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We, as the Fresenius Group, value a diverse, inclusive, and equitable working environment which we aim to build and preserve.

As an active leader across different healthcare markets, we take a decentralized approach to align our products, services, and treatments to accommodate the needs in each market and dynamics in our business segments. Our success is measured by key financial and non-financial figures which are established and well-perceived by our stakeholders.

Regarding topics important to our diverse employee, patient, and supplier populations, this journey has just begun. Diversity, equity and inclusion (DEI) is discussed and embraced in our Group and its entities; however, we recognize there are situations for which a Group approach is not the right approach. Our aspiration is to strive for equity and inclusion, embracing both diversity and belonging as concepts which encompass unique situations and individuals. With this approach, we provide a framework which enables our employees to integrate into a workplace for which we aim to reduce barriers and unconscious bias and that supports them to follow their individual professional ambitions.

Our approach

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At Fresenius we support equal opportunities for all and consciously oppose discrimination of all kinds. No one may be discriminated against on the basis of skin color, ancestry, faith, political views, age, gender, ethnicity, nationality, cultural background, sexual orientation, physical condition, appearance, or other personal characteristics. This extends equally to employees, business partners, and patients. We work in an atmosphere of mutual respect. Our dealings with each other are open, fair, and appreciative. We do not ­tolerate insults, humiliation, or harassment in our daily work, neither internally nor externally. Our managers have a ­special responsibility in this respect and act as role models. These values and our aspirations with regard to diversity are laid down in the Fresenius Code of Conduct, which is binding for all employees. This Code makes our stance clear, i. e., to support equal opportunities for all. This lays the foundation of our cooperation and corporate culture. Further information on our approach to equal opportunities is provided in the Human rights section.

For further information on our diversity concept for the Management Board and the Supervisory Board, please see our Corporate Governance Declaration.

Information about fair compensation can be found in the Employees chapter.

Organization and responsibilities

With the Fresenius Code of Conduct, the Group Management Board provides the framework for shaping diversity and equal opportunities. The strategic and operational responsibility for these topics lies with the respective Management Board committees or management of the business segments.

In order to be able to address existing and potential challenges in connection with diversity and equal opportunities on a context-specific basis, the business segments have also defined responsibilities at regional level.

Fresenius Medical Care has a main contact for diversity, equity, and inclusion (DEI) in North America, who is focused on supporting the advancement of the key objectives in this area in alignment with the global inclusion and diversity work. She is supported by both the business segment’s DE & I Executive Committee and its DE & I Council.

Fresenius Kabi has a Center of Expertise Talent, Leadership, and Organizational Development (CoE TLO), which reports directly to the head of the Global Human Resources (HR) department. The CoE TLO is tasked with anchoring DEI in the management board areas and supporting the HR functions in their activities with a global framework. The DEI department is responsible for the region North America within the regional organization, supported by a regional Steering Committee. Activities there focus on building ­competencies for diversity- and equity-friendly and inclusive behavior and developing regional DEI concepts for Fresenius Kabi employees. The committee is chaired by the Management Board member responsible for the North America reg­ion and meets on a monthly basis.

At Fresenius Helios, the Director of HR in Germany has responsibility for diversity in the German clinics. A diversity working group was set up in 2021 for the strategic development and implementation of overarching measures. In the hospitals, the clinic management is responsible for implementing diversity concepts. Since 2022, representatives of the clinics who further develop the topic at clinic level and manage related projects have been meeting in the Helios div­ersity network. In regular meetings, they discuss the main topics and push projects for the various dimensions of diversity.

Each clinic in Spain employs an equal opportunities officer, who is specially trained and exercises an advisory function for the respective management. In addition, the equality plan is monitored by a central committee comprising members from the management and employee representatives, who report on the implementation and development status at the locations. With specific action plans, measures are implemented to ensure inclusion and equal opportunities for all employees in the clinics and healthcare facilities. For more information, please refer to the Progress and measures in 2022 section.

For other entities or countries in which the business segment is active, the HR manager or medical director, for example, are responsible to follow best practices and coun­try regulations regarding diversity.

At Fresenius Vamed, a diversity and gender representative oversees equality issues.

At Fresenius Corporate, the Corporate HR Management is responsible for DEI. Experts in various divisions develop training courses, communication material and programs in joint discussion with other Group functions.

Policies and regulations

The Fresenius Code of Conduct defines the Group-wide values and principles for dealing with diversity and equal opportunities. In addition, the business segments use ­internal guidelines to set out their respective approaches. In Germany, our home market, various regulations exist to which the Fresenius Group and its German entities have to adhere to, such as the General Equal Treatment Act (Allgemeines Gleichbehandlungsgesetz), the Remuneration Transparency Act (Entgelttransparenzgesetz) and the Works ­Constitution Act (Betriebsverfassungsgesetz).

Fresenius Medical Care’s commitment to inclusion and diversity is incorporated in its Code of Ethics and Business Conduct. New policies were established in 2022, see the Progress and measures in 2022 section.

At Fresenius Kabi, the focus in all personnel-related processes is on equal opportunities for all employees, taking into account all individual characteristics, e. g., education, ethnic background, gender or age. The company values of Fresenius Kabi form the basis for the day-to-day actions of all Fresenius Kabi employees and are part of its Code of Conduct. In North America, Fresenius Kabi published an Equal Employment Opportunity Statement, which is a commitment to comply with non-discrimination laws and embraces and supports the diversity strategy of this region.

Fresenius Helios is committed to operating in a non-­discriminatory and equal opportunity manner. In Germany, this aspiration is also anchored in Helios’ vision and mission with its six guiding principles and is reflected in the guiding principle of Working together. Helios Germany signed the Charter of Diversity (Charta der Vielfalt) and has been specifically developing tools on this basis to strengthen and live diversity in all dimensions since 2022. For more information, please refer to the Progress and measures in 2022 ­section. The Helios intranet makes information, internal and external networks, and examples of best practice transparently available to employees. Helios’ framework agreements ensure non-discrimination and diversity in rec­ruitment. Collective agreements and works agreements stipulate that all employees are entitled to the same benefits. Further information can be found in the Employees chapter.

Helios Spain commits to a diverse corporate culture in its Code of Conduct. The management of Helios Spain has introduced gender equality tools – for example in the form of integrative language and training and in procedures such as personnel selection processes and internal promotions. Furthermore, it is important to prevent sexual harassment or gender discrimination, for example.

In 2022, 62% of Helios Spain's employees were covered by equality plans. This kind of equality plan respects the European directives and the national rules in Spain on equal opportunities and wage transparency between men and women, and also guarantees non-discrimination in the workplace. Equality plans are regularly updated, therefore, negotiations with trade unions are conducted on an ongoing basis.

At the Fertility Services division in Spain, led by the respective HR departments equality plans were developed and implemented targeting non-discrimination measures. For example, the division has implemented a training policy that standardizes the access to training offers. Also, all employees were informed about the whistleblower channel and the prevention protocol in situations of harassment and discrimination. The equality commissions of the Spanish societies received topic-specific training.

At Fresenius Vamed, non-discrimination and the promotion of diversity in HR processes are enshrined in explicit formal regulations.

Reporting systems and dealing with incidents of discrimination

Information about violations of the principles of the Fresenius Code of Conduct and other possible misconduct can be reported via various notification systems – anonymously, if necessary, as described in the Compliance section. Further, business segments offer online platforms for reporting violations of corporate principles to the company in various languages.

Incidents involving discrimination are processed via the responsible function and, depending on the severity of the incident, escalated, for example to regional or central level. At Helios Germany, for example, a crisis management team is deployed to advise on the specific procedure to be used on a case-by-case basis. In addition, employees have the option of confiding in an ombudsperson in the event of conflicts or misconduct. At Helios Spain, incidents involving sexual and gender-based harassment can be recorded via a dedicated complaint ­protocol.

All information is carefully examined and appropriate action taken in accordance with the results of the investigation. Depending on the type and severity of misconduct, sanctions such as actions under employment, civil, or criminal law can be imposed. After finishing the investigation, measures that prevent future misconduct, or at least make it more difficult, are implemented.

Diversity lived in the business segments

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Fresenius promotes international and interdisciplinary cooperation as well as diversity in our business segments and regions. The diversity of our markets and locations is also reflected in the workforce of the four business segments. In our home market in Germany, we have employees of more than 140 nationalities. All business segments attach great importance to equal opportunities for all employees in the workplace as well as in the application, selection, and development procedures. In order to integrate equal opportunities in all processes and workflows, the business segments develop diversity concepts that are adapted to the requirements of their respective business models and regions.

A wide range of measures are being implemented in our hospitals to promote diversity and equal opportunities. The status of implementation varies between the clinics. Examples are:

  • Intercultural after-work meetings
  • Prayer rooms for different religions
  • In-house interpreter pools for foreign patients
  • Queer communities with drop-in centers and regular meetings
  • Gender equality training for all employees
  • Cultural opening through training courses for cultural ambassadors (2022: 27 training courses in Germany)
  • Company daycare centers
  • Individual part-time offers and job sharing
  • Raising awareness of gender-specific professions (Boys’ and Girls’ Day)
  • Development of a language guide on equality to raise awareness of the power of language in everyday and professional life (Spain)

Employee interest groups

Within the Fresenius Group, various employee groups were formed, such es employee impact groups or employee resource groups (ERGs) in the region North America. The Women's Initiative in Europe is committed to networking, mentoring and supporting of women. The initiative was established in 2022 and will be further expanded. These networks are central for the DEI strategy and support the Group’s aspiration to develop a culture of diversity and belonging among our workforce.

By the end of 2022, Fresenius Medical Care had 16 ERGs. They are designed to increase participating employees’ sense of inclusion and belonging in the workplace. ERGs also provide a platform for employees to engage with various elements of the company’s mission, values, business objectives, and sustainability efforts. Going forward, the company expects this number as well as the number of employees engaged in such groups to grow.

At Fresenius Kabi, for example, there are currently four Employee Impact Groups: Voices of African Descent, Women’s Voice, Pride and Alliance of Asians and Pacific Islanders. Detailed information can be found on the Fresenius Kabi website.

Employees with disabilities

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The Fresenius Group also employs people with impairments, some of which are severe disabilities. The spectrum not only includes people in wheelchairs or with mental disabilities. Survival of cancer, or diabetes, rheumatism, depression, back problems, or cardiovascular disease can also be the cause of an impairment.

Fresenius is committed to the inclusion of severely disabled people. We want to enable our employees to apply their knowledge and skills as fully as possible. In doing so, the respective local legal requirements must be implemented. As these differ significantly in some cases, management is decentralized and local. For example, severely disabled employees in Germany are entitled to a workplace suitable for the disabled, part-time work if the disability requires shorter working hours, special protection against dismissal, and additional leave.

In Germany, elections for representatives of the severely disabled are held every four years at Fresenius facilities where at least five severely disabled persons are employed on a more than temporary basis. All members of the com­pany can stand for election to the office of representative for severely disabled persons.

In 2020, Helios Germany concluded an overall inclusion agreement with the division’s representative body for persons with severe disabilities. It strengthens the participation of (severely) disabled people and employees at risk of disability and promotes equal opportunities. Furthermore, it aims to prevent employees with (severe) disabilities from being discriminated against or socially excluded. In addition, two online training courses on the topics of severe disability law and the Corporate Inclusivity Agreement are available to senior executives via the training catalog of the management academy.

Helios Spain has dedicated recruiting, training, and inclusion protocols for disabled people. By this, the division complies with the Spanish legal requirement to employ at least 2% of people with disabilities in relation to the total workforce. In addition, Helios Spain has signed an agreement from the representative foundation Fundación DKV Integralia to promote diversity in the division.

In total, 5,082 persons with disabilities were employed by the Fresenius Group in Germany in 2022. This corresponds to a rate of 5.1% in Germany (2021: 5,051; 5.1%).

Integration of international nursing staff

In order to counter the shortage of skilled nursing staff and to strengthen this occupational group, Helios Germany has implemented a diverse package of measures. Among other things, the division is specifically recruiting international nursing staff. Since 2019, a total of 2,500 nurses have already been employed from abroad.

To support its foreign employees, in particular foreign nurses, Helios Germany already began to train staff as integration managers in 2020. In 2022, 72 integration managers had already completed training. They supported nurses who had come to us from abroad when they arrived in Germany, helping them to deal with authorities and providing support in other situations. The aim here is to help with social and cultural integration, as well as aiding professional and linguistic integration. This is supported and complemented by local initiatives at each hospital location. To further promote cultural openness and understanding among the teams, a total of 27 responsible employees were trained as cultural ambassadors in 2022.

Helios Spain has developed a procedure to address the questions of new employees from abroad and thus facilitate their arrival in Spain. In addition, the division has a function for labor law and related employee services through which international nursing and medical staff can obtain their residence and work permits.

Fresenius Vamed has implemented various projects, especially in Germany and Austria, to integrate international nursing staff in order to counter the shortage of skilled staff. For example, the nurses receive organizational support before and after their arrival. In addition, they undergo an induction program at the respective healthcare facility and receive targeted further support depending on their individual needs. In 2022, a project for nursing staff from Colombia was launched in Austria and projects for nursing staff from Brazil and the Philippines in Germany.

In a joint integration network, the representatives of Fresenius Helios and Fresenius Vamed continue to develop the Helios integration tools for international professionals on a monthly basis. The spectrum of topics ranges from educational and language offers, to intercultural training, culturally sensitive integration concepts, and learning mentors. The professional measures of the Helios education centers can also be booked by employees of the Fresenius Vamed clinics.

Our ambitions

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Promoting diversity and inclusion at all levels of the company is a priority at Fresenius. The Fresenius Group Management Board welcomes the activities within the business segments to further build on this diversity in future and benefi from it more widely.

For the Fresenius Group, diversity targets have been communicated for the first and second management level below the Management Board. Information is provided in the Corporate Governance Declaration of the Annual Report 2022.

In 2020, Fresenius Medical Care defined gender diversity targets to be achieved in 2025. The company reached these targets in 2022 in the context of its organizational transformation. As a result, the Management Board of the company has set new diversity goals. By the end of 2027, Fresenius Medical Care aims to increase the share of women in the first level below its Management Board to 35%, and the share of women in the second level to 45%. The first management level below the Management Board includes all managers worldwide who directly report to a member of the Management Board and participate in the long-term incentive plan (LTIP). The second management level includes all managers worldwide who directly report to a manager of the first management level and participate in the LTIP.

Fresenius Medical Care also set itself the goal of increasing the representation of women in management positions to reflect the percentage of women in the global employee population by 2030. Furthermore, the company aims to grow the number of ethnically diverse managers in the U.S. year over year by 2030.

Fresenius Medical Care has additionally developed objectives for specific focus areas. For example, it aims to increase the global number of Employee Resource Groups (ERGs).

Fresenius Kabi’s transformation framework Vision 2026 sets a clear focus on fostering diversity, equal opportunities and an inclusive working environment. Different backgrounds, experiences, perspectives – it all leads to better decision-making as well as outcome and drives progress on all levels of an organization. It’s an integral part and a key prerequisite for a healthy organizational culture. Already today, Fresenius Kabi’s employees represent a diverse group of enthusiastic healthcare experts and dedicated professionals. Accordingly, Fresenius Kabi constantly strives for further advancing its company culture to attract, develop and keep the best people. In the reporting year, the business segment formulated an internal ambition with regard to the proportion of female executives in top management and is developing suitable measures to achieve this.

For many years – and independently of legislative activities and regulations – Helios Germany has pursued the clear goal of increasing the proportion of women in management positions. In the area of our regional management, the figure is already approximately 50% (2021: 46%).

Progress and measures in 2022

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In 2022, a Group-wide communication campaign in the internal employee newspaper on the topic of diversity was initiated. In October 2022, Fresenius Corporate, Fresenius Digital Technology and Fresenius Kabi launched a joint learning program on Leadership for Women – Boost your Self-Positioning with nearly 150 participants. The women can strengthen their self-positioning using various topic modules and network across divisions by means of peer group coaching.

In 2022, Fresenius Medical Care issued three global policies aimed at advancing this material topic: the Diversity, Equity, and Inclusion Policy, the Employee Resource Group Policy, and the Diverse Candidate Slate Policy. The company also educated its leaders on how to model inclusive behaviors. In the U.S. alone, it conducted ten training sessions with more than 2,500 leaders and employees to foster understanding about the value of inclusion in the workplace.

In the reporting year, the management approach and the governance structure of Fresenius Kabi remained as reported in 2021. Progress focused on diversity and inclusion training for top executives globally. Fresenius Kabi implemented two global initiatives for its top executives. The DECIDE program focuses on unconscious bias in, for ­example, recruiting processes or promotion. The program equips participants with tools and methods to reduce unconscious biases in their daily work. The INCLUDE initiative focuses on inclusive leadership practices, aimed at strengthening inclusive, engaged, and effective teams. In addition, a global guide on inclusion issues with tips for inclusive behavior in the workplace was published on the DEI intranet site.

Fresenius Kabi Australia has established a DEI committee that focuses on DEI, branding and communication. A local survey was conducted there to get a picture of the company’s own diversity and to promote it as part of employer branding. Other measures included, for example, new regulations for parental leave, online training on various DEI topics, the use of gender-neutral pronouns in communication, the creation of an internal DEI page and a communication platform on DEI topics, e. g., International Women’s Day.

Helios Germany focused on giving the topic of diversity more emphasis and visibility in 2022. New structures were created, such as the aforementioned Helios diversity network, and measures were implemented. For example, diversity is now mandatory as training subject at Helios Germany training centers. In addition, the Helios knowledge goal Diversity has been developed, including raising employees' awareness of everyday and systemic racism. New pages on the intra­net and website (German language only) provide information.

Helios Spain implemented various measures to foster inclusion and equal opportunities. For example, compatibility of work and childcare was improved. Further, the division introduced a penalty protocol against sexual or gender-based harassment, and a procedure for language sensitization. For internal promotions, preference shall be given to the less represented gender.

In 2022, one of Fresenius Vamed's lead Austrian companies implemented training on the topic of unconscious bias for the recruiting department and in leadership development. In the reporting year, 33 participants, including 30 executives, completed the training. The business segment also integrated the training into the on-boarding process of new managers. Improving communication and cooperation between the different generations – referred to as generation management – is also a key HR issue. It is to be gradually integrated into existing personnel processes in particularly affected areas of the company. In Germany, personnel training sessions on the topic of inclusion have been held.

In central recruiting for the divisions of Fresenius Vamed in Austria, too, conscious attention is paid to inclusion and age diversity. The integration of refugees was continued in 2022, as people from Ukraine were actively sought and recruited, among other places via the platform Jobs for Ukraine.

At Fresenius Corporate, awareness was raised at various levels regarding the equal treatment of different employee groups. This primarily affected managers, but also employees. In 2022 this included, for example, training sessions on the topic of unconscious bias or the structured annual HR dialogs with all divisional managers, in which diversity and equal treatment were discussed and measures derived where necessary.

As a key aspect of the Group’s strategy, diversity is also applied in the variable Management Board compensation. For more information, please refer to the Compensation Report of the Annual Report 2022.


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If potential violations of our internal guidelines on diversity and equal opportunities are reported, they are documented, evaluated and, if necessary, consequences derived in accordance with the respective reporting structures. In the reporting year, no violations of internal policies on diversity and equal opportunities were reported via our reporting channels whose impact would have been material for the financial position or reputation of the company. Further information on opportunities and risks can be found in the Opportunities and Risk Report.

The proportion of female employees in the Fresenius Group remained at the previous year's level of 69%. The proportion of females in services or care is traditionally higher than in the area of production. This is reflected in the proportion of female employees in our business segments: Our business segment Fresenius Helios has the highest proportion of fem­ale employees within the Group, with 75%. The number of female participants in the Group-wide Long Term Incentive Plan (LTIP 2018) is a good indication of the share of women in management positions. According to this, the ratio of wom­en among the more than 1,800 top executives increased to 33.9% as at December 31, 2022 (Dec. 31, 2021: 32.6% of 1,800 top executives).

Female employees

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Dec. 31 2022 2021 2020 2019 2018
­Fresenius Medical Care 69% 69% 69% 69% 69%
­Fresenius Kabi 51% 51% 50% 50% 50%
­Fresenius Helios 75% 75% 75% 75% 75%
­Fresenius Vamed 63% 62% 62% 63% 64%
Corporate / Other 46% 40% 38% 39% 39%
Total 69% 69% 68% 68% 68%

Fresenius Kabi is continuously working to improve its diversity management and successfully conducted diversity training for top management in the reporting year. Diversity, equity and inclusion are firmly anchored in Vision 2026. As part of the corporate culture measures, further measures to strengthen diversity management are being developed and implemented.

In 2022, individual incidents of discrimination were reported in business segments via the implemented systems. The reports were documented, investigated and evaluated in accordance with the applicable compliance regulations. We also take reports that are not substantiated by the investigation as an opportunity to review existing structures and, if necessary, adjust measures as a precaution.