­Extensive experience of promoters
PMPL is promoted by KEF Healthcare Services Pte Limited, and Peekay Group. KEF Healthcare Pte Limited is into managing a chain of hospitals and provide consultancy and management services and is a wholly owned subsidiary of KEF Holdings engaged into infrastructure, healthcare and investments across India and UAE. KEF Holdings incorporated in Singapore & headquartered in Dubai specializes in offsite manufacturing technology in industries, including healthcare, education, sports and agriculture led by Mr. Faizal E. Kottikollon, an industrialist who has a diversified experience of more than a decade across various industries. Mr. Faizal Kottikollon founded Emirates Techno Casting in Sharjah back in 1997. In 2012, Emirates Techno Casting was sold to Tyco International for over $400 m. This capital was then used to create KEF Holdings. Dr. Ali Faisal is an experienced cardiologist in North Kerala with special interest in non-coronary and peripheral vascular intervention for more than 20 years. The promoters of Peekay group through its group companies are present across various sectors such as steel, flour mills, real estate,construction, plantations,education, healthcare,charitable institution etc.

Improvement in operating performance in 11MFY25
The company reported an improvement in average revenue per occupied bed (ARPOB) per day and overall occupancy level in 11MFY25. The ARPOB improved to Rs.55719 in 11MFY25 from Rs.53748 in FY2024 and Rs.46785 in FY2023. The occupancy level stood at 70 per cent, 56 per cent and 63 per cent respectively for the corresponding period. Although these parameters shown improvement, the company reported marginal improvement in revenue of Rs. 237 Cr. in FY2025 (Est.), Rs.200.37 Cr. in FY2024 against Rs. 222.80 Cr. in FY2023. This improvement in operating performance in 11MFY25 is mainly driven by increased rack rates on billable items, hiring of doctors in-house vis-à-vis on consultation basis earlier, optimisation of costs by entering in long term contract on fixed percentage basis etc. The operating margin stood at 6.10 percent in FY2024 as against 5.41 percent in FY2023. The PAT stood at Rs. (41.97) Cr. in FY2024. In 11MFY25 the operating margin stood at 17.61 per cent, However, the company estimated losses at PAT levels, the PAT margin for 11MFY25 stood at -2.03 per cent.  Acuite believes this improvement in operating performance will sustain over the near to medium term on the back of structural improvements in the overall business risk profile, hwever improvement in profitability while sustaining revenue growth would remain a key rating monitorable.

Weak financial risk profile 
Financial risk profile of the company continues to remain weak marked by high gearing (debt to equity ratio) and weak debt protection metrics. During the year FY2024, the tangible net worth declined and stood at Rs.53.33 Cr. as on March 31, 2024 from Rs. 58.76 Cr. as on March 31, 2023 on account of accrued losses. The total debt stood at Rs. 315.38 Cr. as on March 31, 2024 which includes long-term borrowing of Rs.297.76 Cr. and Rs.17.62 Cr. of short-term borrowing. The overall gearing of the company stood at 5.91 times as on March 31, 2024 as against 5.54 times as on March 31, 2023. The coverage indicators continued to remain weak marked by below unity where the DSCR stood at 0.32 times in FY2024 as against 1.45 times in FY2023 and interest coverage ratio of 0.32 times in FY2024 as against 0.28 times in FY2023. Debt/EBITDA stood high at 24.58 days in FY24 as against 26.12 days in FY2023. The company converted its ECBs into equity of Rs.137.19 Cr. and infused additional equity around ~Rs.30 Cr. as on 31^st March 2025. With this the gearing and debt protection metrics are expected to improve to an extent, however they will remain sub dued to continued losses.

­Stringent regulatory framework in the healthcare sector
Despite the increasing trend of privatization of healthcare sector in India, the company continues to operate under stringent regulatory environment. Accordingly, regulatory challenges continue to pose a significant risk to private healthcare institutions, as they are highly susceptible to changes in regulatory framework. Healthcare is a highly sensitive sector where any mishandling of a case or negligence on part of any doctor and/or staff of the unit can lead to distrust among the masses. Thus, the healthcare providers need to monitor each case diligently and maintain standard in services in order to avoid the occurrence of any unforeseen incident. They also need to maintain high vigilance to avoid any malpractice in any pocket.