■Mia Health Holdings＜7129＞ Company Overview

(2) Nursing care business

In the nursing care business, we mainly develop home-visit services such as home-visit nursing care/nursing, etc., day services, etc., residential services such as serviced housing for the elderly, dementia-compatible group homes, hospices, etc., and a wide range of nursing care services in the metropolitan area. At the end of 2024/3, there will be 65 service locations (26 in Tokyo, 22 in Saitama, 13 in Chiba, and 4 in Kanagawa).

One characteristic of the company's nursing care business is that it dominantly develops as a complex facility where multiple service bases such as day-care services and home-visit services are also installed within the same building, using residential services such as serviced housing for the elderly. Also, in addition to “Mia Helsa Oasis Wako” being selected as a housing stabilization model for the elderly etc. by the Ministry of Land, Infrastructure, Transport and Tourism, “Mia Helsa Care Village Hibarigaoka” was established as a collaboration with the UR City Organization's “housing complex regeneration project,” and “Community Comprehensive Care System” initiatives that provide services not only to Oasis residents but also to the elderly in the region are also being actively developed as a base for total medical and nursing services. Also, in anticipation of future growth in nursing demand, hospice services have also started in 2020. Following the opening of a dedicated at-home hospice floor within the serviced housing “Mia Helsa Oasis Higashi Shinkoiwa” in August 2020, a residential paid nursing home “Mia Helsa Medicare Oasis Shin-Yurigaoka” dedicated to hospice was opened in Kawasaki City, Kanagawa Prefecture in September 2021, and “Mia Helsa Medicare Oasis Nagareyama Canal” in Nagareyama City, Chiba Prefecture in 2028/8 within the same facility as serviced elderly housing (hospice is available 24 hours a day A home-visit nursing station was also opened at the same time). In addition, we believe that our mission is to continue providing an environment where people can live in familiar areas until the end of their lives in cooperation with nursing care services and dispensing pharmacies.

The breakdown of sales accounts for about 60% of the total for day care and visiting services, about 30% for residential services, and the remainder for administrative outsourcing services such as regional comprehensive support centers and other services. As a business model, for services to which the “Long-Term Care Insurance Law” is applied, services are provided based on care plans created by care managers, and part of the compensation is received from the user, and the remainder is received from the National Federation of Health Insurance Organizations. Also, for services not covered by long-term care insurance (rent, meals, life support service costs, etc.) for services not covered by long-term care insurance, compensation is directly received from users. Long-term care insurance is also revised every 3 years according to the actual situation. In the 2024 revision, deterioration in the business environment due to chronic shortage of human resources was also taken into account, and the actual increase was equivalent to 2.04% (nursing care remuneration +1.59%, price increase +0.45%), and the revision exceeded 0.70% of the previous (2021 fiscal year).

(3) Childcare business

Regarding the childcare business, Mia Helsa is developing “Mia Helsa Nursery School Hibiki” (38 authorized daycare centers) and “Mia Helsa Nursery School Yurarin” (12 authorized daycare centers, 4 certified daycare centers) in the Tokyo metropolitan area. In addition, child-rearing plazas, daycare rooms, school children's clubs, etc. are being developed in Tokyo, and comprehensive care for children from age 0 to elementary school is also carried out by carrying out contract management of public nursery schools and metropolitan school children's clubs*. As of the end of 2024/3, the number of operating bases is 77 (66 in Tokyo, 7 in Kanagawa, 4 in Chiba, including contract operations).

* Public outsourced school children's clubs are outsourced operations (5-year contracts) of local government projects, so there is no need for initial investment or customer attraction costs, etc., but metropolitan school children's clubs need to carry out their own customer attraction activities.

Nursery schools are classified into 2 types: authorized daycare centers, certified daycare centers, and unauthorized daycare facilities, and kindergarten children eligible for childcare are infants (under 1 year old) and infants (1 year old to preschool). An authorized daycare center indicates a facility that satisfies the installation standards (size of the facility, number of staff such as nursery teachers, etc., school lunch facilities, disaster prevention management, hygiene management, etc.) determined by the country based on the Child Welfare Act and has been approved by each local government. The average capacity per park is around 60 to 70 people. When establishing an authorized daycare center, each local government determines the opening area about 2 years in advance, and determines the operating operator 1 year in advance by bidding. Since operators can be determined by comprehensively evaluating operating results within the relevant municipal area, it can also be said that it is a difficult market for new entrants.

A certified daycare center indicates a facility that satisfies installation standards independently determined by the Tokyo Metropolitan Government and has been certified by the Tokyo Metropolitan Government. As a classification, it is positioned as an unauthorized childcare facility. The difference from authorized daycare centers is that they carry out recruitment activities for kindergarten children themselves and directly sign contracts with parents, and it looks like they receive some childcare fees, etc. from parents and receive the rest from local governments. If it is an authorized daycare center, recruitment is carried out by the local government, so there is an advantage that recruitment costs are not charged. For this reason, the company is proceeding with development at authorized daycare centers, and will proceed with efforts to meet approval standards for the 4 certified daycare centers previously operated by Life Support, and if approval is difficult, integration, etc.

Looking at the business model of an authorized daycare center, parents who wish to enter kindergarten first apply to each municipality, and after entering kindergarten, they pay childcare fees, etc. to the local government. From 2019/10, usage fees for children aged 3 to 5 became free (households exempt from resident tax for children aged 0 to 2) *, but since authorized nursery schools originally obtained childcare expenses and subsidies, etc. as income from the country and local governments as compensation for service provision, the effects of making it free have become minor. Also, part of the capital investment required to establish a new authorized daycare center is covered by subsidies from local governments, and depending on the local government, part of the facility rent is paid. Subsidies related to capital investment will be decided to be issued just before the opening month (April) (March). The subsidy ratio for equipment funds varies depending on the local government, but it is generally at the level of 80% or more, and the company records it as special profit. For example, 2 new gardens were opened in 2023/4, and equipment subsidy income of 330 million yen was recorded as special profit for the fiscal year ending 2023/3.

* As before, parents are responsible for kindergarten transportation costs, food material costs, and event expenses.

One of the company's strengths in the childcare business is that most of the daycare centers operated by Mia Helsa are authorized daycare centers, and since there are almost no operating expenses for recruiting kindergarten children, high profitability can be maintained. Also, compared to unapproved childcare facilities, authorized daycare centers have strict personnel standards and facility standards, and clearing the same standards is the opposite of being able to provide high quality services. The reason behind being able to provide such high-quality services is that in addition to the company's education and training system functioning properly, it has built a strong network regarding the recruitment of nursery teachers. In addition to continuously exhibiting at fairs for mid-career hires nationwide, they have also built a network by regularly visiting vocational schools. There are also reviews etc. from senior nursery teachers, etc., and the fact that they can stably hire 50 to 100 new graduate nursery teachers per year and achieve a high retention rate even in an environment where human resource recruitment is difficult has led to high profitability.

(4) Others

Other than that, it is developing a food business. We mainly wholesale ingredients for school lunches to approximately 170 public elementary and junior high schools in Adachi-ku and Katsushika wards, and ingredients for nursery schools/nursing homes, and other general restaurants, etc. within the same ward. In addition, they have developed 3 stores in Adachi-ku as a franchisee of the sushi delivery chain “Gin no Sara” operated by Ride On Express Holdings ＜6082＞. Furthermore, a “disaster prevention agreement” was concluded with Adachi Ward in 2020/4. This agreement means that when a disaster occurs or when the occurrence of a disaster is in danger, the company cooperates with Adachi-ku in securing and supplying supplies such as foodstuffs and pharmaceuticals, and providing logistics support, and evacuation centers, and it is one of the efforts for community contribution activities.

(Author: FISCO Visiting Analyst Joe Sato)