Hello, everyone. This is Ahmed Moataz from EFG Hermes, welcome to Care Medical's first quarter of 2026 results conference call. I'm pleased to be joined with Dr. Abdulaziz Al-Obaid, Chief Executive Officer, Jahanzeb Khan, Chief Financial Officer, Syed Mohammad Naseer, Chief Strategy Officer, and Alia Balbaa, Director of Investor Relations and Project Management. The company, as usual, will start with the presentation, then we'll open the floor for Q&A. Dr. Abdulaziz, please go ahead. Thank you, Ahmed, good afternoon, everyone. We'll go over the presentation where we are gonna start first with the operating and performance highlights, then we'll move on to the financial performance. To close with, we'll go over the strategy update. Going on the first slide with the operating and financial performance highlights. During the first quarter of 2026, we reported a revenue of SAR 388 million versus SAR 385 million last year. Operationally, we continued to deliver growth. Total patient volumes increased by 9% year-over-year. This volume growth came despite the full impact of Ramadan and Eid being falling entirely during the first quarter of 2026 compared to 2025, where we had 10 days of Ramadan and Eid falling into quarter two. That demonstrates sustained demand on our services offerings. Our total number of beds currently is at 1,185 beds, while the occupancy remained healthy at around 82%. We also saw a reduction in the average length of stay, which is consistent with the case mix shift towards shorter stay, lower acuity treatments during the period, where patients do prefer to delay their complex surgeries until the end of Ramadan. We operated with an EBITDA of SAR 92 million versus SAR 123 million of last year, and the net profit is at SAR 52 million compared with SAR 85 million of last year. Jahan will provide you with the financial details shortly. Overall, this quarter reflects a well-understood seasonal and cyclical pattern where timing effect, particularly Ramadan and Eid, temporarily impacts the case mix, the payer activity and profitability. These effects are not structural, and we have seen them reverse consistently in previous periods. As activity normalizes, we expect case mix and margins to progressively recover. Of note, we notice an encouraging early signs of recovery during the month of April that has been materialized with volumes and payer activity beginning to normalize, and we expect this momentum to build up through the remainder of 2026. Going over the operational performance, the full 2026 focus. Building on our strong operational base, our focus in 2026 is centered around a number of targeted initiatives to support growth, enhance margins, and strengthen our platform. On the left, you will see that starting with capacity expansion, we continue to add the targeted capacity in high growth areas, including the development of Al Narjis Hospital, as well as incremental expansion within our existing networks, including the addition of 20 beds at Al Salam that had been completed and awaiting the final approval from the MOH. On service line expansion, we are focused on scaling high demand and specialized segments. This includes continued growth of Relive Mental Health platform alongside the introduction of new service lines. We're also expanding our services in Jiwar, where we're installing a cath lab that should be ready to operate before the Hajj season. That will be the only cath cardiac catheterization facility in the central Haram area, where previously all patients were referred to hospitals outside the Haram central area. That supports higher acuity, higher value procedures. Third, we are working to optimize payer and revenue mix by growing volumes through stronger engagement with GOSI, as well as improving pricing dynamics with insurance providers, which will reflect positively on margins over time. Currently, we're in ongoing negotiations with insurance companies to increase the prices of our top procedures. In parallel, we continue to advance digital integration across the network, leveraging automation and data analytics to improve the resource allocation, enhance clinical outcomes, and maintain disciplined cost control. Finally, a key area of focus is the Care Academy and talent development, where we're advancing partnership with universities to expand our Care Academy and support the development of sustainable pipeline of clinical talent while enhancing training and clinical standards across the network. With that, I will leave the floor to Jas to take you through the financial details of Q1 2026. Thank you, Dr. Abdulaziz. Good afternoon, everyone. I will now take you through our first quarter 2026 operational and financial results. We delivered encouraging volume growth during the quarter, despite the full impact of Ramadan and Eid, which typically results in softer activity levels and a shift in patient behavior. Total patients increased by 9% year- on- year, including 16% growth in inpatient admissions and 9% in outpatient visits, reflecting continued strength in underlying demand. In outpatient, growth was led by our Malaz branch, which saw strong increase in activity alongside continued growth at Al Salam and Al Haram branches. Al Rawabi remained broadly stable, reflecting the expected slowdown in GOSI-related activity during the Ramadan and Eid period, with fewer working days translated into lower referral volumes. On the inpatient side, admission growth was supported by higher activity at Al Malaz and Al Salam branches, as well as the continued ramp-up of newer capacity. At the same time, the nature of the activity shifted during the quarter. Surgical growth was more moderate, reflecting the deferral of higher acuity elective procedures due to seasonality, while average length of stay declined, consistent with a higher share of shorter stay, lower acuity cases during the period. Overall, the quarter reflects strong patient inflows despite seasonal headwinds with the impact of Ramadan and Eid, primarily visible in payer mix as well as case mix and complexity rather than demand. Moving to the income statement, revenue remained stable year-on-year at SAR 388 million in the first quarter. The key dynamic in the quarter's revenue performance is the shift in case mix and payer mix. During Ramadan and Eid, higher acuity elective procedures were deferred, with activity shifting toward lower-paying and lower-margin segments, which reduced revenue per patient. This is reflected in lower average revenue across both inpatient and outpatient activity during the quarter. At the same time, costs increased primarily due to our continued investment in our staff. Operating expenses were also higher, reflecting both business expansion and the ECL comparison versus last year, which benefited from a relatively higher reversal. As a result, profitability declined year-on-year. Overall margin movement during the quarter was primarily driven by the seasonal shift in case mix and payer mix, alongside higher operating costs and the year-on-year ECL comparison. These are largely seasonal and timing-related factors rather than reflective of any underlying change in demand or operating performance. Looking at revenue in more detail, at the facility level, performance was broadly stable, with some variation driven by seasonal factors. Al Rawabi declined during the quarter, mainly reflecting slower GOSI-related activity during Ramadan and Eid. Al Malaz remained stable and resilient, while Al Salam was broadly in line with last year as it continues to ramp up. The strongest performance came from our newer assets. Al Haram more than doubled its revenue, and Relive, the mental health facility, also delivered strong growth, reflecting continued progress in scaling the recently added capacity. Pharmaceuticals also supported the top line, growing year-on-year. On the payer side, insurance was the fastest-growing segment. GOSI revenues declined during the quarter, reflecting a seasonal slowdown in referral activity, which was more pronounced this year due to the full overlap of Ramadan and Eid. It is important to look at this in context. GOSI has followed a strong long-term growth trajectory, delivering a CAGR of 16.8% between 2021 and 2025. What we are seeing is a predictable cyclical pattern rather than any structural change in demand. Q1 has consistently been the weakest quarter for GOSI referrals and has recovered in subsequent periods. In April, we are already seeing GOSI's revenue recover versus the Q1. This shift in payer mix towards insurance, currently priced at lower rates relative to GOSI, has impacted average revenue per patient. We are in active negotiations, as Dr. Abdulaziz mentioned, to revise these rates, which we expect to be an uplift going forward. Cost of revenue increased during the quarter, primarily due to continued investment in people to support the group's expanding network and service offerings. Spending on medicines and consumables also increased in line with patient volumes and surgical activity. Revenue per case declined due to the shift in case mix, while a large portion of the cost base remains fixed or semi-fixed. This resulted in cost of revenue increasing as a percentage of revenue. Gross margins were impacted during the quarter, primarily reflecting case mix dynamics rather than any change in underlying cost efficiency. Operating expenses also increased, reflecting the expansion of the business and the year-on-year ECL comparison. Overall, the cost profile reflects a combination of planned investment in growth and temporary pressure from payer mix during the quarter, consistent with the seasonal dynamics that we have discussed. The main movement during the quarter was the increase in trade receivables, which rose significantly as collections slowed during Ramadan and Eid. This was particularly visible across key payers, including GOSI, insurance, and government entities, where settlement cycles were affected by the seasonal timing of the quarter. As a result, working capital requirements increased, with day sales outstanding rising and the cash conversion cycle lengthening, both consistent with slower payer settlement during the period. Cash remained healthy at SAR 505 million, providing sufficient flexibility to support operations and ongoing expansion. Net debt increased during the quarter, reflecting the continued funding for Al Narjis development, lease related obligations, primarily relating to the long-term radiology equipment agreement with Siemens, and the seasonal working capital buildup linked to receivables. We expect these metrics to improve as collections normalize in subsequent quarters. The increase in receivables during the quarter reflects a seasonal slowdown in payer settlements during Ramadan and Eid rather than any deterioration in demand or activity. Insurance receivables also increased in line with strong growth in insurance revenues and the higher contribution of this segment to the overall revenue mix. We continue to actively monitor collections and remain focused on improving the receivable cycle. We have already seen post-quarter payment activity, including collection from GOSI in April, and expect further inflows in the near term. This reflects a normalization of settlement cycles following the seasonal slowdown. Operating cash flow was a net outflow of SAR 28 million in the first quarter, compared to an inflow of SAR 157 million in the prior year period. This change is primarily driven by working capital movements, with SAR 129 million outflow this quarter versus a SAR 33 million inflow last year, reflecting the receivable dynamics discussed earlier. This is a seasonal and timing driven movement, and we expect it to reverse as peer settlements normalize over the coming quarters. Capital expenditure increased to SAR 52 million from SAR 23 million in the first quarter of last year, primarily reflecting progress on Al Narjis Hospital development. Financing inflows of SAR 55 million reflect drawdown on credit facilities to support both working capital requirements and ongoing investment in Al Narjis. As of 31st of March, the group's cash balance stood at SAR 505 million, providing strong liquidity to support both operational needs and strategic expansion. I will now give the floor to Naseer to walk you through the strategy refresh pillars. Good afternoon. I'm going to be taking you through the journey of our strategy. Looking ahead, our next phase of growth is driven by a combination of disciplined expansion and platform development initiatives. At a high level, our strategy focuses on expanding capacity, strengthening our network footprint, and enhancing our operating model to support long-term scalable growth. This includes a balanced approach across greenfield developments, selective acquisitions, and the rollout of outpatient clinics alongside continuing investment in digital and AI capabilities, and this will support scalability and improve clinical decision-making. Together, these initiatives position us to grow efficiently, improve accessibility, and deliver sustainable value over the long term. Next slide, please. I'm going to walk you through the key components of our expansion strategy in a bit more detail. Starting with M&A, we continue to pursue disciplined, highly targeted opportunities that are value accretive and are aligned with our long-term strategic objectives. We are focusing on assets with a minimum of 150 beds in core markets such as Riyadh and the Western provinces. Our recent acquisitions validate this approach. We have successfully integrated those assets with volumes being ramped up and synergies materializing, supporting growth across the platform. Most importantly, based on our experience over the past few years, we have developed strong capabilities in executing turnaround. Al Salam is a very good example of this. It was a loss-making asset for several years that we were able to turn around within a relatively short period. We remain open to similar opportunities going forward, where we believe we can create meaningful value through operational improvements and integration. Going towards the organic side of expansion, Al Narjis Hospital remains a central pillar of our growth pipeline. This is a 400-bed greenfield facility in northern Riyadh, targeting the premium segment with a total planned investment of approximately SAR 1.4 billion. Construction is progressing very well, with capital deployment also in line with plan, and we remain on track for a 2028 opening. In the Western Province, our Jeddah Greenfield project will further strengthen our presence. This expansion is going to be in the Class B segment, which is underserved in Jeddah. This will be a phased rollout, starting with 150 beds and scaling up as utilization builds, reinforcing our dual-core strategy across Riyadh and the Western Province. In parallel, we are progressing a clearly defined expansion pipeline targeting the addition of five to eight new facilities by 2032 through a combination of greenfield developments, selective acquisitions, and outpatient clinics. The first clinic rollouts are expected from 2026 into early 2027, which will provide a capital efficient model to scale and improve patient access. Alongside this, we continue to evaluate a solid pipeline of opportunities focused on the right specialties and geographies where we can drive returns and integrate effectively. I will now hand it over to Dr. Abdulaziz for closing remarks. Thank you, Naseer. As a closing remark, I want to highlight something that I believe is fundamental to how we operate as a management team. That is in the alignment between the management interest and the shareholder interest. As part of this, we have introduced the long-term incentive plan, the LTIP, for senior management, which represents a significant and meaningful component of compensation. The LTIP was structured around a set of clear performance criteria, including profitability, return on invested capital, completion of Al Narjis, and the delivery of key expansion milestones. These are the metrics we believe best reflect the long-term value creation. In particular, the management is incentivized to deliver on the same outcomes that matter to the shareholders, which is disciplined growth, strong returns, and consistent execution. In simple terms, when we create value for our shareholders, the management shares in that success. With that, I concluded the presentation, and we're happy to take your questions. Read the questions out to management. We'll start with questions from the line of Fahad Al-Dakhil. Please unmute yourself and go ahead. To everyone, please, we have a long queue ahead. Keep yourself to two questions, and if we still have time, I'll reopen the mic for you. Salam Alaikum. This is Fahad Al-Dakhil from SAB Invest. Thank you, EFG and management for the presentation. I have two questions from my side regarding GOSI revenue. During the fourth quarter, management, you mentioned that GOSI case mix have been, there was a recovery in the case mix that you witnessed after the end of fourth quarter. If we look to data to GOSI patients, for Q4, GOSI patients grew by 6%. Revenue from GOSI was down by 9%, and the same trend continues during the first quarter of 2026. Revenues are down on a year-over-year basis by 17%. What's the reason behind that? Is it a pricing dynamics change between Care and GOSI? If we look into patients, they are growing. My second question is regarding the net, that we saw a significant spike during the quarter, reaching SAR 225 million net debt. We should assume that debt increased significantly. What is the use of the proceed, any in the short term? Thank you. Thank you, Fahad. Yes, we did notice a decline in the revenue from GOSI during this quarter. If we split the quarter into three months, we did notice an increase in the revenue in January, but then a decline in Feb and March. Feb being and March falling within Ramadan and Eid period. If you look at the historic figures, mostly it was quarter one. Despite that, Ramadan used to be midway between quarter one and quarter two. In the previous years as well, we've seen recovery in quarter two. In April, we did notice a very good recovery of GOSI compared to the previous months and the previous year. There was no price adjustment or changes in GOSI. The case mix, yes, it did differ because, you know, if you have less injuries, less complicated procedures, that will impact the revenue as well. Regarding your question on net debt, we have drawn down facility from our banks, and its primary purpose is to fund the construction of Narjis facility. We haven't used the fund for any other reason. Start of any, to confirm that starting from April, there was a pickup in patients, patient number and the case mix, and you expect it to continue going forward? Um- In line with our previous experience, yes. Yes. We did witness in April a recovery in both patient volume and better case mix. We did witness this. Now, we still have the remainder of the quarter. I think, based on the experience and from what we are seeing now, there should be a very good recovery. Can you quantify the percentage growth? I'm afraid we cannot quantify it, but I can tell you that there is a good recovery. We're engaging very actively with GOSI, and our relationship remains excellent. We have no issue in terms of the relationship, the referrals, the KPIs, et cetera. We believe that this is mostly seasonality and it will recover, inshallah. Thank you. Thank you. We take questions from the line of Pratik from ENBD Saudi. Please unmute yourself and go ahead. Thanks a lot for the call. Am I audible? Yes, you are. Yes. Yeah, this is Pratik from Emirates NBD. I have two questions. First, you know, building upon Fahad's questions, basically. Can you tell us, let's say if we compare four months 2026 to four months 2025, for the overall business, has the revenue and gross margins in line with last year or still tracking downwards? The second, you know, we were expected to see some insurance price hike in Q1, right? Where are we on that? Have you seen any price hike from the insurance or we expect it to, you know, delay to Q2? Yeah, these are my two questions. Yes. I don't think we can compare the first four months of 2026 to 2025. What I can tell you is the same what I have told Fahad before, is that we're seeing a very good recovery in GOSI and overall in April. Frankly, that's what we expected. In terms of the price negotiation, we're still actively engaged with the biggest insurance companies. You know, it's not an easy negotiation. I mean, they hold their sand. We hold our sand firmly because we know our capabilities, we know our level of services, and we do believe that the prices have to be reconsidered significantly. You've seen no impact in quarter one for sure, and Inshallah it will be visible in quarter two. Got it. Yeah, just on the margins, you know, because margins, at least in Q1, has significantly declined. Just for us to get some comfort for the whole year, do you expect, like, how should we look into the margins? Like, should we expect it to be similar or slightly lower? Because if I just take Q1 and into account, it's a big decline. If you can just comment for the whole year, how should we look into gross margins? Although we don't give guidance as per policy, but definitely with the GOSI, having higher average revenue per patient compared to insurance, we do expect significant improvement in our margin profile for the remainder of the year. All right. Thank you. We'll take questions from the line of Mosad Khadir. Please unmute yourself and go ahead. [Non-English content]. Am I audible? Yes, you are. [Non-English content]. Yes. Hi. Thank you management for the presentation. I have two questions from my side, and all of this question will be in terms of client patients. At first, I want to talk about the MOH revenue. I saw, like, it was a flat. However, I believe the company has mentioned last quarter that there will be a repricing. Should that mean that there was a lower patient flow during this quarter? No, I don't believe we mentioned MOH as subject to repricing. It's the insurance company that we are negotiating with aggressively for repricing. You may have perhaps referring to Al Salam that it doesn't have all the accreditations that are available to get, give it a price bump, and we are working towards achieving those accreditations. One accreditation should be forthcoming in the next couple of quarters, and we will have a positive impact of it. The large main one is the HIMSS, but that requires a significant investment in the IT systems. That will take some time. Yes, we are working towards increasing the accreditations that are available to Al Salam. Yes. This is in regard to MOH, you mean, or the insurance? Yes. Yes. For the MOH? Yes, MOH. Yes. MOH. Yes. Okay. We're negotiating as well the prices of the insurance companies for Al Salam. Yeah. Yes, this is my second question. I believe it should be at end of January, and I just want to know if you may quantify the price adjustment for the insurance or not yet has been finalized. It hasn't been finalized, yet. We're, you know, negotiating the prices with the insurance companies across all hospitals, so Rawabi, Malaz and Al Salam. Rawabi and Malaz being in the same group and Al Salam, being in the C class. Projections, how, any, if you may quantify projections, how much it will may increase? We cannot quantify it now, but we're aiming for a significant increase. Okay, great. Thank you, management. Thank you. We'll move on to questions from the line of Hikmat Serahi. Please unmute yourself and go ahead. Hello, am I audible? Yes. Okay. Thank you, gentlemen, for the presentation. Two questions from my side. The first one is regarding your OpEx. I noticed that it has been accumulating consistently for the previous quarters as well, and I understand part of that was attributed in Q4 to professional fees. When I look at the employee cost, and especially as a percentage of revenue, I noticed that it has increased massively. If you can shed some light on the increase in the employee cost, what could it be attributed to? Is it due to the similar trend that we're seeing across the industry that there is a spike in employee cost for talent acquisition, or is it for perhaps addition of new sub-specialties? What could be the reason for this? That's my first question. My second question is regarding your Jeddah expansion. We noticed a trend over the previous years that players are expanding into the western region and it's becoming increasingly competitive. How do you view the dynamics of the western region in light of the expansions by other players? Is it the land that you're building on, the one that you acquired a few years ago, the same one? Still you're gonna acquire another land for that project? Thank you, Hikmat. Yes, there's an increase in the manpower cost because of the higher salaries of the talents, mainly the Saudi talents. This trend is all across the other providers as well. However, we don't expect it to increase significantly as we expect the revenue to improve, the cost of the manpower as a percentage of the total revenue will still remain as per the previous years. In terms of the Jeddah land expansion, it will be on the same land that we did acquire a few years ago, two years ago. The segment seems to be more or less saturated in the A-class VIP segment, so that's not our target. What we're aiming for is the B class, and we believe that there's a shortage in the B class hospitals in Jeddah. Okay. Very clear. Just to follow up on the margin pressure that we saw. If I look at the revenue per inpatient on a quarter-over-quarter basis, it wasn't a decline. It's mainly coming from employee costs and operating leverage of the business because it doesn't seem that the revenue per inpatient has declined on a quarter-over-quarter basis. No, average revenue has declined compared to previous quarters. It, you can say, is exacerbated by the manpower cost because throughout quarter two of 2025 till quarter one, we have been investing in our people as we offer more specialties and services to our patients. You're referring on the per patient on a blended patient basis or on an inpatient basis? On a blended patient basis. On a blended. Okay. Because on an inpatient basis, it hasn't declined. Just to clarify that. Okay. On a blended basis. Okay. Okay. Very clear. That's a common ask, yeah. Very well. Best of luck. If you will, we will share our data pack as well, and you will see that there will be a decline in inpatient as well. Yeah, yeah. It is there. It was, for example, in Q1 2026, SAR 4.93 per inpatient, and in Q4 2025, it was around SAR 4.5. Yeah. Okay. It's very clear. Thank you very much, gentlemen. Okay. Thank you. Thank you very much. Move on to the line of Ricardo from Morgan Stanley. Please unmute yourself and go ahead. Hello. Thanks for taking my question. I just wanted to confirm something you mentioned before. In April, the GOSI patients have recovered both on the volumes and on the complexity compared to a normalized level. The second point, when you mention about M&A as one of the levers for your growth, how are you seeing valuation on some of the private assets? Just yesterday, we saw two of your peers announcing a transaction on a Class B hospital in Riyadh. Is that something that you looked at this asset? How are you seeing competition for some of those private hospitals? Thank you. Thank you, Ricardo. Let me take the first question. Yes, we're seeing a recovery in both, volume and case mix complexity. For the second question, Naseer, do you want to take it? Yeah. Ricardo, on the question on in terms of assets while we are continuing with M&A, keep in mind, when we look at assets, surprisingly, over the past year, we have seen quite a few single assets starting to come up. It is usually fall into two categories. It is usually either players who have started constructing an asset to capitalize on the growth of Riyadh but do not have the funding nor expertise to continue with it, or assets that they have set up but their strategy change and they have shifted out. We are seeing some assets come out. In terms of specific assets, you know, announced by others, I cannot confirm or deny whether we were in the bid process for any of those assets. What I can say is that as far as an active M&A pipeline is concerned, it's quite active, and at any given point in time, we are evaluating and looking at multiple opportunities. We are very mindful of the fact that we have capital to deploy, and this is what we are focused on to make sure we get the value accretive returns out of that. Okay. Thank you. We'll take questions from the line of Aarun Jean from Derayah. Please unmute yourself and go ahead. Am I audible? Yeah. Yes, you are. Please, go on. Yeah. Yeah. Just a couple of brief questions. If you look at your cost of sales on a sequential basis, fourth quarter versus first quarter, we see an increase, that is despite the fact that the volumes came down. I presume that the variable cost came down, but there was some increase in fixed costs on a sequential basis. If you could elaborate on the reason for that would be helpful. The second one is, did you experience any inflation with regards to your cost of drugs and consumables because of this current ongoing crisis? Thank you. Those are my two questions. Okay. I'm sorry, so, your first question was? That's regarding the cost of sales. Yeah. So you- The cost of sales from quarter four to quarter one, yeah? Yes. Yeah. It's mainly, again, mainly driven by manpower costs. As we've said, we are investing in people, and specialties which are going to deliver revenue in the coming quarters and years. Right? Okay. Okay. Now, as far as your question on cost of supply chain due to the ongoing geopolitical issues, yes, we have seen increase in shipping costs to our suppliers because we generally purchase from local suppliers, but they are suffering from higher costs, and we are managing it as well. The consumable, the cost of the logistics, did it have material impact on the first quarter results? To a certain extent, yes, but because we also carry inventory from previous periods. Okay It's a mix. You will continue to see some impact in quarter two and some in quarter three as well. Okay. Thank you very much. If the situation, Okay continues. Okay. Thank you very much. Welcome. Thank you. We'll take our next questions from the line of Mohammad. Please introduce yourself and go ahead with your questions. Yes. Good morning. This is Mohammad from MERAS Investment. I just had a question. Can you please clarify whether GOSI has been referring to other hospitals and the intensive intensity? What is the commercial incentive for GOSI to remain dealing with Care? We cannot confirm a number whether they have referred to other hospitals because we don't have access to the number of injuries reported in Riyadh yet. What we can say is that we remain a preferred partner given our expertise and the quality of care that we have built over the previous decades. I don't have access to the numbers, so I can say there is a decline of the overall referrals from GOSI or not. That's something that simply we not have. What I can tell you is that our relationship remains strong with them and we engage with them on regular basis. If there were to be an alternative to Care for GOSI, who would it be? I'm not sure I understand the question. Yani alternative, GOSI will prefer another provider? Yes. Uh, I, I- Unlikely because. I wouldn't speak for them, so I cannot tell you whether they would prefer. I can tell you, looking at, you know, with all due respect to our competitors, you know, some of the cases requires lots of expertise. In fact, it was an attraction point to some of the highly qualified physicians in rehab and reconstructive surgery. From a quality perspective, focusing on the GOSI aim to rehabilitate the patient, make sure that there is limited disability and faster return to work, we have proven over the past years that we're the right partner. Can you give us an indication of what GOSI revenues will be for 2026? Yeah. I'm afraid we don't give this guidance. Sorry, just to follow up. Is there any reason, like apart from seasonality, that GOSI revenue is down? To our best analysis, no. Okay. Thank you. Thank you. We'll move on to questions from the line of Faisal Suleman from Alpha Capital. Please unmute yourself and go ahead. Hi. Am I audible? Yes. Thank you, [Ahmed], for arranging the call. I only have 1 question from my side. Could you give us further clarity on GOSI? Yes, we acknowledge that you attributed the decline due to seasonality. However, if I look at Q4, there was a clean drop as well, even in unseasonality factor. My question is there any other reason that the decline in GOSI could be structural, instead of seasonality driven? Yani, for example, perhaps lower spending on gigaprojects or, the completion of many of them, which could drive the revenue from GOSI lower? Thank you, Faisal. Yeah, this is an excellent question. If you look at 2021 to 2025, there's always growth. The CAGR is 19%. That will just give you an indication that there is an overall growth in GOSI. Yes, there's a dip here and there. I cannot comment on the projects, but what I can tell you is that still we have to build, I think five more stadiums in Riyadh for, in preparation for the World Cup. New Murabba is coming up. Expo is coming up as well. I believe that there will be continuous growth in the pipeline in terms of construction. Unfortunately, the growth in construction comes with injuries, which is unfortunate. However, we don't expect this to slow down as there are deadlines to meet. What we see is that these projects are going on, the World Cup and Expo, so we don't expect a decline in the construction. There's no structural changes with GOSI. As mentioned, we believe that we're their preferred partner because of our experience dealing with the trauma of these cases. Okay, thank you so much. That was very clear, Doctor. Thank you. Thank you. We'll move on to questions from the line of Maha Almarwani. Please unmute yourself and go ahead. Maha, please try to unmute yourself again. I think there is an issue, Maha. I just sent you a request for you to unmute. All right. Until Maha is able to resolve this, either try again or please send your questions via the chat, and I'll move on to questions from- Am I audible? Yes, you are now. Please go ahead. Yes, we can hear you. I have two questions. With the increase in manpower costs that as we've seen the, for the industry and the slowdown in GOSI revenue in the first quarter, do you expect to surpass net income level of 2025, or should we expect a flat net income growth this year? This is my first question. My second question is, can you give us more color on the M&A strategy that you're focusing on? Do you have a CapEx in mind, or should we expect any M&A announcement by the end of this year? I'll take the first question, and Naseer will answer the second one. We don't give guidance on for the remainder of the year, so I cannot comment whether it's gonna be above or similar. What I can tell you is that we're following a strict business plan with budget assumptions, and it's entirely linked to the shareholder's interest, and that's what is being built in the incentive plan of the management. The second question, Naseer will take it. Yeah. As we highlighted in the presentation, our basic focus is on the core geographies of Riyadh and the Western Province. Practically, what we are looking at are assets that we can scale up, drive value or turnaround, and we are looking at ideally a spot of 150+ beds, right? Now, as I mentioned earlier, we do have an active M&A pipeline, we are evaluating multiple opportunities at any given point in time. It's very difficult to say when the announcement for an acquisition will be, because M&A, by its very nature, is not very predictable. A lot of things can happen from the time you submit a non-binding offer to the time you can actually get to signing you know, the SPA. It's very difficult to predict. However, what we do want to do, and this has been our commitment all along, is that M&A for us is a core lever. Therefore, we will attempt to execute as many of those opportunities as we can in any particular year. Now, in terms of a CapEx or a ticket size, while we do not disclose exact numbers, the way to look at it is if you look at the capacity of our balance sheet. Our balance sheet is mostly unlevered, and we do have surplus cash, so we do want to move to an optimal capital structure that is beneficial for our shareholders, which means that we can deploy quite a significant portion of our balance sheet capacity to pursue M&As of decent size and above. That's very clear. Thank you. All right. We have questions from the line of Madhu from Rashi Capital. Please unmute yourself and go ahead. Thank you, Ahmed, for the opportunity. Two questions if I may. First is related to your net debt, increase in Q1 compared to Q4. You mentioned that, the, some, funds were drawn for Narjis's development. When I look at the details provided in the press release. A substantial chunk of the increase came from the lease liability related to, radiology equipment. Could you provide more details about it? Is this, you know, new equipment that you have added? If yes, then what would be the lease, expenses on an annual basis? This is question number one. Second is a follow-up, related to GOSI patients. Can GOSI send the patients to MOH-affiliated hospitals? Who are the other partners in Riyadh, where, you know, GOSI patients, could be referred? These are my two questions. They will not send them to governmental hospital, except if it's life-saving, they have to stabilize the patient and, you know, the governmental hospital is just across the road. In general, no, they will refer them to the private sector and mainly to us. Regarding your first question on net debt, yes, we did withdraw for the facilities were withdrawn for the Al Narjis construction. The lease arrangement, it is with Siemens Healthineers. What we have entered into is a 10-year long-term contract for all of our hospitals, the existing ones. They are providing us radiology equipment, state-of-the-art, and they are responsible for maintaining them, providing support, training to our people. It's a very strategic partnership that we have entered into with Siemens, and they will be responsible for replacing those assets as well under this contract. It's a majority of the assets will be acquired in the first two years of the contract, which started earlier this year. Yes, you will see the lease, the amortization of the lease asset in each quarter. It's around SAR 3.6 million per quarter. Okay. Did you recognize anything in Q1? Yes, we recognized the lease asset, the liability. The, it's SAR 157 million discounted liability and asset that we have recorded. Okay. Are these new equipments or would you be replacing, I mean, these equipments are additional to what you have or would these equipment be replacing the existing ones for what you had last year? They are replacements. Replacements. Okay. One follow-up on clinics. You have plans to add clinics, which is encouraging. We have seen this, you know, with other hospitals also. Could you provide more details, like what part of the country would you be doing? Would that be Riyadh or would that be a combination of Riyadh and Jeddah? Anything on CapEx and timelines or how many clinics you target by 2030? I can take that one. Look, the clinics will remain within our core geographies, which is Riyadh and the Western Province, because the purpose behind the clinics is to actually build an integrated medical network, right? What we are going to target is we are going to target clinics between 2026, 2027. We will stabilize them, look at the proof of concept and how we can best fit them within to our network, and then we'll roll out the next. What I can say for now is that we are definitely targeting to have at least one clinic operational during 2026. Okay. One this year, and what about next year? I said at least one this year. For the rest of, for 2027 and, rest of 2026, I can't comment, but I'm saying the bare minimum for us is one this year. In Riyadh. In Riyadh. You'll start with Riyadh. Okay. Yeah. CapEx, is it possible to give some details on CapEx? Like how much would it be leased or the land would be owned? Look, we are not currently giving that guidance, but what I can tell you, it's going to be a very CapEx light model. Okay. Thank you. That's helpful. Thank you. I'll move on to questions from Sorry. Questions from the chat before I go back to check if anyone has follow-ups. Ibrahim Atieh is asking, "Can GOSI patients defer their surgeries? Can GOSI patient defer their surgeries? No. GOSI patients, mostly they're acute cases. When we say, defer cases, it's for the, like a knee replacement, elective procedure, something that can wait. Cancer patients, GOSI trauma, they don't usually. The construction is slowed down. The hours of work, the days of work, the time off, for Eid, that's what is slowing them down. It's not that they will opt to delay the cases. The rehabilitation, some of the in-patients rehabilitation, they're admitted for active acute rehabilitation. Many of these patients prefer to be discharged during Ramadan and Eid, to enjoy the time with their family and come back afterwards. Understood. another question from Hamad Abdulaziz. I think it's already been answered. Sorry. Mohammad still has a follow-up. I'll open the mic for you. Please go ahead. Hi. Hello, it's me again. Mohammed from MERAS. You emphasized management alignment with shareholders' outcome. Can you elaborate more on what the structure is, what the management structure is to ensure that we are aligned with shareholder outcomes? It's built on the certain KPIs, the ROIC, the EBITDA target being achieved and the completion of Al Narjis Hospital, plus some key expansion milestones. It's of significant quantum to the management, and the minimum target is to achieve 85% of the target budgeted target in the business plan. If you don't achieve it, you know, zero compensation or? Inshallah it won't come to that, but yes. Okay. Can you assist us on what the target is? Oh, that, I don't think we can mention the exact target. The only thing we can say is that Al Narjis being operational in 2028, Q1. That's easy. Like you can spend money, you can have a hospital that's operational, but the realization is profits and ROIC. It's there, but I cannot mention it. It's there, in the target. Yeah. Yeah, those are defined targets, but they haven't been disclosed publicly, so we are not able to provide them as of now. For Al Narjis, it's it has to be within the budget. Yeah, and it's not we can spend anything we want and get it operational. It has to be within the approved budget. If, yeah, and if you allow me, and I'm sorry, but what's the problem with announcing the targets? That will be guidance for the next two years. As a policy, we don't give the EBITDA target for the next two years. I think, like I think it would be okay if you give like your ambitions, even if they don't happen, at least this is the internal ambition. It's a subject of discussion within the board, on how much we can disclose. I agree with you, it would be helpful. However, as per policy, we don't do it yet, but it's something that's being considered. Okay. Thank you. Thank you. Thanks, Ahmed. Thank you. I'll only ask one question that came in the chat, and afterwards we can conclude the call since we reached the time mark. Do you expect to add more- Ahmed, we're okay if we go, if you have a lineup to say extra minutes. Do you expect to add more specialties during the remainder of the year, which would imply further increases to staff costs? I mean, it's gonna be a disciplined increase. We don't increase specialties and build a post without having a plan on what the target revenue is. Yes, we're increasing specialties. We've done it with the oncology services, with the cosmetic services, and they're doing extremely well. We expanded more on the cardiac surgery, and they're doing very well. I think the right word would be disciplined, thoughtful expansions. Yes. Understood. We have follow-up questions from the line of Hikmat. Please go ahead. Yes. Hello. Thank you. Let me ask again. Just a follow-up, gentlemen. In Q4 2025, there was a guidance or an indication that the margins or at least the gross margins, let's say after the reclassification would be some cost that it will be around 36% in 2026. Given the sustained increase in the free cost and perhaps shifting case impairments, would you consider revisiting this figure or do you think how doable it is to achieve around 36% margin for the full year? There was interruptions in the voice. If I understood your question correctly, is that in 2025 we set the expectation for 2026 margins to be around 36%? Yes, in Q4 2025, the drop in the margins and the explanation of it, you said that 36% for a gross margin would be a good indication for the 2026. Now, after those, the different operating trends in terms of payer mix and case mix and the increase in the fixed cost, do you still maintain that guidance for 2026 at least? Would you consider revising it downward maybe a bit? We don't give guidance. I think what we what we may have referred to is that. Our existing margins, on average, in 2025 were 36% at the gross profit level. Yes, exactly. Yeah? Yes. Exactly. That's a healthy margin that we want to maintain in future. Oh. Yes, we are investing. What we do say when we indicate that we want to maintain margins and we want to grow, right? It's not a guidance that we give, it's our ambition to manage our margins. Seeing the payer mix that we have and the kind of business that we do, majority with government- Yep We do aim to achieve and maintain our margins that we have delivered historically. Okay. Oh, please. Thank you for explaining. Thank you very much. There's a question in the chat, Rayan Zahid is asking: What is the timeline for the Jeddah greenfield facility? What is the expected CapEx? The plan is to get the design ready, we have already sent the RFPs and start the construction in 2027, Inshallah. For phase I, it should be in line within a couple of years, so 2029. The CapEx, it's still too early, but it's gonna be a Class B hospital of approximately 250 beds, 150 for phase I and 100 for phase II. understood. Okay, we received actually another question. Is it possible to quantify the logistics related cost impact that you have witnessed due to the war? We did witness around 5% increase in logistics cost. Understood. Can you also provide us with how many clinics the Jeddah hospital will have? We're still, I mean, we haven't set up the design yet, but I think once we get the approval from the MOH and announce it, we'll have all the details. All right. We have questions from the line of Mohammed Abdulaziz. Please unmute yourself and go ahead. Hello. Thanks for taking my question. I have another question on MOUs. If we assume the rate of recovery and max that you saw in April continue through the rest of the quarter, would this quarter, that means the second quarter margin, compared to the second quarter of 2025, how it would be comparing? Thank you. Thank you, Mohammed. It's hard to say because still we have May and June. We cannot give guidance for the quarter, but we can say that as of April we've seen recovery, but we're optimistic that it will continue in May and June. We cannot go beyond this. If we assume that the rate that you saw in April continue for May and June, would it be better than second quarter of 2025? Like, I mean, just hypothetically, if it's the same rate of recovery that you saw in April. Yeah. I mean, if trends of April continue, definitely we will witness growth. Compared to second quarter of 2025, will it be better, will it be the same or will it be lower? I mean, again, we're putting lots of assumptions. Inshallah, it will continue. Inshallah, it will be better. Speculation speculation. We only had five days of May, so, but we said what we can say in terms of April, and hopefully it will continue. All right, we'll move on to questions from the line of Abdullah Umer from Alj azira. Please unmute yourself and go ahead. [Non-English content]. Just a quick follow-up on the Jeddah hospital. Could you please give more color on the location of the hospital and any nearby hospital in the same Class B segment? It's in northern Jeddah, Obhur, northern Obhur. It's not too far from the Kingdom Tower, on two main roads, Prince Majed and, I forgot the name of the other road, but it was in the announcement, the exact location. There isn't any nearby Class B hospital. It's a residential area with, you know, a lot of housing complexes around it. Okay. apart from if there are no nearby hospitals, which hospitals do you consider as your main competitors in Class B segment in Jeddah? There aren't so many. Just to name a few ones if you can. Habib Fakeeh, they're all in a different class. Salama and King's College, they're all in a different class, Class A and above. IMC. IMC as well. Saudi German, we believe it's a Class A in Jeddah. You know, there isn't a lot of competition in Class B. If you look in Riyadh, I mean, there is Kingdom Hospital, there's the SMC as well, and similar network. In Jeddah, we're not aware of a big hospital group. Thank you. Thank you for answering. Thank you. Right. We haven't received any questions nor a raise hand, request, so I'll pass it back to you in case you have any concluding remarks. Thank you, Ahmed, and thank you everyone for attending the call. As mentioned before, we remain committed to the shareholders, and we strongly believe in the capacity of the company and the strategy deliverables that we have promised. Going forward, I just want to mention that we have planned to continue doing the earnings call in the same day of the announcement of the results. Thank you everyone again, I hope everyone enjoy a wonderful weekend. Thank you very much to Care's management and to all participants. This concludes today's earnings call. Have a good rest of the day, everyone.