Asarfi Hospital — Q4 FY26 earnings call

Call held 27 May 2026

Management summary

Asarfi Hospital reported strong financial performance for FY26, with consolidated revenue growing 42% YoY to INR 173.5 crores and PAT increasing 58% YoY to INR 16.7 crores. Q4 also showed robust growth in revenue and IPD. The company is focused on strategic expansion, including increasing bed capacity and exploring inorganic growth, while navigating challenges related to government scheme reimbursements and regulatory delays for new services.

Highlights

  • FY26 consolidated revenue from operations increased by 42% YoY to INR 173.5 crores, up from INR 121 crores in FY25.

  • FY26 consolidated PAT grew by 58% YoY to INR 16.7 crores, with PAT margin improving to 10%.

  • Q4 FY26 consolidated revenue grew by 29% YoY to INR 45.2 crores.

  • ARPOB for the unit improved significantly to INR 23,000.

  • Total surgeries increased by 26% YoY, exceeding 6,300 procedures.

Concerns

  • Delay in operationalizing the bone marrow transplant unit due to procedural delays in organ transplant policy approval.

  • Proposed merger with another hospital is delayed due to shareholder inheritance issues.

  • Q4 FY26 saw a decrease in cancer patients due to Jharkhand government scheme changes and administrative delays.

  • Ayushman Bharat scheme has small package rates, making realization difficult and putting pressure on cash realization.

Key financials

2 periods

Q4 FY26

  • Revenue
    ₹45.2 Cr
    YoY +29%
  • EBITDA
    ₹7.7 Cr
  • EBITDA Margin
    17%
  • PAT
    ₹3.9 Cr
    YoY +9%

FY26

  • Revenue
    ₹173.5 Cr
    YoY +42%
  • EBITDA
    ₹35.3 Cr
    YoY +42%
  • EBITDA Margin
    20%
  • PAT
    ₹16.7 Cr
    YoY +58%
  • PAT Margin
    10%
  • ARPOB
    ₹23,000
  • Cancer Hospital Occupancy
    42%

What they filed

Q1 FY27: revenue up 32.8%, net profit up 33.4% against the same quarter last year.

₹ Cr · quarterly
Line itemQ2 FY25Q3 FY25Q4 FY25Q1 FY26Q2 FY26Q3 FY26Q4 FY26Q1 FY27
Revenue31 33 35 36 45 +45%46 +40%45 +28%47 +33%
EBITDA7 7 6 7 9 +31%10 +45%8 +22%9 +34%
Net profit3 3 4 3 4 +48%5 +101%4 +7%4 +33%
How to read this

₹ crore, as filed. The percentage beside a figure is the change against the same quarter a year earlier — never the quarter before, which would make every seasonal business look like it collapses and booms each year.

Capital allocation

high confidence
  • Capex ₹15 Cr internal accruals
    • Increasing bed capacity (65 to 150 beds) in cancer hospital ₹2 Cr
    • Healthcare Management Research Institute construction ₹8 Cr
    To increase the bed capacity from 65 to 150, actually we don't require very high capex investment. It will be around INR2 crores to INR3 crores, which will be met through internal accruals. (Harendra Singh) and It will be in the tune of INR8 crores to INR10 crores. (Harendra Singh) and Less than INR15 crores, yes. (Harendra Singh)
  • Debt Debt disclosed
    As of now, we have not decided that we will be going for any debt. It will be managed through internal accruals. (Harendra Singh)
  • M&A Another hospital (unnamed) Merger · Pending regulatory

    Strategic expansion

    And my second question was regarding to the merger, the proposed merger that the promoter has, like, another hospital that will be coming under this company. So, what is the status of that, and why is it still not done, because we are seeing a lot of delays in all these things? (Nipurn Khemka) Yes, there is a delay, because two or three shareholders had died and the heirs have not inherited the shares of those expired shareholders. And because of that reason, we have not been able to push that matter forward. We are in continuous touch and hopefully it should be done this financial year. (Harendra Singh)
  • M&A Unnamed hospitals Acquisition · Announced

    Expansion of number of hospitals under management

    So, we are definitely, thinking, it's in pipeline, we are planning to increase number of hospitals under management. (Harendra Singh) and It is not aspiration. It is almost everything has been settled; only technical issues are being resolved. So, it is not aspirational, it is already, you know, this will be materialized in this financial year, number one. (Harendra Singh)
  • Liquidity Cash ₹8 Cr Sufficient for planned capex and growth without external debt.
    We are holding, INR8 crores to INR10 crores we have. (Harendra Singh)

Guidance & targets

Revenue

  • Consolidated Revenue Revenue · FY27 · High confidence INR 260 crores
    Sir, my question is what could be a top-line target for FY27 as you have mentioned it will be INR260 crores. So, are you confident to achieving that top-line amount? (Gaurav Sanghvi) Yes, sir, we are working very hard and we should be able to achieve it. (Harendra Singh)

    — Harendra Singh

  • Overall Revenue Revenue · Vision 2028 · High confidence around INR 400 crores
    Our Vision 2028 roadmap targets scaling overall bed capacity to 500 plus beds, achieving revenue of around INR400 crores, and improving EBITDA margin to 23% to 25%. (Harendra Singh)

    — Harendra Singh

Profitability

  • PAT Margin Profitability · FY27 · High confidence 13% to 15%
    And also, I have read that you targeted for 13% to 15% of PAT for the FY27. (Gaurav Sanghvi) Yes, sir, as we said that we are trying to tweak our case mix. We have started doing our activities in 10 neighbouring districts, and when people come from distant places, they tend to be ready to pay more. Apart from that, we are working very hard on the front of cost management. We are trying to reduce the cost also, so probably we should be able to achieve it. (Harendra Singh)

    — Harendra Singh

  • EBITDA Margin Profitability · FY27 · High confidence at least 22%
    Sir, we are trying to bring case mix and margins in such a way that EBITDA remains at, achieves 23% to 25%. This year we have achieved 20% EBITDA. We definitely would like to push it to at least 22% next year. (Harendra Singh)

    — Harendra Singh

  • EBITDA Margin Profitability · Vision 2028 · High confidence 23% to 25%
    Our Vision 2028 roadmap targets scaling overall bed capacity to 500 plus beds, achieving revenue of around INR400 crores, and improving EBITDA margin to 23% to 25%. (Harendra Singh)

    — Harendra Singh

Capacity

  • Overall Bed Capacity Capacity · Vision 2028 · High confidence 500+ beds
    Our Vision 2028 roadmap targets scaling overall bed capacity to 500 plus beds, achieving revenue of around INR400 crores, and improving EBITDA margin to 23% to 25%. (Harendra Singh)

    — Harendra Singh

  • Cancer Hospital Bed Capacity Capacity · Coming years · High confidence 150 beds
    Key growth drivers over the coming years will include expansion of cancer hospital capacity from 65 beds to 150 beds (Harendra Singh)

    — Harendra Singh

  • Overall Bed Capacity Capacity · before FY30 · High confidence 1,000 beds
    Okay. And one final thing, in the last quarterly call, we said that we are targeting to reach 1,000 bed capacity before financial year '30. So, do we still hold that? (Nitin Gupta) Yes, sir, it still holds. (Harendra Singh)

    — Harendra Singh

What to watch in Q1 FY27

Bone Marrow Transplant Facility Approval

within 4-5 months
Current Awaiting regulatory approval due to organ transplant policy issues
Target Approval obtained and facility operational

Why it matters

Launch of this high-value service is crucial for expanding specialized offerings and revenue streams.

Sir, it should take another four, five months, because government is very slow and sometime, I feel that their priority is different. Though there are no organ, bone marrow transplant is not going on anywhere in the Jharkhand, but still there is a delay in the process, what we can do. We are trying very hard. We are rather following it up with the minister directly. But things are not moving as desired.

Risks & concerns

  • Procedural delays for bone marrow transplant approval

    medium

    Organ transplant policy in Jharkhand is not in a good state, causing delays in obtaining permission for the bone marrow transplant facility, despite other preparations being complete.

    Basically, in Jharkhand, the organ transplant policy is not in a good state, and we are trying to obtain approval for the organ transplant facility. Other things have been already arranged. Hopefully, we will get that permission very soon and once the permission is there, we can start.

    Management acknowledged

  • Delay in proposed merger due to shareholder issues

    medium

    The proposed merger with another hospital is delayed because heirs of deceased shareholders have not inherited their shares, hindering the process.

    Yes, there is a delay, because two or three shareholders had died and the heirs have not inherited the shares of those expired shareholders. And because of that reason, we have not been able to push that matter forward.

    Management acknowledged

  • Impact of government schemes and administrative delays on cancer patient volume and realization

    medium

    Changes in Jharkhand government schemes and administrative delays led to a decrease in cancer patients in Q4. Ayushman Bharat scheme's low package rates also pressure cash realization.

    In the last quarter, there was some scheme launched by Government of Jharkhand, and there was some changes in the approval system... and Ayushman Bharat scheme, they have very small package rates, and realization becomes difficult.

    Management acknowledged

  • Political stability affecting government schemes

    low

    Government schemes and payments are somewhat related to political stability, but management does not expect it to impact them significantly.

    It appears that things have settled down, but as you know that government schemes and payments are somehow related to political stability. There is some uncertainty in the political spectrum also, but we don't think that it will impact us that way.

    Management downplayed

Q&A highlights

7 direct
Delay in bone marrow transplant facility Direct
Basically, in Jharkhand, the organ transplant policy is not in a good state, and we are trying to obtain approval for the organ transplant facility. Other things have been already arranged. Hopefully, we will get that permission very soon and once the permission is there, we can start.

Highlights a key regulatory hurdle impacting the launch of a new high-value service, indicating a delay from previous guidance.

Asked by Nipurn Khemka

Delay in proposed merger with another hospital Direct
Yes, there is a delay, because two or three shareholders had died and the heirs have not inherited the shares of those expired shareholders. And because of that reason, we have not been able to push that matter forward. We are in continuous touch and hopefully it should be done this financial year.

Explains the specific reason for the delay in a strategic inorganic growth initiative, indicating it's due to external administrative issues.

Asked by Nipurn Khemka

Future expansion strategy (organic vs. inorganic) Partial
We are trying to develop a model, which will be most suited to us. So, we are definitely, thinking, it's in pipeline, we are planning to increase number of hospitals under management. But what exact model we will be moving ahead, that is why we have not added hospitals, because there are hospitals available, plenty of hospitals available everywhere, because people are finding it very difficult to manage hospitals and all because of the cash realization from the cashless patients.

Reveals management's cautious approach to expansion, considering challenges with cashless schemes and low package rates, despite a clear intent to grow.

Asked by Nipurn Khemka

Decrease in cancer patients in Q4 FY26 Direct
In the last quarter, there was some scheme launched by Government of Jharkhand, and there was some changes in the approval system. We take so many government-sponsored scheme patients after the approval is received. So, there was some changes in the methods and there was administrative delay in the approval, and that is why some few patients got decreased in the last quarter.

Explains a specific operational challenge in the cancer segment, linking it to government policy changes and administrative delays, which could be a recurring risk.

Asked by Ridhi Agarwal

Main board migration plans Direct
Yes, we have decided that we will be migrating to main board. We are figuring out the eligibility criteria and process. We will be eligible after the month of July. We have initiated the process; we will migrate.

Provides a clear timeline and confirmation of a significant corporate action that could improve liquidity and investor visibility.

Asked by Nitin Gupta

Need for debt for future growth Direct
As of now, we have not decided that we will be going for any debt. It will be managed through internal accruals. But because government brings on every day some new opportunity comes. So, you have to be ready. As a company, you should be able to grab the opportunity. There are certain news circulating in Jharkhand, and we are looking at it as an opportunity. So, in case of any major capex requirement, we will definitely inform.

Clarifies the company's capital structure strategy, emphasizing reliance on internal accruals for growth, but also hints at potential larger capex if new opportunities arise.

Asked by Gaurav Sanghvi

Acquisition (inorganic growth) status Direct
It is not aspiration. It is almost everything has been settled; only technical issues are being resolved. So, it is not aspirational, it is already, you know, this will be materialized in this financial year, number one.

Indicates that inorganic growth through acquisitions is a concrete plan for the current financial year, beyond just an aspiration, suggesting a significant strategic move.

Asked by Prabhat

Total cancer bed capacity in Jharkhand Direct
Total bed capacity, operational bed capacity in Jharkhand as of now is less than 500. (Harendra Singh) Just for the oncology, yes. (Harendra Singh)

Provides crucial market context, highlighting the limited oncology bed capacity in Jharkhand, which underscores Asarfi's strategic positioning and growth potential in this niche.

Asked by Siddhanth Jain

3 min read 6 chapters

Detailed narrative

Strong Financial Performance in FY26

Asarfi Hospital delivered a robust financial performance in FY26, with consolidated revenue from operations increasing by 42% year-on-year to INR 173.5 crores, up from INR 121 crores in FY25. EBITDA also grew by 42% to INR 35.3 crores, maintaining a healthy margin of 20%. Profit After Tax (PAT) saw an even stronger growth of 58% year-on-year, reaching INR 16.7 crores, with the PAT margin improving to 10%. This growth was supported by a 46% increase in IPD revenue and a 34% increase in OPD revenue.

Q4 FY26 Highlights and Operational Metrics

For the fourth quarter of FY26, the company reported consolidated revenue of INR 45.2 crores, marking a 29% year-on-year growth. EBITDA for the quarter stood at INR 7.7 crores, with an EBITDA margin of 17%, and PAT increased by 9% year-on-year to INR 3.9 crores. Operationally, the Average Revenue Per Occupied Bed (ARPOB) improved significantly to INR 23,000 in FY26, and total surgeries increased by 26% year-on-year to over 6,300 procedures. The cancer hospital's occupancy rate improved to 42% during FY26.

Strategic Expansion and Capacity Building

The company is actively pursuing strategic expansion, aiming for an overall bed capacity of 500+ beds and revenue of around INR 400 crores by Vision 2028, with an EBITDA margin target of 23-25%. A key part of this plan is to expand the cancer hospital capacity from 65 beds to 150 beds. Additionally, the company aims to reach 1,000 bed capacity before FY30. Management also confirmed plans for inorganic growth through acquisitions, which are expected to materialize this financial year.

Capital Allocation and Funding Strategy

Asarfi Hospital plans to fund its growth primarily through internal accruals, with no current plans to take on additional debt. The capex for increasing bed capacity in the cancer hospital (from 65 to 150 beds) is estimated at INR 2-3 crores. Furthermore, the construction of the Healthcare Management Research Institute is projected to incur capex of INR 8-10 crores in FY27. The total capex for FY27 is expected to be less than INR 15 crores, supported by existing cash and equivalents of INR 8-10 crores.

Challenges and Regulatory Hurdles

The company faces challenges, including procedural delays in obtaining approval for its bone marrow transplant facility due to the organ transplant policy in Jharkhand. A proposed merger is also delayed due to shareholder inheritance issues. In Q4, the cancer segment experienced a decrease in patient volume due to changes in Jharkhand government schemes and administrative delays. Management also noted that government schemes like Ayushman Bharat offer small package rates, impacting cash realization and requiring careful expansion strategies.

Future Outlook and FY27 Targets

For FY27, Asarfi Hospital is targeting a consolidated revenue of INR 260 crores and a PAT margin of 13-15%. The company also aims to achieve an EBITDA margin of at least 22% in the coming fiscal year. Management expressed confidence in achieving these targets through a focus on case mix optimization, cost management, and expanding its regional reach by engaging with neighboring districts to attract more patients.

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