Khater assumed the role of chairman in 1999. Alameda currently operates in Egypt and Nigeria with more than 1,100 beds across four hospitals and five clinics. In 2024, the group reported revenue of $140 million. In July 2025, Alameda signed a binding agreement with Development Partners International (DPI) for a $190 million minority investment to support its expansion in Egypt and the GCC, while Khater retained a majority stake. In August 2025, it partnered with Talaat Moustafa Group to finance and operate a 200-bed hospital in Madinaty, in which it holds a majority stake. It is also expanding a brownfield hospital in Saudi Arabia.