RenaCare Dialysis Clinic — Appendices
Supporting detail and reference material underpinning the RenaCare Dialysis Clinic business plan.
Section 16 · Business Plan
Appendices
Supporting detail and reference material underpinning the RenaCare Dialysis Clinic business plan.
Appendix A — Detailed Financial Model Assumptions
| Parameter | Value | Notes |
|---|---|---|
| Project start date | Month 1 (Apr 2026) | Assumes funding close by Month 5 |
| First patient admission | Month 12 | Subject to DSP accreditation |
| First full operating year (Year 1) | Year ending M24 | Partial P&L for months 12–24 |
| Patient treatment ratio | 3 sessions / patient / week | Standard maintenance HD regimen |
| Treatment duration | 4.0 hours | Standard international benchmark |
| Patient census at steady state | ~ 150 | 92% of 162.5 theoretical max |
| Average patient lifetime | 3.8 years | Before transplant / transfer / death |
| Consumable inflation | 5.5% p.a. | Tracks medical device import inflation |
| Staff cost inflation | 7.0% p.a. | CPI + 2.5% for nurse wage pressure |
| Corporate tax rate | 27% | Current SARS rate |
| Assessed loss treatment | Carried forward | Year 1 loss shields Year 2 profits |
| VAT on medical services | Exempt | Per VAT Act supply schedule |
| Section 12B allowance (solar) | 125% capex deduction | Available on solar investment |
| Depreciation method | Straight-line | Over asset useful life |
| Dividend policy | 30% payout from Y4 | After debt covenants cleared |
| Exit assumption | Y5, 6.0x EBITDA multiple | Base case |
| Discount rate (WACC) | 16.5% | Blended debt + equity cost |
| Equity cost of capital (CAPM) | 19.8% | SA equity risk premium + beta adj |
| Debt cost (pre-tax) | 12.75% | Prime + 2.5% |
Appendix B — Full Year 1 Monthly Operating Plan
| Month of Y1 | Stations active | Sessions | Revenue (ZAR ’000) | EBITDA (ZAR ’000) | Patients | Utilisation |
|---|---|---|---|---|---|---|
| M1 (pre-open) | 0 | 0 | 0 | (450) | 0 | 0% |
| M2 (soft launch) | 10 | 170 | 450 | (180) | 25 | 27% |
| M3 | 10 | 390 | 1,033 | 45 | 45 | 62% |
| M4 | 14 | 620 | 1,643 | 150 | 60 | 70% |
| M5 | 16 | 780 | 2,067 | 230 | 70 | 76% |
| M6 | 18 | 920 | 2,438 | 295 | 78 | 77% |
| M7 | 20 | 1,040 | 2,756 | 350 | 84 | 78% |
| M8 | 20 | 1,120 | 2,968 | 395 | 90 | 83% |
| M9 | 20 | 1,170 | 3,100 | 420 | 94 | 87% |
| M10 | 20 | 1,200 | 3,180 | 440 | 97 | 89% |
| M11 | 20 | 1,220 | 3,233 | 455 | 99 | 90% |
| M12 | 20 | 1,240 | 3,286 | 470 | 100 | 92% |
| Year 1 total | 9,870 | 24,800 | 2,480 | 100 (end) | 50% avg |
Appendix C — Key Industry References
- South African Renal Registry (SARR) — Annual Report 2022, African
Journal of Nephrology (published 2024). - Davids MR et al. (2021). Global Dialysis Perspective: South
Africa. Kidney360. - Kaze AD et al. (2018). Burden of chronic kidney disease on the
African continent: a systematic review and meta-analysis. BMC Nephrology
19:125. - Stanifer JW et al. (2014). The epidemiology of chronic kidney
disease in sub-Saharan Africa: a systematic review and meta-analysis.
The Lancet Global Health 2(3):e174–181. - Council for Medical Schemes — Annual Report 2023/24 and Circular
35 of 2024 (tariff guidance). - Council for Medical Schemes — Prescribed Minimum Benefits (PMB)
Regulation under the Medical Schemes Act 131 of 1998. - KDIGO (2024). Clinical Practice Guideline for the Evaluation and
Management of Chronic Kidney Disease. - International Society of Nephrology (2021). ISN Framework for
Developing Dialysis Programs in Low-Resource Settings. - National Health Act 61 of 2003 and regulations
thereunder. - National Health Insurance Act 20 of 2023.
- Protection of Personal Information Act 4 of 2013.
- Occupational Health and Safety Act 85 of 1993.
- Companies Act 71 of 2008.
Appendix D — Glossary of Terms
| Term | Definition |
|---|---|
| AAMI | Association for the Advancement of Medical Instrumentation — sets standards for dialysis water quality |
| CAPD | Continuous Ambulatory Peritoneal Dialysis — manual exchanges performed four times daily |
| CKD | Chronic Kidney Disease — progressive loss of kidney function over months or years |
| CMS | Council for Medical Schemes — statutory regulator of medical schemes in South Africa |
| DSP | Designated Service Provider — a healthcare provider appointed by a medical scheme to supply care to its members at agreed tariffs |
| DSCR | Debt Service Coverage Ratio — EBITDA divided by debt service |
| EPO | Erythropoietin — a biologic drug administered to dialysis patients to stimulate red blood cell production |
| ESRD | End-Stage Renal Disease — the stage of CKD at which dialysis or transplantation is required for survival |
| FCF | Free Cash Flow |
| HD | Haemodialysis |
| HPCSA | Health Professions Council of South Africa |
| IRR | Internal Rate of Return |
| KDIGO | Kidney Disease: Improving Global Outcomes — international clinical practice guideline body |
| KRT | Kidney Replacement Therapy — includes haemodialysis, peritoneal dialysis and kidney transplantation |
| NHI | National Health Insurance |
| NPV | Net Present Value |
| PD | Peritoneal Dialysis — home-based dialysis via a catheter in the peritoneum |
| PMB | Prescribed Minimum Benefits — conditions medical schemes must by law cover in full |
| pmp | Per Million Population — standard epidemiology rate unit |
| POPIA | Protection of Personal Information Act, 2013 |
| PPP | Public-Private Partnership |
| RO | Reverse Osmosis — water treatment technology used to prepare dialysate-grade water |
| SANC | South African Nursing Council |
| SARR | South African Renal Registry |
| WACC | Weighted Average Cost of Capital |
Appendix E — Document Version Control
| Version | Date | Summary of Changes | Approved By |
|---|---|---|---|
| 0.1 | December 2025 | Initial skeletal draft | Founding Management |
| 0.5 | February 2026 | Completed market & operations sections; first financial model | Founding Management |
| 0.9 | March 2026 | Independent model review; sensitivity analysis added | Clinical Advisory Panel |
| 1.0 | April 2026 | Investment-grade release version | Board of Directors (interim) |
Confidential — this business plan is provided to prospective investors and lenders for evaluation purposes only and may not be reproduced or distributed without the written consent of RenaCare Dialysis Clinic (Pty) Ltd.