Rating Rationale
November 06, 2019 | Mumbai
Kailash Healthcare Limited
Rated amount enhanced
 
Rating Action
Total Bank Loan Facilities Rated Rs.166 Crore (Enhanced from Rs.162 Crore)
Long Term Rating CRISIL BBB+/Positive (Reaffirmed)
Short Term Rating CRISIL A2 (Reaffirmed)
1 crore = 10 million
Refer to annexure for Details of Instruments & Bank Facilities
Detailed Rationale

CRISIL has reaffirmed its 'CRISIL BBB+/Positive/CRISIL A2' ratings on the bank facilities of Kailash Healthcare Limited (KHC; part of the Kailash group).

The ratings continue to reflect the group's established presence in the healthcare sector on the back of its multistate operations, extensive experience of promoters, and a strong financial risk profile. These strengths are partially offset by risks related to stabilization and ramp-up in operations at the newly added capacities, working capital intensive operations, and exposure to intense competition in the healthcare industry.

Analytical Approach

For arriving at the ratings, CRISIL has combined the business and financial risk profiles of KHC and Kailash Hospitals Limited (KHL). This is because the entities, collectively referred to as the Kailash group, have considerable operational and financial linkages, are in the same business, and have a common brand. Furthermore, KHC holds 55.8% stake in KHL.

Please refer Annexure - List of Entities Consolidated, which captures the list of entities considered and their analytical treatment of consolidation.

Key Rating Drivers & Detailed Description
Strengths:
* Established presence in the healthcare industry: The group has been offering multi-specialty tertiary healthcare services since 1995, and has one hospital each in Noida, Greater Noida, and Behror, with capacity of 325, 250, and 250 beds, respectively. Two new hospitals have been set up in Dehradun and Khurja, with capacity of 300 and 110 beds, respectively over the past three years. A 200-bed hospital is also planned in Sector 71, Noida in fiscal 2020 and the same is under construction. Revenue, though constrained by early stage of operations at the new hospitals, was Rs. 340 crore in fiscal 2019 and is expected to grow 10-13% over the medium term.

* Promoters' extensive experience: Benefits from the promoter's (Dr. Mahesh Kumar Sharma's) experience of over three decades should continue to support business risk profile. Dr. Sharma obtained his Bachelor of Medicine, Bachelor of Surgery (MBBS) degree from the University College of Medical Sciences, and Diploma in Public Health and Hygiene (DPHH) from New Delhi (1984). Over the years, the promoters have set up new hospitals and successfully managed them in different cities.

* Strong financial risk profile: Networth was Rs 115.96 crore as on March 31, 2019 on the back of steady accretion to reserves. Total outside liabilities to tangible networth, despite the ongoing capex, was 1.78 times as on March 31, 2019, and is likely to remain in the range of 1.50-1.85 times over the medium term. Interest coverage and net cash accrual to adjusted debt ratios were 4.15 times and 0.20 time, respectively, in fiscal 2019, and are likely to be at 4.2-5.2 times and 0.20-0.30 time over the medium term.
 
Weaknesses:
* Risks related to stabilization and ramp-up in operations at the newly added capacities: The two new hospitals set up in Dehradun and Khurja, and the hospital under-construction in Sector-71, Noida (expected to start by December 2019) will take a couple of years to breakeven; cash flows from the projects are expected to be negative (Dehradun hospital is expected to break-even in current fiscal). Furthermore, the group is largely dependent upon the hospital in Noida, as the capacities of other hospitals are still underutilized.

* Exposure to intense competition in the healthcare industry: The group operates under the Kailash Hospitals brand. Although the hospitals are in diverse locations, exposure to intense competition persists from established players, such as Fortis Healthcare Ltd and Metro Specialty Hospital Pvt. Ltd, especially given the image-sensitive nature of the healthcare industry. Revenue and profitability will, likely, remain constrained due to intense competition.

* Working-capital-intensive operations: Working capital cycle though improved from previous fiscal continues to remain intensive, with gross current assets of 88 days as on March 31, 2019 (104 days in previous fiscal), driven by debtors of 78 days (90 days in previous fiscal). Moreover, debtors from tie-ups with Central Government Health Scheme (CGHS) and Ex-servicemen Contributory Health Scheme (ECHS) were stretched to 180-270 days, leading to higher dependence on bank lines.

Liquidity: Adequate
Bank limit utilization averaged at 92% over the 12 months ended July 2019 and the group is planning for enhancement in working capital lines by around Rs. 5 crore for managing working capital requirements for the new hospital in Noida. Timely sanction of the limits would remain a key rating sensitivity factor. Promoters and related parties have extended funding support in the form is unsecured loans which stood at Rs. 3.13 crore as on March 31, 2019; need based fund support should continue. Group is expected to generate adequate net cash accruals in the range of Rs. 28-38 crore per fiscal against repayment obligations of around Rs. 9 crore in fiscal 2020 and Rs. 17-18 crore per fiscal in fiscals 2021 and 2022. Rs. 2.04 crore of cash & bank balance was unencumbered, while Rs. 3.11 crore cash was encumbered as FDs as on March 31, 2019.
Outlook: Positive

CRISIL believes that Kailash group will benefit from the ramp-up in operations in the new hospitals on the back of established market position in the healthcare sector over the medium term.

Rating sensitivity factors
Upward Factors:
* Improvement in working capital cycle or enhancement in bank lines thereby providing adequate cushion in bank lines to support any exigencies
* Fast ramp-up and break-even at the new hospitals, leading to higher-than-expected sales and profitability of above 14%

Downward Factors:
* Decline in profitability or higher than expected debt-funded capital expenditure weakening key credit metrics
* Further stretch in realization of payments thus leading to further elongation of working capital cycle with GCAs stretching beyond 130 days, leading to higher utilization in existing bank lines.

About the Group

KHC was set up in 1993 by Dr. Sharma as Kailash Hospital & Research Centre Ltd, and got its present name in fiscal 2008. The company operates a multi-specialty hospital in Noida and Behror. The Noida facility is approved by the National Accreditation Board for Hospitals. Furthermore, two hospitals are managed under the operations and maintenance contract: Deepak Memorial Hospital & Medical Research Centre in East Delhi and Shri Swami Bhooma Nand Dharmarth Chikatsalya Research Institute in Haridwar, Uttarakhand. The hospitals in Khurja and Dehradun have been operational since March 2016 and December 2016, respectively.

KHL, incorporated in 1999, operates a multi-specialty hospital in Greater Noida. It also runs Kailash Institute of Naturopathy, Ayurveda, and Yoga, which offers a wide range of specialty treatments. KHC holds 55.8% stake in KHL, Uma Medicare Ltd 6.5%, and the Garg family the remainder of equity in KHL.

Key Financial Indicators (Consolidated)
Particulars Unit 2019 2018
Revenue Rs crore 340.00 318.32
Profit After Tax (PAT) Rs  crore 11.00 9.72
PAT margin % 3.2 3.1
Adjusted debt/adjusted networth Times 1.04 1.20
Interest coverage Times 4.15 3.17

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.Cr)
Rating Assigned with Outlook
NA Bank Guarantee NA NA NA 2.0 CRISIL A2
NA Cash Credit NA NA NA 35.0 CRISIL BBB+/Positive
NA Term Loan NA NA Sept-2027 129.0 CRISIL BBB+/Positive
 
Annexure - List of Entities Consolidated
Names of Entities Consolidated Extent of Consolidation Rationale for Consolidation
Kailash Healthcare Limited & Kailash Hospitals Limited Full The entities, collectively referred to as the Kailash group, have considerable operational and financial linkages, are in the same business, and have a common brand. Furthermore, Kailash Healthcare Limited holds 55.8% stake in Kailash Hospitals Limited.
Annexure - Rating History for last 3 Years
  Current 2019 (History) 2018  2017  2016  Start of 2016
Instrument Type Outstanding Amount Rating Date Rating Date Rating Date Rating Date Rating Rating
Fund-based Bank Facilities  LT/ST  164.00  CRISIL BBB+/Positive      29-08-18  CRISIL BBB+/Positive  06-03-17  CRISIL BBB+/Stable  02-02-16  CRISIL BBB+/Stable  CRISIL BBB+/Negative 
            07-03-18  CRISIL BBB+/Positive           
Non Fund-based Bank Facilities  LT/ST  2.00  CRISIL A2      29-08-18  CRISIL A2  06-03-17  CRISIL A2  02-02-16  CRISIL A2  CRISIL A2 
            07-03-18  CRISIL A2           
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
Bank Guarantee 2 CRISIL A2 Bank Guarantee 3 CRISIL A2
Cash Credit 35 CRISIL BBB+/Positive Cash Credit 35 CRISIL BBB+/Positive
Term Loan 129 CRISIL BBB+/Positive Long Term Loan 59.71 CRISIL BBB+/Positive
-- 0 -- Proposed Cash Credit Limit 1.46 CRISIL BBB+/Positive
-- 0 -- Proposed Term Loan 22 CRISIL BBB+/Positive
-- 0 -- Term Loan 40.83 CRISIL BBB+/Positive
Total 166 -- Total 162 --
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
Rating Criteria for the Pharmaceutical Industry
CRISILs Bank Loan Ratings
CRISILs Criteria for Consolidation
CRISILs Criteria for rating short term debt
The Rating Process

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