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2020 SASB Index

Our Sustainability Accounting Standards Board (SASB) Index discloses information in alignment with SASB’s Health Care Delivery Standard. This is part of our commitment to provide transparent and relevant information on our economical, environmental and social performance to our stakeholders. With this, we are acknowledging the growing importance of the SASB standard among our investors. Going forward, we will continuously strive to improve our disclosure of quantitative metrics and further enhance our SASB reporting. The majority of references within this index refer to our Non-Financial Report.

Some of the information requested relates to United States requirements. For this reason, answers provided to these questions are limited to our dialysis business in the United States. In other regions, we are also subject to health care delivery standards in line with local laws and regulations.

SASB Code Accounting Metric Response / Sources
Energy Management
HC-DY-130a.1 1) Total energy consumed, (2) percentage grid electricity, (3) percentage renewable

(1) 9.283.309 GJ (2.5 million MWh)
(2) 50.9 %
(3) For the percentage of renewable energy and further information on energy management, please see our Non-Financial Report – Energy (page 98).

Waste Management
HC-DY-150a.1 Total amount of medical waste, percentage (a) incinerated, (b) recycled or treated, and (c) landfilled Waste is managed on a local and regional level in accordance with applicable laws and regulations. As part of our Global Sustainability Program, we have established a project to assess waste generation at a global level. We performed a status-quo analysis in 2020 to identify and estimate the main waste streams generated. Next, we are planning to disclose waste amounts. For further information on our waste management activities, please see our Non-Financial Report – Waste (page 98).
HC-DY-150a.2 Total amount of: (1) hazardous and (2) nonhazardous pharmaceutical waste, percentage (a) incinerated, (b) recycled or treated, and (c) landfilled
Patient Privacy & Electronic Health Records
HC-DY-230a.1 Percentage of patient records that are Electronic Health Records (EHR) that meet "meaningful use" requirements The dialysis services business in the United States does not participate in the Centers for Medicare & Medicaid Services’ Promoting Interoperability Programs (known as “meaningful use”), since dialysis facilities are not eligible to participate in the program.
HC-DY-230a.2 Description of policies and practices to secure customers’ protected health information (PHI) records and other personally identifiable information (PII)

For a description of policies and practices to secure our patients health information and further data, see our Non-Financial Report – Safeguarding Data (pages 94 ff.). Please see our Notice of Privacy Practices for a description of how medical information is used and disclosed in the United States.

HC-DY-230a.3 (1) Number of data breaches, (2) percentage involving (a) personally identifiable information (PII) only and (b) protected health information (PHI), (3) number of customers affected in each category, (a) PII only and (b) PHI During the reporting period, the United States business identified 15 data breaches as defined by applicable state and federal law. These breaches affected PHI and PII.
HC-DY-230a.4 Total amount of monetary losses as a result of legal proceedings associated with data security and privacy

Fresenius Medical Care North America did not suffer monetary losses incurred during the reporting period as a result of legal proceedings associated with data security and privacy.

All relevant legal proceedings and related financial affects are disclosed in our Annual Report – Notes to the Consolidated Financial Statements (pages 217 ff.).

Access for Low-Income Patients
HC-DY-240a.1 Discussion of strategy to manage the mix of patient insurance status In our dialysis clinics, we treat patients with all kinds of insurance status. In the United States, the insurance mix includes the federal health insurance programs Medicare and Medicaid as well as private/alternative payors such as commercial insurance and private funds. For information on our efforts to expand access to high-quality care for more patients, please see our Non-Financial Report – Access to Health Care (page 86).
HC-DY-240a.2 Amount of Medicare Disproportionate Share Hospital (DSH) adjustment payments received Not applicable.
Quality of Care & Patient Satisfaction
HC-DY-250a.1 Average Hospital Value-Based Purchasing Total Performance Score and domain score, across all facilities

We do not operate acute care hospitals in the United States, only dialysis clinics. Consequently, this indicator is not relevant for us. For general information on quality of care and patient satisfaction, see our Non-Financial Report – Improving Quality of Care (pages 84 ff.).

HC-DY-250a.2 Number of Serious Reportable Events (SREs) as defined by the National Quality Forum (NQF) We do not report this data. For information on quality of care and patient satisfaction, see our Non-Financial Report – Improving Quality of Care (pages 84 ff.).
HC-DY-250a.3 Hospital-Acquired Condition (HAC) Score per hospital We do not operate acute care hospitals in the United States, only dialysis clinics. Consequently, this indicator is not relevant for us.
HC-DY-250a.4 Excess readmission ratio per hospital We do not operate acute care hospitals in the United States, only dialysis clinics. Consequently, this indicator is not relevant for us.
HC-DY-250a.5 Magnitude of readmissions payment adjustment as part of the Hospital Readmissions Reduction Program (HRRP We do not operate acute care hospitals in the United States, only dialysis clinics. Consequently, this indicator is not relevant for us.
Management of Controlled Substances
HC-DY-260a.1 Description of policies and practices to manage the number of prescriptions issued for controlled substances The United States dialysis services business does not permit controlled substances to be kept or administered in its outpatient dialysis units. Dialysis facility staff do not prescribe controlled substances.
HC-DY-260a.2 Percentage of controlled substance prescriptions written for which a prescription drug monitoring program (PDMP) database was queried Not applicable to the United States dialysis services business.
Pricing & Billing Transparency
HC-DY-270a.1 Description of policies or initiatives to ensure that patients are adequately informed about price before undergoing a procedure The United States dialysis services business provides insurance coordination services to help its patients understand available insurance options and informs each of its patients that they have the right to information about charges not covered by his/her health insurer. Additionally, the business has implemented processes to accommodate various state price transparency laws.
HC-DY-270a.2 Discussion of how pricing information for services is made publicly available The United States dialysis services business’s pricing information is generally not publicly available. The business makes certain pricing information publicly available where required by state price transparency laws.
HC-DY-270a.3 Number of the entity’s 25 most common services for which pricing information is publicly available, percentage of total services performed (by volume) that these represent
Employee Health & Safety
HC-DY-320a.1 1) Total recordable incident rate (TRIR) and (2) days away, restricted, or transferred (DART) rate

(1) For the total recordable incident rate, see our ESG Performance Data Table Occupational Health and Safety (page 7).

(2) We currently do not report the days away, restricted, or transferred (DART) rate. As part of our Global Sustainability Program, we have established a project for occupational health and safety. We are analyzing the current data available and are planning to further develop our reporting on employee health and safety. Next, we will define global KPI on occupational health and safety. For further information on employee health and safety, see our Non-Financial Report – Health and Safety (page 91).

Employee Recruitment, Development & Retention
HC-DY-330a.1 (1) Voluntary and (2) involuntary turnover rate for: (a) physicians, (b) non-physician health care practitioners, and (c) all other employees Our total voluntary turnover rate is 11.9 %. Our total involuntary turnover rate is
5 %. We are currently analyzing the turnover rates of healthcare professionals on a global basis. For further information on voluntary and involuntary turnover rates, please see our ESG Performance Data Table – Talent Management (page 5) and our Non-Financial Report – Employees Worldwide (page 89).
HC-DY-330a.2 Description of talent recruitment and retention efforts for health care practitioners For information on recruitment and retention efforts, please see our Non-Financial Report – Attracting and Developing Talent (pages 89 ff.). For additional information on this topic, please see our corporate career website as well as our career website in the United States.
Climate Change Impacts on Human Health & Infrastructure
HC-DY-450a.1 Description of policies and practices to address: (1) the physical risks due to an increased frequency and intensity of extreme weather events and (2) changes in the morbidity and mortality rates of illnesses and diseases, associated with climate change We operate dialysis facilities in many regions of the world with diverse geographic, social and economic conditions. To be able to continue providing our patients with their vital dialysis treatment, even in extreme conditions such as severe storms or floods, we have developed a robust emergency response program. For further information on our disaster response activities, please see our Risk and Opportunities Report – Unpredictable Events (page 73) and our Non-Financial Report – Patient Support in Crisis and Emergency Situations (pages 86 ff.).
HC-DY-450a.2 Percentage of health care facilities that comply with the Centers for Medicare and Medicaid Services (CMS) Emergency Preparedness Rule The United States dialysis services business developed policies and procedures to be adopted by all of its outpatient dialysis facilities consistent with the Emergency Preparedness Rule.
Fraud & Unnecessary Procedures
HC-DY-510a.1 Total amount of monetary losses as a result of legal proceedings associated with Medicare and Medicaid fraud under the False Claims Act The United States business did not sustain any monetary losses as a result of such proceedings during the reporting period.