Greetings everyone. This is Numan Khan.

On behalf of SNB Capital, I would like to welcome you to a conference call with SMC Healthcare management regarding their financial results of Q1 2026. We will first listen to the management feedback, following this we will open the floor for the Q&A.

I will now hand it over to Mr. Faisal Althayab, the Director of IR, SMC Health.

Faisal, please take over the presentation.

Thank you, Numan. Good day everyone, and thank you for joining us in our Q1 earnings call.

Our results presentation and the full financial statement will be available on our IR section of the website right after the call. Please refer to our disclaimer which applies to all disclosures made in today's presentation.

Before introducing today's speakers, I would like to briefly introduce myself as this is my first earnings call with SMC Healthcare. I recently joined SMC as Director of Investor Relations, bringing more than 11 years of experience in investor relations and capital markets.

Most of my experience is in banking and tech sectors. I am very excited to be joining SMC Healthcare at this stage of its journey, particularly following its successful listing, and as the company continues to strengthen its engagement with the investment community.

My focus will mirror the company's vision by supporting clear, consistent, and transparent communication with our investors, analysts, and the wider investment community. With that, I'm pleased to be joined with our CEO, Mr.

Bassam Shaheen, and Mr. Hani Shaarani, our Chief Financial Officer.

Moving on to the agenda, I will briefly start with a quick overview of the company, then Mr. Bassam will take us through key operational highlights as well as the progress we're making against our strategic priorities.

Then Mr. Hani will walk us through Q1 financial performance before concluding with our outlook for the remainder of the year.

Then we will open the floor for Q&A after the presentation. As most of SMC is a Riyadh-based integrated healthcare provider operating two full-service hospitals: SMC 1 on King Fahd Road and SMC 2 on King Abdullah Road.

We continue to strengthen our position as a key player in Saudi Arabia's healthcare sector. Our medical professionals including more than 516 doctors and 1,075 nurses, supporting approximately 40,000 inpatient visits and 342,000 outpatient visits.

Our model covers the entire care spectrum and at the heart of our operations remains a strong focus on patient experience. Furthermore, we continue to integrate technology to enhance customer experience across our facilities, including online booking, check-in, and payments, AI-powered radiology, automated insurance responses, and AI-based clinical recommendation.

With that, now I will hand it over to our CEO to take us through the key highlights for Q1. Over to you, Bassam.

Good afternoon, everyone. It's a pleasure to welcome you to our Quarter 1 earning call for the year 2026, and it's also a pleasure, Faisal, to have you on board.

Let's have now a closer look to our medical services, which is our core segment and the core backbone of our business. In 2024, if you remember, we began our strategic transition from long-term care beds toward higher-margin acute inpatient services and outpatient clinics.

The shift is now complete, and as of Quarter 1 of 2026, we have shifted 217 long-term beds and transitioned into 81 acute beds and 75 outpatient clinics. Also in the same quarter, we have continued to scale our outpatient platform, including the launch of SMC Clinics at Malga district, while further optimizing our service mix toward high-performing acute specialties.

This evolution continues to support stronger utilization across our network while expanding access to integrated healthcare services across Riyadh. Regarding our highlights for the quarter, we have really delivered resilient operational and financial performance while continuing to execute on our strategic priorities.

Our net revenue grew 3.3% versus last year to reach 380.7 million riyals, supported by improved inpatient and outpatient utilization across the network and a continued ramp-up of the newly added outpatient capacity. This was achieved despite the seasonal impact that you know about from the extended school break and the Eid al-Fitr holidays during the quarter.

Building on this momentum, our EBITDA increased by 5.6% to 69.3 million riyals, while net profit rose 9.8% to reach 32.5 million riyal. This is supported by improved utilization, operating leverage, and disciplined cost management.

During the quarter, we have also launched SMC Clinics in Al Malga. Right now, in end of March, we have 14 operational clinics, and the remaining clinics are expected to gradually come online over the course of the year.

This marks an important step in expanding our outpatient platform across North Riyadh. Operational efficiency continued to improve across the platform: stronger inpatient and outpatient utilization, supported by the continued ramp-up of the recently opened clinics and the shift to higher-margin inpatient acute services.

Finally, our leverage profile continued to improve, with net debt to EBITDA declining to 1.7 times as compared to 2.6 times in Quarter 1 of 2025. This was of course supported by strong cash generation and ongoing debt repayment during the period.

Moving to our expansion and outreach and new projects: First, regarding the expansion, we continue to make solid progress across both outpatient platform and the hospital development pipeline. In January 2026, as I mentioned earlier, we officially launched SMC Clinics located at the northwest region of Riyadh, and to remind you, this facility was not part of our IPO guidance.

It was designed to accommodate 35 multidisciplinary clinics alongside emergency, urgent care, and pharmacy services. 14 clinics were operational in that polyclinic as of March, and the remaining clinics will come up online gradually over the course of the year as part of the center ramp-up.

Regarding the PPP project, this is SABIC Behavioral Care Specialist Hospital. It's a 150-bed tertiary mental hospital, an MOH hospital that was probably you know about before, although there were not a lot of announcement recently, but just the range that I'm allowed to disclose is we have finished negotiation with the MOH 2 months ago.

We have obtained the necessary approval from the Ministry of Health and Ministry of Finance, and we have finished the pre-execution version of the project agreement few days ago. We are currently targeting financial close and contract signature in the coming few weeks, and we are aiming, and MOH is aiming for service availability date in January 2027.

This will be the first healthcare PPP project in Saudi Arabia operational. Going to our projects currently under construction and design: SMC 3 on the Northern Ring Road, foundation and early construction activities advancing as planned in Quarter 1, and the project continue to move forward towards structural work and targeted completion in 2028.

Regarding SMC 4, northeast of Riyadh, Al Khozama suburb, 80% of the design has been completed in the quarter. Onsite hoarding completed, and we are continuing advancing the site preparation activities ahead of kicking off the construction, which is expected by the end of this year.

Going back to our long-term growth strategy, which remains centered on expanding SMC integrated healthcare platform across North Riyadh through the combination of hospitals and outpatient facilities. As you see in the slide, the pipeline include the three hospital we have announced before, in addition to the SMC Clinics in Malga.

We have a total investment more than 3 billion Saudi riyal through 2029, and we are funding these with a combination of debt and internal cash flows. I already touched on Malga and SMC 3 and SMC 4.

Regarding SMC 5, as we announced earlier, this is also an important component in our strategy, and we are still on track in acquiring the land this year and to finish the completion of this project by 2029. These projects are expected to significantly expand our healthcare capacity, strengthen our presence across North Riyadh, and support SMC long-term growth strategy.

Moving to our clinical and academic achievements, the first quarter reflected continued momentum and a strong level of achievement across multiple areas. From an academic perspective, probably you know SMC has been accredited by the Saudi Council of Health Specialties to run Saudi Board Residency Program in multiple specialties since 2016.

This is 10 years ago. Recently we have successfully renewed our institutional accreditation for national excellence in health training, and this is for the third time in a row, demonstrating the strength and the consistency of our training platform and our commitment to develop the next generation of healthcare professionals.

Most importantly, we contributed to life-saving outcome through collaboration with the Saudi Center for Organ Transplantation, supporting organ donations effort and resulting in securing a heart, a pancreas, a liver, two kidneys from a young donor with brain death, followed by successful organ transplantation surgery of the donated organs given to four Saudi patient who were at a big need, and we saved their lives. Moreover, our long-term standing partnership with Alfaisal University Medical School continues to be a key pillar of our academic ecosystem.

This is a 10-years-long legacy relationship where we had hosted 2,757 medical interns since 2016. In Quarter 1 alone of this year, we hosted 75 medical interns across seven departments, providing structured clinical exposure and hands-on experience across the organization.

Regarding the achievement and the awards, we have hosted in January a conference on Leading with Vision in Healthcare in the AI Era, and this was aligned with the Saudi Arabia Year of Artificial Intelligence. The event was equivalent to 14 accredited CME hours, brought together leading voices across healthcare to explore how AI is shaping the future of clinical practice, reinforcing our role at the forefront of innovation in the sector.

During Quarter 1 of 2026, SMC hospitals on King Fahd Road and King Abdullah Road were listed among Newsweek ranking for the world best hospital in KSA, and also listed among the best specialized hospitals in the Middle East powered by Statista. In addition to that, SMC Healthcare received multiple awards during the quarter by UK-based magazines, Global Brands and International Finance.

We got awards on the Best Healthcare Branding Transformation, Most Innovative Patient-Centered Healthcare Provider, and Most Innovative AI-Powered Patient Engagement in Healthcare. I cover this part now, and I will leave the floor now to my colleague Hani Shaarani, our CFO, who will take you through the financial performance for the quarter.

Thank you, Hani.

Thank you, Bassam. Good afternoon, everyone, and it's my pleasure to present our financial performance for the first quarter of 2026.

Our Q1 2026 performance continued to benefit from the successful completion of the transition towards higher-margin acute services alongside the continued expansion of our outpatient platform with the opening of those 57 clinics in 2025. Looking at the chart on the left, you can see that the inpatient visits remained broadly stable during the quarter at approximately 40,000 visits despite the completion of our planned reduction in the long-term care activity.

Growth in high-performing acute specialties more than offset the reduction in the LTC volumes, supporting a 3% growth in the inpatient gross revenue year-on-year to reach 195.9 million SAR. Moving to the chart in the middle, you'll notice that the outpatient performance remained strong, supported by the continued ramp-up of those 57 new clinics added in '25 alongside the launch of our new polyclinic in Malga during the first quarter of the year.

Outpatient visits increased by 5.7% year-on-year to more than 341,000 visits. As a result, outpatient gross revenue increased by 5.2% year-on-year to 156.3 million SAR, reflecting the improved utilization and the continued momentum across the outpatient platform.

Overall, the quarter continued to demonstrate the benefits of our strategic transition towards high-margin acute services, together with the scaling of our outpatient clinics network. Turning now to our financial performance for the first quarter of '26, SMC delivered resilient results despite the current operating environment, which included the seasonal impact of the Eid holiday and the extended school breaks during the quarter.

Net revenue reached 380.7 million SAR in Q1 of '26. That's up 3.3% from last year, driven by improved utilization across inpatient and outpatient services, together with the continued shift towards those higher-margin acute services.

We managed to increase our EBITDA by 5.6% year-on-year to 69.3 million SAR while improving our margin to 18.2% from 17.8% in Q1 of 2025. Performance was supported by utilization improvements, operating leverage, and an improved service mix, partially offset by higher operating costs associated with expansion activities during this quarter.

Net profit increased by 9.8% to 32.5 million SAR, with margins improving to 8.6% compared to 8% in the same period last year. Results this quarter were also supported by lower finance costs and reduced selling and marketing expenses.

Remember in Q1 of 2025, we had the increased marketing expenses related to the rebranding of the company pre-IPO. Looking at our operating cash flow, it reached 83.4 million SAR during the quarter, while the free cash flow amounted to 69.7 million SAR, reflecting the continued investment in network expansion and the disciplined capital allocation.

To ensure a smooth and non-interrupted flow of operations, we've adopted a prudent approach to inventory management, increasing our stock levels to mitigate any potential supply chain and logistical disruptions during this volatile period. Finally, our leverage position continued to strengthen, with net debt to EBITDA improving to 1.7 times compared to 2.6 times in Q1 of '25, supported by ongoing debt repayment and strong management of the company's financial position.

Now moving on, looking at our quarter-to-quarter performance results remain solid overall, with some expected moderation driven primarily by seasonality impacts and non-recurring items. Net revenue for the quarter came in at 380.7 million SAR compared to 406.9 million SAR in Q4 of 2025, reflecting a 6.4% decline quarter-on-quarter.

This movement was largely anticipated and reflects the typical seasonal impact during the period, particularly the effect of the Ramadan, Eid al-Fitr holiday, and the extended school breaks, which tend to soften the activity levels. At an EBITDA level, we reported 69.3 million SAR compared to 172 million SAR in the previous quarter.

It's important to highlight that Q4 of '25 included that one-off gain of 60.60 million related to the sale of land. Adjusting for this non-recurring item, the underlying performance shows a more normalized trend.

Similarly, the net profit came in at 32.5 million versus 134 million SAR in Q4 of 2025. Again, this reflects both the absence of that one-off gain recorded in the previous quarter and the seasonal slowdown in operations.

Next, looking at our balance sheet, we continued to strengthen our financial position during the first quarter of the year, maintaining a solid foundation to support future growth and expansion. Our net debt to EBITDA improved further to 1.7 time, down from 2.6 times in Q1 of 2025, supported by a 14.7% reduction in outstanding debt, as our strong cash position enabled us to deleverage our balance sheet.

The debt-to-equity ratio decreased by 53%, and cash and cash equivalents increased by 66.6% year-on-year. Our receivables cycle increased to 107 days, partly due to some reconciliation delays with some of our insurance providers, while payables increased to 102.1 days as part of our disciplined working capital management and revision of some of the contracts with our partners to extend the payable terms.

Finally, capital expenditure totaled 13.8 million during the first quarter of '26, primarily related to the continued investment in SMC 3, the network expansion, the renovation projects, and the development activities across the platform. Before concluding the financial review, let's take a look at the guidance we provided for the full year of 2026.

Keeping in mind this was before the regional uncertainties and events that began in March of this year. As we go through an evolving, fluid, and dynamic market, we continue to monitor the situation closely, and we will provide any updates in event of any material changes.

However, our Q1 performance was resilient despite the current operating environment and seasonality impacts. We have grown our EBITDA and net profit on an underlying basis alongside margin expansion.

This is a statement that our investment case stands solid, and our standard of care remains differentiating factor moving forward. With this, I'd like to conclude the first part of our earnings call.

Thank you, and I will now pass it over to Faisal to initiate the Q&A session.

Thank you, Bassam and Hani, for the presentation. Now we will open the floor for Q&A.

Thank you management for the comprehensive feedback. We will now open the floor for the Q&A.

If you wish to ask a question, you can click on the raise hand icon on your webcast, or alternately, you can type in the questions in the Q&A chat box as well. We'll wait for a moment for the Q&A to line up.

Our first question is coming from the line of Mr. Hikmat.

Hikmat, if you can unmute yourself locally, introduce your company, and before asking the questions.

Yes, Hikmat, you are audible. Okay.

Thank you, Numan Khan is Hikmat from [unclear] Capital. Two questions from my side, gentlemen.

The first one is regarding your gross margins in Q1 2026. I noticed that it expanded on a quarter-over-quarter basis despite having lower revenues on a quarter-over-quarter basis by around 6%.

I noticed that you're perhaps the only player across the sector to have an expansion in margins on a quarter-over-quarter basis. I'm wondering, by also looking at your Q4 '25 numbers, you also reclassified some of the operating costs to cost of revenues instead of the opex.

I'm just wondering what drove this massive expansion in the margins on a quarter-over-quarter basis? Did you now also reclassify some of the operating costs from cost of revenue to opex?

Because given that also your opex has increased massively in Q1 '26. Any color on the factors that drove this margin expansion at the gross level would be very helpful.

That's my first question.

You want us to answer your first question first, or you will ask your question?

Up to you. If you prefer, I can ask the second, or maybe better if you want to answer the first one.

We'll answer that. Of course, regarding the expenses that you mentioned in the Quarter 1 of 2025 and Quarter 4 of 2025, there were some higher than usual marketing expenses.

Regarding the gross revenue impact was increase in activities in clinics, also the quality of the revenue, especially with complex procedures. Now, how this contributed to the margin, Hani, go ahead.

You can give him more details regarding the question on what changed between the quarter to quarter.

Sorry, Hikmat, you're comparing year-on-year, Q1 of '25?

No, no, I'm comparing quarter-over-quarter. For example, in Q4 '25, your gross margin was around 20.9%, and this quarter we saw it increase to 23.9%.

That's roughly 300 basis point expansion. Despite that, you reported lower revenues on a quarter-over-quarter.

I'm just trying to understand, because if I look across the sector, there was a compression in margins on a quarter-over-quarter basis. I want to understand what drove this margin expansion, especially given that also in Q4 you reclassified some of the operating costs from opex to cost of revenue, which resulted in a lower gross margin in Q4 '25.

What drove this margin expansion in Q1?

Look, there's a combination of reductions in supply costs. That was a big initiative started last year, and we really saw the impact this year.

Also, some of the salaries, change in positions, really consolidating the corporate office. We saved there, we didn't see a big spike in the salaries and benefits related to that area.

The cost savings really impacted Q1 of 2026. We're able to control that in line with the reduction in revenue for that period.

Okay. What about the...

The reclassification that happened in Q4, there's no more classification in '26, you can use '26 as a benchmark.

You did not restate Q1 '25 numbers? Because if I look at the numbers, did you also restate Q5 Q1 '25 numbers as well?

No, no.

Clear. Tayyeb, the second...

Second question, please, Hikmat.

Second question is regarding the opening of the new hospitals. Given perhaps the structural change across the sector and delayed ramp-up that we're seeing across the players, would you consider that your ramp-up for the new hospitals that are in the pipeline will take longer than previously budgeted for in terms of ramp-up and breakeven points?

Of course, by looking at a quarter slowdown in the sector or some uncertainty in the region, this is not enough indicator for you to restructure your plans. The market is growing, the demand on healthcare is growing, especially in the city, and I personally do not see any reason to restructure the plan or the timeline for our project.

However, we have to be always sensitive and looking what are the significant changes happening in the market or the region or the sector, and based on that, if this needs to be rescheduled, we'll go ahead and announce that. For now, we're confident that our projects are going according to our timeline without any change or adjustment.

The ramp-up for these projects, you expect it to be within let's say 24 months, or would you factor in more time?

No, no. Usually it did not change.

It has always been 30 months. There is a fund that was established at the beginning of the year for an adjacent land.

There were some additional requirement because it's a 16-floor hotel and require certain additional approval on the traffic impact study and the control of the aviation because there is a helipad on top. It took a little bit more month, but we are on track on timeline to finish this project in 2028.

I'm talking about SMC 3.

Okay. Clear.

Ya'tikum al-'afiya. Very helpful.

Thank you very much. Thank you.

Saad Khdair, tafaddal.

Saad, if you can unmute yourself locally, introduce your company before asking your question.

Yes, you're audible.

Yes. Hi, this is Saad Khdair from Riyad Capital.

Thank you, management, for the presentation, and wish you the best in the future. I have two questions from my side.

My first question is in regard to the profitability of the company. When I see gross margin in terms of the pharmacies and maybe the food and catering, year-in-year there was a big difference.

For the Quarter 1 of 2025, the gross margin for this segment was around 35% relative to around 23% this year for this quarter. What was the major impact or what was the positivity there in the Q1 2025?

What you would like to know are what are the main component of the increase in the gross margin? Is that your question?

Yes, in 2025, and yeah, I want to know how...

Between '25 and '26 in terms of the quarter, right?

Yes.

I think you mean the revenue, correct?

No, no, no. The gross margin.

How are you calculating the gross margin on food?

You have two segments in the gross profit: the hospitals and pharmacies and others. I assume that the pharmacies and other you are considering food and catering with it.

Food and catering, yeah, we disclose it as revenue.

Yes, but I believe you always report it there in your financials. You disclose it by hospitals, pharmacies, and others.

Yeah.

Right.

Okay. Should I rephrase the question, or you understood it?

Can you rephrase?

Is your question is comparing the component of that revenue between the medical services and the pharmaceutical?

No, no, no. I'm focusing only on pharmaceuticals now.

When you see the pharmaceutical gross profit, and then you can divide it to the revenue that was from the pharmaceuticals, the percentage the numbers, the gross margin is much higher for the last year of Q1 relative to this year of Q1. There is a big difference.

Was there anything happened there, or...

I think, Hani, probably we have to look at the numbers that Mosaed is referring to, and we can answer him on that. I don't think the question is clear for us right now.

No worries. We can have a call on...

We can after either call... Or send us by email, and we'll answer that specifically.

Any other question?

Yes, sure. Tayyeb, my second question in regard the 84 I believe long-term care beds there.

Is this similar to referring from the Prince Sultan that was the contract that was ended, right?

I did not hear the question clearly. Can you repeat it, please, I can understand the question?

Go ahead.

Yes, you refer the long-term care beds I believe it declined to 84.

Yes. Yes.

Is this same the contract that I believe it's already ended maybe last year?

That's correct.

Going forward we can no longer see any long-term care beds, right?

Of course. What happened 2024 and before, we used to have big contracts with the government.

You're talking about 300 patients almost. Now we took the decision for the transition in 2024.

In 2025, those patients were done. What happened, they were only one contract, and they are not really long-term patients.

They are ventilated patients, okay? All these beds were either converted to inpatient floors or inpatient beds or clinics.

That's why you notice the bed capacity has been declined by 217 beds and still the revenue went up. This tells you about the quality of the revenue from those beds that were transitioned from long-term to acute.

We are not planning in the future to go back to long-term care because there is a demand and this is more margin revenue component of our acute services. Did I answer your question?

Yes, it's clear. Thank you.

Okay. Thank you, Mosaed.

Ibrahim Attia?

Congrats on the results, and thank you for the presentation. A high-level question from my side: when looking at the numbers year-on-year, 3% top-line growth, operating still up only 1%.

Understand there is a 7 million incremental ECL, however last base, as you mentioned, Hani, as you made an interview post the successful IPO that Q1 2025 included, of course I'm quoting the interview in Argaam website specifically, you mentioned that Q1 2025 included a negative one-off of 15 to 18 million riyal that is split between IPO-related expenses, 5 to 7 million, and clinics pre-operating expenses, 10 to 11 million. Taking this into account and looking at the results on high-level headline basis, and taking to account the incremental 7 million ECL, I don't see the cost saving that you've done during Q3, to be honest.

Please help me out here.

We can hear you, fine.

Let us know how should we look at the results. Just we're learning.

It's new company on the market, just help us how should we look at the results.

Okay. Okay.

Now we'll...

How did you look at it?

I understand. Let me just try to simplify a few important things you have to take into consideration.

The IPO expenses were not paid by the company. IPO expenses paid by the shareholder.

When we were referred to the Argaam interview, it was a matter of rebranding. We did rebranding for the purpose we are going public.

We decided it's time to change the company name and brand and logo. We did a rebranding, and this is one-time off in Quarter 1 of 2025.

Hani mentioned a while ago a few important points we were able to do it if you want to compare Quarter 1 to Quarter 1, '25 to '26. The issue of we are having an increase in activity, you notice, in inpatient beds, in clinics, and the supply cost and the payroll cost did not increase in the same way.

This is because of control, cost control, efficiency, utilization, control over the cost, control over the payroll, control over the direct indirect expenses. This is why you see the impact of the increase, even if small increase in revenue and activity, impacting also the margin.

You want to add something on that point, Hani? No,

I think that the rebranding that happened in Q1 in addition to I think you mentioned the pre-IPO, they're not directly related to IPO, but they were required to get to the IPO process, whether they're consultants helping us, policies, procedures, developing all the required governance to get to the IPO status. We will not have these reoccurring expenses again, but we had to cover them in Q1 of '25.

Perfect. Ya'ni, when you look at the traffic, the inpatient growth, the outpatient growth, the top line, the cost saving, your ECL, what you mentioned, etc., I would imagine higher growth in operating, to be honest, adjusted for the ECL increase.

I would expect higher operating profit. What am I missing?

For Q1,

you were expecting higher for Q1, correct?

No. No.

It's not ahead of results type of expectation. It is what I'm hearing and what I'm seeing on reported results, I would imagine higher operating profit ex-ECL provision.

I think it's too early to judge on this based on a quarter, okay? I think we have to wait for Quarter 2 and Quarter 3 before you start feeling that there is something wrong.

I don't think there is something wrong. I think it's normal growth, normal control of the cost, and the real impact that probably will make you more convinced is when you see the remaining quarters.

Also, I just want to add to this that remember that all the staff we hired, you open 57 new clinics. That's like a small hospital.

There was a lot of staff and investments to open those clinics. The outcome you'll see it in ensuing months.

Q1 did very well expecting that the March was hit hard because of everything going on. I think that the margins would have been better if it was a normal month, but it wasn't.

We saw that across the sector.

Very very clear. Fair enough.

Thank you, gentlemen. Wish you the best of luck.

Thank you.

Thank you, Ibrahim. Taha, go ahead, please.

We still have 20 minutes. We'll try to answer everyone.

I have four questions in the audio, and I have chat around six or seven questions. Let's try to do that quickly.

Taha, go ahead.

Thank you so much, management. A couple of questions.

One, overall sector impacted by Ramadan and extended holidays. If you can just share how is the trend for April and May going around, are you seeing a improvement?

How's the quarter looking like, so that we can sort of get comfort? Because obviously, yeah, overall people are concerned that the sector has sort of underperformed in the first quarter.

Taha, we cannot disclose going forward, and you've been enough in the market and you know this question will not be answered straightforward, but I can tell you the answer if you allow me, yes. Is that okay?

Is that enough to answer yes?

Yes, yes. Thank you so much.

Okay. Overall, in terms of on the JV side, SABIC, any update on that?

The JV has been formed since last year, and I think the presentation I have summarized. After the budget has been approved by the government for 2026, the PPP strategic projects in the kingdom were put on the pipeline, and things move quickly, and we have finished pre-signing the contract, final negotiation and update on the guarantees, and a lot of legal documents.

Alhamdulillah, this has been completed few months ago, and finally we reached a pre-signature final version of the project agreement. We're just waiting for the green light for the announcement of the MOH of the signature of the contract.

This will take place soon, probably few weeks, either before Eid or directly after Eid. We are on timeline to have the service availability, which is 6 months after the signature of the contract.

Of course, there will be a lot of announcement on that, and you'll be the first one to know. This hospital, insha'Allah, will be fully operational on a PPP model on Quarter 1 of 2027.

Understood. Thank you so much, and best wishes for the year.

Thank you, Taha. Mohammed Muqeem, tafaddal.

Mohammed, if you can unmute yourself locally. Adnan?

I guess we have some problems locally.

Mohammed, you stay in the queue. We'll take the question from Ahmed Al-Shaqi, and then we'll come back to you.

Maybe you fix your microphone issue. Ahmed?

Ahmed, can you go ahead, please? Yes, you are.

Tafaddal. It's Ahmed Ishak from SICO Bahrain.

I have a couple of questions from my end. First question is from the first quarter, how much impact do you attribute to seasonality, and how much do you attribute to the geopolitical disruptions?

Did you see some impact specifically in March, maybe a slowdown in outpatient clinics?

You want me to take that, Bassam?

Go ahead. Just to give you a very simple question, Ramadan usually it's 20% less productive time, okay?

This is a normal condition. The situation in that part was not really normal as usual.

Regarding the exact percentage how much it impacted, go ahead, Hani. Please go ahead.

Obviously, we all know that the geopolitical situation in March had an impact. There's an equal impact because of the Eid, and then they extended the school holidays.

All the kids went online. We saw people going on vacations, whether it's internationally or locally, because of those extended school holidays.

March in particular was a direct hit from a combination of both: the seasonality, extended school, and the geopolitical situation.

Obviously, people are uncertain, they postponed a lot of elective surgeries to see what would happen in the following month.

Okay. Thank you.

The second question from my end is related to the clinics you've recently opened. How much of the costs were attributable to that clinic opening, and how has the ramp-up been in the first couple of weeks?

I don't think it was fully consolidated in first quarter, but at least in April and the first half of May, has it been ramping up well?

You're talking about the new polyclinic, correct?

The polyclinic.

Go ahead, Bassam.

The ramp-up was promising. We were finalizing all the insurance agreement during the process of the operation.

It's promising and it's moving steadily. Of course, we'll see the impact starting Quarter 2.

Regarding the cost, I think we have a specific number. I don't know if we can disclose that number, but it was not a substantial number, a very small number in terms of the cost of the full-time people who's been working there.

I don't know if you can share this number with Ahmed, Hani.

In terms of the overall...

The overhead cost of the polyclinics in the first quarter. That's your question, Ahmed, correct?

Exactly.

Ahmed, it's not material at all, to be honest.

Because I think in the full-year earning call, last time you've mentioned that you might see some impact from the opening of the polyclinic. I'm just wondering how severe the impact would be, especially since it would be loss-making in the initial months.

Correct. It is loss-making.

The impact obviously in the investment in equipment, the right-of-use asset will go up, obviously with the lease agreement. Those are the areas that will be impacted the most.

There'll be slight losses during the first quarter until the facility ramps up. I don't know, you're looking for a percentage of overall costs.

You can send me an email, I can share that with you. It's not material compared to the overall company operation.

Perfect. Last question, if I may: how confident are you in meeting this year's guidance given the performance in the first quarter?

Because I think especially after last year, there's a lot of questions on the guidance, and now as a weak quarter, maybe a slowdown in the overall sector. Do you see any reason for the guidance to be changed, or are you confident in meeting it?

Quarter 1 was there were a lot of unexpected developments. However, our performance was resilient.

We don't think that we should be updating the guidance based on a quarter performance, despite the significant change that happened. We are closely monitoring, and we are on track in going into our guidance.

We will be, at the same time, checking if there are any significant changes that were required any adjustment to the guidance. Till now, we have nothing in the pipeline.

Did that answer your question, Ahmed?

Yes, perfect. All the best.

Thank you very much, Ahmed. We have 10 minutes, five written questions and four verbal questions.

Mohammed, I hope your microphone is okay now. Mohammed Muqeem?

Yes, hello, Mohammed. Go ahead, please.

Hello. My name is Mohammed.

I am from Al Rajhi Investment. I have a question on your guidance of EBITDA margin.

Before transition in 2024, your EBITDA margin was around 22% and .5. Now your guidance is around 23% to 25%.

You took whole 1 and 1.5 years for the full transition from LTC to the outpatient clinics and adding new acute inpatient beds. Don't you think these margins guidance are quite low?

We did not change the guidance pre-IPO and post-IPO, even for 2026. Probably what happened, the margin was narrowed a little bit, but there were no significant even a small change in the lower and the upper part of the guidance.

We were just narrowing the margin, that's it.

You narrow it from the higher end. If I remember, the IPO was 27%, from 23% to 27%.

Now the guidance is 23% to 25%. My question is pre-transition, your EBITDA margin was around 22.5%, and now you are guiding for 23%.

You have done the whole exercise for transition from long-term patient care to acute inpatient and opening new clinics, but margin guidance are quite low. Don't you think?

No, no, I do not agree with you. I think this is not a change in the guidance.

This is more realistic range of what we believe is going to be achievable, which is in alignment what we have promised pre-IPO. Right, Hani?

Anything you want to add on that, Hani?

No, I think that's correct. The EBITDA and the net profit margins is the guidance we gave is realistic moving forward and the environment we are in here in Riyadh.

Thank you.

Thank you. Thank you.

We'll try to restrict one question per guest so to be able to answer all the questions. Ahmed, please.

Ahmed is not there anymore. Osama Sahil, tafaddal.

Question

from my side: is it possible for the management to give any guidance regarding the capex for maybe the upcoming few years, maybe until 2028 when I assume some of your projects are coming live? Is it possible?

Your question about the capex?

Capex guidance.

We mentioned this is 3 billion plus. If you want to have breakdown, details, we'll be happy to provide that if you send us an email, of course.

That works.

Thank you very much. I'll go to the written question and answers.

We'll start with Marina. 'Can you provide more color on the recent insurance contract renewals and how you expect them to contribute to revenue going forward?'

You have another question, I'll try to answer one. Of course, the normal relationship between a provider and a guarantor, those contracts every year or every two years, they get negotiated.

The cost of healthcare is going up. Utilization is going up.

Also volume are going up, and at the same time efficiency is going better. Always any improvement in the pricing, and in the rejection, in the utilization, and in enhancing the partnership between both parties will have a positive.

We have also some positive input. We have some contracts being renewed with better terms and conditions, and definitely that has affected and will continue to affect our performance positively.

A second question regarding the receivable day, Marina is asking, 'Will it improve by year-end, especially we have lower LTC exposure?' You want to answer question on the receivable days or I can answer that.

Receivable days, that's true, we're not exposed to governmental contracts. Again, the more you have activities and volume with insurance company, reconciliation take usually more time.

Couple of days were added, and I don't believe that it will be exceeded more than what it have reached so far. Anything you want to add, Hani, on the receivable days?

No, I think that's in line with probably our projections moving forward. Yeah.

Third question from Marina about the ECL provision: 'Any further ECL provision for 2026?'

It's too early to identify any ECL. Obviously ECL is related to receivables.

That could be patient receivables, it could fluctuate. We have reconciliation with insurance companies.

If I reconcile the next quarter, obviously those will be reversed. We don't expect any, but you never know."

Yeah. I hope we answered your question, Marina.

We'll go to Masroor Zaidi: 'Was there any one-off in the opex of 2026 Quarter 1? It seems much higher than the normalized run rate.'

I'm not familiar, Hani, with any one-off opex in 2026 Quarter 1.

No, not in the operating. We have just the ECL in the G&A.

That was adjusted 7 million. Yeah.

Only this ECL, nothing else. Another question from Masroor: 'Why revenue from pharmacies declined this quarter, while revenue from medical services increased, as they're supposed to move together?'

Go ahead and answer this question.

For pharmacy revenue, look, we're trying to control the costs per patient. This is one of our challenges and our directives to really control pharmacy costs in relation to the episodes.

Always insurance companies look at unit cost per visit. We want to work with our insurance companies to reduce it in line with a percentage of the total outpatient revenue.

We were successful in doing that, and I think this will be the challenge of all healthcare providers moving forward to really control the outpatient unit cost.

I'll proceed. SNB, if you allow us to exceed the time, I prefer not to finish this call unless we finish answering all the questions.

Please answer all the questions.

Thank you. Yasser Bin Kaaba, his question about DRG: 'A couple of publicly listed hospitals have started or have stated that DRG system will begin shadow billing in half two of 2026.

Can you please confirm whether this is the case? Additionally, what impact do you expect this to have on your operation and financial performance?'

I believe DRG probably we answered this question before, something new to Saudi Arabia. I'm not in a position to comment on the government strategy and the government timeline of execution.

As we mentioned last year, we have already running a shadow billing. We did all the necessary preparation to run or when the implementation of DRG becomes mandatory.

Once it becomes mandatory, I'm sure it will affect. Certain organization will be less affected than others.

I believe who will be less affected: first, if you have a substantial part of your revenue from outpatient, as DRG do not affect outpatient; second, if you have all the coders and the DRG and the mapping in place, probably will be less affected as you will have more maturity to be able to negotiate and implement it once it become mandatory. Mansoor Zaidi, you're asking too much questions, but we'll answer all your questions: 'How many additional clinics are expected to come online at Malga facility?'

As I mentioned in the presentation, the capacity of Malga is 35 clinics. We hope by the end of this year we'll have the 35 clinics operational.

Right now, we have 1/3 of the clinic operational. Varuna Kamaraj from SICO, hello, Varuna: 'How has been your experience in terms of inpatient admission and outpatient visit in April and May?

Are you seeing a strong recovery?' I answered a while ago yes, and if you like, I can add to that strong.

I hope I answered your question. Ahmed Al-Shaqi, another question again: 'Have you increased prices this year, and was it reflected in Quarter 1 of 2026?'

We have certain increases of prices last year. Of course, it has an impact on of Quarter 1.

We have also more important increases in remaining of 2026 that will be able to see it in Quarter 2 going forward. Rayan Zahid: 'What is the revenue contribution...'

Oh, people are typing, I cannot track it. Okay, 1 minute.

'What is the revenue contribution of the Malga clinic?' I think it was minimal.

This is just first quarter, ramping up. I don't know if you want to share this information with Rayan, Hani.

Revenue percentage contribution of Malga clinic?

Oh, less than 0.5%.

Okay. Tayyeb.

We show on G&A in SNM, 'Would Quarter 1 of 2026 be the run rate for the remaining quarter for fiscal year 2026, or it would trend higher?' Definitely, that's a very obvious question, the answer is no.

You cannot say this is Quarter 1 performance multiplied by four and this is year. There is a lot of things affecting the quarter performance in the sector.

Seasonality is one of them. You cannot do that in trying to predict how 2026 will look like.

Last question from Muzammil Ahmed: 'How much of the amount in capex pertains to new hospital?' As I mentioned in the presentation, if you notice, we have plus 3 billion.

This is allocated only for the three new hospitals, because the clinics we have operated is not an apex, it's an opex model. The capex is for the three hospitals only, and it will exceed 3 billion Saudi riyal.

I think, Bassam, what he was asking is up to date the investment so far of around 13, 14 million, maybe 20% of this was related to SMC 3, the rest is the clinic expansions, Malga, and the renovation.

Muzammil question was general. He wants to know the amount of capex for the new hospitals, and I think I answered this question.

Anyway, if any of the guests or the attendees did not have his question answered clearly, go ahead, send us an email to IR, and we'll be very happy to answer that in more details. Thank you all.

You want to conclude, Numan?

Thank you management. With this, we will end the Q&A session.

I will just hand it back to the management for any closing remarks before we end the call.

Thank you very much. Thank you, SNB.

Thank you all the attendees, and hopeful to see you in the next earning call in few months from now. Stay safe.

Thank you management for taking the time to conduct this call. We would also like to thank all the participants for attending.

We all wish you a very pleasant day. You may all disconnect now.

Thank you.

Thank you.