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GRI 401/103-1, GRI 407/103-1

We want to continue attracting, retaining, and integrating talent at Fresenius. To this end, we need to consolidate and build on our position as an attractive employer in a market environment characterized by a shortage of skilled workers. Employee-friendly working conditions, attractive benefits, and a dialog-oriented corporate culture all help us to achieve this.

Our approach

GRI 401/103-2

Working conditions

GRI 401-2, GRI 407/103-2

As an international health care Group, we create various incentives for employees, depending on the country and location. These include flexible working time models and the chance to participate in the company’s success via variable compensation models. Benefits for full-time employees of the organization are also provided proportionally to part-time employees. In Germany, for example, benefits can be based on joint agreements between management and works councils. We describe our variable compensation models in detail on pages 369 ff. of the Notes.

The collaboration with unions and works councils in various countries globally is explained in section Employee participation. In the case of working time models, challenges remain with regard to an employee’s function or the local markets. Further information is included in the business segments’ reporting.

In recent years, we have established various dialog formats to strengthen communication between management and employees – both at Group level and in the individual business segments. This allows the Management Board to provide employees with information on important issues personally. In addition, we promote our feedback culture and constructive exchange of ideas.

Recruitment and candidate communication

In order to meet our future demand for qualified specialists, we use a variety of different tools to recruit staff. We monitor our working environment and competitive surroundings closely to identify potential. Furthermore, we use digital personnel marketing, organize our own recruitment events, and present the company at career fairs. In recent years, we have significantly broadened our range of personnel marketing activities and expanded our global careers website. In 2021, the market research institute Potentialpark named Fresenius the German company with the best online offering for applicants for the tenth consecutive year.

Employee retention

A variety of initiatives ensure that employees are retained effectively. Fresenius offers various benefit components on a corporate and business segment level. These encompass, for example, employee benefit programs, profit-sharing bonuses, pension plans, compensatory time accounts, and tariff-based future payments. Not all elements are implemented equally within the Fresenius Group, but can, however, be accompanied by local benefits depending on the market and employee requirements and regulatory provisions.

At the site in Bad Homburg, management and the local works council agreed on more flexible working times to address the challenges for employees during the pandemic and to support their work-life balance. For example, the minimum working time per day was reduced from four hours to two hours for full-time employees. This rule applies since January 18, 2021 until March 31, 2022, currently.

Employee participation

GRI 102-17, -21

Exchange with employee representatives

GRI 102-8, -41, GRI 407/103-2, 103-3

Trust and cooperation between management, employees, and employee representatives is well established at Fresenius and is an integral part of our corporate culture. An open and ongoing dialog between management and employee representatives, as well as unions, is important to us.

Fresenius acts responsibly toward its employees. This is detailed in our commitment to respect the international standards mentioned in our Code of Conduct and our Human Rights Statement. Fresenius SE & Co. KGaA respects freedom of association and recognizes the right to collective bargaining. Employees have the right to join or not to join a union in accordance with local laws. We do not tolerate discrimination based on trade union membership and act accordingly. We are committed to an open and solution-oriented dialog between employees and their representatives, and our management within the relevant legal and operational frameworks. For more information, see the chapter on Human rights.

Employees liaise with their supervisors, but they can also turn to their human resources or compliance officers, as well as to the works council, their union representatives, or other employee representatives for assistance. In Europe, about 78% of our employees are covered by collective bargaining agreements. In some European countries, Fresenius is subject to industry-related collective agreements, e. g., in France, which are binding by law due to the industry to which we are affiliated. Where this is not the case, country-specific collective bargaining agreements can be negotiated with local trade unions or comparable social partners. On a global base, about 50%1 of our employees are covered by collective bargaining agreements.

In European countries, workplace representation bodies are organized according to national law. The business segments have overall responsibility for dealing with local employee representatives and trade unions at country or site level. Our discussions with these representatives focus on local and regional circumstances. Together with the employee representatives, we aim to find tailored solutions to the challenges in the different locations. Further information is included in the business segment sections.

Fresenius has reached an agreement with the European Works Council (EWC), making provisions for a structured dialog with the international trade union associations; meetings are subsequently held once a year between representatives of the four business segments, the employee representatives of the Supervisory Board, and representatives of the international trade union associations.

1 Based on about 91% of Fresenius Group total employees.

Dialog at European level

GRI 407/103-3

Fresenius SE & Co. KGaA has a European Works Council comprising 19 employee representatives from 12 countries as of December 31, 2021. These individuals come from the EU and EEA (European Economic Area) member states in which Fresenius employs personnel.

The EWC is responsible for the participation of Fresenius employees in cross-border measures, insofar as these have a significant impact on the interests of Fresenius personnel and affect at least two countries within their area of responsibility, such as the relocation or closure of companies or collective redundancies. For example, the management informs and consults with the EWC on the structure and economic and financial situation of the Group, its anticipated growth, employment situation, investments, organizational changes, and the introduction of new work and production processes. The EWC meets once a year, while its executive committee convenes three times a year, partially in hybrid form due to the COVID-19 pandemic. In 2021, the new elections and appointments to the EWC took place as planned. In preparation for the constituent EWC meeting, an extraordinary meeting of the executive committee (GFA) was held in hybrid form. The EWC was reconstituted in April 2021. The European trade union federations IndustriALL and the European Federation of Public Service Unions (EPSU) attend the meetings at the invitation of the EWC.

The focus topics of the EWC in the past fiscal year were projects in the Group’s business segments for reorganization, e. g., in the area of global human resources management, the digital transformation, the Group-wide cost and efficiency program, and compliance matters relating to the Group’s human rights declaration. Another focus area was the impact of the COVID-19 pandemic on Fresenius’ employees. To this end, an exchange of information took place on the situation in the individual countries. Against the backdrop of the COVID-19 pandemic, the prolongation of the agreement on the digital performance of tasks was reached with the EWC.

At its annual meeting, the EWC entered into a dialog with the Management Boards of Fresenius Vamed, Fresenius Kabi, and the management of Fresenius Digital Technology (formerly Fresenius Netcare).

The EWC elected six employee representatives to the Supervisory Board of Fresenius SE & Co. KGaA, including at least one representative of the trade unions.

Bonus and share-based compensation plans

For many years, Fresenius has offered employees in selected Group companies based in Germany a share-based bonus plan. The Group distributes the bonus when it achieves the EBITEBIT (Earnings before Interest and Taxes)EBIT does include depreciation and write-ups on property, plant and equipment. EBIT is calculated by subtracting cost of sales, selling, general and administrative expenses, and research and development expenses from sales. (earnings before interest and taxes) and earnings targets defined in the program. The current model was for 2019 to 2021. The following performance targets applied for this period: the Group net income had to increase compared to the previous year’s figure and Group EBIT had to increase by at least 5% compared to the previous year. The Group did not achieve its earnings and EBIT targets for this program in any of these years, so no bonus was distributed to employees.

Further, with the share-based Long Term Incentive Plan 2018 (LTIP 2018), a compensation instrument for executives was implemented, linking management’s entrepreneurial responsibility to future opportunities and risks. About 1,800 employees in executive positions participate in this program. For additional information, see pages 369 ff. of the Notes. Fresenius Medical Care also has its own share-based compensation plan. This is also explained in more detail in the Notes of the 2021 Annual Report.

Fresenius Medical Care

Fresenius Medical Care’s employees have always been key to its success. It is important for the business segment to continuously hire and retain the best people for the job, inspire them to stay with Fresenius Medical Care long term, and support their development during their employment. This helps to create an attractive, fair, and trusting work environment for all employees.

Organization and responsibilities

The business segment uses its Global People Strategy as a framework for its activities. Fresenius Medical Care’s global HR function – which is responsible for defining and implementing the Global People Strategy – reports to Fresenius Medical Care’s CEO. This function provides and manages the relevant standards, policies, and processes in accordance with the evolving requirements of the employees and the business. The Global People Strategy has four priorities: (1) engage employees; (2) make the right capabilities available to support the business goals; (3) continuously advance the organization; and (4) foster excellent people practices.

In line with these priorities, the business segment continually develops and improves the Human Resources (HR) policies and guidelines that steer the global activities. In 2021, the business segment established new global employee guidelines on a broad range of topics such as employee engagement, talent management practices, and inclusion and diversity.

Fresenius Medical Care also regularly completes audits of its employee-related activities. In 2021, more than 20% of internal audits had an HR focus.

Employee retention

Fresenius Medical Care has an established organizational and talent review process, which identifies high-performing and high-potential talent among the top leaders of the business segment. This process allows identified employees to be assisted in building their readiness to tackle future challenges and take on more responsibility.


When it comes to hiring talented staff, Fresenius Medical Care faces increasingly strong competition. As a result, the business segment is working to continuously improve its employer brand. The company aims to remain an attractive employer and recruit, engage, and retain excellent employees. In 2021, Fresenius Medical Care started to set various internal targets to help itself achieve this aim. These relate to, for example, employee engagement, survey participation, and voluntary turnover.

Dialog and feedback formats

Fresenius Medical Care’s primary objective of its employee engagement activities is, to give every employee the opportunity to provide feedback and engage with the company in an ongoing and open dialog. In doing so, the business segment hopes to create an attractive work environment, and to boost the employees' commitment and performance. Fresenius Medical Care wants to encourage them to contribute to the company mission and vision. The global employee engagement survey is a tool that helps the business segment do this. Fresenius Medical Care conducts one full employee engagement survey every two years and “pulse checks” in the years between. Through the survey, the company identifies strengths, as well as opportunities to improve the working environment. The results are used to initiate global and local measures, with the aim of increasing engagement levels in the long term. In 2021, Fresenius Medical Care conducted a global engagement survey. Almost 90,000 employees worldwide responded, reflecting a participation rate of 74% – up from 68% in the last full survey in 2019. The latest survey revealed that 56% of employees who participated are actively engaged – the same rate as in 2019. This was despite the challenging environment created by the COVID-19 pandemic. The employee engagement score is based on three aspects: how many employees would speak positively about Fresenius Medical Care, how many intend to stay at Fresenius Medical Care, and how many feel motivated to perform at Fresenius Medical Care. In 2021, the business segment trained about 10,000 managers on how to read and act upon the results from the global engagement survey.

Progress and measures in 2021

The COVID-19 pandemic continued to present the business segment with health care challenges throughout 2021. Fresenius Medical Care has introduced various measures to protect and support its employees during this health crisis. For example, Fresenius Medical Care increased employee opportunities for flexible working, created new opportunities for virtual learning, and continued to adapt the organization to the requirements of a virtual environment. In the United States, Fresenius Medical Care provided its employees with COVID-19-related pay and incentives, as well as other resources to help them overcome financial challenges and to support their overall well-being.

In 2021, Fresenius Medical Care continued to roll out its global HR compliance framework, which sets out its principles and defines how the business segment applies them in its HR processes. Employees received training on the framework, and the roll-out was accompanied by supporting materials to help employees understand what is expected of them.

In Germany, where the business segment is headquartered, Fresenius Medical Care concluded seven agreements with the works councils in 2021. These agreements covered topics such as mobile working, expense reimbursement, COVID-19-related issues, and the HR information system. Other agreements with local works councils related to site-specific workplace matters were finalized.

Fresenius Kabi

Fresenius Kabi aims to be perceived as an attractive employer around the world in order to attract qualified and motivated talent to the company. It is particularly important to understand regional and local characteristics of the markets and to take these into account when addressing talents based on job profiles. Fresenius Kabi is continuously developing its processes for recruiting employees further and fosters the collaboration between the human resources departments and the divisions. In 2021, Fresenius Kabi continued to carry out application and selection processes partially in virtual form due to the ongoing COVID-19 pandemic. In addition, Fresenius Kabi uses social networks to address potential candidates with the close involvement of the communications department. In the past fiscal year, Fresenius Kabi was able to fill vacancies as planned. The company continuously works to offer its employees a modern working environment.

Organization and responsibilities

Fresenius Kabi has a Center of Expertise for Talent, Leadership and Organizational Development (CoE TLO), including Talent Acquisition & Employer Branding and Diversity, Equity & Inclusion in the global human resources department, which reports directly to the head of global human resources. The CoE TLO aims to further develop talent acquisition, personnel and organizational development, and talent management, and to strengthen a company-wide learning culture and corresponding structures and offers for promoting talent at Fresenius Kabi.

Policies and regulations

As the basis for the shared understanding of collaboration, Fresenius Kabi has defined company values that have been introduced worldwide. These company values are anchored in both the Code of Conduct and the Quality Management Handbook. They are embodied in the corporate environment, and employees maintain a culture of cooperation across national borders, as well as functions and hierarchies.

Flexible working conditions and digitalization

In 2021, Fresenius Kabi continued to support the options for flexible working and promoted digital collaboration with the company-wide implementation of additional IT applications. Flexible and mobile working was made possible for additional employees and the scope of the employer/works council agreement “New Ways of Working” concluded in 2020 was extended at the Bad Homburg site.

Employee retention

Fresenius Kabi regularly receives awards for its local activities. In 2021, e.g. Fresenius Kabi’s site in Haina with its more than 4,000 employees was named “Best Place to Work®” in the Dominican Republic and the Caribbean for the second year in a row. This award confirms the site’s efforts to provide a positive work environment during the ongoing COVID-19 pandemic. Fresenius Kabi was also recognized as an attractive employer in China. Here, the business segment was named Kincentric Best Employer and received the Employer Excellence Award of China.


Fresenius Kabi set up a Recruiting Center in 2021 to fill vacant or new positions in the central functions and the Transfusion and Cell Therapies division in Germany, which is part of the CoE TLO. The departments are supported throughout the process by the Recruiting Center’s team of experts in the search for and selection of suitable candidates. In this way, Fresenius Kabi aims to define individual requirements for vacant positions to improve the recruiting process. The team of experts also draws on a network and talent pool of candidates, who are also given a central point of contact for all questions relating to the recruiting process.

In the region North America, the process of recruiting personnel and introducing new employees to the company can be carried out completely virtually, thanks to the adaption of existing IT systems.

Dialog and feedback formats

Fresenius Kabi attaches great importance to dialog with employees across hierarchical levels. Due to the pandemic, dialog and feedback formats could only be conducted online in 2021. To support dialog between management and employees, video messages from the CEO on relevant topics were published on the global intranet, for example. In addition, digital formats were used to foster the exchange between the CEO of Fresenius Kabi and top executives.

For the first time, Fresenius Kabi conducted a global employee survey in 2021. In order to achieve a high level of participation, the business segment decided to conduct an open survey accompanied by an internal communication campaign. The focus was on respectful leadership culture and collaboration, trust and integrity, and agility within the business segment. More than 70% of employees participated in the global employee survey. Initial significant insights were gained with important information for global human resources and the top management: the responses show differences both regionally and in the business units. Fresenius Kabi sees very high levels of positive feedback in Asia and South America as well as in the Transfusion and Cell Therapies division, for example. In addition, the close and cooperative collaboration within the company’s own team was also emphasized, with a satisfaction rate of above 90%. The evaluation of the survey will be finalized in 2022.

Fresenius Kabi also uses regional employee surveys to sustainably increase employee satisfaction, gain valuable insights into business processes, and increase loyalty to the business segment. The business segment conducted a survey in Switzerland, in 2021, in which approximately 90% of employees participated. About 70% of employees took part in another employee survey in the United Kingdom. Fresenius Kabi is currently further evaluating the results to take them into account in the future development of employee-related cultural company initiatives. Once the evaluation has been concluded in 2022, further measures will be derived.

Progress and measures in 2021

In 2021, the newly established Recruiting Center focused on improving the recruitment of new employees in the central functions of Fresenius Kabi and the Transfusion and Cell Therapies division in Germany. Further progress focused on conducting the first global employee survey for Fresenius Kabi to gain important insights into employee satisfaction and retention.

Fresenius Kabi developed the Fresenius Kabi Vision 2026 in the reporting year and adopted it in the fourth quarter of 2021. Vision 2026 entails a cultural change. Fresenius Kabi wants to advance its company culture together with its employees – in relation to how employees work together, what values the company stands for, and how it makes decisions. Further information on Vision 2026 can be found in the chapter Our core competencies of the Group Management Report.

Fresenius Helios

GRI 102-8

Unlike many other industries, hospitals need to work around the clock, 365 days a year to ensure patients are cared for. Against this background, flexible working hours therefore pose certain challenges and require the revision of existing concepts and the introduction of new ones. Further, Helios offers its employees the opportunity to work part-time.

Helios Germany also has to deal with a specific challenge posed by Germany’s Ordinance on the Minimum Requirements for Nursing Personnel in Hospitals (PpUGV), which has increased the need for nursing personnel, of whom there is a shortage on the labor market in some areas. The search for employees focuses on the following fields of action: training of qualified personnel internally, advertising for skilled workers, and searching the international labor market. Helios Germany participates in government-led campaigns to recruit personnel on the international labor market, as well as supporting people who have qualified as nurses abroad in their applications or in their searches for language schools. Many international nursing professionals have completed academic training at universities. These forms of vocational training are mainly aimed at complex medical activities and an often strongly cooperative collaboration in medical teams. The German vocational training system is a generalist training, which enables its participants to care for people of all ages. Specialization is possible during and after vocational training. Bringing together the strengths of both training systems is a great advantage and offers an opportunity to advance the overall quality of medical care in the hospitals.

In Spain, prospective nurses complete their training at a university. Later, they can specialize through a specific program – choosing between occupational health nursing, family and community health, obstetrics and gynecology, geriatrics, pediatrics, and mental health. Helios Spain has established partnerships with universities to provide classroom training for these professionals and to raise its attractiveness for potential candidates.

Helios Spain aims to further expand its position as a leading private provider of health care services in Spain. To do so, it needs to attract new employees, retain them, and develop them further. Along with this, the business segment participated in various online recruitment sites in 2021 and started to promote its main vacancies through social media campaigns. The quality of Helios Spain as an employer was confirmed by various external rankings in the course of 2021; the business segment is one of the 50 best companies to work for in Spain according to Forbes Magazine, for example.

Organization and responsibilities

At Helios Germany, the Central Service for Personnel Recruitment and Development is responsible for creating and implementing measures and strategies for the operating units within the clinics to attract, train and develop personnel. The Central Personnel Management and Collective Bargaining Service is responsible for structuring working conditions under collective agreements and improving the service for employees.

The central function People & Organization of Helios Spain is responsible for collective agreement management and negotiation as well as ensuring that wages are in compliance with applicable regulations. From Spain’s headquarters, the function participates in all collective bargaining processes through the corporate labor relations department.

Helios Spain has a company-wide dashboard to manage, evaluate, and improve the most important personnel KPIs. The dashboard is available to all clinics and enables them to conduct benchmark comparisons. Thus, the company provides transparency for all clinics on the most relevant KPIs and enables best-practice sharing on how to improve personnel management in our Spanish hospitals.

Policies and regulations

All Fresenius Helios hospitals apply collective agreements, including those in Germany, which are linked to the Helios Group collective agreement, the collective agreement for public service (TVöD), or company-specific collective agreements. In Germany, all Fresenius Helios hospitals are subject to the current Working Time Act, which in some cases provides for wage reopener clauses for supplementary tariff regulations. The Works Constitution Act, which grants the works councils co-determination rights and control, also has a regulatory effect. The framework with regard to working hours for the individual companies is regularly agreed by the respective company parties onsite.

In its human resources policy, Fresenius Spain states that the company’s success depends to a large extent on its employees. The guideline also defines the objectives of human resources work; these include transparent internal communication and the development of a program for the ongoing training of employees.

In Spain, all workers are covered by collective agreements set by law, which set out their basic rights, such as pay and working hours. The agreements thus ensure attractive working conditions and market-oriented remuneration for workers and are negotiated with their legal representatives.

There are two different collective bargaining variants at the sites in Latin America: In Peru, there is only one collective agreement; it applies to all employees regardless of the union to which they belong. In Colombia, on the other hand, negotiations take place at the local level. In clinics with a collective agreement, it applies only to union members.

Flexible working conditions and digitalization

In 2021, Helios Germany further continued digitalization in the HR area and transferred about 28% of the companies’ personnel files to the digital HR management system at the end of the year. All HR processes are to be digitalized by the end of 2022.

In addition, Helios Germany is developing new working time models, especially for the medical service, but also for nursing and administration. To this end, workshops and meetings of working groups with the aforementioned occupational groups took place in 2021. The working time models developed from the findings are presented to personnel and clinic managers so that they can test them and put them into practice in the facilities.

At Helios in Germany, 45% of employees work part-time, of whom 40% are from the health care sector. In Spain and Latin America, a total of 20% of employees work part-time, of whom 28% are from the health care sector.

Working hours during the officially ordered lockdown periods, with no or only limited childcare, were also less fixed than before. Mobile working was also made possible in 2021 for employees whose work does not require direct contact with patients.

In addition, Helios Spain introduced an application in 2021 that allows all staff documents to be digitally signed. . The business unit can also monitor COVID-19 outbreaks among employees or digitize requests for medical examinations or vaccinations via software solutions.

Employee retention

At Fresenius Helios, the largest employee group comprises trained nurses and doctors, who account for more than half of the employees in the business segment. Therefore, employee retention measures must be specified to meet the needs of nurses or doctors, which vary from those of staff working in administrative functions.

At the German clinics, the Helios PlusCard, for example, is a free supplementary insurance policy for all Fresenius Helios employees in Germany. As part of the benefit program, employees also receive exclusive discounts from partners, e. g., Fitness First and Weight Watchers. The Helios supplementary pension fund, a company-owned pension institution, enables Fresenius Helios employees in Germany to invest some of their remuneration in their company pension plan via deferred compensation.

Fresenius Spain provides social benefits to all employees. These include private supplementary health insurance and pension plans, along with meal allowances and a wide range of discounts with cooperation partners.

In addition, due to the ongoing COVID-19 pandemic, the business segment focused on recognizing the challenges faced by nurses in their day-to-day work in 2021: salaries were raised in line with market conditions, permanent employment contracts were established at job entry, and improved wage compensation was made possible for those working overtime. Also, Helios Spain took over the costs for the last year of training for nursing students.

Induction of new employees

In the last few years, Helios Germany further developed and standardized the processes used for induction of new employees and new managers. The aim is to reduce early turnover to a minimum. In 2021, new measures were established in the first clinics, such as the appointment of an onboarding mentor, structured familiarization concepts, and feedback discussions during the probationary period. New managers participate in a three-stage program within two years of taking up their posts. A key component of this process is the integration of employees from abroad. This includes language courses and programs to familiarize them quickly with the day-to-day work processes in German hospitals, as well as supporting measures for social integration together with local employees.

Helios Spain uses digital onboarding. By doing so, the business segment ensures that standards set for the induction of new employees are uniform. For instance, the onboarding includes information on the company and its values as well as general and job-specific training. To ensure successful integration, a survey is conducted with new employees both in the first week and after three months. They can also sign up for a mentor program and receive individual support early in their careers.

Work-life balance

Helios Germany offers its employees childcare places in 35 kindergartens – both in company kindergartens and at partner facilities. Although all employees have the option to work part-time, the business segment also has to take into account the special requirements for seamless patient care when considering such options. In addition, Helios Germany supports employees who look after or care for relatives, with free information and advice from the service partner WDS. This offer ranges from a telephone hotline and an online database to care consultations in the clinics and personal appointments at home.


In summer 2021, Helios Germany launched the new target-group-specific campaign #EchtesLeben, replacing its predecessor, Most Important Job. The aim of the employer campaign #EchtesLeben is to reduce prejudice against health care professions and to retain employees in the long term. The most important target groups are medical service, nursing, administration and management, special functions, IT, and training. Helios Germany continues to work on quality and fixed standards for the application process.

Helios Spain uses the IT solution Talent Clue to build up a talent pool, which ensures a standardized recruitment process. The further development of digital projects and processes in human resources management as well as in training and development is a high priority in the company. The business unit’s recruitment is carried out through various channels and campaigns. These include open days as well as job portals and campaigns on social media, and at universities, nursing schools, and job fairs.

Dialog and feedback formats

Helios Germany offers annual appraisal interviews to all employees. From these employee discussions, and from other dialog formats, it became evident how important it is for employees in the nursing division that well-functioning, integrated teams are maintained.

In order to better understand employee satisfaction, especially under the influence of the ongoing COVID-19 pandemic, an employee survey was conducted in Spain in January 2021. The participation rate was about 40% of the applicable employees. More than 21,000 were invited to respond to the survey. The participation rate was impacted by the high working intensity in our clinics due to COVID-19, as well as the high fluctuation rate in the first year of service among our employees in Spain. The results were announced to all employees. According to the results, the employees would like to strengthen mututal recognition promote the contribution of ideas, and cope better with difficult situations in the future. As a result, employees had the opportunity to submit suggestions for improvement in a competition. Helios Spain immediately began to implement the measures derived from the best ideas in regional action plans, which are to be continued into 2022.

Employees in Spain who decide to leave the company likewise have the opportunity to state reasons for their departure in a coordinated interview. These interviews are IT based, automatically conducted and documented.

Progress and measures in 2021

In 2021, the management approach and the governance structure of Fresenius Helios remained as reported in 2020. Progress focused on digitalization and creating flexible working models against the background of the pandemic, and on measures to retain employees.

In 2021, Helios Spain defined and implemented an internal mobility policy with the aim of publishing all vacancies in the employee portal on the intranet with the goal of retaining employees within the clinic Group. In doing so, the business unit highlights opportunities and career paths to professionals who want to develop further, while making an important contribution to retaining talent.

In addition, Helios Spain is planning a project on performance management and sustained feedback for middle management. The implementation is initially planned for specific centers and scheduled for the beginning of 2022.

Fresenius Vamed

Fair working conditions are part of Fresenius Vamed's mission statement. Fresenius Vamed's corporate culture is characterized by the diversity of unique people, open dialog, mutual appreciation, respect, caring, clear goals, and decisive leadership. The company values, strategies, and goals should manifest themselves through open, intensive, and direct communication. The Fresenius Vamed business model is very broad in nature, which places special demands on the recruitment of personnel. The recruiting process is tailored to the individual requirements of the individual positions.

Organization and responsibilities

Human resources work at Fresenius Vamed’s entities is managed by the business segment’s Human Resources division. Since the general conditions in the individual countries in which Fresenius Vamed is active are highly diverse, the division ensures that those responsible in the various countries are actively involved.

In Austria, the management of Fresenius Vamed and the human resources managers of the rehabilitation and care facilities actively participate in the respective collective bargaining negotiations in order to ensure the best justifiable conditions for the employees and the company.

Where collective agreements are applicable, these are overpaid in most locations. In addition, market-specific salaries are evaluated on a regularly basis.

Policies and regulations

Fresenius Vamed has put detailed guidelines and standards in place regarding working conditions and working hours. Compliance with these requirements is constantly monitored. In 2021, new regulations were adopted because of the COVID-19 pandemic, e. g., for working from home, for hygiene at the workplace, and for business trips.

The minimum salaries for the respective job groups in the majority of facilities and locations in Switzerland, the Czech Republic, Germany, and Austria are set in the form of salary bands or collective bargaining agreements. These include the exclusion of unobjective differentiation in pay, e.g., on the basis of gender. In Austria, every employer who continuously employs more than 150 employees is required by law to prepare an income report every two years. In particular, this report must show the number of women and men in the respective collective bargaining or – if available – company employment groups, as well as the average salary. It must also be made available to the respective works council.

Flexible working conditions and digitalization

Digitalization and flexibilization continued to accompany Fresenius Vamed in all areas of ongoing human resources work and communication in 2021. In the Czech Republic, for example, the business segment worked on the development of an app to make communication between the respective management and employees who do not work at the actual workplace faster and more direct. In order to be able to access information on the move in future, the Austrian parent companies have also developed an app for their employees. This can be used to access the contents of the intranet and, for example, certain training courses.

Based on the experience of 2020, flexitime agreements were made more flexible for the parent companies and all companies at the location of the Fresenius Vamed headquarters in Austria, and guidelines for working from home were issued in 2021. The works council was involved in both processes. Flexibilization was also made possible in the Austrian health care facilities by granting extended working time calculation periods.

Employee retention

The benefits offered to Fresenius Vamed employees are diverse and include, for example, discounted admission to thermal baths, meal subsidies, and employee parking spaces, as well as discounted insurance benefits and pension fund subsidies. Employees in Germany receive special benefits and discounts at the segment’s hospitals and tourist facilities and can participate in a bicycle leasing program. In the Czech Republic, every employee receives a specific budget with which non-financial benefits can be obtained according to her or his individual preferences. In 2021, the facilities in the Czech Republic also participated in a state support program for physical and mental health which was created for inpatient health care facilities that accommodate COVID-19 sufferers. Employees can receive a financial contribution to medical services, such as rehabilitation, spa treatment, or psychological counseling. All Fresenius Vamed facilities met this requirement and 412 employees claimed benefits.

Induction of new employees

A clearly structured, partly digital process meanwhile ensures that all new employees at Fresenius Vamed have all the work equipment they need (hardware and software) on their first day and that all the prerequisites for a quick induction are met. Employees are informed in good time of the mandatory online training that new employees must undergo upon joining the company.

Work-life balance

The promotion of work-life balance is an essential factor in the appreciation of the work performance of Fresenius Vamed’s employees. At the business segment’s headquarters in Vienna, this has been taken into account, for example, by extending home office options and framework working hours, making afternoon childcare possible. In 2021, the Neurological Rehabilitation Center Rosenhügel in Austria successfully underwent the certification process for work-life balance.


Finding and retaining qualified personnel is one of the greatest challenges. To meet this challenge, Fresenius Vamed has developed an employee referral program. Employees of some of the companies in Austria and Germany receive benefits for recruiting new employees, linked to the duration of the new employment relationships. Certain employee groups, e.g., members of the Human Resources department, are excluded from participation in this program. In order to counteract the shortage of skilled workers in a timely and efficient manner, cooperation with various training institutions such as schools, universities, and technical colleges has been intensified in the specific areas of expertise. In addition, vocational training concepts are continuously revised so that Fresenius Vamed can train the necessary skilled workers. The business segment is also increasingly using digital recruiting channels in order to be able to address qualified specialists from abroad.

Dialog and feedback formats

Appraisal interviews are an essential part of Fresenius Vamed's management culture. In addition to essential insights and measures for further successful cooperation, the necessary training and further education requirements also result from the detailed discussions. These are summarized in a training plan, on the basis of which the corresponding training and continuing education program is drawn up. This ranges from specialist training in the health care sector and personality-building seminars to customized language training and IT seminars.

Progress and measures in 2021

In 2021, the management approach and the governance structure of Fresenius Vamed remained as reported in 2020. Progress focused on the design of working conditions in the context of the COVID-19 pandemic.

Our ambitions

The four business segments pursue segment-specific ambitions in the areas of working conditions, recruitment, and employee participation. We want to build on the position of our business segments as drivers of innovation in the health care sector. Our aim in doing so is to attract new employees who contribute to the company’s success through their willingness to perform, their expertise, their experience, and their willingness to work together as a team.


GRI 102-8, GRI 401/103-3, GRI 401-1, GRI 401-3, GRI 405-1

At the end of the 2021 fiscal year, the Fresenius Group had 316,078 employees. This was 4,809 or 2% more than in the previous year (December 31, 2020: 311,269). In terms of FTE (full-time equivalents), this also represented a 1% increase at the Fresenius Group. Acquisitions in the business segments Fresenius Medical Care and Fresenius Helios contributed 1% to the increase in employees, while the total number of employees decreased at Fresenius Medical Care.

The regional distribution is as follows: about 31% of employees are employed in Germany, 26% in the rest of Europe, and 24% in North America.

Our distribution of employees by function remained largely unchanged in 2021: About 14% of the workforce was employed in the production sector, and 71% in the services sector. Our personnel structure was thus stable in terms of development. The high proportion of service personnel is mainly due to the large number of nurses in our health care facilities.

The rate of new hires1,2 in relation to the overall number of employees in each business segment is evidence of our efforts within recruitment. The length of service1 within the Group can vary with acquisitions in the business segments. In 2021, the average was 8.3 years and remained close to the previous year’s level of 8.2 years.

In 2021, the proportion of employees who voluntarily left1,3 the company increased to 12.8% (2020: 9.8%). Main reasons for this development were the uncertainty in the labor market associated with the COVID-19 pandemic, stressful labor conditions in the health care sector and thus an increase in early turnover as well as people leaving the industry. We explain this development in detail in our business segments and measures taken to correspond to this situation in the section Employee development.

The average age of Group employees was 41.6 years (2020: 41.7 years). The majority (55%) of our employees are between 30 and 50 years of age. We aim to maintain a well-balanced age structure within our Group. The distribution reflects the demand for a high proportion of skilled and experienced employees in our business segments.

Employees (Headcount) by business segment

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2021 2020 2019 2018 2017
­Fresenius Medical Care 130,251 133,129 128,300 120,328 121,245
­Fresenius Kabi 41,397 40,519 39,627 37,843 36,380
Fresenius Helios 123,484 116,952 106,377 100,144 105,927
­Fresenius Vamed 19,721 19,414 18,592 17,299 8,667
Corporate / Other 1,225 1,255 1,238 1,136 1,030
Total as of Dec. 31 316,078 311,269 294,134 276,250 273,249

Employees (FTE) by business segment

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2021 2020 2019 2018 2017
­Fresenius Medical Care 122,909 125,364 120,659 112,658 114,000
­Fresenius Kabi 39,579 39,032 38,264 36,423 34,923
Fresenius Helios1 101,652 96,899 88,057 82,522 85,577
­Fresenius Vamed 15,730 15,364 14,770 13,665 7,215
Corporate / Other 1,141 1,166 1,154 1,060 969
Total (FTE) as of Dec. 31 281,011 277,822 262,904 246,329 243,913
1 FTE: For Helios Kliniken Germany, the number of employees converted to the full collectively agreed working time on monthly average (Vollkräfte)

Employees (Headcount) by region

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2021 2020 2019 2018 2017
Europe 180,122 174,835 165,862 158,939 154,172
thereof Germany 98,754 96,915 91,014 88,086 86,613
Europe excl. Germany 81,368 77,920 74,848 70,853 67,559
North America 76,740 75,837 74,894 72,672 75,083
Asia-Pacific 27,145 27,805 27,457 25,575 24,381
Latin America 30,192 30,871 23,998 17,610 17,709
Africa 1,879 1,921 1,923 1,954 1,904
Total as at Dec. 31 316,078 311,269 294,134 276,750 273,249
in % 2021 2020 2019 2018 2017
Fresenius Medical Care 23.7 23.1 24.7 21.7 n. a.
Fresenius Kabi 17.1 13.5 17.1 16.9 19.8
Helios Germany 18.8 14.3 15.4 16.0 19.8
Helios Spain 29.0 25.5 20.1 27.6 n. a.
Fresenius Vamed 18.4 18.4 17.8 22.5 11.0
Corporate / Other 11.0 6.1 11.2 12.5 9.7

Average length of service1

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in years 2021 2020 2019 2018 2017
Fresenius Medical Care 7.6 7.3 6.8 7.1 7.0
Fresenius Kabi 7.9 7.9 8.6 7.5 7.4
Helios Germany 10.3 10.3 10.6 10.8 10.5
Helios Spain 7.7 8.0 8.4 8.2 n. a.
Fresenius Vamed 7.8 7.7 6.9 7.8 6.1
Corporate / Other 7.8 7.5 7.3 7.3 7.6
Total 8.3 8.2 8.1 8.2 8.1

Voluntary turnover1,3

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in % 2021 2020 2019 2018 2017
Fresenius Medical Care 16.5 11.9 14.3 13.2 12.2
Fresenius Kabi 11.3 7.1 9.2 9.4 11.3
Helios Germany 9.5 8.3 9.1 6.9 6.0
Helios Spain 11.0 9.8 7.6 3.8 n. a.
Fresenius Vamed 9.3 7.8 7.6 9.5 8.0
Corporate / Other 3.5 1.7 3.5 3.8 2.7
Total 12.8 9.8 11.0 9.8 9.9

Voluntary turnover3 and external hires by region

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2021 (headcount) Voluntary turnover External hires
Europe 9.3% 19.4%
North America 14.4% 22.8%
Asia-Pacific 16.0% 20.4%
Latin America 26.6% 37.3%
Africa 9.4% 13.9%
Total as of Dec. 31. 12.8% 22.0%
2021 2020 2019 2018 2017
Fresenius Medical Care 42.1 41.7 40.8 40.8 41.7
Fresenius Kabi 39.2 39.9 38.7 38.4 38.5
Helios Germany 42.2 42.2 42.5 42.6 42.7
Helios Spain 40.4 40.5 41.0 40.0 n. a.
Fresenius Vamed 44.3 44.0 41.2 43.6 43.0
Corporate / Other 39.7 39.3 39.1 38.9 39.2
Total 41.6 41.7 41.0 41.0 41.5

Age structure1

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2021 2020 2019 2018 2017
Dec. 31 Below 30 Between 30 und 50 Above 50 Below 30 Between 30 and 50 Above 50 Below 30 Between 30 and 50 Above 50 Below 30 Between 30 and 50 Above 50 Below 30 Between 30 and 50 Above 50
Fresenius Medical Care 16% 58% 26% 17% 58% 25% 18% 56% 26% 16% 57% 27% 18% 56% 26%
Fresenius Kabi 21% 60% 19% 22% 61% 17% 23% 60% 17% 23% 60% 17% 25% 59% 16%
Helios Germany 20% 47% 33% 20% 48% 32% 19% 48% 33% 18% 49% 33% 19% 49% 32%
Helios Spain 21% 59% 20% 18% 60% 22% 17% 61% 22% 18% 62% 20% n. a. n. a. n. a.
Fresenius Vamed 16% 47% 37% 15% 49% 36% 16% 50% 34% 15% 50% 35% 18% 54% 28%
Corporate / Other 25% 51% 24% 25% 53% 22% 24% 54% 22% 25% 54% 21% 24% 55% 21%
Total 19% 55% 26% 19% 55% 26% 19% 55% 26% 18% 55% 27% 19% 55% 26%

Parental leave (Germany)

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2021 2020
Employees, total 5% 6%
thereof male 18% 19%
thereof female 82% 81%
Fresenius Medical Care

After declining to 11.9% in 2020, Fresenius Medical Care's voluntary turnover rate rose to 16.5% in 2021. This increase reflects an increasingly competitive labor market, especially in clinics and the manufacturing business. To counteract this increase, the business segment implemented several measures. These include various measures to help managers and HR professionals to help improve employee retention. The average tenure of employees increased from 7.3 years in 2020 to 7.6 years in 2021.

Fresenius Kabi

Total employees at Fresenius Kabi increased slightly in the reporting year. The external hires as well as the voluntary turnover were marked by the constraints for personnel in the health care market, a development which we also experienced in the other business segments.

Fresenius Helios

The total number of employees increased in the reporting year at Fresenius Helios. Employee retention measures were initiated early and thus, we were able to respond to the impacts on the labor market, caused by the pandemic. The voluntary turnover only slightly increased to 10.3% (2020: 9.0%). At Helios Germany, the rate was at 9.5% below the rate at Helios Spain with 11.0%.

In view of the renewed decline in the number of cases by around 16% in the reporting year compared with the pre-COVID-19 year 2019, Helios Germany made moderate adjustments to positions in the medical service in 2021. These job adjustments amounted to around 3% and were carried out by not filling vacant positions or letting fixed-term employment contracts expire. The adjustments in the medical services were conducted without redundancies.

Fresenius Vamed

At Fresenius Vamed, the number of employees increased by 2%. The turnover was impacted by COVID-19 and the change in work-life-balance aspirations of employees in administrative functions. Further, employees in health care facilities faced increasing.

1 Fresenius Medical Care’s 2017 data reflects country data representing 96% of all employees. Helios Germany’s data for 2017 includes the post-acute care business in Germany. Fresenius Vamed’s data for 2017 also includes temporary staff and, as of 2018, the German post-acute care business transferred from Fresenius Helios to Fresenius Vamed. The data from Helios Spain contains the hospitals in Latin America as of 2020. Data does not include the recently acquired company Eugin, yet.

2 Calculated as the number of external hires in a business segment within the reporting period, relative to the number of employees at year-end.

3 Calculated as the number of employees who left the organization voluntarily in relation to the number of employees at the end of the year.