Clariane SE (EPA:CLARI)
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Apr 30, 2026, 5:35 PM CET
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Earnings Call: H1 2023

Jul 27, 2023

Operator

Good day. Welcome to Clariane 2023 half year results presentation. Today call is being recorded. At this time, I'll now turn the call over to Sophie Boissard, CEO, joined by Philippe Garin, CFO. Please go ahead.

Sophie Boissard
CEO, Clariane

Dear investors, thank you for joining Clariane first half call. I am Sophie Boissard, Group CEO, and together with Philippe Garin, Group CFO, I will be presenting and answering to your questions. Let us go to slide number four. I would like to start by underlining some of the key highlights of the recent months. First, let me recall our successful transformation into a purpose-driven company associated with a new name for the group, Clariane, with an overwhelming support from our shareholders. Second, we see more and more confirmation on a back to normal momentum in all our activities, including nursing home, with an occupancy rate at 89.2% and very positive feedback from families and residents. I dare say that last year Gravediggers crisis is now, from an operation point of view, behind us.

Third, we delivered a robust operating performance despite inflation at more than 10% average, reflecting the value of our diversified model. Fourth, in a tightening credit market, we've been able to achieve major milestones on our financing roadmap, both in equity and debt, benefiting from a large support of our financial partners. Fifth, we are therefore on track to meet our targets for the year. Let us now move to slide number six and have a look on the key figures. Regarding operation, we've been supporting 445,000 people in H1, which is a +15% versus previous year. It reflects the development of our patient base in all countries. Occupancy rate in nursing home has been continuously increasing over the last six months, reaching 89.2% +2 points.

Given the unmet demand, there is still a strong growth potential there, closely linked with the availability of qualified staff, which remains the main pain points. Resident feedback are positively oriented. We've, for example, posted + 7 point increase in Net Promoter Score for the temporary stay in France over the first semester, or 87 positive opinion from a recent satisfaction survey performed in France over 1,000 residents. Please note that our yearly customer survey will only take place in H2. Let us move to some of the key ESG targets. This is the second column on the slide. As you see, the first one is about quality, and we are well on track to reach the 100% ISO certification target of our networks by the end of this year.

The second major dimension, and you've heard me very, very often about this, is about the training and HR development. We are currently at 5,800 employees engaged in a graduating or training program, which is actually very close to the yearly target, set at 6,500. We are actually working ahead of the roadmap for 2023 on that very, very important target. The third ESG target I want to highlight is about energy efficiency. We've set an action plan to support reduction in volume, and we've posted for the first half a minus 14%, which is very encouraging. Let us move now to the third column on the financials. They will be, of course, developed in all details by Philippe, but I want to comment on 3 points.

First point, with a 9.3 organic growth, our diversified business model in terms of activities and geographies proved to be very resilient. Operating result is stable, as expected, at EUR 285 million in a challenging environment in terms of cost inflation. Therefore, ability to adjust pricing is key and remain a major focus and priority and of all executives around the company. Operating free cash flow at EUR 45 million has been lower than previous year because of temporary higher working capital requirements due to delays from public payers. This will be recovered in H2. Let us move now to page number 6. The transformation of Clariane into a purpose-driven company is effective since mid-June. It ensures for long-lasting and clear alignment between social and financial performance, and therefore represents a step change in the group's history.

We are very happy to get a strong support from our shareholders to endorse both the new purpose and the commitment roadmaps that go with it. We have also put in place an enhanced governance to foster dialogue with external and internal stakeholders. As you see on page number seven, those changes associated with the purpose-driven company change have already started to materialize. First, the mission committee, with the 13 members, made up of representative of patients and residents, employees, qualified personality, is in place. It has already held two meetings and is fully at work. Second, some of the 10 initiatives associated with our five commitment have already been launched. The first one is the Clariane University in France, that has already, with only three weeks functioning, 150 applications coming from our employees. This shows that it is really meeting a very strong demand.

Second, we have launched some very interesting medical research projects. Third, we've been able to submit the commitment to SBTI initiative, and we aim to submit the quantitative low carbon trajectory by end of 2023, which is a major milestone in our low carbon trajectory and commitment. Let's move now to page number eight. All our activities present strong organic growth. Long-term care reported a 9.1% growth and 9.3% organic, driven by both price and volume. Price, of course, with significant adjustment done on regulated tariffs, notably in Germany, and which contribute to around two-third of the global organic growth at group level. The second dimension is volume. Occupancy rates have been steadily increasing by 2 points between H1, 2022 and H1, 2023, and reaching 89.2% end of July.

This is true for all geographies, as I will comment further. Healthcare segment reported a 17.5% growth, of which 6% organic. This segment now represent 27% of group's revenue, which represent a 200 bps increase. Post-acute and mental health activities are both showing dynamic momentum, notably fueled by continued strong increase of the number of patients we cared for, +17% over the last six months. Community Care reported a 17.7% growth, of which 16.7% organic development on the back of continued momentum of Clariane shared housing concepts and high growth in the home care network. The number of clients served by Petits-fils network in France has increased by 28% in June 2023 versus June 2022 and reach now 70,000 clients in France.

Let us move now to slide number nine with a further look into the Long-Term Care segment. Long-term care segment represents now 62% of group revenue in total. As I said, revenue are growing in all countries on the back of continued normalization of occupancy rates, +2 points between H1 2022 and H1 2023, and actually, year-on-year, +2 points also. High cycle of investment is coming to an end, with 23 refurbishment and new build projects delivered during H1 2023. As you see on page number 10, Healthcare segment is now representing 27% of group revenue, with a continued strong increase in the number of patient cared for, +17%. 75% of healthcare revenue are coming from post-acute and rehabilitation care, and 25% from mental health.

On the post-acute subsegment, the last half has been marked by continued modernization of the network, with 11 projects to be delivered in the full year, including six that have been already delivered in first half. On the mental health subsegment, the semester has been marked by the acquisition of Grupo 5, which is a key milestone in the group European strategy to scale up this mental health activity. Mental health activity is set to represent circa EUR 30 million in 2023, with a strong footprint in three countries: France, namely Spain now, and Italy. As you see on slide number 11, Community Care represents already 12% of the group's revenue, with a strong and untouched growth potential.

The strong development of client shared housing concepts are proven very successful, with close to 700 bed opening over the semester, essentially fueled by the Ages & Vie French concept rollout. As I said before, continued high growth in the home care network has been again proven true over the last semester, with now more than 260 Petits-fils agencies in France, and an increase of 28% clients served in June 2023, versus June 2022. With the, based on the slide number 12, let's now have a look at the evolution of our activities by region and geographies. During the semester, all the countries in which the group operates posted solid growth, as you see on the chart, excluding external growth.

Therefore, on a right organic basis, this performance has been primarily supported by the increase in tariff in all countries to compensate the strong inflation on costs. The strong organic growth in all geographies confirm the well-balanced geographic footprint in Europe and the relevance of our choice for development and reinforcement of our activities. Starting with the slide, slide number 13, I would like to have a look to the various performance in the different countries, starting with France and Italy, which have the most mature and diversified business model, covering all the three segments. In France, revenue amounted to EUR 1,096 million, up close to 6% on a like-for-like basis. The performance has been supported by a progressive recovery in nursing home, reaching now 89% end of July.

Note that there is still room for improvement to get back to the pre-COVID levels, around 91%-92%. Healthcare activities showed also positive momentum, especially in the outpatient segment, which represent now about a third of this activity. EBITDA increased by 5.4%, so a little bit slower than revenue. In Italy, revenue was organically up 8%. In a nursing home, the activity was supported by high occupancy rate and full back to normal, and healthcare posted robust improvement during the first half. In this favorable context, EBITDA amounted to close to EUR 65 million, with a slight improvement in margin. Let us move now to slide number 14, to the countries which are mainly Long-Term Care focused, namely Germany, Belgium, and the Netherlands. In Germany, revenue reached EUR 573 million, an increase of 13%, fully organic.

This development has been fueled by the strong tariff increase in 2022, following significant salary reset, effective from September 2022 on. The EBITDA amounts to EUR 103 million versus EUR 134 million in H1 2022. A visible decrease in the margin as tariff adjustments obtained in H2 2022 proved to only partially offset the total increase in cost in this country, with continued high inflation in H1 2023. In this context, we have started a new campaign of tariff negotiation that will help us to bridge the gap in H2 2023. In the Benelux region, in Belgium and in the Netherlands, revenue organic growth remained high at close to 16%, driven by strong improvement in occupancy rate in Belgium.

We are now over 91%, and the ramp-up of new facilities in the Netherlands. In this context, EBITDA was up 24.9%, driven by continued ramp-up in the Netherlands and this improved occupancy level in Belgium. Last but not least, based on slide number 15, let me finish with our ramping up countries, Spain and the United Kingdom. In those two countries, revenue was up by more than 100%, due to Grupo 5 acquisition in Spain. Excluding the impact of this acquisition, revenue in this region was up 6.4%. This performance, on a like-for-like basis, was mainly driven by price increase and ramp-up contribution in the United Kingdom. EBITDA was at a 24.7%, versus 17.5 in H1 2022. Let me take few minutes to talk about Grupo 5.

The integration process is well on track. With our mental health platform covering now all the main region of Spain, we are able to address a fast-growing market through the combination of Ita expertise on eating disorders and Grupo 5 expertise on psychiatric care and mood disorders. This combination places us as a clear leader in this activity, not only in Spain, but in Europe overall, with a EUR 330 million of revenue expected in mental health segment in 2023. I hand over now to Philippe Garin for the financial report.

Philippe Garin
CFO, Clariane

Thank you, Sophie. Let's move to slide 17. Since Sophie has commented extensively the growth in revenue and the operational performance by BU and country, I will concentrate on the financial performance of the group and the balance sheet. Before going into detail, I would like to highlight that we are fully in line with the guidance, with significant revenue growth and a stable EBITDA. In value, our leverage is at a high point, but should be reduced by the end of this year. Let's look to the figures. On slide 18, let's move to the P&L of the group. We see clearly on this slide how inflation has impacted our EBITDA. Overall, our revenue has increased by 12.2%, where staff and other costs have respectively increased by 14% and 17%.

The amount of EBITDA is therefore only slightly up compared to last year, and thanks to an active real estate management, there is a reasonable increase of 6% of rent, allowing a stable EBITDA in value. Moving to slide 19, we have a bridge which confirm what we have seen in the previous slide. In blue, the volume effect of 2% increase in Occupancy is offset by the decrease of the remaining compensation. In orange, we can see the huge increase of price, but also of cost, leading to a net negative impact of EUR 23 million, mainly reflecting timeline effect in Germany. In green, the favorable net impact of asset management. Let's move to slide 20.

Below EBITDA, there are two significant variation, an increase of amortization, which is a direct consequence of our investment over the previous year, and a decrease of non-current expense following a particularly high level of restructuring booked last year. As a consequence, the net result remain low, representing 1.3% of revenue. If we move to slide 21, on cash flow. Our investment of the semester are very similar to last year one, taking into account both the overall amount and the split. Grupo 5 represents more than 40% of the total. The amount of EUR 375 million will represent the large majority of the CapEx for the full year, as we are expecting a net investment in H2 of around EUR 50 million. We have financed this investment differently than last year.

Despite the lower cash flow, our real estate financing strategy, with the vehicle completed in June, bringing EUR 120 million of equity, has enabled us a lower increase of net debt compared to last year. Slide 22. This graph demonstrates very well what I have just indicated. After a four-year cycle of investment, strengthening the network and scaling capability, we now enter a period focused on leveraging the group. I can tell you that from first of July, we are a self-finance company with cash flow significantly above CapEx. Slide 23. The group benefit after this cycle from a high-quality network, reflected in a resilient valuation despite market condition.

This combination results in a cap rate of 5.5% for the portfolio, after a 5.4% in 2022, and a 5.3% in 2021. Slide 24. As already explained, our real estate partnership has been extended with a new vehicle, allowing us to raise EUR 120 million. Overall, the real estate partner has invested around EUR 500 million since 2020. With a 50/50 approach, we still have around EUR 200 million that can be raised. Page 25. As I mentioned, our focus is on deleveraging. As a result, we have reduced our pipeline by around 50%. Our greenfield pipeline will be largely financed through partnership vehicles, dealing with our recent announcement in June of a partnership in France with Banque des Territoires. Page 26.

At 4.1 x, our leverage is at a high point at the end of June, as a direct result of the front-loaded investment in H1. In H2, we will have a higher free cash flow in line with previous year, very limited level of net investment, around EUR 50 million, and further real estate vehicles. These elements will allow us to reduce significantly our leverage. If the two vehicles are completed, around 2.5 x leverage. Page 27. I am pleased to highlight some key milestone achieved since the beginning of the year. The extension of the term loan with our pool of bank for EUR 505 million, a new sustainability-linked financing for EUR 40 million, and the continued financing or refinancing of our real estate asset with EUR 150 million. Page 28.

With EUR 900 million of liquidity, the group is back to a normal cash position after being over-liquid during the COVID crisis. Let's have a look on our new debt maturity profile following this recent operation. EUR 650 million of debt maturities have been extended beyond the next two year over the semester. After this refinancing, the average maturity has moved from 4 years to 4.5 years.

Sophie Boissard
CEO, Clariane

Thank you, Philippe, for this detailed and clear explanation of the group's financials performance during this first half. I'd like to take the opportunity to thank you for your commitment and the one of your team on the work accomplished in recent months with our financial partners, who have just renewed their confidence into Clariane and its newly adopted mission. Bravo for that. Before leaving the floor to your question, I would like to confirm the following based on slide number 13. Based on the first half robust achievement that you just heard about, we remain fully focused on the short and long-term objective. We therefore confirm our annual objective of organic revenue growth of more than 8% and of a stable EBITDAR. We, last but not least, also confirm our roadmap for reducing the group's debt level.

In the very short term, in the second half, as you heard from Philippe, the group will be in a self-finance situation. This is key in an environment marked by tightening credit conditions. This is also a key differentiator towards some of our peers. In the longer term, the group is now fully armed to face the major challenges of taking care of everyone's humanity in times of fragility. This is our mission. I know that I can rely on the community of professional of Clariane in our seven countries to achieve this mission with greatest dedication. Thanks to you all. Now, let us turn to the Q&A session.

Operator

Thank you. Ladies and gentlemen, if you'd like to ask a question, please press star one on your telephone keypad. We'll pause for just a moment to allow everyone an opportunity to signal for questions. There are no question on the line for now. Please proceed.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

In that case, maybe we can tackle some of the first questions that we have on the webcast. If you Philippe, the first question we have is: What is the situation in Germany? If you could come back to that.

Sophie Boissard
CEO, Clariane

Yeah, thank you very much for the question. Situation in Germany from an operating point of view is a very good one, both from the quality, quality standard and also for the overall momentum in recruiting and retaining good professionals everywhere. The key dimension in Germany is to catch up from the huge inflation, both on wages and other costs, namely energy and food costs.

We did part of the way last year with a significant unheard increase in the tariff, and we are now entering the second round of tariff adjustment with significant increase requested with a strong backing coming from the local authorities because everyone is aware that we had to face a margin squeeze last year, and that we need to recover and to be back to a sustainable level of profitability.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

If there are no questions on the line, I'll carry on with the web questions. Could you also tell us how the mental health activity is evolving?

Sophie Boissard
CEO, Clariane

Mental health activity is actually developing pretty fast, both from an inorganic point of view from the French platform, with the recent development and the opening of 5 further outpatient centers, and now with the contribution of Grupo 5. We are on our way to reach EUR 330 million revenue in 2023. This will represent, at the end of the day, around 30% of the total revenue of healthcare activity across the group. We are also very confident that we can develop, expand further on an asset-light mode, both by taking over some further outpatient centers, especially in Spain, and also ramping up the various centers we have in France with 30 clinics, outpatient clinics, across the country.

That creates a strong opportunity, both from a top line as also from a margin contribution point of view, with a segment that delivers around 15% EBITDA, so after rent, EBITDA margin.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

I think there's a question on the phone line before we move on.

Operator

We will take our question from Patrick Jousseaume, from Société Générale. The line is open. Please go ahead.

Patrick Jousseaume
Managing Director and Head of Midcap Research France, Société Générale

Yes. Good evening. Can you hear me?

Sophie Boissard
CEO, Clariane

Yes, good evening, Patrick. Yes, we can hear you.

Patrick Jousseaume
Managing Director and Head of Midcap Research France, Société Générale

Yes, I have two questions. The first one, in the press release, you mentioned a change of control of Ages & Vie. Could you be more precise about that? Is it just about the real estate assets, or is it the company itself? It's unclear for me. The second is about liquidity and, let's say, debt repayments. We have not access to the slides, and we have seen the slide about liquidity and debt repayment very quickly. Could you give us, let's say, a more precise figure about what you have to repay in second half of 2023 and 2024, please?

Philippe Garin
CFO, Clariane

Yes, I start with the, sorry, Patrick. In fact, with Ages & Vie, we are only speaking about real estate. It was an agreement with the investor at the beginning that as we were developing Ages & Vie, we were, I would say, at the origin of the concept, they were willing that we have a kind of work of management, being the Gérant. The to have the real estate company fully consolidated in our account as being, having the full management of the real estate vehicle. It has been decided to change because we have only 30% of this vehicle.

The first, the, the process now, the concept now is fully I would say very well-known, mature, and there is no reason that we keep such an amount of real estate in our balance sheet when we have only 30%. It's a kind of consequence, and we decided to enter in a new deal with them. We have changed the, the status of this real estate company to real estate, and we keep the Gérant job, but we have less right than before.

Sophie Boissard
CEO, Clariane

We are, but the operating company is still fully consolidated in our figures. We have the management company, and the real estate investment vehicle is now outside of our scope. Is it clear for you?

Patrick Jousseaume
Managing Director and Head of Midcap Research France, Société Générale

Yeah. Yes, thanks for this clarification.

Philippe Garin
CFO, Clariane

Regarding liquidity, our second question, we have EUR 900 million of liquidity, split by both RCF of EUR 500 million and EUR 400 million of cash. We have in the for 2023 and 2024, mainly Schuldschein to as maturity, EUR 200 million end of this year. The UPP of July has been, by definition, reimbursed. We have another maturity of Schuldschein, end of 2025, of EUR 100 million. The slides are now on the website. Sorry for that.

Patrick Jousseaume
Managing Director and Head of Midcap Research France, Société Générale

Thank you very much. I'll be since well.

Operator

There are no further questions on the audio line. Please proceed.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

Thank you. There is a question on the new private placed sustainability bond. The question is, is it unsecured or has it have any sort of full security?

Philippe Garin
CFO, Clariane

No, just to be very clear about, the three financing we have, we have been able to put in place during this semester and until end of July. Real estate side, by definition, it is secure, with real estate. On this EUR 40 million financing and on the term loan, it's totally unsecure, and nothing has changed on this topic.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

There is a next question on: Is there any view on the evolution of the working capital for the rest of 2023?

Philippe Garin
CFO, Clariane

Yes, our working capital during the first semester have not been extremely good. We had, we were expecting a reversal of working capital in Germany. Clearly, in fact, in Germany, the kind of financing is changing year after year. Even though when we were very well-financed, which has been the case during the COVID crisis, we had to face huge documentation to put in place to recover our receivable.

We have been able to do it. Now we have an increase of our working capital in Germany due to the fact that the new situation is with some of people moving to the social aid, which is not an issue regarding recovering the receivable. They are not going to be paid by the same people. We need to ensure a transfer. We keep an overall working capital quite significant in Germany. We have a temporary situation which is not quite good in France.

We have changed our system, and, as a consequence, we, it's a funny consequence, but it is true, we are paying supplier a bit sooner than what was planned from the beginning of this year. These two reasons are totally temporary. I am not expecting a different free cash flow than the one we are able to deliver year after year, roughly 50%, or between 40% and 50% of the EBITDA, at the end of the year, of the EBITDA, without R. No particular situation for the full year regarding working capital and free cash flow.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

We have another question on the webcast. What, if any, are the consequences, I'm not sure of the wording here, but what, if any, are the consequences of the dismantlement of Orpea for clients?

Sophie Boissard
CEO, Clariane

I'm not so sure there is any, any, any outlook of dismantlement of or splitting Orpea. I would say, to my knowledge, no specific consequence. Maybe to say a little bit more, we are very keen on having accelerated normalization on Occupancy situation that will help also to support further back to normal globally of the industry, especially in France. I think this is now the clearly the outlook looking forward. That's that would be my comment on that.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

The next question that we have on the webcast, what are the perspectives in terms of dividends for 2023 and beyond?

Sophie Boissard
CEO, Clariane

I think it's too early to tell on this. We need to discuss, of course, with our board of director. What I can say, and this is more a general statement, we aim to have a balanced return for all stakeholders, and I think we will stick to that approach more than ever.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

Thank you, Sophie. We can't see any other questions on the webcast. Feel free to submit them or to speak on the phone.

Philippe Garin
CFO, Clariane

I think we have a question on the phone.

Operator

We'll take our next question from Fraser Donlon from Berenberg. Your line is open. Please go ahead.

Fraser Donlon
Equity Analyst, Berenberg

Yeah, hi. Can you hear me?

Sophie Boissard
CEO, Clariane

Yes.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

Yes.

Hi, Fraser.

Fraser Donlon
Equity Analyst, Berenberg

Yeah. Hi. Hi, everyone. Thanks for the presentation. Kind of two interlinked questions on my side. The first one, maybe more on the Long-Term Care: Could you comment a little bit on, like, the competitive dynamics, whether it feels like your competitors are also seeing, like, some uplift in occupancy, maybe putting aside Orpea, and that maybe the general dynamic or feeling is a little bit more positive vis-a-vis pricing, perhaps? The second part of that would be like, if it feels like you and other players in the sector are slowing down on investments and there's less capital flowing in, conceptually speaking, do you guys think that you can potentially deliver higher margins than the ones today in the very kind of mid or long term?

Do you think that from, like, a regulatory perspective, that would just be, let's say, difficult to achieve? Those would be the two questions. Thank you very much.

Sophie Boissard
CEO, Clariane

Yes, thanks, Fraser. When it comes to, let's start with the Long-Term Care perspective. My vision is pretty optimistic on this one, because I think the underlying demand is very strong for obvious reason. For the time being, we see that the main bottleneck is related to availability of qualified staff. The ones that are able to attract, train, retain qualified staff are actually also able to have a good volume of activity, and this is our case. Therefore, we've been working hard to integrate our own schools and academies to support that approach and that HR policy.

The pricing, I think now everyone, including the authorities in the major countries, recognize that quality care goes with the right pricing, and there is no idea of saying whether we should be further squeezed in the overall profitability. I think everyone is now realizing, including in France, and also in the U.K., I would say in all European countries, that there is a strong need for further investment given demographics and also the chronic disease issue looking forward.

That's why I think looking forward, that our segment is well referenced and protected and will be supported by authorities and payers, if we manage to deliver quality, which I think is fair enough, in terms of approach. Margin, more broadly seen, I think definitely we've been in a margin squeeze since now 2022, 2022 and now 2023, because of this accelerating inflation and the time lag effect we have, since our price are all regulated, there is always this catch-up effect. Now that we see price inflation stabilizing, it becomes easier to get this inflation reflected in the price adjustment. That would be my take.

I don't see looking forward, significant, at least, short-term in the margin, but I see definitely more margin progressing along the same trend as revenue at top line. Our profitability will come definitely for the outpatient adjacencies, both in the Medical Care segment and in the Home Care segment. This is why we are accelerating our development, which is a fully asset light and mainly organic there.

Fraser Donlon
Equity Analyst, Berenberg

Very useful. Thanks, Sophie.

Philippe Garin
CFO, Clariane

I think we have another question on the call.

Operator

Once again, ladies and gentlemen, please press star one to ask for a question. We'll take our next question from Christophe-Raphaël Ganet, from Oddo. Your line is open. Please go ahead.

Christophe-Raphaël Ganet
Senior Equity Research Analyst, ODDO

Yes. Thank you. Can you hear me correctly?

Philippe Garin
CFO, Clariane

Yes.

Christophe-Raphaël Ganet
Senior Equity Research Analyst, ODDO

Thank you very much for taking my question. Actually, my line was cut off. I hope the questions were not asked. Sorry for that. Four questions, actually. One, on rates of occupation, can you comment a little bit on the looking forward trajectory, what you do expect, where you find there will be more leverage and improvements in the next quarters? That's the first one. The second one relates to CapEx. Can you update us on the CapEx budgets for 2023 and 2024, if possible, splitting with development, construction, maintenance, and so on? Third question is on the M&A. What's your view on the market, on the M&A fluidity, multiples, and intentions? Do you find opportunities and so on? Last question is on regulation and notably on the SMR in France.

How do you see the tariffs evolve, and what could be the impact for, for our client? Thank you.

Sophie Boissard
CEO, Clariane

Okay, I will take the first one on occupancy rates development for Long-Term Care and the fourth one, then we'll let leave the two middle for Philippe. On the occupancy rate development, I see definitely a further uplift. To be very clear, in Italy, where the equipment rate is the smaller, as you know, we are already back at 97% occupancy rate, so it means that that's the normal course of business there. If I look at Belgium, as I said, we are now largely over 91%.

We were, before the COVID, around 92%, 93%, so I can't see why we wouldn't be there in a few months or a quarter at the latest. In France, we are now very close to 90%. We were before the crisis of COVID, we were around 91%, 92%, depending from the new build and the ramp-up contribution. For me, we are definitely traveling to normalization. That's for me, very clear. It will take a few more quarters, but this is where we are heading to. Even in Germany, where the labor market is very scarce, we see in most of the region, we are already well below 90%.

It's more about adjusting the network and also accelerating the shift towards single rooms, which was not trend before in Germany, or not so fast. Looking forward, I'm pretty confident on the model. When it comes to the post-acute regulation in France, you're right, there is a change forecasted with a kind of three bucket regulation. One directly related to the revenue, to the patient flow. Second, related to the local needs of the territories we are in, this is more an external factor.

The third one is linked to the type of care segment, so the specialized care. For the time being, it's still pretty unclear how they are going to combine these very sophisticated and not so clear from a from an intention point of view, regulation. We are actually actively discussing with the healthcare ministry to adjust, and they have already promised that they would stick at least for 2023, to the current framework. I don't see major shift short-term.

I'm actually expecting this tariff framework to be broadly the same as the one we had before, recognizing the specialization and also recognizing the real contribution, both in terms of quality and number of patients served into the tariff. That would be my take on this. I don't see major shift, especially when, with a very diversified portfolio as we have currently.

Philippe Garin
CFO, Clariane

Moving to CapEx.

Sophie Boissard
CEO, Clariane

Sorry, last word, it is not changing the outpatient. The outpatient is representing 1/3 of revenue already. This is also another buffer or mitigation versus major change there.

Philippe Garin
CFO, Clariane

Moving to CapEx, when we are speaking about free cash flow, it's after maintenance CapEx, we have roughly 2.5% of the sales between EUR 100 million and EUR 150 million, which are kept and which will not be reduced during the months to come, clearly. CapEx, overall, the other kind of CapEx are going to decrease very significantly. We have a book for EUR 375 million of CapEx during the first half. The second half, we should have a net CapEx of EUR 50 million, meaning we should complete this year slightly above EUR 400 million for the full year of CapEx.

After, for 2024 at least, and maybe 2025, we will deliver more free cash flow than CapEx.

For that, we really concentrate clearly on CapEx with extremely good return on asset, which is by definition mandatory with the current level of interest rate, and probably more on the ambulatory side with a kind of extension which has been done for the last year in France and can be done elsewhere. Regarding M&A, price are not stabilized, they are decreasing. We see multiple, we are speaking more about multiple than having a look on them because, we don't have a lot of deal achieve around eight for nursing home, around 10 for healthcare. What is sure is the market is moving, and the market is looking for good operating company.

We see more and more landlord or other kind of company with real estate having interest in finding a good operating company. I would say the relationship with vendor has been significantly rebalanced since a few months.

Stéphanie Bisseuil
Head of Investor Relations, Clariane

Thank you very much.

Operator

Thank you, everyone. We don't have any further question on the audio line for today conference. You may proceed.

Sophie Boissard
CEO, Clariane

Okay, so if there are no further questions, I would like to thank you for attending the call and say that, based on a very solid first half, we are very confident and dedicated to the further development of the back to normal activity and driving the development of diversification in our three segment of activity, seven geographies, and with a very, very strong attention both to quality and support of our people. This is really what Clariane roadmap is about. Thank you very much for your attention and see you soon.

Operator

Thank you for joining today conference. You may now disconnect.

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