Enhancing India CARIFORUM Economic Relations and Prospects for Cooperation

Loan (FCTL) of USD 4.50 million to Narayana Hrudayalaya Limited(NHL). NHL through its wholly owned overseas subsidiary Narayana Cayman Holdings Limited held 28.60% of equity shareholding in Health City Cayman Islands Limited (HCCIL), and the remaining shareholding of 71.40% was held by Ascension Health as a Joint Venture. The support from India Exim Bank enabled NHL to establish its footprint in the overseas market. HCCIL had witnessed a steady upward trend in patient volumes and revenues since April 2014. HCCIL has been able to demonstrate the model of affordable and compassionate care philosophy in Cayman Island; thereby making it a prime destination for high-quality affordable healthcare services. HCCIL’s accreditation by the Joint Commission International (JCI) is a testament of HCCIL’s efforts and dedication in providing health care services at par with high standards in global healthcare. The hospital is a comprehensive healthcare provider and provides the best-in-class tertiary medical care across a host of specialties such as cardiac sciences, orthopaedics, interventional radiology, interventional neurology, plastic surgery etc. HCCIL has demonstrated the viability of delivering in global medical tertiary care in the Caribbean and has established its capabilities and positive reputation in the Caribbean. It got the first mover opportunity to expand its services in the Cayman Island. Due to the global presence of NHL, the forex earnings of NHL increased in FY 2017 on account of increased visits of foreign patients for the high-end treatments especially in Heart care and Oncology. In 2017 NHL was able to increase its Average Revenue Per Operating Bed (ARPOB) from Rs. 6.4 million to Rs. 7.6 million by introducing the cutting-edge surgical procedures with relatively higher margin. After NHL successfully repaid the loan of India Exim Bank, the Bank again supported NHL in the year 2017 and sanctioned a term loan of USD 25 million to Narayana Hrudayalaya Limited, Bangalore (NHL) towards part financing investments in Health City Cayman Islands Limited, Cayman Islands (HCCIL) through Narayana Cayman Holdings Limited (NCHL), a wholly owned subsidiary of NHL for acquiring 71.40% equity stake from Ascension Health, USA (AH) under the Bank’s Overseas Investment Finance Programme. The 106 operational bedded hospital, presently, provides a very high standard of care and safety with best-in class medical equipment and civil infrastructure. The facility has broadened its catchment area beyond the Cayman Islands and caters to patients across the Caribbean region, North and Central Americas. The first ever Coronary Artery Bypass Graft (CABG) surgery and Cryo Ablation procedure in the Cayman Islands was performed in HCCIL hospital. The hospital tied up with “Have a Heart” foundation to perform free cardiac surgeries of children of Haiti and Belize and

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Enhancing India-CARIFORUM Economic Relations and Prospects for Cooperation