RenaCare Dialysis Clinic — Executive Summary

RenaCare Dialysis Clinic seeks R20 million to launch a 20-station specialist renal-care facility serving chronic kidney disease and end-stage renal disease patients in South Africa — a 22.4% project IRR (28.7% equity IRR) opportunity scaling to R57.9 million revenue by Year 5 at a 35% EBITDA margin.

Section 1 · Business Plan

Executive Summary

1.1 Business Overview

Renacare Dialysis Clinic (Pty) Ltd is a proposed specialist renal
care facility that will offer in-centre haemodialysis and peritoneal
dialysis services to South Africans living with chronic kidney disease
(CKD) and end-stage renal disease (ESRD). The business will launch with
a single flagship clinic housing 20 dialysis stations operating three
shifts per day, with a clear pathway to replicate the model across
Johannesburg, Pretoria and Cape Town, and ultimately into neighbouring
SADC markets.

The opportunity Renacare addresses is structural and durable. South
Africa faces an entrenched and growing shortfall in dialysis capacity,
driven by a rising burden of diabetes, hypertension, HIV-associated
nephropathy and an ageing population. Fewer than 20% of patients who
need kidney replacement therapy in the public sector currently receive
it, while private-sector capacity is concentrated among two vertically
integrated hospital groups, creating a defensible opening for a focused,
high-quality, lower-cost specialist operator.

1.2 The Investment Proposition

At a glance Renacare requires R20 million in funding to launch a 20-station haemodialysis clinic, projected to generate R57.9 million in annual revenue by Year 5 at a 35% EBITDA margin. The project IRR of 22.4% and ~34-month payback reflect a recurring-revenue healthcare annuity backed by Prescribed Minimum Benefit protection under the Medical Schemes Act.

1.3 Key Investment Highlights

Structural demand: CKD prevalence in Sub-Saharan Africa is
estimated at 15.8% of the adult population, with ESRD cases expected to
double by 2030 — yet public-sector capacity has contracted since
2015.
Recurring revenue model: Each chronic haemodialysis patient
represents approximately R390k to R600k of annual revenue, paid three
times weekly for life or until transplantation.
PMB protection: CKD is a Prescribed Minimum Benefit, meaning all
registered medical schemes are legally required to fund treatment — a
regulatory moat against payer disintermediation.
Lean cost base: The standalone model avoids the overhead loading
of hospital-embedded units, enabling competitive tariffs while
protecting 30%+ EBITDA margins from Year 3.
Scalable platform: The 20-station unit economics are proven by
incumbents (NRC, Life Renal Dialysis) and replicate with minimal
operational re-engineering.
Experienced team: The management cohort combines clinical
nephrology leadership, healthcare operations experience and capital
markets expertise.
Clear exit: Trade sale to hospital groups (Netcare, Life
Healthcare, Mediclinic), private equity recapitalisation, or management
buy-out all represent realistic exit pathways.

1.4 Financial Highlights

Metric (ZAR)	Year 1	Year 2	Year 3	Year 4	Year 5
Station utilisation	50%	72%	85%	90%	92%
Revenue	24.8 M	36.9 M	46.8 M	52.6 M	57.9 M
EBITDA	4.96 M	9.96 M	14.04 M	17.38 M	20.26 M
EBITDA margin	20.0%	27.0%	30.0%	33.0%	35.0%
Net profit after tax	1.20 M	4.80 M	8.45 M	11.95 M	14.50 M
Cumulative free cash flow	(14.5) M	(6.8) M	3.5 M	13.8 M	25.4 M

1.5 Funding Requirement

Renacare is seeking R20 million of total funding to complete
licensing, site build-out, equipment acquisition and initial working
capital. The proposed capital structure optimises the cost of funding,
preserves management control, and aligns lender, equity holder and
vendor interests:

Source	Amount (ZAR)	Share	Instrument
Senior term loan (DFI / commercial bank)	9,000,000	45%	5-year amortising, prime + 2.5%
Equity contribution (founders & investors)	8,000,000	40%	Ordinary shares with pre-emptive rights
Equipment finance lease (vendor-provided)	3,000,000	15%	5-year lease, secured against machines
Total funding	20,000,000	100%

1.6 Return Profile

Based on the base-case financial model, Renacare is projected to
deliver a project-level IRR of 22.4% and an equity IRR of 28.7% over a
five-year horizon, with a cash payback of the initial investment by
month 34 of operations. These returns are benchmarked against a weighted
average cost of capital of 16.5%, leaving a robust 590 basis-point
spread of value creation after risk-adjusted cost of capital.

Figure 1.1

Figure 1.1 — Five-year revenue, EBITDA and net profit (ZAR millions)

1.7 Strategic Roadmap

The Company will execute in four clearly delineated phases over the
next 26 months. Phase 1 (pre-build) focuses on company formation, site
acquisition and regulatory licensing. Phase 2 (build and procurement)
covers construction, equipment installation and staff recruitment. Phase
3 (operations and ramp) covers soft launch, commissioning and
utilisation ramp. Phase 4 (expansion) begins evaluation of a second site
by month 23.

1.8 Why Invest Now

The South African private dialysis market is at an inflection point.
Life Healthcare’s 2023 acquisition of Fresenius Medical Care’s Southern
African operations consolidated the second-largest provider and
signalled sustained strategic interest in the sector. At the same time,
the regulatory transition to the National Health Insurance system is
creating uncertainty for incumbents, opening a window for nimble,
standalone specialist operators to establish referral relationships and
PPP contracts ahead of structural change. Delay reduces the window;
early entry captures the runway.

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.