2022 GRI Index

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, Business for Social Responsibility (BSR), Econsense, European Renal Association – European Dialysis and Transplant Association, the Global Industrial Relations Network (a network of the International Organisation of Employers), MedTech Europe, National Kidney Foundation, Renal Physicians Association.

Compliance training has been provided to employees, governance bodies, and selected third parties. In the reporting year, we assessed and approved around 21,000 third parties.

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

As a global provider of products and services for people with kidney diseases, we are active in more than 100 countries. Due to our business activities, we are subject to various local tax obligations. In the countries in which we operate, we not only support the development of health care systems, but also create jobs that contribute to local tax revenue. This enables us to make a significant contribution to preserving the macroeconomic stability of national economies.

The basis for paying taxes is the business activities of Fresenius Medical Care in a country. When choosing a location, many other aspects such as the availability of qualified personnel, or political, economic, legal, and regulatory framework conditions play a role in addition to strategic business issues. In the course of an overall assessment, the possibility of minimizing currency risks as well as tax considerations can also influence the choice of location.

The global distribution of business activities results in transactions between the individual companies of the Fresenius Medical Care Group worldwide. The pricing of these intercompany transactions is based on the internationally recognized arm's length principle and is in line with the OECD transfer pricing guidelines and the respective local transfer pricing rules. This ensures that profits are generated and taxed where value is created. The intercompany transactions are documented on the basis of legal requirements in accordance with the applicable OECD guidelines and are disclosed to tax authorities upon request.

We have implemented risk management systems that also cover tax risks. In 2022, we mandated an independent external tax auditor to review our Tax Compliance Management System (Tax CMS) in Germany based on an auditing standard (IDW PS 980) and OECD standards. The audit report confirmed that we appropriately mitigate tax-related risks.

Fresenius Medical Care does not specifically settle in certain countries in order merely to generate tax benefits or create tax structures – the focus is always on our business activities.

We use external certifications in addition to our own environmental standards if they add value. In 2022, a total of ten production sites were certified according to ISO 14001 standards. They accounted for 32% of our total energy consumption. In addition, two production sites have ISO 50001 certification. They accounted for 22% of our total energy consumption.

^{1 In part subject to extrapolations. Including the energy consumption of our production sites and the electricity consumption of in-center treatments in our dialysis clinics.
2 Including fuel oil, diesel, liquid gas, and district heating. Excluding mobile assets.}

_{3 Including the water consumption of our production sites and in-center treatments in our dialysis clinics.
4 In part subject to extrapolations.
5 Based on the 2021 water stress assessment of our production sites and our dialysis clinics described in the 2022 Non-Financial Group Report.}

CO₂ equivalent emissions factors include CO₂, CH4, and N₂O gases.

CO₂ equivalent emissions factors include CO₂, CH4, and N₂O gases. We use both location-based and market-based methods based on the residual mix that quantify emissions based on emission factors per country.

Other indirect (Scope 3) GHG emissions

To quantify and disclose Scope 3 emissions, we are preparing a hotspot analysis considering all categories defined by the Greenhouse Gas Protocol.  

As a result of a preliminary internal analysis, we expect Scope 3 emissions from purchased goods and services, upstream and downstream transportation, and waste generated in our operations will be the most significant.

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).

We identify hazards at the dialysis clinics and production sites that we control 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 America region and to local HR or OHS representatives in the other regions. Incident investigation is a locally managed process that covers all employees.

Training on occupational health and safety follows national legislation requirements. All employees who are required to undertake training are closely monitored, and completion rates are checked.

We are committed to providing a safe and healthy work environment. We strive to prevent work-related accidents and hazards to protect our employees and contractors. As part of the Global Sustainability Program, we have been working to create a centralized reporting process on recordable and lost time injuries and fatalities. We monitor three KPIs at global level: number of work-related fatalities, total recordable injury frequency rate (TRIFR), and lost time injury frequency rate (LTIFR).

Our commitment to preventing child labor from occurring within both our business and supply chain is defined in several company policies, such as our Code of Ethics and Business Conduct, our Global Social and Labor Standards Policy, and our Global Supplier Code of Conduct.

Our commitment to preventing acts of modern slavery and human trafficking from occurring within both our business and supply chain is defined in in several company policies, such as our Code of Ethics and Business Conduct, our Global Social and Labor Standards Policy, and our Global Supplier Code of Conduct.

In 2022, we further developed our procedures for evaluating suppliers based on sustainability risks including forced or compulsory labor. So far, no cases of forced or compulsory labor in our supply chain were reported. Potential cases would be investigated and remedied.

In 2022, the U.S. business identified 54 data breaches, as defined by applicable state and federal law.  These breaches affected PHI (Personal Health Information).  Fresenius Medical Care also reported 1 data breach in Serbia (data breach as defined by applicable law).

In 2022, we engaged an external party to perform a global cybersecurity assessment using the NIST Cyber Security Framework (CSF). NIST CSF is a globally recognized framework to measure and benchmark cybersecurity programs and risks. Our senior leadership, management, and supervisory boards receive cybersecurity updates at least three to four times yearly.