Narayana Hrudayalaya Ltd. (NH)
Small CapPharma stocks · Small cap · NSE
Narayana Hrudayalaya Ltd. (NH) operates a chain of 55 healthcare facilities with 5,945 operational beds across India, Cayman Islands, and the United Kingdom as of April 1, 2026. It provides multi-specialty and cardiac care services, employing ~20,750 staff.
One read, four checks
75+ is strong, 60-74 is usable, 45-59 is mixed, and below 45 needs caution. These are research lenses, not buy/sell instructions.
Mixed fundamentals, management trust is acceptable, price trend is neutral, and recent execution is mixed.
Fundamental lens: valuation, quality, growth, balance sheet, and cash flow.
low confidence · 0/8 claims checked
Timing lens: price trend and sector relative strength.
Rolling lens: recent quarterly delivery, not the latest single-result score.
Quarter ended 30 Jun 2026
Average · 32/100margin compression · Rev +78% YoY · PAT +5% YoY
| Metric | This quarter | YoY | QoQ |
|---|---|---|---|
| Revenue | ₹2,684 Cr | +78.1% | +3.5% |
| EBITDA | ₹468 Cr | +38.9% | -7.9% |
| Operating margin | 17.0% | -500 bps | -300 bps |
| PAT | ₹207 Cr | +5.1% | -7.6% |
| PAT margin | 7.7% | -536 bps | -93 bps |
NDF means not disclosed in the current structured filing feed. It is intentionally not treated as zero.
Business & thesis
Growth engines, tailwinds/headwinds, and risk radar from management commentary
Business & thesis
Growth engines, tailwinds/headwinds, and risk radar from management commentary
Where growth can come from, and what can break the case
NH reported robust Q4 FY26 consolidated operating revenues of ₹25,938 Mn (+75.8% YoY, +20.6% QoQ) and FY26 revenues of ₹78,960 Mn (+44.0% YoY). Consolidated EBITDA margin was 20.8% in Q4 FY26 and 21.7% in FY26, with PAT of ₹2,280 Mn (8.8%) and ₹8,105 Mn (10.3%) respectively.
Strong revenue growth across India and international segments, supported by healthy EBITDA margins. Key operational metrics like ARPOB and patient footfalls show positive trends. While international expansion and integrated care units are currently loss-making, the core India hospital business remains robust, supporting the overall thesis.
India Hospital Operations – Specialty-Profile (Q4 FY26)
Latest issuer-disclosed distribution across 7 reported categories.
Robotic Cardiac Surgery
Performed 750+ surgeries in FY26, with 247 in Q4 FY26 at Narayana Institute of Cardiac Sciences, Bangalore.
TAVI Volume Growth
160 TAVIs performed in FY26, translating to a 20% volume increase YoY at Narayana Institute of Cardiac Sciences, Bangalore.
International Expansion
Acquisition of UK operations (13 facilities, 330 beds) effective Nov 6, 2025, contributing GBP 68 Mn revenue in Q4 FY26.
Advanced Therapy Services
Inaugurated Elekta System for Radiation Therapy in Mysuru and operationalized Iodine Therapy facility in Howrah.
Operational Beds
Total 5,945 operational beds across 55 facilities as of April 1, 2026.
UK Facilities
Acquired 13 facilities with 330 beds in the United Kingdom, effective November 6, 2025.
Increased Patient Footfalls
India IP footfalls increased 3% YoY in Q4 FY26, and OP footfalls increased 7% YoY.
Higher ARPOB
India ARPOB for Q4 FY26 was ₹18.6 Mn, up from ₹16.9 Mn in Q4 FY25.
Growth in High-End Procedures
Robotic cardiac surgeries and TAVI volumes are increasing, indicating demand for specialized treatments.
International Segment Losses
Cayman Islands EBITDA was US$ -5.1 Mn in Q4 FY26 and US$ -8.0 Mn in FY26.
UK Acquisition Impact
UK operations reported a PAT of GBP -0.7 Mn in Q4 FY26 and GBP -1.9 Mn in FY26, impacted by interest on acquisition loan and amortization.
Integrated Care Losses
EBITDA for Integrated Care Clinics (NHIC and NHIL) was ₹ -181 Mn in Q4 FY26 and ₹ -674 Mn in FY26.
Foreign Currency Exposure
Consolidated total borrowings include US$117 Mn and GBP £150 Mn denominated in foreign currencies, exposing the company to exchange rate fluctuations.
New Venture Profitability
New centers in the UK and Integrated Care Clinics are currently incurring losses, requiring sustained investment and ramp-up time to achieve profitability.
Management accountability
What management said, and what results must prove
Management accountability
What management said, and what results must prove
What management said, and what results must prove
Issuer guidance and extracted claims are tracked against later reported outcomes. Treat these as management statements, not IndiaPulse forecasts.
YoY comparison is crucial for assessing annual growth and seasonal impacts. QoQ tracks sequential momentum, especially important for new acquisitions and operational efficiency.
India Hospital Operating Revenue
Q4 FY26: ₹11,783 Mn (+12.8% YoY, +6.1% QoQ); FY26: ₹45,233 Mn (+10.2% YoY).
International Hospital Revenue (Cayman Islands)
Q4 FY26: US$49.6 Mn (+12.6% YoY, +11.0% QoQ); FY26: US$178.7 Mn (+27.0% YoY).
UK Revenue
Q4 FY26: GBP 68 Mn (from Nov 6, 2025 acquisition); FY26: GBP 110 Mn.
Consolidated EBITDA Margin
Q4 FY26: 20.8%; FY26: 21.7%.
Numbers and claims to verify in the next filings
| Checkpoint | Current evidence | What to verify next |
|---|---|---|
| International Segment Profitability | Cayman Islands EBITDA: US$ -5.1 Mn (Q4 FY26). | Sustained improvement in profitability and reduced losses. |
| UK Operations Profitability | UK PAT: GBP -0.7 Mn (Q4 FY26). | Reduction in new center losses and progress towards positive PAT. |
| Integrated Care Clinics EBITDA | NHIC and NHIL EBITDA: ₹ -181 Mn (Q4 FY26). | Improved financial performance and reduced losses from these units. |
| Net Debt to Equity Ratio | 0.49 (as on March 31, 2026). | Stability or reduction in the net debt to equity ratio. |
Verification checkpoints are IndiaPulse research interpretation, not investment advice.
Show extracted source claims
Total projected capex for FY24 is INR 3,204 Mn for Cayman replacement/maintenance, brownfield/capacity addition, and greenfield/inorganic investments.
"FY24 PROJECTED"
Total projected capex for FY24 is INR 3,204 Mn for Cayman replacement/maintenance, brownfield/capacity addition, and greenfield/inorganic investments.
"FY24 PROJECTED"
5,000 BMTs will be performed by 2030.
"5000 BMTs by 2030"
5,000 BMTs will be performed by 2030.
"5000 BMTs by 2030"
Paper use across patients will be reduced by 50% by 2025 from 2023 levels.
"50% less Paper use across patients by 2025 from 2023"
Paper use across patients will be reduced by 50% by 2025 from 2023 levels.
"50% less Paper use across patients by 2025 from 2023"
25,000+ doctors, nurses, and paramedical staff will be trained by 2030.
"25,000+ Doctors, nurses, and paramedical trained by 2030"
25,000+ doctors, nurses, and paramedical staff will be trained by 2030.
"25,000+ Doctors, nurses, and paramedical trained by 2030"
Trend score and candlestick chart
47NeutralSMA20 -6.8% / mo · MACD + · sector +2.2pp vs Nifty (3M)
Technical chart
NHdaily · 1Y · AUTO+5.2%Daily technical trend read
Bearish setupTrend is weak — long-term trend down. RSI 44.
- Price below SMA200 (long-term downtrend) — short-term bounces likely countertrend.
- SMA20 falling (~7.3% over last month) — short-term momentum negative.
- RSI(14) at 44 — falling, no extreme reading.
- MACD above signal but histogram contracting — bullish momentum cooling.
- 11% off 52W high · 17% above 52W low.
Mechanical read from the price + indicator series above. Not a recommendation — technical setups can reverse without warning, especially around earnings and macro events.
Relative Strength & Trend Stage
- 10.7% below the 52-week closing high after prior strength.
- The 30-week proxy has stalled (+0.4% over 20 sessions).
- Price has not yet confirmed a full Stage 4 downtrend.
Valuation & score drivers
U-Score 47 · FAIR VALUE · pillar breakdown, sector model, fair-value anchor
Valuation & score drivers
U-Score 47 · FAIR VALUE · pillar breakdown, sector model, fair-value anchor
Fundamental score breakdown
FAIR VALUEWhy this score?
Top U-Score contributors and drags from the latest stored fundamentals.
Positive drivers
- Piotroski is strong at 7/9.
- Growth contributes 20/25 to the score.
- Quality contributes 11/20 to the score.
Main drags
- Fair-value margin of safety is negative at -3.4%.
- Valuation is weaker at 0/30; verify the latest quarterly trend.
- Cash flow is weaker at 4/10; verify the latest quarterly trend.
Healthcare valuation: PE/EVEBITDA with regulatory and pipeline checks
Healthcare valuation needs both earnings quality and regulatory/pipeline context.
Stored run vs live recompute
This shows the stored score trend when snapshots exist, and also compares the latest stored nightly score with a live recompute from current fundamentals and price.
Score history
12 stored score snapshots. Latest stored move: +0 points.
Factor attribution
Modelled fair value
Trust score
Does management behaviour match later outcomes? Claim delivery, forensic breakdown, evidence depth
Trust score
Does management behaviour match later outcomes? Claim delivery, forensic breakdown, evidence depth
Trust asks: does management behaviour match later outcomes? Higher is better, but confidence and evidence depth matter as much as the number.
Healthy Trust: Claim history is still being built. It ranks around the 69th percentile of the scored universe and 58th percentile within Pharma. No major sub-score weakness stands out.
Healthy Trust Lite: Promoter holding is 63.3%. Key concern: Debt/equity is 1.29.
Generally investable credibility. Look for weak sub-scores before increasing position size.
overall median 67 · Pharma: 58th pctile, median 70 · Small: 71st pctile, median 66
136 documents have extracted text, but claim history is not strong enough yet.
8 claims extracted · No contradicted claim yet
How to read this Trust Score
Healthy Trust · low confidenceRead Trust alongside U-Score, result consistency, and technical trend. A cheap stock with weak Trust needs a larger margin of safety; a high Trust score does not make an expensive stock attractive by itself.
Forensic breakdown
Read low sub-scores as due-diligence warnings, not automatic sell signals.
Trust positives
- ▸Promoter holding is 63.3%.
- ▸Promoter pledge is zero.
- ▸6 years of positive FCF.
- ▸4/4 latest quarters had positive YoY revenue growth.
Trust risks
- ▸Debt/equity is 1.29.
- ▸ROCE trend is -5.5%.
- ▸1 of the latest 4 quarters had PAT decline worse than 25% YoY.
Trust Lite uses financial behaviour only. Prefer claim-tested Trust when enough concall claims have later outcomes.
Financials
Full fundamentals table and 10-year revenue / profit / ROE history
Financials
Full fundamentals table and 10-year revenue / profit / ROE history
Fundamentals
Valuation
- P/E
- 44.10
- P/B
- 8.37
- EV/EBITDA
- 19.38
- Market Cap
- 37980.00Cr
Profitability
- ROE
- 20.50%
- ROCE
- 15.50%
- ROA
- 6.55%
- Dividend Y
- 0.24%
Growth (CAGR)
- Revenue 5Y
- 25.00%
- EPS 5Y
- 155.00%
- Revenue 3Y
- 20.00%
- EPS 3Y
- 12.00%
Balance Sheet
- Debt/Equity
- 1.29
- Interest Coverage
- 6.11×
- Altman Z
- 4.67
- Book Value
- 222.00
Cash Flow
- FCF Yield
- —
- FCF Positive Y
- 6/5
- OCF
- 1621.00 Cr
- EPS TTM
- 39.94
Shareholding
- Promoter Hold
- 63.27%
- Promoter Pledge
- 0.00%
- Momentum 52W
- 55%
Financial History
Updated 5/9/2026
Revenue
₹ CrNet Profit
₹ CrReturn on Equity
%Peers
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Peers
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Peers
Business-comparable peers in Pharma — ranked by industry, sub-sector, theme-tag overlap, market cap, and U-Score similarity. Green cells mark the best available peer metric in this table.