GHC: STAR Conference - March 2024

GHC - STAR Conference

March 2024

Agenda

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THE GHC GROUP: THE ONLY OPERATOR LISTED IN ITALY IN THE HEALTHCARE SECTOR

THE HEALTHCARE SECTOR: RESILIENT, PHYSIOLOGICALLY GROWING AND SUBJECT TO CONSOLIDATION

FY2023 RESULTS: GROWING PERFORMANCE DRIVEN BY PRIVATE ''OUT-OF-POCKET''

12 MONTHS 2023 RESULTS OF THE AURELIA HOSPITAL GROUP: FIRST EFFICIENCY ACTIONS ALREADY VISIBLE

CASH GENERATION, M&A AND REAL ESTATE ASSETS AS KEY DRIVERS OF THE EQUITY STORY

SECTOR PERSPECTIVES: EXPONENTIALLY GROWING HEALTHCARE NEEDS, EXACERATED BY THE WAITING LISTS EMERGENCY

GHC OUTLOOK: SOLID ORGANIC GROWTH, STRONG M&A GROWTH AND VALORIZATION OF REAL ESTATE ASSETS

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The GHC Group: the only operator listed in Italy in the

1 healthcare sector

Garofalo Health Care Group (GHC)(1)

Diversified geographical positioning in the most virtuous Regions

• Leader in accredited private

healthcare in Italy, founded and

controlled by the Garofalo

family

• > 65 years of history

• Geographical and sector

diversification:

➢ Present in 8 of the most

attractive regions of Central

and Northern Italy

➢ Wide spectrum of services in

37 Healthcare facilities

in 8 Regions

∼53,000 admissions per year

∼2.6 million outpatient services

per year

∼2,500 beds

CMSR Veneto Medica			Sanimedica	Centro Medico S. Biagio
Altavilla Vicentina (VI)		Vicenza, Altavilla
	Portogruaro (VE)
				Vicentina (VI)
Villa Garda
Garda (VR)					Clinica S. Francesco
Villa Berica					Verona (VR)
Vicenza (VI)					GVDR
XRay One					Cadoneghe (PD), Padova (PD),
				Scorzè (VE), Conegliano (TV)
Mantova (MN)
Eremo di Miazzina				2	Sanatorio Triestino
		1	10	Trieste (TS)
Cambiasca,
2				Centro Medico Uni. Castrense
Gravellona Toce
				S. Giorgio di Nogaro (UD)
(VB)				8
		8
				Hesperia Hospital
					Modena (MO)

the acute, post-acute,

outpatient and social care

sectors

∼5,500 employees and collaborators

Gruppo FIdes	1
Genova (GE)

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Casa di Cura Prof. Nobili

Castiglione dei Pepoli (BO)

Poliambulatorio Dalla Rosa Prati

Parma (PR)

Ospedali Privati Riuniti

Financial results FY 2023 Actual

368.7€M Revenues	18.2%
67.1€M Op. EBITDA Adj	Op. EBITDA Adj. Margin

Rugani Hospital

Monteriggioni (SI)

Gruppo Aurelia

Roma (RM)

Villa Von Siebenthal

Genzano (RM)

Bologna (BO)

Aesculapio

San Felice sul Panaro (MO)

Domus Nova

Ravenna (RA)

Like-for-Like Growth vs.	80.5% Cash Conversion(2)
Revenues: approx. +3%
2.8x Financial Leverage(3)
Op. EBITDA Adj.: approx. +8%

Group entities at 31.12.2023

# of facilities at 31.12.2023

(1) Figures refer to 31.12.2023 including the 12 months contribution of Sanatorio Triestino, acquired in May 2023, and of Aurelia Hospital Group, acquired in November 2023

(2)	Cash conversion defined as (Op. EBITDA Adjusted - Mantainance Capex) / Op. EBITDA Adjusted	3
(3)	Calculated as the ratio between NFP and Operating EBITDA Adj. Pro-Forma of the last 12 months, thus including the 12 months contribution of the acquisition of Sanatorio Triestino (realized in May 2023) and of Aurelia

Hospital Group (realized in November 2023)

Results FY2023 (excluding Aurelia Hospital Group): growing

3 performance driven by private ''out-of-pocket'' activity

Figures 2023 excluding Aurelia Hospital Group (acquired in November 2023)

Revenues (€M)(1)

Organic growth driven by

private ''out-of-pocket''

	356.0
322.6
FY2022	FY2023
	excl. AH Group

Organic Like-for-Like Growth

+3% y/y

Private out-of-pocket growth

+12% y/y

Op. EBITDA Adjusted (€M)(1)

Growing margins despite the

inflationary context

Margin (%)

18.2%18.8%

58.6	67.1
FY2022	FY2023
	excl. AH Group

Organic Like-for-Like Growth

+8% y/y

Marginality increase

+60 bps

Net Financial Positition (€M)(1)

Robust cash generation confirmed

with decreasing leverage

Financial Leverage (x)

2.4x2.0x

145.0	131.2
FY2022	FY2023
	excl. AH Group

Acquired Sanatorio Triestino

17€M (EV)

Operating cash generation

approx. 40€M

(1) The data reported in this slide were communicated by the Company on the occasion of the approval of the economic-financial results relating to FY2023 (which took place on 14 March 2024). The detailed documentation

can be consulted on the Company's website (www.garofalohealthcare.com ) in the "Investor Relations / Price Sensitive Press Releases" sections

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12 months 2023 results of the Aurelia Hospital Group: first

3 efficiency actions already visible

Figures referred to 12 months 2023 of Aurelia Hospital Group (acquired in November 2023)

Revenues (€M)

Increase in healthcare activity

recorded starting from the signing

Op. EBITDA Normalized (€M)(1)

Execution of the first efficiency

actions already visible

Implied Multiplier EV/EBITDA (x)

EV paid lower than the market value

of the Real Estate assets alone

	Margin (%)	Enterprise Value (€M)
6.5%	8.0%	71.4€M

85.0	87.3
@signing - July '23	FY2023
(GHC '23E estimates)

	7.0
5.5
@signing - July '23	FY2023
(GHC '23E estimates)

13.0x

10.2x

Implied Multiplier	Implied Multiplier
@signing - July '23	@FY2023

2023 results affected by the liquidation process which arose due to irreconcilable differences between the shareholders, which, consequently, led to management inefficiencies mitigated only from the signing date

The acquisition includes the ownership of the instrumental Real Estate assets

∼32,000smq in total

(1) EBITDA Normalized excludes some extraordinary items recorded during the year prior to the GHC acquisition

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4 Key drivers of the Equity Story

STRENGTHS OF THE EQUITY STORY

1. 2. 3.

CASH GENERATION

M&A

REAL ESTATE ASSETS

Growing business	Purchasing strategy	Ownership of substantial
with strong cash	with proven ''Buy'' &	real estate assets
generation	''Build'' track record	(still unexpressed)

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Strengths of the Equity Story : approx. 40€M of cash generation

4 in the last 12 months

1.	CASH GENERATION
Growing business with strong cash generation

Cash generation Last 12months (€M)

				92.7	2.7	205.7
145.0	53.1
		13.1	5.3
	Generated approx. 40€M of
	operating net cash in 12
	months, after Maintenance
	Capex for 13.1€M
NFP	Gross cash	Manteinance	Expansion and	(1)	(2)	NFP
M&A	Other
31.12.22	generated	Capex	Development			31.12.23
	from operating		Capex
	activity

Cash absorption

Cash generation

(1) Includes: acquisition of Sanatorio Triestino, of Aurelia Hospital Group and the price adjustment of GVDR. Figure relates to the recognized Enterprise Value (Price + Net Financial Position at 31.12.2023)

(2) Figure includes: extra-Covid costs (net of reimbursements), M&A costs, buy-back

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Strengths of the Equity Story: multi-decade track record in M&A

4 (Buy) and post-merger integration (Build)

2.	M&A
Purchasing strategy with proven ''Buy'' & ''Build'' track record

CASE STUDY: OSPEDALI PRIVATI RIUNITI (hospital)

Enterprise Value	50.0€M
EV / EBITDA @ acquisition (FY2019)	12.5x
EV / EBITDA @ FY2023	7.1x
(€M)
	35.1
26.2
	19.9%
15.3%
4.0	7.0
@acquisition (1)	FY2023
Revenues	Revenues
Op. EBITDA	Op. EBITDA
Margin (%)	Margin (%)

CASE STUDY: S. BIAGIO E UNI. CASTRENSE (outpatient)

Enterprise Value	51.2€M
EV / EBITDA @ acquisition (FY2019)	9.8x
EV / EBITDA @ FY2023	6.2x
(€M)
	26.5
19.0	31.3%
27.3%
	8.3
5.2
@acquisition (1)	FY2023
Revenues	Revenues
Op. EBITDA	Op. EBITDA
Margin (%)	Margin (%)

(1) Values communicated by GHC during the acquisition (for OPR: May 2019, for Centro Medico S. Biagio and Università Castrense: July and September 2019)

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Strengths of the Equity Story: substantial Real Estate assets

4 owned

3.	REAL ESTATE ASSETS
Ownership of substantial real estate assets (still unexpressed)

Book value of Real Estate Assets(1)

181.7€M

Sanatorio Triestino and Aurelia Hospital

Group (M&A 2023) include the

ownership of the instrumental Real Estate assets for a total of approx.

40,000smq

Total area(1)		∼250k sqm

(1) Book Value as of 31.12.2023

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