Global Health Limited — Q4 FY26

Global Health Ltd Q4 FY2025-26 Earnings Conference Call https://www.youtube.com/watch?v=FIAJkXwyNYc Published: 1d ago

0:01 1 second Ladies and gentlemen, good day and welcome to the Global Health Limited, also known as Madanta Q4 FY26 conference 0:10 10 seconds call hosted by ICICI Securities. As a reminder, all participant lines will be in the listenon mode and there will be 0:18 18 seconds an opportunity for you to ask questions after the presentation concludes. Should you need assistance during the conference call, please signal an 0:25 25 seconds operator by pressing star and then zero on your touchstone phone. Please note that this conference is being recorded. 0:33 33 seconds I now hand the conference over to Mr. 0:35 35 seconds Abdul Kadir Kuranwalla from ICICI securities. Thank you and over to you sir. 0:42 42 seconds Uh thank you Saga. Uh good afternoon everyone and a warm welcome to all participants on uh the global health uh 0:50 50 seconds limited Q4 FI26 earnings call hosted by CICI securities. 0:56 56 seconds So joining us today from the management uh we have uh Dr. Naresh Prehan chairman and managing director uh Mr. Pankut 1:04 1 minute, 4 seconds Sanani group CEO and director Mr. Yogesh Kumar Gupta CFO and uh Mr. 1:12 1 minute, 12 seconds Ravi Gautal, head investor relations. Uh we'll now hand over the call to Dr. 1:18 1 minute, 18 seconds Trian for his opening remarks. Thank you and over to you doctor. 1:25 1 minute, 25 seconds Good afternoon everyone and welcome to Madanta's new and full year FY26 earnings conference call. 1:36 1 minute, 36 seconds I would like to start with reiterating the fact that at Madanta, our vision has always been to build a worldclass 1:44 1 minute, 44 seconds institution that seamlessly integrates clinical excellence, research, education and advanced technology with 1:53 1 minute, 53 seconds compassionate patient centric care benchmarking ourselves against the finest global healthcare institutions. 2:02 2 minutes, 2 seconds I am particularly pleased to share with you the key milestones during this year. 2:09 2 minutes, 9 seconds Our 550 bed NOA facility commenced operations during the year 2:20 2 minutes, 20 seconds acquired. We also acquired land to set up a 400 bed plus bed multis-pety hospitals in Gojhati 2:28 2 minutes, 28 seconds which will bring the highest quality of care to the norththeast region of our country. 2:34 2 minutes, 34 seconds We also partnered to build a 400 plus bed hospital in holy city of Aronas. 2:41 2 minutes, 41 seconds During the year, we strengthened our clinical leadership, enhanced institutional capabilities, and further deepened the trust that patients base in us across our network. 2:54 2 minutes, 54 seconds Our team successfully managed several highly complex and high equity cases across specialties, reflecting the depth of our clinical expertise. 3:06 3 minutes, 6 seconds At the same time, we continue to strengthen our capabilities in robotic assisted and minimally invasive procedures, underscoring our focus on 3:15 3 minutes, 15 seconds improving clinical outcomes and enabling faster patient recovery. 3:21 3 minutes, 21 seconds Maidanta Gurugram, our flagship hospital, was recognized by Newsweek as the best hospital in India. This marks 3:29 3 minutes, 29 seconds the seventh consecutive year of the hospital being recognized by Newsweek and we remain the only private Indian 3:37 3 minutes, 37 seconds hospital to be featured among the top 150 hospitals of the world. 3:44 3 minutes, 44 seconds Uh, Lacna Hospital received the prestigious JCI accreditation in January 2026, becoming the first hospital in 3:53 3 minutes, 53 seconds eastern Uttar Pradesh to achieve this distinction and further reinforcing our commitment to global standards of clinical quality. 4:03 4 minutes, 3 seconds I'm also pleased to share that Milanta Noa 550 bed multispety hospital 4:11 4 minutes, 11 seconds formally inaugurated in November 25 secured NABH accreditation within the first six months of operation. 4:19 4 minutes, 19 seconds This of course reflects the strength of our institution system and clinical protocols from inception. 4:27 4 minutes, 27 seconds We have onboarded a highly skilled team of clinician and deployed advanced medical 4:34 4 minutes, 34 seconds technologies enabling us to deliver worldclass care to patients in Naida and western Pradesh. 4:43 4 minutes, 43 seconds On the expansion front we announced 400 bed multispety hospital project in the heart of Arnasi. This project will 4:52 4 minutes, 52 seconds further strengthen our presence in Uttar Pradesh and serve as a key tertiary care hub for eastern Uttar Pradesh addressing 5:00 5 minutes a significant unmet need in the most populous state of India. 5:06 5 minutes, 6 seconds Subsequently to the year end in May 26 we expanded our presence in on inoration 5:15 5 minutes, 15 seconds of a 20 80 bed hospital. This will allow us to add oncology capabilities as well 5:23 5 minutes, 23 seconds as complement our existing multispety facilities. 5:27 5 minutes, 27 seconds As we continue to grow, our focus remains firmly on building integrated healthcare institutions driven by 5:35 5 minutes, 35 seconds clinical excellence, patient trust, ethical practices, research, and long-term sustainability. 5:42 5 minutes, 42 seconds Every step in our growth journey is guided by a clear purpose to make the highest quality of medical care accessible to a larger population and 5:51 5 minutes, 51 seconds specially established where it is needed most. We think that I will now hand over 5:58 5 minutes, 58 seconds the call to Mr. Bangani our group CEO who will take you through the financials and operational 6:05 6 minutes, 5 seconds performance in greater details. Thank you very much. Over to you from please. 6:12 6 minutes, 12 seconds Thank you Dr. Chen. Good afternoon everyone and thank you for joining us today for our Q4 and FY26 earnings call. 6:20 6 minutes, 20 seconds FY 2026 was another important year for Medanta as we continued to deliver strong operational and financial performance across the network. This 6:29 6 minutes, 29 seconds performance was driven by sustained growth in patient volumes, improving realizations and consistent execution across our hospitals. While we 6:37 6 minutes, 37 seconds simultaneously invested in expanding our capacity and strengthening our clinical capabilities. 6:43 6 minutes, 43 seconds Importantly, the year reflects the strength of our operating model where mature hospitals continue to deliver steady performance and our developing 6:51 6 minutes, 51 seconds hospitals are scaling up with strong momentum and the launch of our sixth flagship hospital in NOA creating a solid solid foundation to drive medium-term growth. 7:02 7 minutes, 2 seconds Let me begin with the financial performance highlights for the full year FY2026. 7:08 7 minutes, 8 seconds Total income grew by 20% yearonear to rupees 45,89 7:15 7 minutes, 15 seconds million. Total income excluding NOIA grew by 17%. 7:20 7 minutes, 20 seconds IITa excluding NOIA grew by 19% yearonear to rupees 11,343 7:27 7 minutes, 27 seconds million. IDA margins improved to 25.7% compared to 25.4% 7:33 7 minutes, 33 seconds in the same period last year. IDA including NOIA stood at rupees 10,560 7:41 7 minutes, 41 seconds million with margins of 24.2% reflecting the expected impact of early stage operating losses from our newest hospital. 7:51 7 minutes, 51 seconds NOA remains a key strategic asset for us and we are encouraged by the pace of ramp up since its formal inauguration in November 2025. 8:00 8 minutes We have operationalized 382 beds, 98 ICU beds and 14 operating theaters. The 8:08 8 minutes, 8 seconds hospital has onboarded over 200 doctors and 75 plus senior clinicians. Clinical 8:14 8 minutes, 14 seconds programs have scaled rapidly with over 1,600 surgeries including robotic procedures, over 5,000 catlab 8:22 8 minutes, 22 seconds procedures, the initiation of advanced therapies, including carti cells and bone marrow transplant and kidney transplants. We have also achieved NAB 8:32 8 minutes, 32 seconds accredititation within 6 months reflecting the strength of our clinical and operational processes. 8:38 8 minutes, 38 seconds We have made strong progress on various empanelments including insurance, corporate and PSUs and we have also 8:46 8 minutes, 46 seconds received CGHS empanelment in the month of May 2026 in line with our commitment to live the deliver the highest quality of care to all communities. 8:56 8 minutes, 56 seconds From a financial standpoint, NOIA has delivered revenue of rupees 96 million and an Aida loss of rupees 783 million during FI 2026. 9:08 9 minutes, 8 seconds Importantly, Q3 FI2026 was the peak quarterly loss for NOIA at 9:14 9 minutes, 14 seconds rupees 320 million. Q4 loss reduced to rupees 236 million even as bed capacity expanded from 328 to 382. 9:28 9 minutes, 28 seconds Consolidated profit after tax increased by 15.1% yearonear to rupees 5,541 million. 9:38 9 minutes, 38 seconds On the international business side, revenue grew by 33% yearonear to rupees 2780 9:45 9 minutes, 45 seconds million. International mix has expanded from 6% to 7% of consolidated revenue. 9:52 9 minutes, 52 seconds Despite some short-term challenges given the situation in the Middle East, we see continued runway as NOA's international 9:59 9 minutes, 59 seconds funnel activates and new countries in Africa, Southeast Asia, and the CIS region scale up. 10:07 10 minutes, 7 seconds In line with the company's strong financial performance, the board has recommended a final dividend of 50 pesa 10:13 10 minutes, 13 seconds per share representing 25% of the face value of rupees 2 per share. 10:20 10 minutes, 20 seconds Now for some operational highlights during the year. The total bed capacity increased by 20.5% yearonear with the 10:28 10 minutes, 28 seconds addition of 623 beds during FY 2026 comprising 382 beds at NOA 131 beds at 10:37 10 minutes, 37 seconds Patna and the commissioning of the newly built 110 bed hospital in Ranchi. 10:43 10 minutes, 43 seconds Alongside capacity expansion, we continued to strengthen our clinical depth across the network and onboarded 10:49 10 minutes, 49 seconds more than 550 doctors during FY2026, including over 200 senior clinicians across various specialties, further 10:58 10 minutes, 58 seconds enhancing our institutional capabilities and patient care delivery standards. 11:03 11 minutes, 3 seconds Volume growth remained robust. Inpatient count increased by 16% and outpatient count increased by 19% yearonear. 11:12 11 minutes, 12 seconds Our pop grew by 6.1% year-on-year to rupees 66,550 driven by improvements in ALOS and 11:21 11 minutes, 21 seconds change in case mix. Our average length of stay improved to 3.04 days compared to 3.17 days same period last year. a 4% 11:30 11 minutes, 30 seconds improvement year on year while occupied bed days increased by 11% translating into an occupancy of approximately 62% 11:39 11 minutes, 39 seconds on an expanded bed capacity. Our occupancy excluding our new NOA facility was 64%. 11:48 11 minutes, 48 seconds Moving on to the matured and developing performance update, let me spend a moment on the mature hospital portfolio. 11:55 11 minutes, 55 seconds Our mature hospital portfolio comprising Madanta, Gurugram, Indor and Ranchi delivered revenue of rups 28,482 12:04 12 minutes, 4 seconds million up 9% yearonear and aida of rups 6,946 12:10 12 minutes, 10 seconds million up by 7% with a fullear margin of 24.4%. 12:16 12 minutes, 16 seconds Matured margins were nominally down by 40 basis points during the year. This is largely because of an increase in employee costs which were offset by 12:24 12 minutes, 24 seconds improvement in material costs. It is important to note that all corporate manpower costs are loaded onto the Gorga 12:32 12 minutes, 32 seconds unit. So to that extent there is some moderation required when we evaluate the Gorga unit standalone performance. 12:40 12 minutes, 40 seconds Moving to the developing portfolio, our developing hospitals excluding NOIA continue to outperform recording 29% 12:49 12 minutes, 49 seconds year-on-year revenue growth to rupees 14,130 million and ainta of rupees 4,470 12:57 12 minutes, 57 seconds million, a growth of 35% with margins improving to 31.5% compared to 30.1% in the same period last year. 13:08 13 minutes, 8 seconds Revenue from developing hospitals including NOIA stood at rupees 15,036 13:14 13 minutes, 14 seconds million up 37% yearonear while Ibida stood at rupees 3,663 13:22 13 minutes, 22 seconds million with margins of 24.4% reflecting the expected drag from early stage operations in NOA. 13:31 13 minutes, 31 seconds Inpatient volumes across developing hospitals increased by 32% year-on-year with overall occupancy at 60% and AROP rising 4% to 56,500. 13:44 13 minutes, 44 seconds Moving to the projects update in line with our long-term growth strategy, we continue to make steady progress across 13:52 13 minutes, 52 seconds our expansion and capability building initiatives during financial year 2026. 13:58 13 minutes, 58 seconds In March of 2026, the board approved a 400 bed hospital project in the heart of Vanasi under a build to suit lease 14:06 14 minutes, 6 seconds arrangement with a partner. This is a build to suit structure where our capex would be towards MEP interiors fit out and medical equipment. 14:16 14 minutes, 16 seconds This project further strengthens Maidanta's presence in Uttar Pradesh, building on the successful establishment of its thousand bed hospital in Lucknau 14:25 14 minutes, 25 seconds and the recently launched 550 bed hospital in Nida. 14:30 14 minutes, 30 seconds The company also completed land acquisitions for its proposed 400 bed hospital in Gujhati and has secured various needed regulatory approvals. 14:40 14 minutes, 40 seconds During the year, Maidanta operationalized a newly constructed 110 bed hospital in Ranchi, complementing its existing 200 bed facility and enhancing capacity in the region. 14:52 14 minutes, 52 seconds Additionally, subsequent to year end, Maidanta announced the addition of an approximately 80 bed hospital in Dor 14:59 14 minutes, 59 seconds under a business transfer agreement expected to be operationalized in Q2 of FY 2027. 15:06 15 minutes, 6 seconds Strategically located under 500 meters from the existing indoor facility. This unit will address the gap in oncology 15:13 15 minutes, 13 seconds and will enable us to deliver a comprehensive and integrated cancer care program. Our south Delhi project is 15:21 15 minutes, 21 seconds progressing well. The diaphragm wall on site one has been completed and the civil tender is expected to be awarded by the end of next month. Our Mumbai and 15:30 15 minutes, 30 seconds Pitampura projects in Delhi are at various stages of regulatory approvals. 15:35 15 minutes, 35 seconds Looking ahead, Maidanta will further ramp up the recently added bed capacity. 15:40 15 minutes, 40 seconds In the short term, the company expects to add approximately 500 beds across its existing hospitals with a minimum capex 15:48 15 minutes, 48 seconds investment. In addition, Medanta will add approximately 2,700 beds through five green field projects over the next 3 to four years. 16:00 16 minutes Across the entire expansion pipeline, total project capex over the next 5 years is approximately 45,000 million. 16:09 16 minutes, 9 seconds We exited FY 2026 with a net cash position of rupees 5,96 million and 16:15 16 minutes, 15 seconds generated operating cash flow of rupees 7,144 million during the year growing at a 4-year KGA of 21%. 16:26 16 minutes, 26 seconds The capital plan is fully supported by our combination of internal approvals and project specific debt that we may 16:33 16 minutes, 33 seconds take. Our balance sheet strength gives us the flexibility to execute this growth pipeline with appropriate discipline. 16:41 16 minutes, 41 seconds With that, I will now hand over the call to Yogesh, our group CFO for the quarterly performance update. Thank you, Punkage. 16:50 16 minutes, 50 seconds I will now take you through the financial performance highlights for the Q4 FY 26. Q4 FY 26 was a strong quarter 16:57 16 minutes, 57 seconds for Moransa with the company reporting its highest ever quarterly revenue and IBIDA IBIDA highlighted today is excluding res of expenses which are 17:06 17 minutes, 6 seconds non-cash in nature total income for the quarters to that 11 billion and 958 billion reflecting a growth of 25% 17:14 17 minutes, 14 seconds yearonear driven by a strong patient volume healthy occupancy and improving realization across the network IDA 17:21 17 minutes, 21 seconds excluding NOIA grew by 27% year on year to INR 3 billion and 142 million with improved margins of 27 and a half%. 17:33 17 minutes, 33 seconds IBIDA excluding NASA to debt including NASA to debt and 2 billion96 million 17:40 17 minutes, 40 seconds reflecting a growth of 17% yearon year with a margin of 54.3%. 17:46 17 minutes, 46 seconds Profit after tax for the quarters stood at 1 billion and47 million registering a strong growth of 14% yearonear with a 17:53 17 minutes, 53 seconds bat margin improving to 11.8% from 10.86% 86% in Q4 FY25. 18:02 18 minutes, 2 seconds Operationally, the quarter continued to demonstrate healthy momentum across the network. Occupied bad days during the quarter increased by 18% yearonear 18:11 18 minutes, 11 seconds representing occupancy of approximately 61% on expanded bed capacity and around 64% excluding NOA hospital. Our 18:21 18 minutes, 21 seconds increased by 5% yearonear to INR 66,687 supported by favorable case makes and 18:29 18 minutes, 29 seconds improvement in all loss. Inpatient volumes grew by 23% while outpatient volumes increased by 27% yearonear 18:38 18 minutes, 38 seconds international patient revenue during the quarter increased by 22% yearonear to INR 679 million. Our opd pharmacy 18:48 18 minutes, 48 seconds business continued to witness strong traction with revenue growth of 46.2% year on year to INR496 million during 18:56 18 minutes, 56 seconds the quarter. Overall quarter demonstrated a strong traction across the network. 19:03 19 minutes, 3 seconds Now coming to the mature and developing hospital performance update. Our mature hospitals comprising program in dhanchi 19:11 19 minutes, 11 seconds delivered steady performance during the quarter with revenue of INR 7 billion and 257 billion growth of 11% year on 19:20 19 minutes, 20 seconds year and IBIDA of INR 1 billion and 935 million growth of 15%. Ida margins 19:28 19 minutes, 28 seconds improved to 26.7% compared to 25.7% in the same quarter last year. ARPOP stood at 74,941, 19:38 19 minutes, 38 seconds resting a healthy year on year increase of 7% supported by improved casemates and a loss reduction and sustained traction across key specialties. 19:49 19 minutes, 49 seconds Average length of stay improved to 3 days compared to 3.17 days in the same quarter last year, reflecting continued 19:56 19 minutes, 56 seconds focus on clinical efficiency and patient throughput. IPD volumes grew by 10% yearonear while occupancy remained 20:04 20 minutes, 4 seconds healthy at 61% reflecting consistent demand across our mutual hospital network. 20:10 20 minutes, 10 seconds Our developing hospitals excluding NOA continue to deliver strong performance delivering improvement in efficiency 20:18 20 minutes, 18 seconds specially specialty expansion and a scale up in operations. 20:24 20 minutes, 24 seconds Revenue from developing hospital excluding NOIA stood at 3 bill728 million reflecting strong growth of 33% 20:32 20 minutes, 32 seconds year on year while IA stood at 1 billion and 207 billion with the resurrecting strong growth of 42% yearon year with 20:41 20 minutes, 41 seconds healthy margins of 32.4%. Including NOAN hospital revenue stood at 4 million and 253 million with strong growth in patient volumes and specialty programs. 20:53 20 minutes, 53 seconds No hospital reported a revenue of INR 525 million during Q4 FY26 while IRA 21:00 21 minutes loss reduced to 236 million compared to 320 million in Q3 FY26 reflecting a 21:08 21 minutes, 8 seconds steady improvement in operating performance as the hospital continues to ramp up. 21:15 21 minutes, 15 seconds No hospital uh already uh developing hospital AROP stood at 21:22 21 minutes, 22 seconds 57,349 restoring a healthy yearon-year growth of 7% while overall occupancy remains strong at 61%. Average length of stay 21:32 21 minutes, 32 seconds improved to 3.13 days as compared to 3.22 days in the same quarter last year reflecting continued focus on clinical 21:39 21 minutes, 39 seconds efficiency and patient throughput. IPD volumes grew by 45% yearonear driven by a strong ramp up of NOA facility along 21:47 21 minutes, 47 seconds with sustained growth across existing and working hospitals. 21:52 21 minutes, 52 seconds The company continues to maintain a strong balance sheet with the net cash position of INR 5 billion and 96 million 21:59 21 minutes, 59 seconds as of March 31st 26 providing flexibility to support our long-term growth initiatives and expansion 22:07 22 minutes, 7 seconds pipeline. With this I request operator to open the line for the questions. Thank you very much. Thank you very much. 22:15 22 minutes, 15 seconds We will now begin with the question and answer session. Anyone who wishes to ask a question may press star and then one on their touchstone phone. 22:25 22 minutes, 25 seconds If you wish to remove yourself from the question cube, you may press star and two. 22:30 22 minutes, 30 seconds Participants are requested to use handsets while asking a question. 22:36 22 minutes, 36 seconds Ladies and gentlemen, we will wait for a moment while the question queue assembles. Again, to register for a question, please press star and one. 22:49 22 minutes, 49 seconds The first question comes from the line of air from JM Financials. Please go ahead. 22:56 22 minutes, 56 seconds Yeah, thank you for giving me opportunity and congrats to the management and good numbers. So first question I have on uh VA unit uh uh the 23:04 23 minutes, 4 seconds unit is performing well. Is it uh possible uh assuming that uh that 300 beds were uh operational from the day 23:13 23 minutes, 13 seconds one of the quarter is it possible to give what was the occupancy uh for the quarter for this unit and uh do you expect this unit to break even by quarter two of next year? 23:26 23 minutes, 26 seconds So um we do expect this unit to break even uh during the course of uh this year but uh I would say that probably we 23:35 23 minutes, 35 seconds would look at the second half of next year rather than to look at uh giving you a number on quarter two. Um but 23:42 23 minutes, 42 seconds during the course of the second half of this financial year we do expect the unit to break even. Um our occupancy in our NOA hospital is currently running 23:51 23 minutes, 51 seconds somewhere around 30%. Um and uh obviously you'll appreciate that because we are still ramping up and even some of 23:59 23 minutes, 59 seconds the empanelments are still coming on as recent as uh you know these last few weeks uh that is actually changing quite dramatically uh month on month. 24:12 24 minutes, 12 seconds Sure. So if the uh break even is in second half so should we expect some uh losses even in small amount next year for the NOA. 24:25 24 minutes, 25 seconds So on a cumulative basis uh I mean I guess it really depends how quickly we are able to get the occupancy to 24:33 24 minutes, 33 seconds somewhere I guess in the 40 to 45% range we normally find that the hospitals do break even. Um so it really depends on 24:42 24 minutes, 42 seconds the extent right um this last quarter as I mentioned in the notes uh we have just 24:48 24 minutes, 48 seconds about 30 crores of uh uh losses in Q4 um 23 sorry 23 crores of losses in Q4. So 24:56 24 minutes, 56 seconds if that continues to reduce in the or or the revenues and if it does continue to grow uh in this way then you know we 25:05 25 minutes, 5 seconds should be able to make up whatever losses we have in the first uh part of the year but I don't want to give you a definitive commitment um because it 25:14 25 minutes, 14 seconds really depends on how much accumulated losses we are carrying as we move towards a profitable sure and the second question I have on 25:23 25 minutes, 23 seconds the other developing units Lang and Patna We don't have breakup but it looks like these units typically 4Q is 25:30 25 minutes, 30 seconds slightly softer quarter compared to 3Q but these two units have also delivered good numbers. Uh so uh we have bed 25:38 25 minutes, 38 seconds expansion here in these two units next year. Uh so if you can provide occupancy uh for these two units as well and uh is 25:46 25 minutes, 46 seconds there a scope to do add these uh beds in uh in the first half of the next year or it will also be a back end date 25:53 25 minutes, 53 seconds considering the occupancy I believe should be in mid60s for both these units uh occupancy for uh these units uh during the quarter was 68%. 26:10 26 minutes, 10 seconds So let me first touch on Patna. Uh as far as the bed expansion concerned um occupancy in Patna actually a little bit 26:17 26 minutes, 17 seconds higher uh than what said closer to the 70% number. Uh and we are actually 26:24 26 minutes, 24 seconds significantly constrained in terms of our need to add specifically ICU and critical care beds in Patna. So we have 26:31 26 minutes, 31 seconds actually already given uh orders for uh a bed addition there. uh and we do hope to add that within the course of the uh 26:40 26 minutes, 40 seconds first half of the year but uh project construction work is on so we will see when that comes up. Um we also have uh 26:47 26 minutes, 47 seconds project construction work happening in our lucknau facility and we will probably add in some of the beds in this half of the year only. Um specifically 26:56 26 minutes, 56 seconds some of the super specialty areas like uh neonatlogy ICUs uh etc are being added into luckno. So we will likely see 27:05 27 minutes, 5 seconds some amount of bed addition in both the units in the first half of the year as itself. Now I also wanted to clarify 27:12 27 minutes, 12 seconds that more important than the bed addition both the units are adding operating rooms. In fact we have about four or five operation theaters being 27:21 27 minutes, 21 seconds added in our lucknow unit and four or five operation theaters being added in our partner unit. So beyond beds the 27:29 27 minutes, 29 seconds actual constraint and the actual growth we will see coming in from our procedural capacity expansion beyond just beds. So that's important point to 27:38 27 minutes, 38 seconds note because as you're aware we have a very high procedural orientation in our group and this is a uh you know long 27:46 27 minutes, 46 seconds pending demand from the local unit leadership. So we are fulfilling that. 27:50 27 minutes, 50 seconds In fact, um just to touch on the operation theater expansion, even in our Gong facility, we are adding in 27:58 27 minutes, 58 seconds operation theaters. Uh two operation theaters will be activated in Q1 itself. 28:03 28 minutes, 3 seconds And another two operation theaters we hope to get activated either towards the later part of Q1 or at least by Q2 and we will also be adding additional CAT lab capabilities in our Gurong facility. 28:14 28 minutes, 14 seconds So I just want to you know stress on the point that it's not only beds that drives the enhanced work. A lot of our enhanced work will come from procedural capacity addition. 28:26 28 minutes, 26 seconds Sure. Sure. That's clear. And the last question if I can uh squeeze in uh on our uh bag addition or the uh the 28:33 28 minutes, 33 seconds greenful units which are coming up uh two in Delhi, one in Mumbai etc. Uh it looks like looking at the uh uh the 28:40 28 minutes, 40 seconds progress on these projects uh do you think that the any of these units can come up uh in first half of FY 29 or the 28:49 28 minutes, 49 seconds these will be beyond 29 looking at the uh progress on these projects. 28:56 28 minutes, 56 seconds So um you know we are sitting in the first half of FI26. Um just to give you a uh sorry for FI27 just to give you uh 29:04 29 minutes, 4 seconds an idea our NOIA facility from construction start to construction end took approximately 3 years. Um and uh 29:13 29 minutes, 13 seconds normally hospitals of this scale take about that much time to get built out. 29:18 29 minutes, 18 seconds Uh so you know I think that we should uh assume that they will take about the same amount of time. Um maybe if you're 29:27 29 minutes, 27 seconds sitting in May of 2026, you could say May of 2029 hospitals could be up and running. Um but that may not be FY29 29:35 29 minutes, 35 seconds uh numbers. That may be more FY30 numbers. 29:38 29 minutes, 38 seconds Sure. Got it. Thank you so much. I will join. Thank you. 29:43 29 minutes, 43 seconds Thank you. Your next question comes from the line of Bansi Desai from JP Morgan. Please go ahead. 29:51 29 minutes, 51 seconds Yeah, thanks for taking my question and congrats on good set of numbers. So my first question is on uh Noa you know now that you know we are inching closer 29:59 29 minutes, 59 seconds towards uh break even uh in this fiscal you know historically we've seen very strong ramp up for our 30:07 30 minutes, 7 seconds newer units beat Lucknau Patna I know panka you've always cautioned us that you know don't simply extrapolate but uh 30:14 30 minutes, 14 seconds should we think about uh no's ramp up differently you know more so because this is also a region of our you know uh 30:22 30 minutes, 22 seconds core strength where we have a very strong ecosystem. So should we think any differently post the break even? 30:30 30 minutes, 30 seconds So I think structurally and let me answer that in two parts. I think structurally I don't see any very significant difference in the way in 30:37 30 minutes, 37 seconds which we we operationalize or operate these units. I also don't see any very significant difference in terms of the 30:44 30 minutes, 44 seconds uh complexity of the procedures there or the demand for our services from these communities. Uh I I will however just 30:52 30 minutes, 52 seconds mention I'm not sure if it was in the commentary uh there are some specialties that we still have not started in NOA 31:00 31 minutes and one of those is our pediatric services which was started towards the end of the year and our uh or actually towards uh in in this financial year for 31:09 31 minutes, 9 seconds 27 and our obstetrics practice has still not started and our liver transplant practice has still not started. So there are a few of these um you know 31:18 31 minutes, 18 seconds specialties which will come in. They will of course have their own impact on the financials. Some have a slightly higher margin profile. Some have a 31:26 31 minutes, 26 seconds higher realization profile and they will of course translate to various sets of financial metrics as those scale up as well. Um but other than these 31:34 31 minutes, 34 seconds specialties which are not there I see no structural difference uh in NOA as far as our operations or the excitement for 31:42 31 minutes, 42 seconds this ramp up. Now the only difference that I would say with respect to both uh Lucknau and Patna is uh please keep in 31:50 31 minutes, 50 seconds mind that those hospitals opened right in the middle of the covid pandemic. So there were some very different kind of 31:57 31 minutes, 57 seconds situations in both the units. Um lucknau opened just before the pandemic started and Patna opened you know maybe towards the later part of of the covid pandemic. 32:08 32 minutes, 8 seconds So there are some differences. Um, one thing which you know has been an advantage for us uh as far as the operations are concerned is that we were 32:16 32 minutes, 16 seconds able to bring in a lot of very senior clinicians in NOA on day of opening and as you may have recalled from my 32:24 32 minutes, 24 seconds commentary in uh the last quarter earnings call. We consider this to be a investment in our clinical talent. So 32:31 32 minutes, 31 seconds while it is hit it was hitting the uh operating P&L and therefore you see some aida loss because of the manpower cost 32:39 32 minutes, 39 seconds this is really the core investment beyond the capex that we do make. So we have very strong exceptionally talented 32:46 32 minutes, 46 seconds clinical teams in place and you're seeing that uh with respect to the kind of work we're doing in robotics in cancer uh even the complex cardiac work 32:55 32 minutes, 55 seconds whether it's tabies and so on and so forth. So we have the firepower to get moving quickly. Um you know but uh and 33:03 33 minutes, 3 seconds we don't see any real reason why we can't but also keep in mind Lucknau and Patnau were different times different cities. Uh so that's my only caution. 33:12 33 minutes, 12 seconds Also punkage were these more underserved markets uh in general I mean noa doesn't appear you know to be underserved at 33:20 33 minutes, 20 seconds least on face of it but you are highlighting that at least structurally demand doesn't seem to be a problem. So you know should we think of that as a factor as well? 33:30 33 minutes, 30 seconds So I think for this we have to get a little bit into each other cities. I'll take a second to do that. Uh let's start with Lucknau. I think Lucknau had uh 33:38 33 minutes, 38 seconds always had a very strong and uh very robust government medical ecosystem. So it is not like there was not clinical 33:46 33 minutes, 46 seconds talent or complex work happening in Lucknau. Probably in the private sector it wasn't that uh common but there was talent available there. So I don't think 33:55 33 minutes, 55 seconds that you can call lucknow as a completely uh absent of medical care. It is just that it was delivered in a 34:02 34 minutes, 2 seconds different kind of an ecosystem. Patna I think uh yes definitely nanta pata kind of a facility is probably not been seen 34:10 34 minutes, 10 seconds in Bihar before and the scale and the nature of the kind of infrastructure equipment and clinical talent that we 34:17 34 minutes, 17 seconds have brought to Patna and even greater Bihar probably didn't exist in that area. So maybe there was a element of 34:24 34 minutes, 24 seconds being underserved in in Bihar much more than uh say in other areas. That being said as you're aware Maidanta does attract patients from all over. Uh so we 34:33 34 minutes, 33 seconds have getting patients both in Lucknau as well as in Patna from the broader region beyond those cities. Now as far as Noa is concerned uh you have to break down 34:42 34 minutes, 42 seconds Noa into three catchments. One is the local Nida catchment. It has some hospitals but not many and not of that same caliber. The other is the catchment 34:51 34 minutes, 51 seconds which flows from the Delhi NCR area. Uh there are of course hospitals in that region but we are seeing a good demand actually from even areas like South 34:59 34 minutes, 59 seconds Delhi moving into a NOA facility. And the third area which I do believe remains underserved uh is entire western 35:06 35 minutes, 6 seconds UP. So uh we do get a lot of patients from that area and we are seeing a lot of excitement about patients coming in 35:15 35 minutes, 15 seconds uh even as far as places like BI. So I think that NOIA has some elements of coming uh you know patients coming from 35:22 35 minutes, 22 seconds underserved areas um but also some amount of local uh capabilities and local patients are coming in and also 35:30 35 minutes, 30 seconds some amount of movement from the Delhi area towards NOA for treatment. 35:36 35 minutes, 36 seconds Understood. And my second question is on our mature units. Um you know we've seen some margin compression this year. You highlighted higher employee costs. So 35:44 35 minutes, 44 seconds I'm assuming you know given we've done these kind of investment this year uh incrementally going forward should we expect margins to improve? What would be 35:52 35 minutes, 52 seconds the key drivers if we have to think about margins for mature units over the next two to three years? 35:59 35 minutes, 59 seconds Yeah sorry so you know I think the way in which uh we look at this right and as you're aware we don't kind of give uh 36:06 36 minutes, 6 seconds margin guidance but if you look at the margin profile over the course of the year uh we have gone from 28 24.8% 28% 36:14 36 minutes, 14 seconds to 24.4%. So it's just about a 40 basis points uh swing, right? So it's not it's not that this is a kind of very 36:22 36 minutes, 22 seconds significant uh movement. If you look at our fourth quarter margin profile for the matured hospitals, it's coming in about 100 basis points over last year same period at about 26.7%. 36:34 36 minutes, 34 seconds So uh we do have uh you know a good feeling around some of the actions taken to optimize on uh material cost. We are 36:43 36 minutes, 43 seconds taking some further actions on uh the optimization of our costs in our gurau unit. But also we do have as I mentioned 36:50 36 minutes, 50 seconds on the call the entire corporate costs are loaded onto our uh matured hospital group in fact loaded onto our good 36:58 36 minutes, 58 seconds facility. So you know there will be as we move forward various types of scale and and uh benefits of that because 37:07 37 minutes, 7 seconds obviously you won't hire more and more corporate resources as you scale the operations. Um but we are feeling fairly 37:14 37 minutes, 14 seconds confident about the margin profile remaining in this kind of 24 25% range. 37:20 37 minutes, 20 seconds um we don't see any real reason for any kind of dips and to the extent that you get the benefits of you know some incremental growth or some tariff or 37:28 37 minutes, 28 seconds realizations growth uh some of it kicked in last year with respect to some of the tariff increases and the CGHS benefits so partial year this year it should be 37:37 37 minutes, 37 seconds fullyear impact of that so you may see some upward tricking uh you know on that but you know I think that we believe generally speaking that the margin 37:46 37 minutes, 46 seconds profile of the mature units is largely stable uh and we are working to see if we can you know tweak out inefficiencies wherever we can. 37:56 37 minutes, 56 seconds All right. Thank you. I'll join the queue. 38:02 38 minutes, 2 seconds Thank you. The next question comes from the line of Virat Sha from PGIM. Please go ahead. 38:09 38 minutes, 9 seconds Uh hi, thank you for the opportunity and congratulations on great setup numbers. 38:14 38 minutes, 14 seconds Uh so my uh first question is that uh see I I see that your developing hospitals is sitting at 60% occupancy as 38:21 38 minutes, 21 seconds of now and you mentioned that your pata unit is at 70% occupancy uh with along with noa ramp up and the 38:31 38 minutes, 31 seconds next leg of hospitals broadly coming in in around FI29 what are the growth levers on general basis which you are 38:39 38 minutes, 39 seconds seeing for the next two or three So let me first uh you know kind of address the leadin to the question on 38:48 38 minutes, 48 seconds occupancy right um and uh I also just wanted to uh you know call out if you look at our uh ALOS performance over the 38:57 38 minutes, 57 seconds course of the last 5 years you will see that despite uh all the complex work you do there has been a consistent uh 39:04 39 minutes, 4 seconds reduction in a loss uh from 3.76 days in FI22 which is just after COVID all the way down to 3.04 days in FI26. 39:14 39 minutes, 14 seconds So you know occupancy is a function of how many patients sleep in the hospital at midnight. Uh it is not necessarily 39:21 39 minutes, 21 seconds the only metric to show what is the volume work and volume and throughput that is happening in the hospital. A lot 39:29 39 minutes, 29 seconds of work is moving towards daycare. This is a trend in healthcare globally. uh our particular case as I mentioned in one of the earlier questions uh we have 39:37 39 minutes, 37 seconds a lot of focus on procedural uh work and so for us it's almost more important to have operation theaters cat labs 39:47 39 minutes, 47 seconds endoscopy rooms and ICUs than it is to have only ward beds so if I if I look at 39:54 39 minutes, 54 seconds the example I gave you in Patna we are in a very urgent basis trying to add an ICU but we do believe at least I do 40:01 40 minutes, 1 second believe that we still have operational efficiency to reduce length of stay in our ward beds there. So beds for me is 40:08 40 minutes, 8 seconds not the only constraint uh for us to find the growth lever. The growth lever will come from three or four broad aspects. First of all of course in the 40:17 40 minutes, 17 seconds areas where we don't have the complete set of suite of services like in Indoor we mentioned we'll be adding cancer in Noa we'll be adding some specialties 40:25 40 minutes, 25 seconds plus the ramp up. So ramp so growth will come first and foremost from adding in services, adding in procedures, adding in specialties. The second thing that 40:33 40 minutes, 33 seconds will happen is that there will be bed additions during the course of the year in all of the existing facilities which includes NOIA as well as some of the 40:42 40 minutes, 42 seconds others. The third is that there will be procedural u additions. So I already mentioned we'll be adding somewhere 40:50 40 minutes, 50 seconds around 10 operation theaters in our ecosystem in the existing hospitals which have all been operating for four five years that doesn't even include noa 40:57 40 minutes, 57 seconds or the new endor facility so we will be adding in this capacity in addition to this there has been a lot of momentum on 41:06 41 minutes, 6 seconds minimally invasive robotics complex care like tavies etc. So if you look at for example the volume of tavis which we do 41:14 41 minutes, 14 seconds it's probably the highest in the country. If you look at the kind of volume and the awareness of robotic surgery happening uh not only for us but 41:21 41 minutes, 21 seconds across the industry you'll find that that is also uh growing. So uh more and more the new age therapies will come in and given our complex work profile we 41:30 41 minutes, 30 seconds will see a lot of that um coming into Madanda as well. So these are three four areas. Now of course beyond this there's the routine activities around sales and 41:38 41 minutes, 38 seconds marketing. There's the routine activities around international growth in new markets. I do believe that at some point in time you will see the 41:46 41 minutes, 46 seconds challenges in the Middle East taper off and we hope that will come back. We do believe Bangladesh also as an international market will eventually come back but we've seen a lot of 41:55 41 minutes, 55 seconds traction in Madant group uh from newer markets like Africa, Southeast Asia and CIS and in fact we've seen a good amount 42:03 42 minutes, 3 seconds of growth in our international business about over 30% growth in international business this financial year. So we are feeling fairly confident about the 42:11 42 minutes, 11 seconds complete ecosystem and the portfolio that we have. Uh and we will also go out into the market and look for additional clinical talent because in some cases we 42:20 42 minutes, 20 seconds do have our doctors extremely busy and we do need to add in clinical talent etc. 42:27 42 minutes, 27 seconds I hope that answers all the levers that I could think of instantaneously. 42:32 42 minutes, 32 seconds Yes. Can can we also assume u so I what I'm seeing is that your mature unit ARP 42:39 42 minutes, 39 seconds growth has been much higher in comparison to the developing ones which is broadly luckno and patna at this 42:46 42 minutes, 46 seconds point so can arpo growth be higher going ahead for these two units 42:53 42 minutes, 53 seconds you mean lucknau and patna yes yes yeah so again right uh our pop is a function of length of stay and and and 43:02 43 minutes, 2 seconds and that as well. But let me uh not just talk about AROC, let me talk about realizations. Uh so if you look at realizations as a whole, um there are 43:11 43 minutes, 11 seconds two important points. One is that Putna has been operational now for approximately 4 and a half years. We have not taken a single rupee of tariff 43:19 43 minutes, 19 seconds increase in Patna. Uh so there may be some tariff adjustments that we may look at in Patna. Basis the the market conditions there. Maybe some in Lucknau 43:28 43 minutes, 28 seconds as well. Um however beyond the tariff we will also see certain more complex specialties adding. So robotic work will 43:36 43 minutes, 36 seconds scale up in both the units. We already have a good portfolio of robotic work in Lucknau. We are thinking of adding in a second robot there. Uh we will have 43:43 43 minutes, 43 seconds additional services like liver transplant coming to place in places like Patna. Uh chest and thoracic surgery, lung transplant coming into 43:52 43 minutes, 52 seconds places like Patna which don't exist there. So uh even our um mother and child services have really started in Patna just very recently and because 44:00 44 minutes they tend to have a shorter length of stay. So from an ARPOP growth point of view they tend to be accretive even though realizations may not be as high 44:08 44 minutes, 8 seconds as some of the cardiac or other types of work. So I think the three four levers will play in you may see an opportunity for u you know our growth in in all of these areas. 44:21 44 minutes, 21 seconds Yeah understood. Uh just one last question in this uh with a strong net cash position 44:28 44 minutes, 28 seconds which you have and cash generation is pretty strong on an annual basis any plans for over and above this bed 44:36 44 minutes, 36 seconds expansion uh any plans for any inorganic expansion which you have on your cards? 44:42 44 minutes, 42 seconds Uh yes um obviously you are aware we cannot uh reveal any of the transactions until they are fully complete and uh 44:50 44 minutes, 50 seconds announced to the exchanges. So we have done a very small uh transaction recently with the indoor acquisition. 44:57 44 minutes, 57 seconds There are couple of other transactions that we are looking at both on the O andM side as well as on the M&A side. uh like we've always maintained uh we will 45:06 45 minutes, 6 seconds continue our philosophy on M& uh not going for M&A just for the sake of it but looking at the quality of the asset 45:14 45 minutes, 14 seconds looking at the values of the partner in case it's things like on uh looking at the structure and the ethics of the transaction and then of course looking 45:22 45 minutes, 22 seconds at whether it makes financial sense and whether it is needed in that particular territory so we are actively exploring 45:30 45 minutes, 30 seconds uh various types of uh transactions both your acquisition as well as partnerships or on O andM types of models beyond the green. 45:39 45 minutes, 39 seconds Fair enough. Great. Uh that's all from my side. Thank you so much and all the best. Thank you. 45:46 45 minutes, 46 seconds Thank you. Your next question comes from the line of Toshar Manutan from Motil Financial Services. Please go ahead. 45:53 45 minutes, 53 seconds Thanks for the opportunity sir and congrats on a good set of numbers. Uh so firstly on um number of doctors being 46:01 46 minutes, 1 second onboarded in 26 almost about 550 while the new hospital required a good set of 46:08 46 minutes, 8 seconds doctors to be there at NOA. How to think about you know addition of doctors in FI27 28. 46:17 46 minutes, 17 seconds So um you know uh what's happening Pashar is that across the network uh let me start with Gong which is our oldest 46:23 46 minutes, 23 seconds facility. uh across the network. We are seeing actually quite a bit of demand for uh our clinicians and also seeing a 46:32 46 minutes, 32 seconds very uh you know strong focus on actually adding capacity to be able to service the appointments, service the 46:41 46 minutes, 41 seconds waiting list for getting access to certain doctors and so on and so forth. 46:45 46 minutes, 45 seconds And as you're aware, we have a kind of a outreach or a scale of activity that is happening now beyond the hospital. So 46:54 46 minutes, 54 seconds with four clinics operating in NCR there is a demand for access to doctors in these clinics as well. So we do believe 47:02 47 minutes, 2 seconds that there is a need to hire clinical talent in our ecosystem and we are also looking selectively at some of the 47:10 47 minutes, 10 seconds clinical talent coming in as a preparation for the assets that come on board 3 to four years from now. So just to give you a very simple example, let's 47:17 47 minutes, 17 seconds say I hire a cardiologist or a cardiac surgeon uh who in four three or four years would like to move to Guahhati uh 47:24 47 minutes, 24 seconds and you know kind of take a senior position there. This is something that we are actively uh looking into. So we will be hiring in almost every single 47:33 47 minutes, 33 seconds unit. Uh Gorga is the oldest and has the most density of doctors but we are looking to actively hire here. Lucknau 47:41 47 minutes, 41 seconds we will f and patna we will first look to fill the gaps as I mentioned. So examples were um you know obstetrics was 47:48 47 minutes, 48 seconds recently added in patna liver transplant not yet there chest surgery not yet there in Patna. So wherever there are clinical gaps we will add those in. Uh 47:57 47 minutes, 57 seconds this last year we added in uh pediatrics uh advanced pediatrics in lucknau we may scale some of those services up further. 48:04 48 minutes, 4 seconds uh we will also look at adding in additional bandwidth at a lateral level in Patna and Lucknau both because those 48:12 48 minutes, 12 seconds also are now reaching uh situations where the doctor's capacity is becoming an issue. So there will be a reasonable amount of addition in all of these 48:20 48 minutes, 20 seconds places. Of course Indoor Ranchi both of them have new bed capacity. So they will have doctor addition to uh meet some of that bed capacity and of course 48:28 48 minutes, 28 seconds full-fledged of cancer services will come on board in Indor. All of this is in addition to the NOA facility ramp up that you uh mentioned. 48:38 48 minutes, 38 seconds Understood. So it was uh I'm coming to Gura now that you know two new hospitals 48:45 48 minutes, 45 seconds coming up in Gura probably in September October period uh competitors hospital. 48:52 48 minutes, 52 seconds So how do you sort of think about u across demand or let's say the inflow of 48:58 48 minutes, 58 seconds patients and the doctor attrition or retention of doctor whichever way you may look at as far as Gura hospital is concerned. 49:09 49 minutes, 9 seconds Yeah. So uh you know we've been talking about this now I think for two three quarters and every quarter we believe that the hospital is coming on board in 49:18 49 minutes, 18 seconds the next 6 months. So um we are aware of this. Uh our clinicians obviously are also aware of this. I am proud to tell 49:26 49 minutes, 26 seconds you that as on date uh at least from what I'm aware of no senior clinician has been lost to any of these hospitals 49:34 49 minutes, 34 seconds which are in the process of coming on board. Um so we have not seen any very major attrition at least as on today. Um 49:42 49 minutes, 42 seconds we have as you're aware a very strong clinical value proposition and we hope that our clinicians are uh happy with the kind of work environment and the 49:51 49 minutes, 51 seconds value system that we deliver for them to operate here. Uh that being said obviously we have to be aware of it. 49:56 49 minutes, 56 seconds Obviously we have to keep in mind what would be the manpower cost implications of this as I mentioned in the last couple of calls that we there is always 50:04 50 minutes, 4 seconds a shortage of highquality talent and therefore we will see some amount of a war for talent in in the clinical side 50:11 50 minutes, 11 seconds at least and uh you know we are prepared for that we believe we have a good proposition we are also as I mentioned earlier actively hiring so it is not 50:20 50 minutes, 20 seconds that uh you know it's only mana doctors who are good there are good doctors elsewhere in the market as well and we are looking to actively uh augment and add in that capacity. So 50:29 50 minutes, 29 seconds that's on the hiring part. As far as the demand part goes, look, Burau over the last 15 years plus that Manta has been 50:38 50 minutes, 38 seconds operating has seen every kind of environment. We have seen environments where there was no hospital to where 50:45 50 minutes, 45 seconds Maidanta was, you know, uh just starting out. We've seen Maidanta scale to over 1500 beds. We have seen hospitals open, 50:54 50 minutes, 54 seconds close, get acquired twice over. So for us, this doesn't sound like a very worrying issue. As far as the demand and 51:01 51 minutes, 1 second the success of Nanta or our ability to compete in this market, I think there is a demand. Obviously, that's why 51:08 51 minutes, 8 seconds hospitals are being added. More and more patients will come to uh Golo for care. 51:14 51 minutes, 14 seconds And also don't forget as clinicians get added into hospitals it becomes more attractive of a medical destination for 51:22 51 minutes, 22 seconds people from outside the region. So if you have a if you have a group of 10 doctors working in one hospital versus a group of 500 doctors working in 10 51:30 51 minutes, 30 seconds hospitals, you will actually see a disproportionate growth in patient volumes because all doctors attract patients to the territory. Uh and we see 51:39 51 minutes, 39 seconds that as a good thing by the way. So we are not overly worried either on the demand side or on our ability to attract or retain clinical talent. 51:47 51 minutes, 47 seconds And also you see that the new beds then get added like when we open hospital we added new beds. We we have not seen 51:55 51 minutes, 55 seconds anybody saying that their demand has gone down in their hospital because of new hospital has come up. Similar story stands for when Max Darka opened up 52:04 52 minutes, 4 seconds right they rammed up their hospital but nobody said that we we got hurt because of a 52:11 52 minutes, 11 seconds new hospital has come up so demand is enough I think demand is enough and there's actually no demand for the quality beds 52:19 52 minutes, 19 seconds still understood understood and just lastly if you could chalk out the capex to be spent on in 52:27 52 minutes, 27 seconds FI27 and maybe uh project wise If you could share uh project wise we will not be able to 52:34 52 minutes, 34 seconds share it with you right now but but the overall capex for the year will be somewhere around the 800 to 900 cr 52:43 52 minutes, 43 seconds and maybe for fi28 broad numbers given that as as highlighted in the presentation like certain projects are 52:51 52 minutes, 51 seconds where the drawings submitting or architectural drawings being submitted. 52:55 52 minutes, 55 seconds which is why are trying to just understand 28 how the capex spend will look like. 53:03 53 minutes, 3 seconds That's what I I spent for the year 27 will be somewhere around 800 to 900 next year it will be in the range of 600 to 700. 53:16 53 minutes, 16 seconds Understood. And just lastly if I may on Rati where we added beds in July 25. So specifically while 53:24 53 minutes, 24 seconds sorry just sush just just one quick question I know because uh in some of the earlier calls also I think this point has come up. Uh uh keep in mind 53:33 53 minutes, 33 seconds also that sometimes the capex is different from the cash flow or that the commitment uh of what has been uh 53:40 53 minutes, 40 seconds announced in terms of uh you know the spend gets different and the cash flow gets different. So uh you're aware that when we built out the hospitals the 53:48 53 minutes, 48 seconds green field hospitals the cash flows are actually backended uh as opposed to being frontended. So uh I don't know how you're looking at it. Some of it would 53:57 53 minutes, 57 seconds be in CIP and some of it will be in actual capitalized. So there'll be differences in this and differences in the cash. 54:04 54 minutes, 4 seconds Yeah. Yeah. I mean I'm not connecting this with the number of beds getting added. Just purely understanding the cash outflow uh from the from the capex 54:13 54 minutes, 13 seconds point of view. not connecting this to the just on Raji if you could share like a 54:20 54 minutes, 20 seconds post bed additions in July 25 how the ramp up of that unit has happened 54:28 54 minutes, 28 seconds but we look at Ranchi as a single unit only we don't look at them separately because it's done like a campus 54:36 54 minutes, 36 seconds no I meant to say with addition of beds and as a overall entire unit with addition of beds how the business scaleup has happened in Ranchi. 54:49 54 minutes, 49 seconds So what's happening in Ranchi Tasar is that uh you know as we've added in this facility uh we have also tried to scale 54:56 54 minutes, 56 seconds up our various entanglements and various uh you know insuranceances and CGHS NABH 55:03 55 minutes, 3 seconds etc. So uh this has taken a little bit of time to get up and running. We have now our CGHS implements. We'll get our 55:11 55 minutes, 11 seconds railways. we have actually got our NA units also in the new unit. Uh so some of this is a addition of that in 55:19 55 minutes, 19 seconds addition as I mentioned I think when we went when we went ahead with this uh addition of this hospital camper or part of the campus we also intend to shut 55:28 55 minutes, 28 seconds down some of the beds on the older hospital for innovation. So we have seen a reasonable amount of growth coming 55:35 55 minutes, 35 seconds into this facility. Uh approximately uh 15 to 16% growth we have already seen. 55:41 55 minutes, 41 seconds Uh and as this hospital gets up and running we should see that scale up. Um I don't know if you're aware but you know historically we haven't seen a kind 55:49 55 minutes, 49 seconds of 16 17% growth. Uh historically it has been much lower and some of that was constrained by um bed availability and 55:57 55 minutes, 57 seconds the quality of the infrastructure given the old asset. So we do expect to see this growth hit upwards of 20% as this 56:06 56 minutes, 6 seconds unit scales 20 to 30% like we've seen in some of the other units. But as Yogesh mentioned it runs as one campus. So what 56:14 56 minutes, 14 seconds actually we will do is some specialties will move to the newer site and some will remain on the older site. So we will also try to add in a few more 56:21 56 minutes, 21 seconds specialties like oncology. So I think as this gets added you will see this float scale up. 56:27 56 minutes, 27 seconds Got it. So just connecting this to the matured hospital category where the measures taken at Rachi is sort of helping to react the revenue growth. 56:37 56 minutes, 37 seconds Similarly with indoor at beds getting added uh with sort of the ready asset available the scale up in that and 56:45 56 minutes, 45 seconds subsequently the improvement in further optimization of casemix pair mix at Gura. The matured hospital route is also 56:53 56 minutes, 53 seconds sort of set for a decent uh revenue growth along with improvement in the profitability. Is it am I is my understanding right? 57:02 57 minutes, 2 seconds I mean we believe so yes. Um but obviously you know given the scale of Gurong uh Ranchi and Indor are you know 57:10 57 minutes, 10 seconds very very small um as far as the uh overall scale of mature. So you know a 30% growth in Ranchi doesn't move the 57:18 57 minutes, 18 seconds needle much when you look at it on an overall scale. Um so you know you're right it will add to it uh both revenue 57:26 57 minutes, 26 seconds growth as well as profitability. But I think also we should look at uh you know the continued focus on driving uh growth 57:34 57 minutes, 34 seconds and efficiency in our gura unit is also something that we are taking very seriously as I mentioned. So uh I already told you that we will be adding 57:42 57 minutes, 42 seconds clinicians into Guranga and we'll be adding operation theaters into Gulgam and cat labs into Gulam. So if I look at 57:49 57 minutes, 49 seconds the next year I would say at least 5 to 10 procedural rooms uh will get added 57:56 57 minutes, 56 seconds and that doesn't even include some of the daycare areas. So we are investing quite a bit in putting in additional 58:03 58 minutes, 3 seconds capabilities into our Gurang facility even though you may not see it translate into bed numbers. 58:11 58 minutes, 11 seconds Understood. This is in thanks. 58:16 58 minutes, 16 seconds Thank you. Your next question comes from the line of Anchul Aarwal from MK. Please go ahead. 58:22 58 minutes, 22 seconds Hi, thank you for the opportunity. Just one quick question on the NOA unit. Are there any insurance empanments pending 58:30 58 minutes, 30 seconds or are we done with uh all the empanelments uh in the NOA unit? 58:36 58 minutes, 36 seconds So all major empanelments are done or in the process of getting done within the next you know week or so. So by 31st of 58:44 58 minutes, 44 seconds March all of them are not done. Um but by today almost all of them are done. I wouldn't say everything is done. I know 58:52 58 minutes, 52 seconds that there are two or three which are pending. Um but I think most of the major ones are either done as we speak 59:00 59 minutes or in the process of getting done within a matter of a week or so. 59:06 59 minutes, 6 seconds Great. So uh occupancies as well as uh the revenue throughput of this unit should further accelerate in Q1 on the 59:15 59 minutes, 15 seconds back of these empanelments both scheme patients as well as obviously TPA uh empanelments. Uh that would be a fair assumption to make. 59:24 59 minutes, 24 seconds Yes. So scheme has literally come in I think two or three four days ago. Other than that of course it's been all cash 59:30 59 minutes, 30 seconds and TPA. Um so as we get uh various impanments as this scales up you will 59:38 59 minutes, 38 seconds see growth in both of these areas and then the various schemes we will take a call as we get them on board CBHS 59:45 59 minutes, 45 seconds railways to do not to do when to do how to do um we'll have to taper that also with respect to the capacity 59:52 59 minutes, 52 seconds availability and the clinician and uh infrastructure availability but yes we do believe that this will continue to 59:59 59 minutes, 59 seconds grow not only Q1 but as we move towards to the full year you will see I think growth in in all of these areas. 1:00:06 1 hour, 6 seconds Great. Just one more followup question on the NOA unit. Could you help me with the ARPOB range of uh this facility currently? 1:00:16 1 hour, 16 seconds I can um it is I think today actually performing almost uh in the 1:00:23 1 hour, 23 seconds 70,000 range or more I think uh maybe closer to 80,000 rupees. However, I 1:00:31 1 hour, 31 seconds would extremely caution that you cannot take this as a baseline because obviously this is a 100% cash 1:00:39 1 hour, 39 seconds kind of tariff till now on a very small base. So please don't project out that this is a standard. I think uh fair to 1:00:47 1 hour, 47 seconds say that this will probably be more or less same as Guram maybe little bit lower than some of the higher priced 1:00:55 1 hour, 55 seconds facilities in in Delhi area but I would say in our thinking we think that our pops ranges of Nida and Guram are more or less same. 1:01:07 1 hour, 1 minute, 7 seconds Great very useful. Thank you so much. 1:01:08 1 hour, 1 minute, 8 seconds That's it from all the very best for the next year. Thank you. 1:01:13 1 hour, 1 minute, 13 seconds Thank you. Your next question comes from the line of Sanitia Agarwa with Unicorn Assets. Please go ahead. 1:01:21 1 hour, 1 minute, 21 seconds Hi Prank. Hi team. Good set. I think after seven eight quarters now the 1:01:27 1 hour, 1 minute, 27 seconds company's back to uh 25% growth levels which is excellent and there's no reason to not believe that next five six 1:01:35 1 hour, 1 minute, 35 seconds quarters will continue to be ramping up at this pace. Uh my question is more from the perspective of uh next year 1:01:44 1 hour, 1 minute, 44 seconds maybe you can say 2028 calendar year. So while we see ramp up continuing and new 1:01:50 1 hour, 1 minute, 50 seconds additions in this year uh with the existing facilities and some expansions 1:01:57 1 hour, 1 minute, 57 seconds in that as well. How do you see beyond this? Because uh what we also uh have 1:02:03 1 hour, 2 minutes, 3 seconds seen in the past is uh we once we ramp up the new facilities 1:02:11 1 hour, 2 minutes, 11 seconds or there comes a phase of lull where we are somewhere in 15 12 14% range because 1:02:20 1 hour, 2 minutes, 20 seconds we are uh trying to get the best out of the mix that we operate in uh adding super specialties 1:02:28 1 hour, 2 minutes, 28 seconds uh getting the right pops it's driving occupancy optimizations and of course no problem in that but on 1:02:36 1 hour, 2 minutes, 36 seconds this other side uh why don't we capture the larger share whether it comes 1:02:43 1 hour, 2 minutes, 43 seconds through brownfield uh or some smaller facilities that we can expand further or something like a 1:02:52 1 hour, 2 minutes, 52 seconds sister market to say something like a japur or chandigar or something like that and honestly quite phenomenal 1:03:00 1 hour, 3 minutes transformation in NA unit. So that would be the first question. 1:03:07 1 hour, 3 minutes, 7 seconds Okay. So uh I mean lot of elements of strategy that you have or theoretical strategy that you have laid out there. 1:03:13 1 hour, 3 minutes, 13 seconds Let me first give you a couple of data points. See our Gnau uh sorry our Lacnau facility which is classified as developing is 6 and a half years old. 1:03:22 1 hour, 3 minutes, 22 seconds Our Patna facility is 4 and a half years old. In the larger context of most hospitals they would have supposedly as 1:03:29 1 hour, 3 minutes, 29 seconds per your theory plateaued by now they are giving growth of 30% more or less year on year for the last couple of years on a u volume basis as well as on 1:03:38 1 hour, 3 minutes, 38 seconds a revenue basis. So I don't believe that maidanta has uh followed what you articulate as a normal approach. I don't 1:03:46 1 hour, 3 minutes, 46 seconds know if it is being done in other hospitals but our hospitals even after year four five are showing reasonably 1:03:53 1 hour, 3 minutes, 53 seconds phenomenal growth. Uh and uh keep in mind that these are not 200 300 bed hospitals. These are 600,000 bed 1:04:01 1 hour, 4 minutes, 1 second hospitals. So on a very very high base you are seeing a very phenomenal amount of growth even after the so-called early 1:04:08 1 hour, 4 minutes, 8 seconds years. uh so we don't believe that uh you know that Dant is just following any kind of other uh approach that we may we 1:04:17 1 hour, 4 minutes, 17 seconds may be looking at uh and we've seen a very very strong performance across all of these units and we continue to see that in addition to that as I mentioned 1:04:25 1 hour, 4 minutes, 25 seconds on the call uh you know we have a fairly significant bed addition coming in all these units uh including NOA so almost 1:04:32 1 hour, 4 minutes, 32 seconds 200 plus beds will be coming in this year with almost negligible capex so you know we do continue to believe that there'll be a very robust growth in the 1:04:40 1 hour, 4 minutes, 40 seconds developing portfolio. At some point in time, I guess luck now will technically get classified as a developed hospital 1:04:47 1 hour, 4 minutes, 47 seconds after it crosses whatever reporting threshold we have and we may change how we report out that information. But forgetting about the reporting, if you 1:04:55 1 hour, 4 minutes, 55 seconds just look at the performance of Lucknau, still a lot of juice left in that asset, right? Uh as well as in the other assets. Now, as far as will we expand to 1:05:04 1 hour, 5 minutes, 4 seconds Jaipur or will we look at other opportunities? I mean of course we are looking at new strategies all the time. 1:05:10 1 hour, 5 minutes, 10 seconds Um we've talked about these as and when is appropriate. Um and we are constantly evaluating brownfield green uh bolt-on strategies in some of the earlier calls. 1:05:22 1 hour, 5 minutes, 22 seconds I've talked about hub and spoke strategies in various cities. Uh you see that vanasi is an outcome of what we had 1:05:29 1 hour, 5 minutes, 29 seconds talked about couple of years ago after Lucknau stabilized and we said that we have a thousand beds in Lucknau. we looked at other cities in eastern UP and 1:05:37 1 hour, 5 minutes, 37 seconds Vanasi is a reflection of the execution of those stated uh goals. So of course you will continue to see this and at the 1:05:45 1 hour, 5 minutes, 45 seconds appropriate time we will share uh what we can uh with the community to see that this is how we are moving forward but 1:05:52 1 hour, 5 minutes, 52 seconds all things that you described are very much part of our case. 1:05:58 1 hour, 5 minutes, 58 seconds Great that answers. Uh just last one uh if uh you could highlight what would be the arc of for the developing uh so or 1:06:06 1 hour, 6 minutes, 6 seconds particularly the patnau and the uh luck now unit like we in the developing uh 1:06:13 1 hour, 6 minutes, 13 seconds there was some uh deg growth last year given the pair mix and since we have not 1:06:21 1 hour, 6 minutes, 21 seconds taken any hikes in terms of prices should we expect something in near 1:06:29 1 hour, 6 minutes, 29 seconds So um as mentioned in the investor presentation the RPO for the developing cluster is about 56,500 for this year 1:06:37 1 hour, 6 minutes, 37 seconds which is an increase of about 4% over last year. Uh and uh we do believe that you know as this work this scales up 1:06:46 1 hour, 6 minutes, 46 seconds you'll continue to see uh as the complexity scales up you'll continue to see alpha growth. I also mentioned in in 1:06:54 1 hour, 6 minutes, 54 seconds response to one of the earlier questions that we do believe that there's some alos opportunity improvements especially in partner. So you may see some arop 1:07:02 1 hour, 7 minutes, 2 seconds benefits because of that um because of the way in which our is calculated. So uh all of this by the way has nothing to do with the tax increases that we may 1:07:11 1 hour, 7 minutes, 11 seconds take innovate time we will take the tariff increases and we will uh you know hopefully see some benefits of realizations for that. 1:07:21 1 hour, 7 minutes, 21 seconds But you know you may have followed the commentary earlier. We are reasonably conservative in uh tariff increases. 1:07:28 1 hour, 7 minutes, 28 seconds Just because we can take tariff increases doesn't mean we do. But we take them as per what the market conditions uh and what we feel is appropriate for our patients. 1:07:38 1 hour, 7 minutes, 38 seconds No, fair enough. So I was just thinking that sorry yeah ju just just concluding madam. So I was just uh 1:07:46 1 hour, 7 minutes, 46 seconds thinking if we could would want to at some point uh other than our Bob give a number of average itations or something 1:07:54 1 hour, 7 minutes, 54 seconds like that because that would be if if into the way the management is thinking that would be a much appropriate 1:08:01 1 hour, 8 minutes, 1 second uh say statistics for us to track uh for how the performance per hospitals or something like that if you want to share later. Thank you. 1:08:13 1 hour, 8 minutes, 13 seconds Thank you. 1:08:16 1 hour, 8 minutes, 16 seconds Ladies and gentlemen, this was the last question for today. I now hand the conference over to the management for closing comments. 1:08:26 1 hour, 8 minutes, 26 seconds Thank you everyone for your questions and for joining us today. Um we are very happy and confident with uh the results 1:08:33 1 hour, 8 minutes, 33 seconds for FY26 and the growth that we have coming forward and very excited for what uh healthcare opportunities India has to 1:08:40 1 hour, 8 minutes, 40 seconds offer us as we move forward. Um uh with this I would like to end the call. If you have any questions or if there's anything that has remained unanswered, 1:08:48 1 hour, 8 minutes, 48 seconds please feel free to reach out to our investor relations team. Thank you once again and see you all soon. 1:08:55 1 hour, 8 minutes, 55 seconds Thank you. 1:08:58 1 hour, 8 minutes, 58 seconds On behalf of ICICI securities, that concludes this conference. Thank you everyone for joining us and you may now disconnect all lines.