Rating Rationale
February 27, 2024 | Mumbai
Regency Hospital Limited
Ratings upgraded to 'CRISIL BBB+/Positive/CRISIL A2'
 
Rating Action
Total Bank Loan Facilities RatedRs.228 Crore
Long Term RatingCRISIL BBB+/Positive (Upgraded from 'CRISIL BBB/Stable')
Short Term RatingCRISIL A2 (Upgraded from 'CRISIL A3+')
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 upgraded its ratings on the bank facilities of Regency Hospital Ltd (RHL) to CRISIL BBB+/Positive/CRISIL A2 from CRISIL BBB/Stable/CRISIL A3+.

 

The upgrade and the positive outlook reflects continued expected improvement in the credit profile of the company over the medium term. Company’s business risk profile has improved driven by increasing revenue and sustenance of improved operating margin. The company has already achieved revenue of Rs.362 crore during the nine months ended December 31, 2023 owing to sustenance of improved occupancy at ~69% in the first 9 months of fiscal 2024. As a result of this, the company is expected to achieve revenue of more than Rs. 481 crore in fiscal 2024 supported by average revenue of Rs.40 cr. per month. RHL is expected to witness healthy growth in revenue aided by its diversified presence in various specialties with experienced consultants and quality of healthcare provided. Company further plans to add two hospitals over next one year and a third hospital over next 2-3 years which will further support the company’s revenue growth and business risk profile. Also, RHL’s revenue improved to Rs. 425 crores in fiscal 2023 from Rs. 365 cores in fiscal 2022 and the same was also higher than CRISIL Ratings’ previous expectations. The growth in revenue is supported by the increase in the occupancy levels from 55% in FY22 to more than ~64% in FY23.  The ARPOB of the hospital has been consistently increasing owing to increase in the number of surgeries and in-patients.

 

Operating margins of the company have remained stable at around 20% in last 2 fiscals ending FY23; the operating margin is expected to remain at similar level of ~20% in FY24. The operating margin has improved from historical levels owing to the healthy occupancy levels across all the hospitals and also due to increasing patients for Oncology treatment which has higher margins. Further, with additional capex and diversification of locations, and resultant operating efficiencies, continued growth in revenue backed by improved occupancy along with sustenance of improved operating margin is expected. The operating margins are expected to remain comfortable in the range of 17-18% over the medium term backed by consistent improvement in the occupancy levels and increasing scale, and the same will remain a key rating sensitivity amid the timely completion of on-going capital expenditure and stabilization of operations in the new hospitals.

 

Also, improvement in the business risk profile has consequently resulted in improvement in the financial risk profile. Networth improved to Rs.204 crore as on March 31, 2023 (Rs 174 crore as on March 31, 2022) which is expected to further improve to over Rs.384 crore with gearing level below 1.0 times as on March 31, 2024. The improvement in networth is on account of healthy profitability along with capital infusion of Rs. 150 crore by Private Equity (PE) investor, Norwest Capital LLC.

 

The rating reflects the company’s established position as a healthcare provider and its healthy financial risk profile. These strengths are partially offset by risks related to timely commencement of operations at the new hospitals and high geographical concentration in revenue and regulatory risk.

Key Rating Drivers & Detailed Description

Strengths:

  • Established position as a healthcare provider: RHL is an established healthcare provider, with a track record of over 30 years in Kanpur. The flagship multi-specialty hospital at Sarvodaya Nagar (including Tower-1 and Tower-2) has 248 overnight beds, with occupancy of around 78% in fiscal 2023. RHL enjoys strong brand equity in Kanpur and adjoining areas, as it is the only tertiary care provider in the region. RHL has total bed capacity of 434 overnight beds which are occupied to around 64% in FY23. Benefitting from healthy brand equity, the company has grown at CAGR of 19% in the five fiscal years through 2023. The company has already achieved revenue of Rs.362 crore during the nine months ended December 31, 2023 owing to sustenance of improved occupancy at ~69% during the same period; the company is expected to achieve revenue of more than Rs. 481 crore in fiscal 2024 supported by average revenue of Rs.40 cr. per month. Post operationalization of new hospital the market position is expected to improve further.

 

  • Healthy financial risk profile: The financial risk profile is supported by healthy networth of Rs. 204 crore and moderate gearing of 0.89 times as on March 31, 2023. In Nov-23, Norwest Capital LLC has freshly invested in RHL to the tune of Rs. 445.21 Crores, out of which, Rs. 295.21 were paid for purchasing the stake of outgoing investors (Kois, IFC and Healthquad holding total of 31%) and Rs. 150 Crores was further invested in the company. Company is undertaking sizeable capex of Rs. 800-815 crore over three fiscals (FY23-FY26) towards regular maintenance and setting up of three new hospitals- one tower in main hospital called as Tower-3 in Kanpur, one in Gorakhpur and one in Varanasi. Capex will be funded through mix of debt and internal accruals, despite debt funded capex the financial risk profile of the company is expected to remain comfortable. Any cost overrun or delay in the commencement of operations at the new hospitals and the resultant impact on the overall financial risk profile and liquidity will remain the key monitorable over the medium term.

 

Weaknesses:

  • Risks related to timely commercialization of new hospitals: RHL undertook several greenfield expansion projects in the past five years, with one facility becoming operational each year between fiscals 2017 and 2021. The company further plans to open 2 new units in the next one year and third one in next 2-3 years in Uttar Pradesh. CRISIL Ratings will continue to monitor the progress of these projects and their timely completion, as well as any cost over-run in capex and its impact on the company’s capital structure and debt protection metrics.

 

  • Geographical concentration in revenue and regulatory risk: The majority of the healthcare facilities of RHL are in Kanpur. Though these hospitals do cater to patients from adjoining areas in Uttar Pradesh, dependence on local patients remains high. Although the company has started a super specialty hospital in Lucknow in April 2020 and is also under process of opening 2 new hospitals one in Gorakhpur and one in Varanasi but currently the majority of its revenue currently comes from the Kanpur units.  Furthermore, the healthcare industry is susceptible to government guidelines related to medical practices, such as disposal of solid waste and timely renewal of approvals, licenses and permits. Any increase in compliance cost or regulatory changes could affect the business and financial operations. Moreover, ability to offer new medical services with advanced technologies will be a key factor for improved performance.

Liquidity: Adequate

Bank limit utilization is low at around 54 percent for the past twelve months ending December 2023.  Cash accruals are expected to be over Rs.55-65 crore which are sufficient against term debt obligation of Rs. 25-30 crore over the medium term. In addition, it will act as a cushion to the liquidity of the company.

 

The current ratio is low at 0.93 times on March 31, 2023. Moderate cash and bank balance of around Rs. 40.55 crore as on March 31, 2023.

Outlook: Positive

CRISIL Ratings believes the business risk profile will continue to improve with the sustenance of improved operating margin backed by increase in occupancy level and revenue growth.

Rating Sensitivity factors

Upward factors:

  • Improvement in scale of operations while sustaining operating profitability around 17-19%, leading to cash accrual of over Rs.70 crore on a sustained basis.
  • Stability in financial risk profile with no new major debt funded capex.

 

Downward factors:

  • Decline in revenue or profitability leading to cash accrual below Rs 35 crore.
  • Any cost-overrun in the planned capex impacting the financial risk profile.

About the Company

RHL was incorporated in 1987 by Dr Atul Kapoor and his wife, Dr Rashmi Kapoor. The company has multiple healthcare centres and hospitals in Kanpur. It has eight operation theatres at its multi-specialty hospital in Sarvodaya Nagar in Kanpur (including Tower-1 and Tower-2), two at its Renal Scinces centre in Swaroop Nagar in Kanpur and two at the South Kanpur hospital. RHL also operates a city clinic in Parade in Kanpur. Its super-speciality hospital in Lucknow started operations in April 2020.

Key Financial Indicators

As on / for the period ended March 31

 

2023

2022

Operating income

Rs crore

424.68

364.77

Reported profit after tax

Rs crore

29.39

27.30

PAT margins

%

6.92

7.48

Adjusted Debt/Adjusted Net worth

Times

0.89

1.53

Interest coverage

Times

4.56

3.90

Status of non cooperation with previous CRA:

RHL has not cooperated with India Ratings which has classified it as issuer not cooperative vide its release dated May 09, 2017. The reason provided by India Ratings is non-furnishing of information for rating.

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

level

Rating assigned with outlook

NA

Auto loans

NA

NA

Mar-2023

1.0

NA

CRISIL BBB+/Positive

NA

Bank guarantee

NA

NA

NA

2.75

NA

CRISIL A2

NA

Cash credit

NA

NA

NA

27.4

NA

CRISIL BBB+/Positive

NA

Long-term loan

NA

NA

Jan-2027

179.5

NA

CRISIL BBB+/Positive

NA

Proposed term loan

NA

NA

NA

17.35

NA

CRISIL BBB+/Positive

Annexure - Rating History for last 3 Years
  Current 2024 (History) 2023  2022  2021  Start of 2021
Instrument Type Outstanding Amount Rating Date Rating Date Rating Date Rating Date Rating Rating
Fund Based Facilities LT 225.25 CRISIL BBB+/Positive   --   -- 02-12-22 CRISIL BBB/Stable 03-11-21 CRISIL BBB/Stable CRISIL BBB-/Stable
      --   --   --   -- 25-10-21 CRISIL BBB/Stable --
Non-Fund Based Facilities ST 2.75 CRISIL A2   --   -- 02-12-22 CRISIL A3+ 03-11-21 CRISIL A3+ CRISIL A3
      --   --   --   -- 25-10-21 CRISIL A3+ --
All amounts are in Rs.Cr.
Annexure - Details of Bank Lenders & Facilities
Facility Amount (Rs.Crore) Name of Lender Rating
Auto Loans 1 Kotak Mahindra Prime Limited CRISIL BBB+/Positive
Bank Guarantee 2.75 HDFC Bank Limited CRISIL A2
Cash Credit 5 Axis Bank Limited CRISIL BBB+/Positive
Cash Credit 22.4 HDFC Bank Limited CRISIL BBB+/Positive
Long Term Loan 105.2 HDFC Bank Limited CRISIL BBB+/Positive
Long Term Loan 71.8 Axis Bank Limited CRISIL BBB+/Positive
Long Term Loan 2.5 YES Bank Limited CRISIL BBB+/Positive
Proposed Term Loan 17.35 Not Applicable CRISIL BBB+/Positive
Criteria Details
Links to related criteria
CRISILs Approach to Financial Ratios
Rating criteria for manufaturing and service sector companies
CRISILs Approach to Recognising Default
Understanding CRISILs Ratings and Rating Scales

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