Rating Rationale
January 25, 2018 | Mumbai
Aster DM Healthcare Limited
Ratings downgraded to 'CRISIL BBB/Negative/CRISIL A3+'
 
Rating Action
Total Bank Loan Facilities Rated Rs.671 Crore
Long Term Rating CRISIL BBB/Negative (Downgraded from 'CRISIL A-/Negative')
Short Term Rating CRISIL A3+ (Downgraded from 'CRISIL A2+')
1 crore = 10 million
Refer to annexure for Details of Instruments & Bank Facilities
Detailed Rationale

CRISIL has downgraded its ratings on the bank facilities of Aster DM Healthcare Limited (ADMHL; part of the Aster group) to 'CRISIL BBB/Negative/CRISIL A3+' from 'CRISIL A-/Negative/CRISIL A2+'.

The rating downgrade reflects the pressure on Aster group's financial risk profile marked by aggressive capital structure, aggressive operating leverage and deteriorated debt protection measures. The stretch in receivables from Kingdom of Saudi Arabia (KSA) has continued, leading to significantly higher than expected levels of external debt. The Aster group has knocked off, from its books, a huge amount of goodwill that was created post acquisition of Sanad Hospitals in fiscal 2016. Overall profitability has remained constrained on account of higher overheads and provisioning, thereby leading to restrained accretions. Subsequent to the aforesaid, the debt to equity is estimated to be around 1.4 times, while Debt/ EBITDA will remain at around 5 times over the medium term. The ratios of net cash accruals to total debt (NCATD) and interest coverage are expected at 0.13 times and 2.08 times for fiscal 2018. The Aster group has filed with the exchanges for coming up with an Initial Public Offering (IPO) of about Rs.1000 crores including Offer for Sale, whereby a sizeable portion of the proceeds are expected to pare debt in the Indian companies. The movement in operating and financial leverage, rebounding of profitability, and reduction in receivables cycle will determine the rating direction over the near term.

The ratings reflect the Aster group's established market position in the healthcare segment, particularly in the GCC (Gulf Corporation Council) region, supported by promoters' extensive experience and diversified revenue profile. These strengths are partially offset by a deteriorating financial risk profile marked by aggressive operating leverage and weakening debt protection metrics, susceptibility to regulatory risks in the GCC region and to risks related to stabilisation of operations in new facilities.

Analytical Approach

For arriving at its rating, CRISIL has combined the business and financial risk profiles of ADMHL, its subsidiaries, step-down subsidiaries, and joint ventures (JVs) in India and the GCC region. This is because all the entities, collectively referred to as the Aster group, have a common management, are in the same line of business, and have strong business and financial linkages. 

Key Rating Drivers & Detailed Description
Strengths
* Established market position in the healthcare segment in the GCC region: The Aster group operates through a network of 19 hospitals, 98 clinics, and 206 pharmacies in the GCC region, Philippines and India. It has a healthy brand recall with its Aster, Medcare, and Access brands; with GCC contributing to around 84% of the consolidated revenue and the remaining from the domestic market.

* Promoters' extensive experience: The Aster group is promoted by Dr Azad Moopen and his family. Dr Moopen has over 25 years of experience in running hospitals in the GCC region. Over the years he has developed the group into one of the largest and well-reputed healthcare providers in the region.

Weakness
* Deteriorating financial risk profile marked by aggressive operating leverage and weakening debt protection metrics: The net worth stood at Rs.2251 crores as on March 31, 2017. The gearing stood at 1.23 time as on March 31, 2017, against 0.79 time as on March 31, 2016. The group's NCATD and interest coverage ratios were at 0.15 time and 1.83 times, respectively, for fiscal 2017; the ratios stood at 0.16 time and 2.94 times, respectively, for fiscal 2016. The NCATD and interest coverage are expected at 0.13 times and 2.08 times respectively for fiscal 2018. The Debt/EBITDA ratio is expected remain high at around 5 times over the medium term. The timeliness of the IPO and debt paring initiatives by Aster's management will remain a key rating sensitivity factor.

* Exposure to regulatory risks in the GCC region: The group is exposed to significant regulatory risks in the GCC region. Though the group has a presence in various geographies, most of the revenue comes from the GCC market. With strong rules and regulations in the region, the group is exposed to significant regulatory risks.

* Risks related to stabilisation and ramp-up of operations in newly added capacities: The Aster group has been adding significant capacities in India and the GCC, both organically as well as inorganically. The newly added beds typically take anywhere between one to two years to break even in case of the GCC and well over two years in case of India, resulting in negative cash flows from these projects. Consequently, the group's return on capital employed ratio (RoCE) and Debt/EBITDA ratio are expected remain weak over the medium term. The RoCE declined to 1.4 times for fiscal 2017 against 9.9 times for fiscal 2016 and is expected to be at around 3 times for fiscal 2018.  With capacity addition plans expected to continue over the medium term, the Aster group will remain exposed to risks related to stabilisation of operations in newly added beds. 
Outlook: Negative

CRISIL believes that the Aster group's financial risk profile will remain under pressure marked by aggressive operating leverage and inadequate debt protection measures. The rating may be downgraded in the near term if the group is unable to correct its operating leverage and capital structure significantly which will be primarily by rebounding of operating margins, and reduction in debt levels. The outlook may be revised to 'Stable' if profitability improves backed by better occupancies, coupled with an improvement in capitalisation ratios with significant paring of its debt levels resulting in an improvement in financial risk profile. 

About the Company

ADMHL (formerly, DM Healthcare Pvt Ltd), established in 1987, is the holding company of the Aster group. It operates 19 hospitals, 98 clinics and 206 pharmacies in the GCC region and India through its subsidiaries and step-down subsidiaries. ADMHL runs a quaternary super-speciality hospital, Aster Medcity, near Kochi, and Aster CMI in Bengaluru. The group is promoted by Dr Azad Moopen. It enjoys healthy brand recall for its Aster, Medcare, and Access brands. The GCC region accounts for 84% of revenue and India for the rest.

Key Financial Indicators
Particulars Unit 2017 2016
Revenue Rs crore 5,934.4 5,253.6
Profit after tax Rs crore 97.53 106.38
PAT margin % 1.6% 2.0%
Adjusted debt/adjusted networth Times 1.23 0.79
Interest coverage Times 1.83 2.94

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
NA Bank Guarantee NA NA NA 30 CRISIL A3+
NA Cash Credit/ Overdraft facility NA NA NA 80 CRISIL BBB/Negative
NA Corporate Loan NA NA 31-Jul-2018 46 CRISIL BBB/Negative
NA Long Term Loan NA NA 31-Sep-2028 515 CRISIL BBB/Negative
Annexure - Rating History for last 3 Years
  Current 2018 (History) 2017  2016  2015  Start of 2015
Instrument Type Quantum Rating Date Rating Date Rating Date Rating Date Rating Rating
Fund-based Bank Facilities  LT/ST  641  CRISIL BBB/Negative    No Rating Change  19-01-17  CRISIL A-/Negative  07-01-16  CRISIL A-/Stable  05-11-15  CRISIL A-/Watch Developing  -- 
                    22-01-15  CRISIL A-/Stable   
Non Fund-based Bank Facilities  LT/ST  30  CRISIL A3+    No Rating Change  08-03-17  CRISIL A2+    --    --  -- 
Table reflects instances where rating is changed or freshly assigned. 'No Rating Change' implies that there was no rating change under the release.
Annexure - Details of various bank facilities
Current facilities Previous facilities
Facility Amount (Rs.Crore) Rating Facility Amount (Rs.Crore) Rating
Bank Guarantee 30 CRISIL A3+ Bank Guarantee 30 CRISIL A2+
Cash Credit/ Overdraft facility 80 CRISIL BBB/Negative Cash Credit/ Overdraft facility 80 CRISIL A-/Negative
Corporate Loan 46 CRISIL BBB/Negative Corporate Loan 46 CRISIL A-/Negative
Long Term Loan 515 CRISIL BBB/Negative Long Term Loan 515 CRISIL A-/Negative
Total 671 -- Total 671 --
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 Approach to Recognising Default
CRISILs Bank Loan Ratings
CRISILs Criteria for Consolidation
The Rating Process

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