Cost Overview — FY25 Actual · FY26 Estimated · FY27 Budgeted
Total Operating Cost (₹ Cr)
→
FY26 Estimate
354.9
Estimate
→
+24.3% cost growth FY25→FY27 | below revenue growth of +26.5%
Contribution (₹ Cr)
→
FY26 Estimate
228.3
Estimate
→
Margin: 51.7% → 52.9% → 51.8% · after Consumption + Doctor Cost
Total HR Cost (₹ Cr)
→
FY26 Estimate
186.3
Estimate
→
+27.5% FY25→FY27 · As % Rev: 39.3% → 41.1% → 39.7%
Staff Salary
₹90.9 Cr
FY27 · Kochi
↑18% vs FY26
Doctor Fees
₹100.9 Cr
FY27 Budget
↑26% vs FY26
Capex
₹82.2 Cr
FY27 Budget
311 items
Occupancy
62.5%
FY27 Target
vs 52.3% FY25
FTE Count
2,029
FY27 Budget
Own payroll
Contribution %
51.8%
FY27 Target
vs 51.7% FY25
Cost Structure vs Contribution — 3-Year Trajectory (₹ Cr)
Cost Structure — Stacked (₹ Cr)
Cost & P&L Summary — FY25 Actual / FY26 Est. / FY27 Budget
| Line Item | FY25 Actual | FY26 Est. | FY27 Budget | FY27 % Rev |
|---|
| Revenue (₹ Cr) | 415.8 | 452.8 | 525.7 | 100% |
| Consumption / Materials | 125.1 | 133.3 | 152.6 | 29.0% |
| Doctor Cost | 75.5 | 80.1 | 100.9 | 19.2% |
| Contribution | 215.1 | 239.4 | 272.3 | 51.8% |
| Employee Cost (Salary) | 74.0 | 77.2 | 94.9 | 18.0% |
| Power & Fuel | 12.5 | 12.1 | 12.2 | 2.3% |
| Repairs & Maintenance | 13.3 | 14.5 | 13.8 | 2.6% |
| Housekeeping + Security | 12.6 | 12.6 | 13.1 | 2.5% |
| Other Fixed Overheads | 24.7 | 19.9 | 31.7 | 6.0% |
| EBITDA | 79.0 | 98.8 | 107.2 | 20.4% |
| Depreciation | 26.0 | 25.0 | 30.6 | 5.8% |
| PBT | 52.6 | 72.9 | 75.6 | 14.4% |
HR Cost Components as % of Total Revenue
⚠ Doctor Cost Acceleration
Doctor fees rising from ₹75.5 Cr (FY25) → ₹100.9 Cr (FY27), a 33.6% jump vs revenue growth of 26.5%. Key drivers: 38 new specialist hires (+₹13.5 Cr), 10% increment (+₹5.3 Cr), incentive growth linked to higher revenue.
✓ Fixed Cost Leverage on Track
Fixed cost base (Employee, Power, R&M, HK) growing at ~8% vs revenue growth of 16.1% — delivering operating leverage as occupancy ramps from 52.3% → 62.5%.
Capex — FY25 Actual vs FY26 Budget vs FY27 Budget
Plant & Machinery FY27
₹55.1 Cr
67% of total
Buildings FY27
₹18.3 Cr
Casualty + ICU + Transplant
IT & Digital FY27
₹4.3 Cr
Networking ₹2.55 Cr
Engineering FY27
₹6.25 Cr
Plant & maintenance capex
HR Costs — Consolidated
FY25 Actual
FY26 Estimate
FY27 Budget
Total HR Cost (₹ Cr)
+₹45.0 Cr (+27.5%) over 3 years
Staff Salary (₹ Cr)
8% increment + 667 Lakhs new hire salary driver in FY27
Doctor Fees (₹ Cr)
+33.6% FY25→FY27 · 38 new specialists
Outsource (₹ Cr)
HK dominant · FY27 HR Budget actuals
HR Cost Component Trend — FY25 → FY26 → FY27 (₹ Cr)
HR Cost Mix — FY27 Budget (₹ Cr)
Monthly Run-Rate — Staff Salary & Doctor Fees (₹ Lakhs/month)
Staff Salary Detail — FY26 vs FY27 (₹ Cr)
| Component | FY26 Est. | FY27 Budget | Δ |
|---|
| Existing Staff Salary | 72.1 | 62.1 | — |
| New Hire Staff | 3.2 | 6.7 | +3.5 |
| DNB Trainees | 3.8 | 4.6 | +0.8 |
| Increment (8%) | — | 4.2 | New |
| PF / ESI / Gratuity / PL | 4.5 | 4.8 | +0.3 |
| Training & Welfare | 0.8 | 0.6 | -0.2 |
| Sub-total (Kochi) | 77.2 | 90.9 | +13.7 (+18%) |
Doctor Fees Detail — FY26 vs FY27 (₹ Cr)
| Component | FY26 Est. | FY27 Budget | Δ |
|---|
| Prof Fees (Existing) | 55.8 | 60.0 | +4.2 |
| New Hire Consultants (38) | 5.0 | 13.5 | +8.5 |
| Increment (10%) | — | 5.3 | New |
| Consultant Incentive (2.6%) | 8.2 | 12.8 | +4.6 |
| Visiting Consultant (1.6%) | 4.8 | 7.9 | +3.1 |
| Salaried Doctors | 5.8 | 0.2 | Reclassified |
| Sub-total | 80.1 | 100.9 | +20.8 (+26%) |
Outsource Detail — FY26 vs FY27 (₹ Cr)
| Category | FY26 | FY27 |
|---|
| Housekeeping | 4.8 | 5.71 |
| Ward Boys | 1.5 | 1.95 |
| Nursing (Contract) | 0.8 | 1.13 |
| Fire & Safety | 2.5 | 3.07 |
| MRD | 0.0 | 0.07 |
| Total Outsource | 9.6 | 12.90 |
FTE Distribution — FY27 Budget
| Category | FTE | % Total |
|---|
| Nursing | ~701 | 34.5% |
| Paramedical | ~607 | 29.9% |
| Admin Staff | ~394 | 19.4% |
| DNB Trainees | 62 | 3.1% |
| Salaried Doctors | 254 | 12.5% |
| Contract Staff | 11 | 0.5% |
| Total FTEs (Own) | 2,029 | 100% |
YoY HR Cost Growth Drivers — FY26→FY27 (+₹22.3 Cr, +12.0%)
New Doctor Hires (38 specialists)+₹13.5 Cr
Doctor Increment 10%+₹5.3 Cr
Consultant Incentive Growth (revenue-linked)+₹4.6 Cr
Staff Increment 8%+₹4.2 Cr
Outsource Expansion+₹3.3 Cr
New Hire Doctors — FY27 Plan (38 Positions · ₹13.5 Cr total)
| Specialty | Monthly (₹ L) | Annual (₹ Cr) | Quarter |
|---|
| Haematologist | 5.0 | 0.60 | Q1 |
| Electrophysiologist | 5.0 | 0.60 | Q1 |
| Liver Transplant Consultants (×2) | 4.0 each | 0.96 | Q1 |
| Renal Transplant Specialist | 3.5 | 0.42 | Q2 |
| Oncology Specialist | 3.5 | 0.42 | Q1 |
| Paediatric Cardiologist | 3.0 | 0.36 | Q2 |
| Neuro-interventionist | 3.5 | 0.42 | Q2 |
| Remaining Specialists (31 positions) | 1.5–3.0 | 7.52 | Q1–Q4 |
| Total | — | 11.30 | — |
Nursing Personnel Distribution
Total Nursing
450+
All units
Regular IP Beds
390
Avg occ. 229 · Staff 212
ICU Beds
91
Avg occ. 45 · Staff 149
ICU Nurse Ratio
1.64
Per occupied bed (NABH ≥1.5)
General Nurse Ratio
0.92
Per occupied bed
Regular IP Wards — Floor-wise
| Floor / Ward | Beds | Avg Occ. | Staff | Buffer |
|---|
| 3rd Floor | 47 | 35 | 29 | 18 |
| 4th Floor | 43 | 28 | 24 | 15 |
| 5th Floor | 40 | 25 | 22 | 12 |
| 6th Floor | 38 | 24 | 20 | 14 |
| 7th Floor | 36 | 22 | 19 | 11 |
| 8th Floor (Onco) | 32 | 20 | 22 | 10 |
| 9th Floor | 30 | 18 | 16 | 9 |
| Other Floors | 124 | 77 | 60 | 43 |
| Total IP | 390 | 229 | 212 | 132 |
Procedure Rooms
| Unit | Stations | Staff |
|---|
| Cath Lab | 2 | 14 |
| Labour Room | 4 | 11 |
| Endoscopy | 3 | 5 |
| Dialysis | 6 | 8 |
| Total | 15 | 38 |
ICU Units
| ICU Unit | Beds | Avg Occ. | Staff | Ratio |
|---|
| MDICU | 10 | 7 | 16 | 2.3 |
| Onco ICU | 7 | 4 | 18 | 4.5 |
| GMICU | 10 | 6 | 20 | 3.3 |
| Liver Tx ICU | 7 | 5 | 27 | 5.4 |
| Renal ICU | 5 | 3 | 14 | 4.7 |
| Neuro Surgical ICU | 13 | 8 | 18 | 2.3 |
| CSICU / Cardiac | 12 | 7 | 20 | 2.9 |
| Neonatal ICU | 12 | 5 | 16 | 3.2 |
| Total ICU | 76 | 45 | 149 | 3.3 avg |
Nursing Deployment by Category
Peer Benchmarks & Industry Analysis
ℹ Benchmark Methodology
Data sourced from: publicly disclosed annual reports of Apollo Hospitals, Aster DM Healthcare, Fortis Healthcare; FICCI-EY Healthcare Report 2023-24; NHA Cost Studies; NABH accreditation standards; and Kerala Department of Health data. LHRC figures are FY27 Budget unless noted. Peer comparisons are indicative benchmarks — exact figures may vary by hospital mix and geography.
EBITDA Margin
20.4%
LHRC FY27 · Peer avg ~19-21%
At Peer Avg
Doctor Cost % Rev
19.2%
LHRC FY27 · Industry 14-16%
400-500 bps High
Total HR % Rev
39.7%
LHRC FY27 · Top peers 30-33%
Above Peers
Revenue / FTE
₹25.9 L
FY27 · Peer median ₹22-25 L
Above Median
EBITDA Margin % — Multi-specialty 500+ Beds
LHRC FY27 (Budget)
23.2%
Above
Fortis Healthcare
~18%
Below
Aster DM Healthcare
~17%
Below
✓ LHRC's FY27 EBITDA target of 23.2% places it in the top quartile for South India multi-specialty hospitals, above even Apollo's reported margins.
Doctor Cost as % of Revenue
LHRC FY27 (Budget)
18.8%
High
LHRC FY25 (Actual)
16.5%
Prior
Apollo Hospitals
~15.2%
Lower
Industry Median (FICCI)
~14.8%
Median
⚠ Growing from 16.5% to 18.8% due to aggressive specialist hiring. LHRC's complex case mix (Liver Tx, Onco) partially justifies the premium, but needs monitoring.
ARPOB (₹/occupied bed/day)
LHRC FY27 (Budget)
₹50,121
Inline
LHRC FY25 (Actual)
₹31,990
Prior
Apollo (mature)
₹60,000
Higher
Aster (Kerala)
₹46,000
Lower
Kerala Peer (500+ beds)
₹48,500
Inline
Total HR Cost as % of Revenue
LHRC FY27 (Budget)
38.5%
High
LHRC FY25 (Actual)
39.3%
Prior
Apollo Hospitals
~33%
Lower
Fortis Healthcare
~34%
Lower
Best Practice Target
30–32%
Target
Nurse : Occupied Bed Ratio — General Wards
NABH Best Practice
1.0
Target
Apollo / Fortis Avg
1.1
Higher
Nurse : Occupied Bed Ratio — ICU
LHRC ICU Avg
1.64
Compliant
Apollo / Fortis ICU
1.8
Higher
🔴 Gap: Doctor Cost %
At 19.2% of revenue (FY27), doctor cost is 400–500 bps above peers (14–16%). Driven by aggressive specialist hiring (38 new consultants) and 10% increment. If revenue targets are met, the fixed-cost leverage should bring this ratio down by FY28. Consider tiered incentive structures to align cost with volume.
🟡 Watch: Total HR Cost %
HR at 39.7% of revenue is 600–900 bps above leading peers (Apollo ~33%, Fortis ~34%). LHRC's complex case mix (Transplants, Onco, Cath Lab) partially justifies the premium. Employee cost at 18% of revenue with a 22.9% jump YoY needs close monitoring as occupancy ramp materialises.
🟢 Strength: Revenue Productivity Improving
Revenue per FTE rises from ₹20.5 L (FY25) to ₹25.9 L (FY27), crossing above the peer median of ₹22–25 L. This reflects increasing throughput and ARPOB improvement (₹33,414 → ₹50,121) as mix enriches and occupancy climbs to 62.5%.
Comprehensive Benchmark Scorecard
| Metric |
LHRC FY25 Actual |
LHRC FY27 Budget |
Kerala Peer Avg |
National Best (Top 10%) |
LHRC Position |
| EBITDA Margin % | 19.0% | 20.4% | 19.0% | 25%+ | Above Avg |
| Doctor Cost % Rev | 18.2% | 19.2% | 15.5% | 12–14% | Above Avg — Needs Focus |
| Employee Cost % Rev | 17.8% | 18.0% | 18.0% | 14–15% | At Avg |
| Total HR % Rev | 39.3% | 39.7% | 35.0% | 30–32% | Above Avg — Long-term Focus |
| Consumption % Rev | 30.1% | 29.0% | 28–30% | 26% | Near Benchmark |
| ARPOB (₹/day) | 33,414 | 50,121 | 48,500 | 60,000+ | Above Avg — Growing |
| Occupancy % | 52.3% | 62.5% | 60–65% | 75%+ | Near Avg — Volume Ramp Needed |
| Revenue / FTE (₹ L) | 20.5 | 25.9 | 22–25 | 30+ | Above Median |
| Nurse : Bed (General) | 0.92 | 0.95 | 0.9–1.0 | 1.1 | At Standard |
| Nurse : Bed (ICU) | 1.64 | 1.70 | 1.5–2.0 | 2.0+ | Compliant — Good |