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We aim to develop an integrated environmental approach for the Fresenius Group and foster a balanced view across all functions with regard to relevant environmental aspects. In its business operations, the Fresenius Group is subject to numerous guidelines and regulatory requirements that must be applied and complied with at all times. We integrate national requirements into our internal guidelines, which are defined in ISO-based or ISO-oriented management systems.

Our approach

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We aim to analyze our impact on the material environmental aspects in both the manufacturing and services areas, as the risks of financial or reputational costs linked to environmental litigation are expected to increase. Also, reducing in-process material is essential for many industries affected by growing natural resource scarcity. Dedicated monitoring of natural resource consumption and waste-generating activities can lead to lower costs and, in some cases, new business opportunities. This is why we assess trends and adapt our activities if deemed essential to support the sustainable, long-term growth of our business. In the Progress and measures in 2022 section we report on our activities and projects in the reporting year. The results achieved are presented in the Evaluation section. Information on risks can be found in the Group Annual Report 2022 in the Opportunities and Risk Report.

Within the Fresenius Group Management Board, the Chief Executive Officers (CEOs) of the business segments are responsible for operational management. Responsibility for environmental management is regulated by the respective Management Board committees or managements, e. g., via a business allocation plan. The business allocation plan of the Fresenius Group Management Board does not provide for a separate department for this purpose. As part of risk reporting, the Fresenius Group Management Board is informed quarterly about the effectiveness of the environmental management systems, i. e., about risks or incidents that could have a significant impact on the operating business, the reputation or the value chain of the Group and its business segments. The Audit Committee of the Supervisory Board is also informed of these developments on a quarterly basis, and the Supervisory Board as a whole is informed annually. For further information, please refer to the Risk Report and the Non-Financial Group Report, section Compliance.

On a business segment level, the environmental management strategy is aligned to the respective business models. Since the requirements in our business segments differ, environmental management is decentralized. The common foundation of environmental management approaches in our business segments is the ISO 14001 standard. All segments have implemented local, regional, or global management systems to take into account the respective business models and adapt processes accordingly. Each business segment has functions that monitor and control the respective environmental impacts. They analyze environmentally relevant vulnerabilities, develop suitable standard procedures, and implement appropriate measures. They also support their certified local entities in effective, directed environmental goal-setting, monitoring these goals as well as developing and implementing mandatory guidelines for all entities.

Certifications and commitment

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The environmental commitment of our business segments is reviewed or certified by external partners and regulatory bodies. We are continuously expanding the number of sites certified to ISO 14001. In 2022, further entities were added on a Group level. More information on the various standards is provided for each business segment in this chapter.

The environmental management approach of the Fresenius Group is controlled by internal specialists or dedicated functions within the business segments. Relevant data is reported regularly, e. g., on a monthly basis, to identify deviations. If deviations occur, our specialists initiate a root cause analysis which is evaluated, and corrective or preventive actions are implemented where necessary. Regular internal audits, partially annually, support the verification of data and management approaches, both for certified and non-certified entities. In this way, we ensure that activities to protect the environment are in accordance with internal guidelines and regulatory provisions. The overarching ambition is to improve efficiency of our management systems and to extend their scope to new or not yet integrated sites, so as to ensure the effectiveness of the procedures and systems in place.

Certifications and standards Fresenius Group

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External standards (ISO 14001) 46%
Regulatory frameworks 100%
Internal standards 100%
1 Scope applies to the entities for which environmental data is consolidated.
Fresenius Medical Care

Part of Fresenius Medical Care's environmental management involves monitoring national and international regulations concerning the environment, so that the internal policies and manuals are up to date. The business segment has established internal environmental standards, which it complements with external certifications where it adds value. The production sites, distribution centers, laboratories, and dialysisDialysisForm ​of ​renal ​replacement ​therapy ​where ​a ​semipermeable ​membrane ​– ​in ​peritoneal ​dialysis ​the ​peritoneum ​of ​the ​patient, ​in ​hemo­ ​dialysis ​the ​membrane ​of ​the ​dialyzer ​– ​is ​used ​to ​clean ​a ​patient’s ​blood. clinics are subject to internal and external audits. This involves checking their compliance with environmental laws and regulations, certification requirements, and internal guidelines. Due to the COVID-19 pandemic, some audits in 2022 took place virtually. In total, 25% of production sites are certified according to ISO 14001 standard and 5% of production sites have ISO 50001 certifications.

Environmental certifications Fresenius Medical Care

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Environmental standard ISO 14001 ISO 50001
Certified production sites (%) 25 5

Fresenius Medical Care`s environmental management is described in this section, for energy management and emissions see section Climate protection – energy and emissions.

Fresenius Kabi

Fresenius Kabi has a matrix certification for both its global environmental management system and the energy management system; both systems are audited annually and certified by TÜV Rheinland. The business segment continuously monitors certified organizations to ensure that they comply with the standard process guidelines that are binding for them. To this end, globally appointed auditors conduct regular internal audits of the organizations. Fresenius Kabi is working to implement the environmental management system according to the international standard ISO 14001 and the energy management system according to ISO 50001 at all manufacturing plants worldwide by 20261. To achieve the goal of implementing the management systems, the business segment has drawn up an ambitious implementation plan and is working systematically on its realization. By expanding the coverage of the management systems, Fresenius Kabi aims to continuously improve its environmental and energy performance. 39 Fresenius Kabi manufacturing plants are currently certified according to ISO 14001, including 6 additional manufacturing plants which were certified in 2022. Further, 27 manufacturing plants are certified according to ISO 50001, including 7 additional manufacturing plants which were certified 2022. Information on the environmental management of Fresenius Kabi can be found in the Environmental management in the business segments section; for energy management and emissions see the Climate protection – energy and emissions section.

1 Implementation will be concluded at all Fresenius Kabi manufacturing plants in 2026. The certification issuance from the individual certifi cation companies may extend into the following year.

Environmental certifications Fresenius Kabi

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Environmental standard ISO 14001 ISO 50001
Number of certified manufacturing plants 39 27
Certified manufacturing plants (%)1 76 53
1 %-coverage of manufacturing plants according to implementation goal of the management systems.
Fresenius Helios

Fresenius Helios started introducing an environmental management system in accordance with ISO 14001 in Germany in 2020 and continued this process in 2022. To this end, the necessary structure was created in the reporting year at the level of the business segment as well as at the level of the individual clinics, for example by establishing sustainability teams. The certification of all Helios clinics is to be covered by matrix certification in the coming years. An energy management system in accordance with ISO 50001 was implemented at all Fresenius Helios sites in Germany by the end of 2020 and the sites are externally certified accordingly.

At Helios Spain, five further hospitals were certified according to ISO 14001 in 2022. The total number is now 49 hospitals. The number of hospitals certified to ISO 50001 increased by three to a total of ten. The certification audits were conducted in 2022 and the valid certificates are expected in early 2023.

The four Spanish clinics of the division Fertility Services have all already been certified to ISO 14001 in 2021.

Environmental certifications Fresenius Helios

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Environmental standard ISO 14001 ISO 50001
Number of certified locations
Germany 01 87
Spain 53 10
Number of certified locations (%)
Germany 0%1 100%
Spain 100% 19%
1 Implementation planned
Fresenius Vamed

In 2022, at Fresenius Vamed no new certifications according to ISO 14001 or ISO 50001 were performed. The number of facilities with appropriate certifications was unchanged, with 8 facilities certified to ISO 14001 and 53 certified to ISO 50001.

Environmental certifications Fresenius Vamed

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Environmental standard ISO 14001 ISO 50001
Number of certified entities 8 53
Number of certified entities (%)1 100 100
1 %-Coverage based on entities for which the standard is of relevance.

Environmental management in the business segments

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Fresenius Medical Care

The Global Environmental Policy provides a framework for Fresenius Medical Care's environmental management. It addresses how the business segment manages and monitors its environmental impact and forms the basis for other policies and manuals. Also, various guidelines help to manage global data and correctly report on environmental indicators related to energy, greenhouse gas (GHG) emissions, and water. Fresenius Medical Care plans to extend these guidelines in 2023 to other indicators such as waste and wastewater in line with internal and external reporting requirements.

Life cycle assessments

To help understand the environmental impact of its products, Fresenius Medical Care conducts simplified product life-cycle assessments (screening LCA) for selected products. These assessments identify the life cycle phase with the highest impact, and the processes and materials needed to focus on to improve the eco-performance of the products and services. Screening LCAs are used to assess most of the active medical device product lines and are gradually being extended to disposables. In addition, the business segment has conducted detailed comparative product life cycle assessments for important disposables.

Fresenius Kabi

The focus of the environmental management system at Fresenius Kabi is to improve environmental performance and prevent environmental incidents. Key opportunities are, e. g., reducing energy and water usage, as well as wastewater, waste, and emissions, in relation to production activities.

A manual for the respective management system and standard operating procedures provide the certified units with the framework for their local environmental or energy management system.

The local management reviews the environmental management system at least annually to ensure continued compliance with the applicable requirements and effectiveness of the systems, and to identify potential for improvement. These local reviews are consolidated, analyzed, and evaluated on an annual basis by Fresenius Kabi’s global EHS (Environment, Health, and Safety) function. Appropriate corrective measures will be initiated, if deviations from the requirements of the ISO 14001 or ISO 50001 management systems are identified. Based on the local management reviews, the global EHS function presents a global management review to the responsible members of Fresenius Kabi’s Management Board and other relevant functions of the business segment. In addition, the global EHS function reports on a quarterly basis about Fresenius Kabi’s environmental and energy performance with selected indicators and provides an update on the implementation of the ISO 14001 and ISO 50001 management systems.

Fresenius Kabi has implemented mandatory environmental guidelines worldwide, which provide the framework for environmental protection in all Fresenius Kabi’s organizations. The guidelines include general principles on how to address and mitigate environmental risks, as well as how to prevent environmental incidents. Fresenius Kabi also expects careful and responsible handling of nature and its resources from its suppliers; this is set out in the Suppliers’ Code of Conduct. In addition, since 2021, the business segment takes sustainability criteria into account in decision-making processes for new projects, such as the development of products or capacity expansions.

Manufacturing sites must identify environmental protection measures associated with environmental aspects of their activities and services. This can relate to emissions into air, water, or soil, consumption of natural resources and raw materials, waste and wastewater, packaging, transport, or other local environmental impacts. Environmental impacts of organizations are evaluated and, where necessary, environmental protection measures are implemented and reviewed for effectiveness. In addition, using internal audits, Fresenius Kabi identifies further improvement opportunities and develops appropriate measures with locally responsible managers to tap that potential. During an audit, a review is conducted as to how environmental aspects have been evaluated by the respective organization and whether objectives have been set for significant environmental aspects. Objectives and respective measures are reviewed by the auditor during inspection tours or on the basis of monitoring records. This is carried out at certified sites in particular. In addition, internal audits cover preparedness for emergencies including heavy weather events, floods, earthquakes, or hurricanes, depending on relevance or location. The frequency of global internal audits depends on audit observations from previous audits, environmental incidents, certification status, or the evaluation of the management review and can vary between one and four years. Worldwide internal audits are conducted by the global EHS department. Due to the ongoing COVID-19 pandemic in 2022, most audits have been conducted remotely.

Fresenius Kabi has a reporting process for environmental incidents such as violations of environmental regulations, pollution caused by uncontrolled spills, or complaints from third parties. Environmental incidents are recorded internally and categorized into five levels – depending on the impact of an environmental incident. Environmental incidents are reported to the global EHS function by local managers. Where necessary, Fresenius Kabi immediately reports environmental incidents to the relevant authorities. Environmental incidents are analyzed to determine the cause and to prevent future incidents.

Fresenius Helios

The environment has a direct impact on health. As a hospital operator, Fresenius Helios therefore feels a responsibility to protect the climate and the environment. With its environmental management strategy, the business segment works continuously to reduce the environmental impact of hospital operations. It is the aim of Fresenius Helios to control and reduce its Scope 1 and Scope 2 emissions. The business segment also aims to raise employees’ awareness of the environment, and with these measures, to improve the ecological sustainability performance of its hospitals in the long term.

In Germany, the Infrastructure business unit is responsible for the energy and environmental management strategy of Helios hospitals. It supports them in the central purchasing of products or services and in sharing best practice procedures, among others. The business unit reports directly to the Chief Operating Officer (COO) of the parent company Helios Health.

In Spain, environmental management is part of operational management and is carried out by the Quality Management department and by the local environmental management committees of the hospitals. The Group management policy, which applies to Helios Spain as a whole, contains the following obligations: to protect and preserve the environment, to promote environmental initiatives, to apply environmental protection and conservation measures, and to comply with the applicable requirements. In 2022, a corporate environmental committee with multidisciplinary participation has been started, that joins efforts and aligns projects to improve the environmental management of hospitals. Since 2021, diverse working groups develop and promote environmental guidelines and support the hospitals in their implementation. The guidelines serve to raise environmental awareness and tackle climate change through optimized energy use.

Furthermore, the division is part of the Clúster de Cambio Climático alliance, organized by Forética, a leading corporate network for sustainability and corporate responsibility in Spain and Latin America. The alliance meets three times a year to discuss a specific topic with experts and authorities, to evaluate the best climate-related practices in the private sector, and to promote exchange and transparency between companies.

In the environmental area, the division Fertility Services has the commitment to develop its business in a sustainable way, preventing pollution and minimizing the environmental impact of its operations by using natural resources and energy more efficiently.

Furthermore, the division contributes all necessary human and material resources, as well as the continuous training of its employees, to guarantee that all activities are carried out in accordance with environmental protection standards. In addition, to improve the awareness of energy efficiency, waste separation and environmental protection, the division’s Quality Department in Spain develops and communicates initiatives.

Fertility Services in Spain has implemented an Integrated Management System to monitor the compliance of management in the environmental area. The persons in charge of the integrated management system take into account and evaluate the areas of energy expense, atmospheric emissions, heat, noise and vibration emissions, water spills and soil contamination, among others. In addition to the person responsible for supervising and monitoring the environmental management, the commitment to environmental protection is anchored in the entire organization.

Fresenius Vamed

Fresenius Vamed continuously monitors national and international regulations on environmental and climate protection. Internal principles, guidelines, and standard operating procedures are updated as necessary. The business segment also expects its suppliers to treat the environment and natural resources with care and responsibility; this is set out in the Code of Conduct for Business Partners. The responsibilities and processes for the environmental area of Fresenius Vamed were collected and recorded in an internal process documentation.

Our ambitions

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In February 2022, the Management Board of Fresenius Management SE adopted a climate target for the Fresenius Group in addition to the existing programs. The Fresenius Group aims to be climate neutral in 2040 and to reduce Scope 1 and Scope 2 emissions by 50% in absolute terms by 2030, compared to 2020. Furthermore, we will assess the impact of Scope 3 emissions in the future to include them in our targets as well.

We are currently developing key performance indicators (KPIs) at Group level to measure our environmental performance, which are also to be included in the future variable compensation of the Board of Management. For more information, please refer to the Corporate Governance Report in the Annual Report 2022, section Compensation Report.

The environmental efforts undertaken in the reporting year are aimed at supporting the Group’s target. Further, each business segment has its own approach to environmental management.

Fresenius Medical Care is also currently assessing Scope 3 emissions that arise from activities or assets that the business segment does not own or control along its value chain. With this information, the company intends to evaluate the possible inclusion of Scope 3 emissions in its climate target roadmap. In the Scope 3 assessment, Fresenius Medical Care places particular focus on five categories that it considers especially relevant to its business: purchased goods and services, upstream transportation and distribution, waste generated in operations, use of sold products, and end-of-life treatment of sold products. Fresenius Medical Care aims to disclose information on its Scope 3 emissions in its own reporting for the financial year 2024 at the latest.

Fresenius Kabi constantly works to improve its environmental management and reduce negative impacts on the environment. Certified organizations set local targets to constantly improve their environmental and energy performance; this includes targets for waste, water, wastewater and energy consumption.

Helios Germany is working to reduce its environmental and CO2 footprint. First and foremost, the consumption of energy resources is to be reduced. The goal is to reduce energy consumption in all clinics by 20% by the end of 2023.

Helios Spain has set itself ambitious overarching goals and defines the environmental targets for each hospital locally each year. Since 2020, clear targets have been in place to reduce electricity and gas consumption in all hospitals. Furthermore, Helios Spain set itself comprehensive goals to raise employees’ environmental awareness, improve energy use, and document CO2 emissions in all hospitals. To this end, the infrastructure of the hospitals is to be analyzed first, then their own generation of energy is increased and their equipment improved.

The division Fertility Services has set two main strategic environmental objectives for 2022 and 2023. The first is to improve awareness and sensitization of the entire organization in terms of environmental protection. The aim is to promote the proper use of resources and recycling practices. Secondly, Fertility Services wants to continuously improve the ISO 14001 certified centers.

Fresenius Vamed continues to strive to evaluate its strategy on the basis of sustainability criteria and to identify performance indicators that will serve long-term strategic development. Moreover, Fresenius Vamed intensifies its focus on efficiency measures, investments in renewable energy production and heat generation to further reduce CO2 emissions in line with the Group’s target.

Progress and measures in 2022

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In the reporting year, the Fresenius Group initiated various measures and projects to achieve the Group climate target, which was approved in February 2022. Environmental managers of the business segments and representatives of the Group function Investor Relations & Sustainability form the Climate Target Working Group, that meets on a regular basis. The participants exchange information on the development of measures and the coordination of corresponding activities. As a first measure, Helios Germany, for example, has been purchasing green electricity with certificates of origin from renewable sources since 2022.

Since 2021, Helios Germany has been developing a system for collecting and evaluating Scope 3 emissions. At Helios Spain, the emissions from waste management and from business trips by air and rail have been calculated in the reporting year. In addition, the emissions of the journeys made by workers to their workplace have been estimated with a mobility survey.

Further information about climate protection can be found in the Climate protection – energy and emissions section. Scope 1 and Scope 2 emissions for the reporting year can be found in the Evaluation section.

In addition, our business segments achieved progress according to environmental management on which we report in the following.

Fresenius Medical Care

In 2022, Fresenius Medical Care set up a governance function responsible for global environmental management in the Global Sustainability department. Responsibility for environmental management in the dialysis clinics lies with the respective management in the global Care Delivery segment, which was implemented on January 1, 2023 as part of the new operating model. The global Care Enablement segment, which also came into effect in 2023, is accountable for environmentally sustainable manufacturing, product development, supply chain, and sales operations for the product business. Updates on environmental protection activities are provided to top management as needed. In 2022, the global network of environmental experts continued to exchange regularly on best practices related to topics such as energy and waste management, decarbonization, and water. These experts, which include representatives from the company’s new global structures, provide input on the implementation of the global environmental management strategy and goals.

Fresenius Medical Care additionally performed further assessments to determine how environmental factors such as water stress, climate change vulnerability, and waste management can represent risks to its business. The company updated the global environmental risk management process and catalog based on the results of these assessments to increase awareness but did not identify any significant new risks. In 2022, Fresenius Medical Care also continued to integrate the recommendations of the Task Force on Climate-related Financial Disclosures (TCFD) into its enterprise risk management approach. The business segment reviews climate-related risks and opportunities on an annual basis.

Fresenius Kabi

In 2022, Fresenius Kabi progressed with the roll-out of the environmental management system at the designated manufacturing plants. The global EHS function supports the local organizations in preparing and implementing the management system and certification according to ISO 14001.

Since 2019, Fresenius Kabi has an internal information platform, the Global Competence Cluster (GCC) Energy and Water Management, in which all production sites can participate. Exemplary practice and information exchange is thus globally facilitated. In 2022, the GCC conducted an internal awareness campaign to raise awareness for environmental management and generate approaches to improve water or energy management at its sites. The campaign generated over 70 ideas from about 25 sites for environmental protection. The ideas were assessed by an internal jury which choose the best ideas in the three categories Energy, Water and Awareness. They shall result in concrete projects to further enhance Fresenius Kabi’s environmental protection efforts and increase efficient use of energy or water. Examples can be found in the sections Water management and Climate protection.

Furthermore, Fresenius Kabi established a catalogue of exemplary environmental management practices for its manufacturing sites in 2022. All manufacturing sites were asked to check if the examples were applicable for their site. Based on these assessments, the global EHS function will work with the manufacturing plants on the implementation.

Fresenius Helios

In July 2022, Helios Germany established the Helios Sustainability Board to manage its environmental activities. It meets once a month. Under the leadership of the Sustainability Office, it comprises the management of Helios Germany and the heads of the relevant central services such as Purchasing and Logistics, Infrastructure, Compliance and Hygiene. Non-permanent members who participate in the Sustainability Board depending on the topic focus are management of the central services Risk Management, Pharmacy, Medical Technology, Occupational Safety, Human Resources, IT and Data Protection. The Board steers all issues relating to environmental and energy management. This includes, for example, ensuring and monitoring the climate target and ISO 50001 certification. It is also responsible for evaluating employee suggestions in the context of sustainability, managing overarching sustainability projects in the company, and discussing new technologies, such as CO2 reduction. In addition, sustainability teams were formed at the level of the clinics in 2022 under the leadership of the clinic managing directors to deal with the same setting of topics at the clinic level. These teams are also responsible for implementing decisions made in the Sustainability Board at the clinic level. In this context, the integrated energy teams specifically take care of the implementation of the energy management system according to ISO 50001.

Helios Spain has been working on corporate environmental objectives for many years, which are documented annually in the corporate targets. However, in 2022 a Corporate Environmental Committee has been created to promote projects and align environmental policies. The current targets are:

  • the implementation of renewable energy generation projects,
  • decarbonization of industrial facilities and
  • progress in the fight against climate change.

With joint initiatives and the pooling of forces, the segment supported its units in achieving these in the reporting year.

Fresenius Vamed

Fresenius Vamed pursues the goal of creating a central governance structure. Therefore, the business segment continues to record and review responsibilities and processes and to define strategies on the core topics of energy and water in the reporting year.


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In the reporting year, we further made progress to develop and prepare an integrated environmental management approach for the Fresenius Group, thus improving and aligning the assessment of relevant environmental aspects at all functions. The various measures conducted in the reporting year are described in the Progress and measures in 2022 section. Internal and external audits are used to identify potential for improvement at both local and global level and to take measures to continuously improve environmental performance.

In the reporting year, no environmental incidents were reported via the reporting channels whose impact would have been material to the financial position or reputation of the company. Furthermore, no incidents were recorded in which the respective environment or the general public were directly harmed. Further information on opportunities and risks can be found in the Opportunities and Risk Report.

Fresenius Medical Care

At its production sites, the business segment is involved in local environmental projects that are reported on as part of the global Green & Lean initiative. This initiative enables best practices to be shared across the organization. The objective is to reduce emissions, promote the efficient use of natural resources, and increase recycling rates. By the end of 2022, more than 110 projects were reported as part of the initiative. They were aimed at, for example, using efficient equipment to reduce energy consumption and improving processes to save water. As a result of these projects, per year Fresenius Medical Care expects to save more than 18,000 MWh of energy (0.7% of the total energy consumption), prevent 4,400 tons of CO2 equivalent emissions (0.6% of the total Scope 1 and 2 emissions), save more than 88,000 m3 of water (0.2% of the total water consumption), and recycle or reuse more than 270 tons of waste. Fresenius Medical Care also includes environmental considerations in its scientific activities. For example, in 2022, the business segment collaborated with other institutions to research the impact of climate change on dialysis patients. Further information on clinical trial management is provided in the Digital transformation and innovation chapter.

Fresenius Kabi

In 2022, no systematic non-compliances were detected during the global internal audits ISO 14001 and ISO 50001, and by TÜV Rheinland with regard to the certification of environmental management in accordance with ISO 14001. Nevertheless, some observations at local sites showed improvement potential, e. g., enhancing knowledge about the local energy management. To support this, regular trainings on a global and local level have been implemented or repeated in 2022.

In 2022, Fresenius Kabi documented environmental incidents in its internal reporting system. Where necessary, local authorities were informed of the incidents immediately after an incident became known. Necessary measures were implemented to reduce the environmental impact of the respective incidents. Fresenius Kabi has also taken the environmental incidents at the affected sites as an opportunity to implement preventive measures, such as training courses, in order to avoid future incidents. No incident led to a severe impact on the environment, biodiversity, or the communities nearby.

Fresenius Helios

Helios Germany conducts internal and external energy audits at the hospital sites as part of its energy management program. As part of the monitoring process, the respective personnel is sensitized to potential savings and increasing energy efficiency as well as related measures. The effects on energy efficiency are regularly monitored and evaluated within the energy management system. This process is part of the continuous improvement according to the requirements of ISO 50001. Helios Spain sets annual targets. To objectively assess target progress, the hospitals conduct quarterly self-evaluations. Every six month, the division evaluates the progress.

Fresenius Vamed

As part of Fresenius’ key performance indicator development, Fresenius Vamed has defined targets for 2023 and measured consumption data on a quarterly basis. In case of deviations from the target path, measures will be enforced in the future. In 2022, a first trial run was conducted. The data collection, validation, and release processes as well as the documentation requirements have been defined and are evaluated in audits. There were no environmental incidents at our health facilities in Europe in the reporting year.