Global Health Ltd (NSE: MEDANTA) Q4 2025 Earnings Call dated May. 16, 2025
Corporate Participants:
Naresh Kumar Trehan — Chairman and Managing Director
Pankaj Sahni — Group Chief Executive Officer
Yogesh Kumar Gupta — Chief Financial Officer
Analysts:
Tushar Manudhane — Analyst
Vinayak Mota — Analyst
Damayanti Kerai — Analyst
Jainil Kothari — Analyst
Anshul Agarwal — Analyst
Sumit Gupta — Analyst
Tushar Manudhane — Analyst
Unidentified Participant
Alankar Garude — Analyst
Presentation:
Operator
Ladies and gentlemen, you have been connected to Global Health Medanta Conference Call. Please stay connected. The call will begin shortly. All participants, you are connected to Global Health Medanta Conference Call. Please stay connected. The call will begin shortly. Thank you ladies and gentlemen, good day, and welcome to Global Health Medanta Q4 FY ’25 Earnings Conference Call hosted by Motilal Oswal Financial Services Limited. As a reminder, all participant lines will be in the listen-only mode and there will be an opportunity for you to ask questions after the presentation concludes. Should you need assistance during the conference call, please signal an operator by pressing star zero on it at stone phone. Please note that this conference is being recorded. I now hand the conference over to Mr Tushar Manudhani from Motilal Oswal Financial Services Limited. Thank you, and over to you, sir.
Tushar Manudhane — Analyst
Thank you. Thank you,. Good evening, and a very warm welcome to all the participants on Global Health Limited 4Q FY ’25 earnings call hosted by Motilal Oswal Financial Services. Joining with us today from the management side, we have Dr Naresh, Chairman and Managing Director; Mr Pankat Sani, Group CEO and Director; Mr Yogesh Kumar Gupta, CFO; and Mr Ravi Godwal, Head, Investor Relations. Over to you, for the opening remarks.
Naresh Kumar Trehan — Chairman and Managing Director
Good afternoon, everyone. Thank you for joining us for today’s Q4 and Full-Year F ’25 earnings conference call. Our results were published yesterday and we have already uploaded the press release and earnings presentation on the website and the stock exchanges. I’m pleased to share with you that our flagship hospital in, widely known as the, celebrated its 15th anniversary and over the years we have consistently set benchmark in clinical excellence and higher standard of patient-care. I’m also proud to share that all our accomplishments have been achieved because the Zanta Gurugram has once again been ranked India’s best private hospital by Newsweek for the sixth year consecutive and we are proud to know that we are the only one in the first 150 hospitals of the world. This of course is a reaffirmation of our quality and the quality of care and systems. Let me now highlight the clinical achievement of this year. In addition to the many new technologies that we introduced for the benefit of the patient, we have accomplished the first set of CAR-T cell therapies, starting with making a significant milestone in the advanced cancer care. Following this, Medanta also conducted CAR-T cell therapy, an innovative treatment that leverages the patient’s own immune system of back cancer. Has emerged as a center of excellence for robotic surgeries in the and successfully performed over 100 robotic procedures within the first-six months of operations. Medanta crossed the milestone of 25 250 plus transplants since inception and established itself as a leading center for transplant in the region. Gurugram secured a for a device known as developed for the advanced treatment of cervical cancer in. This has been appreciated very widely and we are now in the process of getting a manufacturing individual who can actually bring it to-market. Doctors at employed invasive and normal techniques to treat a rare cardiac condition idiopathic and many other surgical procedures which were done for the first time. These clinical milestones are not isolated humans, they reflect deep institutional expertise, cross disciplinary collaboration of highly-skilled doctors to deliver superior patient outcomes. During the year, we have onboarded 100 plus doctors across the Lanta network of hospitals. We have also continued to invest in latest technology to enable our doctors to deliver high-end medicines and precision. As we look-ahead, we plan to add approximately 1,000 beds over the next two years of this Noida facility with a capacity of 550 beds is set to become operational in Q2 FY ’26. Further in mind, with our commitment to expanding to early access to high-quality tertiary and care, we have announced this year three large-format greenfield hospitals in high-growth regions of Mumbai, and most recently the Harti. With that, I would like to now hand over the call to Mr Pankar Sani, new CEO to share further details and financial update for the year. Over to you, Pankaj. Thank you.
Pankaj Sahni — Group Chief Executive Officer
Thank you, Dr. Good afternoon, and welcome everyone to our Q4 and FY ’25 earnings call. Let me take you through the key highlights of our annual performance for the year. After that, I will hand you over to our Group CFO, Mr Yogesh, who will discuss the quarterly performance for FY ’25 Q4. During the year, Medanta delivered a total consolidated income of INR37,714 million, registering a growth of 13% year-on-year. EBITDA was INR9,562 million, a growth of 9% year-on-year with a strong EBITDA margin of 25.4%. Profit-after-tax for the period was INR4,813 million after adjusting it for one-time exceptional expenses of INR499 million related to the merger of, that is MHPL with Global Health Limited. Adjusted profit-after-tax stood at INR5,186 million, a growth of 9% with a margin of 13.8%. I’m also pleased to share that the Board has recommended the first-ever dividend of 25% amounting to INR0.5 per share. Now moving on to the operational highlights for the year. During the year, 219 new beds were added across the Medantha network, representing a 7.8% growth in bed capacity. This includes the addition of a 49 bedded dedicated floor for mother and child at Medantha Gurugra. 112 beds were added in Patna and 58 beds were added in Lucknow. The average occupied bed days for the year increased by 10% year-on-year with an occupancy of 62% on increased bed capacity. Our pops were INR62,722, a marginal increase of 1.3%. Increasing PPP and scheme business has been marginal — marginally ARPOP dilutive, but it has been offset by growing contribution from cancer and changing case-mix. Inpatient count increased by 12% year-on-year and outpatient count increased by 10% year-on-year. Coming to the matured and developing hospital performance update, our matured hospitals revenue from them was INR26,118 million, reflecting a growth of 10% on a year-on-year basis, driven by a combination of increased patient volumes and improved realizations. EBITDA was INR6,481 million, up by 8% year-on-year with an EBITDA margin of 25%. Occupancy was at 64%. Our developing hospitals, which includes and Patna registered a year-on-year revenue growth of 10%, amounting to INR10,940 million. EBITDA was INR3,290 million, a growth of 3% year-on-year with strong EBITDA margins at 30%. The occupied bed days at our developing units increased by 19% year-on-year with an occupancy rate of 59% on an increased bed capacity. ARPOP declined by 4% year-on-year to INR54,303, largely due to increased share of PPP patient and scheme patients in Patna and. We continue to see strong financial performance in Patna despite the lower realizations with extremely high revenue and EBITDA growth numbers and very robust EBITDA margins. As highlighted in the past, our Lucknow operations have stabilized and we remain committed to further strengthening our clinical capabilities in Lucknow. In-line with this, we have added seven new directors and over 20 senior clinicians across various specialties. We have also commissioned our XI surgical robot and a new cat lab, significantly enhancing our surgical and interventional capabilities. Additionally, we enrolled the Bharat and CGHS and other schemes enabling — enabling us to serve a broader patient population. In other key updates, our revenue from international patients increased by 8% year-on-year to INR2,086 million, contributing approximately 6% of our total revenue. Our OPD pharmacy business continues to register strong growth with revenue increasing by 26% to INR1,400 million in FY ’25. During the year, we have launched Nedanta Clinics at Gold Cost Road in Gurgaon and at Ranchi in the city center, bringing high-quality outpatient services closer to the patients making healthcare more accessible to them. Capex of INR6,449 million was incurred during the year, of which INR1,367 million was towards the Mumbai hospital, while the remaining was spent towards expanding bed capacity, upgrading technology and our Noida construction. Overall, we ended the year with a strong net cash surplus of INR8,123 million, positioning us well to drive future expansion plans and growth. Moving on to our various projects. In Ranchi, we have signed an O&M agreement this year to operate a 110-bed hospital with advanced OT and critical care facilities and we expect to operationalize this in the first-quarter of FY ’26. This is in addition to our existing 200-bed hospital in Ranchi. In Noida, the development of our 550-bed greenfield hospital is in-full swing and is expected to be operational in Q2 FY ’26. Mumbai, during the year, we acquired 9,288 square meters of prime land in Oshiwara to develop a 500 plus bed super specialty hospital there and that activity is also underway. In Pitampura in Delhi, we have signed an operations and management agreement to jointly build and operate a 750-bed super specialty hospital at Pitampura. Both Mumbai and hospitals are in various stages of drawing preparation and regulatory approvals. Most recently, our Board has approved a new project to acquire land and build a 400 bed super specialty destination care hospital in Gwahati, Assam with the aim to reserve the entire northeastern region of India. Overall, we have built a strong pipeline to add approximately 1,000 beds in the next two years and another 2,000 beds across various greenfield projects over the course of the next three to four years. With this, I hand over the call to Yogesh to share with you the performance for the quarter.
Yogesh Kumar Gupta — Chief Financial Officer
Thank you,. Now I would like to discuss consolidated financial and operational performance for the quarter. Financial perfor mance for Q4 FY ’25. During the quarter, Miranda delivered total income of INR9,542 million compared to INR8,361 million same quarter last year, registering a strong year-over-year growth of 14%. EBITDA for the quarter was INR2,476 million, an increase of 20% year-on-year with an improved EBITDA margin of 26% compared to 24% 24.7% in the same quarter last year. Profit after the tax for the period was INR1,014 million with a PAT margin of 10.6%. Overall, our growth during the quarter was primarily driven by the consistent volume growth over the network. Operational performance for Q4 FY ’25, our inpatient volumes during the quarter increased by 15% year-over-year to 42,901 and outpatient volumes increased by 13% year-over-year. Average occupied bed base for the quarter increased by 12% year-on-year with the occupancy of approximately 61% on increased bed capacities. Average revenue per bed for the quarter was INR63,629, a marginal increase of 1%. During the quarter, revenue from international patients increased by 17% year-over-year to INR567 million. Now coming to the developing hospitals. During the quarter, developing hospital clusters continued to grow strong registering a total income of INR2,814 million, a growth of 24% year-over-year. EBITDA for the quarter was 871 million, an increase of 40% year-on-year with the improved EBITDA margin of 31%. Average bad days increased by 36% year-on-year, representing improved occupancy of 60% on increased capacity. ARPO during the quarter was 53,818 compared to 57,696 same quarter last year de-growth primarily due to uptick in the patients at Patna and now coming to the mature hospitals. Total income for the quarter was INR6,389 million, up by 5% year-over-year. EBITDA was INR1,535 million compared to 1,548 million same quarter last year, down by 1%. Average occupied debt days increased by 2%, representing an occupancy of 62%. Grew by 6% to INR9,592 quarter for FY ’25 due to a change in the case-mix. Now coming to the capex plan, as Pankash highlighted, is on-track to double its bed capacity by adding approximately 3,000 beds across multiple projects over next three to four years. We have earmarked the total capex — capital outlay of around INR4,000 crores for this expansion, which includes both the capacity addition and ancillary sport services along with the maintenance capex of about INR454. The majority of this investment is expected to be back-end and the project will be funded through combination of internal approvals and the debt financing. I would like to draw your attention to the standalone financial filed by — with the stock exchanges pursuant to the merger with MSPL, which was holding a Lucknow Unit entity with the holding company GHF, the standard loan financial results now include the performance of Lucknow unit. According to the figures of comparative period have been restated to include Lucknow Unit as well. The key benefits of the merger are export benefits under EPG steel will now be available to Lucknow against the ForEx earnings of free-cash flow generated by can be utilized by GHL without any additional tax obligations, enabling optimized fund deployment for both organic and organic growth, maximizing shareholder value and streamlining of legal, regulatory and recording processes reducing complexity and compliance cost. With this, I request operator to open the line for the questions. Thank you very much.
Questions and Answers:
Operator
Thank you very much. We will now begin the question-and-answer session. Anyone who wishes to ask a question may press star and one on the touchstone telephone. If you wish to withdraw yourself from the question queue, you may press star and 2. Participants are requested to use handset while asking a question. Ladies and gentlemen, we’ll wait for a moment while the question queue assembles. First question is from the line of Vinayak Mota from XE Asset. Please go-ahead.
Vinayak Mota
No. Yeah, am I audible?
Operator
Yes, please go-ahead.
Vinayak Mota
Yeah, perfect. Sir, could you please repeat the capex numbers? I just laid out on the total capex for the beds. Did you say INR4,000 crores?
Naresh Kumar Trehan
Yeah. I said INR4,000.
Vinayak Mota
Okay. Perfect, perfect. And the second question I had, could you give a sense of how many transplants have been done in this quarter and in FY ’25 and how has — how have those grown on a year-on-year basis or maybe on a trajectory-wide, how have transplant transplants room for us.
Naresh Kumar Trehan
So I don’t have the number upfront with me. I just wanted to, however, quickly clarify two, three points because there are many different types of transplants. We do kidney transplants, liver transplants, bone-marrow transplants, heart transplants. I don’t have that number, I’m sorry with me off the top of my head, but our Investor Relations team will be able to get that back to you. Only thing that I mentioned in our script is that in Lucknow now, we have crossed 250 transplants in the kidney area. And I think that we do a significant number of transplants across liver, kidney, DMP, of course, in our facility and then we do liver and kidney and BMT and Lucknow as well. And partna, we have not yet started liver transplants, but we’re doing all the others.
Vinayak Mota
Understood. Understood. And sir, last question would be, how are you seeing the competitive intensity across your major markets? I mean, all the larger players, I think except for Patna at least in as well as in the NCR region have been expanding and doing their own work as well. So just a sense on how are we seeing that competitive intensity play-out across-the-board?
Naresh Kumar Trehan
So I think there are two-ways to look at this. One-way that you see is a lot of what you gmay hear because of the various listed players that you mentioned, who are expanding their build-outs across various cities of India, not only in the north, but also in the south. So we do see an increase in the amount of bed — beds announced, the amounts of hospitals announced. Although I also want to caution a lot of the announcements are just that announcements, the hospitals are not yet being built that will of course take a certain amount of time to build the hospitals. So we do see some amount of that. The second thing that may not be so visible to our capital markets investor community is that we do also see a scale-up of local hospitals. So you see renovations, you see increasing amounts of innovation coming in and new talent coming into the smaller local hospitals that may not be listed, but may be relevant in one city or the other of the country. Now our point-of-view actually is that all of these things are very, very positive for the industry as well as, of course, for the patient community. So the reason I say that it’s very positive is that if you look today at the Gurgaon market, many people refer to Gurgaon as a medical hub and what that results in is two things. One, of course, we get patients coming in from all parts of the country or at least the northern part of the country. But we also get clinical talent that is gravitating towards the city and that enables people to hire better and so on and so forth. So this idea that Gurgaon today is a medical hub is not something that was always there. In fact, before Medanta, Gurgaon opened, there was hardly one or two smaller hospitals in Gurgaon. In fact, we were very much part of building it into a medical hub and that actually creates a phenomenon where, you know to put it frankly, it’s a rising tide will lift all both type of phenomenon. And we believe that is likely to happen in several markets. So we have already seen when we initially went into Lucknow, there’s a lot of skepticism about why are you going to Tier-2. We have seen our competitors following us into those markets and we do believe that the Lucknow Kanpur region will also become a medical hub in the years to come. Similarly, we believe that there will be additional development of the Delhi region, all aspects of it, frankly, both the Central Delhi region as well as places like Noida into other medical hubs and of course, with the huge and expanding population of Delhi, we personally feel that there’s still a lot of capacity addition that is required to service that need over there. And then lastly, if you look at some of the movements that you’ve seen over the course of the last year or two in the western part of the country, which again was not very active with the established players, you see now a lot more activity happening in Maharashtra, Mumbai, Nagpur, then Pune, etc. So these in our personal opinion are actually all very positive for the industry and very positive for the patient community. So we are not overly worried. We feel that in the long-run, this will be very beneficial.
Vinayak Mota
Okay, great. Thank you. Thank you so much.
Naresh Kumar Trehan
Go-ahead.
Operator
Thank you. Next question is from the line of Damiani Kedia from HSBC. Please go-ahead.
Damayanti Kerai
Hi, good afternoon and thank you for the opportunity. My first question is in Lucknow and Patna hospitals. So I understand most of the patients are there cash-paying patients excel based. And then you mentioned you are seeing — you have now in panel and some other schemes. So just want to understand, should we assume these two hospitals will mostly remain cash heavy and the contribution coming from the insurance channel might not be very significant in near-term, term, near-to-medium term. How should we look at the pay next year?
Naresh Kumar Trehan
Yeah. So I think just to clarify them, I’ll let Jogesh also chime in on the numbers. But just to clarify, I think when we use this word cash, we typically actually mean cash plus TPA. I think the more appropriate word would be to use our listed tariffs rather than the actual mechanism of cash. And I think the intention is not to define cash versus credit in the sense cashless insurance, but a lot more to say that these are the published rates of the hospital, which are a little bit — of course, the scheme rates, as you’re aware, are lower than the published rate. So if you look at our payer mix across the group, we still have about 82% of our payer mix coming from the cash TPA market. And if you look at our Lucknow and Patna markets, I think that may be even closer to 90%. Of course, we do have some PPP business in our Patna market. And as we had mentioned, I think in maybe a year-ago plus earnings call, we did always intend to take some of the steam business in Lucknow to serve those patients, but Yogesh can correct me on the numbers. I think still upwards of 80%, 85% is — can I continue?
Damayanti Kerai
Okay. Yeah, I think I was considering only cash, but thanks for clarifying its cash plus PPA. Okay. That’s first question. Second is your ARPO, as we saw in last few quarters, single-digit growth. So just want to understand whether you have any plans to take any tariff hike or like in the past, you will just continue to focus on volumes and business mix?
Pankaj Sahni
No, I think we will be taking some tariff hikes. We have in fact taken some tariff hikes already which in Gurgaon at a nominal rate. And as you are aware, some of our discussions and negotiations with the insurance companies, they happen typically once in a two-year time-frame. So those negotiations and discussions will also happen. As you rightly pointed out, we have not yet taken a tariff hike in Lucknow and Patna, but that may also be something that we may do in the course of this financial year. However, as I’ve always mentioned, our tariff hikes are typically nominal. We don’t make very big jumps in tariff hikes, preferring to maybe stick to numbers which are near about maybe the routine inflation. And the intention is not to overly burden the patient community with increased direct, but just to cover for the inflationary and input cost aspects.
Damayanti Kerai
Got it.
Pankaj Sahni
Largely it will be selective unit-by-unit and even within the units, it may be selective for certain departments because we do take the clinicians into confidence before doing any of things.
Damayanti Kerai
Okay. So for, the growth trajectory, which we should look for next few years should be in single-digit, right, maybe low-to mid-single-digit range?
Pankaj Sahni
I mean, I think that would be fair. I would be a little hesitant to say that it would be in double-digits, barring some very strange kind of input cost changes, which we saw right after COVID. Typically, if you go back to earlier times pre-COVID, we did see it in the single-digit maybe middle level, mid level single-digit times, which is broadly in sync with how it moves globally, little bit more than inflation is typically healthcare and inflation.
Damayanti Kerai
Got it. And my last question is on your unit, although like it’s a bit away. But nonetheless in your presentation, it’s mentioned you’ll be incurring around INR600 crore of capex. And you are doing this hospital jointly with the society. So this INR600 crore is your portion or that’s the like total capex which you are — which you are planning this is our —
Yogesh Kumar Gupta
This is our solution because the structure, etc., will be built by the society. So we are not counting that to our capex outlook.
Damayanti Kerai
Okay. And this will be obviously much backloaded, right? Nothing maybe in say next one, two years with late in terms of — yeah, okay.
Yogesh Kumar Gupta
Nominal amount because design wellness is incur some expense or design. Design side, but mostly this expense will be after we have built this.
Damayanti Kerai
Got it.
Pankaj Sahni
And just to clarify, even our — even our greenfield projects, which we build completely are typically from a cash-flow point-of-view, typically also back-end loaded because a lot of the expenses come in the interiors and medical equipment. The greenfield projects upfront have typically the sale cost, but I would say even if you are taking 100%, I would say almost 60% or so is backloaded in the routine cash-flow of a greenfield project.
Damayanti Kerai
Okay., can you also clarify in a typical greenfield, again, the majority of cost is towards the medical equipment and, et-cetera and the civil constitute relatively smaller part, the way you can maybe it’s 40-50 or how should we look at that?
Pankaj Sahni
No, I was referring to the cash-flow, not the breakup between civil. So the — any project has basically, I would say, four major buckets. One, of course is, well, I’m not including the land cost, but let’s — if you take-out the land cost, there would be the civil and the construction-related activities. There would be all the services, which is your electrical, mechanical, air-conditioning HVAC services. That’s the second component. The third component would be your interiors and the fourth component would be your medical equipment. This broadly is how you think about the project cost. I’m not including any of the pre-operative expenses and also in the consultancy expenses, etc., but those are also there. So most of the costs beyond civil are back-end loaded because it does take about a year, 18 months-to get the sales structure up and then probably another 18 months or so maybe a little bit more to get the interiors and then the medical equipment is the last, of course, to come in. So the cash-flow is a bit backloaded, but I would say the breakup between these four components are maybe a little bit more on the interiors and services part because obviously it depends on how many operating, et-cetera. Civil is probably the lowest component of it now. But I would say it’s probably between 20% to 30% is each component, maybe with civil being a little bit lower.
Damayanti Kerai
Okay. That’s helpful. Thank you. Thank you. I’ll get back-in the queue.
Operator
Thank you. Before we move to the next question, a reminder to the participants to ask a question, you may press R&1. Next question is from the line of Janil Kothari from Vasuke India Capital. Please proceed.
Jainil Kothari
Hello. Hi. My question actually revolves around the gross block per bed or maybe CapEx per bed. Our gross block has always been around 9.5 million to INR10 million per bed, but our country is actually witnessing a good acceptance of pre-engineered buildings, especially in a very capex-heavy business, which helps to lower down the capex spends and which eventually helps to have a superior return profile. So hospitals being a very capex heavy business along with a good gestation period for breakeven. What’s your point-of-view regarding the acceptance of pre-engineered buildings in this sector?
Pankaj Sahni
So we have been looking at this very closely. I think that you know the jury is still out on this and I can give you two very specific challenges or concerns. One, of course, as you understand, hospitals have significantly higher requirements for various types of services because of our operating rooms, our ICUs, etc. And the way in which Medanta builds these facilities in-line with the best international standards, we may have even higher than many others in the industry. So we do need to be cautious about these pre-engineered types of buildings. We’ve also looked at steel structures versus cement structures. But the second major concern in all of this construction is around safety and some of that safety is related to fire safety and the ability to bear the fire ratings as well as the structural safety of the building. So unfortunately, we have not yet seen very mass adoption of this in the hospital sector, probably because of these two reasons and that is the reason why till now we have not gone with any of these structures. But new technologies, new materials, new techniques are being done. And we are evaluating this and also evaluating whether kind of a hybrid structure can be put in-place. So we are looking at this hybrid structure for say for example, our Mumbai project to see if that is possible and that may help with more than anything, maybe speed to construction, but still to-be-determined.
Jainil Kothari
Thank you. Thank you so much. That helps a lot
Operator
Of ask a question you may press star N1. Next question is from the line of Anshul Agarwal from Emkay. Please go-ahead.
Anshul Agarwal
Hi, thank you for the opportunity. Am I audible?
Operator
Yes, please go-ahead.
Anshul Agarwal
Great. Sir, a few questions or clarifications on upcoming projects. Could you help us with the timeline for the DLF project and the project.
Pankaj Sahni
So both the — so let me go one-by-one. So our DLF project is currently in the phase of where we have started the barricading activity and the soil testing activity. But that construction activity will still probably take about three years, I would say, to go to complete finishing. We’ve started in our Pitampura facility doing the drawings and we are ready to do those submissions. So as soon as we get the approvals, we’ll be in a position to start that activity as well. And that also is likely to take somewhere around three years. So both the projects about three years out.
Anshul Agarwal
Okay. Got it. And just a follow-up on these two projects, sir, we’ll be sharing rent or will be sharing part of revenues in both these projects?
Pankaj Sahni
Yeah. So I mean it’s more or less the same thing. Part of revenue is in a way a rental income only for the — for the party that owns the land. So in — depending on the commercial arrangements with the party, it is typically rent or revenue-share or some combination of both with a minimum guaranteed rent.
Anshul Agarwal
Okay. We have the same kind of conditions in both the projects.
Pankaj Sahni
Yeah, I mean there are slight differences in both of the projects. but really that is a question of what is the commercial arrangement that you have come to terms with respect to the landlord or the other party that is in the construction in the hospital partnership.
Anshul Agarwal
Sure. Second question I had was
Pankaj Sahni
It depends on how much money the other party may be putting in-building. So obviously, if somebody gives you just the land, it’s different rate, if somebody is your land in the cold shell it’s different if you give land plus shell it’s different. So that’s how it typically works in the industry.
Anshul Agarwal
Sure. The second question I had was on the Noida project. We would have already hired certain doctors, clinicians for this project. Are those costs sitting in our Q1 would have we — have we incurred any of these costs in the current quarter one by Q4
Yogesh Kumar Gupta
I not hired any doctors as of now, because doctors will get hired year to the opening of the facility, so we are talking to various people.
Pankaj Sahni
So how much offers are out in the market, but the cost is not yet in the P&L, except for the people that are already sitting in our other units who may move to — who may move to Noida, sorry.
Anshul Agarwal
Great. Thank you so much. That’s it from my end.
Operator
Thank you. Next question is from the line of Sumit Gupta from Centrum. Please go ahead.
Sumit Gupta
Hi, thank you for the opportunity. Am I audible?
Operator
Yes, please Rashid.
Pankaj Sahni
Yes so sir, strong momentum was visible in developing units in this quarter. So do you see the momentum continuing for the foreseeable future for the next at least one to two years I mean, I always caution on these calls and in my meetings that we don’t — we don’t run this business quarterly. We don’t really look at how things move quarterly. Those just happen to be the outcomes basis how you put the calendar reporting together.
What I would — what I would say is that we feel still fairly confident about the future growth, both in the short-term as well as in the longer-term on all the developing hospitals. Now just to kind of keep in mind that as we move Lucknow into what we had originally at the IPO time classified as developing and non-developing, I think we had taken about a six-year timeframe. So theoretically or technically, I guess Lucknow will now start to move into the mature hospitals depending on how you define that. But that’s really just how you know-how you report out in the investor presentation. But I think if you forget about this normenclature or classification of developing versus non-developing and you talk specifically about both the units as well as the — both the cities. I think we have — we have good amount of growth to come in both Lucknow and Patna because we still have better additions to do there first of all. Secondly, we are still doing very aggressive hiring in both the units. And thirdly, if you look at the potential of these markets, both in terms of the city of Lucknow and the city of Patna as well as the surrounding areas. There’s quite a lot of scope for all of this to grow. And I did mention as well in response to another question that we do believe at least the Kanpur region will develop as a more robust medical hub. And we’ve seen that already with, we’ve seen that with other cities like Delhi and even places like Bangalore, Hyderabad. They end-up you know, delivering a good amount of growth for all the hospitals in the ecosystem once they become these more established medical hubs. So I think Lucknow and Patna very, very early days for those markets from a healthcare industry point-of-view and they will continue to develop and continue to grow.
Sumit Gupta
Okay, sir. And sir, second question is on the Noda facility, which is more to come. So how do you see this ramping on the first year? And do you see competition from Max or JC will add to the competitive intensity and some other hospitals are also there to change. So how do you see the competitive intensity in the region particularly?
Pankaj Sahni
So first of all, just to clarify, Max JP is the same now because Max has taken over JP. If you look at the Noida region, right, that the population explosion just in Noida itself, forget about the surrounding cities all the way up to Agra,, andpur, etc, is just very, very, very, very-high, very, very dense. And frankly speaking, historically, Noida has had a very short supply of hospital beds, 1 quality hospital beds. So we believe that there is a very big opportunity in Noida. We believe that even after you know, kind of our hospital is open and some of the other expansion that has been discussed with some of the other hospitals, there’s still quite a lot of capacity required in that territory. That’s our belief. So we don’t see any big issue with respect to oversupply, if that is the first question. As far as the ramp-up goes, look, again, hospitals typically do take a couple of years to ramp-up. Medanta has been very fortunate that we’ve been able to deliver EBITDA breakeven in our recent facilities of both Patna and Lucknow within the first year. I would say that is good and fortunate. We shouldn’t always plan for that. There is a certain buildup time. And a lot of it depends on how the clinicians come on-board, how the community reacts to our services. And we are feeling fairly confident about this, but you know, any normal hospital, especially a hospital of this size does have a certain ramp-up period and we are planning that for that, but of course, we are hopeful for as fast as possible.
Sumit Gupta
Okay, sure. Thank you, sir.
Operator
Thank you. Okay. Next question is from the line of Tushar from Motilal Oswal Financial Limited. Please go-ahead, sir Mr MR., your line is unmuted. Please go-ahead.
Tushar Manudhane
Yeah, am I audible?
Operator
Yes, please proceed.
Tushar Manudhane
Yeah. So with respect to the addition of operating beds maybe like specifically for FY ’26, ’27, like with Moyda getting added, is there scope to add more number of beds at Lucknow, at Patna, maybe specifically for FY ’26, ’27, if you can just bridge the bed additions for the next 20 to 24 months. Even the other projects are on the construction piece.
Pankaj Sahni
Yeah. So if you look, Tushar at our investor presentation, I think it’s slide number 32, if I’m not mistaken, you will see that there is bed addition plan not only in Noida, but also in Lucknow and Patna over the course of the next, let’s say, 12 to 18 months. So we do add — do expect to add approximately 1,000 beds across all of these three units in the next few months and years. And that doesn’t include or maybe that’s part of that also will have our new 110 bed facility, which we have just taken on-board being January of this year, if I’m not mistaken, in Ranchi, which is augmenting our existing 200-bed facility because we had some capacity constraints there and wanted to upgrade the technology and infrastructure. So the Ranchi facility, we hope to come on-board this quarter itself in Q1 FY ’26. And then all the three other facilities, Noida, Laknow and Patna should have bed additions as well.
Tushar Manudhane
Got it, sir. If you could elaborate on this Gohati as a new addition in terms of location in first-place for us and subsequently what kind of sort of investment specifically over next one year or two year and then subsequently in terms of construction. Now you have already highlighted the overall capex, but if you could just base that into, say, construction cost and let’s say, land purchase cost?
Pankaj Sahni
Yeah. So we’ve — we have been looking actually for land in or in the Northeast region for some time. And I believe when we announced this as part of the government’s invest in ASAM summit or initiatives, we have been able to get land from the government and to build-out a 400 plus bed super specialty. We currently have been allocated three acres of land in. This is, you know, I don’t know-how familiar you are with, but this is on one of the main highways, which actually connects to Meghalay and Shilong as well. So it has a good drainage not only from the region, from the upper SAM region as well as from parts of. So we’re very well situated from that point-of-view. The project cost is about INR30 crores to INR35 crores is the cost of the land and the total cost is approximately about INR500 crores. And like with most greenfields, that should take us about three years or so to get going. So we have already triggered some of the planning as far as the clinical planning and the drawing activities of that. But of course, that will take some time. We just got the land, I think in a month or so ago.
Yogesh Kumar Gupta
No, we got basically agreement from the government and now we have to get the registry done.
Pankaj Sahni
Yeah,
Yogesh Kumar Gupta
There is a composition of that.
Pankaj Sahni
Yeah
Unidentified Participant
Understood. Sir. Just on this is it INR500 crores for 400 beds given the location is is still a crore per bed sort of an investment on like typically Tier-2, correct me if I’m going to take place this year city, but this capability is lower than any particular reason why we are the spending is much more?
Pankaj Sahni
You know, Tushar, we at least in ecosystem because I think you may have seen something that you’re audible some track.
Unidentified Participant
Sir, you’re audible. now.
Pankaj Sahni
Yeah, okay. So I was saying if you have seen our kind of hospitals that we have built-in Lucknow and Patna, both from a civil and interiors and infrastructure point-of-view, as well as in terms of the medical equipment that we put in there, whether it’s the latest CTMRI or in fact the latest and most advanced linack machines, we have not compromised on any of the quality in these cities. So the basics of construction remain the same. Our belief is that we should be able to deliver this kind of standard-of-care and build-out these kind of facilities. And in fact, one of the reasons why the government was very keen that Medanta come into that region as opposed to maybe many of the other options was exactly because they understood that we — when we go in, we bring a standard that is second to none and we don’t necessarily compromise on the quality of the facility that we put up just because it may be a city that is a non-metro city. So having this in mind, yes, there is a difference between the land cost in and say a Delhi or Mumai and we’ve been fortunate to get land at very attractive rates, thanks to the scheme of the government. But the basic cost is more or less the same. I think today, if you build a hospital with any kind of standards like what we put up, I think a crore, a crore 0.2, sometimes even going a little bit higher is a typical cost, especially if you’re going for bigger scale, you could possibly do it at less for a smaller 200 bed facility, but this will be 400 beds and maybe even higher than that. So I don’t think it’s very different from getting anywhere frankly.
Tushar Manudhane
Got it, sir. And just lastly, while you outlined the overall INR4,000 crore capex for next prices, but if you could maybe highlight the the capex for FY ’26 and FY ’27.
Pankaj Sahni
Yeah, I’ll let you get
Yogesh Kumar Gupta
Sushar, you haven’t done breakup your voice at present.
Tushar Manudhane
Okay, okay.
Operator
Okay next question is from the line of from Jefferies. Please go-ahead.
Unidentified Participant
Hi, sir. Thank you for taking my question. So not sure if you covered it earlier, but I wanted to know the outlook for Lucknow Hospital. Do you expect significant volume growth to continue? When are you adding additional beds into the unit? And did the quarter have any positive or negative impact because of? And have you seen those impact reversing in the first-quarter? How were — how were the trends in April? So that’s one. Second data point what’s the sensor bed count in our developing hospital units?
Pankaj Sahni
Okay. So couple of questions. Let me see if I remember all of those. I think the first question was around Lucknow, right? What is the — when you say what was the growth on that?
Unidentified Participant
Yeah. Yeah. The outlook and when do you see adding more capacities within the unit, do you see profitability being steady or improving and you know, growth being higher than what we have seen or steady or any kind of adverse impact.
Pankaj Sahni
Okay. So if you recall our various quarterly presentations over the course of the last few quarters, you will of course remember that we had a little bit of a lower-growth rates in Q4 and Q1 specifically as Q4 of last year and Q1 of this year and some drag of that into Q2 to some extent of this year. And we had mentioned significant steps being taken to bring that unit back to the kind of volumes that we had seen earlier. So happy to report since Q3, Q4, we see fairly strong performance in Lucknow, very good EBITDA margin profiles, very good growth volumes, good amount of performance across all of that units. So very happy with how that has played out over the last couple of quarters. Obviously, as you look at all the four quarters together, there is some impact of that on a year versus year basis, but we do see that growth having come back already and we do see good opportunities as we move forward. We will be adding beds in. We have a certain amount of beds to add-in on various floors in our existing facility, which is already partially completed. We could be adding currently maybe mother and child additional number of beds and maybe adding some more beds for some of our transplant and complex specialties. I mentioned, I think Dr and may have also mentioned, we’ve added in pretty advanced equipment there in terms of robots. I think we’ve already done within a period of about six months, we’ve done over 100 robotic cases, which is the highest number in the Lucknow area, I think in a short period of time. And we continue to invest in clinical talent. There is technology there. So for us, we’re not stopping anything in Lucknow going full-speed ahead with all of the activities there and we do believe that there is good potential left in the city. We’ll be adding in additional specialties also in the coming months and quarters. So there are certain specialties. We still don’t have that. And we have — we have plans to acquire clinical talent to be able to deliver those specialties as well. So that’s the — that’s the story with now. What was your second question, sorry, if you can remind me again?
Unidentified Participant
Yeah. So do you think your operations were impacted because of during the quarter? Was there any delay in elective surgeries that you felt and that kind of impacted occupancy and maybe that could have come in — started to come in from April onwards or overall you were neutral or you saw some benefit because of lot of you know population coming into the UP region and Lucknow region also. So was there any kind of impact because of the entire population you know, moving into this you know UP region out there?
Pankaj Sahni
So I mean I, I, I, I don’t have any specific data that tells me people who are coming from Mahak whom suddenly decided to also use it as an opportunity for any kind of healthcare experience. So I don’t think it was positive in that way in terms of adding any great population inflow into the healthcare facilities. There is of course definitely some impact on these kind of festivals in terms of people having elective procedures. We see this pretty much every season where during of course, COVID aside — sorry, Dengu and some of the seasonal diseases aside, we see that during, say, the Diwali, the Shera, kind of timeframe where the festivals are on, we do see some kind of dip in the electric procedures. And so to that extent, I guess also has more of a negative impact than a positive impact because of the population coming into the UP region, I think. But I don’t think that I can tell you very specifically exactly what was the number of people who did not come or came because of, I don’t think we track that. But yes, you know some movement across different weeks, travel constraints, et-cetera, it does impact patient movement to some extent.
Unidentified Participant
Gfffot it. And lastly, just a — yeah, data point, what’s
Pankaj Sahni
Question on census bed side?
Unidentified Participant
Yeah. On thre developing hospital side, yeah.
Pankaj Sahni
Yeah. So if you look at our census beds on the developing hospital side, we have about 600 or so beds in Lucknow and about 320 beds in Patna. So around 930 is the census beds for the developing.
Unidentified Participant
Okay. Thank you. That’s it from my side.
Operator
Thank you. Thank you. Next question is from the line of Alankar Garude from Kotak Institutional Equities. Please proceed.
Alankar Garude
Hi, good evening, everyone. Sir, first question, mature hospital margins have come down on a year-on-year basis by 120 basis points. So can you please call-out the reasons for the same?
Pankaj Sahni
So margins in developing hospitals, you said.
Alankar Garude
Mature one, sir.
Pankaj Sahni
Sorry, I’m sorry, did you ask mature or developing?
Alankar Garude
Mature. The question was on mature.
Pankaj Sahni
Yeah. So on a year-on-year basis, EBITDA margins in mature hospitals have gone from 25.2% to about 24.8%. So nominal dips, but I think if you look at it at a macro-level, 24.8%, 25.2%, more or less stable. Of course, there is some fluctuation with respect to how we see the various specialties. So as we find certain specialties, which are maybe more heavy on material costs, they have some kind of an impact. Also to the extent that we did some hiring over the course of the last year or so, there is some amount of clinician cost and manpower cost that comes in. But broadly speaking, I would say that I would consider these to be more or less stable in nature, not much difference between a 25.2% and a 24.8%. But yes, maybe some amount of material cost increase a little bit between the two years.
Alankar Garude
If you look at the presentation, Slide 26, it shows the margins have come down from 25.2% to 24%. That’s why I that question.
Yogesh Kumar Gupta
Sorry, you are asking quarter-on-quarter, right? Or because
Alankar Garude
New-on-year because year-on-year. So if I look at 4th-quarter FY ’24, our margins as we said were 24 versus Q4.
Pankaj Sahni
Yeah. Sorry, I was giving you full-year versus full-year. Hello.
Alankar Garude
Yeah, yeah. The question was on Q4. Go-ahead, sir.
Pankaj Sahni
Yeah. So Q4 versus Q4, again, I think maybe some amount, I’m just looking at some of our numbers, I think maybe about 100 basis-points is the swing in material cost. No real significant change in any of the other costs. So I would assume that this is broadly pertaining to some amount of increases in the cancer work because the pharmaceutical costs have some impact on the material costs to revenue ratios. So as we see some of our cancel work increasing, you may see some amount of material cost increase. But again, just looking at two quarters in isolation doesn’t necessarily, I think, give the whole picture because obviously certain specialties have some impact in certain months, it’s not very, very crystal-clear to look at Q4 versus Q4. I would say that a more realistic picture would be to look at full-year versus full-year.
Alankar Garude
Understood. Sir, just maybe one clarification there. No acquisition — merger-related expenses have been accounted in that margin number, right?
Yogesh Kumar Gupta
No,
Pankaj Sahni
No, not in the EBITDA, that’s come in below
Yogesh Kumar Gupta
That’s a below in an exceptional cost.
Alankar Garude
Got it. And the other question was on Indore. I see the second hospital has not been included in our capex plan. So is it a — I mean, is it still possible to go-ahead with that or as a matter of precautions, we decided to kind of not include that in our current plan.
Pankaj Sahni
Yeah, you know, Alankar, we had mentioned couple of times that this hospital had gone from a to a non-binding agreement some time ago and I said that it was more appropriate to say that we just put it on the back-burner from a disclosure point-of-view. We haven’t terminated our conversations with that party and we still maintain that there is a door open there for us to do it. I did also mention in some of our earnings call maybe one or two quarters ago that we are looking at alternatives as well. But I thought it was more appropriate for us to pull it out-of-the current disclosure to not mislead that this is something which is imminent because it will require kind of a revisit.
Yogesh Kumar Gupta
And also since we don’t have a very clear timeline on the legal case, so we don’t really know that whether it will happen in next four years or not. So that’s why we have taken it out and put into the modes today
Alankar Garude
Fair enough. That’s clear. That’s it from my side. Thank you.
Operator
Thank you. Ladies and gentlemen, we will take this as the last question for the day. I would now like to hand the conference over to the management for the closing comments.
Pankaj Sahni
Thank you, I thought you had one more question. So thank you everybody for your questions and for joining us today. Just to wrap-up, as we step into our next phase of growth, we, of course, remain committed to our original philosophy of delivering the highest-quality of care at the highest standards with the highest values. We believe that through this approach, we’ll continue to expand our footprint in a responsible manner, invest in our people in a responsible manner and also continue to bring the highest-quality and higher standard of infrastructure as close to the communities as possible. Please do feel free-to reach-out to our Investor Relations team in case there are any questions that remain unanswered. Otherwise, all the very best and thank you for joining. See you soon.
Operator
Thank you. And on behalf of Motilal Oswal Financial Limited, that concludes this conference. Thank you all for joining us and you may now disconnect your lines