Hello, everyone. This is Ahmed Moataz from EFG Hermes, and welcome to SMC 2025 results conference call. I'm pleased to be joined with Bassam Chahine, Chief Executive Officer, Hani Charani, Chief Financial Officer, Sadeq Al-Ali, Director of Investor Relations. The company, as usual, will start with a brief presentation and then we'll open the floor for Q&A. Sadeq, please go ahead.
Thanks, Ahmed. Bismillah ar-rahman ar-rahim. Good day, and thank you for joining us today. Welcome to SMC Healthcare Q4 and full year 2025 results presentation. My name is Sadeq Al-Ali. I'm the Director of Investor Relations and Board Secretary. Since our IPO in June 2025, we have remained committed to transparency and consistent engagement with all our stakeholders as we continue to build the foundation for long-term growth and sustainable value creation. Once our call has concluded, the presentation and all relevant material will be available on the IR page of our website. Please refer to our disclaimer which applies to all disclosure made in today's presentation. Kindly note that all figures discussed during today's call are in Saudi riyal, unless otherwise stated.
Hello, Bassam? Sadeq or Hani, anyone? Sorry, everyone. Just hold on with us. I think there's a technical issue from the company side.
I think we're back in with Sadeq and Bassam. Can you confirm, Sadeq, Bassam?
Yeah.
Okay.
We are back. We don't know what happened to the internet. Got disconnected.
Okay. Sadeq, can you take it from here, please?
Yeah.
Yeah, we're back. Thank you.
Great. I'm joined today by our CEO, Bassam Chahine, and CFO, Hani Charani. Bassam Chahine brings 30 years of leadership experience in healthcare, including 25 years driving growth and innovation at SMC. Hani Charani offers 34 years of financial experience, 21 of which have been dedicated to strengthening SMC's financial performance. They will take us through the company's results and performance during the Q4 and full year 2025. After concluding, we will open the floor for questions at the end of the presentation. The presentation will start with a brief overview of SMC and key strategic updates. Then we will share our key financial and operational highlights for the quarter and the full year 2025. After that, the presentation will outline our outlook for 2026.
With this, it is my pleasure to hand over to our CEO.
Thank you very much, Sadeq, Ahmed Moataz, and Sam. Good afternoon, everyone. I hope you are all safe and sound, and apologies for the small disconnection. It's a pleasure to welcome you to our Q4 and full year 2025 earnings call. As most of you know, SMC is a Riyadh-based integrated healthcare provider operating two full-service hospitals, SMC 1 on King Fahd Road and SMC 2 on King Abdullah Road. Our first year as a listed company, we continue to be on an upward trajectory as a key player in Saudi Arabia healthcare sector.
Our team of medical professionals, including more than 500 full-time doctors, almost 1,100 nurses, have served approximately 160,000 inpatient days and 1.4 million outpatient visit in 2025. Our model covers the entire care spectrum, and at the heart of our success is an unwavering focus on patient experience. Furthermore, we continue to integrate technology across customer experience and across our facilities, including online booking, eCheck-in, ePayment, AI-powered result reports, automated insurance responses, and AI-based clinical recommendation that we run on our mobile application. Taking a closer look at our core medical services segment, which forms the backbone of SMC Health Care business. Since the Q4 of 2023, we have strategically transitioning to redeploy long-term care beds into higher margin acute inpatient services and outpatient clinics.
We are progressing as planned with 53 long-term beds transitions to acute services and 57 new clinics roll out during 2025. The change is focused to a value-based model, is already materializing, as you can see with our consistent revenue growth. Through this transition, we are expanding access to integrated healthcare, improving utilization efficiency, and supporting sustainable margin enhancement across our network. Turning to our key highlights for 2025, we have another period of strong operational and financial progress, reflecting continued execution on our strategic priorities. Our net revenue grew 7% year-on-year to a record SAR 1.5 billion. This strong growth was achieved despite the complete phase out of 217 long-term care beds since 2023 and was driven by high-performing acute specialties and outpatient services.
Building on top line momentum, profitability strengthened even further as net profit rose 43.7% year-over-year to SAR 262.2 million. This was driven by strong revenue growth, an improved service mix, operating leverage from clinic ramp up, and continued cost optimization. Net profit also benefited from a SAR 60.6 million one-off gain of the sale of the land contributed to Al-Wadi Real Estate Fund. SMC board recently announced and recommended to the General Assembly the company first ever ordinary cash dividend amounting to SAR 80 million for 2025. This decision lies at the core of our belief in rewarding our shareholders for their trust and confidence in SMC. We have also invested in Al-Wadi Real Estate Fund.
As part of this, SMC contributed more than 4,200 square meter land plot, value around SAR 100 million as an in-kind equity stake. This project aligned with SMC 3 project supporting medical tourism in Saudi Arabia and in Riyadh in particular, and reflects also our disciplined approach to capital allocation, helping unlock the value of our asset base while supporting future growth. Finally, we have launched our first outpatient clinic center in Al Malqa district, northwest of Riyadh, consisting of 35 specialty clinics, and this is the cornerstone of our expansion in Riyadh Northern Corridor. Operation started in January 2026 ahead of schedule. Talking about the dividend, in SMC, we have and we are creating value to our shareholders. It's not about growth in the business, but also translating this into tangible returns.
As you know, at the beginning of the year, we have distributed SAR 200 million Saudi riyal special one-time cash dividend, which was previous dividend from year 2024 that was returned to the company by shareholder before listing. Earlier this week, the board recommended our first ordinary cash dividend of SAR 80 million for the 2025 financial year. It's a clear reflection of our confidence in the strength of the business, the quality of our cash generation, and the long-term outlook for SMC. Just as important, these returns have been delivered while maintaining a strong and disciplined financial position with a net debt to EBITDA the last 12 month is 1.4 times. We remain well below our long-term leverage guidance, which is 3 times, allowing us to continue funding our growth pipeline with confidence.
This is exactly the balance we aim to achieve, rewarding shareholders today, retaining the capacity to invest in the opportunity that will drive SMC next phase of growth. Talking about Al Malqa clinics, it was a strategic milestone. We have launched this clinic after announcing about it in quarter four of 2025. We have launched it in January 2026 as our first standalone outpatient clinic center in Al Malqa district, northwest of Riyadh. We commenced it ahead of schedule. It was an important step in expanding our outpatient footprint and bringing integrated specialized care closer to fast-growing communities north of Riyadh.
35 clinics, broad range of patient-centered services in high demand specialty, general medicine, pediatrics, dermatology, obstetrics, orthopedics, dentistry, in addition to an urgent care and medical emergency unit and pharmacy services. This center strengthens our ability to deliver accessible multidisciplinary outpatient care, while also complementing our existing hospital-based services. As of March 10, 14 clinics were already operational, with the remaining clinics expected to ramp up and become fully operational by year-end. This project follows a capital light model, approximately SAR 19.5 million of CapEx over 2 years, allocated tower fit-out and medical equipment, again, reflecting our disciplined and capital efficient approach to growth. Beyond its near-term contribution, SMC Clinics also supports our longer Northern Riyadh expansion and strategy, helping build brand presence, improving accessibility and reinforcing our positioning ahead of future development, including SMC 5, which is gonna be in the same location.
Going back to our project in progress, our strategic project that we have announced earlier. First, the Al-Wadi Real Estate Fund. We have contributed the land to the fund. The value was around SAR 100 million. As I mentioned before, it's an in-kind equity stake. It support the development of SMC 3 and demonstrate our disciplined approach to funding future growth. SMC 3 project, if you are living in Riyadh, you will see now the tower cranes are already in place. Foundation work is ongoing. There was a little bit delay in some regulatory things related to the Royal Commission for Riyadh City, which has been fixed, but this has delayed the schedule till 2028. SMC 4, we have secured SAR 800 million Islamic financing facility. The design is almost completed.
We have installed the hoarding on the land few weeks ago. We expect to kick off the excavation in the coming few weeks and to run the tender and to start the construction this year. We remain confident in the strength of our development and in our ability to deliver long-term growth through disciplined execution and capital planning to enhance SMC service capacity and presence in Riyadh, rapidly growing healthcare market. Talking about the long-term strategy, our plan, you know, we have announced the three hospitals, and we have announced the clinic that was not part of our guidance. This is a SAR 3 billion total CapEx investment by 2029, funded through a combination of debt and internal cash generation. We have already taken an important step in opening the clinic, not part of our IPO guidance.
It was really an opportunity for us in a highly strategic location, a great addition that fits closely with our broader expansion plan by opening the first standalone clinic center with 14 operational clinics and the remainder, as I mentioned, before the end of the year. I mentioned about SMC status and also about SMC 4. Regarding SMC 5, land prices in Riyadh are still going down, as you all know by now. We are still waiting until the prices stabilize, but we will be acquiring this land this year, and we are expecting to kick off the design and the construction next year, and this project is supposed to be completed by 2029. All these projects form the backbone of our long-term expansion strategy and are expected to materially increase our capacity and support sustainable future growth.
I will leave now the floor to my colleague, Hani Charani, our CFO, who will be guiding you through the financial highlights of the quarter and the year. Hani.
Thank you, Bassam. Welcome, everyone. Ramadan Kareem. It's a pleasure to present to you our results for the full year and Q of 2025. Our results this year reflect the continued execution of SMC's strategic shift towards high-performing acute and outpatient services, successfully offsetting the reduction in our long-term care capacity. Starting with the inpatient chart on the left there, despite the significant reduction in our LTC capacity during the year, the higher margin acute specialties helped support the inpatient revenue growth of 5.1% year-on-year, reaching SAR 785.5 million, reflecting improved utilization and a stronger service mix. Meanwhile, the outpatient activity continued to expand strongly, supported by the ramp-up of newly launched clinics. Outpatient clinic visits grew by 11.8% year-on-year, reaching approximately 1.4 million visits.
As these new clinics continued to scale up, outpatient clinic revenues also grew to SAR 660.5 million, representing a 13.4% increase year-on-year following the rollout of the 57 new clinics during 2025. We also continued to see solid performance across our emerging, our emergency department and outpatient pharmacy services, with revenues increasing by 7.9% and 9.3% respectively. Overall, this growth demonstrates the strength of our outpatient expansion strategy and the ongoing transition towards high-margin acute services, positioning the business for continued operational momentum going forward. Turning now to our financial performance for the fourth quarter and full year. SMC delivered a strong performance reflecting continued progress in our strategic transition. Net revenue reached SAR 406.9 million in Q4 2025.
That's up 24.4% year-on-year, driven by solid growth across inpatient and outpatient services as the clinics that we opened during the year continued to ramp up and acute inpatient utilization improved. For the full year, net revenue increased by 7% year-on-year to SAR 1.54 billion. Looking at our EBITDA, it rose significantly during the quarter to SAR 172 million compared with SAR 464.5 million in Q4 of 2024, with margins expanding to 42.3%. This increase was driven by strong operating leverage from the ramp-up of the newly added clinics, improved utilization in acute services, and the SAR 60.6 million one-off gain related to the land contribution to the Al-Wadi Real Estate Fund.
For the full year, EBITDA increased by 25% year-on-year to SAR 416.5 million, with margins expanding by 3.9 percentage points to 27.1%. Looking at the net profit, it increased to a record SAR 134 million in Q4 of 2025, compared with SAR 26.2 million in the same period last year, representing a significant increase with the net profit margin improving to 32.9%. For the full year and including the one-off gain, the net profit rose by 43.7% year-on-year to SAR 266.2 million, with the net profit margin expanding to 17.3%, reflecting improved operational performance and a very strong Q4 that offset earlier non-recurring expenses during the year.
Looking at our operating cash flow, it reached SAR 140 million in Q4 of 2025, while the full-year operating cash flow totaled SAR 322.7 million. Free cash flow amounted to SAR 116.6 million in the Q4 and SAR 228.3 million for the full year, reflecting continued investment in network expansion alongside strong underlying operating performance. Looking at the leverage position, it improved further with net debt to EBITDA declining to 1.4 times compared with 2.3 times in the prior year, supported by stronger cash generation and disciplined capital allocation. Looking at the revenue EBITDA net profit, our Q4 and full-year results reflect strong operational execution and continued progress in our strategic transformation.
Starting with the chart on the top, you'll notice that revenue grew by 6.3% quarter-on-quarter to SAR 406.9 million in Q4 of 2025 and increasing by 7% year-on-year to SAR 1.54 billion for the year. As mentioned, this growth was driven by the successful execution of our operational shift, which more than offset the planned phase out of our long-term care capacity. Moving to the chart in the middle, EBITDA rose by 64.5% quarter-on-quarter to SAR 172 million, reflecting stronger operating leverage as the newly opened clinics continued ramping up and the transition towards higher margin acute services delivered the expected results.
For the full year, EBITDA increased to SAR 416.5 million compared with SAR 333.3 million in 2024, with margins expanding to 27.1%. This improvement reflects stronger operational performance, improved service mix, and the one-off gain related to the land contribution to the Al-Wadi Real Estate Fund. Moving to the chart on the bottom, the net profit reached SAR 134 million in Q4, which includes the one-off gain, compared to SAR 66.2 million during the previous quarter. If we exclude that SAR 60.6 million one-off gain from the sale of the land, we grew by 10.1% quarter-on-quarter as net income reached SAR 73.4 million.
For the full year, net income reached SAR 266.2 million compared with SAR 185.2 million in 2024. Again, if we can exclude that one-off gain, net income amounted to SAR 205.6 million, representing an 11% jump year-on-year. In conclusion, the strong Q4 performance reflects the disciplined execution and efficiency of our strategic transition towards outpatient services and higher margin acute services, which are translating into improved service mix, margin expansion, and a steady revenue growth as we move forward. 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 further to 1.4 times, down from 2.3 times a year ago, reflecting a 16.4% reduction in outstanding debt alongside a 30% stronger cash position, supported by improved cash generating during the year. The debt-to-equity ratio decreased to 44.9%, improving by over 32 percentage points year on year as a result of our efficient capital structure and disciplined approach to leverage. Our receivable cycle improved to 103 days as we continue to optimize collections under our insurance and cash-based model, while the payable days remained stable at around 35 days.
Finally, our capital expenditure totaled SAR 94.5 million for the year, primarily related to the opening of the new clinics, the ongoing renovation projects, the replacement of medical equipment, and the construction activities associated with the SMC 3 and SMC 4 expansion 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. Following a year of strong financial performance and sustained strategic execution and a transitional year, we are introducing our outlook for the coming year. For 2026, we expect net revenue to reach between SAR 1.6 billion and SAR 1.7 billion, supported by continued outpatient expansion, improved clinic utilization, and the ongoing shift towards higher margin acute services.
From a profitability perspective, we are guiding for an EBITDA margin of between 23%–25% with a net income margin in the range of 14%–16%, reflecting the further operating leverage as the clinics open during 2025 continue to ramp up, become more efficient, and contribute positively to our financial performance. Operationally, we expect to reach 581 inpatient beds and between 350-360 outpatient clinics as we continue to expand our access points while improving utilization across our existing network. Looking at the chart on the left from a 2025 perspective, it denotes continued growth across our key financial metrics. This comparison excludes the SAR 60.6 million one-off gain from the sale of the land recorded in Q4 of 2025, thus providing a clear view of our core underlying operating trajectory.
Based on this outlook highlights a revenue growth of approximately 4% alongside a robust 8.9% increase in net profits. Leverage is expected to slightly increase due to the expected drawdowns from our existing facilities allocated for expansion plans while remaining below our healthy long-term guidance of 3x. It's important to note that the growth figures shown on the slide are calculated using the lower end of the guidance range, which reflects a conservative approach. As the newly opened clinics continue to ramp up and utilization increases further, we are likely to exceed these levels as the year progresses. With this in mind, we conclude the first part of this earnings call. Thank you, and I'll pass it over to Sadeq to initiate the Q&A session.
Thank you, Bassam and Hani, for the presentation. Now we will open the floor for the questions.
Thank you very much. To all participants that wish to ask questions, you can either send them through the chat or use the Raise Hand function. Until we get questions in the chat, we have a couple of Raised Hand functions. One second. We'll start with Mashael from SMB. Please, to everyone, keep yourself to a maximum of two questions because we have a long queue ahead. Mashael, please unmute yourself and go ahead.
Salaam alaikum. Thank you, Ahmed. Thank you, Bassam and Hani, for the presentation, and Ramadan Mubarak. If you'd allow me two questions. One, regarding SMC 4. I remember that we have secured the land since Q3 call, but can you share how much was the CapEx paid to that land? My second question is related to OpEx during the Q4 . I understand that we have recorded a one-off gain of SAR 60 million related to the land, but I believe this is recorded under the EBIT line. Looking at EBIT, looking at gross margin, there are a lot of disruptions there. If you can elaborate on Q4 and give us more color on the numbers. Thank you.
Thank you. Shukran, Mashael. Ramadan Mubarak. I will answer the first question, Hani, on the SMC 4, and you will answer the second question. Regarding SMC 4, we have bought the land for 5,000 SAR. I believe it was 15,200 times 5,000, so SAR 76 million. What happened, that land that we took, part of Khuzam Suburb, was very adjacent to properties and land by the Ministry of Defense. They took a lot of time in issuing the deed. You know, we need the deed and proceeding with the formalities.
What happened, during that time, we were doing the design, and when we thought that it's taking too much time, we have asked for an adjacent land with the same dimension that part of the ownership by NHC. This took place one month ago. After this took place, we took over the land, and we did the hoarding. What we are doing right now is finalizing the design. We will be kicking off the excavation, in the coming maybe few weeks, and we will have the tender and the appointment of the contractor before the end of the year. We are still in timeline to have this hospital fully constructed by 2028. Hani, the second question?
Yeah. I think you were asking about the Q4 . Remember the Q4 , we recorded the SAR 60.6 million, the sale of the land as other revenue. It'll affect your net profit and EBITDA. It has nothing to do with the top-line revenue. If you take that out, the revenue increased by 7%, and the net profit, excluding the one-off, increased by 11%.
Yes, Hani. Maybe I need to rephrase my question on the performance. Yes, I understand the SAR 60 million is a one-off, and it's in other income. Usually, other income is reported below the EBIT line, right? Am I correct?
Yeah, yeah. You need to remove the one-off from the EBITDA.
All right. I need to remove the amount from the net profit. Looking at the
Yeah.
Operating income.
Okay.
Okay. When I look at the annualized operating income, it's. You know, the numbers are not adding up. Is it included in EBIT or not?
Sorry, are you still there?
Yeah, Hani. Am I audible?
Yeah, it's included in EBITDA.
All right. This adds up. Just one last question on the Q4 . The gross profit margin profile, I understand that year-over-year we're marking a great expansion that's around 600 basis points. But, you know, sequentially looking at it, Q3 we were doing well. We reported 26.6% gross profit margin. What happened in Q4? I mean, despite this upward growth, we still printed a pressured gross margin profile.
Well, I think Q4 was under a little bit of pressure. The ramp-up of the facilities or the additional clinics was expected in April of 2025. Due to delays in equipment being received from the suppliers, there was 6-9 months delay. Some of the more profitable clinics didn't open as expected in the Q4, which really impacted that.
Clear. Thank you, Hani. Thank you, Bassam. Best of luck.
Thank you, Mashal.
Thank you. We'll move on to questions from the line of Salman Al-Rashidi. Please just introduce. He's from Thamain, sorry. Unmute yourself and go ahead.
Hello, everyone. Thank you for the presentation. I have two questions. The first question is, we saw a year-over-year increase by 21%. I saw the breakdown, outpatient up only for 10.7%, emergency room 14%, and inpatient revenue 8%. I would love to know how the 21% is, the revenue is up by 21%. This is the first question. Second question is, regarding the SMC Three. In 2028, when exactly in 2028? End of the year, or beginning of the year, or mid of the year?
Yeah. Thank you for the question. I will try to give you a general answer on the first question. Hani can comment on that. I will start with your second question. Basically, our project timeline is 30 months. When you start the foundation work, by 30 months, we'll finish the project. Sometimes you get delay from regulatory. Here in Riyadh, it's a little bit complex, especially when you are on a main development, main street. There are a lot of issues that usually delay us. When I say 2028 for SMC 3 and SMC 4, I'm targeting and taking into consideration the regulatory things. Q4 2028, both, Inshallah, will be fully commissioned. This is as far as the timeline. Regarding the increase in revenue, of course, there were increase in activity.
I can just give you a justification. Many beds were converted to inpatient beds. Many space occupied by long-term beds were converted to clinics. That's why we have seen the increase in inpatient and outpatient activities and revenue. Now, regarding the 21%, if I'm not mistaken, Hani, because this is the gain the company took from selling the land, the profit we got from selling the land to the Al-Wadi Real Estate Fund. You can correct me if I'm wrong.
I just want to have a clarification on the question. Are you talking about net revenue or the profit? You're talking about re-
I'm talking about the net revenue.
Okay. Between 2024, 2025 or the quarter?
Yes, Q4 2025 comparing to Q4 2024.
You're comparing Q4 to Q4 of 25, correct?
Yes, year-over-year.
Remember, we added the almost 57 clinics over that period from Q4. We transitioned away from those long-term beds. They became acute beds that were generating almost double the revenue per bed that the long-term care beds were doing.
Yeah.
Is that?
What I'm trying to understand is there is a 21% increase year-on-year, right?
Yeah.
24% net revenue. I just want to know that the inpatient revenue is only up by 8% and the outpatient revenue up only 10.7%, while the emergency room is around 14%.
Okay.
How come it become 21% or 24%?
Well, you have the inpatient. Remember, we lost around SAR 60 million in long-term care revenue, so you had to offset that revenue with acute services. We offset those losses and came even above it. That's that 8% you're seeing. Outpatient is related to the ramp up of the clinics. ER is related to, we expanded the ER as well, and we saw more ER visits through the ER.
Okay. Mainly it's due to the contractual obligation, I guess.
What's that?
Mostly booked on Q4, right?
Q4?
Yeah. I mean, the Q4 decline in 2024 is mainly because the reduction of LTC beds and the Q3 2024 contractual obligation has been booked in Q4.
Exactly.
2024.
That was in Q4 before pre-IPO. Correct.
Okay.
The big difference in inpatient, remember that loss of that revenue. We had to recover that revenue and come above it to reach that 8% Q-on-Q, Q4-to-Q4 comparison.
Okay. Clear. Thank you.
Thank you, Salman. Next question, please.
Next question is from the line of Hikmat Salahi from Merfiq. Unmute yourself, please, and go ahead.
Hello. Am I audible?
Yes, Hikmat.
Yes.
Okay. Thank you, doctor. This is Hikmat from Merfiq Capital. I just have two questions from my side. Basically, if I look at your guidance for 2026, the revenue guidance is around 4%, and you have recently opened the new outpatient clinics, and you should be ramping them up. In addition, you're also expecting more clinics in 2026. Are you expecting a softer ramp-up of those new clinics? Why is the revenue guidance towards the lower end for 2026? My second question is regarding your non-operating income below the operating profit in 2025. Basically, you said that you booked the SAR 60 million under the operating profit. This gives me a net positive inflow in Q4 2025 under the operating profit. Can you shed some light on the net inflow? Where does it come from?
My third and last question is regarding the claim rejections from insurance companies. If, given that in Q4 you booked the contractual obligations in net revenue, does this by any chance impact your receivables or, the impairments on the receivables, or it doesn't affect the balance sheet by any chance? Thank you.
Thank you, Hikmat. Hani, I will start with the first question on the guidance for the 4% for 2026, and you can continue that on the receivable and on the, I think, the second question on the cash flow, if I'm not mistaken. The first question, you were talking about the guidance. Now, right now, we are in full capacity. We are still ramping up few clinics. We are supposed to ramp up a few clinics in Al Malqa that will be reflected in the second half of 2026. We are ramping up also 9 clinics in SMC One, but we don't have major floors or big expansion in the pipeline. It's a matter of increase in the activity, some improvement in the pricing.
That's why the guidance was on that 4% side. Can you continue, Hani, with the rest of the question?
Yeah. You were talking about the.
The below operating profit item. Basically, if I look at the numbers, you ended up with a net positive inflow below the operating profit. If I take the net income and subtract operating, I see a net inflow. Can you shed some light? What is this other income, since you mentioned that the SAR 60 million was booked in the EBIT or EBITDA item? Below that, what was booked there that resulted in a net inflow to the company?
Yeah. It was booked under other revenue, so it's gonna affect your EBITDA.
Below EBITDA, if I go below EBITDA, so for example, finance cost and Zakat expense, the difference between this and the operating profit, it was a net positive.
Yeah. If you don't mind, can you send me detailed questions, like, and I can answer them, as you require? It's probably better so I can see what you're talking about.
Okay. The third question, Hani, about the effect of contractual obligation on net revenue, right? That's your question?
Yeah. Is there any way that it impacts the balance sheet, or it doesn't by any chance?
No. Net net revenue includes the contractual obligations, okay? Obviously, as the business increases, the contractual obligations will increase. However, as a percentage of revenue, it's maintaining about the same. You're not gonna see a big shift from year to year.
Yeah, I understand. If you settle with insurance companies and there is some percentage of claim rejections, it doesn't then later on flow to the balance sheet.
No.
It's just mainly booked under net revenue.
No. No.
Okay. Very clear.
All the contractual obligations are factored, and what you see is the net revenue.
Okay. Very clear. Thank you very much. I'll take one off here.
Thank you.
Thank you.
Next question is from the line of Naaman Khan from SMB. Please unmute yourself and go ahead. Please, again, remind everyone, keep yourself to a limit of two questions.
Thank you. Can you hear me?
Yes, Naaman. Hello.
Hi, Bassam and Hani. Again, congratulations for an excellent set of questions again. It's just that there is a bit of confusion. I think Mashal asked about it, and I think Hikmat also asked about it, that if you look at OpEx, just a pure OpEx number, I will not talk about anything else, but just a pure OpEx number. The OpEx in Q4 was about SAR 5 million, whereas it was SAR 29 million last quarter. I think a lot of people is asking why the OpEx, specifically just the OpEx, has nothing to do with the capital gain, has nothing to do with one-time. Why the OpEx was so low in Q4, which includes G&A or S&M, like sales and marketing expense. That's my first question.
Second question again is based on your guidance. Again, at the time of the IPO, you were guiding for growth of about 11%–12% in 2027 and a margin of about 26% or above. In your latest guidance, I think now you are guiding a much more conservative number. Even, like I do understand the base is low, but even if you do 11%, what you initially were guiding for, the number is still lower than what the initial guidance was, and the margin or EBITDA assumptions are also lower. Why is the change in these two things, given that you've added a new clinic there, new ramp-ups as well? Why the growth trajectory have slowed down as per your IPO guidance?
Okay. Hani, you wanna take that call?
First I wanna address the issue of the one-off. Obviously, the one-off is below the operating profit. It'll increase the EBIT and net profit. Operating profit does not include that one-off.
Yes, yes, Hani. That is completely understandable. That means your OpEx in Q4 was only SAR 5 million. OpEx, operating expense, which includes G&A and S&M. That is why I think where the confusion is why that operating expense is so low. Vis-à-vis your gross margins are also extremely low. Like, they dropped from 26%– 20%. Is there some level of reclassification in accounts that have been moved from OpEx to gross income?
Yeah, there was. I can give you details offline. I can answer that. There was some reclassification of some expenses.
Perfect. I think that cleared up.
I'll clear that, clarify to you if you can send me the email.
Perfect. Thank you. The other part of the guidance, why the guidance have been lowered, the growth trajectory rather have been lowered as compared to what you're talking about the IPO.
Well, I think. Remember the guidance we had mentioned that the clinics was supposed to be operational in April of 2025. They were not fully operational by then. We still have clinics to be opened this quarter. We had a delay in equipment several months, so that affected the ramp-up of the clinics and obviously the guidance for 2025.
I agree with that. The growth trajectory should remain the same. The growth trajectory, what you're guiding now, is lower than what you were guiding for IPO. The margin as is guiding is well lower. Just wanted to have a sense of why is that so.
This is our guidance. I mean, it's relevant to what you're comparing to.
Okay.
The EBIT, it's in line with our historical averages, and this is where we think is achievable moving forward. Remember, you're gonna have more and more competition, many hospitals and clinics opening up, putting pressure on all the margins throughout all the hospitals. You might not see it this year, but it's gonna come.
Thank you.
We wanted to be very realistic about our guidance for the top line as well as net profit and EBIT.
Thank you very much. I think that's all from my side.
Thank you, Naaman. What we did really, we did not change significantly anything in the guidance. What we did, we just narrow a little bit in the range, lower end and the higher end, to take into consideration all the challenges that all the competition like Hani was mentioning. Next question, please, Ahmed.
Thank you very much.
Thank you so much. Thank you.
Next question is from the line of Divya Shah. Please introduce your firm and keep yourself to two questions. Yeah, unmute yourself, please.
Ahmed, I have questions on the chat also. We don't wanna forget about it, okay?
Yeah. After Divya, there is no more raised hand.
Okay.
Hi. Hi, management. Thank you for the presentation. Just one question from me. As I remember in the last conference call, earnings call, you had mentioned you had projected guidance on top line and margins, but the actuals for financial year 2025. I've seen that we have not met the same, like both in terms of top line as well as bottom line. Is there anything specific that we had factored in at the time of providing guidance and was not crystallized?
I think in terms of the top line, yes, we didn't, but we squeezed our cost and we met the guidance for the EBIT and net income, net profit margins.
We were monitoring, Divya. We were monitoring our revenue as with the guidance, and we do that on a monthly basis, on a quarterly basis. We noticed because of the delay in the ramp-up, we might not be able to meet the guidance. That's why we made lot of cost containment activities and lot of operational efficiency initiatives to be able to control the cost, so we reach the net profit margin. Did we answer your question?
Okay. Yeah. Fairly. I just had a concern. Was there something that was factored in and it did not meet? Of course, on the net profit, there was a very little variance, but yeah, there was something. Yeah. Okay, fine. I think my question is answered.
All right. Thank you.
Thank you.
Ahmed, am I allowed to call in chat?
Yeah, please go ahead.
We don't wanna miss anyone. Okay.
There are just some questions that I got directly, so I'll just paste them for you in the chat.
Go ahead. No. Go ahead. Go ahead. Don't miss any question, please. Go ahead.
No, you go ahead, and I'll just paste for you the other questions on the chat.
Sure. All right. Bye. I think we answered the question. I'm just trying to go over all the questions of Bader, Atheer Research. I think we answered the question on the guidance. About SMC 3, there is a question, we answered, but I will answer again with more clarification. Okay. Question from Marina. Two questions. I will just pose the question and give you the answer. Can you elaborate more on the delay in the launch of SMC 3? Which government regulation and approval is still pending? That's the first question. I will answer that. The second question, explain why you're guiding only at 4% top-line growth in 2026. I think we just answered that. Regarding SMC 3, first of all, it's a complex project for multiple reasons.
First, the approval from RCRC is an exceptional approval because this is a tertiary referral center on an international road. There is a helipad on top. There is a lot of requirement with the civil aviation. There is a requirement also with the traffic impact study. Not only that, the exceptional approval is mixed use because this is a preparation for Al-Wadi Fund. They have also approval for the hotel. There are additional requirement mainly related to traffic impact study based on RCRC regulation. We're not wasting time because we start the foundation work, the dewatering, all the pre-installation before we kick off the foundation. We have also supported the excavation. That was also an additional thing that we did in the past three months, which was not part of our plan.
These are the simple regulation related to the complexity of the project itself. The second question, I think we answered you. Saleh is mentioning that he's not seeing his hands raised. Saleh, can you go ahead and ask your question right now if you can? Please introduce yourself and what organization. I think he might not be online anymore. Okay. If you cannot hear me or you can hear me, just type the question and I will mention it to you. LAFANA Holding, five questions. I'll try to go over them quickly. Decline in gross margin during 2025 Q4 , this decline is permanent or one-off? You wanna answer that quickly, Hani? I think we answered that, but go ahead, answer that quickly.
that was the decline in Q4 she asked?
The question about the gross margin.
Gross margin?
Q4 , the decline is permanent or one-time?
No, it's a one time.
Okay.
It's a one time.
Okay.
I wanna go back to the guidance really quick, Bassam.
Go ahead.
Because I had mentioned it in the presentation that the difference they're seeing only 4%, that's the low end of the guidance. The spread you're talking for an upwards of 10, 12% at SAR 1.7 billion. The 4% you're looking at is just the low-end guidance.
Occupancy rate for new added outpatient clinics, some of them occupancy rate is 70%, 80%, some of them 40%, but they are ramping up quickly. By that I mean the clinic that were added in 2025.
Clear.
Occupancy rate of Al Malqa Clinic, it just started a few weeks ago. We're still finalizing a few insurance companies, but it's picking up quickly. I cannot disclose because we don't have the details right now. We did not even finish Q1 with the operation. Fourth question, do you see yourself affected by the recent changes in the National Insurance Sector Strategy? The answer is yes. We see ourselves positively affected. Same as what will happen with all private sector who is well established in the market. The NHIC, the National Health Insurance Center and the strategy that will be supporting the insurance industry, it will reflect positively. There are more insurance, more insured, more utilization, and the private sector, especially the publicly listed company, are well off to meet that challenge and requirement and that demand that is coming.
The fifth question, inpatient, outpatient revenue exceed revenue from medical services. Are there any deduction? If yes, what does it pertain to? The inpatient and outpatient is the medical services revenue. Probably you add on it the emergency revenue. In case it was not clear during the discussion, your question, send it privately, and we'll respond to that. I'll go quickly, so we don't skip any questions. Bader did not specify what organization. When we will be announcing the contractor for SMC 3 and SMC 4. The SMC 3 already we finished the tendering process, and the contractor has been selected. The contract and the announcement will be done very soon once we finish a final legal permit from the RCRC.
Regarding SMC 4, I think I mentioned that the construction tendering process will take place this year, and this year we will announce the contractor who will do the construction of SMC 4. I will go quickly. Okay, Salman Al-Rashidi, he asked two questions, but he has one more question, so we need to accommodate him. Hani Charani, he asked why we booked Q3 2024 contractual obligation in Q4 2024. I think you mentioned about.
This was-
Yeah, go ahead.
This was pre-IPO, and we had. We were trying to clean up everything before IPO for 2024, so it was all booked in the Q4 of 2024, all the contractual obligations and different requirements.
Great. Another question from Salman. I hope we answered you the first question. The second question, any update on the PPP project? Of course, there is an update. After approval of the government for the budget, they were in approval of the PPP. Before, each ministry was sending the PPP as a separate project and a separate budget. They have asked each ministry to prioritize, and the Ministry of Health prioritize SABIC PPP project. We have been notified by email and by phone calls a few weeks ago that the budget has been approved and this project is high priority. They have set up a date of us. Of course, I'm not supposed to be telling you this, but I want to be very transparent with you.
This will be announced soon, and we're planning to sign the contract end of this month if all the conditions, Inshallah, improve. Otherwise, probably this will be signed in the coming two weeks. After a few weeks, we will sign the contract on this project, SABIC mental health hospital. The first PPP operational hospital will be coming live before the end of the year. That's for sure. We have received all the confirmation for that. Hikmat, again, another question. Can you disclose how many long-term beds were converted into acute beds and how many have been terminated? I think we have mentioned this in the presentation, my part. There were 217 beds that were canceled from 2023 to 2024. What were converted to acute beds were 57.
Not all the space that was utilized by long-term was converted to acute. 57-bed acute, and as you mentioned earlier, an SMC 140 clinics added. Any more conversions pending, Ajai? No, that's it. We have mentioned all the conversions that took place last year and this year. I think I'm done with that. Thank you, Bader. Shukran. I think we're done. Any other questions before we conclude?
A final reminder to everyone, if you have questions, please either send them or use the raise hand function.
Any question we did not answer or you think of, please go ahead and send it to IR@smc.com.sa, and we'll be very happy to answer that.
Yeah. We haven't received questions, so I think we can conclude.
Okay. Thank you very much. Thank you, Ahmed, EFG, Sam, and my colleagues and all our partners who attended the call. Hopefully we'll meet again in better security conditions.
Thank you very much to SMC and to everyone that attended today. This concludes today's earnings call. Have a good rest of the day, everyone.
Thank you.