have there, which is the fruit of what we want to be as a consolidated network. We have been doing this with a lot of structure and carefulness, so we can have something really well-balanced with what we need in our strategy. Okay. All right. Anything else? Any other points?
That is it. That is it. Thank you so much, Dr. Henrique.
Now moving on to Tizelle from Bank of America for his next question.
Good morning. Good morning, Dr. Henrique. How is it going? Thank you for answering our question. We just have one slide.
One question that we wanted to explore a bit of the environment with the operators considering partnerships you have in Minas Gerais. We know that the verticalized players bought some companies that had some proximity, maybe there are some shifts. I just wanted to hear from you if there was any specificities with the loss in flow, such as Vitallis or any other person in this sense. Just to understand what the environment is like and what is changing in Minas Gerais and how this is changing. Thank you very much.
Well, good morning, Tizelle. Thank you so much for this question. Actually, all of these movements that were implemented, Vitallis actually impacted very little of this. What most impacted this was the movement with the sales of Premium to Hapvida because our Mater Dei Betim-Contagem Hospital had a bigger premium.
This was recovered by the accreditation of some payers for that hospital. One of the most relevant ones was IPSEMG for social pension in the state of Minas Gerais. Just in the region of Belo Horizonte, there are 160,000 lives. Also the Institute of the Military Police in the state of Minas Gerais. The impact of these movements with Hapvida and GNDI has been a real small movement for our units.
Thank you, Dr. Henrique. That was very clear. Thank you very much.
No problem.
We do have some other questions that came in. If anyone else has any questions, you can just raise your hand. We have another question here about which were the main purposes for these operations derivatives, which would be the 4.131, which is quite small. It is going to end in the middle of the year.
It is not very significant. We do not have any exposure to foreign currency. What we are noticing now is some opportunities with the increase in the interest rate. What are the opportunities between currencies?
We have debt and IPCA rates so that we can be well positioned in the best structure. We have no important derivative in the company, just some debt operations that the bank loans to you in foreign currency. We also had another question about the flows of hospitals in April and May. Of course, we cannot provide that much guidance on information, but we can scale up this. In our vision, when it comes to ticket and movement, we are doing better than in the first quarter. There is a perception with the elective surgeries with new complexity that are better in the month of April. We have a good perspective.
Let us expect to see what is going to happen in May and June, but April was a lot better.
I just wanted to take advantage of this question from Caio Rocha, and I wanted to say that the arrival of A3Data and the development of products that are specific, that are more competitive for the operators that are our partners, besides this movement I mentioned with the opening of the clinical team and attracting physicians, has really provided an increase of our occupancy rate. The expectation is really a growing occupation rate.
We have no other questions. With this, I wanted to thank you for your presence, everyone. We have been working strongly in the company to overcome all of the challenges.