sdg:
sdg:
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3
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8
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13
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16
Investments
Our investments (ex-M&A) reached BRL 2,862.2 million in 2023, moving 8.2% up compared to the previous year, mainly due to expenditures with expansion projects.
Investments in the maintenance of our operations totaled BRL 313.9 million, which is equivalent to 1.2% of net revenue from hospitals, oncology and other lines recorded in the period (2.1% in the previous year).
| (BRL million) | 2023 | 2022 | Change (%) |
|---|---|---|---|
| Capex | 2,862.2 | 2,645.3 | 8.2 |
| Maintenance | 313.9 | 472.8 | -33.6 |
| Expansion | 2,548.4 | 2,172.5 | 17.3 |
| Mergers & Acquisitions | 45.7 | 1,033.3 | -95.6 |
| Total investment | 2,908.0 | 3,678.6 | -20.9 |
Over the last 20 years, our growth strategy has been characterized by high volume of acquisitions, accompanied by successful integration processes. Since filing for the IPO, in October/2020, we have already announced 17 acquisitions, which added 2,213 new beds to our service network.
The returns from Rede D’Or’s integration strategy come from economies of scale and the effects of synergies
in optimizing operational costs, in addition to potential revenue gains from an increase in the volume of services and the complexity of procedures performed in the units. These are coupled with benefits of improving
the units’ technology park, the relationship with the medical profession, and the level of quality and variety of services provided in each unit [GRI 3-3]
Further information on the projects under development can be found in our Reference Form, available on our website https://ri.rededorsaoluiz.com.br.
Organic growth
The business strategy we adopt at Rede D’Or includes taking parallel and complementary initiatives that promote our organic growth through greenfield (new units) and brownfield (expansions of existing units) projects to expand our operational capacity. In May 2023, we updated our Reference Form, which currently contains 63 projects that together add 6,634 new beds.
In addition to the start of operations at Hospital São Luiz Campinas (SP), four major projects are in the final stages of execution by the end of 2023: Memorial Star, Aliança Complex, Macaé, and Vila Nova Star II (Itaim Torre).
Projects delivered in the last three fiscal years and those already planned for the coming years
| Project | Type | Beds | Completion | Investments | State |
|---|---|---|---|---|---|
| Total (with set dates) | 6,634 | 9,867,944 | |||
| Greenfield projects (GF) | 2,083 | 3,368,757 | |||
| 1 Itaim R. Helena (Delivered) | GF | 173 | 2021 | 217,974 | São Paulo |
| 2 Campinas (Delivered) | GF | 325 | 2022 | 441,308 | São Paulo |
| 3 Memorial Star - Phase 1 | GF | 150 | 2023 | 405,462 | Pernambuco |
| 4 Macaé - Phase 1 | GF | 150 | 2023 | 226,033 | Rio de Janeiro |
| 5 Alphaville - Phase 1 | GF | 212 | 2024 | 392,908 | São Paulo |
| 6 Guarulhos - Phase 1 | GF | 268 | 2024 | 446,562 | São Paulo |
| 7 Novo Barra | 253 | 2024 | 513,485 | Rio de Janeiro | |
| 8 Taubaté - Phase 1 | 120 | 2025 | 119,101 | São Paulo | |
| 9 Novo Aviccena | 150 | 2025 | 183,782 | São Paulo | |
| 10 São Conrado | 132 | 2026 | 265,297 | Rio de Janeiro | |
| 11 Santos | 150 | 2027 | 156,845 | São Paulo | |
| Brownfields ("BF") | 4,551 | 6,499,188 | |||
| 1 CEMA - Fase 1 (Delivered) | BF | 14 | 2021 | 10,267 | São Paulo |
| 2 São Vicente - Fase 1 (Delivered) | BF | 35 | 2021 | 61,735 | Rio de Janeiro |
| 3 São Rafael - Fase 1 (Delivered) | BF | 50 | 2021 | 34,989 | Bahia |
| 4 Sino Torre (Delivered) | BF | 90 | 2021 | 184,932 | São Paulo |
| 5 Expansões Diversas (Delivered) | BF | 49 | 2021 | 19,600 | N/D |
| 6 Cardio Pulmonar (Delivered) | BF | 32 | 2022 | 26,789 | Bahia |
| 7 CEMA - Fase 2 (Delivered) | BF | 65 | 2022 | 26,579 | São Paulo |
| 8 Mauá - Fase 1 (Delivered) | BF | 11 | 2022 | 8,505 | São Paulo |
| 9 São Vicente - Fase 2 (Delivered) | BF | 35 | 2022 | 60,103 | Rio de Janeiro |
| 10 Ribeirão Pires - Fase 1 (Delivered) | BF | 16 | 2022 | 6,167 | São Paulo |
| 11 São Rafael - Fase 2 (Delivered) | BF | 62 | 2022 | 40,598 | Bahia |
| 12 Various Expansions 2022 (Delivered) | BF | 14 | 2022 | 4,787 | N/D |
| 13 Itaim Tower | BF | 140 | 2023 | 347,784 | São Paulo |
| 14 Aliança | BF | 196 | 2023 | 282,390 | Bahia |
| 15 Serra Mayor - Phase 1 | BF | 25 | 2023 | 12,199 | São Paulo |
| 16 Atibaia - Phase 1 | BF | 24 | 2023 | 16,103 | São Paulo |
| 17 Santa Isabel - Phase 1 | BF | 10 | 2023 | 10,008 | São Paulo |
| 18 Central Leste - Phase 1 | BF | 10 | 2023 | 8,008 | São Paulo |
| 19 Various Expansions 2023 | BF | 298 | 2023 | 461,900 | N/D |
| 20 Ribeirão Pires - Phase 2 | BF | 27 | 2024 | 38,176 | São Paulo |
| 21 Assunção Torre - Phase 1 | BF | 183 | 2024 | 299,646 | São Paulo |
| 22 Serra Mayor - Phase 2 | BF | 19 | 2024 | 20,157 | São Paulo |
| 23 Santa Isabel - Phase 2 | BF | 26 | 2024 | 27,583 | São Paulo |
| 24 Oeste | BF | 100 | 2024 | 112,080 | Rio de Janeiro |
| 25 Santa Cruz - Phase 1 | BF | 50 | 2024 | 98,113 | Paraná |
| 26 Aeroporto - Phase 1 | BF | 34 | 2024 | 35,700 | Bahia |
| 27 Various Expansions 2024 | BF | 320 | 2024 | 35,700 | N/D |
| 28 São Lucas | BF | 115 | 2025 | 236,009 | Sergipe |
| 29 Brasil Bloco C | BF | 330 | 2025 | 561,543 | São Paulo |
| 30 Atibaia - Phase 2 | BF | 98 | 2025 | 112,357 | São Paulo |
| 31 Santa Isabel - Phase 3 | BF | 25 | 2025 | 26,523 | São Paulo |
| 32 UDI Tower Phase 1 | BF | 130 | 2025 | 265,954 | Maranhão |
| 33 São Carlos | BF | 60 | 2025 | 63,946 | Ceará |
| 34 Nova Torre Caxias | BF | 92 | 2025 | 125,172 | Rio de Janeiro |
| 35 DF Star-Phase 1 | BF | 80 | 2025 | 156,518 | Distrito Federal |
| 36 Vivalle | BF | 40 | 2025 | 47,698 | São Paulo |
| 37 Central Leste - Phase 2 | BF | 77 | 2025 | 87,819 | São Paulo |
| 38 Ribeirão Pires - Phase 3 | BF | 82 | 2026 | 84,575 | São Paulo |
| 39 Mauá - Phase 2 | BF | 219 | 2026 | 277,536 | São Paulo |
| 40 Proncor | BF | 84 | 2026 | 102,568 | Mato Grosso do Sul |
| 41 Artur Ramos | BF | 64 | 2026 | 78,147 | Maceió |
| 42 BH Star | BF | 150 | 2026 | 306,038 | Minas Gerais |
| 43 Assunção Tower - Phase 2 | BF | 54 | 2027 | 62,848 | São Paulo |
| 44 DF Star - Phase 2 | BF | 83 | 2027 | 162,387 | Distrito Federal |
| 45 Lot 4 Project | BF | 150 | 2027 | 174,578 | Distrito Federal |
| 46 Nossa Senhora das Neves | BF | 74 | 2027 | 90,358 | Paraíba |
| 47 Circular do Bosque | BF | 81 | 2027 | 94,272 | São Paulo |
| 48 Esperança | BF | 64 | 2027 | 74,486 | Pernambuco |
| 49 Santa Cruz - Phase 2 | BF | 50 | 2027 | 98,113 | Paraná |
| 50 Aeroporto - Phase 2 | BF | 115 | 2027 | 133,843 | Bahia |
| 51 São Luiz Jabaquara | BF | 69 | 2027 | 80,306 | São Paulo |
| 52 Quinta - Phase 1 | BF | 200 | 2027 | 244,700 | Rio de Janeiro |
Investment in infrastructure
In our infrastructure projects, we maintain strict parameters that show our concern in implementing ESG aspects that are very significant for the society [GRI 3-3].
The lighting system with efficient LED lamps is installed to create a pleasant ambience from the front desk to the internal environments of the inpatient wards. The specified chillers offer energy savings in air conditioning equipment of 15 to 20% when compared to regular equipment. Filters are designed for indoor air quality, with three high-efficiency A3 absolute filters (HEPA) in the operating rooms. This allows the operating rooms to have filtered air with an efficiency of 99.97%. The other areas use the set of filters G4 and F8, with G4 having an efficiency of up to 90% and F8 between 90% and 95%, in compliance with current legislation. Renewing indoor air avoids the feeling of “still air” in the building.
They guarantee the operation of our hospitals even without energy from the electricity utility, with the Company’s focus being the purchase of renewable incentivized energy on the Free Energy Market.
Our care for people is also present in the adoption of noise attenuators applied to generators, so that engine noise does not disturb users and neighbors.
Our projects include a smoke extraction system with motorized fire dampers to operate in the event of an accident. Information and Communication Technology (ICT) data will be protected in the data processing center and air- conditioned with air conditioning with fine filtration and a no-break power system, i.e., systems that never stop working and have reserves in case of need.
Fire detection and alarm systems are installed with an alarm repeater center at nursing stations and power generators offer parallelism between the utility’s network and local power generation, i.e., the generators increase the safety of the facilities. Systems with automatic electric shock protection switch (DR device) will guarantee quality in energy installation and operation.
These projects foresee rainwater harvesting for reuse and use for cleaning, as well as rainwater retention reservoirs to assist in the efficient use of this natural resource. The specification of faucets and sanitary ware also follows such criteria with a focus on reducing water use internally. Examples include faucets with an articulated aerator to save water during use and faucets with a built-in aerator for emergency environments, bathrooms and shower rooms to consume up to 90% less water than common faucets. Changing rooms have a design specification for toilets that are prepared for use with dual flush technology, for full flush and reduced volume flush. These toilets guarantee water savings of up to 60%.
All installations are 100% tested and checked before they are put into operation, and the tests on pipes used in procedures such as hemodialysis are reinforced, following our Water Safety Plan. We also install fans with a frequency inverter, which in addition to excellent pressure and flow regulators for the air conditioning system, enables us to save energy, avoiding peaks and more energy consumption.
Our air renewal projects follow the recommendations of the ABNT 7256 standard in all environments. The kitchen hoods have air scrubbers and UV (ultraviolet) systems, which eliminate unpleasant odors. The kitchens are designed with negative air pressure in relation to the adjacent rooms, preventing food odors from escaping into other rooms or circulating. The heating system was designed with low- impact refrigerating gas that do not harm the ozone layer nor does it increase global warming. Building automation control and supervision systems equipped with sensors are well dimensioned. Likewise, the technical plants are well positioned for constant maintenance throughout the building’s life cycle.
These are planned with integration between the water, energy and air conditioning installations, optimizing energy consumption, as well as individual meters per floor. And system networks are organized with the external Operation Control Center (CCO, in Portuguese) to ensure reliability.
Since the proper operation of the infrastructure systems depends on people, we direct our efforts to training our teams in automation systems, air conditioning, electrics, hydraulics, medical gases, hoods, generators, chillers and kitchen equipment.
UP TO 90% REDUCTION
in water consumption with aerator faucets, compared to standard faucets.
