I'll be your host for today's conference call. Joining us from the Care management team today are Dr. Abdulaziz Alobaid, Managing Director and CEO; Mr. Jahanzeb Khan, Chief Financial Officer; Mr. Naseer Ali, Chief Strategy Officer; and Ms. Alia Balbaa, Director, Investor Relations. Today's call will have a presentation by company management, followed by a question-and-answer session. To ask a question, please click the hand-raise button. Alternatively, you can post your questions in the chat box. With that, I would now like to hand the call over to Ms. Alia Balbaa to kick things off. Alia, please go ahead.
Thank you, Saikhat, for the introduction and hosting our call today. Good afternoon, everyone. Thank you for joining us today. We are pleased to present Care's nine-month results, which reflect a strong continuation of the positive momentum we've witnessed through the year. Care has delivered a period of strong operational and financial growth for the first nine months, supported by a strong third quarter. Dr. Abdulaziz will start with an overview of our performance and strategic direction. Following that, Mr. Jahanzeb will walk us through a detailed breakdown of our financial performance for the nine months. We will then open the floor for a Q&A session to address any questions you might have. With that, I will hand over to Dr. Abdulaziz to start the presentation. Dr. Abdulaziz, over to you.
Thank you, Alia. Thank you, and good afternoon, everyone. Thank you for joining our call. In this video, you see that our results for the nine-month period validate the strength of our growth strategy, with Care delivering strong performance across all key financial and operational metrics. Gradually, we saw a 41% year-on-year increase in our total patient count to approximately 711,000. You can see it in the middle of the top graphs. This was supported by strong volume momentum at legacy facilities and significant inflows following the integration of Al Salam branch, which is a 100-bed facility on the right top side. We saw notable growth across our patient segment, with outpatient visits up 41% year-on-year and inpatient admissions rising 46% year-on-year in the first nine months of this year. This momentum reflected positively on our financial performance, with the revenue growing 32% year-on-year to SAR 1.2 billion.
This growth is broad-based across our hospitals and includes a record-breaking revenue performance during the third quarter. Further down the income statement, we saw EBITDA expanding by 34% year-on-year to SAR 350 million in the bottom left, and the net profit climbing 70% year-on-year, reaching SAR 248 million. Further, our operational efficiency improved significantly, with our bed capacity expanding by 17% year-on-year to almost 1,200 beds and a group-wide bed occupancy rate averaging 82% in the nine-month period. Looking ahead, our strategic priorities remain focused on sustainable expansion, revenue diversification, and enhancing operational efficiency through continued investment in digital transformation. Now, let's take a closer look at the key strategic initiatives driving these results. If we can go to the next slide, please.
The Care Medical ability to deliver consistent growth and high-quality care at scale is a direct result of our multi-transformational strategy, which is based on four key pillars: new services, expansion, efficiency improvement, and digital automation. Our efforts and investments across all four pillars are clearly translating into improved performance and solid returns. Starting with the new services at the top, we have successfully diversified our offering and captured higher value streams. This includes the launch of ReLib, our dedicated mental health platform, which provides specialized mental health services for wellness-focused patients, successfully supporting growth in our cash segment. On the expansion front, we remain committed to unlocking both organic and inorganic growth avenues. The successful integration of Al Salam Hospital added meaningful scale and continues to demonstrate strong potential. In parallel, our biggest project underway is the planned launch of Al Narjis Hospital in Northern Riyadh.
This new facility will house 400 beds with a total CapEx of SAR 1.4 billion and is developed in phases targeting the premium segment. With regards to digital transformation and efficiency, we continue to deliver on our strategy by leveraging data-driven systems and technologies to maximize operational efficiency and enhance patient outcomes and experience. Finally, we're in the process of developing the strategy refresh, which will be finalized and launched in Q1 of 2026 to guide our new. Next phase of growth and transformation. With that, I will hand it over to Jahz to talk about the operating and financial performance.
Thank you, Dr. Abdulaziz, and good afternoon, everyone. Our solid operational growth in the nine months of this year was driven by a strong volume momentum at legacy facilities, successful integration of Al Salam Hospital, and recent capacity expansions. As you can see on the slide, we served approximately 711,000 patients in the first nine months, marking a strong 41% year-on-year increase from the same period of last year. This growth was supported by a 41% year-on-year rise in outpatient visits. Al Salam Hospital contributed nearly 127,000 visits, while our Rawabi and Malaz branches each recorded a 15% year-on-year increase in the volumes for the nine months. Similarly, inpatient admissions also increased 46% year-on-year to close to 22,000 patients. This surge was primarily driven by Al Salam, which contributed 4,300 admissions alongside higher activity at Rawabi and Malaz branches due to the Prince Sultan Military contract.
In line with increasing admissions, surgical procedures rose significantly by 36% year-on-year to a little over 18,600 surgeries. Al Salam contributed around 3,500 surgeries, accounting for 19% of total surgeries. Care's overall bed occupancy rate improved significantly to 82%. This utilization came despite the 17% year-on-year expansion of our overall capacity versus the first nine months of last year. The improvement reflects our proactive approach to diversify our patient mix and increasing volumes, particularly with Rawabi and Malaz occupancy rising to 85% compared to 65% in the previous year. Our ongoing operational enhancements and our diverse service offerings ensure we maintain our leading market position as a trusted partner for major players like GOSI, Ministry of Health, and insurance providers, which is key to capturing higher referral volumes and successfully navigating the rapidly evolving healthcare market. Let's now move on to the financial trends for the period.
Care delivered a robust financial performance during the first nine months, with revenue rising 30% year-on-year to SAR 1.2 billion. While the total cost of revenue increased by 27% compared to the same period in 2024, the impact was offset by company-wide efficiency initiatives, resulting in a 34% year-on-year increase in gross profit to SAR 440 million. This translated into an improved margin of 37%. Operating expenses rose 39% year-on-year, primarily due to a 38% increase in SG&A expenses, reflecting the expansion of our operational footprint, strengthened head office capabilities, and new capacity additions. Despite this, enhanced gross profitability flowed through to the bottom line, with EBITDA growing 34% year-on-year to SAR 350 million. The EBITDA margin expanded by one percentage point to 29%, demonstrating continued operational leverage.
Net profit increased 17% year-on-year to SAR 248 million, with the net margin contracting by two percentage points to 20.7%, mainly due to higher zakat and finance costs, as well as the absence of one-off tax reversals recorded in the prior year period. Adjusting for prior year tax reversals, which amount to SAR 29 million, the normalized net profit margin for the nine months of 2024 stands at 19.8%, indicating an underlying improvement of 0.9 percentage points year-on-year in the current period's net margin. Now, let's take a closer look at our revenue and cost breakdown. Our top-line expansion for the first nine months was fueled by several factors: broad-based growth across all facilities, higher revenue from GOSI referrals, contribution from Al Salam acquisition, and the continued expansion of the ReLib platform. GOSI remained the largest contributor at 37% of total revenue, growing 29% year-on-year due to higher occupational hazard referrals.
Cash-paying segment revenues saw strong growth, rising 50% year-on-year, propelled by targeted management initiatives and the continued expansion of the ReLib platform. The insurance segment delivered 28% year-on-year growth. Excluding Al Salam Hospital, the segment growth normalized at 10%, with the remaining uplift attributable to Al Salam. In terms of revenue by hospital, Rawabi remains the primary revenue contributor at 45%, followed by Malaz at 39%, while the newly integrated Salam contributes 7%, and Al Haram branch delivered a standout performance by more than doubling its revenue year-on-year. Now, let's take a closer look at our cost structure and its trends. Care Medical's total expenses increased 29% year-on-year to SAR 923 million during the first nine months. Cost of revenues accounted for almost 82% of this amount, totaling SAR 754 million, while operating expenses represented the remaining 18%.
During the period, cost of revenue rose 27% year-on-year, mainly due to two factors: higher salaries and benefits associated with Care's expanded operations and recent capacity additions, and increased spending on medicines and consumables, reflecting the rising volumes of surgical procedures in nine months of 2025. Salaries and benefits remained the largest component, accounting for 62% of the total cost of revenue, followed by medicines and consumables at 27% of the total cost. Operating expenses grew 39% year-on-year, reflecting a 35% increase in G&A category, mainly linked to recent capacity additions, expanded head office capabilities, and the addition of Al Salam Hospital. Operating expenses also included ECL provisions of SAR 19 million, compared to SAR 16 million in the prior period, with the increase reflecting higher outstanding receivables and slower recoveries in the third quarter. Let's turn now to our balance sheet and cash conversion cycle.
As of the end of the third quarter of 2025, Care Medical's balance sheet was solid, supported by a healthy liquidity position. Starting with our asset base, our total assets increased by 4% year-to-date, reaching SAR 2.6 billion. This growth was driven by an increase in current assets, reflecting higher receivables, with cash and cash equivalents remaining elevated. Total liabilities declined by 7% year-to-date to SAR 810 million. This was mainly due to an 11% decrease in non-current liabilities, reflecting lower lease liabilities and long-term loans. Current liabilities also decreased by 2% year-to-date. Turning to our working capital metrics, day sales outstanding increased 6% year-to-date to 162 days. Meanwhile, continued discipline in managing payables and inventory led to day payable outstanding decreasing to 95 days from 112 days, and day inventory outstanding shortening to 75 days.
As a result, the cash conversion cycle lengthened to 142 days compared to 124 days at the end of 2024. Care Medical's net debt position stood at SAR 52 million as of September 30th, reflecting lower cash and time deposit balances. I will now provide a brief update on our receivables management trends during the nine-month period before moving on to our cash flow dynamics. Trade receivables grew by 38% year-to-date to SAR 1.3 billion at the end of the third quarter. This increase is consistent with our top-line revenue growth, but also reflects slower settlements versus the prior year period. Trade receivables increased 38% year-to-date, reaching SAR 1.3 billion at the end of the third quarter. This growth is in line with our top-line expansion, but also reflects slower settlement cycles compared to the prior period.
The increase was primarily driven by higher balances from insurance providers and the MOH and related government entities. The most notable increase was recorded in the insurance segment, which rose 52% year-to-date, and Ministry of Health and other government segments grew 49% year-to-date. Our receivables portfolio remains well-diversified across payer segments and maintains a balanced aging profile. We continue to actively manage receivables aging and remain focused on enhancing collection efficiency and strengthening our cash conversion. In the nine months of 2025, Care Medical's net cash flow from operations improved significantly, reaching SAR 28 million, compared to an outflow of SAR 54 million in the prior year period. This improvement was primarily driven by higher earnings and a notable reduction in zakat payments. However, working capital outflows rose to SAR 324 million, reflecting increased working capital needs, mainly due to higher trade receivables.
Our CapEx totaled SAR 72 million, primarily related to the building improvements and medical equipment, as well as expenditures for the Nurjis Hospital development. Net cash used in financing activities amounted to SAR 149 million, driven by payments on loans and lease liabilities. As a result, Care Medical recorded a net increase in cash and cash equivalents of SAR 110 million in nine months of 2025. Our cash reserves stood at SAR 374 million as of the end of September, positioning us well to support our ongoing operational growth and strategic expansion initiatives. This concludes our presentation. We are now happy to take your questions.
Thank you, Mr. Jahanzeb, for the insights. I will now open the line for questions. Again, for asking a question, either you can raise your hand through the hand-raise button, or alternatively, put your questions in the chat box.
As a reminder, please limit yourself to two questions so that we can accommodate as many participants as possible. The first question comes from Ms. Mashal Al-Tawajiri. Mashal, please mention your company name and proceed with your question.
[Foreign language] . This is Mashal Al-Tawajiri from Al-Ahli Capital. A couple of questions from my end, just to touch base on what we previously communicated. Last call on contract pricing renegotiation in October, if we can get an update on that. Just to zoom in on the second quarter, revenue, Mashallah, grew by almost 4% quarter-over-quarter, comparing Q2 and Q3, while we saw a slight decline, very, very slight, of 40 basis points in gross margin. Can we get a color of that, a dip in GPM despite the growth in sales? Maybe a color on the GPM profile. Lastly, delays in collection this quarter, was it mainly MOH?
One by one. I think your first question was regarding the contract renegotiations that were supposed to happen in October. Yes, they are ongoing, and we expect to finalize our negotiations by the end of Q4. At most, they may go up to early Q1, but they will be retrospectively applied from the date the contract was actually renewed. Your second question was on the slight decline in margins. That's primarily driven by payer and case mix, nothing significant. Thirdly, you asked about receivables. Yes, we have experienced some delays from the Ministry of Health, and that was primarily driven by the fact that they have changed their system and they've moved on to the Munassa system. It was an administrative issue rather than anything else.
Because they moved to using Nafees' platform, right?
No, they're using the Munassa platform. I don't believe they are in Nafees. Munassa. Munassa.
Okay.
Okay. Okay. Thank you. That's all from my end.
The next question comes from the line of Chiro Ghosh. Chiro, please proceed with your question.
Hi. This is Chiro Ghosh from SICO Bahrain. My first question is, I'm trying to get a sense of a long-term revenue growth driver. As we can see, the occupancy rate is quite good, and no new hospitals are lined up, at least over the next two and a half years. Where would the prime revenue growth come from over the next two years? That would be my first question. Can we expect some more inorganic growth as we saw over the last two years? Would that be, or would there be any other form of driver of revenue that you can foresee over the next years? That's my first question.
My second question, I know you have answered this in the past, but again, can you remind us the technical difference between the GOSI and MOH and government side of it? I mean, what are the drivers? What kind of delay in payment we see, and what kind of revenue per bed we see from both? If you can compare it for us. Yeah, these are my two questions.
I'll take your second question for the difference between GOSI and MOH. You wanted to understand the difference between those two contracts, right?
Yes. Yes. Yes.
What we do for GOSI is GOSI provides occupational hazard coverage to all private sector employees in the kingdom.
If anyone gets injured while driving to work from their home, while being at work, or going to either their home or some other facility of their workplace, if they get injured during this timeline, they are covered by GOSI, not by their insurance company. Such cases generally in the Riyadh region would come to our hospitals, in the majority of the cases, as we believe, and we will treat them to make them better and get them back to work ASAP. That is what the GOSI business is. For the Ministry of Health, specifically, we, as almost every other hospital operating in the kingdom, are part of their EHALA online system, where cases that they do not have the capacity or the skill set to deliver, those are up for grabs by the hospitals linked to the EHALA system.
Those could be long-term care patients, total knee replacements, or any other procedure, and it is on a first-come, first-served basis. Whoever raises their hand first can treat the patient, and the prices are determined by a published price list that was done back in 2017 by the Ministry of Health, and you can get extra premium on that base price if you have certain previously identified accreditations. Other government entities are generally direct B2B contracts. As an example, our Prince Sultan Medical City contract is a long-term care contract for up to 250 patients. On an average daily basis, we have around 200 patients from Prince Sultan currently in our Rawabi and Malaz facility. That is the difference between different government entities and their relative contracts. I think your first question was, where is the organic growth going to come from in terms of the existing facilities, correct?
Yes.
In the next one and a half years?
Yes.
We are working towards it. We have increased our bed capacity. Now, we understand that we are at 85%, but it does not mean that we cannot go to 100% as well. Generally, the sentiment is that anything above 80% is not recommended, but if you manage your infection control protocols properly, and considering that almost 200 patients in our facilities are long-term care patients which require nursing care only, there is no risk of infection, that is still manageable. Post one and a half years, when the Prince Sultan contract is up for renewal, that is when we will reconsider whether we want to continue with this contract or not.
Yeah, they are less profitable, right? The Prince Sultan is less profitable.
Sorry?
Is Prince Sultan less profitable versus a direct patient?
Definitely, because it is a long-term care contract covering, for a three-year period, almost guaranteeing a certain minimum number of patients. It does not require significant medical intervention as well. They do decent margins, but compared to a GOSI, Ministry of Health, or perhaps an insurance patient, they may not be as profitable.
The beds in around 230 will improve a lot, and the maximum you can. Time to make revenues from the first 48 hours of admission. Definitely, if the patient stays for a longer time, your margins will get lower. Plus, we are redistributing the beds, increasing the intensive care unit beds, remodeling the clinics, improving our retail pharmacy services, and considering adding new services to the hospitals like IVF and others.
Fantastic. Very, very, very clear.
Thank you very much. That is all from my side.
I will just go back, go to the chat box because there are some few related questions. Abdullah Al-Shamshan is asking, what are the drivers for GOSI business growth, and what makes the occupational hazard to grow? Faisal Al-Suleiman is asking, can you elaborate the certainty of collecting the one-plus-year receivables, especially after the increase in ECL provision this year so far?
The GOSI growth would come from having more workers working on the infrastructure projects that the country is doing now. In Riyadh, there are five new big international stadiums in preparation for the World Cup. There are huge housing complexes coming up, New Murabba, ROSHN, etc. The expo is coming.
All of these tell us that most probably there will be more injuries if you look at the numbers as a percentage of people who may get injured during work. The second question was about the ECL provision.
The ECL provision, what we as management do is that we provide ECL provisions against insurance companies only because our view here is this: that ECL is the ability to pay. Because we are already accounting for rejection provisions at the revenue level, we do not take any further bad debt provision against the government clients. For insurance, we have had contracted talks with the insurance companies to settle and close the years. We are under final discussion.
Unfortunately, we were not able to close most of the bigger players during Q3, but hopefully by the end of Q4, we will be able to finalize our settlements and recover the money and be able to reverse these provisions.
Follow-up question on receivables coming from Ibrahim Attiya. He is asking, can you show us the receivables breakdown again and kindly expand more on the risk of higher provisions going forward?
You have to understand that 25% of our business comes from insurance companies, and most of that, around 70%-80%, is from Bupa Arabia. Then followed by MedGulf and AL Rajhi Takaful. If you take these big four insurance companies, you will probably cover 85%-90% of the insurance business of Care. These are very strong, long-running insurance businesses that are not at risk of going bankrupt and not have the ability to settle their bills. As of now.
Similar to previous years, we do not believe that these ECL provisions will result in an actual bad debt. These are cyclical. They are required by IFRS standards, and we will continue to make these provisions. There will always be movement from quarter to quarter in this balance as we grow our business, as we increase our insurance business, and as we do our settlements.
Next question is from the chat box on insurance contract. The question is, the contract that you referred to, which will be renewed by October, the attendee wants to know the name of the insurance company. If I just want to add a question from my side, previously you mentioned there is another contract to be renewed sometime first half of next year. Has the negotiation started on that insurance contract?
We are not disclosing specific names of the insurance company, but it is one of the largest insurance companies operating in the kingdom. What we can say is that, look, the negotiations are ongoing, and even for the next year, it is not in the beginning of the year. It is in the mid of the year, but we have started sending out fillers of what we—so it is a process, and it does take some time. The one coming up next year is also one of the largest insurance companies operating in the kingdom.
I want to go back to the audience who want to ask the questions. The next questions come from the line of Fatima Al-Dusayri. Fatima, please proceed with your question.
Hi. Can you hear me?
Yes. Fatima.
Okay. I have two questions.
I think you had a chart that showed the, or yeah, that the receivables. Is there a delay in insurance receivables? Is it because you are in negotiations right now with insurance companies, or is it aligned with the revenue growth? If you can, coming in from insurance companies, if you can just shed some light on that. The second question is regarding employee costs. I think there was one of your charts that you had in the presentation shows a jump in employee costs. Is that related to the ramping up of operations you had, or you hired more staff, or is it because of employee inflation that you are seeing in the market?
Sorry, could you remind me your first question?
About the receivables. I mean, there is a 52% jump in insurance receivables, and I just was wondering, is it related to [crosstalk].
See, we are growing our business.
We have added Al Salam as well. Al Salam was added in Q4 of last year, so it was not there in Q3. You have to understand that the provisions are coming from Al Salam as well, which are being added. Plus, these are settlement negotiations that are taking time. It is not like the receivables—they keep coming from the higher business. It is both increased business, plus the settlement negotiations have. Fallen over to Q4 rather than completing in Q3.
And just given that you're negotiating as well. Price increases for these insurance price increases. Does that mean that it could also fall into and get pushed to for the first quarter next year?
Not really, because those are two separate teams that you deal with, and generally, definitely, the company would like to couple both conversations.
The insurance company would like to couple both conversations in one, but one has nothing to do with the other. The rejection provision is purely based on your past claims. So they're not as such related.
Okay.
And the employee cost. Yeah. The employee cost that you're seeing increase, definitely, there's an element of Al Salam being added. So their cost has added as well. Plus, we're increasing the BUs. We're increasing other specialties in our hospitals. The medical staff needs to go up as well because of the extra volumes. And with the growing group, we have to strengthen our head office as well.
Okay. And.
Also, the license has increased from 20 - 30 beds because we're seeing more business, so we had to add more staff as well.
Okay. So it's more of numbers rather than employee inflation?
Yeah.
Okay.
And just the last question regarding M&A activity and previous expansions. How are you targeting that compared to a year ago? So if we look at the operating market that you're operating in or the mindset you had, I would say, a year or two ago in terms of acquisitions and M&A activity, how has that changed compared to what you're targeting at the moment or how you look to expand your business?
So we have actually not changed in terms of our focus and commitment, which is to deploy capital for M&A. Our scanning of the pipeline of opportunities remains the same robust process that we put into place a year ago.
I think what has actually changed is that we are getting a lot more opportunities because over the year, people have found out that we are in the market, and that makes our job a little bit difficult because a lot of the opportunities are not a strategic fit for us, but we have to go through them to see if they are viable or not. But in reality, just to be clear, in terms of the opportunities currently in the market, if you're looking at standalone hospitals or you're looking at investing into brownfields, there's really not that much out there in our geographic concentrated focused areas, which is primarily Riyadh, followed by the Western Province. But we continue to scan whatever comes up, and we are committed to deploying capital for maximizing the returns as and when required.
Okay. Thank you.
The next question comes from the line of Madhu Appisa. Madhu. Please mention your name and proceed with your question. Madhu. Okay. In the meantime, let me take a few questions from the chat box. Abdullah Al-Shamshan asking. There is strong inpatient admission growth. However, revenue per inpatient dropped 13% and 1% quarter on quarter. What is the reason behind the drop?
If the inpatient revenue per patient is declining, that would be contributed by Al-Salam because that's a class C network hospital. They have lower revenue per patient.
Thank you. Follow-up question on Al-Salam coming from Michelle. She's asking, how was Al-Salam profitability this quarter?
We're not disclosing the exact profitability, but it remains EBITDA positive till now.
If I just want to add a follow-up question on Al-Salam from my side.
We have seen, after your takeover, Al-Salam Hospital, the revenue increased significantly in Q4 last year and Q1 this year. After Q1, we are seeing a flattish kind of sales in Al-Salam. What's the next stage for Al-Salam's top-line growth, and what's your strategy on that?
It's a payer mix, and definitely, Q2 was a slower quarter because of the summer vacations and everything. We benefited in Q4 and Q1 with revenue coming from Ministry of Health, while in Q2 and Q3, we saw more insurance patients as opposed to Ministry of Health. Insurance patients carry a lower price point because of the network of the hospital. That also added to the lower revenue base.
Next question from the chat box. Abdulaziz is asking, could you please shed a color on the 1% fees on Nafees system? And what is the company's current exposure to Nafees?
They send us monthly invoices for their services, and we pay them on a monthly basis as well. We don't have any outstanding exposure against them.
I'll go back to the audience pool. Madhu. Are you there to ask your questions now?
Hi, Saeed. Can you hear me?
Yes, Madhu. Yeah.
Thank you. All right. A couple of questions. One is.
Madhu, can you be a bit louder?
Yeah. Let me increase the volume. Is it better now?
Yes. Loud and clear.
A few questions. I'll divide this into two. A couple of them related to results and one related to the strategy. The results, I noticed that cash patients' revenues went up sequentially by almost SAR 8 million -SAR 9 million, which was more than 50% of the sequential growth in revenues. This is the highest cash revenue that we have noticed in several quarters and this year.
At the same time, your revenues from Al Haram also increased to SAR 6 million from SAR 2 million in Q2. Were these cash patients from Haram? If not, then where did this increase come from? This is question number one. Second, your cost of sales also increased sequentially by SAR 11 million, which was broadly in line with the revenues. You mentioned that there were no charges related to Nafees for Ministry of Health. However, one of your peers mentioned that. MOH fees for—sorry, Nafees fees for MOH client MH patients was applicable starting last quarter, and it was 1% of their gross revenues. What was the case for you? If it is not implemented already, would it be implemented going forward? What about GOSI patients? How is the claim processing done for GOSI patients? Would it also shift to Nafees in the future?
These are questions related to results. I have another question related to strategy, which I'll ask later.
In terms of GOSI, there is no plan to move it to Nafees, up to our knowledge. We continue dealing with the TPA as usual. Nothing has changed for GOSI in the past, I would say, three years. In terms of the cash revenue, yes, we saw an improvement because of Al Haram. Not only that, our cosmetic center is doing very well in Rawabi, with a lot of patient growth and more surgeries being done from the cosmetic center, plus the dental services expansion across all facilities. Your second question was related to Nafees?
Yeah. Cost of sales in Nafees.
Yeah. I'm sorry, I'm not aware that MOH has moved to Nafees. I doubt it because they use GlobeMed as their TPA.
This is something I will look into, and if you drop me an email, I'll respond on that once I've had a chat with our RCM team.
Sure. Jahanzeb, let's take a scenario that you have to move to Nafees for MOH and GOSI. Would that be impacting your numbers negatively, or would the charges be similar to what you're paying now?
No, it will be similar to what we're being paid now because Nafees is a system for coding and submission of claims and checking eligibility and pre-authorization. It will not dictate what prices you get.
Okay. Clear. My third question is related to your new strategy. Previous strategy, we know M&A played a major role, but you had a high cash balance in the last few years. In fact, you were a net cash company. M&As did not impact your balance sheet.
Now, going forward with Narjis CapEx coming up and you having lesser cash balance, can we expect bolt-on acquisitions like M&As, which are smaller in size, and the focus would be more on Narjis Hospital to drive the next leg of growth?
Yeah. As of now, we are going through our strategy refresh. As part of that refresh process, we will be running all of our financials again, as well as our capital structure, our balance sheet, and looking at it from the perspective of affordability. It's not just Narjis. We may pursue some organic expansions as well. That should be concluded by the end of the year, and early next year, we'll give guidance to the market. As of now, before that strategy refresh is completed, Narjis does not.
As of now, does not actually put any sort of a drag on our cash flow or our financials, which still leaves us room for any acquisitions. Now, I would hesitate to call them bolt-on because we will be looking at acquisitions more from a strategy-fit perspective. But again, as I said, let's just wait for early next year when we have refreshed our strategy and are in a position to give guidance to the market.
Sure. Just to follow up, are you looking at Riyadh for organic expansion, or are you open to other geographies as well?
Again, we will give you a view in terms of our geographic priorities early next year.
As of now, as I mentioned earlier in response to a question, we are focused right now on Riyadh overall and the Western Province, whether that's from the perspective of organic or from the perspective of M&A.
Thank you. That is clear. That's all from me. Thank you.
I just want to add a follow-up question on the expansion. Is there any scope to launch more beds in your current facilities, mostly Rawabi or Malaz?
So I don't think we can increase significantly in Rawabi and Malaz. Malaz was at the peak of 459. Rawabi also is almost as it speaks. So even if there is any change, it won't be significant. We may change the distribution of beds, adding more intensive care units, etc., but you shouldn't expect a big growth in inpatient beds.
Thank you, Mr. Abdulaziz.
Again, for asking your questions, either you can raise your hand through the hand-raise button, or alternatively, put your questions on the chat box. There are a few questions on the chat box. Someone is asking about expanding the liabilities decline that you have. The next question is the blended price increase that you were expecting from the insurance renewals.
Sorry, could you repeat your question?
Yeah. There is a liabilities decline, and the person wants to know the decline and the reason for that.
It's usually when the liabilities come due, we pay. There were possibly a lot of invoices that were due early Q3. Sorry, yeah, early Q3. They were reported as liabilities at the end of Q2. It's a general cycle. Nothing significant in change of terms or suppliers.
The second question was, what is the blended price increase that you were expecting with the insurance company, with the contract renewals?
We're not disclosing that. We're still in negotiating phase. Once we finalize the contracts, we may consider giving some guidance on it, but we don't want to, what you can say, affect our negotiation strategy with the insurance companies. Follow-up question from Chiro Ghosh. Can we expect Al Salam Hospital to turn into category B hospital in 2026?
Not yet. We just got the hospital less than a year ago, so we're still optimizing the operations. We're still working on improving the prices, the case mix as well. There is no plan to change its classification as yet.
Thank you, Mr. Abdulaziz. There are no further questions on the chat box.
Again, as a reminder, if you want to ask a question, please raise your hand or put your question on the chat box. Okay. If there are no further questions, I want to hand over the call back to the Care management team for any closing remark.
Thank you, everyone, for joining the call. We remain fully committed to executing our strategy and build on the successes that we had. We had a very good quarter despite that it's being the third quarter of the year. We continue to promise that the company and its management are doing the best they can to improve further on what you have seen. Again, thank you, everyone, for joining us, and I wish you a pleasant afternoon.
Thanks to the entire management team of Care Medical, and thanks everyone for joining today's call. You can disconnect the call now.