Operator
Welcome to the Clariane 2026 half year results presentation. For the first part of the conference call, participants will be in listen-only mode.
However, during the questions and answers session, participants are able to ask questions. This can be done by dialing pound key 5 on their telephone keypad or by typing a question in the chat box.
Now I will hand the conference over to the management team. Please go ahead.
Sophie Boissard
Thank you very much. Ladies and gentlemen, dear investors and financial partners, good afternoon and welcome to the Clariane Group's 2026 half year result presentation.
I'm Sophie Boissard, Chief Executive Officer of the Clariane Group, and together with Grégory, the group Chief Financial Officer, I will present our results for the first half of 2026, the refinancing transaction we completed during the period, and our outlook for '26 and '28. Let me start with the agenda.
I will begin with the main highlights of the first half and the progress we made on our operational, financial, and non-financial priorities. Grégory will then take you through the income statement, cash flow, debt, and our own real estate portfolio.
I will return for the final section on the drivers of our performance, and of course, on the outlook. Let me now start with the key highlights.
The first half result reflects the sound execution of our roadmap and confirmed the solidity of our fundamentals. The strong improvement in our operating performance, underpinned by the quality of our activities, the discipline in execution, and the relevance of our model, place us in a very favorable position with regard to our medium-term objectives.
Three messages stand out. First message: the group delivered a clear improvement in operating performance.
As you see here on the slide, organic revenue growth reached 4.6%, supported by volume growth for 1.6% and a pricing gain of 3%, with all activities and all geographies contributing. Pre-IFRS 16 EBITDA rose by 14.9% on a pro forma basis excluding disposals, and the margin increased by 90 basis points to 10.4%.
Opco EBITDA grew by 25.1% on a pro forma basis, driving a 100 basis point margin increase to 6.2%. This reflects the first impacts of the various operational levers we are implementing, including higher volume on the existing network, a diligent care mix management, and several cost efficiency programs, which results in a positive price-over-cost effect.
The second message, as you see here on the slide, we have further strengthened and simplified our balance sheet structure. Following the assignment of Moody's and S&P ratings, we regained access to the debt capital markets and issued more than €1 billion over the last 6 months.
We have streamlined and strengthened our capital structure, and we have also extended our debt maturity profile. We are now benefiting from a very strong liquidity position of more than €1.7 billion before the [Oceane?]
repayment that will happen in September. Holdco leverage as published stood at 4.9 times on a reported basis, and Grégory will explain later on how it translates in our balance sheet structure after repayment of the two hybrid bonds we had.
Third message: we confirm both our '23-'26 outlook and our '25-'28 medium-term plan outlook. The strong operating momentum achieved during the first half, together with the refinancing completed and the implementation of our corporate roadmap succeed together, gives us the means to execute our strategy with confidence.
Let me now walk you through the key financials. I have already presented the main items of the P&L.
I will therefore focus here only on the complementary cash flow, balance sheet, and portfolio indicators shown on the right-hand of the slide. As you see, operating cash flow increased by 8.3% to €144 million, reflecting the strong operating performance achieved during the period.
Net financial debt, excluding IFRS 16 and IAS 17, stood at more than €3 billion at the end of June, down by €539 million compared with June 2025. Net profit attributable to the group stood at -€42 million, and post-IFRS 16 at -€48 million.
These figures include €51 million in exceptional costs related to restructuring and disposal transaction we have executed over the last two years. Finally, the gross value of our real estate portfolio was €2.4 billion, broadly stable excluding perimeter effects, while net asset value increased by €19 million to €515 million versus December 2025.
Let me now say a few words about the ESG milestones achieved in H1 '26. The progress achieved on this dimension also reflects the central role of our mission commitment in Clariane's operating model, its value creation, and long-term resilience.
I would like to highlight three dimensions. The first one refers to social dialogue and human resources.
We have renewed the agreement establishing our European company committee for a further 4 years, with unanimous support from the members and the EPSU trade union federation. We agreed with the workers' representatives that we would work on an agreement at European level to further promote common occupational health and to prevent absenteeism and workplace accident.
We have also decided to work with the workers' representatives on artificial intelligence and how we can best roll it out in our operation. When it comes to HR and to training and talent development, we have also continued to invest in leadership and internal development.
We have launched a new program called OLM, Operational Leadership Masterclass, dedicated to regional directors, and we have already 40 participants among the group's senior managers. The same program will be rolled out in Germany during the second half and also in Belgium, with the aim to reach the target of 75% of facility directors and operational leaders promoted from within by the end of 2026.
In France, we initiated an innovative value-sharing and incentive scheme called the Prime Opérationnelle de Progrès, benefiting to all Korian and Inicea facilities. This scheme is calculated at facility level, each facility level, on a half-yearly basis, and based on financial value creation beyond budget.
Payment is of course conditional on mandatory quality of care indicators. Close to 50% of the facility could benefit from the incentive scheme over the first half, and we aim to replicate the scheme across all the network in 2027.
Let me now say a few words about quality of care and what we do in terms of medical research. Our medical teams have brought a strong contribution on research on healthy aging and prevention over the last half.
They have contributed to 60 research projects with very well-known universities and hospitals, including 24 indexed publications, and we are very proud about it. On digital solutions in care, the benefits identified through the [Karlsfeld?]
experimentation, a pilot project in Germany close to Munich, are now being rolled out more broadly. This includes, and will actually be deployed everywhere, AI-supported fall detection sensors to enhance patient safety, and also, and that is actually the most efficient, voice-assisted care documentation that bring productivity gain for employees and also much more comfort in the daily routine.
Last but not least, let me say a few words on the environmental side. We have carried out in '24 and '25 a vulnerability analysis that had identified already extreme heat, heavy rainfall, and flooding as the main risks that potentially can affect our portfolio.
We have started to translate this work, this analysis, into a climate adaptation plan for priority sites, with the related operating and capital expenditures integrated in our financial planning. I would like also to mention what we do in the dimension of energy saving.
We have signed and/or are implementing nearly 100 energy performance contracts in France that took place at end of 2025, and we are continuing this effort across the whole portfolio, across Europe, with a view to further reducing our carbon footprint, but globally our energy consumption. I would like now to say a few words about the very acute climate risk Europe is facing, and that is, of course, also a critical dimension for Clariane network.
This slide illustrates how our climate adaptation work, the one I just mentioned, translates into concrete operational preparedness beyond regulatory standards, of course, and into support for local communities. The various weather events currently affecting many regions across Europe provide a very concrete illustration of what our responsibility and capacity to act are about.
In France, all the 260 Korian nursing homes naturally comply with the requirements that were introduced following the 2004 heat wave regulation. Each of our facility has at least two air-conditioned areas supported by mobile cooling units, and we have also installed a hotline with our key suppliers so that they are able to carry out urgent repairs within a target timeframe of 2 to 4 hours in terms of extreme heat condition.
Beyond these measures, we have taken recently voluntary action by building and activating a dedicated internal heat wave response plan that we call Plan Bleu, blue plan, across the network. Our plan reinforces the monitoring of residents and patients and the coordination of health, technical, and human resources teams.
We have put in place a dedicated crisis unit at group level, which coordinates on a daily basis the response within each country. This dedicated crisis unit will remain in place all along the summer.
We are also making strong contributions to the communities around our facilities, as our teams have been doing in Bordeaux over the last days by rescuing and hosting over 100 people that had to flee areas affected by the wildfires. The same happened also in the Madrid community.
I would like to warmly thank all our employees for their daily commitment. Their responsiveness, their professionalism, their dedication remain the group's greatest strength.
Let me now comment how we regained access to debt capital markets. The ratings assigned in February, B+ by S&P and B2 by Moody's, have confirmed our access to debt capital markets and evidence the strength of the group's fundamentals.
The three-in-a-row refinancing transactions completed during the first half provide a solid foundation for the execution of our medium-term plan. In total, more than €1 billion was issued in demanding market conditions and with solid subscription rates.
The outcome is a simpler capital structure, a debt maturity profile largely extended beyond 2030, and greater visibility for the implementation of our business model with a clear focus on three priorities that are reflected here. First priority: we will continue to fully leverage our existing capacities via an embedded growth representing roughly 7,000 beds in the nursing home segment, and we are continuing developing patient activity in specialty care and enrich the service offering.
The second priority is the pursuance of capex-light development for disciplined capital allocation and with the maintain of strict selectivity for greenfield projects. Last but not least, this is the third priority, we will continue actively managing the pricing and care mix to nurture positive price-over-cost effect, benefiting here from our balanced regulation profile between private pay resources and public funding, which represent each roughly 50% of our revenue.
This combination of profitable and embedded organic growth, disciplined capital allocation, and active management of the pricing and care mix is the basis of our '25-'28 plan. Let me now say a few words about the operational roadmap we have designed to deliver on the plan.
Here you see the operating priorities that form a clear operational roadmap supporting our succeed together plan, and are directly linked to the public health needs identified in each region. Here in the blue column, you see what we are focusing on for the long-term care activities, namely supporting the increase in care intensity, in complexity within our facilities.
We see that increasingly month after month. We are also working closely hand-in-hand with local hospitals, which are becoming our closest partners in care pathways for nursing homes.
Last but not least, we are developing new support solutions for relatives, for family helpers, including respite and short-stay solutions, which are offered in all our nursing homes across Europe. In the green line, you see what are our priorities for specialty care activities, namely promoting mixed rehabilitation pathways combining inpatient and outpatient care in all clinics.
In addition, we are transforming our post-acute clinics into integrated geriatric platforms that can support aging population in the local communities. That is, of course, a critical need everywhere.
Last but not least, we are also developing, on top, specialized pathways in coordination with payers and local public agencies to cover segments such as addiction, mood disorders, neurological disease, and oncology. Across both segments, digital and AI-enabled solutions support not only quality consistency, but also the efficiency of our services, and at the end of the day, contribute to margin improvement.
This combination of levers are central to the Better Support efficiency program. I will now hand over to Grégory, which will take you through the income statement, cash flow, debt, and real estate portfolio in greater detail.
Grégory, the floor is yours.
Grégory Lovichi
Thank you, Sophie. Good afternoon, ladies and gentlemen.
I will begin with the group's revenue performance in the first half. As Sophie indicated, consolidated revenue stood at €2 billion and €699 million, up 1.6% on a reported basis and 4.6% on an organic basis.
All activities and all geographical areas contributed to organic growth. By activity, long-term care, which accounts for 75% of group revenue, grew by 5% organically.
Medicalized nursing homes increased by 4.9%, supported by higher occupancy and pricing, while alternative living solutions increased by 5.7% organically. Specialty care, which accounts for 25% of revenue, grew by 3.2% organically.
Specialty and post-acute care increased by 1.9%, driven by higher volumes, particularly in outpatient care and an improvement in care mix. Mental health grew by 6.6%, supported by the development of the network, particularly in Spain.
Looking at the geographical breakdown: Germany delivered organic growth of 7.2%, Belgium and the Netherlands 5.9%, Italy 3%, and Spain 15.5%. France grew by 1.7% organically.
In long-term care, growth was primarily volume-driven, with average occupancy rate in medicalized nursing homes increasing by 1.1 percentage points, while price increases remained limited in the country. Specialty care continued to recover, supported by higher outpatient volumes and the favorable impact of care mix improvements implemented during 2025.
Adjusting the comparison basis for the exceptional SMR-related effects recorded in the first half of 2025, organic growth would have been at 4.3% on the segment of specialty care in France, out of which two-thirds are coming from price effects. The difference between reported and organic growth mainly reflects the disposal completed in 2025 as part of the plan to strengthen the group's financial position.
Let us now look at the revenue bridge. We start with reported revenue of €2 billion, €656 million in the first half of '25.
Disposal plan and perimeter effects represent a negative €90 million, or 3.5%. Organic growth was driven by volumes and by price and care mix.
Volumes contributed €41 million, or 1.6%. Long-term care accounted for €36 million of this increase, mainly through higher occupancy in medicalized nursing homes, particularly in Belgium and the Netherlands.
Specialty care contributed €5 million, reflecting higher activity, including outpatient care, mainly in France and Spain. Price and care mix contributed €77 million, or 3%.
In long-term care, the effect was €61 million, led by Germany, with positive contributions from France, Belgium, Netherlands, Spain, and Italy. Specialty care contributed €16 million, with positive effects in France, Italy, and Spain.
As a reminder, other effects contributed a positive €16 million, as H1 '25 was affected by the starting point for the tariff reform of SMR specialty care in France. In total, reported revenue increased by 1.6% and organic revenue by 4.6%.
Taken together, volume, price, care mix, and other effects largely offset the planned reduction in perimeter. Turning to occupancy, the positive trajectory in medicalized nursing homes continued throughout the first half.
The average occupancy rate reached 91.7% compared with 90.5% in the first half of 2025, an increase of 1.2 percentage points. Based on beds actually available for occupancy, excluding around 400 beds temporarily unavailable due to renovation or maintenance work, the occupancy rate was 92.3%.
The improvement was broad-based across the group, confirming the additional growth potential embedded in the existing network. I will now turn to the EBITDA bridge pre-IFRS 16.
Published EBITDA for the first half of '25 was €263 million. The scope effects related to the disposal plan and the closure of a small number of underperforming facilities was negative €19 million.
This gives a pro forma comparison base of €243 million with a margin of 9.5%. Volumes contributed a positive €10 million.
Contribution was slightly positive across the geographies and reflects the increase in occupancy and activity. The net price effect was positive €27 million.
Price and tariff increases contributed €77 million across all geographies, led by Germany. Cost inflation represented €50 million, mainly in France and Germany.
On this basis, pre-IFRS 16 reached €280 million, up 14.9% on a pro forma basis excluding disposals, and 6.5% on a reported basis. The margin increased to 10.4% compared with 9.5% on a pro forma basis in the first half of 2025.
This improvement reflects higher volumes, good control of operating costs, active care mix management, and the adaptation to the new pricing framework for SMR activities in France. Opco EBITDA reached €168 million, up 25.1% on a pro forma basis and 13% on a reported basis.
The Opco EBITDA margin increased to 6.2% from 5.2%. This performance illustrates the strength of our operating model: organic revenue growth of 4.6% translated into a 15% increase in pre-IFRS 16 EBITDA and a 25% increase in Opco EBITDA, supported by the positive price-over-cost effect and the operational improvements, primarily in Germany and specialty care in France.
This slide places the first half performance in the context of the trajectory since 2023. H1 EBITDA margin, excluding real estate development, reached 10.4% in the first half of '26.
This represents an improvement of around 100 basis points compared with the first half of 2023 on a pro forma basis. Now looking at H2 versus H1 over the past four years, seasonality has consistently driven a sequential improvement in the pre-IFRS 16 EBITDA margin in the second half, ranging from 100 to 220 basis points compared with the first half.
Let us now move to cash flow and debt. Operating cash flow increased to €144 million in the first half of '26 compared with €133 million in the same period last year, primarily driven by €70 million increase in EBITDA and €11 million improvement in non-cash and other items before taking into account the working capital and investment effects.
Working capital requirements showed a temporary and limited deterioration of €9 million, and maintenance and IT investments increased to €57 million from €50 million. Financial expenses and taxes paid amounted to €124 million compared with €110 million in the first half of '25.
The increase mainly reflects the full first half impact of the €500 million bond issued in June '25 and, to a lesser extent, the high-yield bond issued in April 2026. This was partially offset by the repayment of the revolving credit facility.
Operating free cash flow stood at €20 million compared with €23 million last year. Development investments remained tightly controlled at €46 million compared with €48 million.
Further financial divestments contributed to a positive €22 million compared with a negative €23 million in the first half of '25. As a result, net free cash flow after capex improved significantly by €44 million, from a negative €48 million to close to break-even.
This is consistent with the ambition to turn cash flow positive from 2026 on. After coupon payments, real estate transactions, and the financing operations completed during the period, net debt decreased by €49 million including IAS 17, and by €35 million excluding IAS 17.
The full-year cash benefit of around €40 million from refinancing the sterling hybrid at a lower cost of funding is therefore only partially reflected in the first half cash flow. The first half was marked by three successful bond transactions totaling €1 billion and €63 million.
Following the assignment of a B+ rating by S&P and a B2 rating by Moody's, Clariane gained access to a broader range of financing options, including the high-yield market. These repeat transactions enabled the group to extend its maturity profile, simplify its capital structure, and secure additional liquidity.
First transaction was a €500 million inaugural high-yield senior unsecured bond issued on 10th of April, maturing in 2031 and bearing a coupon of 6.875%. The proceeds, together with available cash, are being used to refinance the Schuldschein maturing in '26 and '27, and the remaining Euro PP bond maturing in '28.
The €40.8 million Euro PP originally due in 2027 was repaid early on 25th of June. Second transaction was the issue on 28th of April of €230 million of additional high-yield senior unsecured notes, fungible with the initial €500 million issuance and forming a single series maturing in 2031.
The proceeds enabled us to redeem the £200 million sterling perpetual green hybrid bonds on 15th June. The transaction improves cash generation by around €14 million on a full-year basis.
Third transaction was a €333 million deeply subordinated undated hybrid bond issued on 23rd of June with a fixed coupon of 7.875% for the first 3 years. The proceeds will be used to redeem the [Oceane?]
by 8th of September and avoid the application of the coupon step-up clause. Once the corresponding repayments have been completed, the three transactions will extend the maturity profile, streamline the capital structure, and improve cash generation by approximately €27 million on a full-year basis.
Refinancing the sterling hybrid with senior debt mechanically increased Holdco leverage by approx 0.4 times, from 5.1 times reported to 5.5 times pro forma on the end 2025 reference base. The June hybrid issue retains equity treatment under IFRS and is neutral for leverage once its proceeds have been used to redeem the [Oceane?]
. Following the assignment of our S&P and Moody's ratings, we are also beginning to benefit from our position as a repeat issuer in the debt capital markets, with greater investor familiarity supporting broader access and more efficient execution.
This slide now shows the effect of the refinancing transactions on the group's maturity profile. On a reported basis, the proceeds are temporarily held in cash while the relevant instruments are repaid either at maturity or ahead of scale.
The 2031 senior notes would refinance the Schuldschein maturing in '26 and '27, and the remaining Euro PP bond maturing in '28. The 2027 Euro PP has already been repaid early.
After the planned use of proceeds, the corporate debt profile is significantly simpler, with fewer debt instruments and main maturities pushed to 2030 and 2031. It is also worth noting that our factoring arrangements are diversified across two separate revolving facilities provided by two different banking partners.
Overall, the real estate debt profile remains well spread over time. This combination reduces short-term refinancing risks and supports the group's policy of anticipating refinancing 12 to 18 months before maturity.
The balance sheet trajectory continues to improve. Net financial debt stood at €3 billion and €20 million at the end of June compared with €3 billion, €559 million one year earlier.
This represents a reduction of €539 million. Gross borrowings and financial debt were €4 billion and €431 million.
Cash and cash equivalents stood at €1 billion, €411 million. Together with the undrawn revolving credit facility of €325 million, reported liquidity reached a solid €1 billion and €736 million.
This sound level of liquidity includes the €333 million proceeds from the hybrid issue, which were still held in cash at 30th of June and are expected to be allocated to the redemption of the outstanding amounts under the [Oceane?] .
Reported Holdco leverage stood at 4.9 times, including the temporary €333 million hybrid proceeds held in cash. Pro forma for the use of those proceeds to redeem the [Oceane?]
, Holdco leverage stood at 5.4 times. On a comparable pro forma basis, this compares with a 5.6 times at the end of June '25.
Compared with December '25, net debt was broadly stable, while EBITDA increased strongly, supporting the improvement in leverage. At constant financial structure, neutralizing the mechanical effect of refinancing the sterling hybrid with senior debt, Holdco leverage stood at 5.1 times.
The trajectory since 2023 remains clear. Holdco leverage has decreased substantially, supported by the completion of the plan to reinforce the capital structure, improved operating performance, discipline in capital allocation, as well as cash management and active debt management.
I will conclude my section with the owned real estate portfolio. Please note that as of June 2026, portfolio is appraised by CBRE, replacing Cushman & Wakefield as the group's external real estate valuer.
The gross asset value of the group's real estate portfolio stood at €2 billion and €428 million at 30th of June '26 compared with €2 billion, €456 million on a pro forma basis excluding disposal last year. The €28 million decrease reflects three main effects.
First, indexation contributed a positive €23 million. Then, investments made during the period contributed €9 million.
Then, these two positive effects were offset by a €60 million impact from the limited increase in the average capitalization rate to 6.6% compared with a 6.44% one year earlier. Real estate debt decreased to €1 billion and €389 million from €1 billion and €494 million at the end of June '25 after restatement of RGV financial receivables.
This decrease resulted from disposal of real estate assets over the past 12 months and the amortization of part of this debt. The loan-to-value ratio was stable at 57%.
Net asset value increased to €515 million compared with an adjusted €496 million at the end of December '25, an increase of €19 million. Portfolio therefore remains broadly stable in value, excluding perimeter effects, while the reduction in real estate debt supports an increase in the net assets value.
Taken together, the deleveraging trajectory, the resilience of our real estate value, and the free cash flow now close to break-even, these results confirm that Clariane's financial foundations are being rebuilt on a solid ground. I will now hand back to Sophie for the outlook.
Sophie Boissard
Thank you very much, Grégory. Let me conclude by recalling the operating levers supporting our performance looking forward and confirming our objectives.
The improvement in EBITDA are supported and will be supported, by a diversified and well-identified set of levers I've already touched upon previously. The first lever is definitely the use and the full leverage of our existing capacities and the continued enrichment of the service offering.
We are step-by-step increasing occupancy in medicalized nursing homes, and we are expanding outpatient activity in specialty care clinics. We are also developing services that respond to more complex care needs and improve the relevance of our pathway for patient, resident, and family caregivers.
The second lever contributing to EBITDA improvement is definitely active pricing and data-driven care mix management. The progress we achieved in Germany and in specialty care at Inicea in France during the first half confirms the value of a detailed facility-level approach to activity, tariffs, and care mix.
The third lever contributing to EBITDA improvement is definitely the Better Support efficiency program. We are streamlining, process by process, both the overheads and shared service centers.
We are also redesigning selected operating workflows with the support of automation and artificial intelligence, applying a disciplined make-or-buy approach to selected services and optimizing maintenance and energy costs. These actions are already contributing to our performance.
Their impact will build progressively for the second half of '26 and into 2027. They strongly support the combination of relative organic growth, margin improvement, and continued financial discipline set out in our medium-term plan.
To conclude, we confirm our objective across the two complementary horizons that are presented at the full year result. For the '23-'26 period, we continue to target an average annual organic revenue growth of around 5%.
We expect an improvement of 100 to 150 basis points in the pre-IFRS 16 EBITDA margin, pro forma of disposal and excluding real estate development, compared with 2023. We also target Holdco leverage below 5.5 times at the end of 2026.
For the '25-'28 period, we target average annual pro forma revenue growth of around 4%. We target average annual growth in pro forma pre-IFRS 16 EBITDA of between 7% and 9%, and average annual growth in pro forma Opco EBITDA of between 11% and 14%.
Holdco leverage is expected to be around 5 times at the end of 2028. As you have understood, and as Grégory explained, the leverage objective has been, of course, mechanically adjusted to reflect the new capital structure following the refinancing of the sterling-denominated hybrid bonds with senior debts.
Our operational ambition and the discipline of our financial policy remain unchanged. The first half performance of Clariane confirms the relevance of our model and the sound execution of our roadmap.
We will remain more than ever focused on the quality of care, on the development and safety of our employees, on the disciplined capital allocation, and on the progressive reduction of the leverage. More than ever, our work at Clariane is guided by our purpose: the purpose of taking care of each person's humanity in times of vulnerability.
Thank you very much for your attention. Grégory and I are now available to answer your question.
Operator
Ladies and gentlemen, if you wish to ask a question by phone, please dial pound key 5 on your telephone keypad to enter the queue. If you are attending the conference on the web, you can also ask question using the chat box at the bottom of the page.
Grégory, Sophie, thank you very much for the presentation. We already have a few questions.
The first one probably for you Sophie: what is your expected wage salary increase for 2027? Are the negotiations done?
Sophie Boissard
Thank you. Thank you very much for the question.
Average expectation is around 2%. This is of course variable across the countries, most of the negotiation or indexation are already known and set.
This is the case for France. This is also the case since we are already negotiating the care rate for '27 in Germany.
Indexation is also fully known both in Belgium and in the Netherlands.
Thank you Sophie. Next question probably for Grégory regarding the guidance in EBITDA.
The EBITDA growth projected is higher than the revenue growth. Can you explain the different levers and what part is cost-saving?
Grégory Lovichi
Thanks for the question. Maybe before starting with the guidance, as this is what is already visible on the first half, as a reminder, with 5% growth on the organic growth of revenue, this has been translated into a 25% improvement in the EBITDA Opco.
On the guidance and the way you need to look at it, it's 50% of the improvement that will come from top line, and the remaining 50% will come from performance measures. If you then go into detail, on the top line, and what we see in the guidance, half of the growth will come on the volumes, remaining will come on pricing and care mix, and this is already visible in Germany and as well in France clinic and Inicea.
The remaining 50%, as I was mentioning, will come on the performance improvement plan. One of them are the one already implemented in the reduction of the cost of structure.
Last but not least, in our industry of fixed costs, obviously the improvement of volume will benefit on the additional incremental EBITDA.
Thank you Grégory. Next question is regarding the current events that we're experiencing in France and in Europe overall with the heat wave and fires.
Regarding heat waves, is there any impact on your cost structure? Are you planning to put AC in your care homes, and do you know how much it could cost?
Then regarding the fires in Spain and in France, is there any impact on our operations?
Sophie Boissard
Thank you very much for the question. Starting with the last one, currently we don't see any impact of the wildfire in Spain or France on our operation.
I would say our facilities are doing, and the staff are really doing well. We are welcoming on the top of our residents or patients additional people coming from the local communities.
I don't see a negative impact on our activity, pretty much the opposite. When it comes to the impact of extreme heat wave and additional costs related to further equipment into air conditioning, we have brought additional air conditioner with, in a lot of cases, some funding coming from the healthcare insurance to help us in it.
Directionally, for the next 3 years, we are going to prioritize and accelerate some further investments into air conditioning, especially the northern part of our network, including south of Germany, Belgium, and the Netherlands to equip them with more powerful air conditioning equipment. All in all, it should represent a kind of €10 million capex, so as you see, it is totally absorbable in our maintenance capex.
Thank you Sophie. An additional question regarding the heat waves.
As your facilities have AC, did you see any additional business coming because of the heat wave?
Sophie Boissard
It's always difficult to answer this in that sense, because of course what's happening is very difficult for the communities that are impacted. Definitely, we see a kind of 15% increase in short stays in our facilities overall versus the previous years, very much related to this extreme heat waves.
A lot of families are asking to put their beloved ones in a safe place and knocking at the door in that sense. Indeed, I would say the volume of activities has never been so acute and dense as this time of the year.
This is actually all over Europe. Obviously, families have realized that our beloved one are much safer in one of our nursing homes or clinics than alone at home without any close support to go through this extreme temperatures.
Thank you Sophie. We have one question, actually is asked by several people, regarding the seasonality in your business between H1 and H2.
Would you please explain the seasonality and the reason of the seasonality, and are you expecting the same kind of seasonality as last year?
Grégory Lovichi
Thanks for this. As you've seen, we just went back to the last 3 years on seasonality between H1 and H2.
As you can see on the historical basis, you see a difference between 100 and 200 basis points EBITDA margin between H1 and H2. If you can see as well, as we are confirm our guidance, and if you do the math, you will understand that the H2 of '26 should be higher in term of margin than the H1.
Several elements that we see, but certainly on the H2 of this year, what will drive the continued improvement of margin, and we see this good trend of volumes that we expect to continue on the remaining part of the year, good job on the care mix and pricing in France, especially clinics, and as well in Germany will continue and will be visible in second semester, and we'll have as well the full effect of the performance improvement plan that has already launched beginning of the year. That's the key drivers that have already pushed the EBITDA margin up last year in H2 that will continue, and this is what is confirming our guidance for the second half of this year.
Thank you Grégory. We have a question regarding the occupancy rate.
What trends do you anticipate in occupancy rates within the next few years? Maybe
Sophie Boissard
I will take this one. We expect actually to be up in the next 3 years at least by 100 basis points to 150 basis points on a yearly basis in our nursing home network.
That's the step upward that we are expecting.
Thank you. The next question is regarding the organic growth that is seen as being slowing sequentially, particularly regarding pricing.
What can you share on this point?
Grégory Lovichi
Just as a reminder, the organic growth remains solid at 4.6%. When you compare versus Q1, where we had an organic growth of 4.9%, have in mind certainly that in the Q1 we benefited from a supportive basis point of comparison with the severe flu that we have in the Q1 '25.
As well, the German pricing effects remain very solid in the half year with 7%, but was at 8% on the first quarter.
Thank you Grégory. Regarding Spain, what would you say is a normalized EBITDA level as a percentage of revenue?
Grégory Lovichi
EBITDA level in Spain could be expected as a normative between 18% to 20% EBITDA margin.
Regarding Italy, how do you explain a decrease in EBITDA margin?
Grégory Lovichi
There is no decrease in EBITDA margin in Italy. Pro forma of the disposal plan, last year EBITDA margin was at 22.2%, while this year is at 22.1%, it's a stable margin that.
Sophie, we have a few questions regarding Germany and the nursing home reform. What do you expect regarding this reform?
Sophie Boissard
It's still a little bit early to have a full picture. What we expect for sure is the recognition of what AI and digital can bring in terms of additional efficiency, and the tackling of the structural scarcity of skilled nursing staff in Germany.
There is already a financing dedicated per facility or per resident to accelerate the digitization of the main processes, including care and reporting processes, documentation processes. There might be some transfer of financing from the healthcare insurance or the federal state to local communities for people that have low revenue.
This is actually the discussion ongoing. Last but not least, after a very strong catch-up on the wage level that are fully refinanced in the care rate, we expect to see a kind of slowing down of this catch-up of the wage level.
Anyhow, the catch-up has been really done since the average wage of skilled nursing staff stand now above the average wage for the German working population. That's basically what we expect to see.
We expect also the equipment in additional beds to be reopened in Germany because of the demographics, for sure, the accelerating aging of the population, and it seems that they are going to allow additional beds to be reinstalled into existing facilities, which of course will be very beneficial to large networks like Korian network in Germany. That's basically the main actions or measures that could be in the package that is not yet final.
Thank you Sophie. The next question is regarding Benelux.
Someone understood that there was a cost inflation for the reason of margin compression in Belgium or in Benelux. Do you have any comments to make?
Grégory Lovichi
No, certainly just to have in mind that on the Benelux, we have a stable margin on the period and an improvement margin in Belgium only. This is a comment we can do on this perimeter, where we see visible improvement on the EBITDA margin.
Sophie Boissard
The only thing I can say is that the refinancing of staff costs and cost basis in general in Belgium is pretty well done with an indexation of the rates according to wage evolution. This is definitely a geography where the price-over-cost effect is a positive one.
Thank you Sophie. We have one question regarding the starting point of the 2023-2026 guidance in terms of EBITDA margin.
Would you please remind the starting point and the basis?
Grégory Lovichi
The guidance on the EBITDA margin is between 2023 and 2026, and the EBITDA margin to be retained as a starting point stands at 10.5%. That was the EBITDA margin we had on 2023.
The improvement between 100 and 150 basis points that bring us to the guidance '26 need to be done with this basis of 10.5% EBITDA margin.
Thank you Grégory. I think we have a question live from Bernstein.
Operator
The next question comes from Aleksander Peterc from Bernstein. Please go ahead.
Aleksander Peterc
Hi. I have a few questions.
Maybe we can take them one by one. The first one is on Germany.
You've already said quite a lot about it. I'm just wondering, given the EBITDA margin you achieved and very strong growth in the first half, are we there now in terms of as good as it gets for Germany, or can you still envisage going back to the historical levels of 26% to 28%?
That will be the first one. Maybe we can take it one by one.
Sophie Boissard
Yes. Hi Aleksander.
We expect further EBITDA margin growth in Germany, for sure, since we are not fully done with our repricing and we still have some room for further volume improvement there. Of course, the marginal occupancy in existing nursing home, as Grégory explained, with a strong fixed cost base is a very contributive one.
Last but not least, we are not fully mature yet in Germany with, I would say, additional services pricing. We are progressing and we see additional levers in terms of revenue and pricing in there.
Aleksander Peterc
That's great, very helpful. Thank you.
Second one is, I think you highlighted more than 7,000 remaining beds in nursing homes,
Sophie Boissard
the
Aleksander Peterc
unused capacity. Can you tell us where these opportunities sit geographically, what are the main bottlenecks to fill them, and whether you expect as a result occupancy gains to remain a meaningful contributor to growth beyond '26?
Sophie Boissard
The three large contributors to this to this volume growth are France, Germany, and Benelux, and especially the Netherlands with a ramping up a very recent network. We expect to fill them step by step with with the right staffing.
Staffing is for sure a point of attention in Germany, but we are now we have now, I would say, the largest basis for apprentices in comparison with our other players with 2,800 nursing nurses apprentice there. They need 3 years to be to be certified, and then and then we keep them ongoing.
That's that's definitely the critical dimension to to fully occupy, but we have already we are we are really progressing on a very very constant and and steady way in Germany. The next pool is definitely coming from France, where we have actually a closer and around 90% average 90% occupancy rate in France.
We see actually a strong potential with this demographic dip that we are progressively stepping out, and we see strong increase of demand coming forward starting '27, '28, '29. Average, what we expect to see is that all networks will stabilize above 95%, that that is actually what we see forward.
Probably because I don't expect a lot of new buildings to come in the next 7 years for for various reasons, we will stabilize well above 95%. For the time being, that's that's the target or the assumption we have taken.
This is also, we are also very, very focused on defending the pricing, because definitely we we really don't want to be entangled in a in a vicious circle where we would go for volume without being able to deliver sound and profitable quality. This is why we are very, very attentive and cautious on defending the pricing everywhere.
Aleksander Peterc
That's very helpful. Coming back to France briefly, there was a dip, obviously, in French specialty care last year.
H1 appears pretty encouraging, it would seem. What are you seeing today in terms of care mix normalization, outpatient growth, profitability, and so on?
In particular, how much of the planned increase in EBITDA in France is going to come from specialty care versus long-term care?
Sophie Boissard
Yes. You're right, situation is now normalizing.
If we correct first half '25 from the various failure in the calculation of the funding and the rate, the post-acute activity in France posts a +4.2% growth that is well balanced between additional volume, mainly outpatient, because inpatient was already very high, and care mix and various levels of pricing. I expect this type of momentum to be continued over the next 2 years because of further openings on outpatient units, because of additional specialty to be granted that will of course fuel increase in the care mix management and funding, and also opening of additional beds and specialty.
That's this +4% of only organic growth is the rhythm we expect for Inicea. The growth of the margin in France is actually equally balanced between elderly care with again a continuous increase in occupancy rate and a sound pricing approach on Korian side, and this development at Inicea now that we have digested the new financing scheme.
The Better Support efficiency program is contributing in both segments.
Aleksander Peterc
Great. Thank you very much for your very complete answers.
That was all my questions. Thank you.
Grégory, Sophie, we have a question regarding the new climate mitigation initiatives that we're taking. Are those initiatives already incorporated in the capex assumption, or do we expect to increase capex typically for air conditioning in nursing homes?
Sophie Boissard
No, they are fully encompassed in the trajectory of capex.
Thank you Sophie. We have an interesting question regarding AI.
You mentioned AI automation, which is included in your efficiency program earlier presented. Could you elaborate on how Clariane plans to leverage AI in the future?
Sophie Boissard
Yes, actually we have started to implement AI at scale on the back office and transactional services, so that's for the accounting, for the billing, for the staff planning. Everything that is done back office is now AI-supported, and this was actually one of the trigger of the social plan we delivered in France and in Germany.
It's a total of 250 FTE that have been actually encompassed in this efficiency program. Now we are starting to tackle, I would say, the front office function in the networks.
All the service facility management in the facilities with cleaning robots and everything that can be automated on the non-care function, and based on the pilot case that we have tested and validated in Germany, we also see that AI and automated reporting and tracking can save precious time for the nurses. It's around 30 minutes a day.
As I just said, in places where we are struggling to get the right number of nurses, it will help us to better cover and to better deploy the time of our skilled staff close to the residents. This is actually how you should think about how AI can help, replacing back office function and giving to the caregivers, the nurses, the skilled staff more time to be close to the resident and patients, and also more time, more comfort to better support.
Thank you Sophie. We have a question regarding the plans that we've announced in France and Germany last year or early this year.
What have been the impacts of those plans in H1?
Sophie Boissard
In H1, there is limited impact on the EBITDA because actually the costs reflected in EBITDA are not fully reflected yet. It will be a much bigger in H2.
When it comes to the non-current costs related to the plans, they are fully factored into the figures we published for H1.
Thank you Sophie. There's a question regarding post-2029 with the expected growth of the demand in nursing home.
What capex would be needed to match with the demand? Now
Grégory Lovichi
what you see certainly is that we expect to keep the €300 million capex we have for the next 2 years, the €150 million capex on the maintenance and the €150 million on the development or capex to develop. On top of this capex, having in mind and rebounding of what's mentioned by Sophie earlier, we have as well in between sufficient as well capacity to continue to grow, especially in the nursing homes in the next 2 years.
This is the way you need to look at it.
Thank you Grégory. We
Operator
Ladies and gentlemen, if you wish to ask a question by phone, please dial pound key 5 on your telephone keypad to enter the queue. If you are attending the conference on the web, you can also ask question using the chat box at the bottom of the page.
On our side, we don't have any more question. Sophie, if you want to conclude.
Sophie Boissard
Yes, thank you everyone for your interest in Clariane. Our next publication is set for the 28th of October.
Until then, I wish you all restful holidays and à bientôt.
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