By Brazil Stock Guide – Alliança Saúde e Participações (B3: AALR3) recognized R$1.28 billion ($250 million) in impairments, provisions and other accounting write-offs in its 2025 financial statements as its new management conducted a sweeping review following a change of control. Released on Thursday, July 30, almost seven months after the end of the fiscal year, the results exposed accumulated problems involving assets, receivables, related-party credits and tax obligations.
The company reported a net loss of R$1.37 billion in 2025, widening sharply from R$117.2 million a year earlier. Most of the loss had no immediate cash impact and can be viewed as a balance-sheet cleanup by the new management, although there is no evidence that the previous figures were manipulated.
Alliança is one of Brazil’s largest medical diagnostics companies, with 91 facilities across 42 cities. Its operations include medical imaging, clinical laboratory testing and diagnostic services for hospitals.
Alliança itself linked the adjustments to the arrival of its new controlling shareholder. According to the company, the ownership change led to a strategic shift toward profitability and cash generation, alongside a reassessment of the forecasts and assumptions used to value its assets.
Control passed in March to Tessai, a fund managed by Geribá Investimentos, following the enforcement of collateral over shares previously linked to Brazilian businessman Nelson Tanure. The company also reshuffled its management and began reviewing internal controls, billing and collection procedures.
Losses Pushed Into the Past
The largest adjustment was a R$728 million impairment that reduced the carrying value of assets associated with nine cash-generating units. The calculation used a 14% annual discount rate and revised forecasts reflecting slower expected growth and management’s new emphasis on profitability.
Alliança also recognized R$180 million in expected credit losses on accounts receivable. The provision incorporated more detailed information on defaults, disputed or rejected medical claims and the likelihood of recovering amounts owed by health insurers.
A further R$106 million was provisioned against related-party receivables arising from a management agreement with Hemera. Hemera controlled ProEcho, a cardiovascular diagnostics business, and Cepem, a women’s health center. Alliança said the expected synergies and transactions related to the partnership were no longer applicable following the ownership change and that there was no firm expectation of recovering the money.
The review also included R$104 million in interest, penalties and lost benefits under tax installment programs, as well as a R$65.2 million write-off of deferred tax assets. The company is preparing to negotiate its tax liabilities with Brazil’s Federal Revenue Service and the Attorney General’s Office for the National Treasury.
The financial statements had been postponed more than once. Alliança attributed the delays to its financial restructuring, additional accounting tests, a review of internal controls and supplementary requests from its independent auditors.
Siemens Triggered a Crisis That Was Already Building
The dispute with Siemens was the immediate trigger for Alliança’s liquidity crisis, but it hit a company already facing expensive debt, concentrated maturities and difficulties converting revenue into cash.
In October 2025, Alliança entered into an approximately $10 million financing agreement with a company in the Siemens ecosystem. Receivables were pledged as collateral, with part of Alliança’s collections flowing through a restricted escrow account.
Following the change of control, Siemens declared the loan immediately due, citing the ownership change and alleged breaches of nonfinancial obligations. Alliança says it had not missed any payments and disputes the validity of the acceleration.
The creditor initially blocked more than R$10 million in receivables. In April, Alliança said approximately R$11.8 million held in the escrow account had been transferred unilaterally to Siemens, even after the company had obtained court protection.
According to Alliança, the transfer impaired its ability to pay suppliers and medical staff. The company argued that the collateral structure gave Siemens the ability to interfere directly with revenue streams essential to its operations.
Siemens Healthineers confirmed that it and Siemens Servicios Comerciales were among the creditors covered by the court proceedings. It said the companies operate independently and exercise their rights in accordance with applicable law. The group declined to comment on the details of the commercial relationship.
Protection From Creditors
The dispute prompted Alliança to obtain a court injunction in March that suspended enforcement actions and protected essential contracts and services for 60 days. The company also entered mediation with creditors in an effort to avoid a court-supervised restructuring.
The broader restructuring is much larger than the Siemens contract. Alliança reported approximately R$1.3 billion in obligations owed to 449 creditors. Court filings cited the risk that roughly R$1.1 billion in financial contracts could be declared immediately due. Itaú Unibanco also reportedly sought to freeze about R$4 million belonging to the group.
“Effectively overcoming the challenges described above depends on the success of the ongoing negotiations, as well as the effective implementation of the identified improvements in controls and processes,” Alliança said.
The company acknowledged that some of those factors are outside management’s exclusive control and could cast doubt on its ability to continue as a going concern.
The pressure is visible in its short-term financial indicators. Net working capital deteriorated from a positive R$28 million at the end of 2024 to a negative R$1.29 billion in December 2025. The current ratio fell to 0.28 from 1.04, while the average time taken to pay suppliers jumped to 93 days from 37 days.
Part of the deterioration resulted from the reclassification of R$532 million related to a capital increase that was subsequently canceled. The amount was moved into current liabilities. The change of control also triggered the early maturity of other financial obligations.
Operations Still Generate Too Little Cash
Excluding nonrecurring adjustments and discontinued operations, Alliança’s adjusted net loss narrowed to R$51.8 million in 2025 from R$82.9 million a year earlier. Adjusted net revenue rose 2.2% to R$1.19 billion, while adjusted Ebitda declined 15.4% to R$240.9 million.
The deterioration was concentrated at the end of the year. Fourth-quarter adjusted Ebitda plunged 95% to R$3.3 million, while the margin dropped to 1.2% from 26.4% a year earlier. The quarterly adjusted net loss widened 75.7% to R$48.9 million.
Gross debt declined 39.6% in 2025 to R$498.1 million, while net debt fell 46.2% to R$381.4 million. Those figures, however, do not capture the full amount of obligations included in the restructuring, such as supplier liabilities, tax debts and amounts related to the canceled capital increase.
To strengthen liquidity, Alliança’s Cura subsidiary raised R$126 million through a local bond issuance. The new management also plans to exit low-return contracts, integrate regional brands, prioritize higher-value examinations and improve collections from health insurers.
Alliança provided no quantitative guidance for 2026, citing the continuing restructuring. The challenge now is to demonstrate that the accounting cleanup did more than push losses into the final balance sheet associated with the previous management — and that it created a realistic foundation for restoring margins, normalizing payments and stabilizing the business.
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