Rating Rationale
January 08, 2025 | Mumbai
Kovai Medical Center and Hospital Limited
Ratings reaffirmed at 'CRISIL AA-/Stable/CRISIL A1+'; Rated amount enhanced for Bank Debt
 
Rating Action
Total Bank Loan Facilities RatedRs.500 Crore (Enhanced from Rs.400 Crore)
Long Term RatingCRISIL AA-/Stable (Reaffirmed)
Short Term RatingCRISIL A1+ (Reaffirmed)
Note: None of the Directors on CRISIL Ratings Limited’s Board are members of rating committee and thus do not participate in discussion or assignment of any ratings. The Board of Directors also does not discuss any ratings at its meetings.
1 crore = 10 million
Refer to Annexure for Details of Instruments & Bank Facilities

Detailed Rationale

CRISIL Ratings has reaffirmed its ‘CRISIL AA-/Stable/CRISIL A1+’ ratings on the bank loan facilities of Kovai Medical Center and Hospital Ltd (KMCH).

 

The ratings reflect the company’s long vintage, the extensive experience of the promoters in the healthcare industry, its diversified revenue streams and comfortable operating performance and a strong financial risk profile. These strengths are partially offset by geographic concentration in revenue and exposure to regulatory risks.

Analytical Approach:

CRISIL Ratings has considered the standalone business and financial risk profiles of KMCH.

Key Rating Drivers & Detailed Description

Strengths:

  • Long vintage and extensive industry experience of the promoters: KMCH was incorporated in 1985 and commenced operations in 1990 with its flagship multispecialty hospital in Coimbatore. The company has set up satellite centres in Coimbatore (City Center, Sulur Hospital and Kovilpalayam Hospital) and Erode (Erode Speciality Hospital). The company also started a medical college, KMCH Institute of Health Sciences & Research, during 2019-2020 and is one of the prominent players in the region. The promoters, Dr Nalla G Palaniswami and Dr Thavamani Devi Palaniswami, have experience of over four decades in the healthcare sector.

 

  • Diversified revenue streams, healthcare and education, and comfortable operating performance: The revenue stream is diversified across two sectors since the inception of the medical college, with the healthcare sector contributing to around 92% and the education sector contributing to 8% of total revenue in fiscal 2024. Over its more-than-three-decade journey, the hospital has serviced urban and rural patients from Tamil Nadu and Kerala. The company is recognised as a forerunner in transplant and gynaecology surgeries. In fiscal 2023, KMCH inaugurated a new treatment option for cancer – IceCure, which is the third system in India and the first in south India to be installed. The operating performance was 27-29% in the last three years, supported by stable margins from the healthcare sector and higher margins from the education sector. Return on capital employed was also healthy at more than 20% in fiscal 2024.

 

  • Strong financial risk profile: The financial risk profile is supported by sizeable networth of Rs 973 crore and comfortable gearing of 0.40 time as on September 30, 2024. Debt protection metrics have improved, with interest coverage ratio of around 9.53 times in fiscal 2024, compared with around 6.44 times in fiscal 2023. The net cash accrual to adjusted debt ratio was 0.95 time, compared with 0.42 time in fiscal 2023. The total debt to Ebitda ratio was less than 1 time as on March 31, 2024, as against 1.64 times as on March 31, 2023, and with capex of Rs 250-300 crore over the medium term, to be funded majorly through internal accrual.

 

Weaknesses:

  • Geographic concentration in revenue: KMCH has been in operation for around 30 years and continues to enjoy patronage in Coimbatore. The company has high reliance on its flagship hospital, which contributed to around 75% revenue in fiscal 2024, and revenue from Coimbatore contributes around 90%. Though KMCH has been starting peripheral centers in nearby areas, the flagship hospital is likely to be the key revenue and profitability driver over the medium term, mainly because peripheral centres are smaller. With the company’s plan to establish a hospital in Chennai in the medium term, the dependency on Coimbatore will likely be reduced.

 

  • Exposure to regulatory risk: The group, like other hospital chains, remains exposed to regulations, which may come into play. For instance, the performance of private hospitals was significantly impacted on account of price caps imposed on cardiac stents and knee implants in the last quarter of fiscal 2017. Besides, the cap on cash transactions up to Rs 2 lakh also caused temporary challenges when introduced in fiscal 2018. In addition, the Supreme Court proposal to standardise the prices for different procedures across public and private hospitals, if implemented, will be monitorable.

Liquidity: Strong

Liquidity is healthy, with cash and bank balance and fixed deposit of around Rs 250 crore as on September 30, 2024, and barely used working capital limit for the 12 months through November 2024, due to negative working capital cycle and healthy liquidity. Annual accrual of over Rs 300 crore will be sufficient to meet debt obligation of Rs 30-40 crore over the medium term and capex. The company is unlikely to pay dividends over the medium term, and cash flows will likely be reinvested to fund growth. Additionally, low gearing supports financial flexibility to withstand adverse conditions or downturns in the business.

Outlook: Stable

CRISIL Ratings believes KMCH will continue to benefit from its established presence in Coimbatore and healthy operating efficiency. The company is expected to maintain financial prudence and sustain its healthy credit metrics while pursuing growth.

Rating sensitivity factors

Upward factors:

  • Steady revenue growth and stable healthy operating margin over 25% leading to higher cash accrual
  • Geographical diversification in the hospital business while maintaining strong financial risk profile.

 

Downward factors:

  • Sluggish revenue growth or decline in operating margin leading to net cash accrual.
  • Additional large debt-funded capex or acquisition weakening the key credit metrics with debt to Ebitda ratio of more than 2.25 times

About the Company

Incorporated in 1985, KMCH operates a 854-bed multispecialty hospital in Coimbatore. The company has set up satellite centres in Coimbatore (City center, Sulur Hospital and Kovilpalayam Hospital) and Erode (Erode Speciality Hospital). Dr Nalla G Palaniswami and Dr Thavamani Devi Palaniswami are the promoters. The company also started a medical college, KMCH Institute of Health Sciences & Research, in 2019-2020 to offer MBBS degree course with annual intake of 150 students along with a 750-bed medical college hospital. The company’s shares are listed on the Bombay Stock Exchange.

Key Financial Indicators

As on / for the period ended March 31

Unit

2024

2023

Operating income

Rs crore

1,219.55

1,019.74

Reported profit after tax (PAT)

Rs crore

179.73

115.77

PAT margin

%

14.49

11.18

Adjusted debt / adjusted networth

Times

0.31

0.66

Interest coverage

Times

9.53

6.44

Any other information: Not Applicable

Note on complexity levels of the rated instrument:
CRISIL Ratings` complexity levels are assigned to various types of financial instruments and are included (where applicable) in the 'Annexure - Details of Instrument' in this Rating Rationale.

CRISIL Ratings will disclose complexity level for all securities - including those that are yet to be placed - based on available information. The complexity level for instruments may be updated, where required, in the rating rationale published subsequent to the issuance of the instrument when details on such features are available.

For more details on the CRISIL Ratings` complexity levels please visit www.crisilratings.com. Users may also call the Customer Service Helpdesk with queries on specific instruments.

Annexure - Details of Instrument(s)

ISIN Name Of Instrument Date Of Allotment Coupon Rate (%) Maturity Date Issue Size (Rs. Crore) Complexity Levels Rating Outstanding with Outlook
NA Bank Guarantee NA NA NA 15.00 NA CRISIL A1+
NA Inland/Import Letter of Credit NA NA NA 100.00 NA CRISIL A1+
NA Secured Overdraft Facility NA NA NA 15.00 NA CRISIL A1+
NA Proposed Term Loan NA NA NA 50.00 NA CRISIL AA-/Stable
NA Proposed Term Loan NA NA NA 9.15 NA CRISIL AA-/Stable
NA Term Loan NA NA 31-Mar-36 119.95 NA CRISIL AA-/Stable
NA Term Loan NA NA 31-Mar-36 50.00 NA CRISIL AA-/Stable
NA Term Loan NA NA 31-Mar-36 140.90 NA CRISIL AA-/Stable
Annexure - Rating History for last 3 Years
  Current 2025 (History) 2024  2023  2022  Start of 2022
Instrument Type Outstanding Amount Rating Date Rating Date Rating Date Rating Date Rating Rating
Fund Based Facilities ST/LT 385.0 CRISIL A1+ / CRISIL AA-/Stable   -- 31-12-24 CRISIL A1+ / CRISIL AA-/Stable   --   -- --
Non-Fund Based Facilities ST 115.0 CRISIL A1+   -- 31-12-24 CRISIL A1+   --   -- --
All amounts are in Rs.Cr.
Annexure - Details of Bank Lenders & Facilities
Facility Amount (Rs.Crore) Name of Lender Rating
Bank Guarantee 15 Indian Bank CRISIL A1+
Inland/Import Letter of Credit 100 Indian Bank CRISIL A1+
Proposed Term Loan 9.15 Not Applicable CRISIL AA-/Stable
Proposed Term Loan 50 Not Applicable CRISIL AA-/Stable
Secured Overdraft Facility 15 Indian Bank CRISIL A1+
Term Loan 119.95 Indian Overseas Bank CRISIL AA-/Stable
Term Loan 140.9 Indian Bank CRISIL AA-/Stable
Term Loan 50 Indian Bank CRISIL AA-/Stable
Criteria Details
Links to related criteria
CRISILs Approach to Financial Ratios
CRISILs Bank Loan Ratings - process, scale and default recognition
Rating criteria for manufaturing and service sector companies
CRISILs Criteria for rating short term debt

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