Ladies and gentlemen, good day and welcome to Yatharth Hospital's Q3 FY2024 Earnings Conference Call hosted by Ambit Capital. As a reminder, all participants' 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 then zero on your touchtone phone. Please note that this conference is being recorded. I now hand the conference over to Mr. Prashant Nair from Ambit Capital. Thank you, and over to you, sir. Thank you, Manuja. Good morning and welcome to the Q3 FY2024 Earnings Call of Yatharth Hospital & Trauma Care Services. Today we have with us from management: Mr. Yatharth Tyagi, full-time Director; Mr. Amit Kumar Singh, Group CEO; Mr. Pankaj Prabhakar, CFO; and Mr. Deepak Tyagi, President, Strategy and Finance. I would now like to hand the call over to Mr. Yatharth Tyagi for his opening remarks. Over to you, Yatharth. Good morning and a very warm welcome to Yatharth Hospital & Trauma Care Services Limited Earnings Conference Call for the quarter and nine months ending December 31, 2023. Let me draw your attention to the fact that on this call, our discussions will include certain forward-looking statements which are predictions, projections, or other estimates about future events. These estimates reflect management's current expectations about future performance of the company. Please note that these estimates involve several risks and uncertainties that could cause our actual results to differ materially from what is expressed or implied. We have uploaded our presentation on the Exchange and the company website, and I hope you all might have received and have had an opportunity to go through it. This quarter was full of dynamism, and yet I'm happy to announce that we have ended this quarter with a stellar performance. Our revenue has experienced a 21% year-on-year growth, reaching INR 1,670 million, while our profit after tax has surged by 39% compared to the same period last year. As part of our ongoing commitment to diversifying and expanding our range of medical specialties across all our hospitals, I am delighted to share some noteworthy achievements from quarter three. Our company introduced robotic surgeries marked by the installation of the da Vinci X surgical robot and Stryker's Mako orthopedic robot at a Noida Extension Hospital. We have indeed taken the lead in conducting Greater Noida region's first robotic surgery ever. Furthermore, during the quarter, we expanded our transplant services to include liver transplants. These initiatives underscore our dedication to delivering cutting-edge healthcare solutions and improving patient outcomes. In summary, the quarter has been marked by impressive double-digit growth across most of our specialties. Our gastroenterology and pulmonology revenues surged by 50%+ year-on-year, while our nephrology and urology and cardiology grew 30% year-on-year. Additionally, our oncology revenues surged by more than tenfold on a year-on-year basis. As a result of these strategic initiatives, the share of internal medicine in our revenue mix has decreased to 26%, down from 33% previously, and thus our overall ARPOB reached INR 29,367, up by 14% year-on-year and 7% quarter-on-quarter. Among all our hospitals, Noida Extension registered the highest share of revenue coming from super specialties at around 60% and thus highest ARPOB levels of INR 34,287 during the quarter. Our commitment remains to enhancing our specialty mix, expanding our few oncology services, and creating a comprehensive one-stop destination for all cancer-related treatments. The radiation oncology line has already arrived in our Noida Extension Hospital, and we are expected and set to commence operations in March 2024, seamlessly integrating it with our oncology center. As we advance, our focus remains on expanding our medical tourism business, anticipated to fuel significant growth and enhance the average revenue per occupied bed (ARPOB) in the coming quarters. Ladies and gentlemen, as outlined in our IPO plans, we express our intent to vigorously explore opportunities, including both organic and inorganic, and strategic partnerships to bolster our bed capacity in the forthcoming years. Today, I am delighted to announce that we have signed a definitive agreement to acquire Asian Fidelis Hospital, a 200-bedded super specialty hospital located in Faridabad, Delhi NCR. This hospital was built three years ago on 1.25-acre land. It is equipped with all the latest facilities and currently operates with a bed capacity of 175 beds, expandable to 200-225 beds. The acquisition involves the 100% equity purchase of Pristine Infracon Private Limited at a consideration of INR 1,160 million. The transaction is expected to be completed by March 2024. The hospital is ready to be operationalized immediately as all necessary approvals, accreditations, and empanelment with all major healthcare insurance companies and TPAs are in place, and hence we are confident that this hospital will commence generating revenue from day one. We understand that inorganic growth is not merely about expansion but also about identifying synergistic opportunities that amplify our strengths, extend our reach, and ultimately enable us to serve more patients with exceptional care. And thus, this acquisition fits well with the company's stated approach of expanding its presence in the North India region and further enhances Yatharth's positioning in the Delhi NCR market. At our current capacities, our Noida and Greater Noida hospital reported highest occupancy levels of 90% and 68% respectively during the nine-month period. Our other hospital at Noida Extension has achieved an occupancy level of 42% during the same period, in line with our Noida and Greater Noida hospital. We expect our Noida Extension hospital to reach optimum utilization levels by financial year 2025. Thus, we have already acquired a land parcel adjacent to our Greater Noida hospital and have also been allotted land adjacent to our Noida Extension Hospital in the last quarter. With this land, we aim to take Brownfield expansion towards increasing our Greater Noida bed capacity to 600 from 400 presently and Noida Extension bed capacity to 700 from 450 presently. Overall, we remain committed in our aim to double our bed capacity over around next three years via a mix of both Greenfield and Brownfield expansion. Further, our focus remains on continuing our growth trajectory, creating value for our shareholders, and advancing our strategic initiatives, all while maintaining the highest ethical standards. Your trust and support throughout this period have been invaluable, and we are more determined than ever to propel our company towards success and sustainable growth. I would now like to hand over the call to our Chief Financial Officer, Mr. Pankaj Prabhakar, for the financial updates for the quarter. Thank you, Yatharth. Good morning, everyone. I am happy to announce another robust set of results for the quarter ending December 31, 2023. Our quarterly revenue has stood at INR 1,668 million, recording a robust growth of 21% year-over-year with improvement witnessed across all our specialties. Our in-person revenues were up by 22% year-over-year during the quarter. Our company reported an EBITDA of INR 464 million for the quarter, up 29% year-over-year and 2% quarter-over-quarter. We are pleased to report a significant increase in our margins for the quarter. Our EBITDA margin expanded by 160 basis points year-over-year and 123 basis points quarter-over-quarter to 27.8%, reflecting our continued focus on operational efficiency and adaptability of our business model in navigating market challenges and capitalizing on opportunities. Our profits grew by 39% year-over-year and 7% quarter-over-quarter to INR 295 million, primarily attributable to lower finance costs during the reporting period. As mentioned earlier, the full impact of debt reduction is starting to kick in with our finance costs reduced by 97% year-over-year and 94% quarter-over-quarter during the quarter. This significant reduction in finance costs underscores our prudent financial management strategies, which have effectively optimized our capital structure and reduced our borrowing expenses. As a result of this and flow-through of improved EBITDA, our PAT margin expanded by 220 basis points year-over-year and 154 basis points quarter-over-quarter to 17.7%. Our revenue per operating bed for the quarter improved to INR 29,309, up by 14% and 6% quarter-over-quarter. The improvement was driven by a consistent shift towards higher complexity procedures and was witnessed across specialties, with nephrology and urology, pediatrics, and oncology being key drivers. Bed occupancy for the quarter stood at 52%. Let me also briefly touch on the consolidated nine-month FY 2024 result. Numbers of the company: our revenue grew by 31% year-over-year to INR 4,926 million. Our EBITDA for nine months was INR 1,334 million, up by 40% year-over-year, while our EBITDA margin expanded by a solid 177 points to arrive at 27.1%. Our profit after tax went up by 57% year-over-year to INR 761 million, and TAT margin came in at 15.5%, expanding by 259 basis points. Our average revenue per operating bed for the nine months is INR 28,316, up by 8% year-over-year. The improvement was witnessed across specialties and gastroenterology and pulmonology, growing by over 50%+. Nephrology and urology, cardiology by 30%+. And oncology revenue growing over 10x on a year-on-year basis. Bed occupancy has stood at 53% versus 44% in the corresponding previous nine months. Our balance sheet continues to be strong, with net cash position of INR 2,840 million, which we strive to invest towards our ongoing and planned organic and inorganic expansion as stipulated in our IPO objectives. In essence, our earning momentum remains robust, and we anticipate this trend to persist in the future. I express this with confidence as our growth drivers are clearly outlined in our strategic plans. With this, I would like to hand it over to the moderator for questions and answers. Thank you. 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 their touch-tone telephone. If you wish to remove yourself from the question queue, you may press star and two. Participants are requested to use handsets while asking a question. Ladies and gentlemen, we will wait for a moment while the question queue assembles. The first question is from the line of Huseain Bharuchwala from Carnelian Asset Management. Please go ahead. Am I audible? Yes, sir. So, ma'am, my first question is just wanted to understand in regards to the acquisition. So this acquisition that we have done, can you give us some details as to is it a pre-revenue acquisition or the hospital is completely ready and basically all the approvals, as you said, are in place? So is it currently running with all the staff and everything, or we have to set up staff? We have to do the marketing, and the ramp-up will happen gradually? Also, tell us, I wanted to update as to what are the other hospitals in the region which are the peer competition and whose market share that we'll be able to grab? So if you can give us some details on that front, we'll be very grateful, Yatharth. Thank you. So this hospital was built three years back. It was operational earlier. It was being run by the previous promoter. And then for the last two, three months, this hospital has been paused. But as I said, all the empanelments and all the licenses are available. So the ramp-up will happen very quick in this hospital. Yes, the revenue will start from zero onwards, but we expect it to catch faster given the fact that all the healthcare insurances and some of the government empanelments are already in place. This hospital is in Faridabad. And if you look at the micro-market in Faridabad, this hospital is actually located in Greater Faridabad. And Faridabad is a big healthcare market. The drainage is not just from Faridabad but also from the nearby cities, including the likes of Mathura. A lot of patients come there and that whole belt of Haryana, which is catering and draining into Faridabad. So yes, there are other hospitals also. I wouldn't like to take names of that. But yes, there are big hospitals in the vicinity of around beds of 400 beds, 300 beds, 200 beds as well. And this is already a very fertile and well-established healthcare market of Faridabad, and we hope to reap the benefits of the same. Just a follow-up question on the same. Any reason why the previous promoter exited and they actually sold the and the hospital got closed down? If you can just give us some details on that front. This was earlier owned by a corporate chain of hospitals that also have a private equity investor with them. This hospital was actually. In this specific hospital was 50% owned by them roughly and 50% by another real estate person. I think there was some dispute among both of them, and that is why the hospital was paused. It is a great locality. There are a lot of urban societies coming up and already in that area with a lot of high population, and that is why we expect the same to ramp up. But I think our meeting with all those, both the promoters, are very amicably well done, so there is no further any disputes will come into our picture, so. Okay. So 100% equity back to both the promoters. Whatever their differences, those have been settled, and we are going to get a very clean 100% equity. Okay. And so by when will we be able to start ramping up, and when will we start seeing the revenue? From which quarter we can see this happening? I think we are planning to launch the hospital from April 2024. So from the first day of the new financial year, we should be hoping to get the revenue from this hospital. Got it. Got it. Got it. Got it. And just secondly, on the quarter-on-quarter revenue, when we see there is a slight dip in the revenue, I understand that there was a dengue event which happened in the last quarter. So I think as a result, there was higher occupancy. But any specific reason as to the revenue quarter-on-quarter, there was a slight dip? If you can explain that fact. So I think, see, that is, I mean, if you look at the hospital industry, that is an industry-wide trend. That is nothing specific to us. But yes, being in North India, specific two, three reasons that we did see was this quarter had a lot of festivals and holidays. Diwali was there. Chhath Puja was there. So that does a lot of people in the nearby areas, they go back to their hometown. So the OPDs usually dip in this quarter. The second reason was by late November and December, winter comes in North India, and a lot of fog is there, and due to lower visibility, usually traditionally also, we have seen lesser OPD volumes in this quarter. And I think that's in line with the industry. Got it. Got it. That was the only question. I will get back to you. Thank you. Thank you very much. The next question is from the line of Nirvana Laha from Badrinath Family Office. Please go ahead. Thanks for the opportunity, and congratulations on a strong set of results. So I have a few questions, basic questions around your hospital. So can you tell us if there are any government commitments across your hospital to provide free-of-cost outpatient or inpatient services? Because these typically happen when you're allotted land, etc. So if you can talk a little bit about that. No, absolutely not. So there is no any we are bound from the government side to provide any free of these things. All four properties of ours are absolutely owned by us. So there is no compulsion whatsoever. Yes, the lands that our hospitals own, we have purchased these lands from the local authorities, and it has not been allotted from the government at any subsidy rates. We have paid the market rates. And this is why, at least in the regions that we operate our hospitals in, we don't have any liability to treat any government patients at a reduced price. Got it. That's true also for the new land that you're expanding in Noida, right? Yes. Yes. Yes. Okay. Thanks. So coming to your receivables and payer mix, so I think right now you're at 27% insurance and 37% government-selling payments. So in terms of your internal benchmarks, how is this looking like? Where would you like to be in terms of government, insurance, and cash? And how does it compare with competition, do you think? So I think we are roughly one-third, one-third, one-third across all three segments. That is cash, insurances, and corporates, as well as government. One or the other quarter, one is 5% up and down, and that happens. But overall, I think we are on the similar line. And that is something right now we have capacity to utilize. So we do. There's no specific discussion that one share should be bigger than the other. But yes, we do feel that over the course of a few years, when the share of both cash and insurance and corporate patients should increase up given the fact of the increasing identity of a brand and the infrastructure coming up. And I think that will happen over the course of periods. Okay. Any number as to an aspirational target three years out that you would like to have? No, there is no specific or internal targets also that we have kept for that. Okay. Got it. Can you tell us what, out of your receivables right now, how much is government-linked in terms of the number right now? Say again? Out of your receivables, can you tell us how much is government-linked? So the number on total receivables, and out of that, how much is related to government-linked payouts? And what's the average aging for the government payments? Whatever the debts we have, see, as Mr. Tyagi just mentioned, that we have around 33%-35% of the revenue coming in from the government, yes. But if you see the debtor inventory, you have taken a very potent question. Around 70% of our total debt is from the in spite of the fact that it's around 35% of the total business, around 75% of the debt remains with the government authorities. So we are working on that. We have systems in place, but government debt is high. And it's not even us. It's basically people who are working with the government and the market. This is the same story with them. Right. We are aware of that. Sorry to question. Thanks for sharing the perspective. So coming to your medical tourism, you said that one of the hospitals you want to make it a center for medical tourism. So can you tell us which geographies you are targeting and what kind of marketing or patient acquisition strategy you are already doing? And do you already have a team? How big is it? What's the focus right now? So then in the last two quarters earnings call, what we had mentioned earlier, so we have set up altogether a complete separate international marketing team. And that team is progressing very well. In fact, to be very honest, I'll not take a number, but I'll tell you first quarter versus this quarter, number has grown significantly. But yes, not that which you can tell you that this is a percentage in percentage. But yes, internally, that number has probably doubled in terms of the revenue. The couple of areas which we have focused deliberately because one is that if you look at it, many patients come from the Bangladesh region, which is another very easier market for us. So we are targeting that market. We have a sign-up agreement with the CIS countries. Fiji, there was another country. Recently, we are focusing on Iraq because lots of, as we have started transplant programs, so a good number of transplant patients come from the Iraq government. And we are doing significant progress on our African market. So these are the four, five markets which we are working on. And I think I'm very happy to see the progress. And probably in the next couple of quarters, you'll see significant numbers which we would be able to tell you in the contribution. Plus, airport, next year, this is going to come probably by end of this year, probably. So that is where also hopeful. So we are planning accordingly. And that is what these 200 beds, Greater Noida and Noida Extension [to Tibet], we are planning on the similar line of it. Got it. In terms of margin, do you think medical tourism offers the same kind of EBITDA that you are currently delivering, or will it be EBITDA accretive? So yes. I mean, the international market will always give you much better the ARPOB that will have impact on your EBITDA margin. So that is a well-known fact. But yes, it varies which country, which where you are working, what kind of deal you are there. But yes, it has a significant increase in ARPOB in a procedure-wise. Okay. I have one more question. Can I ask now, or should I come back in the queue? Please go ahead. Please go ahead. Okay. So see, from our conversation, we have understood that right now, ortho-cardio, these departments are sort of becoming basic necessity for any good hospital. They are no longer differentiated. That's what we have understood. So do you think that is true? And if that is true, then which departments are you focusing on as centers of excellence to sort of differentiate yourself? Because Delhi NCR is a pretty crowded market. So your hospitals will be known by which centers of excellence. How is your thinking there? So I think we are growing towards a share now where our super specialties are increasing. So definitely, as a brand grows, the more high-end treatments and more life-saving treatments and life-saving risky surgeries patients opt for, that is always a good benchmark of how a hospital reputation and brand is growing. And that is similar to how our cases of super specialty mix is growing. In fact, as I mentioned in my commentary about the Noida Extension Hospital, our share is already coming from 60% from the super specialties. And this is increasing in the latest months also. And I think as far as creating a different and sort of a niche in the market where we present and what we are doing in terms of different specialties is that is in terms of robotic surgeries. So during the quarter, we started our robotic surgeries. We installed da Vinci X, and we installed the Mako orthopedic robot. So even if ortho and general surgeries are important for any basic and good hospital, but even then, what infrastructure and technologies you have also plays a role. So that's why having these robots in these specialties is really differentiating us in the markets we are present. And that is the route we have taken. Got it. Apart from robotics, do you think any other department you're trying to develop based on the reputation of which you think patients will get attracted to Yatharth? Or is it like a general spec? Yeah. So our whole transplant program, if I say, so bone marrow transplant, kidney transplant, and liver transplant, if you can see if these transplants are happening at any hospital, they require the highest, most standards of infection control in terms of quality, in terms of the medical expertise present. So patients do understand if these levels of high-end transplants are happening, then that means all the other specialties have to be up to the mark in order to support these transplants, whether it be the lab services, radiology services, blood bank services. So developing high-end transplant program is what we are developing as well. And Oncology, definitely, starting Radiation Oncology very soon will be completing this whole suite of services. Got it. Got it. Thank you so much. I'll get back in the queue. Thank you very much. Ladies and gentlemen, in order to ensure that the management is able to address questions from all the participants in the conference, please limit your questions to two per participant. Should you have a follow-up question, we will request you to rejoin the queue. Thank you. The next question is from the line of Dhara Patwa from SMIFS Limited. Please go ahead. Thank you for the opportunity, and congratulations, and a good set of numbers. So I just had one question regarding acquisition of Fidelis. Since currently, it's a zero-revenue hospital, so by when can we expect a bit of break-even for this hospital? And will we be having radiation and oncology unit from day one, or we would be adding it later in the year? Fidelis Hospital, we are not planning a Radiation Oncology unit as of now because we are quite content with the other specialties. We feel the other specialties would be a much key attractor for this hospital rather than just Radiation Oncology. We will be having Medical Oncology. We will be having Surgical Oncology there, but not Radiation Oncology there. Traditionally, if you talk about a bit of break-even, all our hospitals tend to break-even in two years' time. I think this hospital being in Delhi and NCR market should also be no different to that. Within two years, I guess we could see a bit of break-even and thereafter a positive approach trajectory, right? Yes. I think that's correct. Yeah. That's it from my side. Thank you very much. The next question is from the line of Ankur Kumar from Alpha Capital. Please go ahead. Hello, sir. Thank you for taking my question. So my first question is, in terms of if I look at our IPD and OPD volumes, they're down in nine months as well as in Q3 year-on-year. While our revenues have grown. So basically, the length of stay has increased, but volumes have been going down. So any comment on that, please? See, if you look at it, two things. A, in terms of revenue, we have grown. But yes, the volume, it's a degrowth marginally. Reason being, and this is a scenario of probably all hospitals in Delhi NCR or North India particularly, if you see it, because this time, I think winter has extended. Earlier, the end of January, the winter gets over. But this time, even in February, we are sitting. So I think this good, healthy month has increased. Probably one more month has extended. So that's the reason we would say. Otherwise, there's no other specific reason. Yeah. And also. So, nine months also, it's—sorry, sir. Nine months also, it's degrown. Yeah. That's what we are coming to now. And also, see, last year, in this specific region we are in, there was a flu season. So there were a lot of not just dengue was definitely higher last year, but even other flus. There were a lot of pediatric patients with flu and other flu symptoms are there. So that was the seasonal thing. But even then, our revenue has grown because our increase in the ARPOB leading to higher revenue. And it is bound to grow much further ahead. It's not cause of worry, absolutely. Got it, sir. And sir, on Faridabad Hospital side, you said EBITDA break-even in two years. So for next year, what kind of losses at EBITDA level we will have to bear for that? I think. See, Ankur, good question. The thing is that the two years we have said now, first of all, you'll see that the overall size, this is a 116 total bed where the capitalization is not that heavy in spite of the fact that all the specialties we will be running. So we are not going to have a debt finance out of it. So it's a complete because we do have INR 650 million staying with us for the acquisition, and the rest we will be doing from the general corporate reserves. So there would not be a net debt I'm talking because we still have around INR 284 crore of cash lying with us. It could be a temporary arrangement. We do something. Now, second thing come on the depreciation side. So depreciation is not that heavy. We are expecting because it's a mature market, the revenue will be coming very quickly. I'll not be able to give because that's still with a discussion with the management that what kind of revenue are we expecting in 2024, 2025. My expectation, I'm saying that in the second year, we will be having a sizable turnover. That's starting 2025, 2026. We will be having a sizable turnover. In 2024, 2025 also, we will not be having much losses coming out of it. So EBITDA, it would be if EBITDA loss we are talking, it would not be much of drag on the overall financials. And with the momentum we are getting from the established hospital, our EBITDA margins will remain solid the way we are presenting as of now. One thing important to see, this hospital, it's already doing good revenue. It's just that three months pause. That's the advantage we will definitely going to get it. Got it, sir. Last question is on that IT rate that happened. Anything came out on that front? No. I think as we have already stated earlier, there has been no finding as of now in that. We are in compliance with the authorities to settle that case very soon. As and when there's any update on that, we will inform the exchanges. Got it. Thank you and all those. Thank you very much. The next question is from the line of Aashil Shah from CJ Investment Group. Please go ahead. Good morning, sir. Congrats on a good set of numbers. I had a couple of questions. One was, what is the current level of doctor attrition, and what are we doing to control that? Because I believe that was a little bit difficult point earlier on. I mean, doctor attrition is, again, as we have said earlier, very much controlled, less than 10% at the consultant level. And then even in the last quarter, what we talked about, that we started a couple of in-house programs like a DNB and diploma courses. So there is no attrition on even an RMO, which we call it as a floating doctor. So it is very much under control. 10% attrition is, as we said, in the super specialty doctors. I mean, but overall attrition also in terms of doctors has also significantly come down, as Mr. Amit mentioned, the start of the DNB programs. Got it. And sir, what is the importance of having super specialty doctors in terms of drawing the patients in for surgery? How would you view it in terms of importance as compared to other hooks to draw in the patients? So, I think the super specialty is like a general specialty is like you're doing; you're getting admitted for anything. It's like Internal Medicine, surgery, cancer, general surgery, the gynecology problem. But super specialty is when you have a cardiac, neuro, transplant program, or something. So very high-end procedures, you need to have a super specialty because and then super specialty, we add in a business perspective, you see that all these super specialty procedures has a high pricing, and then they will have a good ARPOB, and finally, it will add in EBITDA. So, I think this has to be a good combination because and this is all interlinked. It's with a patient who comes in a specialties. If it looks like we're going to the physicians, and physicians feel that you have a problem with some kind of cardiac, so you have to go to the cardiology department, which are very specialized, and there are lots of very specialized tests for that. So super specialty has a significant distinct. Any good set of hospital having a 300-400 beds kind of have to have a good super specialty. Okay. And, sir. If I can answer yeah, please. Sorry. Go ahead. Go ahead. I think hope it answers your query. Sure. Yeah. Second question I had was on the receivable side. What is our current amount of receivables? Well, receivables, as I said, that, you know, it was answered in the previous question also because we have sizable business coming from government side. So receivables have a little gone up. It's around 100 days as of now because government is a little sluggish in payment. A good fact is that the government has created their information system where we can see that our debts are with the sovereign guarantee. So debt has slightly gone up in this quarter. Got it. So it's 100 days on the government revenue part. I'm talking about the overall, sir. Okay. 100 days. I'm talking about overall. Understood. Sir, Jhansi, quarter-on-quarter, the occupancy has not increased considerably. It's only a 1% increase, although we are barely 20% occupancy. I just wanted to understand, was there any one-off, and what are our plans to ramp? How are our plans to ramp that up faster? So Jhansi is doing pretty well in terms of both ARPOB. It has also increased there. And occupancy, as I said, overall in the quarter was down for the whole group. So nothing specific to Jhansi. As we mentioned about the seasonal dip in this quarter across healthcare industry, so that was also the impact on Jhansi. But other than the seasonal dip, the overall other KPIs at Jhansi are really improving, and we are quite happy of the working of the latest quarter from there. Got it. Thank you, sir. That's good. Thank you very much. A reminder to all the participants, you may press star and one to ask a question. Thank you. The next question is from the line of Prerna from Purnartha Investment Advisory. Please go ahead. Yeah. Hello. Can you guys hear me? Yes. Yeah. So first of all, congratulations on a good set of numbers. So last quarter, we spoke about empanelment. We are looking for empanelment from radiation and insurance for a Jhansi hospital. What has been an update on that and also the land case? I understand for the land case, we've got a stay order, but could you throw some more light on that? And I think our receivable also last quarter was up, and we were talking about how there was a shift in the payment structure. So I believe from the previous I think the query you answered for one of the analysts, I believe that hasn't changed much. Well, about the Jhansi hospital government panels, we have received now more empanelments in the latest quarter, and we have recently received ECHS, which is the ex-Army people empanelment. And Jhansi area is a hub for Army cantonment. So we have received this empanelment in the latest quarter. We have also received more healthcare insurances in Jhansi. And this is the result why we are seeing a good increase there as well. And about the fact that on the receivables, I think Mr. Deepak said. Yeah. I think I've answered it twice, Mr. Prerna. I reiterate that debtors have slightly gone up in this quarter, all because of the government thing coming in, government setup. But our receivables from others, that is, the corporates and insurance, that's pretty much under control and coming down over a period of time. And just lastly, taking a question on the Jhansi land case. So as we have already mentioned earlier, we have received the official stay on that letter from the Jabalpur High Court of Madhya Pradesh. And the hospital is working as normal. There's no impact both at the operational or the financial front because of that. And as we said, we have received the letter from the high court for the stay of that earlier order. Okay, sir. Okay. Thank you. So my last question is, if you look at the tax rate, I think in December 2022, we paid around INR 4 crore, and now we are paying 14 crore. Although I understand the tax rate is somewhere around 30%. So that 12% tax we paid last time, was it a one-off only for that year, last year, December 2022? First of all, correction. What the tax cost you were saying, ma'am, it's the ultimate tax cost coming in. It's not an outflow completely. So first of all, what we and you are saying is a tax cost, not the payout. Because what happens, ma'am, that when we receive money with insurance or government, they usually deduct our 10%. So our deduction of tax is sufficient. So it doesn't go cash out of our bank. Now, second question is about the impact. Now, impact is basically that the two three companies we have, three operational companies we have, that is, Yatharth and AKS Medical Research Center and Ramraja. So Ramraja, there is no tax because we have tons of accumulated losses coming in, and we will be not paying any tax except MAT out of that. Rest of the two companies, this is the conservative approach we have taken up, that this would be the max kind of thing. I expect that with the unfolding of things, we will see little reduction in the next quarter on the tax cost coming in. Very conservatively, we have posted these figures. Okay, sir. Thank you so much for the details, Yatharth. Just one last question. I don't know if I heard it right from the previous questions you answered. You told that it will take two years for the new hospital, that is, the Asian Fidelis, to break even the EBITDA margin. But for our current EBITDA margin, it will be solid. It won't affect. Did I hear that right? You heard it very absolutely and very right, ma'am, because see, you have to see the scale of operations. Now, scale of operation, as I mentioned and as Mr. Yatharth Tyagi mentioned, that our flagship on ARPOB and on EBITDA side is being overtaken by Noida Extension Hospital, where we are handling around 35,000 of ARPOB and very close to 30% of EBITDA coming in. They are the volume and the revenue ramp-up coming in, and so is from Greater Noida and so is from Noida. So this EBITDA, what we are seeing as of now, will be driven by these hospitals, where the new hospital, even if it's making slightly slight losses on EBITDA side, would be compensated by these hospitals, and we will be maintaining these EBITDA margins, expected to maintain these margins in future. Okay, sir. Thank you so much for answering all the questions, and wish you great luck again for the next quarter. Thank you. Thank you very much. The next question is from the line of Siddharth Agarwal from AASN Capital. Please go ahead. Hi. Good afternoon, everyone, and thank you for giving me the opportunity. Congratulations for a great set of numbers in what is seasonally a weak quarter. So Yatharth, my first question is around for this Faridabad acquisition, could you please elaborate a little bit what kind of ARPOB can we expect in this particular micro market where we have this hospital? Will it be similar to our Noida hospital? So yes. I mean, in fact, I would say the ARPOB in that region is definitely because it's part of Delhi NCR. So the ARPOB would be similar to what the Greater Noida regions have. But also, I do feel that it will be more than us specifically should talk about our Noida hospital because in Faridabad, especially in Asian Fidelis Hospital, we will have a good portion coming from a super specialty there, which will be starting very soon. So somewhere between, I would say, between our Noida Extension and Greater Noida Hospital should be roughly the ARPOB for the Faridabad hospital. Great. And Yatharth, you also mentioned that we expect close to optimum replacement for our Noida Extension Hospital for 2025. So do you think current occupancy is closer to 42%? So where can we reach there in the next two years if we can give some trajectory of expected replacement in both Greater Noida and Noida for the next two years? Yes. So as I said, that with the Radiation Oncology coming up from the March, so we do feel that the occupancy will shoot up there. And also, if you look at the existing occupancy of the coming month, existing month, so it is already higher than the last quarter average. And we do feel that we are well on our path towards optimal utilization in that. And similarly, on the Greater Noida, Greater Noida, we feel that we should reach the occupancy a bit faster than there. And that is why we have bought the adjacent land parcels in both of these two hospitals where the capacity would be utilized. Yatharth, so when do we plan to kickstart the brownfield expansion here and any estimate of the CapEx that we would be required to expand to 700 and 600 beds specifically? Yeah. So I mean, the CapEx amount, we've already mentioned in our previous calls. We do expect both Greater Noida Hospital and Noida Extension expansion. The CapEx per bed should be around INR 70,000- 70 lakhs for that, roughly. And with the expansion plans, we're going to start very soon now. As I mentioned, that this time was very cold winters here in Delhi NCR. So I think now, with the weather improving, the construction will kickstart very soon. Great. Today, between Greater Noida and Noida Extension, both of them have the ability to treat super-specialty diseases and tertiary diseases. So where do you see—I mean, the difference between their ARPOB converge at some point, especially with ongoing investments in Greater Noida as well? So how does this trajectory look like to you? Well, I think both Greater Noida and Noida Extension are seeing good increase in the ARPOB. This is to credit to the fact of the increase in the super specialty. In fact, if you look at it from quarter-on-quarter also, our RFOP has significantly increased. Yes, year-on-year, we have increased very high. But even quarter-on-quarter, there was significant increase in the RFOP. This is in line with our approach to build much more on the super specialty front. And of course, with the radiation oncology starting in Noida Extension, the RFOP will increase much more further in Noida Extension and in Greater Noida because Greater Noida Hospital is very close to the Jewar Airport, which is going to start at the end of this year. So international patient share will be quite high in Greater Noida Hospital. So I think that will be a big driver for the ARPOB increase in Greater Noida also in the coming years. Great. Thanks a lot, Yatharth, and wish you all the best to the entire team. Thank you. Thank you very much. The next question is from the line of Priyank Parikh from Abakkus Asset Manager LLP. Please go ahead. Yeah. Thanks. Am I audible? Yes, sir. Yes. Yeah. Sir, I have a very basic question on our business. Sizable revenue of our business comes from the Internal Medicine. Can you throw a light on what exactly this specialty is and what are the growth drivers? So Internal Medicine consists of the Department of Internal Medicine, which comprises communicable and non-communicable infectious diseases and general lifestyle diseases like cough, cold, fever, even dengue, and hypertension. This is what is treated in this branch. It is the physicians, the physician doctors who are part of the Department of Internal Medicine. It was high earlier in our brand. Now, as I also mentioned earlier, it is decreasing in our revenue share because our other case mix of super specialties are increasing. I think the Department of Internal Medicine is a basic necessity for any hospital to have. Initially, when patients come, usually, it is where the patient is identified, okay, if they have a cardiac problem, if they have a gastro problem, and then they are referred to different departments. This is how Internal Medicine functions. With the course of, as already I mentioned, our reduction in our percentage term is going down, and our percentage of other super specialties are increasing. Okay. So got it. So in terms of competition, we must be competing with local dispensaries and secondary care hospitals for this internal medicine rather than the large things. Is it the right way to see it? So you have to understand one thing. Even a patient is coming in the Internal Medicine department, but Internal Medicine department should be supported with a very high-end other department, radiology, high-end pathology, and then other super specialty in the same, right? So patients' preferences will always be to the place where all those super apart from specialties, super specialties are there, right? So that is what as such, there is no competition from the local nursing homes and other reasons. But yes, when a patient choose, they prefer to go to the specialty first. And then from there, there is a diverting to the super specialty depends on whether the issues. So as such, there is no competition with this smaller unit. Even in this department, our competition would be from other corporate chains that are listed and present in our geographies. Okay. They are not specifically classifying this department separately. That's what we are. Okay. Got it. Thank you. Thank you very much. The next question is from the line of Amit Thawani, an individual investor. Please go ahead. Hi, Amit. Hi, Yatharth. Hi, Pankaj. Thank you for taking my call. Am I audible? Yes, Amit. My first question is, can you tell me what kind of occupancy we did about 52% in December quarter? Can you tell me what was the occupancy in January, February? No. I mean, the January, February occupancy will reveal in the results of the coming quarter. But definitely, I mean, the occupancy is bound to increase in this latest quarter as compared to the December quarter. Great. I understand that. But it is materially higher. I mean, is it negative? Yes, Amit. It's materially higher. And as I said, it was a winter effect. So as winter is slowly, slowly going off, I think the occupancy is bound to increase. Okay. Okay. And any guidance if you can give on margins? Are the current margins sustainable, or are the margins also going to go higher? So Amit, as I mentioned, that definitely for this year, we are almost on course, just one and a half months left. So expect that the similar kind of margin we should be ending as of this year. In the future year also, though, I don't want to get into and give any guidance on the future years. But knowing the trends and the way we are increasing, we are very hopeful, and we are very much certain that the current margins what we are putting up should be sustainable in the future as well. Got it. Got it. My last question is, are we break-even yet on Jhansi-Orchha, or can you tell us what the margins on Jhansi-Orchha are right now? Jhansi Orchha, the operation is very small, and it's not much significant. But Jhansi is very significant in our overall strategy. We are a bit positive there. I think we are around 6%-7% a bit positive there, quarter on quarter YTD basis. Excellent. Excellent. Excellent. Thank you. Thank you very much. Thank you very much. The next question is from the line of Naman from Perpetuity Ventures LLP. Please go ahead. Thank you for the opportunity, sir. Just one question. When we see our operational bed versus bed capacity, so we have 1450 bed capacity, which we report. So what could be the operational bed number in it? Because I think one of the earlier the 90% occupancy which you do on I think one of the Noida hospitals is on operational bed. So what would be the operational bed versus the bed capacity number? All our 1,405 beds are operational beds. So that's that. And even at Noida, the operational bed is 250 beds, out of which the census bed would be around 210 and 215 approximately. And on that, we have 90% occupancy. Okay. For the remaining hospital, what would be the census beds? I think that is information we can share with you. I think it's already it's a detailed information and available on the website also. If you want, it can be answered specifically. But otherwise, it's available in public. Got it. Thank you. Thank you very much. The next question is from the line of Nirvana Laha from Badrinath Family Office. Please go ahead. Yes. For giving me another opportunity. So I wanted to understand how the decision for Jhansi was taken and what factors were considered before you decided to open up in Jhansi. Because even Western UP, I think, is a very big market, right? It is like Agra, Bareilly, Moradabad, etc. And how did we decide on Jhansi? I mean, Western UP is also something which excites us. We will also consider any opportunity that comes up in Western UP. And when it comes to Jhansi-Orchha, which is technically in Madhya Pradesh. Orchha is a town in Madhya Pradesh. When we inquired about the property that was available to acquire there and the nearby area and the demographics, we felt that there's a huge catchment that was coming all the way to Delhi NCR because there are not a big hospitals around that area. In fact, our Jhansi-Orchha Hospital would be probably the biggest super specialty hospital even up till the kilometer radius of even up till Gwalior and the whole Bundelkhand area. And there's a huge potential there. And this is why we went there. And we are well in line with the strategy to expand across North India Delhi NCR markets. Okay. So in terms of ramp-up in another one year, where do you see the ramp-up being for Jhansi-Orchha and maybe what kind of EBITDA margins if you already are projecting something? I'm not going to give you a specific number. But if you see them quarter-on-quarter, these two and all those KPIs are increasing. It's even a quarter to quarter three, it has increased. Yeah. And at Jhansi, we do feel that current occupancy in the coming quarter, in the coming year would be much and would be materially higher. And we do feel even the margins there will improve over time. Right. Because correct me, sir, I'm in tier two, tier three maybe. I'm not sure what Orchha is. But in those kind of towns, when a known name goes in, typically, isn't it the case that the hospital is able to do 50% kind of capacity utilization within two years? Yeah. I mean, that's probably a right estimation. But I think we would be reaching that capacity utilization probably from now until maybe a year and a half for sure will be roughly around that occupancy level. Much earlier, I think, roughly a year, yes. Okay. And one more question. Overall, across your hospitals, what is the OPD to IPD conversion rate? So typically, if you look at it, any hospitals, OPD versus IPD, anything between 5%-8% is a good conversion rate. So this is what I think it's there in our setup as well. Okay. In Delhi NCR, isn't the number much higher, like 15%? And 15% is a normal conversion rate in other hospitals? This is answering in a very one sentence would be difficult. It totally depends on where you are, what all the services you are offering. If it's more of the super specialty, this percentage definitely increases. So any hospital who is doing much more super specialty business, this OPD to IPD conversion is always higher. So there's no specific answer to it. But yes, this is what the range what I told you is about the range it goes. But if you do more super specialty, this percentage increases. Got it. So in your Noida Extension, I think you do the most super specialty, right? And that's where you're planning medical tourism and organ transplant, etc. So can you tell us the figure for that hospital? Yes. Noida Extension hospital, yes, we do maximum super specialty business. So there, the percentage would be much better. But similarly, I mean, in a near future, if you see other hospitals also, if you see that these numbers are much better in Greater Noida and particularly now what our expectation for Faridabad as well. In Noida Extension, we are doing roughly around 60% of the business from super specialties. This is increasing significantly even in the coming quarter. We are well in line for that. Right. So is it possible to give the OPD/IPD conversion there for that particular hospital? We'll let you know. I mean, I think we'll request our team to forward it to you. Yes. Okay. All right. Thanks. And all the best. Thank you very much. The next question is from the line of Aashil Shah from CJ Investment Group. Please go ahead. Hi. Thanks again for the questions. Wanted to know what is the eventual occupancy ARPOB and EBITDA margins we can get to in Jhansi and how long we feel will take to get to that? So I think it's difficult to exactly state the figure. But as I mentioned just two questions earlier, we do feel that more than half, more than 50% of the capacity utilization in Jhansi can be reached roughly around one year. And there have been multiple strategies that we're doing there. When it comes to ARPOB, yes, ARPOB will be definitely much lesser than the Delhi NCR market there. But even if we look at the ARPOB that is there currently, we are increasing that quarter-on-quarter basis. And that ARPOB is also bound to increase further as we go forward. EBITDA margin? Just asking because it's a little bit of a different market compared to all the other hospitals we have, including Faridabad. So just wanted to understand where we can get that. Aashil Shah mentioned that for this quarter nine, Jhansi is already a bit positive proposition. So at this level, we are a bit positive, yes. Ramp-up will come because our cost structure is very much variable there. So with the top line coming in, the margins are expected to increase. Right. And the last question is on the overall currently, we're at around 52%-55% occupancy across all the hospitals. So just wanted to know that we have this plan to double bed capacity. Wanted to know the thoughts behind why we are choosing to expand the beds so much more than other hospitals. So the occupancy that you mentioned is at the group level. And individual hospitals have a different occupancy. So when we talk about the Greater Noida Hospital, the occupancy there is closer to 65%-70% in between. Yes, Q3 was a dip in occupancy overall, but I'm talking just in general. So I think we do feel that in a couple of years' time, this hospital will reach optimized utilization there, similar to like we have proven with a Noida Hospital in the past. So that's where the capacity the reason to expand Brownfield expansion in this hospital exists. And also in Noida Extension Hospital, as we mentioned, that with the Radiation Oncology coming up in March, we do feel that probably in 2.5 years, this hospital will also reach capacity optimization. And that is why we are adding beds. Also, it is not just in line with the occupancy and the bed capacity. When we add any new infrastructure to a hospital, we get it up to date with the latest infra possible. It is very important to constantly upgrade your infrastructure, your rooms, your patient waiting areas, your OPD areas. We have so far been a very high bed capacity hospitals in the region we operate in. In the future also, with the competition coming in, we would like to continue this highest bed capacity in the region. This is why also we are upgrading our hospitals. Okay. Got it. Thank you. Thank you very much. In the interest of time, that will be the last question. I now hand the conference over to management for closing comments. Thank you very much. Thanks for your faith and trust on us. I think we'll keep on delivering good results. Q4, we expect that will be much better as every hospital thing. We are also doing great next one and a half months. I'm sure. Let's meet up after Q4 results out. Thank you very much. Thank you, everyone. On behalf of Ambit Capital, that concludes this conference. Thank you for joining us. You may now disconnect your lines. Thank you.