Rating Rationale
July 05, 2018 | Mumbai
Apollo Hospitals Enterprise Limited
Rated amount enhanced
 
Rating Action
Total Bank Loan Facilities Rated Rs.2600 Crore (Enhanced from Rs.2400 Crore)
Long Term Rating CRISIL AA/Stable (Reaffirmed)
Short Term Rating CRISIL A1+ (Reaffirmed)
 
Rs.200 Crore Non Convertible Debentures CRISIL AA/Stable (Reaffirmed)
Rs.200 Crore Non Convertible Debentures CRISIL AA/Stable (Reaffirmed)
Rs.319 Crore Non Convertible Debentures CRISIL AA/Stable (Reaffirmed)
Fixed Deposits FAA+/Stable (Reaffirmed)
1 crore = 10 million
Refer to annexure for Details of Instruments & Bank Facilities
Detailed Rationale

CRISIL has reaffirmed its 'CRISIL AA/FAA+/Stable/CRISIL A1+' ratings on the debt programmes and bank facilities of Apollo Hospitals Enterprise Limited (AHEL).

Operating profitability of existing hospitals segment has recovered to large extent in the second half of fiscal 2018 which was hit in fiscal 2017 and the first quarter of 2018 by one-time factors such as demonetisation of high-value currency notes in November 2016, and regulations for stent price control. Also, occupancy at the Apollo Gleneagles Kolkata Hospital which had dropped sharply in the first quarter of 2018 due to certain one-time events, impacting profitability has improved by the end of fiscal 2018, and expected to stabilize by fiscal 2019.

While profitability of new hospitals has improved, operating loss at the recently commissioned Navi Mumbai facility limited profitability in this segment. However, the Navi Mumbai hospital witnessed healthy occupancy of around 59% in 4Q FY2018, and is expected to ramp-up operations as per schedule. With limited capacity addition in the medium term, profitability of new hospitals should improve.

The pharmacy segment's profitability improved to 4.5% in fiscal 2018 from 4.4% in fiscal 2017 and 3.6% in fiscal 2016, aided by store addition, increase in revenue per store and cost rationalization.

The ratings continue to reflect the company's established and leading market position, healthy operating profitability, and strong financial risk profile. These strengths are partially offset by continued losses in the clinics and cradles segment, and exposure to risks inherent in its greenfield projects.

Analytical Approach

For arriving at the ratings, CRISIL has combined the business and financial risk profiles of AHEL and its subsidiaries (fully consolidated), and joint ventures (JVs; proportionately consolidated), because of their strong operational and financial linkages. The entities are together referred to herein as AHEL.

Key Rating Drivers & Detailed Description
Strengths
* Established and leading market position in the healthcare segment:
AHEL is currently the market leader in the Indian private healthcare segment. It operates the largest chain of hospitals in India with 70 hospitals (43 owned, with capacity of 8,353 beds; 5 managed with 934 beds; 11 day-care/short-surgery centres with 259 beds; and 11 cradles with 298 beds) as on March 31, 2018. It has presence predominantly in Chennai and Hyderabad clusters, and has expanded to regions such as Mumbai and tier-2 and 3 towns. Its market leadership is driven by strong brand equity and superior quality of service due to strong relationships with highly qualified consultants. CRISIL believes AHEL, due to its market leadership, is well-positioned to capitalise on the healthy growth in the Indian healthcare market.
 
* Healthy operating profitability; expected to improve over the medium term:
Over the past 3 years, operating profitability has been supported by hospitals and pharmacy segments. The pharmacy segment's profitability improved to 4.5% in fiscal 2018 from 4.4% in fiscal 2017 and 3.3% in fiscal 2015 aided by store addition, increase in revenue per store, and cost rationalisation, and is expected to remain at similar levels over the medium term. The company is nearing the end of large capital expenditure (capex), with 2,423 beds commissioned in the past four years. It plans to add 265 beds (owned, subsidiaries, and JVs) by 2020. Earnings before interest, tax, depreciation, and amortization (EBIDTA) has improved slightly to Rs 801 crore in fiscal 2018 from Rs 786 crore in fiscal 2017 and Rs 736 crore in fiscal 2016. It was impacted by temporary slow-down in Chennai and Kolkata cluster as well as demonetization, GST and losses due to stent price control in fiscal 2017 and 2018. EBIDTA is expected to recover to more than Rs 900 crore in fiscal 2019 and more than Rs 1000 crore by fiscal 2020, driven by increased profitability in new hospitals, and reduced loss in the clinics segment.

Weakness
* Modest financial risk profile:
Financial risk profile is constrained by significant increase in debt and stagnation in EBIDTA over the past three fiscals. Delay in rights issue and sizeable capex led to increase in debt to around Rs 3500 crore as on March 31, 2018, from Rs 2000 crore as on March 31, 2015. As a result, ratio of debt to EBIDTA increased to over 4.3 times in fiscal 2018 from 4.0 times in fiscal 2017 and 2.6 times in fiscal 2015. However, the ratio is expected to improve to about 3 times by March 2019, primarily due to reduction in debt through infusion of equity, and to around 2.5 times by March 2020 with improvement in EBIDTA. Gearing has also increased to 1.2 time as on March 31, 2018 from 0.9 time as on March 31, 2017. Timing and quantum of equity infusion over the medium term will be a rating sensitive factor.  

* Continued operating loss in the cradles and clinics business
Apollo Health and Lifestyle Ltd (AHLL), which operates clinics, diagnostic centres, short-stay surgery, and boutique birthing centers under the Apollo brand, has been incurring operating losses in the past few fiscals and will continue to incur loss in fiscal 2019. While existing centres are expected to break even at the operating level over the medium term, the new centres are expected to post losses due to early stage of operations. The equity infusion of Rs 450 crore by International Finance Corporation (IFC) in December 2016 was used towards funding losses, prepay debt and acquire 100% stake in Apollo Specialty Hospitals. In April 2018, AHEL infused around Rs 80 crore in AHLL to fund its expected losses in fiscal 2019. CRISIL expects AHEL to fund the losses of AHLL till it achieves breakeven in the medium term. The extent of reduction in losses over the medium term will be a key monitorable.

* Project risk embedded in greenfield projects
AHEL's greenfield bed addition of 265 beds at an estimated cost of Rs 778 crore over the medium term constitutes only 3% of its current capacity. Of this, Rs 507 crore was spent till March 2018. However, profitability of recently commissioned facilities (including Navi Mumbai) as well as successful ramp-up of operations at facilities to be commissioned in the medium term remain key monitorables.

The management has the ability to complete projects on time without significant cost overrun, and make these profitable within a short span of time. Nevertheless, the company is susceptible to execution and market risks inherent in greenfield projects and to the risk of losses in the initial phase.
Outlook: Stable

CRISIL believes AHEL will maintain its healthy revenue growth while increasing its capacity and maintaining steady operating profitability. Healthy cash accrual and prudent funding of capex will result in conservative gearing and comfortable debt protection metrics.

Upside scenario
* Significantly higher-than-expected profitability in greenfield projects, and sizeable growth in revenue and profitability

Downside scenario
* Significant decline in operating profitability, adversely impacting debt-to-EBITDA ratio
* Larger-than-expected debt-funded capex or investments in group companies
* Delay in correction of debt-to-EBITDA ratio due to higher than expected debt or lower than expected EBITDA

About the Company

AHEL started operations in 1983 with Apollo Chennai, the first Indian corporate hospital. The company had 70 hospitals, with total capacity of 9,844 beds as on March 31, 2018. Of these, 43 hospitals are owned including subsidiaries, JVs, and associates, with 8353 beds; 5 hospitals with 934 beds are managed. It also has 11 day-care/short surgical stay centres with 259 beds, and 11 cradles with 298 beds. Besides its hospital-based pharmacies, AHEL runs pharmacy operations through a retail pharmacy chain of 3,021 stores, which accounted for 40% of revenue in fiscal 2018. As on March 31, 2018, Dr P C Reddy, AHEL's promoter, and his family members collectively owned 34.4% of the company's equity shares; mutual funds owned 6.3%; and public and foreign institutional investors owned the remainder.

Consolidated net profit was Rs 60 crore on revenue of Rs 8,562 crore in fiscal 2018 against net profit of Rs 147 crore on revenue of Rs 7,599 crore in fiscal 2017.

Key Financial Indicators - Consolidated (CRISIL adjusted numbers)
Particulars Unit 2018 2017
Revenue Rs Cr. 8562 7599
Profit after tax Rs Cr. 60 147
PAT margin % 0.7 1.9
Adjusted debt/adjusted networth Times 1.2 0.9
Interest coverage Times 2.8 3.1

Any other information: Not applicable

Note on complexity levels of the rated instrument:
CRISIL complexity levels are assigned to various types of financial instruments. The CRISIL complexity levels are available on www.crisil.com/complexity-levels. Users are advised to refer to the CRISIL complexity levels for instruments that they consider for investment. 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)
Rating assigned
with outlook
INE437A07104 Debentures 22-Aug-2014 * 22-Aug-2028 200 CRISIL AA/Stable
INE437A07062 Debentures 28-Dec-2010 10.3 28-Dec-2020 100 CRISIL AA/Stable
INE437A07070 Debentures 21-Mar-2011 10.3 21-Mar-2021 100 CRISIL AA/Stable
INE437A07112 Debentures NA NA 07-Oct-2026 300 CRISIL AA/Stable
NA Debentures# NA NA NA 19 CRISIL AA/Stable
NA Fixed deposits NA NA NA 0 FAA+/Stable
NA Cash credit NA NA NA 74.27 CRISIL AA/Stable
NA Bills payable NA NA NA 105.92 CRISIL A1+
NA Short-term loan NA NA NA 60 CRISIL A1+
NA Proposed long-term bank loan facility NA NA NA 284.81 CRISIL AA/Stable
NA Rupee term loan^ NA NA June-2018 65 CRISIL AA/Stable
NA Rupee term loan NA NA Mar-2026 200 CRISIL AA/Stable
NA Rupee term loan NA NA July-2028 300 CRISIL AA/Stable
NA Rupee term loan NA NA July-2028 300 CRISIL AA/Stable
NA Rupee term loan NA NA Oct-2027 150 CRISIL AA/Stable
NA Rupee term loan NA NA Jan-2032 100 CRISIL AA/Stable
NA Rupee term loan NA NA Jan-2031 350 CRISIL AA/Stable
NA Rupee term loan NA NA Jan-2030 350 CRISIL AA/Stable
NA Working Capital Demand Loan NA NA NA 100 CRISIL A1+
NA Working Capital Demand Loan NA NA NA 160 CRISIL AA/Stable
*Variable interest rate-10.2% per annum for first 5 years, 10.25% per annum for next 5 years, and 10.3% per annum for remaining 4 years
#Yet to be placed
^CRISIL is awaiting independent confirmation of redemption before withdrawing ratings on these instruments
Annexure - Rating History for last 3 Years
  Current 2018 (History) 2017  2016  2015  Start of 2015
Instrument Type Outstanding Amount Rating Date Rating Date Rating Date Rating Date Rating Rating
Fixed Deposits  FD  0.00  FAA+/Stable      31-10-17  FAA+/Stable  04-10-16  FAA+/Stable  18-08-15  FAA+/Stable  FAA+/Stable 
                10-06-16  FAA+/Stable  12-01-15  FAA+/Stable   
Non Convertible Debentures  LT  700.00
05-07-18 
CRISIL AA/Stable      31-10-17  CRISIL AA/Stable  04-10-16  CRISIL AA/Stable  18-08-15  CRISIL AA/Stable  CRISIL AA/Stable 
                10-06-16  CRISIL AA/Stable  12-01-15  CRISIL AA/Stable   
Fund-based Bank Facilities  LT/ST  2600.00  CRISIL AA/Stable/ CRISIL A1+      31-10-17  CRISIL AA/Stable/ CRISIL A1+  04-10-16  CRISIL AA/Stable/ CRISIL A1+  18-08-15  CRISIL AA/Stable  CRISIL AA/Stable 
                10-06-16  CRISIL AA/Stable/ CRISIL A1+  12-01-15  CRISIL AA/Stable   
Non Fund-based Bank Facilities  LT/ST    --    --    --    --  18-08-15  CRISIL A1+  CRISIL A1+ 
                    12-01-15  CRISIL A1+   
All amounts are in Rs.Cr.
Annexure - Details of various bank facilities
Current facilities Previous facilities
Facility Amount (Rs.Crore) Rating Facility Amount (Rs.Crore) Rating
Bills Payable 105.92 CRISIL A1+ Bills Payable 105.92 CRISIL A1+
Cash Credit 74.27 CRISIL AA/Stable Cash Credit 74.27 CRISIL AA/Stable
Proposed Long Term Bank Loan Facility 284.81 CRISIL AA/Stable Proposed Long Term Bank Loan Facility 344.81 CRISIL AA/Stable
Rupee Term Loan 1815 CRISIL AA/Stable Rupee Term Loan 1815 CRISIL AA/Stable
Short Term Loan 60 CRISIL A1+ Short Term Loan 60 CRISIL A1+
Working Capital Demand Loan 100 CRISIL A1+ -- 0 --
Working Capital Demand Loan 160 CRISIL AA/Stable -- 0 --
Total 2600 -- Total 2400 --
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 Consolidation
CRISILs Criteria for rating short term debt

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