2021 GRI Index

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In the reporting period, we were a member of several external organizations. The most important ones include: American Nephrology Nurses Association, Business for Social Responsibility, American Society of Nephrology, APACMed, European Renal Association – European Dialysis and Transplant Association, Global Industrial Relations Network (a network of the International Organisation of Employers), MedTech Europe, National Kidney Foundation, and Renal Physicians Association.

Examples of our collaboration with these groups include joining the newly established working group on sustainable corporate governance of MedTech Europe, a trade association representing the interests of the medical technology industry in Europe, as well as the working group on business and human rights within the German Chemicals Industry association (Verband der Chemischen Industrie e.V.). We also joined the Corporate Social Responsibility working group within the Confederation of German Employers’ Association (Bundesvereinigung der Deutschen Arbeitgeberverbände) and became a member of the sustainability network econsense.

The percentages of women at first and second management level below the Management Board in 2020 were adapted in the 2021 Non-Financial Report to reflect a new definition of these levels. The figures now include all managers in the respective leadership positions according to our new global job evaluation system. In previous reporting, the definition included all employees that participated in our Long-Term Incentive Plan and reported directly to a Management Board member.

We define corruption as the misuse of power for private gain, including bribery. Any direct or indirect payment, or promise, offer, or authorization of a payment of anything of value made to corruptly obtain or retain business or an improper advantage, could be considered a bribe. The offer or acceptance of bribes, including facilitation payments, is strictly prohibited.

We have a policy on conflicts of interest, reflecting our commitment to minimize them. Conflicts of interest are defined as situations when the personal interests of an employee (including interests and activities of family members and other non-FME persons) influence or appear to influence an employee’s ability to perform his or her professional duties objectively and in the best interests of FME, and/or interfere with or potentially interfere with FME’s reasonable business interests. Potential conflicts of interest are disclosed via a disclosure form, which is part of the policy/standard operating procedure and reflected in training and guidance materials.

We have policies, controls, and procedures in place to guide donation and sponsorship (“educational grants”) processes. Dedicated committees review and approve charitable donations and educational grants based on a set of compliance criteria reflected in the corresponding policy/standard operating procedure.

Compliance

In addition to various other monitoring activities, at Group level all operations are formally assessed at least annually in terms of all kinds of ethics and compliance risks, including bribery and corruption. 

Our anti-corruption policies and procedures have been communicated to all Management Board and Supervisory Board members, as well as employees. Likewise, training has been provided to employees, governance bodies and high-risk/selected third parties.

Below you will find an overview of employee training numbers per region:

In 2021, more than 200 third parties received compliance training. Third parties refer to our third parties in the sales channel, i.e., distributors, re-sellers, wholesalers, commercial/sales agents, and any other third party involved in the sales of our products that potentially interact with government officials and/or health care professionals for sales of our products.

For all training, completion is tracked, and overdue cases are addressed through, for example, automated reminders and escalation processes. We target a global compliance training completion rate of 90%.

Energy and climate protection

CO₂ equivalent emissions factors include CO₂, CH4, and N₂O gases. We calculate our Scope 1 greenhouse gas emissions following the methodology of the Greenhouse Gas Protocol, using the UK Department for Environment, Food and Rural Affairs’ (DEFRA’s) latest version, as well as the emission factors of the International Energy Agency for electricity consumption.

CO₂ equivalent emissions factors include CO₂, CH4, and N₂O gases. We calculate our Scope 2 greenhouse gas emissions following the methodology of the Greenhouse Gas Protocol, using the UK Department for Environment, Food and Rural Affairs’ (DEFRA’s) latest version, as well as the emission factors of the International Energy Agency for electricity consumption.

We use external certifications in addition to our own environmental standards if they add value. In 2021, a total of ten production sites were certified according to ISO 14001 standards. They accounted for 9% of our total Scope 2 emissions. In addition, two production sites have ISO 50001 certification. They accounted for 1% of our total Scope 2 emissions.

As part of our Global Sustainability Program, we are planning to quantify and disclose Scope 3 emissions. Therefore, we are preparing a comprehensive hotspot analysis considering all categories defined by the Greenhouse Gas protocol.  

We have ongoing waste initiatives to help us reduce our environmental footprint.

In our Global Sustainability Program, we are planning to develop a global approach to consolidating waste data and to defining reduction targets. As part of this, in 2021 we introduced new measures to improve our waste data collection processes at four pilot production sites. We plan to roll these measures out to all sites at the beginning of 2022.

We have identified five human resources (HR) related sustainability areas to focus on:

• Employer attractiveness and retention
• Employee engagement
• Learning and development
• Inclusion and diversity
• Employment standards and HR policies

International program teams are working on implementing global management concepts for the above-mentioned areas.

In accordance with legal requirements, we have established occupational health and safety (OHS) management systems in all locations under the direct responsibility of Fresenius Medical Care. The most important regulatory and legal requirements include:

• Occupational Health and Safety Administration (OSHA) and voluntary health and safety organizations such as the American National Standards Institute (ANSI) and the National Fire Protection Association (NFPA)
• EU Directive (89/391/EEC) on the introduction of measures to encourage improvements in the safety and health of workers at work
• Directive 2010/32/EU on the prevention from sharp injuries in the hospital and health care sector for clinics
• Regulation 1907/2006/EC concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) (e.g., handling and storage, exposure controls, personal protection)
• Regulation 1272/2008/EC on the classification, labelling, and packaging of substances and mixtures (i.e., general obligations to classify, label, and package).

Fresenius Medical Care identifies hazards at the dialysis clinics and production sites that it controls directly. Identified hazards are evaluated based on their severity and/or frequency to determine their likelihood of causing harm. Once this step has been taken, appropriate measures to reduce the hazards and any related risks are identified and adopted. As an example of actions taken, regular meetings are carried out at production sites in Europe, Middle East and Africa to share best practices, discuss lessons learned from accidents, and identify significant near misses.

All actions to mitigate hazards are assigned to a specific OHS department in the North American region and to local HR or OHS representatives in the other regions. Incident investigation is a locally managed process that covers all employees.

As part of our Global Sustainability Program, in 2021, we improved our internal and external reporting processes in addition to our global risk assessment procedures.

Depending on the location, we offer a wide range of benefits aimed at promoting employee health. These benefits focus on preventing illness and injury. Offers include fitness and sport activities, as well as nutrition and safety courses. An example is the initiative Health at Work at Fresenius Medical Care’s headquarters, which includes a variety of classes, workshops, and events to help employees stay fit and healthy.

Quantitative OHS data is currently reported at regional level. As part of the Global Sustainability Program, we have been working to create a centralized reporting process on injuries and fatalities. In 2021, we identified three global KPIs to report on: number of work-related fatalities, total recordable injury frequency rate (TRIFR), and lost time injury frequency rate (LTIFR). In the last three years (2019 – 2021) no fatalities were recorded. We plan to report the TRIFR in 2023.

In our dialysis clinics, the most frequently reported type of injuries are minor injuries, for example injuries that result from needlesticks. To further prevent injuries, each respective clinic has introduced measures such as offering training programs at local level.

Sustainability management

Sustainability management

Our global commitment to zero tolerance for discrimination and harassment is anchored in our Human Rights, Workplace Rights and Labor and Employment Principles, as well as in our Code of Ethics and Business Conduct. In December 2021, we launched a Global Social and Labor Standard Policy, which is our leading document concerning human rights topics related to our employees. It outlines our global commitment to a discrimination and harassment-free workplace by specifying that we do not tolerate any form of discrimination based on age, ethnic origin/race, color, national origin, citizenship, disability status, gender, gender expression, gender identity, marital status, pregnancy, religion, sex, sexual orientation, and any other criteria as protected by local laws and regulations. This commitment is further specified in our global policy “Prohibition of Discrimination, Harassment, Sexual Harassment and Bullying”. Non-discrimination topics are integrated into our global Code of Ethics and Business Conduct training. We make compliance training mandatory for employees and take appropriate remedial and corrective action when our Code of Ethics and Business Conduct and company policies are violated, including disciplinary action. Where non-employees such as business partners or patients are involved, other measures might be taken, such as counseling, termination of the business relationship, or other.

Various channels are available to employees, patients, and third parties to report potential violation of human rights, laws, or company policies. The person affected by an issue related to discrimination may alert any member of management or human resources, or make use of other channels such as the Compliance Action Line. We are currently working to improve our data collection in order to track globally the cases on discrimination and other human rights issues, independently from the channel used to report them. 

We launched an initiative to evaluate suppliers based on sustainability risks, which includes the risk for incidents of child labor.

Establishing a solid understanding of our company’s actual and potential human rights impact is a crucial element of our approach to human rights due diligence. In 2020, we initiated a global risk assessment to obtain a holistic view of our actual and potential impacts on employees, patients, and local communities in the vicinity of our sites.

For our own operations, we have mapped key activities against human rights standards to identify relevant human rights issues. After careful review and interviews with relevant HR, Legal, and Compliance representatives, we have concluded that the risk of child labor is minimal and that for the moment it does not require additional revision. This risk will be reviewed and updated annually.

We are currently analyzing the environmental and social impact associated with our supply chain

We are further developing our global compliance program with the support of the Independent Compliance Monitor (“Monitor”). We continue to improve the Company’s culture regarding compliance, with the support of messages from top management and from middle managers to their teams. We have enhanced this area through regular, company-wide management communications on the topic of compliance, coupled with specific training on compliance communications for our managers.

We have also stepped-up coordination between functions such as Compliance, Finance, Legal, HR and leadership. For instance, we implemented a Global Compliance Oversight Committee at CEO level that meets regularly to evaluate the enhancements and challenges of our anti-corruption program. We established a Project Management Office, staffed by an executive level professional, with responsibility for coordinating collaboration between management and all support functions. We are continually working on our  policies and procedures to make them more user-friendly and to improve their effectiveness.

We are dedicating resources to implementing our third-party due diligence program. This includes expanding our mergers and acquisitions (M&A) due diligence with the aim of establishing a clear understanding of any additional risk the Company might be taking on through its M&A program. We have also implemented a global platform for classifications, due diligence, tracking, and payments related to third-party relationships.

Our financial controls framework builds on an infrastructure with more than 150  internal controls. We work to  continuously strengthen this framework. In 2021, we established a monitoring solution that will help us to identify red flags in instances where questionable transactions are detected.

We also continue to emphasize the importance of internal reporting and investigations. Our Global Investigations department evaluates and examines matters in coordination with the Global Legal function. Cases, statistics, and trends are presented in quarterly meetings of the Global Investigations Oversight Committee, whose members include the Chief Executive Officer, Chief Financial Officer, Global General Counsel, and Global Chief Compliance Officer. Our Global Legal function has increased its capacity to conduct significant internal investigations, for example, through the addition of a dedicated investigations counsel and forensic capabilities, as well as a document management and review platform.

Finally, we have put consistent policies and protocols in place for handling and executing enforcement and discipline decisions. Our Human Resources and Legal departments have set up global and regional disciplinary committees comprised of senior managers, who discuss facts and findings from investigations or circumstances concerning employee discipline. This disciplinary framework fosters a culture in which substantiated violations result in clear, consistent, and appropriate disciplinary action.

Furthermore, we have expanded the Global Internal Audit’s capabilities by adding resources and focusing internal audits in high-risk areas on anti-corruption.

With the objective of promoting a culture of ethical business conduct worldwide, we have developed consistent compliance messaging that we distribute globally so that we speak in one voice. In 2021, we launched four global campaigns, more than 60 pieces of content positioning leadership in the ethics and integrity space, and extensive tracking processes to monitor deployment, awareness, and changes in mindset as we a build a healthy, sustainable organizational culture.