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The Hospital is highly dependent on doctors, nurses and other healthcare professionals and its business and financial performance will be impacted significantly if the Hospital unable to attract, retain or train such professionals.
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As a healthcare provider, the ongoing COVID-19 pandemic, stringent restrictions to slow down the Hospital spread and its resulting impact is uncertain, may be significant and continue to have an adverse effect on its business, operations and the Hospital future financial performance.
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The Hospital operations are concentrated in the Delhi NCR region. Its also significantly dependent on certain specialties for a majority of the Hospital revenues. Any impact on the revenues from these hospitals or earnings from its top specialties could materially affect the Hospital business, financial condition, results of operations and cash flows.
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The Hospital business depends on the strength of its brand and reputation. Failure to maintain and enhance its brand and reputation, and any negative publicity and allegations in the media against it, may materially and adversely affect the level of market recognition of, and trust in, the Hospital services, which could result in a material adverse impact on its business, financial condition, results of operations and prospects.
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Because of the risks typically associated with the operation of medical care facilities, patients may contract serious communicable infections or diseases at its facilities.
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The Hospital is subject to various operational, reputational, medical and legal claims, regulatory actions or other liabilities arising from the provision of healthcare services and may be subject to liabilities arising from claims of malpractice and medical negligence which could materially and adversely affect its reputation and prospects.
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The Hospital may not be successful in expanding its operations to other parts of India which could have an adverse effect on the Hospital business, financial condition, results of operations and cash flows. If the Hospital is unable to successfully identify and integrate acquisitions, its growth strategy and prospects may be adversely affected.
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If the Hospital is unable to increase the hospital occupancy rates, Its may not be able to generate adequate returns on the Hospital capital expenditures, which could materially adversely affect its operating efficiencies and th Hospital profitability.
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The provision of healthcare services has high costs such as manpower cost, infrastructure maintenance and repair cost, high medical equipment cost and any failure to pass on such costs to the patients may have a material adverse impact on its business, financial condition, results of operations and prospects.
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The Hospital arrangements with certain of its doctors are on a consultancy basis. If such doctors discontinue their association with it or are unable to provide their services at the hospitals for any reason or if the Hospital is unable to attract or retain such consultants, and other healthcare professionals, its business, results of operations and cash flows may be materially and adversely affected.
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The Hospital relies on third party suppliers and manufacturers for its supplies and equipment. Failure of such third parties to meet their obligations could adversely affect the Hospital business, results of operations and cash flows.
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The Hospital face competition from other hospitals, pharmacies and other healthcare services providers. Any adverse effects on its competitive position could result in a decline in its business, revenues, profitability and market share.
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The Hospital is required to adapt to rapidly evolving technological advancements related to its medical equipment and technology, failure of which could adversely affect its business prospects and financial performance.
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The Hospital operate in a highly regulated industry, and compliance with applicable safety, health, environmental and other governmental regulations and any violations of existing regulations may adversely affect its business, financial condition, results of operations and cash flows.
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Regulatory reforms in the healthcare industry and the uncertainty associated with pharmaceutical pricing and other matters could adversely affect the Hospital business, results of operations and cash flows.
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The Hospital may not be able to successfully integrate its acquisitions or investments, which may negatively affect their performance and respective contributions to the Hospital results of operations.
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Failure to obtain or renew approvals, licenses, registrations and permits to operate the Hospital business in a timely manner, or at all, may adversely affect its business, financial condition, results of operations and cash flows.
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Failure or malfunction of the Hospital medical or other equipment, could adversely affect its ability to conduct the Hospital operations. Its may also experience ambulance related risks.
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The Hospital operations could be impaired by failure of its in-house information technology systems or thirdparty technology service providers.
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The Hospital could be exposed to risks relating to the handling of personal information, including medical data.
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If the Hospital is unable to establish and maintain an effective internal controls and compliance system, its business and reputation could be adversely affected.
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The Hospital has in the past been non-compliant with certain provisions of the Hospital Act, 2013, in relation to allotment of equity shares. While it has filed application for the compounding of these offences with relevant of authorities, its cannot assure you that the compounding application will be resolved in the Hospital favour or its will not be penalised for any of the contraventions.
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The Hospital has high fixed costs, which can adversely impact its profitability. Further, if the Hospital fail to achieve favorable pricing on medical consumables, pharmacy items, drugs, and surgical instruments from its suppliers or are unable to pass on any cost increases to hospital payers, its profitability could be materially and adversely affected.
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The Hospital has incurred net loss in the past, and its may not be able to achieve or maintain profitability in the future.
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The Hospital developing or to be developed units, specialties, and facilities may experience delays in obtaining the required approvals, in reaching full operational capacity and may not achieve the synergies and other benefits its expect from such facilities.
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The Hospital has outstanding litigation against its an adverse outcome of which may adversely affect the Hospital business, reputation, financial condition, and results of operations.
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The Proforma Financial Information included in this Draft Red Herring Prospectus is not indicative of its future financial condition or results of operations.
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The Hospital relies on financing from banks or financial institutions to carry on its business operations, and inability to obtain additional financing on terms favourable to the Hospital or at all could have an adverse impact on its financial condition. If the Hospital is unable to raise additional capital, its business and future financial performance could be adversely affected. A downgrade in credit rating could also adversely impact interest costs or access to future borrowings. The Hospital inability to meet its obligations, including financial and other covenants under the Hospital debt financing arrangements could adversely affect its business, results of operations and cash flows.
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The Hospital enter into contracts with third-party service providers, third party administrators and insurers that could be terminated. The Hospital is also empaneled with several government organisations including Employees` State Insurance Corporation ("ESIC"), Central Government Health Scheme ("CGHS"), Ex-Servicemen Contributory Health Scheme ("ECHS"), as well as public sector undertakings and private enterprises. Any breach or termination or non-renewal of such contracts could have a material adverse impact on its business, reputation, financial condition, results of operations and prospects.
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Delays in receiving payment of outstanding dues from third parties may affect the Hospital business, financial condition, cash flows and results of operations.
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The Hospital intend to invest in the Company and Subsidiaries (AKS and Ramraja), to fund capital expenditure and repayment of borrowing in part or full. Its placed purchase order for certain medical equipment of AKS and Ramraja and have not entered into any definitive arrangements for remaining medical equipment and availed quotation from vendors to utilize certain portions of the Net Proceeds of the Offer. The Hospital proposed schedule of implementation and deployment of Net Proceeds may also be subject to delays and its may have to reduce or extend the deployment period for the stated objects.
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The Hospital may not be able to grow its business due to a failure in successfully implementing all the Hospital growth strategies.
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The Hospital registered office and three out of four of its hospitals are located on leased premises. Any termination, inability to renew or inability to terminate the Hospital lease agreements, or breach of its lease agreements by the counterparty, for the Hospital offices or its may lead to disruptions in the Hospital operations and affect its business operations.
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The Hospital inability to protect or use its intellectual property rights or comply with intellectual property rights of others may have a material adverse effect on its business and reputation.
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The Hospital insurance coverage may not adequately protect it and this may have an adverse effect on its business and revenues.
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The Hospitals are susceptible to risks arising on account of fire, natural disasters or other incidents.
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The Hospital is dependent on a number of key personnel, including its Promoters and senior management, and the loss of or the Hospital inability to attract or retain such persons could adversely affect its business, financial condition, results of operations and cash flows.
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The Hospital may be subject to labour unrest, slowdowns and work stoppages, which could affect its reputation, business, financial condition and results of operations.
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The average cost of acquisition of Equity Shares held by the Hospital Promoters and the Selling Shareholders may be less than the Offer Price.
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In the event that the Hospital Net Proceeds to be utilised towards inorganic growth initiatives are insufficient for the cost of its proposed inorganic acquisition, the Hospital may have to seek alternative forms of funding.
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Certain of the Hospital Subsidiaries has negative net worth which may adversely impact its financial condition and results of operations.
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Various challenges currently faced by the healthcare industry in India may adversely affect the Hospital business, results of operations and financial condition.
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The Hospital is exposed to the risks associated to foreign exchange fluctuations, which could adversely affect its financial condition, results of operations and cash flows.
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The Hospital funding requirements and the proposed deployment of Net Proceeds are not appraised by any bank financial institution, or independent agency, which may affect its business and results of operations. Any variation in the utilisation of the Net Proceeds as disclosed in this Draft Red Herring Prospectus shall be subject to certain compliance requirements, including prior Shareholders` approval.
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The Hospital has certain contingent liabilities that may adversely affect its business, results of operations, financial condition and prospects.
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The Hospital has in the past entered into related party transactions and may continue to do so in the future, which may potentially involve conflicts of interest with the equity shareholders.
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Certain of the Hospitals Directors and Key Managerial Personnel hold Equity Shares in the Company and are therefore interested in its performance in addition to their remuneration and reimbursement of expenses.
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The Hospital has in this Draft Red Herring Prospectus included certain Non-GAAP Measures and certain other industry measures related to its operations and financial performance. These Non-GAAP Measures and industry measures may vary from any standard methodology that is applicable across the Indian healthcare industry, and therefore may not be comparable with financial or industry related statistical information of similar nomenclature computed and presented by other companies.
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Industry information included in this Draft Red Herring Prospectus has been derived from an industry report commissioned by it, and paid for by the Hospital for such a purpose.
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Conflicts of interest may arise out of common business objects between the Company and its
Subsidiaries.
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The emergence and effects related to a pandemic, epidemic or outbreak of an infectious disease could adversely affect the Hospital operations.
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The Hospital has not been able to trace certain corporate records of its Subsidiary, Ramraja Multispeciality Hospital & Trauma Centre Private Limited.
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The requirements of being a publicly listed company may strain its resources.
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The Hospital quarterly results may fluctuate for a variety of reasons and may not fully reflect the underlying performance of its business.
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The Company will not receive the entire proceeds from the Offer. Some of its Shareholders are selling shares in the Offer and will receive proceeds as part of the Offer for Sale.
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The Company has availed and may continue to avail in the future certain unsecured loans which may be
recalled by its lenders at any time.
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Its Promoters, Ajay Kumar Tyagi and Kapil Kumar, have provided personal guarantees in relation to certain loan facilities availed by it, which if revoked may require alternative guarantees, repayment of amounts due or termination of the facilities and may adversely impact its cash flow, business and result of operations.
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Its promoters and members of its Promoter Group will continue to retain control over the Company after completion of the Offer, which will allow them to influence the outcome of matters submitted for approval of its shareholders.