Hello everyone, welcome to SMC's third quarter of 2025 results conference call. This is Ahmed Moataz from EFG Hermes, and I'll be the host for today's call. From SMC's side, I have Mr. Bassam Chahine, Chief Executive Officer; Mr. Hany Charani, Chief Financial Officer; and Mr. Sadiq Al -Ali, Director of Investor Relations. The company, as usual, will start with the presentation, and then we'll open the floor for Q&A. Sadiq, please go ahead.
Good day, and thank you for joining us today. Welcome to SMC Healthcare Q3 and 2025 financial year results presentation. I'm Sadiq Al -Ali, Director of Investor Relations and Board Secretary. Following SMC IPO this year, this marks our second quarterly earnings call as a listed company. We remain committed to transparency and consistent engagement with all of our stakeholders. 2025 represents SMC's first year as a public company, a year in which we are establishing the foundation for long-term growth and sustainable value creation. Once our call concluded, the presentation and all relevant material will be available on our IR page on the website. Please refer to our disclaimer, which applies to all disclosures made in today's presentation. Kindly note that all figures discussed during today's call are in SAR, unless otherwise stated. I'm joined today by our CEO, Bassam Chahine, and our CFO, Hany Charani.
Bassam Chahine brings 30 years of leadership experience in healthcare, including 25 years of striving growth and innovation at SMC. Hany Charani offers 34 years of financial expertise, 21 of which have been dedicated to strengthening SMC's financial performance. They will take us through the company's third quarter and first nine months 2025 results and performance. After concluding, we will open the floor for questions at the end of the presentations. The presentation will start with a brief reminder of SMC's core business and history. Next, we will share our key highlights for the quarter, followed by a comprehensive update on our expansion strategy. Next, we will review the Q3 and nine months 2025 financial results in detail. After that, the presentation will outline our outlook for the coming period. With that, it is my pleasure to hand over to our CEO.
Thank you very much, Sadiq. Thank you very much also, Ahmed from EFG. Good afternoon, everyone. I hope you're having a good day so far. It's a pleasure to welcome you to our second earnings call as a listed company. I'd like to begin with a brief overview of who we are and what defines SMC Healthcare. An apology for my sore throat. We are a Riyadh-based integrated healthcare provider operating two full-service hospitals: SMC One on King Fahd Road and SMC Two on King Abdullah Road. Our footprint spans a growing network of more than 300 outpatient clinics across the city. Our medical team now includes over 490 doctors, more than 1,060 nurses, collectively serving 141,000 inpatient days and over 900,000 outpatient visits during the first nine months of 2025.
Our model covers the entire care spectrum, as it is anchored by centers of excellence in areas like oncology, cardiology, IVF, urology, and more. At the heart of our success is an unwavering focus on patient experience. We've also launched an in-house developed mobile application that allows patients to book appointments, check in, and make payments seamlessly, ensuring an effortless technology-enabled journey across all touchpoints. Furthermore, we continue to integrate advanced digital technology across our facilities, including AI-powered radiology, automated insurance responses, and AI-based clinical recommendations. Let's take a closer look at our core medical services segment, which forms the backbone of SMC Healthcare business. This is more into two areas: inpatient and outpatient, where inpatient encompasses all medical care that requires hospitalization, surgeries, intensive care, and related ancillary services, while outpatient covers consultation, diagnostic, and minor procedures that do not require admission, such as routine check-up and day procedures.
We are in full speed in our strategic transition, which we communicated earlier this year. As part of this shift, we have completed the redeployment of long-term care beds into higher-margin acute inpatient services. As we are progressing as planned in repurposing long-term space into more than 60 new outpatient clinics, the change in focus towards acute specialties and outpatient clinic services is already materializing, as you will see shortly. Through this transition, we are expanding access to integrated healthcare, improving utilization efficiency, and supporting sustainable margin enhancement across our group. Turning to our key highlights for the third quarter, I'm proud to report another period of strong operational and financial progress, reflecting continued execution on our strategic priorities. Gross revenues grew 9.5% year-on-year, despite the complete fade-out of approximately 240 long-term care beds by September.
This growth was driven by high-performing acute specialties, where revenues rose by 14% year-on-year, highlighting the success of our shift towards higher-value services. On the outpatient side, the ramp-up of new clinics opened in the first half of this year continued to deliver results, with outpatient visits up 12% year-on-year to reach 353,000 visits in Q3 alone, driving 13.4% growth in outpatient clinic revenue. Again, this demonstrates the tangible benefits of our clinic expansion and service mix optimization strategy. Building on the top-line momentum, profitability strengthened even further, as net profit rose 12.4% year-on-year to reach SAR 66.2 million, with a margin of 17.3%. This is up by 2.3 percentage points. This was driven by streamlined corporate functions that resulted in structural and recurrent cost savings in G&A, in addition to improved collection efficiency and lowering the ECL-related charges.
Separately, in a landmark move, we are about to launch our first outpatient clinic center in Al Malqa District, northwest of Riyadh, which will house 35 specialty clinics and serve as a cornerstone for our expansion in Riyadh's northern corridor. Operations are scheduled to commence in the first quarter of 2026. Also, as part of our expansion plan progresses, we signed a SAR 1.1 billion credit facility, which includes a SAR 800 million long-term facility earmarked for the development of SMC Four Hospital in Al Khuzam. Furthermore, we secured legal approval from the RCRC for the construction activities of SMC Three Hospital and Wadi Fund Hotel, which is adjacent to SMC Three Hospital. The hospital project foundation works are well underway. Finally, we have announced two weeks ago a SAR 200 million special dividend, supported by our strong cash generation and solid financial position.
We are confident in the company's fundamentals and future growth trajectory. This decision lies at the core of our belief in rewarding our shareholders for their trust and confidence in SMC. Turning now to a key strategic milestone, we are proud to announce the launch of SMC Clinics, our first outpatient center in northern Riyadh, Al Malqa District. This marks an important step in expanding our footprint and bringing our services closer to fast-growing communities in the city's northern region. The center will comprise 35 specialty clinics, offering a comprehensive range of high-quality patient-centered services, including general medicine, pediatrics, dermatology, orthopedics, dentistry, and other high-demand specialties. The facility will also ensure an outpatient pharmacy as well. Operations are scheduled to commence in the first quarter of 2026, as I mentioned earlier, and we have already signed a 15-year lease agreement ensuring long-term presence and scalability.
The project carries a CapEx-like model of SAR 19.5 million over two years, specially allocated for [private health] and for medical equipment procurement, which emphasizes our capital-efficient growth approach. Beyond capacity expansion, SMC Clinics strengthens our position ahead of the establishment of our upcoming hospital, SMC Five, in northern Riyadh, Al Malqa area, as we are focused on establishing brand presence, improving accessibility, and reinforcing our vision to deliver integrated, high-quality healthcare across the capital. Moving on to another key initiative, I'm pleased to share with you, like what I mentioned earlier, as the SMC Three project on northern Ring Road continues to progress according to plan, marking another important step in our growth and capacity expanse journey. As I mentioned earlier, we have the full legal approval from RCRC for the construction of the hospital and the adjacent Wadi Fund Hotel.
This is the first joint approval of its kind for a hospital and a hotel on the same land plot. With that funding already secured pre-IPO, the project has moved into the next stage of development, with foundation works well underway and construction advancing on schedule. We are fully confident that SMC Three will introduce a new dimension to our suite of offerings and will enhance SMC's service capacity and presence in Riyadh's rapidly growing healthcare market. Talking about our long-term strategy, our core long-term growth strategy remains centered around the fast-developing northern Riyadh corridor, where we are building a strong multi-facility healthcare ecosystem. Over the next four years, this plan includes the rollout of three new hospitals and one outpatient clinic center, representing a combined CapEx of around SAR 3 billion, financed through a mix of debt and internally generated cash flows.
SMC Clinics is already advancing toward launch of operation, and SMC Three is under active construction. The next phase will see the unfolding of SMC Four in the Al Khuzam area, where we are planning to finish the design at Q1 of 2026 and kick off the construction next year, and SMC Five in Al Malqa District, where both are strategically located to extend our reach and serve Riyadh's growing northern population. Before concluding, I would like to highlight that the launch of SMC Clinics was not part of our guidance. This decision was assessed in detail and taken as an opportunistic venture that aligns with SMC's growth strategy. I will hand turn things over to my colleague, Hany Charani, our CFO, who will guide you through the financial highlights of the quarter. Hany.
Thank you, Bassam. It's my pleasure to present to you our results for the third quarter of 2025. Starting with the next slide. Okay. Our results this quarter reflect the continued execution of SMC's strategic shift towards high-performing acute and outpatient services, successfully offsetting the reduction in the long-term care capacity and relevant revenues. Looking at the chart on the left, you'll notice on the inpatient side, despite phasing out the 90 LTC beds in the last 12 months, the higher-margin acute specialties helped to drive a 6.3% year-on-year increase in inpatient revenue, which reached SAR 196.5 million for the third quarter of 2025. Meanwhile, looking at the chart in the middle, you'll notice that our outpatient activity continued to expand strongly, supported by the ramp-up of the newly launched clinics. Outpatient clinic visits grew by 12.1% year-on-year, reaching 353,000 visits.
As the newly opened clinics scaled up, outpatient clinic revenues hit SAR 169 million in Q3, achieving a 13.4% increase year-on-year. This momentum is expected to carry on in the fourth quarter as we roll out the remaining 19 clinics. We are also maintaining steady growth in our emergency department and outpatient pharmacy services, with revenues increasing by 3.1% and 5.7%, respectively. This growth in revenue was achieved despite the lower footfall typically associated with the summer periods, and we expect the momentum to pick up even further in the last quarter of the year. I would like to take this opportunity to highlight that the long-term care revenue declined by SAR 45.7 million, almost 70% for the nine months ending September 2025, compared to the same period in 2024. However, if you exclude the long-term care revenues, acute inpatient revenues actually grew by SAR 68.3 million, or 14%.
Turning now to our financial performance for the third quarter, SMC delivered another solid performance, reflecting steady progress in our strategic transition towards higher-margin acute and outpatient services. Gross revenues reached SAR 465 million, up 9.5% year-on-year, driven by solid growth across inpatient and outpatient services. Net revenues softened to 2.2% year-on-year in Q3 2025, reflecting the timing effects as the contractual obligations were recognized earlier in Q3 2025, while most of the prior year adjustments were recorded in the fourth quarter of 2024. This year-on-year variance was further amplified by the strategic shift in inpatient volumes from government-related inpatient services, which have no contractual obligations, towards the insurance-dependent acute services. In the ensuing months, we expect the gross revenue growth to be reflected at the net profit level.
Looking at the EBITDA, it rose by 8.4% year-on-year to SAR 104.6 million, with margins expanding to 27.3%, up 2.7 percentage points. This increase was driven by streamlined corporate functions and improved collection efforts, which reduced the ECL-related charges, with cost reductions more than offsetting the pre-opening and ramp-up expenses. The net profits increased to 12.4% year-on-year to SAR 66.2 million, with the net margins improving by 2.3 percentage points to 17.3%, supported by the details previously mentioned. Our operating cash flows grew nearly 59% to SAR 107.9 million. As a result, free cash flow nearly doubled to SAR 85 million, driven by an optimized collection cycle for both government receivables and dues from related parties. Our leverage position improved, with net debt to EBITDA decreasing to 2x , supported by the debt reduction and stronger cash position. Looking at the revenue, EBITDA, and net profit. Next slide.
Sorry for the delay. Our Q3 results reflect strong operational and execution and continued progress in our strategic transformation. Revenues in the third quarter grew 0.7% quarter-on-quarter to SAR 383 million and a 1.9% year-on-year growth for the nine-month period comparison, fully offsetting the impact of phasing out those 90 long-term care beds since September of 2024. This growth was supported by higher inpatient volumes from acute specialties and the continued ramp-up of the new outpatient clinics and SMC Two operations. EBITDA rose by 40.8% quarter-on-quarter to SAR 104.6 million, reflecting the stronger operating leverage as the new clinics continued to ramp up and the shift to acute services yielded the higher margins we had anticipated. In parallel, EBITDA margins strengthened significantly in Q3, reaching 27.3%.
While the year-to-year date EBITDA declined to SAR 244.5 million from SAR 268.8 million in 2024, this is in line with our expectations for a transition year, given the retention of the LTC staff, pre-operating expenses associated with the new clinics, and the one-time rebranding and IPO-related costs incurred in H1. Q3 results demonstrate strategic initiatives translating into stronger profitability, with margins reaching EBITDA of 27.3% and net profit margin of 17.3%. In conclusion, we're seeing solid momentum as transitional costs absorbed in prior periods are translating into margin expansion and a steady revenue growth even during the slower summer months. This is putting us firmly on track to achieve our full year 2025 guidance. Looking at the value for our shareholders slide next.
In recognition of SMC's strong financial performance and robust balance sheet, as mentioned before by my colleague Bassam, the board of directors have recommended to distribute a special one-time cash dividend of SAR 200 million, equivalent to SAR 0.8 per share. We are fully confident in SMC's long-term growth outlook and are committed to delivering value to shareholders who have placed their trust in the company. Our leverage position remains healthy at 2x net debt to EBITDA, well below the three-time threshold, providing financial flexibility and headroom to distribute this special one-time cash dividend. Moving on to the balance sheet. With respect to our balance sheet, we continue to strengthen our financial position, maintaining a solid foundation to support growth and expansion. Our net debt to EBITDA improved to 2x .
That's down from 2.4x a year ago, reflecting a 6.3% reduction in outstanding debt and a substantial increase in cash and cash equivalents of more than fourfold. The debt-to-equity ratio decreased to 62.1%, improving by over 15 percentage points year-on-year as a result of our efficient capital structure and disciplined approach to leverage. Our receivables cycle improved to 117 days as we continue to optimize collections under our insurance and cash-based model. Payable days remain stable at around 35 days. Finally, capital expenditure totaled SAR 23 million, primarily related to the opening of the new clinics, the ongoing renovation projects, and the construction activities associated with the SMC Three and SMC Four hospital projects. Before concluding, let me share our outlook on how we see the remainder of the year shaping up and the key drivers that will support our continued progress.
With respect to our outlook for the full year 2025, we reiterate our financial and operational guidance set during the IPO as we continue our progress after achieving solid results during the first nine months of the year. Operationally, we expect to maintain the 578 inpatient beds and to open and ramp up the remaining clinics to reach a total of 326 clinics by year-end, supported by the continued rollout and growing outpatient demand. On the financial side, we're guiding for the net revenues in the range of SAR 1.6 billion-SAR 1.8 billion, driven by rising patient volumes and our expanded clinic network. We expect EBITDA margins in the range of 23%-26%, and as a result, we aim to achieve a net profit margin in the range of 17.5%-19%.
With respect to our leverage profile, we plan to maintain a disciplined capital structure with a debt-to-EBITDA range of around 2.3x -2.5x. Finally, and as mentioned before, we will be distributing a SAR 200 million one-time special dividend in Q4 of 2025 as part of our commitment to reward our shareholders' trust in SMC's vision. I would like to thank you for your time, and I'll pass it over to Sadiq to initiate the Q&A session.
Thank you, Bassam and Hany, for the presentation. Now we will open the floor for the questions.
Thank you very much for all participants. The call, you can either send them through the chat or you can use the raise hand function.
We'll start with questions from the line of Mashal from SMC. Please unmute yourself and go ahead.
Thank you, Ahmed, and thank you, Bassam and Hany, for the presentation. Just two questions from my end. One on the patient traffic profile. So inshallah, we're seeing the growth year over year, and namely in the outpatients giving the ramp-up in clinics. You printed almost 12% year-over-year growth. I want to focus more on the Q over Q profile, the sequential basis. We're looking at almost 3% outpatient visits, Q over Q, 9% growth in the inpatients, while medical services revenue is almost flat. If you can shed color on the patient yield profile this quarter, and how should we look at the full-year revenue guidance? We're saying that we're expecting volumes in the fourth quarter, and our guidance is still standing at SAR 1.6 billion-SAR 1.8 billion. For the second question, you secured almost SAR 1 billion in facilities this quarter.
Is this in excess of the SAR 3.6 billion communicated at the time of the IPO? That's all from my end. Thank you.
Okay. Thank you, Mashal. I will just answer the first two questions, Hany, in general, and you can add any details if you like. Regarding the first question related to the revenue, our revenue, the medical revenue, is coming from outpatient and inpatient. It's something very important to know. We still have around 20 clinics not operational that are supposed to be operational starting November. We just opened them a few days ago, and these were not operational in quarter three. We are anticipating, with a quick ramp-up of these clinics, to have more volume of outpatient and therefore revenue. Of course, the more you are adding outpatient activities, you will have more conversion and admissions. Plus, the issue of the occupancy rate. We have been our occupancy rate in the 80% margin.
By adding more clinics, we are expecting to have the capacity to receive more and more inpatient, knowing that we are also receiving more complex patients. Patients are staying more in the hospital, and this is all contributing to the revenue. Regarding the second question related to the SAR 3.6 billion, this was the total estimated funding required for our expansion. The SAR 1.1 billion that we have secured was related basically to SMC Four project that is for tendering and start of construction next year. We have allocated SAR 800 million from the SAR 1.1 billion for SMC Four project and SAR 300 million as working capital. Hany, feel free to add any comment on the compilation.
Yeah, I think you've covered most of those issues. It's very important that, and I highlighted in the presentation, that we lost SAR 45.7 million in the long-term care-related revenue. That was almost a 70% decline from September of last year. At the same time, we were able to increase the acute inpatient revenues by SAR 68.3 million, or 14%, to offset that decline in inpatient revenue. That's why you're seeing at this point a little stagnation, but then it'll pick up again because now we're at the fourth quarter when the long-term care patients last year were pretty much transitioned out.
Hany, if you'd allow me a small follow-up. Am I audible?
Yes.
Yes.
Yeah. Hany, if you'd allow me just a small follow-up here. In Q2, long-term patients were already phased, right? We didn't see, or I'd say the decline was already in effect in Q2. I'm comparing the figure of Q2 2025 and Q3 2025. Medical services revenue was flat, while we saw almost 9% growth of patients overall from Q2 till Q3. My question was regarding the patient yield. Did we see any dip or decline in that figure or KPI?
The patient numbers you're talking?
Patient number, total outpatient visits, I'd say in Q3. In Q3, this quarter was 350,000 patients, am I right? 350.
353, yes.
Yes. In Q2, it was 344. We're looking at almost 3% growth in outpatient number, right?
Okay.
was also 9% growth in inpatient number from second quarter this year and third quarter this year. Combined, we're looking at almost 5%-6% growth in number of patients from Q2 this year and Q3 this year. However, medical services revenue was flat. This indicates that the patient yield declined a bit. If you can just shed a color there on how should we look at Q4 profile.
Yeah, I think that looking at the medical services, obviously most of it with the outpatient services, the big ramp-up is going to happen in Q4. We noticed that in Q3. You saw a significant jump in Q3, although there were the summer months, which is historically lower. The transition will really happen in Q4, both in terms of the volume of business and the revenue per bed or per outpatient visit. We have another contract price increase that occurred in October of 2025, 1st of October. That is why you'll see a bigger shift in the Q4 numbers than you will in Q3.
Perfect. Thank you, Sadiq, from my end.
Thank you, Mashal. Ahmed, if you allow me to save time and to give enough time for everyone to have their questions answered, I'm going to take the chat. I'm reading the chat as we speak.
Okay.
Yeah, if you don't mind, then I will go straight asking the question and answer it, either me or Hany. Faisal Sliman, his question is about what type of OpEx savings did you do that caused such a drop in G&A? Was there any reclassification of a cost item from OpEx to COGS? Hany, can you provide more details about our drop in G&A?
Look, there were two things related to the G&A. There was the ECL adjustment in Q3 of 2025, which was basically related to the military hospital long-term care patients. Last year, there was a big receivables balance. Most of that has been paid. So the ECL was reduced because we had confirmation now that the balance will be paid. That's one area. The other area is the corporate overhead. We eliminated several key positions, senior positions, and the related benefits. That impact will move forward in the ensuing months. That's the cost savings that we experienced in Q3 of 2025.
Sandesh Shetty asked a question about the other income reported in quarter three. He noticed a significant year-on-year increase. What were the main drivers behind this growth? I believe some of them were due to certain rents and others. You remember, Hany, the other income that was increased. Can you explain to Sandesh exactly what was the reason why we have an increase in other revenue? You got the question, Hany?
Yeah, can you hear me?
Yes, yeah, we can hear you. You were muted for a second.
Okay.
Go ahead.
Basically, the biggest attribution to the other revenue was related to interest earned. We had time deposits related to the SAR 200 million. That earned several million during this period when we received the SAR 200 million back. The other ones are educational and training support we received from companies. The biggest one was the interest earned.
Okay. Masroor Zaidi, he asked a question. I believe I answered it, but we will repeat it again. How many clinics are we planning to add in quarter four, 2025?
I just mentioned a while ago that we still have 19 clinics, around 20 clinics, not operational. We just started the operator a few days ago, and this will be fully ramped up in November and December. The number is around 20 clinics. Sandesh, again, he asked another question about financing of SMC Four. He wants to know whether construction will commence immediately or will be scheduled after SMC reaches a certain stage of progress. SMC Four is currently under the final phase of design. We have done with the concept and with the architectural design. Now we are finishing the detailed design. We believe the whole design process will be completed in quarter one of 2026.
Shortly after we start the tendering formalities, we'll have the tender documents shared with all major construction companies in Saudi Arabia, and we'll be completing the formalities next year, and we will be launching the construction next year. No, we will not wait until SMC reaches a certain stage of progress.
Another question from Murshid Mawahib. He's asking about the progress of Sabic Behavioral Facility.
This is the MOH PPP project. Of course, as you know, many PPP projects in Saudi Arabia were a little bit delayed waiting for the Ministry of Finance and the Council of Ministers approval being strategic projects. The Minister of Health visited us in Global Health two weeks ago, and he confirmed that the Sabic project is still on top priority. They have asked us to extend our bonds and guarantees, bank guarantees, till March.
We believe probably in the coming few weeks or in quarter one of 2026, the contract will be signed, and this project will be operational, as we mentioned before, in 2026. There is no change in the plan for the Sabic hospital except a few months' delay from the Ministry of Finance.
Okay. Next question from this is rolling up. Okay. From Sulaiman Rajhi, did you include ECL when calculating EBITDA, Hany?
Yes. I didn't include it.
The answer to you, Salman, is yes, it was included. Also, Adnan Farooq, he wants to quantify the ECL reversal amount.
Yeah, it's around SAR 10 million.
Okay. Marina, you have three questions. Let me read them quickly. On the current 578 beds, she wants to know the breakdown between long-term and acute for 2025 and 2024. I believe the number of long-term beds in quarter three, we were still phasing out, if I'm not mistaken. The number at that time, I would say it was in the average of 120 beds, Hany, if I'm not mistaken. By the time of the end of quarter three, the number was reduced to around 30 or 35 patients, which is the same number that we have right now. Is that accurate, the statement, Hany?
Yeah, correct. Now, we've allocated 84 beds to long-term care as of Q3, but we only have the almost, like you said, 35-40 patients. A decision will be taken whether we keep those or we allocate them to acute. The total number of beds is still the same. It's 578 beds.
Also, Marina had another question on the total IPO-related expenses. How much was paid, and in which quarter it was recognized? You remember we have mentioned this. We have recognized them in quarter two, but probably you'd answer her with the exact details on that question.
Yeah, I think we mentioned that before. It was around SAR 10 million in IPO and rebranding costs in H1.
It was in H1, yeah.
Yeah.
We don't.
Yeah, yeah.
If the question, Marina, is, do we have any more IPO-related expense we did not encounter for, the answer, I guess, is no. Correct, Hany?
Yeah, no. No more.
Yeah. Okay.
I want to step back, Bassam. I want to step back to the lady earlier asking about the medical services. Just to be clear, the medical services includes the contractual obligations. These adjustments last year were made in Q4. That's why maybe she's seeing this almost stagnant effect on the medical services.
Oh, okay. Okay. Okay. This answer to you, a late answer for Mashal. Regarding the last question from Marina, how do you view 2026 in terms of growth and profitability outlook? We believe the same momentum that we are having right now. We expect that it will continue in quarter four, 2025, and would also continue in 2026. I've seen your question, Sandesh, but we'll try to give a chance to other questions that are unanswered. Once we're done with them, I'll go back to you. Regarding Faisal, Faisal Bin Zara, he has a question. He wants to know, he wants to have more light on the price adjustment that happened in October. How much net impact on Q4? I believe one of the major companies, there is a partial price increase that was effective in October.
Probably if you want to give some more details, Hany, on the percentage impact on the revenue, go ahead.
Yeah, you need to factor around 3%-3.5%. This was a two-year contract. The first increase happened last year, and this was the second increase agreed upon to happen October 1, 2025. In addition, it's important to highlight that we'll have further increases expected in January and February of 2026. We're in current contract negotiations with some of our insurance companies moving forward.
Okay. Taha, I have a question with a lot of numbers. I'll try to cover it all. Taking 2025 lower end of guidance, revenue SAR 1.6 billion into 17.5% net margins brings SAR 280 million net income. Nine months 2025, net income SAR 132 million. So balanced net income SAR 148 million left, while quarter three 2025, net income of SAR 66 million. His question is about, are we going to achieve such a big improvement in the net income in quarter four 2025?
Yeah, we're still on guidance to achieve around the 280, but remember that that includes that one-off of around SAR 57 million related to the Wadi Fund land, sale of the land. I hope you're including that almost SAR 60 million within that 280 figure.
If you take that into consideration, Taha, you will need to have a little bit improvement of our performance in quarter four to be able to reach our guidance, and we are on track to reach that guidance. Adnan Farooq, another question. What will be the normalized quarterly run rate for the G&A? Given that there are few adjustments this quarter, it will be helpful if we can highlight a normal run rate for that. For the G&A, quarterly G&A.
For the quarterly G&A?
Yeah.
I can get back with you on that. Considered a run rate moving forward.
Okay, Adnan. We'll try to send you that question because he needs to look at the certain numbers so we can give you that number. Okay. Murshid Mawahib, he wants to have certain details on the hotel project plan at SMC Fourland. As I mentioned in the presentation, we have received approval from Royal Commission for Riyadh City to build that hotel next to the hospital. Of course, this encourages health tourism, and at the same time, it was part of our guidance. Now, what is unique, this is not something very common that the Riyadh Commission gives approval to build a hospital and a hotel next to each other. What happens, we have received that approval two weeks ago.
We are in the process of formalizing the fund composition, all the details, and all the decisions that will be discussed with the board in order to obtain the necessary approval and proceed with that project. We will be announcing those milestones once it is finalized, and we expect to finalize it in the coming few weeks. Okay. Question from Mohammad Adnan. He wants to know more details on contractual obligations recognized in quarter three, 2025, and why it was recognized earlier. This is, I guess, a question on the ECL, if I am not mistaken.
No, no. That's the difference from the ECL. The contractual obligations, obviously, when the long-term care patients were transitioned away, those all have around SAR 60 million of non-contractual obligations requirements. When you're replacing this revenue with insurance-based business, we had to increase the contractual obligations. It was much higher than expected with some of our insurance companies. That's why we did the adjustments. You'll see it'll level out in Q4 because the adjustments last year were done in Q4 of 2024.
Great. Thank you, Hany. We'll go over quickly the question. Faisal Bin Zara again. He wants to know about the status of SMC Three. Is the design finalized and how much already spent? Regarding how much we spent so far, you can give a rough number if you have it. About the status, as we speak, we are finalizing the foundation, dewatering, and infrastructure. They call it in the technical term the perforated work. They put the dewatering system for the foundation. The design has been finalized since last year. There is no change. We have already obtained approval from RCRC on additional two floors on that project. It is under construction right now. How much has been spent? I think, Hany, for the foundation work currently undergoing, I think we have spent around SAR 13 million.
I don't know if we have any, maybe the excavation, you can give a rough figure how much we paid for the excavation. I don't have it in front of me right now.
Yeah. I think what he's asking as of the nine months or year to date is around SAR 14 million-SAR 15 million for the SMC Three.
Maybe the amount of excavation was paid 2024. Okay. Question from Taha Javed on Malqa District Clinics. Is the building constructed or under construction? Will the 35 clinics be opened in phases? How many will come online in half one of 2026, and how many in second half of 2026? Of course, this was not part of our guidance. We have always said that whenever we see an opportunity, we will explore the primary or the polyclinics presence as a standalone project. That was an opportunity, and that was a ready building, and this was constructed by someone to his kids who are doctors, and they decided to abort the project. The building is ready, fit-out ready, pre-installation ready. All we're doing right now, getting the equipment, hiring the doctors, and we will be opening that clinic in quarter one, 2026.
Regarding the ramp-up, like any other project, we are planning partial ramp-up with emergency and diagnostic services. Probably within the end of 2026, all the clinics and all the specialties will be fully operational. Another question from [Lanud Rashid]. Can we have more details on the contractual obligation in terms of source, recurring nature, and what changed versus historical level, why the shift in timing? I think you answered that question if you want to add more details for [Lanud], Hany.
No, I mean, contractual obligations consist of four key components. Obviously, the Nafees fees that are set at 1% of claims. 1% is paid by the provider and then 1% by the insurance company. So it is 2% total. There is an early payment discount, and that fluctuates based on whether the insurance company pays the 70%-80% claim within 10 days. That can go up and down based on their cash flow. You have the volume discount. Again, that is related to the volume of business sent by each insurance company. That can fluctuate month by month. The other one is the rejection related to medical rejections or technical rejections. These are the four key components. We hope to maintain the existing contractual obligations as a percentage of revenue moving forward.
Thank you, Hany. I promise you, Sandesh, I'll go back to your question, and I'm now coming to your question. Your question probably about the leverage. Is the planned capital investment in our new hospitals, how we're planning to manage the envision of the leverage evolving on the medium and the long term? Hany?
Yeah. Like we mentioned in our investor meetings and early look and deep dives, we use a combination of internal cash flows, and then we move to our short-term loans during usually the pre-construction, excavation, and initial construction periods. We move towards the long-term loans. These long-term loans are 12 years with a four-year grace period. Basically, halfway through the construction or towards the end, we start digging into or drawing down from the long-term loans. This allows us to get into positive cash flow before we even have to pay off those loans. That helped a lot, that four-year grace period. That is the combination we have done with all of our expansion, including the SMC Two project in the past.
Great. Thank you, Hany. [Lanud], I'll go back to your second question. Will the new medical center in Al Malqa replace your SMC Five plans in the same area? Of course, the answer is no. Our plan for SMC Five is still as planned. However, we have delayed the decision of acquiring the land. As you know, there were recent historic decisions in Riyadh, especially in north of Riyadh, where the prices of the land are going quickly down. If you are an investor, probably you will not be buying the land during that time. You will wait a little bit. That is why we have decided to delay the purchase of the land for SMC Five for next year till the prices of the land stabilizes.
We felt that is a great opportunity to be present in terms of brand and services in the area that we are planning to build a hospital. That is why we believe it will enhance early our presence in Al Malqa area in preparation for our upcoming hospital after a few years. Ibrahim Attiya, question on the breakdown revenue and patient counts into inpatient, outpatient, and you want a breakdown of revenue, inpatient revenue, outpatient revenue, and revenue.
You want it as a percentage? I didn't understand how he wants to break it down.
I think we can answer him. If you don't have the number in front of you right now, we can give him a percentage. How much are outpatient and contribute to our overall revenue from the quarter?
Yeah. You can look at there's around 50% is inpatient, around 44% is the outpatient, and around 8% is
Okay. We hope we answered your question, Ibrahim. Yasin Mohammad, he wants to know our outpatient clinic utilization rates.
Yeah. Outpatient, currently, we're running at around 57% overall as a network. Or sorry, 55% as of Q3 2025 as a network. That is due to the remember, we added 40 clinics. When you increase capacity, obviously, utilization goes down until you pick up the load and start filling these clinics again.
Okay. Another question from Ibrahim. He wants to know if the price increases. I'll read your question, Ibrahim, exactly so Hany understands what's the purpose. Please correct me if I'm wrong. Contract renewal and price increases happen by mid of every year. To answer the question, no. Each contract, they have a certain time for renewal. Some contracts at the beginning of the year, some contracts in February, some contracts in July. So the answer to the first part of the question is no. Second, last price increase was June, July of 2025. And next one would be mid-2026. Why would you expect price increase in October? I think you answered that question. You can go ahead and answer, Ibrahim, again.
Yeah. Ibrahim, this was a contractual agreement with the insurance, one of our major insurance companies, that the first increase would occur in October of 2024, with the second increase now October 1st of 2025. That's with regards to that. All other insurance companies were effective in January and February of 2024. We have another review of increases occurring in H1 of 2026 as well that we're currently negotiating.
Okay. Thank you, Hany. We show you had the question, and I think we answered that. Hany answered that, but I'll read your question. Maybe you would like to hear the answer again. Based on your top-end revenue guidance of SAR 1.8 billion, this implies almost SAR 668 million revenue in quarter four, 2025. I think this is a typo mistake. Maybe you meant SAR 168 million. This is significantly higher than quarter three revenue. What could be the driver to reach the top end of your guidance, considering only 20 clinics will be operational in quarter four, 2025? I think this has to do with the guidance, also with the selling of the Wadi Fund hotel land. I think we answered that question. In case the answer was not clear, go ahead and send us the question one more time.
Regarding a question from Ahmad Shaki, can we assume that the new clinics in Al Malqa District will have the same revenue patients as the new clinics coming in SMC Three, Five, as mentioned in your IPO guidance? The nature of the services provided in polyclinics is different than hospital in terms of equity, utilization, and even pricing. It will be a little bit different from the guidance mentioned in the IPO. Remember, not only the reimbursement in the clinic is usually slightly lower than the hospital, but also the running cost. We assume that the revenue will be slightly lower from the clinic anticipated in the guidance that was shared before in our clinics in SMC Three and Four and Five. Murshid Mohab, you have a question on any material competition from insurance players entering the outpatient segment. It's a good question.
We have different opinions about it. We believe, first of all, positively, insurers are probably covering the healthcare needs of the community and the primary care needs of the cities that they are operating. How well it will perform, how serious it will be considered to a private operator like SMC, we believe if the selection of the services being provided in the right location, probably they will not be in a serious competition. In another opinion, and I believe the mindset of patients going to insurance companies to get treatment might be a little bit confusing. If I'm a patient, I will have access to a clinic or to a hospital or to an insurance company to get direct clinical services. I probably prefer to go to a provider and not an insurance company. I think it's too early to judge how they will perform.
In the meantime, we acknowledge their presence, and we know they are also receiving a number of patients, but we believe the demand is high. The coverage of multiple cities, especially Riyadh, is just to cover the need and the demand. We will probably be able to comment on that in the near future. Taha Javed, another question. How satisfied with the response of the large increases in clinics in your facilities in SMC One and SMC Two? How many quarters will these clinics reach maturity in our view? Regarding the response that we are getting, it was good. You can see the numbers. By adding 40 clinics in quarter one and quarter two, you are seeing those double-digit growth in outpatient activities and revenue. First of all, we will have more clinics, 20 more clinics. We will anticipate another increase.
At the same time, remember, we have proper utilization, and we have the possibility to add more numbers and capacity to our existing clinics. Always with proper utilization and efficient operation, we will be able to have more patients. We will never be happy 100% unless we have 100% utilization. I believe we're done with the time. I do not know if you can get more questions, Ahmed.
If you have the capacity to take more, yeah. There is just, I think, one more question in the chat, and there are let me check. There's just one raised hand as well.
Okay.
We can either take them, or they can send whatever they want to.
Yeah, yeah. I think Salman Alrajhi had a question about the operating cost run rate. Hany promised he will provide that. He will make sure to provide it to you, Ahmed, and you can share it with Salman and the other gentlemen who asked the same question about the run rate. If someone has a hand raised, we'll be happy to receive that question.
Sure. Saleh, if you still have questions, please unmute yourself. Otherwise, we can conclude the call.
Hello?
Yes. Go ahead, please.
Yes. Congratulations on your results for this Q3. My question has been asked before, but just I want to reiterate the guidance here. You mentioned that if we take the midpoint of your guidance for net revenue and also for the net income margin, we will end up with a revenue for Q4 of SAR 570 million almost. And the net income adjusted for the one-off of SAR 57 million for the land, after we adjust for that, you will end up with a net income of SAR 121 million. That is almost close to the whole nine months of 2025. Just want to make sure, how confident are you in terms of achieving that? And how updated is the guidance? Is it up to today's or end of the nine months, meaning the numbers you mentioned here? Thank you.
Thank you. You can answer, Hany, the same question for the third time. Go ahead.
Yeah, Ahmed. Basically, remember, we opened the most of the clinics were open towards the end of H1. So the full benefit was not realized or will not be realized till the fourth quarter. The third quarter is the summer months. You have a lot of people traveling. In addition, although there was a lot of people traveling, we still achieved that substantial growth in those three-month period. What we're expecting, you cannot say that Q3 is going to be like Q4. Q4 historically is always the big jump in the year at SMC. Now you're adding another 20 clinics. The 40 clinics that already opened now are transitioning and continuing to ramp up to cover the cost. The net profit will considerably increase in Q4, in addition to the SAR 60 million of the Wadi Fund, the SAR 57-60 million.
That's where we see the big jump will happen in Q4 with the increased capacity, increased utilization of the clinics. In addition, remember, the inpatient unit is generating much higher margins than the long-term care did a year ago. Again, the big increase will happen in the Q4 period.
Great, Hany. Thank you very much. Before we conclude, I do not want to have any question in the chat not answered. Last question from Salman. I think we answered that, but I will answer it again. When you will open the 19 clinics at the beginning of quarter four? As I mentioned, Salman, we opened those 19 clinics a few days ago. We are ramping up, and we expect to have the ramp-up completed by the end of the year. Ahmad?
We have no further questions. So I can thank you very much for taking all questions patiently. I'm not sure if you have any concluding remarks for the call. Otherwise, we can end it.
Thank you very much for all the questions and for your patience.
Right. Thank you very much, SMC's management, and to all participants today. This concludes today's earnings call. Have a good rest of the day, everyone.
Thank you very much, and have a good day.
Thank you.
Thank you.