Ladies and gentlemen, good day and welcome to the KIMS Hospitals' Q3 FY 2025 earnings conference call hosted by IIFL Capital. 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 the 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. Rahul Jeewani from IIFL Capital. Thank you and over to you, sir.
Hi, good morning everyone. This is Rahul from IIFL. I welcome you all to the third quarter earnings conference call of KIMS Hospitals being hosted by IIFL Capital. From KIMS, we have with us today Dr. Bhaskar Rao Bollineni, founder and managing director, Dr. Abhinay Bollineni, executive director and CEO, Mr. Sachin Salvi, CFO, Dr. Nitish Shetty, CEO for KIMS Bangalore Cluster, and Mr. Sreenath Reddy, director of business strategy and M&A. Over to you, sir, for your opening comments.
Good morning. I extend a warm welcome to you all for the first investors' meet of this year. Gross revenue of INR 790 crore, a growth of 29.7% year- on- year and 1% on quarter-on-quarter basis. EBITDA of INR 205 crore, a growth of 36.4% year- on-20 year and a decline of 8.1% on quarter-on-quarter basis. EBITDA margins at 25.9% versus 24.7% in quarter three FY 2024 and 25.85% in quarter two FY 2025. That at INR 93 crore in quarter three FY 2025 against INR 77 crore and INR 121 crore in Q3 FY 2024 and Q2 FY 2025 respectively. Consolidated EPS for nine months of INR 7.1 face value of shares at INR 2, a growth of 15.6% adjusted for share split on year-on-year basis.
Cash and cash equivalents include cash bank balance deposits with maturity less than 12 months and investment in mutual funds at INR 112 crore as on Q3 FY 2025. Financial highlights consolidated. Consolidated revenue from operations grew by 27.5% on year-on-year and a decline by 0.6% on quarter-on-quarter basis, INR 772 crore. Consolidated EBITDA pre-Ind AS grew by 34.7% on a year-on-year and declined by 10% on quarter-on-quarter basis to INR 198 crore. Consolidated EBITDA pre-Ind AS and excluding other income to total revenue margin stands at 23.3% growth of 25.4% year-on-year basis and a decline of 16.2% quarter-on-quarter basis. Operational highlights consolidated. Average revenue per operating bed, ARPOB, grew by 25.2% and 0.5% on year-on-year and quarter-on-quarter basis respectively. Average revenue per patient grew by 12.2% and 2.8% on year-on-year and quarter-on-quarter basis respectively. IP volume grew by 13.8% and declined by 3.1% on year-on-year and a quarter-on-quarter basis respectively.
The other developments, we are happy to announce that the opening of 200-bedded multispecialty hospital at Guntur on a O&M basis called KIMS -Sikhara at Guntur, a very important town in Andhra Pradesh near the capital city of Amaravati. The Honorable Chief Minister of Andhra Pradesh, Chandrababu Naidu Garu, has kindly consented to inaugurate this hospital on 12th February of this month. KIMS entered into an agreement with the VIMS, Valiyath Institute of Medical Sciences Hospital in Karunagappally of Kollam District. It has a total of 300 beds since it is our second hospital in Kerala. The other one is at Kannur, opened recently and is doing well. Within three months, the Kannur hospital has achieved breakeven, which is a landmark in Kerala. As you may be aware, Kerala occupies the first place in the percentage of people seeking hospitalization. KIMS Hospitals has now set a benchmark in neuro care.
It now features South Asia's first MRI-guided focused ultrasound with the Hero 3T MRI. It is proven to reduce the tremor-dominant Parkinson's and essential tremors in patients. It gives benefits of without anesthesia, reduces the tremor totally, safe and effective. Admission is not required. Single session treatment. The first patient was a young math teacher from rural parts of Maharashtra. He was suffering from hand tremor.
Yes, sir, please go ahead.
On hearing about this, he came to us and underwent a non-invasive, surgery-free procedure, and walked back tremor-free immediately. KIMS Foundation and Research Center has developed AI-based Smart Glasses for the visually impaired that will enhance their quality of life. The product was launched in a function presided by the Honorable Governor of Telangana Sri Jishnu Dev Varma. Recently, KIMS Secunderabad was awarded a non-clinical operations excellence award by Association of Healthcare Providers of India. KIMS Kondapur also got the Award for Excellence in Nursing Practices from AHPI. KIMS Cuddles Secunderabad hosted a two-day conference of Indian Association of Pediatric Surgeons of both Telugu states, which had a record number of participants, which is able to speak about the awareness and the.
Ladies and gentlemen, please stay connected while we reconnect the line for the management. Thank you. Reconnect you, sir. We have the line for the management reconnected, so you can go ahead.
Clinically, KIMS achieved another distinction by becoming the first private hospital in the country to have performed 100 robotic-assisted Whipple surgeries, a significant achievement in treatment of pancreatic cancer. You all know that we have been ordered about 25 robots. Out of that, five have been placed in the different institutions, and all of them are doing well. That is a good move, and it is going to improve the quality of the treatment. At KIMS- Kingsway Hospitals, Nagpur robotic-assisted CABG was successfully done, which is first in central India. This minimally invasive approach ensures faster recovery, reduced post-operative pain, shorter hospital stay, and minimal scarring. KIMS Manavata Hospital Nashik performed the first finger joint replacement. This is the first such operation in Maharashtra and third in India. KIMS Secunderabad has done within no time about 200 robotic knee replacements.
I have intentionally kept a good and important news in the end. I am glad to inform that a distinguished personality has joined our board, Sri Suresh Patel, who held many prime positions in his illustrious career. He was CMD of Andhra Bank, presently Union Bank of India. Later occupied one of the top positions in the country as CVC, that is Central Vigilance Commissioner. Our board will be greatly enriched with his contributions, and all the projects, new projects are going in time. The only thing is that the entire civil structures have been finished in the quarter four. As we know that the problems what we faced in Nashik, after the civil works are finished, to get the required permissions to start the hospital, it takes a little longer time.
That maybe we may be end of the first quarter or the beginning of the second quarter, we can be able to commence with all these permissions so that we can be able to bring down the loss funding. Usually, when we finish the civil structure, we will try to recruit all the doctors, and then it causes a loss funding heavily. So by after getting all the permissions, if we start and then start recruiting the doctors, we can be able to minimize the loss funding. So that is the reason that we may be able to start full-fledged with quarter two, all the three projects in Bombay and Bangalore, Thane and Bangalore two hospitals, quarter two of 2026, maybe early in the quarter one. Okay, over to the audience for any questions, clarifications.
Thank you very much. We will now begin the question and answer session. Anyone who wishes to ask a question may press star and one on the 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. Ladies and gentlemen, you may press star and one to ask a question. A reminder to all participants, you may press star and one to ask a question. The first question comes from the line of Anshul Agrawal from Emkay. Please go ahead.
Hi, thank you for the opportunity. Am I audible, sir?
Sir, your audio is not clear, sir. May I request you to use your handset, sir? We are unable to hear you.
Hi, is this better?
Now can you say something, sir?
Is this better?
Yes, sir.
Great, thank you. So my first question is on the Maharashtra cluster. Is there any one-off there? I see a sharp decline in the EBITDA margins here. What could be the EBITDA loss in the Nashik unit?
Maharashtra cluster, now reports both Nashik and Nagpur. In Nagpur, there has been a decline in revenue owing to a seasonal impact. Hence, there has been a decline in EBITDA and some one-off write-offs on general dues and PBDD provisions. As far as Nashik is concerned, we have incurred a loss of INR 5 crore for the quarter. That's why Maharashtra is a cluster. The EBITDA margins have significantly declined. That should get rectified by Q2, Q3, given that Nashik will break even by then.
So Nashik is on course to break even within one year of commencement. Would that be correct?
Correct.
Great, thank you. That's it from my end.
Thank you. Ladies and gentlemen, to ask a question, please press star and one on the touch-tone telephone. The next question comes from the line of Abdul kader Puranwala from ICICI Securities. Please go ahead.
Yeah, hi sir. Thank you for the opportunity. So my first question is with relation to your corporate overhead. So if we see for the current quarter, because of the fresh hiring, I think the corporate overheads have gone up. So could you please provide some color as to how do we see this cost? Is there any one-off element also included in this? And how should that manage for the next coming years? Thank you.
Sorry, would you repeat the question again, please? It's not clear.
Sure, sir. So my question was pertaining to the corporate overheads. I think the corporate overheads in this particular quarter, as a percentage of your revenue, has gone up. Partly my understanding is this may be because of the recruitments what you have done in terms of your various clusters. So if you could provide us some color as to how this would pan out in the next couple of years would be helpful.
I don't think we have classified corporate overheads in any part of the presentation. There has been a decline in EBITDA margin because of a decline in revenue from mature units owing to seasonal impact from Q2 versus Q3. But Q3 and Q3, there has been a significant growth both in revenue and EBITDA. And there has been a one-time expenditure towards the tune of INR 8 crores-INR 9 crores, largely because of provisions of PBDD and general dues write-off. Other than this, there has not been any expansion in corporate expenditure. And I don't know where this has been picked up, but it's not mentioned anywhere in the presentation.
As far as corporate overheads on account of new hiring in particular in the Bangalore cluster, as such, we have not started yet the Bangalore cluster. So it is not coming to a profit and loss account directly. It's a pre-operative kind of a thing. So there is no surge in corporate overheads as such. Once we start the newer cluster, I think it will not be there.
No, I was referring to if I look at your operating margins across the cluster, I think it is close to 26.5% as per the presentation. While on a reported basis, the EBITDA margin was close to 24%. So total EBITDA section. Second, on the Bangalore project, so any reason why the timeline for project two has shifted to, say, from Q4 of fiscal 2025 to Q2 FY 2026?
The second project in Bangalore, there has been some delay in execution. Hence the delay.
Okay, sir. No questions, but I will get back in a bit.
Thank you. A reminder to all participants, you may press star and one to ask a question. The next question comes from the line of Harith Ahamed from Avendus Spark. Please go ahead.
Hi, good morning. Thanks for the opportunity. So when I look at Telangana and AP clusters, not just for this quarter, but for the entire FY25, there's been a strong ARPOB growth, and you've called out a loss reduction as the primary reason for that. So if I look ahead, maybe into FY 2026 and 2027, how should we think about ARPOB growth in these two regions for us?
So both in Telangana and in Andhra, for the first nine months, there has been a significant growth in both volume, IP and OP volume, as well as ARPP volume. Sorry, ARPP in absolute number. So I think that will continue to do. That will continue to grow at the same growth rate. And there will be more efforts in trying to reduce the ALOS from the current 3.5 to probably 3.3, 3.4. And that impact on the ARPOB will reflect.
Okay. And the other income that you've reported for this quarter, it's a bit higher than our usual run rate. What exactly is leading to this?
There is the income from sale of land at Chennai of about INR 12.5 crore, which is sitting in other income in this quarter. Otherwise, it is normal.
Okay. Last one, this time we have clubbed Sunshine with our Telangana cluster. So if you can comment a bit about the performance there, how the quarter-on-quarter revenue ramp-up has been, as well as some color on the margin profile there.
So Sunshine ramp-up is in line with the rest of Telangana, Harith. There has been a decline in revenue of INR 8 crore. And proportionately, the EBITDA decline of around INR 6.5 crore in Sunshine. The occupancies are holding up. The bed-based facility is doing quite well. So we're pretty happy with the progress there and how things are ramping up. So the reported number for Sunshine this quarter on revenue has been INR 150 crore versus INR 158 crore of Q2. And the EBITDA has been INR 40 crore versus INR 48 crore of Q2.
Perfect. That's very helpful. I'll get back in a few. Thanks.
Thank you. A reminder to all participants, you may press star and one to ask a question. Ladies and gentlemen, you may press star and one to ask a question. The next question comes from the line of Arunachalam, who's a freelancer. Please go ahead.
Am I audible, sir?
Yes, sir. Please go ahead.
Very, very good morning. And in fact, I'm very happy with the organic growth both in the revenues as well as in the bottom line. So what is actually our fraction? What would be the percentage of in all these specialties, whether it's cardiac or neuro or gastro or onco, or it's equal?
It's a fragmented split of specialties. Cardiac is around 17%-18%. Rest of the specialties like renal, neuro, orthopedics, oncology, gastro are around 9%-10%. It's quite fragmented across all specialties.
What I wanted to know is how does somebody perceive KIMS? Do they see you as a multi-specialty, or do they see you as a cardiac or a neuro or an onco? That's why I wanted to know. Particularly, you're also into medical tourism. That's why. Like international patients.
Given that the specialty makes it quite fragmented, I think the perception is that we are a multi-specialty hospital.
Okay, sir. Thank you very much.
Thank you. Thank you. A reminder to all participants, you may press star and one to ask a question. The next question comes from the line of Amey Chalke from JM Financial. Please go ahead.
Yeah, thanks for taking my questions. And congrats for the management on good set of numbers. The first question I have is on Kerala geography. So far, we have announced three units. One, we have already added Kannur. There are other two, Kollam and Thrissur. So what would be the timeline for these Kerala units? And if you can also provide some color on how would the mix like would these be more secondary care kind of hospitals, or there would be tertiary care as well? And what would be the ARPOB range for these units?
Right now, we have Kannur, which is fully operational. We are planning to add another 50 beds by end of this financial year in the same campus. And maybe another two years from now, we should be able to add another 100-150 beds in the Kannur facility, taking it up to 350-400 beds. The intent for Kerala as a cluster is to have all specialties, and all of them will be doing tertiary quaternary care work. So in Kannur, we will soon start kidney transplant. In the expansion for 100-150 beds, we are factoring in oncology also with LINAC and all the other services that are required. So all the hospitals in Kerala will be focused on tertiary and quaternary care. Kollam, which should commence operations from April.
Sorry to interrupt. Ladies and gentlemen, please stay connected while we reconnect the management line. Ladies and gentlemen, we have the management line reconnected. So please go ahead.
I spoke about Kannur. As far as Kollam is concerned, we are renovating the facility. We'll rebrand it by the first week of April. That again will be a hospital that will service tertiary and quaternary care. We don't have oncology at the moment, but we may eventually look at adding oncology once there's an initial ramp-up. Thrissur should take another 12 to 15 months before we start operation. In phase one, we don't intend to have oncology there, but we intend to do transplant as a service, both liver and kidney. As the hospital ramps up, we will add oncology as a service as well. Overall, the idea is to have oncology and all the other specialties in all the hospitals in Kerala. We might just stagger it and do it in phases.
Sure. And the second question I have is on the Queen's NRI. Since the acquisition, how has this unit fared? And if you can give some color on the operational front of this unit, whatever improvements have happened so far, and what would be now the profitability? Has it improved since we acquired? Thank you.
Queen's NRI, it's a very old facility. It's a 20-year-old facility. So a lot of the renovation works are happening at this point in time. And usually, North Andhra, the December, January is a very weak season, even among our other hospitals in North Andhra. And most of the doctors have agreed to join only post-Sankranti. So as we speak, a lot of the onboarding is happening. By end of February, a lot of the doctors will be fully onboarded. And part of the renovation work also should be completed. So right now, we're not losing any money. It is EBITDA neutral. But there will be a good ramp-up in FY 2026.
What would be the occupancy for this unit currently?
It will be around 35%-40%.
Okay. Got it. Sure. Thank you so much.
Thank you. A reminder to all participants, you may press star and one to ask a question. The next question comes from the line of Rahul Jivani from IIFL Capital. Please go ahead.
Yeah. Hi, sir. Sir, on the Nashik hospital, you have talked about EBITDA break-even in 2Q, 3Q of next year. But can you also talk about how has the doctor onboarding progressed in that hospital? And do we have the requisite doctor talent to allow us to break-even in, let's say, 2Q, 3Q of next year?
Yeah. So I think all the doctors have been identified, Rahul. And joining letters have been issued to all of them. In the month of January, we have done the occupancy has been around 25 beds. So that's around 10% occupancy. And a revenue of INR 3.5 crores-INR 4 crores in the month of January. We have yet to onboard 50% of the doctors. And the dates given are mostly February and March. So hopeful that by March end, 70%-80% of the doctor onboarding would have been completed. Hence, two quarters from there.
Sure, sir. And in terms of specialties, are you offering all the specialties at Nashik right now?
Yes. Except for oncology, we are offering all specialties.
Okay. Sure, sir. And so you called out this INR 8 crore-INR 9 crore of one-time, let's say, write-off on advances. So this was across clusters, or was this in the Telangana and AP cluster?
It was almost INR 3 crore in Nagpur alone. INR 3.5 crore in Nagpur alone. The remaining is in Telangana and Andhra.
Sure, sir. And we had these write-offs in Nagpur last quarter as well. So are we done with these write-offs, or do you expect this to continue, let's say, going forward?
Nagpur, before we took over, there were a lot of advances which were given. We haven't obtained any services, or the vendors have not provided any goods against those particular advances. We have taken a write-off against these advances in the last quarter and this quarter. Most part of it is done. In Q4 of this financial year, you will see about some INR 50 lakh-INR 1 crore write-off. Over and above that, I think most part of it is done in Nagpur.
Okay. So you mean that another INR 2 crore-INR 3 crore of write-off might come in the next quarter as well?
Not INR 2-INR 3 crore. I'm saying INR 50 lakhs- INR 1 crore.
Okay. Sorry. I misheard numbers. Sure. And one question on the Thane micro market. Now, one of our peers is already in that market, and we would be coming up with a hospital 1Q, 2Q of next year, while one another larger peer has also announced their plans to enter the Thane market. So how do you see the competitive intensity in that market shaping out to be, let's say, over the course of the next four to five years? Do you think that the competitive, let's say, intensity in that market would worsen, or you think that there is enough demand for, let's say, three or four large players to coexist in that micro market?
That just reinforces our thought process that there is a lot of opportunity in Thane. And given that Jupiter announced its second hospital in Thane, it's even more reassuring. I think there is opportunity for all of us to coexist. And good part is there is a good four, five-year window before these hospitals get commissioned. So it gives us a good runway to get ourselves established in those micro markets.
And sir, in terms of doctors, let's say, ability to attract doctors in Thane, that I think should not be much of a problem. Is that correct?
Correct.
Okay. Sir, last question from my end. Nashik is expected to break-even next year, but what kind of a loss funding you are expecting from Thane and the two Bangalore hospitals in 2026 and 2027? Thank you.
So I think I don't think we should have loss funding for 2027. But for 2026, for each of these facilities, we have factored around INR 10 crore-INR 15 crore.
On each. So total could be around INR 30 crore-INR 45 crore?
Correct.
Okay. Thank you, sir. That's it from my side.
Thank you. A reminder to all participants, you may press star and one to ask a question. The next question comes from the line of Harith Ahamed from Avendus Spark. Please go ahead.
Hi. Thanks for the opportunity again. So on the Kollam unit, which we've acquired, can you talk a bit about this hospital?
I have a question, sir. Sorry to interrupt you. May I request you to use your handset, sir? The audio is slightly muffled, sir.
Just a second.
Yes, sir.
Yeah. I hope this is better.
Yes, sir.
So my question was on the Kollam hospital. Just looking for some color on the history of this hospital, whether it's already operational, how long has been, how many years this has been operational, and if you can share something about the unit-level economics here in terms of revenues and whether it's profitable at this point.
Are you referring to Kollam?
Yeah. Yeah. Kollam. Yeah.
Yeah. So Kollam is a running hospital. It's been operational for the last four to five years. It's very similar to how when we acquired Kannur, around INR 4 crore-INR 5 crore of revenue. I think here it is around INR 3 crore-INR 4 crore of revenue. I think on the operational break-even, it should be similar to what we have experienced in Kannur, at around INR 8 crore-INR 8.5 crore, we should be a bit neutral.
Okay. Okay. Got it. And in Kerala and Bangalore, two markets where you've stepped up your focus, can you talk a bit about the bed addition plans? What's the pipeline looking like? And which are the cities that you'll probably be targeting? And then specifically, if you can comment on your plans for Kochi, which is a large market in the state of Kerala, if you have any plans to enter that market.
Yeah. I think, like we had mentioned in the past, both Karnataka and Kerala are very, very important for us. I think Karnataka as a plan should be that we scale up to at least 2,000 beds in Bangalore over a period of time. At this point, we have two hospitals that we get commissioned in this financial year. And then we have a land for a facility, which we will start work maybe in the next financial year. And then it might take three years from there. But as far as Kerala is concerned, the idea is to again scale up to around 2,500-3,000 beds over a period of time. The cities, obviously, the focus is to be in the larger cities like Kochi, Calicut, Trivandrum. But at this point in time, we have no visibility.
There are a good number of transactions that we're looking at, both acquisition, greenfield, and semi-brownfield. But at this point in time, we have three assets which will add up to 1,000 beds, which is Kollam, Thrissur, and Kannur. As and when we zero in on more assets in Kochi and Calicut, we'll be moving into it. But the intent is to do a large facility in Kochi, close to around 1,000 beds over a period of time.
And on Karnataka, if you can talk a bit about your plans there.
Like I said, Karnataka, we already will commission two this year. We will also start a hospital in Sarjapur soon. Maybe we should start construction from early next year and then three years from there, that should get commissioned. We're looking at two more opportunities in the northern part of Karnataka. Nothing concrete at this point in time but as and when we do, we can potentially add around 750-1,000 beds in the northern part of Bangalore. We are largely present today in the south part of Bangalore. We're looking to add around 750-1,000 beds in North Bangalore but that will take time. It will take at least three to four years before we start anything.
Okay. That's helpful. And last one, when I look at the Maharashtra cluster for this quarter, there's been a decline quarter- on- quarter, and I assume it's coming from the Nashik hospital. But if I think of, let's say, at that maturity, what kind of outcome should we expect for Nashik? Will it be in line with Nagpur or slightly higher? If you can give some comment that way.
It will be in line with Nagpur, around INR 32,000-INR 33,000. Right now, it's around INR 24,000-INR 25,000. Nagpur continues to be at INR 34,000-INR 35,000. So a blended number came out to be around INR 28,000-INR 29,000. But I think once it matures towards the end of the first 12 months, we should get towards INR 30,000-INR 33,000 kind ARPOB .
Okay. That's helpful. Thank you very much.
Thank you. Ladies and gentlemen, you may press star and one to ask a question. The next question comes from the line of Tushar Manudhane from Motilal Oswal Financial Services. Please go ahead.
Thanks for the opportunity. Sir, firstly on this ARPP with respect to Andhra Pradesh, it's seen significant scale-up. So is it to do with the case mix or payer mix?
It's a mix of both, case mix and payer mix.
So, in which particular case, as in therapy, has been driving this? And how sustainable that is?
There is a price hike because of insurance renewals. There has been a case mix change, and also, Queen's NRI is largely driven by cash and insurance as a payer and very little scheme work, so all these three factors pull the ARPP up.
Understood, sir. And just on the, as far as the expansion plan goes, while we've been expanding in, let's say, Bangalore as well as the other areas, but in Telangana, itself, which has been the profitable territory for us, is there any scope for further expansion out there?
Yeah. Even in Telangana, I think we have a lot of opportunities still. I think Sunshine is still only at 60% occupancy. There is opportunity for us to ramp up beds there. So a ramp of occupancy there and increase expand margin. So I think eventually Sunshine's margin expansion will be in the tune of 30%-33%. So there is one opportunity there. Kondapur, we are adding 500 beds, incremental 500 beds, which should be ready by the next financial year. So that will be a big pull for us in terms of revenue and EBITDA . And yeah, these four assets for now. And then we're doing one O&M hospital in a place called Kompally, which is a 250-bedded hospital, which also should get commissioned by end of this financial year.
Got it. And I just missed this, the overall operational cost that would come up because of these new hospitals which are expected to commence in FY 2026. If you could just repeat that number.
Overall operational, sorry, could you repeat the last part?
Overall addition in the operational cost because of commencement of new hospitals?
Yes. Yeah. So since we're reporting them on a cluster-on-cluster basis, Telangana and Andhra, we're not seeing much incremental cost happening because we are all mature. Maharashtra, we said Nashik will be around INR 10 crore-INR 15 crore of operating losses. Kerala, fortunately, we have broken even. And Thane, as well as Bangalore, we should see INR 10 crore-INR 15 crore drag this financial year for each of the assets.
And for the Kollam, we are doing an O&M model. So no operational costs concern our beds. So we.
Please stay connected while we reconnect the management line. Ladies and gentlemen, thank you for patiently holding. The management line has been reconnected. So you can go ahead.
So as far as Kompally asset is concerned, since it is an O&M model, by the structure of the transaction itself, no operational cost comes on our books. We are only entitled to some percentage of revenue that will be accounted in an income. So there will not be any material cost on account of material operational cost on account of that.
Done. That's it from my side. Thank you.
Thank you. A reminder to all participants, you may press star and one to ask a question. The next question comes from the line of Arunachalam, who is a freelancer. Please go ahead.
Good morning again. Hope I'm audible.
Yes.
Hello. Yeah. See, you have been planning massive expansion in Kerala. So just one question is, how does the brand name, does it not cause any sort of confusion among the public? Because there's one more hospital there. Or how does it work, sir?
Hello? Are you referring to the other KIMS in Kerala?
Yeah. Correct.
See, basically, it is a KIMS Health City, isn't it?
Correct. Correct. Correct.
We are putting a co-branding as of now, KIMS Sreechand and KIMS Valiyath, and then Thrissur also. By the time it is coming to operational, then our brand also will be able to come to the notice of the public.
Okay. That's why I just wanted to know if there's any plan for rebranding it or something like that. That's the question.
Already keep adding the existing hospitals, and when we do standalone, we'll look into that whether we should be able to rebrand or we'll continue by the time if it is brand has been penetrated well in the public.
Thank you, sir. Wish you all the best for all the markets. Thank you.
Thank you. Ladies and gentlemen, you may press star and one to ask a question. The next question comes from the line of Parvati Rai from Equentis Wealth Advisory. Please go ahead.
Hello. Am I audible?
Yes. Yes, ma'am. May we request you to use your handset, please? Thank you.
Yeah. So I want to understand, given these expansion plans and while last quarter you did mention that debt to EBITDA would be around 2x in the next couple of years as we take the expansion. So interest expense was quite high again this quarter. So going forward, as we move into FY 2026, what is the kind of debt and the interest that one should factor in or assume? Because for the last two quarters, it's inching up. And also on the CapEx for the next year, is it still at around INR 500 crore-INR 600 crore guidance? Or given the expansion plans, there's a change that we're looking at?
As far as outstanding debts are concerned, as of 31st December 2024, it is roughly INR 1,550 crore. The interest expense, which has been debited to the profit and loss account in this quarter, increased mainly because Nashik assets we have capitalized, and all the borrowing cost on that asset gets factored into interest expenses from this quarter. As far as the guidance as to the CapEx, nothing changes. It remains the same. We have already announced and we are on track, and we have already got a sanction for most of our facilities, and the expenses which we are incurring are in line with our budgets which we have estimated for these projects.
I think in a couple of calls earlier also, we have mentioned the outstanding debts would be somewhere in the range of INR 1,750 crore kind of a range, which will be still in the range of below 1:1 debt equity and below 2:1 in terms of debt EBITDA. That will continue. Certainly, once all these hospitals get matured, this debt equity and debt EBITDA percentage will come down in the subsequent financial year.
Okay. That's it from my side. Thank you.
Thank you. The next question comes from the line of Alankar Garude from Kotak Institutional Equities. Please go ahead.
Hi. Thank you for the opportunity. First question, what was the minority share of EBITDA in the third quarter? And maybe if you can give the number for nine months as well?
It is 9.9% in quarter three. If you're asking about nine months, it would be somewhere in the range of 10%-11% in the same range it would be. Not more than that.
Any outlook, sir, which you can share given so many new hospitals coming up in FY 2026? Any outlook as far as FY 2026 is concerned?
Outlook as to minority interest, you are saying?
Yeah. Yeah. I mean, how many of these hospitals which are coming up have a doctor equity structure? And accordingly, how do you expect the minority share to play out? Because some of these hospitals will also have losses. So do you expect a major change versus the 10% number, or it would be broadly in that same range?
So the only incremental thing will be the Karnataka cluster where we have 20% minority towards the management team. But otherwise, the Thane is 100% owned by the company. Kondapur is anyways part of the current hospital. So we don't see any other minority adjustments.
Got it. And maybe the other question is related to the expansion. Now, we have been announcing new deals every few months. Now, while we have been adding beds for the last two decades, the pace of additions as well as the expansions being announced is currently much higher than what we have seen in the past. So just trying to understand there, what are the key learnings so far? And on the operational side, which are the areas you believe we need to invest in to manage the execution smoothly?
Yeah. Obviously, the size of the company has also increased, so that allows us to do more transactions. That is number one. As far as where we would like to strengthen, I think on the project delivery, there is scope for us to improve further. We'd like to strengthen that, and we're trying to build teams to strengthen that because we want to do a lot more assets in the future. So we need to have a consistent team that we should be able to achieve on that. And also, one of the big reasons why we are doing this bed addition is if you see, there is a lot more opportunity in AP and Telangana. We have a very strong team. We are on ground. So it makes sense to keep investing more and more to expand this opportunity.
Thanks to Sreenath and Nitish in Karnataka, Farhan and team in Kerala, given their bandwidth, given their experience, it makes sense for us to grab as many opportunities as we get and be able to scale up as quickly as possible in these clusters, given their 20-25 years of experience in running such large format clusters.
Understood. Maybe Abhinay, just one question pertaining to what you mentioned for some of these newer hospitals in terms of ramp-up. For Kollam, for Thrissur, as well as I think for Nashik as well, you mentioned that except oncology, you will start with all the specialties. On the other hand, for our AP hospitals, we have been adding oncology over the last few years. Just wanted to understand the basic question, why keep oncology for later? Any specific reason?
So I think all our greenfield projects, all the large format hospitals, we have oncology from day one. So Bangalore, in both the hospitals, we have oncology from day one. Thane, we have oncology. Nashik, contractually, we are obligated to not do oncology. And that's why oncology is out of the equation there. As far as Kerala is concerned, the way the current hospitals are designed is it does not have space for oncology. So when we ramp up the current hospitals and then do the next phase of expansion, that's where we're bringing oncology. But if you're doing a greenfield project in Kerala or a brownfield, we will focus on oncology from day one.
Got it. Yeah. That's it from my side. Thank you.
Thank you. The next question comes from the line of Rahul Jeewani from IIFL Capital. Please go ahead.
Yeah. Hi, sir. So sir, on the AP cluster, our margin profile is still lower than what we do in the Telangana cluster, largely because of our presence in some of these tier two, tier three markets in AP. But with the addition of, let's say, oncology and mother and childcare, which you have been planning across your hospitals, when do you think that the AP cluster margins can catch up to Telangana cluster margins in terms of what time period or what time period can we get to Telangana cluster margins in AP?
Yeah. Now, there will always be a gap of 300- 400 basis points from AP and Telangana given the ARPOB and given the positioning there. But I think if you look at Q2, we have reached a 26% margin in AP. And now we are at that's in spite of adding Queen's NRI. With oncology and mother and child coming in most hospitals in this financial, I mean, in FY 2026 and FY 2027, maybe three years from there, we should get to a 30% kind of a margin.
Okay. Sure. So AP cluster margins with nine months are around 24%. You expect it to inch up to 30% in two years?
Yeah. In two to three years after the oncology facilities are operational.
You said that most of these onco, let's say, capacities will get commissioned in 2026?
2026- 2027.
Okay. Sure. So yeah, that's it from my side.
Thank you. A reminder to all participants, you may press star and one to ask a question. The next question comes from the line of Aman from PhillipCapital. Please go ahead.
Thank you for the opportunity and taking my question. So I just had a question around your Maharashtra cluster. So we have seen a fair amount of bed addition. So what has been the occupancy trend in the Q4 so far that we have seen?
Sorry, in Q4? Q4, what is it?
Yeah. I mean, so what has been the trend so far? We are almost halfway there in Q4, right? So what has been the trend in occupancy?
I think in Nashik, sorry, in Nagpur, the occupancy is around 160-170. In Nashik, it's around 30-35 in the month of January.
Okay. Got it. Okay. So that was the only question from mine. Thank you.
Thank you. Ladies and gentlemen, you may press star and one to ask a question. The next question comes from the line of Jay from Finnovate. Please go ahead.
Yeah. I hope I'm audible. Good morning. My question pertains to medical tourism. Could you provide an estimate of the percentage of international patients that KIMS currently caters to? Additionally, which hospitals in your portfolio contribute the most to international patient revenue? And what are your views on the broader medical tourism trend in India? And how do you see KIMS positioning itself to capitalize on this segment? Thank you.
I think Hyderabad as a location is not very well recognized for international tourism. But however, we have seen significant improvement from last financial year to this financial year. This year, we should do around INR 40 crores-INR 50 crores of revenue from international patients. We are hoping that it will go up to INR 100 crores-INR 150 crores over a period of time just from the Telangana cluster. But I think given Bangalore and Thane, both the locations are very well poised for international patients. We're hopeful that the contribution for international from these two hospitals will be significantly higher than what it is in Telangana.
Okay. And just if KIMS as the hospital is tracking this metric, so how much EBITDA percent the company is earning from these international patients?
Right now, since it's in growth phase, there is hardly any EBITDA. Once we scale up, we're still at INR 40 crores-INR 50 crores of revenue. But once we scale up, there will be more EBITDA. But it won't be higher or on par with what we are already getting from domestic.
Sure. Sure. That's it from my side. Thank you on all the questions.
Thank you. A reminder to all participants, you may press star and one to ask a question. Ladies and gentlemen, you may press star and one to ask a question. As there are no further questions from the participants, I now hand the conference over to the management for closing comments. Ladies and gentlemen, please stay connected.
Thanks for all the questions and enlightening us with knowledge. And we are very happy the way which we are running in terms of bed expansions and as well as the specialties we are adding. And we have been planned in such a way that it will not be able to go beyond our EBITDA debt more than two at any given time. And also, equity to debt will be less than one, maybe 0.8, 0.9. And opportunities are coming, and the doctors are showing a good response with all the new facilities and even the existing facilities where we are adding new branches. And that way, I think we are very happy the way which we are performing, and we will still continue to perform the same thing. Thank you very much.
Thank you. On behalf of IIFL Capital, that concludes this conference. Thank you for joining us, and you may now disconnect. Your lines.