Max Healthcare Institute Ltd (NSE: MAXHEALTH) Q1 2026 Earnings Call dated Aug. 14, 2025
Corporate Participants:
Unidentified Speaker
Abhay Soi — Chairman and Managing Director
Yogesh Sareen — Senior Director and Chief Financial Officer
Analysts:
Unidentified Participant
Suraj Digawalekar — Analyst
Tushar Manudhane — Analyst
Damayanti Kerai — Analyst
Shalin Lakhan — Analyst
Viraj Shah — Analyst
Neha Manpuria — Analyst
Kunal Dhamesha — Analyst
Mohammed Patel — Analyst
Sujith Shah — Analyst
R. Gajra — Analyst
Presentation:
operator
Ladies and gentlemen, good day and welcome to Max Healthcare Institute Limited’s Earnings Conference call. 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 this conference call, please signal an operator by pressing Star then zero on your touchtone phone. Please note that this conference is being recorded. I now hand the conference over to Mr. Suraj from CDR India. Thank you. And over to you sir.
Suraj Digawalekar — Analyst
Thank you, Neeraj. Good afternoon everyone and thank you for joining us on Max Healthcare’s Q1FY26 earnings conference call. We have with us Mr. Abhay Soy, Chairman and Managing Director, Mr. Yogeshwarin, Senior Director and Chief Financial Officer and Mr. Keshav Gupta, Senior Director, Growth M and A and Business Planning. We will begin the call with opening remarks from the management, following which we will have the forum open for an interactive Q and A session. Before we begin, I would like to point out that some statements made in today’s discussion may be forward looking in nature and a disclaimer to this effect has been included in the earnings presentation shared with you earlier.
I would now like to invite Abhay to make his opening remarks. Thank you. And over to you Abhay.
Abhay Soi — Chairman and Managing Director
Good morning everyone and thank you for joining us on Max Healthcare’s first quarter FY26 earnings call. We are pleased to report a strong start to the financial year with a year on year growth of 27% in revenue and 23% in operating EBITDA for the network. This marks the 19th consecutive quarter of year on year growth underscoring the success of our strategy and strong execution capabilities of the team. This performance is driven in part by the successful integration of the hospital acquisitions made in recent years which have significantly bolstered both our top and bottom line results.
Looking ahead, our focus remains on commissioning the new bed capacity scheduled to come on stream. During the course of the year we expect to add approximately 1,000 brownfield beds and 500 greenfield beds. Trial runs have already been initiated at the new 160 bed brownfield tower at Maxmohali. In addition, our board has recently approved the execution of an agreement to lease for a bill to suit 130 bed hospital in Dehradun. The site is located approximately 100 meters from an existing 220 bed hospital max Dehradun facility which reported over 80% occupancy in the first quarter FY26. The new facility is expected to be commissioned by the end of 2028 and will primarily focus on advanced oncology services including radiation therapy which is presently missing at our Max Dehradun facility.
As part of our strategy to focus on super speciality care in selected geographies, we have executed a binding term sheet to divest Chitta and Anoop share hospitals for Rupees 40 crores with completion expected by September 2025. Of the two, only Chitta Hospital was operational and reported approximately Rupees 5 crores in revenue and Rupees 1 crore of EBITDA loss in the first quarter FY26. These assets were part of the overall JP Healthcare acquisition and had limited strategic alignment. Now coming to the performance highlights of the first quarter, please note that the term existing units hereafter refers to the network facilities that were operational prior to Q1 FY25 while Max Noida and Max Dwarka are categorized as the new units.
Average occupancy for the Network stood at 76% compared to 75% in both quarter one last year and the trailing quarter. However, existing units achieved occupancy levels of over 78%. Occupied bed days increased by 26% year on year and 4% quarter on quarter. Average revenue per occupied bed for the quarter was rupees 78,000, growing nominally by 1% year on year as well as quarter on quarter for the existing units. Like for like, RPOP grew by 5% year on year and 2% quarter on quarter. Network gross revenue was 2,574 crores up from 2028 crores in Q1 last year and rupees 2,429 crores in the previous quarter.
This reflects an increase of 27% year on year and 6% versus the trailing quarter of this New units reported a gross revenue of rupees 231 crores. Like for like revenue growth in existing units was 16% driven by an increase of 10% in occupied bed days and 5% in RPOP. Digital revenue from online marketing activities, web based appointments and digital lead management was rupees 744 crores accounting for approximately 29% of the overall revenue. Website traffic witnessed over 69 lakh sessions during the quarter, growing by 61% year on year and 7% quarter on quarter. International patient revenue reached rupees 208 crores, registering a growth of 32% year on year and 3% quarter on quarter.
Despite airspace restrictions and geopolitical volatility in certain regions, network operating EBITDA stood at 613 crores reflecting a growth of 23% year on year and a 3% dip quarter on quarter primarily due to the impact of annual increments and additional manpower hired for new capacities. New units contributed rupees 27 crores to the network EBITDA representing a growth of 19% compared to trailing quarter. Network operating EBITDA margin was 24.9% for the quarter. Existing units reported an EBITDA margin of 26.2% which is 44 basis points higher than Q1 last year. Also adjusted for the one time donation of rupees 12 crores, the margin increased to 26.7% for existing units.
Annualized EBITDA per bed for the network should at rupees 68 lakhs like for like EBITDA per bed for existing units was rupees 75 lakhs reflecting a 7% growth year on year. Profit after tax for the network was Rupees 345 crores versus Rupees 295 crores in Q1 last year and Rupees 376 crores in the previous quarter reflecting a growth of 17% year on year. Free cash flows for the quarter were 389 crores. We deployed rupees 435 crores towards ongoing capacity expansion projects and facility upgrades at newer units while rupees 131crores were spent towards land purchase for brownfield expansion at Max Vishali.
As a result, net debt for the Network stood at 1755 crores compared to 1576 crores at the end of March 2025. Continuing our efforts to support the local communities, we provided free treatment to approximately 40,000 patients from economically weaker sections of the society worth rupees 62 crores at hospital talent. Both are strategic business units continued to report steady growth in the revenue and profitability. MaxatHome reported a top line of Rupees 60 crore reflecting a robust growth of 22% year on year. It offers 15 specialized service lines across 15 cities with over 50% repeat transactions. On the other hand, Maxlab reported a revenue of Rupees 48 crore reflecting a growth of 19% year on year.
It provides services in over 55 cities through its network of more than 1300 collection centers and active partners. Now coming to the status of our expansion project. Firstly, the 268 beds at Nanavati in phase one we are in the advanced stages of commissioning three basements ground to third floor along with seventh floor. Over the next few weeks 400 beds of max Smart and Saket Complex, the interior and MEP Fit out work are progressing as planned with phase commissioning expected to start towards the end of Q2FY26 max Lucknow the current capacity of the hospital stands at 413 beds and we expect this to increase to 520 beds by end of the financial year.
Of the 107 additional beds 32 beds are ready for commissioning. The encore bunkers are also. This is the oncology bunker are also in advanced stages of completion with Linac installation expected to start in early September this year. The 500 beds at Sector 56 Gurgaon structural MEP work is currently in progress with high side equipment under installation. We expect to commission the facility by the end of this financial year. 100 beds at max Nagpur we are currently awaiting formal environmental clearance. While the project has been otherwise approved, civil contract has been awarded. We Expect complete within 24 months.
397 beds at Patparganj Post receipt of environmental clearance, barricading and tendering work is in progress. The Deworld designs etc. Has been done and work is now being awarded accordingly. This is also in line. What we had projected 550 beds at max Vikrant Saket. We are still awaiting clearance from the Forest Department for tree transplantation. A fresh application has been submitted in line with discussions with the department. Any which way this project is to start upon commissioning of the 400 beds at Max Saket by the end of this year. The 400 beds is Zeeragpur Mohali. The partner has received approval for the drawings and construction and site work is progressing at a very fast pace.
The project is expected to be completed within the next 24 months. 140 beds at land adjoining Maxim Shali. Demolition of the existing structure is underway and the building plans are being filed with authorities. We expect to complete this project within the next 30 months. 500 beds at Thane Partner is in the process of finalizing the master plan for the larger site. Detailed drawings for the hospital are being prepared and we expect submissions to begin by the end of this quarter. The 250 beds at Pritampura Delhi partner has submitted the drawing for approval. Site cleanup and barricading works have been completed with construction work to commence upon receipt of necessary approval.
With this we open the floor for any questions you may have.
Questions and Answers:
operator
Thank you very much. We will all begin with the question and answer session. Anyone who wishes to ask a question may press STAR and one on their touchstone telephone. If you wish to remove yourself from the question queue you may press STAR and do. Participants are requested to use handsets While asking a question. Ladies and gentlemen, we will wait for a moment while the question queue assembles participants. You may press star and one to ask the question. The first question is from the line of Tushar Manudani from Motel Oswal.
Tushar Manudhane
So thanks for the opportunity. So just in terms of the operational beds has increased by almost 25%. So and that is how the revenue growth it seems to be with given the stable RPOB at the headline level. So if I exclude this additional operational bed which would have happened over last one year then the remaining beds performance how it has been. If you could throw some light.
Abhay Soi
So like I mentioned the existing beds is what we are calling what opened in the last 12 months. Sudwarka opened in July and JP Noida was acquired in October November. So if I just take these two facilities out then the growth in revenue has been 16%.
Tushar Manudhane
And that is driven again by further sort of optimizing pair mix or is it combination of.
Yogesh Sareen
No. So let me. So let me. Let me say this. Basically the recent hospital that means including the. Including the Lucknow and Nagpur the growth has been 16% and 80% as Abhi mentioned. Right. If we take out the two new hospital that we added in this basically the. Basically the you know the Lucknow and Nagpur which was which the acquisition happened in the quarter four of the FY24. So in that case the growth will be. If I take that out then the growth will be around 13% in the revenue and around 15% in the EBITDA.
So that means even the base level distinct hospitals, even taking out Lucknow and Nagpur the revenue is quite robust.
Tushar Manudhane
Got it sir. And so subsequently extending to this, you.
Yogesh Sareen
Know now and also I want to mention that in that case the growth in rpop would be 7% instead of 5% that Abhay mentioned over the existing hospitals. So that means the base level efficiency hospital growth would be you know R4 been 7% 5% in the. In the obds. And overall growth in the revenue would be 13%.
Tushar Manudhane
And of course the occupancy would be any which is going sort of 80% plus. Right. I mean because the headline occupancy itself is at 75, 76%.
Yogesh Sareen
No, I think in the base level. Hospital will be around 79.9% in this. In this quarter.
Abhay Soi
But if I 79.9% is almost 80% okay. In the quarter base hospitals. But if you add lnow and. And Nakur to it, okay then it comes to 78%. But then if you add the other two which we did last year. Then it comes down to the 76% which is similar to what it was last year.
Tushar Manudhane
Got it.
Abhay Soi
That’s why.
Tushar Manudhane
Yeah, fair, fair. I mean the, the further extension to this is that if I exclude this new whatever that got added lower last year then the base hospitals may, given that we’ve already grown in this year as well and we are already at 50% occupancy.
Abhay Soi
That’s right. But you see, I just want to tell you. No, I want to just tell you see, we are calling listening hospital the two hospitals which were added in the last 12 months. Right? Yeah, but if I extend this argument to 15 months then it becomes four hospitals. So therefore I’m just telling you from existing hospital we are only counting the 12 months. In spite of that the occupancy is going up from 75 to 78%.
Tushar Manudhane
Got it.
Abhay Soi
But if I take out the two which were added in the month 13, 14, 15 last March, then it goes to about 80%.
Tushar Manudhane
No, so. So subsequently new growth because of these new additions is very much intact, you know, for FY 26 to 28 or 29. Just trying to understand if I like if I exclude all these and only on the base hospitals, probably now the base is being dynamic in nature so can’t do much about it. But let’s say if I exclude last 12 months additions then subsequently, whatever, there’s the recent comment and we reaching at 80% occupancy in the next two to three years, is there still scope to. Grow. And further increase the occupancy or that becomes more or less the base and so the addition of beds is what is going to drive the growth going forward.
Abhay Soi
See your base hospital itself, the nomenclature changes, you see whatever has been added really over the last 12 months or the 15 months has been acquisition in Greenfield. Right?
Tushar Manudhane
Yeah.
Abhay Soi
So for example, what we are going to be growing in the next 30, 60 days, the three brownfields which are coming through in the Next, let’s say 30 odd days is going to be brownfields. So they add on to the existing facility. So then it’s difficult to say that look, in a brownfield the earlier beds are growing by this much and the newer beds are going that much.
Tushar Manudhane
Fair, I’m just saying.
Abhay Soi
So I think, yeah, so the take up of this should be, although it’s brownfield, the take up should be very quick.
Tushar Manudhane
Understood. And so just secondly on this international patient flow, which at all, which all other geographies, you know, we’ve been sort of engaged with to get this kind of high growth.
Abhay Soi
I don’t want to actually go into details of other countries etc. Okay. Because I don’t want all the players going into that those countries as well. But yeah, they’ve been newer geographies in some of the developing countries as well. Developed countries as well. Right. But of course, you know, some time back we had guided you to the fact that we were opening direct to fly offices. Right. And you know, in other countries and so on and so forth that you know, there was a focus towards international marketing and businesses. Something we had called out much earlier, even a few years back.
And I think what has led is we’ve got increased traction through that strategy and we’ve been doing more of that and being able to drive more and more patients.
Tushar Manudhane
Got it, sir. And just lastly from my side, in terms of net debt, given the projects at hand without considering any inorganic opportunity at this point of time because that will be as and when it comes how net debt one should sort of think of at the end of FY26.
Yogesh Sareen
Yes, the net debt will go up to some extent because we have tied up some funds for the projects underway. So if I really say by the end of FY25 we may have probably addition in the net debt to the extent of around 400 to 500 crores.
Tushar Manudhane
200 crore. Right.
Abhay Soi
4 to 500. So it will become net debt to EBITDA of maybe then still less than 1, I believe.
Tushar Manudhane
Thanks. Thanks.
operator
Thank you. Next question is from the line of Damyanti Kirai from hsbc. Please go ahead.
Damayanti Kerai
Hi, thank you for the opportunity. My first question is on your focus on the oncology segment. So this is largest for you and year on year also I think it has grown up. So it’s already 25, 26% of your total hospital revenue. And I understand in newer hospitals also you are trying to offer these services. So in terms of further growth from current level, what kind of headroom do you think is available here?
Abhay Soi
So I think first and foremost some of the newer hospitals, particularly Dwarka and Lucknow, both don’t offer radiation oncology at this point of time because the bunkers are not there. But you know, in the third quarter we expecting the bunkers to sort of come through in both these hospitals. And so therefore you see a larger share of oncology certainly in these and that will make an overall sort of this thing as well. We don’t believe that there is any sort of reason for the growth in oncology to abate. These are structured. I mean we are essentially catering to the Market, you know, essentially the market is growing at what it is and that is what is leading to increase in our share of oncology.
Damayanti Kerai
Okay. And do you think the kind of, you know, demand out there in the market and your leading position here, this therapy could be upwards of 30% in say a few years from now? And why I’m asking because I guess what we are hearing from your peers also, they are focusing a lot more on oncology compared to few years back. From that perspective,
Abhay Soi
I think to a large extent we can say we are focusing on it, but we are also all reacting to what is happening in the marketplace. Right. And yes, we’ve seen growth in numbers in oncology, perhaps more than other specialties. And if you compounded at that, then certainly you will start increasing the market share of oncology and it will be a higher resort of market share. It’s been growing. And it’s not necessarily that the new facilities that we acquired that has led to growth in oncology alone because the newer facilities like I mentioned have a lower component at this point of time because of radiation oncology not being there.
For example, Nagpur does not have radiation oncology. Lucknow did not have radiation oncology. Dwarka does not have radiation oncology. Okay. JP has but you know, that’s really one out of the four. So you know, I think as and when and like I said, when we are able to expand our suite of services which is in Q3, in at least two out of those four hospitals, then the share should go up.
Damayanti Kerai
Got it. Thanks. My second question is on your your newer hospitals which will open soon, say Nanabati will start in next few weeks or so and then SMART is also coming up by end of this current quarter. So what is the status right now on the doctor hiring part? Like when do you onboard most of the doctors like before start of the unit or you will add on gradually as you offer more and more services and what kind of numbers you’re looking at.
Abhay Soi
So all the Brownfield expansion pretty much offered the entire suite of services. So like I mentioned in my speech, also some amount of whatever was required for augmentation of these has already happened, particularly with both Nanavati as well as Nanavati Mohali and Saket. But all three and you know, but incrementally as when you open more beds. So we definitely have whatever we believe because you know again you’re opening 400 beds, you know, opening 400 beds in day one, as in when you get the flows, you kind of open it up. But we have more than adequate sort of clinicians who are already onboarded to be able to support what it is.
And incrementally you keep growing thereafter as well. But that will be incremental so you won’t feel it. So whatever has been absorbed, absorbed, you will not see any impact because of that.
Damayanti Kerai
Got it, Got it. Okay, that’s helpful, thank you. I’ll get back in the queue.
Abhay Soi
Yeah,
operator
thank you. Next question is from Lenov Charlene from UBS Group, please go ahead.
Shalin Lakhan
Yeah, hi guys, thank you so much for the opportunity. So one question which I want to understand, you know you made a comment away also that direct cost has gone up and it’s largely because of the new units. But is this going to be stable from here? For example, I can see that your direct cost is 1000 crore right now from 917 has gone to 1015. So now the growth would be of this unit would be inflationary or there will be more addition will be that and the subsequent impact on the margin. So you know, from Q4 to Q1 I understand this is seasonally weak but if, if direct cost shouldn’t go up then one should expect margin to expand from here onwards meaningfully.
Abhay Soi
So look, as far as direct cost is concerned, the significant majority of it is manpower cost and on 1st of April we have increased. Yeah. So you know you get that step up because from 31 March to 1 April you have that one little bump up because of salary sort of this thing. But we also happen to be at this point of time and always maintain that, you know, brownfields don’t really impact. But you know, 30 days before or weeks before when you’re doing trial runs etc. You have staffed. It may not necessarily only be clinicians, it’s also people down the line, you staff for those sort of this thing and you are kind of carrying that cost.
So yes, I think going forward at present that cost, that little bit of cost may not be generating extra revenues but it will do so as and when over the next few weeks these brown fields kick in. Theoretically it would increase. Yeah.
Shalin Lakhan
And on the diet cost specifically going to about 1,000. Yes. So a bunch of doctors have joined which is the part of the system that was pre built up for the new questions coming in. But a lot of them will join alongside when the questions get commissioned phase by phase they will go in tandem to the revenue sticking in as well.
Abhay Soi
Yeah, but there’s no negative impact on the.
Yogesh Sareen
Charlene also as we, as we, you know, get into the, into the new Quarters. I think as far as these hospitals concerned, the share of the PSU bed will come down. Right. Because you know that our strategy is to fill up the beds and then distill. I have to distill this, this ratio should improve. Right? Because I mean you know that the PSU share has gone up because of the new beds etc. And you know as we speak the occupancies in hospitalized Vata which is started only 12 months back, I mean it’s 81, 82%. Right.
It’s because we said let’s fill it up with whatever we have. So once that ratios kind of improve this, the percentage will also come down. The direct cost percentages.
Shalin Lakhan
Sure sir. Because typically from when we move from Q1 to Q2 there is a sequential reasonable jump of 5, 6% happens on the revenue. It may be more or less depending upon ramp up of the new facility. I hope it’s more but I don’t expect. We should not expect direct cost to also move up in the same line. Right? It may not move up. Right.
Yogesh Sareen
So yeah, this should be moderate here.
Shalin Lakhan
Okay.
Abhay Soi
No, you’re right, you’re right.
Shalin Lakhan
All right sir, so we should expect a decent margin expansion. Then this 12 crore thing, is it, is it part of your CSR expense or is it outside of that?
Yogesh Sareen
No. So you know CSR expense is generally made by the companies. Right. It’s not made by the trust. So this is the money which is not out of the DDS Society. Right. So this has been, you know, on the recommendation of the board of governance. So there’ll be some benefit that the network hospital will get out of this. But I think nevertheless it’s a one time donation that has been made from the society.
Shalin Lakhan
So this is a part of our indirect cost.
Yogesh Sareen
It’s part of the indirect overhead. Yes. At this point.
Abhay Soi
That’s the one time.
Yogesh Sareen
Yeah,
Shalin Lakhan
the one time. Yeah. So just wanted us because if it’s a CSR then it’s not one time. So. But it’s X of CSR then it’s a one time. So I.
Yogesh Sareen
In a society now, in a charitable society there’s no CSR only it applies to companies. Right?
Shalin Lakhan
Right, Right, right.
Yogesh Sareen
This money has gone out of the DDF society. So that’s the reason why saying it’s a donation, it’s not.
Shalin Lakhan
Basically when I think about it, let’s say everything remains same next quarter then I should add back this 12 crore to the revenue, right?
Abhay Soi
That’s right. Your 12 crores will never happen again. Yeah, yeah.
Shalin Lakhan
So yeah, that’s, that’s my 12 crore which I, which I can add back to my EBITDA right. Next quarter. Everything.
Abhay Soi
That’s right, that’s. That’s right.
Shalin Lakhan
That’s right, sir.
Abhay Soi
And also. And all subsequent quarters.
Shalin Lakhan
All subsequent. Absolutely, absolutely. And and the last bit, any color if you can give us on 2Q. How’s it been going for you guys? Right? How’s the season on the vector born, et cetera? Typically it’s the strong season for us.
Abhay Soi
I’m not going to, I’m going to avoid giving any forward looking statements.
Shalin Lakhan
Okay. But I mean this year, this year.
Abhay Soi
This year, this year. Normally I just sort of tell you normally what happens is that, you know, towards the end of monsoons, okay, the vector season, this thing, this year has been a long monsoon. So only at the end of monsoon you start seeing it. You may have to have stagnation of water for vector borne diseases to kind of spread.
Shalin Lakhan
Got it. No worries.
Abhay Soi
Right. So it normally happens when your monsoon kind of starts going down. But right now I mean it’s been going up or not going up, but sort of.
Shalin Lakhan
Sure, I think that’s it. Good. Thank you so much guys and congratulations.
Abhay Soi
I think the important thing Shaleen to look at is existing hospitals, okay. Prior to any additions that we did over the last 15 months where there’s a 7% growth in RPOP and there’s I think significant increase in revenue and EBITDA as well and occupancy has certainly gone up to 80% of those. Second thing to look at is the two hospitals which added 15 months ago. Both those will have obviously a better sort of sense of maturity about them because they’ve been longer with us. Both these have also contributed to high increase in their occupancies and in spite of both of them, you still see RPOB move up by maybe 5% and occupancies go up by a couple of percentage points.
And then if I add the two hospitals which, you know, one we really acquired in October, November, the other was a Greenfield in July that we started, okay, those have. In spite of those, we see flat occupancies on overall basis. So it’s not, I mean the newer facilities haven’t really dragged down our operations or our numbers by any significant distinct. And yet, you know, they provide us an opportunity as they mature.
Shalin Lakhan
Yeah, absolutely, absolutely. I can see that. Great guys, thank you so much. I’ll go back in the queue.
Abhay Soi
Thank you.
operator
Thank you. Next question is from Nano Viraj Shah from PGIM India. Please Go ahead.
Viraj Shah
Hi,
operator
may I request to unmute and proceed with your question?
Viraj Shah
Hi, am I audible?
operator
Your aura is very feeble. Can you speak little louder and through the handset?
Viraj Shah
Hello. Hello, am I audible?
operator
Yeah, go ahead please.
Viraj Shah
Yeah. So I just wanted to know regarding. The growth trajectory of the acquired hospital on revenue and EBITDA basis, how has it been post the acquisition?
Abhay Soi
We’re talking about the Nagpur and Lucknow.
Viraj Shah
Including Lucknow, Nagpur and also Noida.
Yogesh Sareen
Yes. So Lucknow has been doing very well on one. On one basis. The revenue growth is 97%. Growth is, you know, is 191% Nagpur. We grown the revenues by 27% y. EBITDA growth is also in the same range. Noda has been a bit subdued. So the revenue growth is yoy. Again this is based on the numbers that we have of the last year. These are not our numbers but it’s basically the number that we protect from the Eastfield management. That’s around 14% growth. YoY and EBITDA growth is 32%. So that’s the numbers.
Viraj Shah
Okay, perfect. Yeah, that’s it from my side.
operator
Whereas do you have any follow up question?
Viraj Shah
No, that’s it from my side. Thank you.
operator
Thank you. Next question is from the line of Neha Manpuria from Bank of America. Please go ahead.
Neha Manpuria
Yeah, thanks for taking my question. First question, when does Nanavati, the new block fully become operational? You said that we currently operationalizing the, you know, one of the floors and I think the basement. When can we see the unit becoming let’s say fully operational from a bed perspective?
Abhay Soi
The basement is not just the basement. Basement is also used for, for encore services and so on. Right?
Neha Manpuria
Yeah, yeah.
Abhay Soi
So it’s, it’s like the nuclear medicine department is in the basement. So let me kind of rephrase that. Yeah. So we will be starting with the next few weeks, you know, a couple of floors and then you know we will transition towards. By October, November we should be starting the rest of the beds including the OTs, et cetera.
Neha Manpuria
Okay, understood. And my second question is, you know, if I look at the new units, you know, numbers that you have given for fourth quarter versus this quarter, it seems like, you know, you know, it’s broadly similar to what we did in the fourth quarter. Is it because I thought that Dwarka had achieved break even last quarter and that should be positive. So is it just a seasonality thing? Because I thought the seasonality isn’t as stark quarter on quarter from fourth to first. I would have expected that we see or Should I assume till the time we don’t see Onco come in in Dwarka, you won’t really see that big ramp up happening.
Abhay Soi
No, no, no. I mean on the contrary, few seasonalities, you’re right, are there but for a new unit there are no seasonalities because your growth momentum itself takes care of the seasonality and beyond. So we’ve seen very high ramp up of occupancies and everything at Dwarka. So I don’t think we’re waiting for anything to come in. In fact, we are already planning down for field at Dwarka because we are hitting facility doubt status over there.
Yogesh Sareen
Yeah. So Dwarka growth on quarter, on quarter basis is 24% which means that we drawn the revenues from the quarter four, FY25 to quarter one by 24%. The EBITDA is also 78 crores up than quarter one, quarter four. Sorry. So is no, no, no reason for anybody.
Abhay Soi
Yeah, yeah. And this thing I think we have way past the break even and any seasonality questions over there, etc. We are talking capacity out status.
Neha Manpuria
Okay. And so in which case then I’m wondering if, you know, Noida could have done better this quarter. But you know that generally, because I would have assumed that, you know, you would see a much larger improvement, you know, given the ramp up in Dwarka and also, you know, Noida starting to improve performance. So just trying to get a sense, is Noida on track with what we are expecting or should I expect an acceleration as we go through the rest of this year?
Abhay Soi
So we will certainly see acceleration in Noida as well. Like we had mentioned, we acquired in October, November. The first couple of quarters are always the more distinct because you’re kind of integrating it into your IT systems. We changed the name of the company we bought it from LCLT when we did that, in this particular case, all the licenses, including transplant licenses, blood bank licenses, etc. Etc. We had to reapply for each one of these. So those have been coming through, etc. So you know, it’s literally we’ve been operating a little bit with our hand side behind our back.
And you know, even again, this was a company from which has been in liquidation for many, many years. Equipment is out of life. We ordered all the equipment. They’ve been coming in for phases in. All the building blocks have been put in this particular listing. So you typically what you have is that look, in any acquisition that you do of this nature, the second year is better than the first year. The first Quarter will always be the weaker quarter will be the weaker quarter because that’s perhaps the time you have been able to implement the least amount of changes that you wish to.
Because whether it’s equipment, whether it’s management, whether it’s doctors and so on, on and so forth. And onboarding does take three to six months. And like I said in this particular case, you know, we, it almost like somewhere it was it’s acquisition that we did, but somewhere it was a greenfield kind of thing because we lost all the licenses and then we had to, you know, sort of get them all renewed in new company and so on and so forth and all of that. But yeah, most certainly what’s going to happen is that going forward, okay, you have a snowballing effect you’re going to have in the quarters to come.
You should see significant upside down.
Neha Manpuria
It’s fair to assume that all of the grunt work that needed to be done for Noida in terms of licensing, you know, equipment, etc. Will be done. I mean you should start seeing that from the subsequent.
Abhay Soi
It’s already done. It’s already done. But when you order this equipment, the supply chain itself, it comes from overseas. There’s a six month process from the day you indented for you to get the some of the equipment in place.
Neha Manpuria
Understood? Understood. Yogesh, what did you mention the Noida EBITDA at? Sorry, I missed that number.
Yogesh Sareen
So, so noida EBITDA is. YoY growth is 32%.
Neha Manpuria
Okay.
Yogesh Sareen
Right. And the revenue growth is 14%.
Neha Manpuria
And, and would you have the absolute number sir, for the ebitda? Sorry
Abhay Soi
I mean I have the absolute numbers. It’ll be around 24 crore rupees.
Neha Manpuria
Okay, thank you so much. That’s helpful sir. Thank you.
operator
Thank you. Participants, you may press star N1 to ask the question. Next question is from line of Kunal dha. Misha from my query group, please go ahead.
Kunal Dhamesha
Hi. Thank you for the opportunity. Just continuing on the Dwarka and Noida thing. I think the total EBITDA contribution is around 23 crores or something. Or 27 total contribution for Dwarka and Noida which we have mentioned the new it is 27 of which we are seeing 24. Is Noida, right?
Yogesh Sareen
No. So I think you’ll also consider that you know when the, the unit EBITDA will be two plus two and a half percent higher because we also cross charge the the ho toss when we report numbers to the investors. But when I, when you see a unit performance, you know, then it’ll be 2% higher in terms of beta margin. Right. Two and a half percent higher. There’s two and a half percent of the revenues allocated to units as H cost.
Kunal Dhamesha
So this 27 is unallocated.
Yogesh Sareen
This 24 is the 24 that I mentioned. Is the unit middle, right? Unit 24.
Kunal Dhamesha
Okay.
Yogesh Sareen
Yeah.
Kunal Dhamesha
And which would come down to what? Around 20. Yeah. Because Dwarka, you said seven eight, right?
Yogesh Sareen
Yes, that’s right.
Kunal Dhamesha
Okay. Okay.
Yogesh Sareen
So. So this 27 number is after two and a half percent of 231 crores being allocated to these units. Right. So if you take out the this extra cost, you add 5 crores to this 27th row, 32 throws. Is the number combined for Guata and Noida.
Kunal Dhamesha
Sure.
Yogesh Sareen
Okay.
Kunal Dhamesha
Thanks. Yeah. Yeah, thanks. Second question on the you know, R pop. We you suggested that including Lucknow and Nagpur the RPOB is around what 4.9% growth rate excluding Noida and Darka. And then we are seeing that the 3500 bed that we originally had at 7%. That translates to around 7%. Harpob D Group for Lucknow and Nagpur. Is that a correct math?
Yogesh Sareen
No. So I think I know there’s some confusion out there. So first of all let’s take the. The existing resistance hospital. Right. Without taking even the Nagpur. And now the RPAP growth is 7%, right?
Kunal Dhamesha
Yes.
Yogesh Sareen
These are the hospital which are in operation, you know in December 23rd.
Kunal Dhamesha
Correct.
Yogesh Sareen
Right. So if I take out. Taking the. The Narpur and luck now which is the hospital that we acquired in February and. And March of 24 then the, then the. The RPAP growth is 5%. Right.
Kunal Dhamesha
4.9.
Yogesh Sareen
If I say Dwarka as well as the Noida and the RPAP growth is 1.2%.
Kunal Dhamesha
Correct? Correct. So I am saying that for our 3500 bed to do 7% RPOB growth the R4 should have been degrown in Lucknow and Nagpur. Right. Then only 7% comes down to 5%.
Yogesh Sareen
No, I’m not sure what is seen because you know there’s no yoy number for the. For the, you know, Dwarka. Right. There’s no number for last quarter, right?
Kunal Dhamesha
No, no. Just exclude Dwarka and Nagpur. The Dwarka and the sink. Yeah.
Abhay Soi
Look, there’s no degrowth in RPOB in any of these things. The only increase in R. But then.
Kunal Dhamesha
Numbers are not basically connecting because a seven. Yeah. So 3,500 beds. You are saying 7% are. Right. And then we include. Include Lucknow and Nagpur which is around 600 beds. Our presentation says that 4.9% growth or 5% let’s say. Right. So then 7% is coming down to 5% by addition of Lucknow and Nagpur in the mix.
Abhay Soi
Which means occupied bed. No?
Kunal Dhamesha
Correct.
Yogesh Sareen
You’re getting confused. Let me just. Let me. Numbers. Right. So just note these down. In the hospital which are operating till December 23 the beds were 2,732. Right. If we take on take in the two hospital which is Nagpur and now the occupied beds are 311 7. Right. And if we take Dwarka and Noida the occupied meds were 355 6. Okay. Now you do the math and.
Kunal Dhamesha
Yeah. Yeah. I’ll maybe connect offline on this.
operator
Sure.
Kunal Dhamesha
Yeah, sure.
Abhay Soi
Please get your formula straight. I’ve seen your formula in some of the others. The thing is, you know, in spite of us saying that occupied bed days have gone up and a loss has gone down. I believe statements have been made in your formula that our footfalls have come down for ipd. You know, theoretically that’s not even possible. So please get your facts right.
Kunal Dhamesha
Sure, I’ll do that. Sir. Yeah. And then second question is we have seen significant increase in institutional business. Right. Even let’s say because last year, same quarter we would not have Noida or Dwarka. But there is a significant increase. And I assume that Lucknow and Nagpur are not you know the. The center for a lot of institutional patients. Right.
Abhay Soi
So we started institutionally in Bombay. Also in. In view of the new bed coming. We’ve also been. Nagpur. We started was not there earlier prior to U.S. takeover. So it started last year. So is Lucknow.
Kunal Dhamesha
Okay. But then existing beds on the 3500 bits. What would be your, you know view would. Is it more or less stable in terms of bed days from institutionals or.
Yogesh Sareen
So I think for example, let’s say Mohali. Right. So Mohali, we add in 160 beds. So you can’t take institutional at that point of time. Right. So we take an institutional in the. In the last quarter. Right. And. Right. And we. We will. We would. We’ll. Obviously you know, we are preparing for the new bets.
Abhay Soi
So it takes you six months. It takes you six months to impanel yourself. Okay. Mumbai for example. Erstwhile there was no institutional business. Now we impaneled for institution.
Kunal Dhamesha
Sure. So wherever the new expansion is coming, it is more strategic.
Abhay Soi
That’s right.
Kunal Dhamesha
Great. Thank you. And all the best.
Abhay Soi
Thank you.
operator
Thank you. Next question is from the line of Mohammad Patel from Edelweiss. Please go ahead.
Mohammed Patel
I have a question on RPOB growth. So it has been flat overall. So how should we think of overall RPOB in the near term?
Abhay Soi
Well, it’s growing. Beds have grown by 7%. If you add the two bots we put up 15 months ago, then it’s grown by 5%. If you look at all of the hospitals, then it looks flat. Of course, if you’re going to start a new hospital or you acquire a new hospital, the rpob of that particular hospital is going to be lower. Right. So it’s going to bring the average down. Otherwise, both for existing and the newer hospitals, you know, existing hospitals gone up, rpob and occupancy significantly.
Mohammed Patel
Overall rpob growth will take some time to reflect. Right.
operator
Mohammed, Sorry, your voice is breaking. Can you please come in? Better reception area.
Abhay Soi
Yeah. So when you acquire a new hospital, you acquire it because you lower our corp and you acquire at that price. And the whole idea is to increase the occupancy and the R4 of that. Right. Going forward, you will see rpob move up.
Mohammed Patel
Okay. So eventually, after a few quarters, the overall up of growth will again start inching towards the ic.
Abhay Soi
That’s right.
Mohammed Patel
And my second question is, should we.
Abhay Soi
You know, having said that, okay. It also depends where you’re acquiring. We buy for roce, we don’t buy for, you know, I may acquire something in a tier 2 city where the R pop is, let’s say half the present R pop. And that R pop of that place may never go up to my existing cluster rpob. The fact is we have to figure out what ROCE are we buying it at. If I’m buying it at 20, 25% ROCE, if I believe I can get it to a 25% ROC in. In spite of it having a lower sort of impact on my overall RPA will still acquire it.
Right. I think the cadence you’re looking at is incorrect. RPO by itself or a margin by itself. Okay. Of any capacity that you’re acquiring or your starting today. Okay. Is incorrect. What we have to see is do we have superior return on capital profile over there or not?
Mohammed Patel
Okay. Okay, fair enough.
Abhay Soi
I mean, let’s say if I get, if I. If I get an opportunity to buy a chain of hospitals which operates at less than half the R pop I’m overall operating at and I’m able to buy it at a 25% ROCE, should I or shouldn’t I? I should, right? What it would do is bring my overall RPOB down and I may never be able to climb up to sort of my present levels of rpob. So be it. Are we on the same page?
Mohammed Patel
Yes, yes, I get your point, I get your point. My second question is so should we expect EBITDA margin improvements in FY26?
Abhay Soi
You will expect improvement. But having said that, let me also tell you, and I keep repeating this, okay? EBITDA margin is incorrect sort of this thing. But because the higher payer mix your EBITDA margin, my international business is growing by 32%. Supposedly it’s higher margin business in value terms, okay? But the percentage term it’s a lower margin business. When you do robotics or you do transplants, or you do any of the high end business, surgical business, okay, it gives you less margins in percentage terms, but it gives you more in value terms. Please consider EBITDA per bed as the right cadence and not EBITDA margins.
Mohammed Patel
Okay?
Abhay Soi
So one end, okay? Because the better occupancy, okay? At one end because of better occupancy, higher utilization and so on, your margins will increase. On the other end because you’re going for a superior payer mix and a superior clinical mix as well, okay? Your margins should decrease because of that, right? But your EBITDA per bed will increase and your roce will increase.
operator
Mohammed, do you have any follow up question?
Mohammed Patel
No.
Abhay Soi
Are you with me on this?
Mohammed Patel
Yes, yes, I’m with you.
Abhay Soi
Okay,
Mohammed Patel
thank you,
operator
thank you. Next question is from line of Sujith from SK Enterprises. Please go ahead.
Sujith Shah
Am I audible?
Abhay Soi
Yeah, we can hear you.
Sujith Shah
Yeah. Firstly, I want to appreciate the entire Max healthcare team at this scale expanding so rapidly while maintaining profitability is not easy task. And my all question is already asked and answered. So not any question I have to ask.
Abhay Soi
Thank you, thank you.
operator
Thank you very much ladies and gentlemen. Next question. Mr. Online from Informus Media, please go ahead.
R. Gajra
Hello, can you hear me? Am I audible?
Abhay Soi
Yes, yes we can hear you.
R. Gajra
Yeah. Earlier in the call you mentioned that at the end of FY26 the net debt will be. And you gave some figure for that. I was not able to catch that number. Can you please repeat that? The net debt level at the end of FY26. Thank you.
Abhay Soi
What Yogesh mentioned at the end of the year, between now and end of the year your total debt for project purposes may go up by another 4 to 500 crores. May go up to 4 by 4 to 500 crores.
R. Gajra
Okay. All right, that’s it. Thank you very much.
Abhay Soi
Thank you.
operator
Thank you. As there are no further questions, I’ll now hand the conference over to the management for closing comments.
Abhay Soi
Thank you once again. We appreciate all your time and look forward to connecting with you next quarter. Thank you so much.
operator
Thank you very much on behalf of Max Healthcare Institute limited that concludes this conference. Thank you for joining us and you may now disconnect your lines. Thank you.