Cleopatra 2019 English
Cleopatra 2019 English
Cleopatra 2019 English
EGP 511.1 million EGP 153.8 million EGP 1,798.1 million EGP 501.1 million
Total Consolidated Adj. EBITDA2 Total Consolidated Adj. EBITDA2
Revenue (+27% y-o-y) Revenue (+24% y-o-y)
(+30% y-o-y) (30% margin) (+23% y-o-y) (28% margin)
• Revenues were up 23% y-o-y in FY2019 to EGP 1,798.1 million. In 4Q2019, revenues reached EGP 511.1 million, a 30% y-
o-y increase.
• Gross profit margin (GPM) for the year stood at 35%, unchanged versus the previous year despite the significant expansion
completed by CHG. In the fourth quarter of the year, GPM came in at 34%.
• Adjusted EBITDA2 expanded 24% y-o-y to EGP 501.1 in FY2019. On a quarterly basis, adjusted EBITDA came in at EGP
153.8 million, up 27% y-o-y. A full breakdown of CHG’s adjusted EBITDA is available on page 9 of this release.
• Net profit for the year came in at EGP 265.4 million (NPM 15%), compared to EGP 315.2 million in FY2018. In the final
quarter of the year, CHG reported a bottom-line of EGP 95.4 million (NPM 19%), up 6% y-o-y. Adjusting for non-operational
expenses in 2019 (LTIP and impairments), net profit year-on-year growth stood at 21%.
• On the expansion front, CHG added El Katib Hospital to its network during the last quarter of the year. This is the second
hospital acquired by the Group during 2019, as CHG had previously closed on Queens Hospital in Q1 2019.
• During 2019, the Group also launched its first two polyclinics. Both facilities continue witnessing growing demand, with
combined daily visits in excess of 400 patients and supporting the 14% y-o-y growth in outpatients visits that the Group
witnessed during 2019.
• This brings the number of new facilities for the year up to four and the total number of facilities operated by the Group of at 31
December 2019 to eight.
1
Consolidated figures include the newly added East and West Cairo Polyclinics as well as Queens and El Katib Hospitals.
2
EBITDA, Earnings before Interest, Tax, Depreciation and Amortization adjusted for provisions, impairments, LTIP, acquisitions expenses, pre-operating expenses
and excluding contributions from other income.
3
Cases served includes number of in-patients, outpatient visits and ER visits.
Commenting on Cleopatra Hospitals Group’s performance for FY2019, Chief Executive Officer Ahmed Ezzeldin said:
“With 2019 having come to a close, I am delighted to report that Cleopatra Hospitals Group delivered, once again, excellent
operational and financial results for the year, as we broadened our geographic reach and service offering while continuing to drive
enhancements in the quality of care the Group delivers to its growing pool of patients. 2019 was a year of expansion, internal
restructuring and integration for the Group. In the last twelve months, we added four new facilities to our network acquiring
Queens and El Katib Hospitals and rolling out our East and West Cairo Polyclinics. In parallel, we also worked to increase capacity
at our existing hospitals through a Group-wide renovation plan and a series of expansions at Al Shorouk and Nile Badrawi Hospitals.
On the operational front we worked to enhance our claims collection process instituting a new revenue cycle management
framework, introduced several new business entities to better oversee various aspects of our day-to-day operations, and continued
to drive digitalization across the Group’s network of facilities. During the past year, we continued to place great emphasis on the
professional development and careering advancement of our staff as we look to continue attracting and retaining the best
professionals the industry has to offer.
We enter 2020 with renewed confidence that the solid fundamentals that underpin the Egyptian economy and the foundations we
laid over the course of the past twelve months, have us placed in an ideal position to continue generating sustainable value for all
stakeholders. In the coming year we expect to begin seeing strong contributions to our top- and bottom-line coming from the new
assets added to our network during 2019. In parallel, we will continue to pursue strategic growth opportunities in line with our
six-pillar expansion strategy. I am particularly excited for the roll out of the first phase of our Bani Suef hospital, the Group’s first
facility outside Greater Cairo, which we expect to complete during the last quarter of 2020.
Going into 2020 we expect to see strong revenue and net income growth as our efforts to enhance the quality of the Group’s claim
collection and revenue cycle management continue to bear the desire results. At this time, with the end of 1Q2020 fast approaching,
we have good visibility on financial and operational results for the period and expect top-line growth ahead of last year’s first quarter
figure with expanding margins maintaining the momentum gained in the fourth quarter of the year just ended. With this trend
expected to continue throughout the year, and with the impact of higher LTIP expenses and impairments behind us, we expect to
return to see the full reflection of the Group’s EBITDA and earnings growth on our bottom-line profitability in 2020.
With regards to the recent Coronavirus outbreak, I would like to take this opportunity to reassure you that we are closely monitoring
the situation and keeping a close eye across our operations. At this time, the number of registered cases in Egypt remains limited
and fully under the control of the relevant authorities, with businesses continuing to operate normally. CHG’s management is
confident that the Egyptian government and the Group are well-equipped to handle developments as the situation evolves.
We are regularly updating our staff on the progression of the outbreak and providing them with necessary training and precautions
to ensure of the safety of our workforce and our patients and to safeguard our operations. CHG will provide all stakeholders with
any and all updates through official corporate channels.”
—Ends—
Expansion Strategy
# of Surgeries
(Rev/surgery) Expansion Strategy
In addition to better utilising existing capacities, the Group has been actively working
toward expanding the number of hospitals it operates and its geographic reach, ultimately
EGP 9,502
EGP 8,255 ensuring it delivers the high-quality care it has become known for. To maximise the
effectiveness of the Group’s expansion, back in 2018 management introduced a six-pillar
39,627
34,650
expansion strategy which guided management’s decisions throughout the course of 2019
and will continue to provide guidance heading into the new year. The Group’s expansion
strategy focuses on:
I. Creating a feeder network through the launch of polyclinics across the Greater Cairo
FY2018 FY2019 area.
II. Building additional capacity at existing facilities. To this end, the Al Shorouk
Hospital extension is expected to come online in 2Q2020, with the extension to Nile
# of OP Clinic Visits Badrawi Hospital expected to launch in the coming period as well. The Group also
(Rev/visit) continues pushing forward with the Group-wide renovation project. In 2019, work
focused on enhancing the Electromechanical systems across all CHG facilities.
EGP 322
EGP 322 Management expects to complete all renovation works by end of 2020.
III. Strategically acquiring operating hospitals characterised by strong brand names and
708,152
IV. Targeting brownfield expansions in and outside the Greater Cairo area.
V. Exploring new verticals to ensure the Group continues to grow and create long-term
value for all its stakeholders. This involves expanding past its current multi-
specialty service network model to include a more diverse offering, venturing into
healthcare facility management, long-term patient care, and home care. CHG is also
FY2018 FY2019 targeting a further operational expansion of its pharmacy business in the coming
year.
VI. Creating new business operation entities to oversee specific areas of the Group’s
# of Inpatients day-to-day operations as the Group looks to leverage synergies and expand its
(Rev/stay) service offering.
EGP 7,575
EGP 7,431
New Facilities Updates
54,778
47,826
El Katib
The Group officially took over operations at El Katib Hospital on November 6th having
completed the business transfer agreement (BTA) with the hospital’s operating company.
The 89-bed facility located in the Dokki neighborhood of Greater Cairo, recorded a very
strong start to operations and immediately began contributing to the Group’s consolidated
FY2018 FY2019 results in the fourth quarter of the year. Having recently undergone a series of significant
upgrades to its facilities and equipment, the hospital is expected to continue contributing
strongly in the coming year. Heading into 2020, the Group aims to build on the existing
# of ER Visits infrastructure, adding further state-of-the-art equipment, as it seeks to develop the
(Rev/visit) hospital’s capabilities and transform it into the Group’s urology centre of excellence.
Management is confident that the integration of El Katib into the wider Group’s operating
EGP 256 EGP 289 framework will conclude smoothly and in a short timeframe with the new management
team working to execute the facility’s 100-day integration plan.
257,164
252,761
Queens Hospital
Queens Hospital continued to operate at reduced capacity as the Group works to complete
the facility’s upgrade works. Management expects the hospital to begin operating at full
capacity by the end of the first six months of 2020 once the renovation plan is completed.
Since having taken over operations in the first quarter of 2019, the Group has worked to
FY2018 FY2019 enhance the hospital’s OBGYN services and expand its service offering to include
orthopaedics and general surgery, both of which are specialties characterised by high
patient demand. As part of the renovation plan, CHG will be adding a new ICU unit and a
diagnostics centre, expand the hospital’s ER facilities, upgrade of its operating theatres,
and revamp Queens Hospital’s inpatient ward.
# of Catheterizations Polyclinics
(Rev/catheterization) CHG East Cairo Polyclinic continued to outperform the Group’s expectations, averaging
close to 300 visit per day, in line with volumes recorded by a typical hospital’s outpatient
EGP 33,051
clinic department. At the Group’s West Cairo Polyclinic management is also witnessing
EGP 29,526 strong growth in demand with volumes continuing to expand in the second half of 2019.
4,514
4,050
The launch of the East and West Cairo Polyclinics is part of the Group’s feeder network
strategy which aims to grow CHG’s geographic reach across Greater Cairo while driving
up volumes at the Group’s main hospitals through the referral of patients. Polyclinics are
relatively underdeveloped in Egypt, but they represent a low-CAPEX expansion avenue.
FY2018 FY2019 The facilities are located strategically across high-catchment and currently underserved
areas of Cairo, allowing it to not only extend its geographical reach, but to fill a supply gap
Historical figures have been adjusted to for segments of the population who currently have limited healthcare access.
account for standardization of KPI reporting
across all facilities.
Bani Suef
All KPI figures for FY2019 refer to all six of During the final quarter of the year, CHG kicked off civil works at its new 198-bed hospital.
CHG hospitals as well as the Group’s East The Group is looking to complete the first phase of the hospital before the end of 2020,
and West Cairo Polyclinics (contributing to
group’s outpatient visits volumes)
which will see between 70 and 90 beds come online. The Beni Suef hospital is CHG’s first
medical facility outside Greater Cairo and is a move to expand the Group’s reach to more
secluded regions of the country. The facility will also house a teaching section dedicated
to Nahda University’s faculty of medicine. The total estimated cost for the refurbishment
and development of the facility is estimated at EGP 360 million.
Operational Review
During the last twelve months, CHG’s management worked to improve the Group’s claim
collection process, roll out a Group-wide HIS/Enterprise Resource Planning (ERP) system,
and introduced multiple new internal functions to improve on various aspects of the
Group’s day-to-day operations.
Information Technology
The Group continued to make progress on the rollout of its Group-wide HIS/Enterprise
Resource Planning (ERP) system. As of year-end 2019. the system is operational at both
the East and West Cairo Polyclinics as well as at Cairo Specialised Hospital. Currently, the
Group is rolling out the new system at Cleopatra Hospital before moving on to Queens
Hospital. Management expects the full migration by end of 2020. The Group is also in the
pre-launch phase for its new CHG app. The new app will allow patients to book
appointments, review diagnostics, and follow up on their medical cases from anywhere in
the world through their smartphones.
Financial Review
Revenue by Hospital
(FY2019) Revenues
1% 1% Consolidated revenues for the year came in 23% above last year’s figure to reach EGP
17% 1,798.1 million for the year supported by a solid revenue expansion across the Group’s full
array of services and procedures. On a by service basis, inpatient services contributed to
23% of the Group’s consolidated revenue having expanded 17% y-o-y in FY2019. This
42% was closely followed by surgeries which reported a 32% y-o-y rise in revenues and
18% contributed to 21% of the Group’s top-line over the past twelve months. Outpatient services
recorded a 14% y-o-y rise in revenues and made up 13% of the consolidated figure for the
period. Revenues generated from the Group’s laboratory services were up a solid 31% y-
o-y, with the segment making up 9% of total Group revenues in FY2019. Revenues from
21% catherization services was up 25% y-o-y, with their share of total revenues coming in at
Cleopatra Hospital* 8% for the year. Finally, radiology services recorded a 33% y-o-y rise in revenues with
Cairo Specialised Hospital their contribution to consolidated top-line standing at 6% for the quarter.
Nile Badrawi Hospital
Al Shorouk Hospital
El Katib On a quarterly basis, consolidated revenues saw an impressive 30% y-o-y rise to EGP 511.1
Polyclinics** million. Inpatient services continued to make the largest contribution to consolidated top-
*Cleopatra Hospital results for the quarter include line in the last three months of the year at 22%, followed by surgeries at 21% and outpatient
revenue generated by Queens Hospital
**Polyclinic revenue includes both East Cairo
services at 13%. Laboratory services reported the fastest revenue expansion rate for the
Polyclinic, which was launched in Feb 2019 and period up 45% y-o-y, followed by catherization, up 44% y-o-y, and surgeries, which
consolidated with the start of 2Q2019, and West expanded 37% y-o-y for the quarter.
Cairo Polyclinic where operations began in July
2019.
On a per hospital basis, Cleopatra Hospital, which includes revenues of around EGP 13.6
million generated by Queens Hospital, continued to make up the largest share of
Revenue by Segment consolidated revenues at 42% for FY2019. This was followed by Cairo Specialized
(FY2019) Hospital “CSH”, which made a 21% contribution, Nile Badrawi Hospital “NBH” with an
18% share of total revenues, and Al Shorouk Hospital “ASH” with a 17% contribution.
23%
The Group’s newly launched East and West Cairo Polyclinics contributed to around 1% of
13%
total revenues for the year, with the newly acquired El Katib Hospital also making up
around 1% of consolidated revenues in FY2019.
9%
Revenue Progression by Hospital (EGP mn)
8% FY17
21%
4% FY18
764
16% 6% FY19
677
Surgeries
Outpatient Clinics
493
Inpatients
374
Laboratories
323
301
287
Cardiac Catheterization
257
255
244
202
191
Emergency Room
25
17
Radiology
All Others
Cleopatra Cairo Nile Badrawi Al Shorouk El Katib Polyclinics
Specialized
COGS
Cost of goods sold in FY2019 increased to EGP 1,172.7 million, a 24% y-o-y rise. During
the year, medical supplies made up 30% of total COGS, followed by consulting physicians’
fees at 28%, and salaries and wages at 25%. Salaries and wages continued to be the fastest
growing component, expanding 30% y-o-y in FY2019. The Group’s COGS/sales ratio
stood at 65% for the year. On a quarterly basis, COGS expanded 37% y-o-y to EGP 337.5
million in the last three months of the year.
Gross Profit
CHG reported a gross profit of EGP 625.5 million in FY2019, a 22% y-o-y increase. GPM
for the year stood at 35% unchanged from last year’s margin. Cleopatra Hospital, which
continues to include Queens Hospital’s results, reported a 13% y-o-y rise in gross profit
and made up half of total gross profit for the period. Cairo Specialised Hospital reported
the fastest gross profit growth rate for the year expanding 47% y-o-y and making up 20%
of CHG’s consolidated gross profit. Nile Badrawi Hospital reported a 21% y-o-y rise in
gross profits, making up 17% of the Group’s gross profits, followed by Al Shorouk
Hospital which saw a 27% y-o-y rise in gross profit, making a 14% contribution to
consolidated gross profit for the year.
In the last quarter of the year, the Group’s gross profit expanded 17% y-o-y to EGP 173.6,
with an associated margin of 34%. On a per hospital basis, Cairo Specialised Hospital
continued to report the fastest year-on-year growth rate at 39%, with Cleopatra Hospital
(which includes results from Queens Hospital) continuing to make up the lion share of total
gross profit at 48% for 4Q2019.
G&A Expenses
General and administrative (G&A) expenses consist of the company’s non-medical staff
costs, including those of senior management and Group-level professional consulting fees.
G&A expenses also include the Group’s Long-Term Incentive Program (LTIP), a non-cash
charge linked to share price appreciation and EBITDA growth. The LTIP has a four-year
maturity period maturing by 30 June 2020, after which amounts will be disbursed. Outlays
for G&A purposes increased 85% y-o-y in FY2019 to EGP 338.0 million, and 41% y-o-y
to EGP 64.6 million on a quarterly basis.
The year-on-year increase on both a full-year and quarterly basis, came on the back of an
increase in the accrued non-cash LTIP expense and a rise in impairments for the periods.
In FY2019, LTIP expenses came in at EGP 83.8 million compared to EGP 20.4 million in
FY2018. In the last three months of the year, LTIP expenses recorded EGP 11.2 million
compared to EGP 3.6 million in the same quarter of 2018. The Group booked EGP 58.6
million in impairments during FY2019 compared to EGP 1.7 million in FY2018. The rise
in impairments for the year was related to claims from 2016, 2017, and to a lesser extent
2018. However, during the last three months of the year, impairments continued on their
path towards normalization coming in at EGP 9.7 million. This brings the total impairments
booked in 2H2019 to EGP 17.4 million, significantly down from the EGP 41.2 million
booked in the first half of the year. The decrease was supported by the Group’s efforts to
establish a more structured revenue cycle management and enhance the quality of its claims
collection procedure.
EBITDA
CHG’s EBITDA, factoring out acquisition expenses, impairments, the LTIP’s non-cash
charge, pre-operating expenses and contributions from other income, increased 24% y-o-y
in FY2019 surpassing the half-a-million mark to reach EGP 501.1 million. EBITDA
margin for the year stood unchanged at 28%. On a quarterly basis, EBITDA increased to
EGP 153.8 million, up 27% y-o-y with an associated margin of 30%.
Excluding the negative impact on EBITDA of the Group’s East and West Cairo polyclinics
launched in 2019 and Queens Hospital, currently undergoing refurbishment works,
EBITDA would have expanded 32% y-o-y in FY2019, with a margin of 30%.
Net Profit
GHC’s consolidated net profit came in at EGP 265.4 million for FY2019 compared to the
consolidated EGP 315.2 million net profit booked in FY2018. The decrease came largely
on the back of higher LTIP expenses, impairments, and heighted depreciation outlays
related to the recent acquisitions by the Group. NPM for the year stood at 15%. In 4Q2019,
net profit increased 6% y-o-y to EGP 95.4 million, with an associated NPM of 19% for the
period.
CAPEX
Total CAPEX outlays stood at EGP 360 million as of 31 December 2019 including down
payments for CAPEX purchases not yet delivered. Throughout the year, CHG’s
expenditures focused on renovation and upgrades works, and the procurement of new state-
of-the-art equipment, as the Group continues to focus on improving its healthcare services
and continue to provide superior clinical outcomes.
38%
For further information, please
contact: 62%
Hassan Fikry
Corporate Strategy & Investor Relations Director
Care Healthcare Ltd. Free Float
T: +2 (0)2 2241 7471
[email protected]
investors.cleopatrahospitals.com
Forward-Looking Statements
This communication contains certain forward-looking statements. A forward-looking statement is any statement that does not relate
to historical facts and events, and can be identified by the use of such words and phrases as “according to estimates”, “anticipates”,
“assumes”, “believes”, “could”, “estimates”, “expects”, “intends”, “is of the opinion”, “may”, “plans”, “potential”, “predicts”,
“projects”, “should”, “to the knowledge of”, “will”, “would”, or, in each case, their negatives, or other similar expressions that are
intended to identify a statement as forward-looking. This applies, in particular, to statements containing information on future
financial results, plans, or expectations regarding our business and management, our future growth or profitability and general
economic and regulatory conditions and other matters affecting us.
Forward-looking statements reflect our management’s (“Management”) current views of future events, are based on Management’s
assumptions, and involve known and unknown risks, uncertainties, and other factors that may cause our actual results, performance,
or achievements to be materially different from any future results, performance, or achievements expressed or implied by these
forward-looking statements. The occurrence or non-occurrence of an assumption could cause our actual financial condition and
results of operations to differ materially from, or fail to meet expectations expressed or implied by, such forward-looking statements.
Our business is subject to a number of risks and uncertainties that could also cause a forward-looking statement, estimate, or
prediction to become inaccurate. These risks include fluctuations in the prices of raw materials or employee costs required by our
operations, its ability to retain the services of certain key employees, its ability to compete successfully, changes in political, social,
legal, or economic conditions in Egypt, worldwide economic trends, the impact of war and terrorist activity, inflation, interest rate
and exchange rate fluctuations, and Management’s ability to timely and accurately identify future risks to our business and manage
the risks mentioned above.
Certain figures contained in this document, including financial information, have been subject to rounding adjustments.
Accordingly, in certain instances, the sum or percentage change of the numbers contained in this document may not conform exactly
to the total figure given.
Distributed as follows:
Shareholders of the company 90.9 84.0 8% 257.4 294.9 -13%
Minority rights 4.5 6.2 -28% 8.0 20.3 -61%
Profit for the period 95.4 90.2 6% 265.4 315.2 -16%
Non-current assets
Fixed assets 560.5 908.5
Intangible assets 241.0 413.6
Right of Use - 10.2
Payment under investment 143.9 -
Total non-current assets 945.4 1,332.4
Current assets
Paid under subsidiaries capital increase - -
Inventory 40.8 49.3
Accounts receivables 302.8 337.2
Other receivables and debit balances 48.5 105.2
Due from related parties 7.1 2.0
Treasury Bills - 50.1
Cash 953.4 791.3
Total current assets 1,352.5 1,335.0
Total assets 2,298.0 2,667.4
Equity
Share capital 800.0 800.0
Reserves 274.2 284.4
Retained earnings 529.8 746.2
Equity attributable to the parent company 1,604.0 1,830.6
Non-controlling interest 74.7 103.9
Total equity 1,678.7 1,934.5
Non-current liabilities
Long term debt – non-current portion 67.9 -
Non-current portion of lease liability - 5.8
Deferred tax liability 66.9 74.8
Total non-current liabilities 134.7 80.6
Current liabilities
Provisions 24.9 15.6
Creditors and other credit balances 317.7 442.3
CPLTD 27.2 -
Current portion of lease liability - 2.7
Long term incentive plan 45.2 129.1
Current income tax 69.4 62.6
Total current liabilities 484.5 652.3
Total liabilities 619.3 732.9
Total liabilities & shareholders’ equity 2,298.0 2,667.4
Adjustments for:
Depreciation 46.8 65.0
Allowance for impairment of current assets (4.4) 57.5
Provision 3.3 (9.3)
Capital gain/Loss (1.0) (1.0)
Credit / Debit Interest (91.3) (89.6)
Changes in current tax liability (32.9) (101.0)
Share-based payments financial liabilities 20.4 83.8
Operating profits before changes in assets and liabilities 348.9 372.9
Changes in working capital:
Changes in Inventories (10.5) (7.1)
Change in trade receivables , debtors and other debit balances (115.0) (86.6)
Changes in Due from related parties (1.6) 5.1
Change in trade and other payables 78.0 149.0
Net cash flows generated from operating activities 299.8 433.2
Cash flow from investment activities:
Proceeds from sale of fixed assets 1.2 1.6
Payments for purchase of fixed assets (86.6) (101.1)
PUC purchased (48.4) (194.1)
Advanced payments for purchase of fixed assets (24.6) (64.8)
Payments for acquisition of a subsidiary, net cash acquired - (160.1)
Payments under investment (0.4) -
Credit interest collected 129.3 97.2
Time deposits with maturity more than 3 months 11.0 (50.1)
Paid under subsidiaries capital increase - -
Net cash flow from investment activities (18.4) (471.4)
Cash flow from financing activities:
Proceeds from Minority Share in Subsidiary Cap Increase - 22.5
Dividends Paid (21.7) (31.9)
Repayment of borrowings (230.9) (95.1)
Cash proceed from overdraft 106.6 85.2
Cash paid to overdraft (132.6) (85.2)
Interest paid (45.5) (20.0)
Net cash flow from financing activities (324.1) (124.6)
Net change in cash & cash equivalents during the period (42.7) (162.7)
Cash & cash equivalents at the beginning of the period 996.1 953.4
Cash & Cash equivalent at in acquired subsidiaries at the beg. of the period - 0.6
Cash & cash equivalents at the end of the period 953.4 791.3