Document and Entity Information
Document and Entity Information | 3 Months Ended |
Mar. 31, 2024 | |
Document and Entity Information | |
Document Type | 6-K |
Entity Registrant Name | FRESENIUS MEDICAL CARE AG |
Entity Central Index Key | 0001333141 |
Document Period End Date | Mar. 31, 2024 |
Amendment Flag | false |
Current Fiscal Year End Date | --12-31 |
Document Fiscal Year Focus | 2024 |
Document Fiscal Period Focus | Q1 |
Consolidated statements of inco
Consolidated statements of income - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Revenue: | ||
Health care services | € 3,748,264 | € 3,712,731 |
Health care products | 976,258 | 991,487 |
Revenue | 4,724,522 | 4,704,218 |
Costs of revenue: | ||
Health care services | 3,027,456 | 3,022,039 |
Health care products | 523,415 | 533,037 |
Costs of revenue | 3,550,871 | 3,555,076 |
Operating (income) expenses: | ||
Selling, general and administrative | 775,644 | 782,154 |
Research and development | 47,801 | 55,760 |
Income from equity method investees | (28,843) | (27,514) |
Other operating income | (113,499) | (117,471) |
Other operating expense | 246,535 | 195,276 |
Operating income | 246,013 | 260,937 |
Other (income) expense: | ||
Interest income | (15,663) | (12,081) |
Interest expense | 103,850 | 94,653 |
Income before income taxes | 157,826 | 178,365 |
Income tax expense | 39,511 | 44,512 |
Net income | 118,315 | 133,853 |
Net income attributable to noncontrolling interests | 47,356 | 47,491 |
Net income attributable to shareholders of FME AG | € 70,959 | € 86,362 |
Basic earnings per share | € 0.24 | € 0.29 |
Diluted earnings per share | € 0.24 | € 0.29 |
Consolidated statements of comp
Consolidated statements of comprehensive income - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Consolidated statements of comprehensive income | ||
Net income | € 118,315 | € 133,853 |
Components that will not be reclassified to profit or loss: | ||
FVOCI equity investments | (4,273) | |
Actuarial gain (loss) on defined benefit pension plans | 23,204 | (362) |
Income tax (expense) benefit related to components of other comprehensive income not reclassified | (6,581) | 94 |
Total | 12,350 | (268) |
Components that may be reclassified subsequently to profit or loss: | ||
Gain (loss) related to foreign currency translation | 192,328 | (326,841) |
FVOCI debt securities | (1,685) | 7,989 |
Gain (loss) related to cash flow hedges | (3,840) | 598 |
Cost of hedging | 1,579 | 707 |
Income tax (expense) benefit related to components of other comprehensive income that may be reclassified | 1,014 | (1,775) |
Total | 189,396 | (319,322) |
Other comprehensive income (loss), net of tax | 201,746 | (319,590) |
Total comprehensive income (loss) | 320,061 | (185,737) |
Comprehensive income attributable to noncontrolling interests | 72,706 | 21,453 |
Comprehensive income (loss) attributable to shareholders of FME AG | € 247,355 | € (207,190) |
Consolidated balance sheets
Consolidated balance sheets - EUR (€) € in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Assets | ||
Cash and cash equivalents | € 1,148,261 | € 1,403,492 |
Trade accounts and other receivables from unrelated parties | 3,999,789 | 3,471,213 |
Accounts receivable from related parties | 50,247 | 165,299 |
Inventories | 2,216,401 | 2,179,175 |
Other current assets | 721,097 | 730,460 |
Other current financial assets | 250,354 | 244,172 |
Assets held for sale | 896,531 | 507,600 |
Total current assets | 9,282,680 | 8,701,411 |
Property, plant and equipment | 3,672,917 | 3,782,780 |
Right-of-use assets | 3,633,509 | 3,671,241 |
Intangible assets | 1,360,259 | 1,362,327 |
Goodwill | 14,675,530 | 14,650,008 |
Deferred taxes | 268,336 | 283,953 |
Investment in equity method investees | 615,755 | 642,928 |
Other non-current assets | 137,806 | 223,576 |
Other non-current financial assets | 689,307 | 611,584 |
Total non-current assets | 25,053,419 | 25,228,397 |
Total assets | 34,336,099 | 33,929,808 |
Liabilities | ||
Accounts payable to unrelated parties | 725,178 | 762,068 |
Accounts payable to related parties | 110,235 | 123,081 |
Current provisions and other current liabilities | 1,661,690 | 1,617,434 |
Other current financial liabilities | 1,689,179 | 1,675,556 |
Short-term debt from unrelated parties | 109,137 | 456,904 |
Current portion of long-term debt | 795,734 | 487,699 |
Current portion of lease liabilities from unrelated parties | 591,609 | 593,033 |
Current portion of lease liabilities from related parties | 24,813 | 23,926 |
Income tax liabilities | 225,695 | 191,265 |
Liabilities directly associated with assets held for sale | 270,331 | 180,624 |
Total current liabilities | 6,203,601 | 6,111,590 |
Long-term debt, less current portion | 7,016,649 | 6,959,863 |
Lease liabilities from unrelated parties, less current portion | 3,385,999 | 3,419,338 |
Lease liabilities from related parties, less current portion | 106,725 | 109,649 |
Non-current provisions and other non-current liabilities | 372,936 | 332,813 |
Other non-current financial liabilities | 714,332 | 715,660 |
Pension liabilities | 647,995 | 664,327 |
Income tax liabilities | 44,508 | 39,747 |
Deferred taxes | 711,027 | 750,286 |
Total non-current liabilities | 13,000,171 | 12,991,683 |
Total liabilities | 19,203,772 | 19,103,273 |
Shareholders' equity: | ||
Ordinary shares, no par value, €1.00 nominal value, 362,370,124 shares authorized, 293,413,449 issued and outstanding as of March 31, 2024 (December 31, 2023: 293,413,449) | 293,413 | 293,413 |
Additional paid-in capital | 3,385,588 | 3,380,331 |
Retained earnings | 11,027,128 | 10,921,686 |
Accumulated other comprehensive income (loss) | (798,773) | (975,169) |
Total FME AG shareholders' equity | 13,907,356 | 13,620,261 |
Noncontrolling interests | 1,224,971 | 1,206,274 |
Total equity | 15,132,327 | 14,826,535 |
Total liabilities and equity | € 34,336,099 | € 33,929,808 |
Consolidated balance sheets (Pa
Consolidated balance sheets (Parenthetical) - € / shares | Mar. 31, 2024 | Dec. 31, 2023 |
Consolidated balance sheets | ||
Nominal value per share | € 1 | € 1 |
Shares authorized | 362,370,124 | 362,370,124 |
Shares issued | 293,413,449 | 293,413,449 |
Shares outstanding | 293,413,449 | 293,413,449 |
Consolidated statements of cash
Consolidated statements of cash flows - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Operating activities | ||
Net income | € 118,315 | € 133,853 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation, amortization and impairment loss | 512,443 | 437,814 |
Change in deferred taxes, net | (44,365) | (22,373) |
(Gain) loss from the sale of fixed assets, right-of-use assets, investments and divestitures | (11,367) | (25,900) |
Income from equity method investees | (28,843) | (27,514) |
Interest expense, net | 88,188 | 82,571 |
Changes in assets and liabilities, net of amounts from businesses acquired: | ||
Trade accounts and other receivables from unrelated parties | (669,126) | (406,332) |
Inventories | (40,995) | (88,394) |
Other current and non-current assets | (17,927) | (8,147) |
Accounts receivable from related parties | 116,405 | 49,484 |
Accounts payable to related parties | (14,296) | (25,224) |
Accounts payable to unrelated parties, provisions and other current and non-current liabilities | 140,895 | 61,349 |
Income tax liabilities | 64,213 | 79,590 |
Received dividends from investments in equity method investees | 1,472 | 1,033 |
Paid interest | (83,423) | (77,255) |
Received interest | 15,547 | 11,855 |
Paid income taxes | (19,828) | (33,575) |
Net cash provided by (used in) operating activities | 127,308 | 142,835 |
Investing activities | ||
Purchases of property, plant and equipment and capitalized development costs | (133,900) | (142,131) |
Acquisitions, net of cash acquired, investments and purchases of intangible assets | 892 | (4,195) |
Investments in debt securities | (188) | (45,886) |
Proceeds from sale of property, plant and equipment | 4,406 | 1,638 |
Proceeds from divestitures | 39,687 | 12,267 |
Proceeds from sale of debt securities | 20,736 | 15,030 |
Net cash provided by (used in) investing activities | (68,367) | (163,277) |
Financing activities | ||
Proceeds from short-term debt from unrelated parties | 11,505 | 93,346 |
Repayments of short-term debt from unrelated parties | (356,359) | (57,584) |
Proceeds from short-term debt from related parties | 10,204 | |
Repayments of short-term debt from related parties | (1,000) | |
Proceeds from long-term debt | 9,288 | 6,472 |
Repayments of long-term debt | (16,445) | (14,193) |
Repayments of lease liabilities from unrelated parties | (155,928) | (179,670) |
Repayments of lease liabilities from related parties | (6,197) | (6,413) |
Increase (decrease) of accounts receivable facility | 276,297 | 232,989 |
Distributions to noncontrolling interests | (56,948) | (83,469) |
Contributions from noncontrolling interests | 5,130 | 1,332 |
Net cash provided by (used in) financing activities | (289,657) | 2,014 |
Effect of exchange rate changes on cash and cash equivalents | (4,514) | (31,469) |
Cash and cash equivalents: | ||
Net increase (decrease) in cash and cash equivalents | (235,230) | (49,897) |
Cash and cash equivalents at beginning of period | 1,427,225 | 1,273,787 |
Cash and cash equivalents at end of period | 1,191,995 | € 1,223,890 |
Thereof: cash and cash equivalents within the disposal groups | € 43,734 |
Consolidated statements of shar
Consolidated statements of shareholders' equity - EUR (€) € in Thousands | Total FME AG shareholders' equity | Ordinary shares | Additional paid in capital | Retained earnings | Foreign currency translation | Cash flow hedges | Pensions | Fair value changes | Noncontrolling interests | Total |
Balance at beginning of period at Dec. 31, 2022 | € 13,989,453 | € 293,413 | € 3,372,799 | € 10,711,709 | € (207,210) | € (627) | € (155,526) | € (25,105) | € 1,459,726 | € 15,449,179 |
Balance at beginning of period (in shares) at Dec. 31, 2022 | 293,413,449 | |||||||||
Transactions with noncontrolling interests without loss of control | (7,709) | (7,709) | (17,317) | (25,026) | ||||||
Noncontrolling interests due to changes in consolidation group | (12,857) | (12,857) | ||||||||
Contributions from/ to noncontrolling interests | (51,978) | (51,978) | ||||||||
Put option liabilities | 53,349 | 53,349 | 53,349 | |||||||
Net income | 86,362 | 86,362 | 47,491 | 133,853 | ||||||
Other comprehensive income (loss) related to: | ||||||||||
Foreign currency translation | (300,803) | (303,972) | 7 | 2,864 | 298 | (26,038) | (326,841) | |||
Cash flow hedges, net of related tax effects | 1,002 | 1,002 | 1,002 | |||||||
Pensions, net of related tax effects | (268) | (268) | (268) | |||||||
Fair value changes, net of related tax effects | 6,517 | 6,517 | 6,517 | |||||||
Comprehensive income | (207,190) | 21,453 | (185,737) | |||||||
Balance at end of period at Mar. 31, 2023 | 13,827,903 | € 293,413 | 3,365,090 | 10,851,420 | (511,182) | 382 | (152,930) | (18,290) | 1,399,027 | 15,226,930 |
Balance at end of period (in shares) at Mar. 31, 2023 | 293,413,449 | |||||||||
Balance at beginning of period at Dec. 31, 2023 | 13,620,261 | € 293,413 | 3,380,331 | 10,921,686 | (765,581) | (4,585) | (192,490) | (12,513) | 1,206,274 | € 14,826,535 |
Balance at beginning of period (in shares) at Dec. 31, 2023 | 293,413,449 | 293,413,449 | ||||||||
Transactions with noncontrolling interests without loss of control | 5,257 | 5,257 | 386 | € 5,643 | ||||||
Contributions from/ to noncontrolling interests | (54,395) | (54,395) | ||||||||
Put option liabilities | 34,483 | 34,483 | 34,483 | |||||||
Net income | 70,959 | 70,959 | 47,356 | 118,315 | ||||||
Other comprehensive income (loss) related to: | ||||||||||
Foreign currency translation | 166,978 | 223,357 | (94) | (3,047) | (53,238) | 25,350 | 192,328 | |||
Cash flow hedges, net of related tax effects | (1,740) | (1,740) | (1,740) | |||||||
Pensions, net of related tax effects | 16,623 | 16,623 | 16,623 | |||||||
Fair value changes, net of related tax effects | (5,465) | (5,465) | (5,465) | |||||||
Comprehensive income | 247,355 | 72,706 | 320,061 | |||||||
Balance at end of period at Mar. 31, 2024 | € 13,907,356 | € 293,413 | € 3,385,588 | € 11,027,128 | € (542,224) | € (6,419) | € (178,914) | € (71,216) | € 1,224,971 | € 15,132,327 |
Balance at end of period (in shares) at Mar. 31, 2024 | 293,413,449 | 293,413,449 |
The Company and basis of presen
The Company and basis of presentation | 3 Months Ended |
Mar. 31, 2024 | |
The Company and basis of presentation | |
The Company and basis of presentation | 1. The Company and basis of presentation The Company Fresenius Medical Care AG (FME AG or the Company) is a German stock corporation ( Aktiengesellschaft — AG In these unaudited notes, “FME AG,” the “Company” or the “Group” refers to Fresenius Medical Care AG or Fresenius Medical Care AG and its subsidiaries on a consolidated basis, as the context requires. “Fresenius SE” and “Fresenius SE & Co. KGaA” refer to Fresenius SE & Co. KGaA. “Management Board” refers to the members of the management board of the Company and “Supervisory Board” refers to the supervisory board of the Company. The term “Care Enablement” refers to the Company’s Care Enablement operating segment and the term “Care Delivery” refers to the Care Delivery operating segment. For further discussion of the Company’s operating and reportable segments, see note 12. At an extraordinary general meeting (EGM) of the Company held on July 14, 2023, the shareholders of the Company approved a proposal to change of the legal form of the Company from a partnership limited by shares ( Kommanditgesellschaft auf Aktien – KGaA Basis of presentation The consolidated financial statements and other financial information included in the Company’s quarterly reports furnished under cover of Form 6-K and its Annual Report on Form 20-F are prepared solely in accordance with International Financial Reporting Standards (IFRS) as issued by the International Accounting Standards Board (IASB), the “IFRS® Accounting Standards”, using the euro as the Company’s reporting and functional currency. The interim financial report is prepared in accordance with International Accounting Standard (IAS) 34, Interim Financial Reporting, and contains condensed financial statements, in that it includes selected explanatory notes rather than all of the notes that would be required in a complete set of financial statements. However, the primary financial statements are presented in the format consistent with the consolidated financial statements as presented in the Company’s Annual Report on Form 20-F for the year ended December 31, 2023 (the 2023 Form 20-F) in accordance with IAS 1, Presentation of Financial Statements. The interim consolidated financial statements at March 31, 2024 and for the three months ended March 31, 2024 and 2023 contained in this report are unaudited and should be read in conjunction with the consolidated financial statements contained in the Company’s 2023 Form 20-F. The preparation of interim consolidated financial statements in conformity with IFRS Accounting Standards requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Such interim financial statements reflect all adjustments that, in the opinion of management, are necessary to provide a fair statement of the results of the periods presented. All such adjustments are of a normal recurring nature. On February 21, 2024, one of the Company’s third-party service providers was subject to a cyber-attack leading to the shutdown of its systems. As this third party provides the Company with a range of financial clearinghouse services, the cyber-attack on its systems led to certain impacts in the Company’s consolidated financial statements as the Company was unable to apply cash received to its accounts receivable balances or raise claims with certain payors during the three months ended March 31, 2024. As a result, cash received, but not yet applied directly to customer accounts receivable in the amount of $240,505 (€222,463) was recorded as a contra-accounts receivable balance. Additionally, trade accounts and other receivables from unrelated parties increased by approximately $294,677 (€272,571) due to the aforementioned inability to raise claims. As this cyber-attack was pervasive within the health care industry, the U.S. Centers for Medicare & Medicaid Services (CMS) made certain advance payments to providers and suppliers experiencing claims disruptions related to the incident. The Company received $175,214 (€162,070) in advance payments which are recorded as contract liabilities within the line item “Current provisions and other current liabilities.” Additionally, the third-party service provider agreed to provide an interest-free advance payment of $56,907 (€52,638) to the Company which is required to be repaid shortly after payment processing recommenced. Accordingly, this payment is recorded as “Other current financial liabilities” on the consolidated balance sheet as of March 31, 2024. As a result of the increases in trade accounts receivable and the liabilities noted above, the incident resulted in a decrease in cash and cash equivalents of $62,841 (€58,127) as of March 31, 2024. As noted in the Company’s 2023 Form 20-F within note 2 of the notes to the consolidated financial statements, significant judgments and sources of estimation are applied, particularly in relation to revenue recognition, trade accounts and other receivables from unrelated parties and expected credit losses. The Company updated inputs used to estimate explicit and implicit price concessions as of March 31, 2024. Changes to inputs related to the Company’s increases in cash received, but not yet applied directly to customer accounts receivable as well as accounts receivable aged three months or less resulting from the third-party clearinghouse service outage are based on the best information available to the Company and did not result in a material change in the Company’s estimate of explicit and implicit price concessions. In the case of the third-party service provider noted above, the Company has engaged alternative options for clearinghouses in the short-term. The Company applies IAS 29, Financial Reporting in Hyperinflationary Economies (IAS 29), in its Lebanese and Turkish subsidiaries due to inflation in these countries. The table below details the date of initial application of IAS 29 and the specific inputs used to calculate the gain or loss on net monetary position on a country-specific basis for the three months ended March 31, 2024. The ongoing re-translation effects of hyperinflationary accounting and its impact on comparative amounts are recorded in other comprehensive income (loss) within the Company’s interim consolidated financial statements. The subsequent gains or losses on net monetary position are recorded in other operating income and other operating expense, respectively, within the Company’s consolidated statements of income and within other current and non-current assets within the Company’s consolidated statements of cash flows. Inputs for the calculation of (gains) losses on net monetary positions Lebanon Turkiye Date of IAS 29 initial application December 31, 2020 June 30, 2022 Consumer price index Central Administration of Statistics Turkish Statistical Institute Index at March 31, 2024 6,321.2 2,137.5 Calendar year increase 6 % 15 % (Gain) loss on net monetary position in € THOUS 2 882 The effective tax rate of 25.0% for the three months ended March 31, 2024, respectively (25.0% for the three months ended March 31, 2023), is recognized on the basis of the best estimate made for the weighted average annual income tax rate expected for the full year and applied to income before income taxes reported in the interim financial statements. Due to the size of the Company’s revenue, it is within the scope of the Organisation for Economic Co-operation and Development’s Inclusive Framework on Base Erosion Profit Shifting (BEPS) Global Anti-Base Erosion Model Rules (GloBE): Global Minimum Taxation (Pillar Two) legislation. The legislation was enacted in Germany on December 15, 2023, the jurisdiction in which the Company resides, and became effective on January 1, 2024. The Company applies the exception not to recognize or disclose deferred taxes in connection with Pillar Two income taxes. Income tax expenses related to Pillar Two income taxes are included within the income tax expense line item in the Company’s consolidated statements of profit or loss. The results of operations for the three months ended March 31, 2024 are not necessarily indicative of the results of operations for the year ending December 31, 2024. Goodwill as of March 31, 2024 was €14,675,530 (December 31, 2023: €14,650,008), thereof €12,571,036 (December 31, 2023: €12,573,423) in Care Delivery and €2,104,494 (December 31, 2023: €2,076,585) in Care Enablement. In the first three months of 2024, the market capitalization of the Company decreased by 6% to €10,460,189 at March 31, 2024 (December 31, 2023: €11,137,975) and remains below total FME AG shareholders’ equity, which increased by 2% to €13,907,356 as of March 31, 2024 from €13,620,261 as of December 31, 2023. Due to the carrying amount of net assets exceeding the Company’s market capitalization, a continued higher level of interest rates and ongoing uncertainties in the macroeconomic environment, the Company reviewed the impacts on the impairment test, which was performed as of December 31, 2023. Additionally, in 2023, a study on glucagon-like peptide 1 (GLP-1) receptor agonists, regarding its effectiveness in treating CKD experienced by diabetic patients was terminated early as a result of the study having met certain prespecified clinical endpoints. Although there is only limited available information currently, including high-level data published in 2024, the ability to delay CKD or ESRD progression and cardiovascular mortality improvements as a result of the use of these and other pharmaceuticals or treatment modalities could have an impact on our patient population in the future and was included as a consideration for our goodwill impairment test review. During the first quarter of 2024, the Company compared the carrying amounts of its group of CGUs, Care Delivery and Care Enablement, to the respective group of CGU’s value in use, using the free cash flows of the group of CGUs considered in the impairment test as of December 31, 2023, and updated its free cash flow projections using the results of the latest available assessments. Cash flow projections were updated to reflect the impacts of divestitures and the classification of certain entities as held for sale during the first quarter as disclosed in note 2 as well as the status of current initiatives, without considering any growth and improvement from initiatives related to the transformation of the Company’s operating structure and steps to achieve cost savings (FME25 Program) which have not yet commenced as of March 31, 2024. The following table shows the key assumptions of value-in-use calculations, which are presented based upon the goodwill impairment tests performed as of March 31, 2024 and December 31, 2023. Key assumptions in % Care Delivery Care Enablement March 31, 2024 December 31, 2023 March 31, 2024 December 31, 2023 Average revenue growth in ten year projection period mid-single-digit mid-single-digit mid-single-digit mid-single-digit Average operating income growth in ten year projection period high-single-digit high-single-digit low-double-digit low-double-digit Residual value growth 1.00 1.00 1.00 1.00 Pre-tax WACC 10.78 10.53 9.07 8.41 After-tax WACC 8.32 8.09 7.34 6.54 For a detailed description of the impairment test procedure, see notes 1 g) and 2 a) of the consolidated financial statements contained in the 2023 Form 20-F. As of March 31, 2024, the impairment test procedure was performed on our operating segments (Care Delivery and Care Enablement). The assessment did not result in any indication of impairment as of March 31, 2024. Management continues to monitor the situation. As of March 31, 2024, the recoverable amount of the Care Delivery group of CGUs exceeded the carrying amount by €4,918,691 (December 31, 2023: €4,740,257). For the Care Enablement group of CGUs, the recoverable amount exceeded the carrying amount by €3,454,949 (December 31, 2023: €3,285,391). The following table shows the reasonable amounts by which the key assumptions would need to change individually that the recoverable amount equals the carrying amount: Sensitivity analysis (1) Change in percentage points Care Delivery Care Enablement March 31, December 31, March 31, December 2024 2023 2024 31, 2023 Pre-tax WACC 2.17 2.10 2.28 2.27 After-tax WACC 1.64 1.60 1.69 1.66 Residual value growth (7.49) (7.26) (5.42) (5.57) Operating income margin of each projection year (2.47) (2.35) (3.03) (3.02) (1) The sensitivity analysis is based upon the goodwill impairment tests performed as of March 31, 2024 and December 31, 2023. On May 7, 2024, the Management Board authorized the issuance of the Company’s interim consolidated financial statements (unaudited). New accounting pronouncements Recently implemented accounting pronouncements The Company has prepared its interim consolidated financial statements at and for the three months ended March 31, 2024 in conformity with IFRS Accounting Standards that have to be applied for the interim periods starting on or after January 1, 2024. In the three months ended March 31, 2024, there were no recently implemented accounting pronouncements that materially affect the business. Recent accounting pronouncements not yet adopted The IASB issued the following new standard which is relevant for the Company: IFRS 18, Presentation and Disclosure in Financial Statements On April 9, 2024, the IASB issued IFRS 18, Presentation and Disclosure in Financial Statements (IFRS 18). IFRS 18 aims to improve how information is communicated in financial statements to give investors a more comparable basis to analyze companies’ performance. The standard introduces three sets of new requirements: new categories and subtotals in the consolidated statements of income, disclosure regarding management-defined performance measures and guidance related to the aggregation and disaggregation of certain information. The consolidated statements of income will be split into three newly defined categories (operating, investing and financing) and will include two newly defined subtotals (operating profit and profit before financing and income taxes). Management-defined performance measures are subtotals of income and expense used in public communication outside the financial statements and communicate management’s view of certain aspects of a company’s performance. Such measures are required to be described in a clear and understandable manner in a single note explaining how the measure is calculated, why it is useful, providing a reconciliation to the most directly comparable subtotal noted above, the income tax and non-controlling interest effect on each item and how the income tax effect was determined. Lastly, companies must disaggregate items if such information is material and avoid using the label “other” in financial statements. Certain additional details for depreciation and amortization, impairment and other expense classifications may be required. IFRS 18 is effective for fiscal periods commencing on or after January 1, 2027. Earlier adoption is permitted. The standard is expected to impact the Company’s presentation of items within the consolidated financial statements and its notes disclosures once implemented, though the standard is not expected to change how the Company recognizes or measures items in its consolidated financial statements. In the Company’s view, no other pronouncements issued by the IASB are expected to have a material impact on the consolidated financial statements. |
Disposal groups classified as h
Disposal groups classified as held for sale | 3 Months Ended |
Mar. 31, 2024 | |
Disposal groups classified as held for sale | |
Disposal groups classified as held for sale | 2. Disposal groups classified as held for sale As of March 31, 2024, the Company’s management committed to a plan to sell the following in connection with its Legacy Portfolio Optimization program (as defined below). Each business listed below is currently included in the Company’s Care Delivery segment: ● the Company signed an agreement to sell 46 of its renal dialysis clinics in Sub-Saharan Africa to a South African hospital group, which were divested on April 1, 2024; ● the Company signed an agreement to sell its Cura Day Hospitals Group (Cura) in Australia to a global alternative asset manager and a consortium of health care professionals, which was divested on April 30, 2024; and ● the Company committed to sell its renal dialysis clinic facilities and/or networks in Guatemala, Curacao, Peru, Turkiye, Brazil, Colombia and Ecuador. On April 5, 2024, the Company divested its service business in Turkiye. Transactions which remain open as of the date of this report are subject to regulatory approvals or certain other closing conditions, but are expected to be completed within a year from the date of classification as assets held for sale. Immediately before the classification of these disposals as held for sale, an impairment loss was recognized for the agreed-upon divestitures and is included in other operating expenses in the consolidated statements of income (see note 3 for further details). The carrying amounts of the assets in the disposal group for the proposed divestiture of facilities in Guatemala, Curacao, Peru, Turkiye (prior to its divestiture on April 5, 2024, as noted above), Brazil, Colombia and Ecuador are recognized at their fair value less costs to sell. The portion of the non-recurring fair value measurement attributable to the Company and its shareholders of €237,590 for this transaction is categorized as level 3 of the fair value hierarchy using the preliminary purchase price. The divestitures of the Company’s clinic network in Sub-Saharan Africa and Cura did not result in an impairment loss and the assets are recorded at their carrying amount. As of March 31, 2024 and December 31, 2023, the following assets and liabilities were classified as held for sale: Assets and liabilities of disposal groups classified as held for sale in € THOUS March 31, 2024 December 31, 2023 Cash and cash equivalents 43,734 23,733 Trade accounts and other receivables from unrelated parties 194,876 27,535 Property, plant and equipment 80,768 42,710 Right-of-use assets 124,776 114,602 Goodwill (1) 396,976 274,543 Other 55,401 24,477 Assets held for sale 896,531 507,600 Accounts payable to unrelated parties 22,620 12,880 Lease liabilities 153,313 128,653 Provisions and other liabilities 94,398 39,091 Liability directly associated with assets held for sale 270,331 180,624 (1) As of March 31, 2024, the accumulated foreign currency translation losses recognized in other comprehensive income related to the disposal groups amounted to €150,518. |
Notes to the consolidated state
Notes to the consolidated statements of income | 3 Months Ended |
Mar. 31, 2024 | |
Notes to the consolidated statements of income | |
Notes to the consolidated statements of income | 3 . Notes to the consolidated statements of income a) Revenue The Company has adjusted the prior year financial information below in order to include additional contracts identified during the course of the year ended December 31, 2023 which were subject to certain disclosures in accordance with IFRS 17. The Company has recognized the following revenue in the consolidated statements of income for the three months ended March 31, 2024 and 2023: Revenue in € THOUS Revenue from Revenue from contracts with insurance Revenue from customers contracts lease contracts Total For the three months ended March 31, 2024 Health care services 3,365,334 382,930 — 3,748,264 Health care products 954,084 — 22,174 976,258 Total 4,319,418 382,930 22,174 4,724,522 For the three months ended March 31, 2023 Revenue from Revenue from contracts with insurance Revenue from customers contracts lease contracts Total Health care services 3,465,868 246,863 — 3,712,731 Health care products 976,569 — 14,918 991,487 Total 4,442,437 246,863 14,918 4,704,218 The following table contains a disaggregation of revenue by categories for the three months ended March 31, 2024 and 2023: Disaggregation of revenue by categories in € THOUS For the three months ended March 31, 2024 2023 Care Delivery US 3,101,758 3,002,715 International 686,396 752,832 Total (1) 3,788,154 3,755,547 Care Enablement Total (including inter-segment revenues) (1) 1,297,058 1,310,529 Inter-segment eliminations (360,690) (361,858) Total Care Enablement revenue external customers 936,368 948,671 Total 4,724,522 4,704,218 (1) For further information on segment revenues, see note 12. b) Selling, general and administrative expense Selling, general and administrative expense recorded in the consolidated statements of income comprises both distribution costs as well as general and administrative expense. Distribution costs are generated in the selling, marketing and warehousing functions of the Company which are not attributable to production or research and development (R&D). General and administrative expense is generated in the administrative function of the Company’s business and is not attributable to selling, production or R&D. The following table discloses the distribution costs as well as general and administrative expense recorded by the Company for the three month period March 31, 2024 and 2023: Selling, general and administrative expense in € THOUS For the three months ended March 31, 2024 2023 Distribution costs 190,562 203,278 General and administrative expense 585,082 578,876 Selling, general and administrative expense 775,644 782,154 c) Research and development expenses Research and development expenses of €47,801 for the three months ended March 31, 2024 (for the three months ended March 31, 2023: €55,760) included research and non-capitalizable development costs. d) Other operating income and expense The following table contains reconciliations of the amounts included in other operating income and expense for the three months ended March 31, 2024 and 2023: Other operating income in € THOUS For the three months ended March 31, 2024 2023 Foreign exchange gains 61,676 72,140 Gains on right-of-use assets, from the sale of fixed assets, clinics and investments 3,144 13,625 Revaluation of certain investments 15,197 19,286 Income from strategic transactions and programs 3,106 — Other 30,376 12,420 Other operating income 113,499 117,471 Other operating expense in € THOUS For the three months ended March 31, 2024 2023 Foreign exchange losses 70,415 84,403 Losses on right-of-use assets, from the sale of fixed assets, clinics and investments 2,064 10,539 Expenses from strategic transactions and programs 154,955 83,439 Other 19,101 16,895 Other operating expense 246,535 195,276 Included within the “expenses from strategic transactions and programs” line item in other operating expense are the proposed divestitures (including associated impairment losses) of certain businesses in connection with strategic programs such as Legacy Portfolio Optimization, defined below, and the FME25 Program. For further information on the proposed divestitures and associated impairment losses, see note 2. Consistent with the Company’s policy to present impairment losses within other operating expense, such costs related to cost of revenues, selling, general and administrative expense or research and development expenses are included within other operating expense. “Expenses from strategic transactions and programs” primarily consist of: ● strategic divestiture program expenses identified during the review of our business portfolio, mainly due to exiting unsustainable markets and non-core businesses, as well as the cessation of certain research and development programs to enable more focused capital allocation towards areas in our core business that are expected to have higher profitable growth, which included the proposed divestitures identified in note 2, above, the cessation of a dialysis cycler development program and the divestiture of the Company’s service business in Chile which occurred during the first quarter of 2024 (Legacy Portfolio Optimization); ● certain impairment losses in connection with the FME25 Program; and ● certain costs associated with the Conversion, primarily related to the requisite relabeling of its products, transaction costs (such as costs for external advisors and conducting an extraordinary general meeting) and costs related to the establishment of dedicated administrative functions required to manage certain services which have historically been administered at the Fresenius SE group level and paid by the Company through corporate charges (Legal Form Conversion Costs). Expenses from strategic transactions and programs comprised the following for the three months ended March 31, 2024 and 2023: Expenses from strategic transactions and programs in € THOUS For the three months ended March 31, 2024 2023 Derecognition of capitalized development costs and termination costs (1) — 59,113 Legacy Portfolio Optimization — 59,113 Impairment of intangible and tangible assets (2) 1,047 24,326 Legacy Portfolio Optimization — 24,326 FME25 Program 1,047 — Impairment resulting from the measurement of assets held for sale 123,552 — Legacy Portfolio Optimization 123,552 — Loss from the sale of business 24,988 — Legacy Portfolio Optimization 24,988 — Other (3) 5,368 — Legacy Portfolio Optimization 4,152 — Legal Form Conversion Costs 1,216 — Expenses from strategic transactions and programs 154,955 83,439 (1) Primarily R&D expense. (2) For the three months ended March 31, 2024 and 2023, the amounts relate primarily to cost of revenues and R&D expense, respectively. (3) Primarily selling, general and administrative expense. For more information on the disposal groups classified as held for sale, see note 2. e) Earnings per share The following table contains reconciliations of the numerators and denominators of the basic and diluted earnings per share computations for the three months ended March 31, 2024 and 2023: Reconciliation of basic and diluted earnings per share in € THOUS, except share and per share data For the three months ended March 31, 2024 2023 Numerator: Net income attributable to shareholders of FME AG 70,959 86,362 Denominators: Weighted average number of shares outstanding 293,413,449 293,413,449 Potentially dilutive shares — — Basic earnings per share 0.24 0.29 Diluted earnings per share 0.24 0.29 |
Related party transactions
Related party transactions | 3 Months Ended |
Mar. 31, 2024 | |
Related party transactions | |
Related party transactions | 4. Related party transactions Fresenius SE is the Company’s largest shareholder and owns 32.2% of the Company’s outstanding shares at March 31, 2024. The Else Kröner-Fresenius-Stiftung is the sole shareholder of Fresenius Management SE, the general partner of Fresenius SE, and has sole power to elect the supervisory board of Fresenius Management SE. The Company has entered into certain arrangements for services and products with Fresenius SE or its subsidiaries and with certain of the Company’s equity method investees as described in item a) below. The arrangements for leases with Fresenius SE or its subsidiaries are described in item b) below. The Company’s terms related to the receivables or payables for these services, leases and products are generally consistent with the normal terms of the Company’s ordinary course of business transactions with unrelated parties and the Company believes that these arrangements reflect fair market terms. The Company utilizes various methods to verify the commercial reasonableness of its related party arrangements. Financing arrangements with certain equity-method investees as described in item c) below have agreed-upon terms which are determined at the time such financing transactions occur and reflect market rates at the time of the transaction. The relationship between the Company and its key management personnel who are considered to be related parties is described in item d) below. a) Service agreements and products Prior to the Conversion, the Company was party to service agreements with Fresenius SE and certain of its affiliates (collectively, Fresenius SE Companies) to receive services, including, but not limited to: administrative services, management information services, employee benefit administration, insurance, information technology services, tax services and treasury management services. These related party agreements generally had a duration of 1 In connection with and subsequent to the Conversion, the Company entered into transition service agreements with Fresenius SE Companies to receive services, including, but not limited to: administrative and facility management services, employee benefit administration, insurance brokerage, information technology, intellectual property and certain treasury services. These related party agreements have generally been entered into for transitional periods of several months up to 2 years (in some cases with extension options). Additionally, the Company also entered into various service agreements with Fresenius SE Companies to provide services, including, but not limited to, fixed asset accounting services and IT and communications-related services for up to a year The Company provides administrative services to one of its equity method investees. The Company also sells products to Fresenius SE Companies and purchases products from Fresenius SE Companies and equity method investees. In connection with, and subsequent to, the Conversion, the Company entered into a limited amount of shared procurement contracts with Fresenius SE Companies for the purchase of products from third parties. In December 2010, the Company and Galenica Ltd. (now known as CSL Vifor) formed the renal pharmaceutical company Vifor Fresenius Medical Care Renal Pharma Ltd., an equity method investee of which the Company owns 45%. The Company has entered into exclusive supply agreements to purchase certain pharmaceuticals from, as well as into certain exclusive distribution agreements with, Vifor Fresenius Medical Care Renal Pharma Ltd. Below is a summary, including the Company’s receivables from and payables to the indicated parties, resulting from the above-described transactions with related parties. Service agreements and products with related parties in € THOUS For the three months ended For the three months ended March 31, 2024 March 31, 2023 March 31, 2024 December 31, 2023 Sales of Purchases of Sales of Purchases of goods and goods and goods and goods and Accounts Accounts Accounts Accounts services services services services receivable payable receivable payable Service agreements (1) Fresenius SE — 5,289 35 8,067 1,472 395 10 1,778 Fresenius SE affiliates 155 23,616 1,942 14,558 2,512 8,514 589 14,299 Equity method investees (2) 1,209 — 1,078 — 28,820 — 51,442 — Total 1,364 28,905 3,055 22,625 32,804 8,909 52,041 16,077 Products Fresenius SE affiliates (2) 18,772 6,643 18,335 6,492 17,443 5,474 23,535 9,585 Equity method investees (2) — 96,383 — 111,164 — 69,201 — 67,403 Total 18,772 103,026 18,335 117,656 17,443 74,675 23,535 76,988 (1) In addition to the above shown accounts payable, accrued expenses for service agreements with related parties amounted to € 15,754 and € 5,172 at March 31, 2024 and December 31, 2023, respectively. (2) Sales of services and purchases of goods related to equity method investees for the three months ended March 31, 2023 in the amount of €6,539 and €23,873 as well as purchases of goods related to Fresenius SE affiliates for the three months ended March 31, 2023 in the amount of ( €4,246 ) were adjusted to correct for an error in presentation. The adjustment does not have an impact on the Company’s consolidated statements in income for the periods presented. b) Lease agreements In addition to the above-mentioned product and service agreements, the Company is a party to real estate lease agreements with Fresenius SE Companies, which mainly include leases for the Company’s corporate headquarters in Bad Homburg, Germany, and production sites in Schweinfurt and St. Wendel, Germany. The leases have maturities up to the end of 2032. Below is a summary resulting from the above described lease agreements with related parties. Lease agreements with related parties in € THOUS For the three months ended March 31, 2024 For the three months ended March 31, 2023 March 31, 2024 December 31, 2023 Interest Lease Interest Lease Right-of-use Lease Right-of-use Lease Depreciation expense expense (1) Depreciation expense expense (1) asset liability asset liability Fresenius SE 1,630 215 223 2,088 255 230 28,212 31,148 29,214 29,017 Fresenius SE affiliates 4,603 376 — 4,452 430 — 100,780 100,390 102,029 104,558 Total 6,233 591 223 6,540 685 230 128,992 131,538 131,243 133,575 (1) Short-term leases and expenses relating to variable lease payments as well as low value leases are exempted from balance sheet recognition. c) Financing As of March 31, 2024 and December 31, 2023, the Company had outstanding accounts payable related to a cash pooling program with certain equity-method investees in the amount of €26,651 and €26,875, respectively. The interest rates for these cash management arrangements were set on a daily basis and were based on the then-prevailing overnight reference rate, with a floor of zero, for the respective currencies. d) Key management personnel Due to the Company’s previous legal form of a German partnership limited by shares until the effectiveness of the Conversion, Fresenius Medical Care Management AG (Management AG), the Company’s former general partner (General Partner), held a key management position within the Company. In addition, as key management personnel, members of the management board of Management AG and the Supervisory Board, as well as their close relatives, were considered related parties. Upon effectiveness of the Conversion, the General Partner exited the Company and is no longer entitled to reimbursement of the remuneration of its board members (other than outstanding amounts, if any, for service prior to the effective date of the Conversion as set forth below). The members of the Supervisory Board and the newly established Management Board, as key management personnel, as well as their close relatives, are considered related parties of the Company. Also upon effectiveness of the Conversion, the existing service agreements between the General Partner and the members of the management board of Management AG were transferred to FME AG. The long-term incentive plans of Management AG applying to the former members of the management board of Management AG established before the Conversion were accordingly adopted by the Supervisory Board of FME AG as compensation plans of the Company. For further information regarding the Conversion, see note 1. Prior to the Conversion, the Company’s Articles of Association provided that the General Partner shall be reimbursed for any and all expenses in connection with the management of the Company’s business, including remuneration of the members of the General Partner’s supervisory board and the members of the management board of Management AG. The aggregate amount reimbursed to the General Partner was €7,675 for its management services during the three months ended March 31, 2023. As of March 31, 2024, the Company did not have accounts receivable payable |
Insurance contracts
Insurance contracts | 3 Months Ended |
Mar. 31, 2024 | |
Insurance contracts | |
Insurance contracts | 5. Insurance contracts The following tables provide reconciliations of the Company’s portfolios of insurance and reinsurance contracts, showing the change in insurance and reinsurance contract receivables (liabilities) as of March 31, 2024 and December 31, 2023. These receivables are recognized in the consolidated balance sheet within trade accounts and other receivables from unrelated parties. Reinsurance contract receivables and liabilities in € THOUS 2024 2023 Present Risk Present Risk value of adjustment value of adjustment future cash for non- future for non- flows financial risk Total cash flows financial risk Total Reinsurance contract receivables (liabilities) at the beginning of the period 53,137 (931) 52,206 23,925 (1,801) 22,124 Incurred claims and other directly attributable expenses (169,404) 174 (169,230) (166,161) 825 (165,336) Changes that relate to past service – changes in the fulfillment cash-flows relating to LIC (1) (18,517) — (18,517) 1,544 — 1,544 Claims and other directly attributable expenses paid — — — (387,949) — (387,949) Premium revenue 179,913 — 179,913 583,269 — 583,269 Foreign currency translation and other changes 1,139 (20) 1,119 (1,491) 45 (1,446) Reinsurance contract receivables (liabilities) at the end of the period 46,268 (777) 45,491 53,137 (931) 52,206 (1) Changes that relate to past service include premium revenue for past performance years of € 568 and € 9,038 as of March 31, 2024 and December 31, 2023, respectively. Insurance contract receivables and liabilities in € THOUS 2024 2023 Present Risk Present Risk value of adjustment value of adjustment future cash for non- future for non- flows financial risk Total cash flows financial risk Total Insurance contract receivables (liabilities) at the beginning of the period 27,389 (553) 26,836 20,669 (254) 20,415 Incurred claims and other directly attributable expenses (193,179) 84 (193,095) (208,884) (314) (209,198) Changes that relate to past service – changes in the fulfillment cash-flows relating to LIC (1) (2,891) — (2,891) (2,666) — (2,666) Claims and other directly attributable expenses paid — — — (423,377) — (423,377) Premium revenue 205,750 — 205,750 642,529 — 642,529 Foreign currency translation and other changes 648 (12) 636 (882) 15 (867) Insurance contract receivables (liabilities) at the end of the period 37,717 (481) 37,236 27,389 (553) 26,836 (1) Changes that relate to past service include a reduction in premium revenue for past performance years of € 3,303 and € 7,696 as of March 31, 2024 and December 31, 2023, respectively. |
Inventories
Inventories | 3 Months Ended |
Mar. 31, 2024 | |
Inventories | |
Inventories | 6 . Inventories At March 31, 2024 and December 31, 2023, inventories consisted of the following: Inventories in € THOUS March 31, December 31, 2024 2023 Finished goods 1,260,470 1,232,702 Health care supplies 437,373 451,316 Raw materials and purchased components 369,815 361,804 Work in process 148,743 133,353 Inventories 2,216,401 2,179,175 |
Short-term debt
Short-term debt | 3 Months Ended |
Mar. 31, 2024 | |
Short-term debt | |
Short-term debt | 7 . Short-term debt At March 31, 2024 and December 31, 2023, short-term debt consisted of the following: Short-term debt in € THOUS March 31, December 31, 2024 2023 Commercial paper program 85,580 399,078 Borrowings under lines of credit 23,544 57,754 Other 13 72 Short-term debt 109,137 456,904 The Company and certain consolidated entities operate a multi-currency notional cash pooling management system. In this cash pooling management system, amounts in euro and other currencies are offset without being transferred to a specific cash pool account. The system is used for an efficient utilization of funds within the Company. The Company met the conditions to offset balances within this cash pool for reporting purposes. At March 31, 2024 and December 31, 2023, cash and borrowings under lines of credit in the amount of €116,956 and €126,836, respectively, were offset under this cash pooling management system. Before this offset, cash and cash equivalents as of March 31, 2024 was €1,265,217 (December 31, 2023: €1,530,328) and short-term debt from unrelated parties was €226,093 (December 31, 2023: €583,740). Commercial paper program The Company maintains a commercial paper program under which short-term notes of up to €1,500,000 can be issued. At March 31, 2024, the outstanding commercial paper amounted to €86,000 (December 31, 2023: €400,000). |
Long-term debt
Long-term debt | 3 Months Ended |
Mar. 31, 2024 | |
Long-term debt | |
Long-term debt | 8 . Long-term debt As of March 31, 2024 and December 31, 2023, long-term debt consisted of the following: Long-term debt in € THOUS March 31, December 31, 2024 2023 Schuldschein loans 226,035 228,759 Bonds 6,773,647 6,676,465 Accounts Receivable Facility 301,921 22,857 Other 510,780 519,481 Long-term debt 7,812,383 7,447,562 Less current portion (795,734) (487,699) Long-term debt, less current portion 7,016,649 6,959,863 Accounts Receivable Facility The Company has an accounts receivable securitization program (Accounts Receivable Facility) with a maximum capacity of $900,000 (€768,049 at the date of execution) and an ending term date of August 11, 2024. The following table shows the available and outstanding amounts under the Accounts Receivable Facility at March 31, 2024 and December 31, 2023: Accounts Receivable Facility - maximum amount available and balance outstanding in THOUS Maximum amount available (1) Balance outstanding (2) March 31, 2024 March 31, 2024 Accounts Receivable Facility $ 900,000 € 832,485 $ 325,000 € 300,620 Maximum amount available (1) Balance outstanding (2) December 31, 2023 December 31, 2023 Accounts Receivable Facility $ 900,000 € 814,482 $ 25,000 € 22,624 (1) Subject to availability of sufficient accounts receivable meeting funding criteria. (2) Amounts shown are excluding debt issuance costs. The Company also had letters of credit outstanding under the Accounts Receivable Facility in the amount of $28,332 and $28,332 (€26,207 and €25,640) at March 31, 2024 and December 31, 2023, respectively. These letters of credit are not included above as part of the balance outstanding at March 31, 2024 and December 31, 2023. However, the letters reduce available borrowings under the Accounts Receivable Facility. Syndicated Credit Facility The Company entered into a €2,000,000 sustainability-linked syndicated revolving credit facility (Syndicated Credit Facility) in July 2021, which serves as a back-up line for general corporate purposes and was undrawn as of March 31, 2024. On June 2, 2023, the Syndicated Credit Facility was extended an additional year until July 1, 2028, with a maximum available borrowing amount of €1,918,367 in the last year. |
Capital management
Capital management | 3 Months Ended |
Mar. 31, 2024 | |
Capital management | |
Capital management | 9. Capital management As of March 31, 2024 and December 31, 2023 total equity in percent of total assets was 44.1% and 43.7%, respectively, and debt and lease liabilities (including amounts directly associated with assets held for sale) in percent of total assets was 35.5% and 35.9%, respectively. The Company’s financing structure and business model are reflected in its credit ratings. The Company is rated investment grade by Standard & Poor’s, Moody’s and Fitch. The Company’s current corporate credit ratings and outlooks from the credit rating agencies are provided in the table below: Rating (1) Standard & Poor´s Moody´s Fitch Corporate credit rating BBB- Baa3 BBB- Outlook negative negative negative (1) A rating is not a recommendation to buy, sell or hold securities of the Company, and may be subject to suspension, change or withdrawal at any time by the assigning rating agency. |
Commitments and contingencies
Commitments and contingencies | 3 Months Ended |
Mar. 31, 2024 | |
Commitments and contingencies | |
Commitments and contingencies | 10. Commitments and contingencies Legal and regulatory matters The Company is routinely involved in claims, lawsuits, regulatory and tax audits, investigations and other legal matters arising, for the most part, in the ordinary course of its business of providing health care services and products. Legal matters that the Company currently deems to be material or noteworthy are described below. The Company records its litigation reserves for certain legal proceedings and regulatory matters to the extent that the Company determines an unfavorable outcome is probable and the amount of loss can be reasonably estimated. For the other matters described below, the Company believes that the loss is not probable and/or the loss or range of possible losses cannot be reasonably estimated at this time. The outcome of litigation and other legal matters is always difficult to predict accurately and outcomes that are not consistent with the Company’s view of the merits can occur. The Company believes that it has valid defenses to the legal matters pending against it and is defending itself vigorously. Nevertheless, it is possible that the resolution of one or more of the legal matters currently pending or threatened could have a material adverse effect on its business, results of operations and financial condition. Beginning in 2012, the Company received certain communications alleging conduct in countries outside the United States that might violate the U.S. Foreign Corrupt Practices Act (FCPA) or other anti-bribery laws. The Company conducted investigations with the assistance of outside counsel and, in a continuing dialogue, advised the Securities and Exchange Commission (SEC) and the United States Department of Justice (DOJ) about these investigations. The DOJ and the SEC also conducted their own investigations, in which the Company cooperated. In the course of this dialogue, the Company identified and reported to the DOJ and the SEC, and took remedial actions with respect to, conduct that resulted in the DOJ and the SEC seeking monetary penalties including disgorgement of profits and other remedies. This conduct revolved principally around the Company’s products business in countries outside the United States. The Company’s remedial actions included separation of those employees responsible for the above-mentioned conduct. On March 29, 2019, the Company entered into a non-prosecution agreement (NPA) with the DOJ and a separate agreement with the SEC (SEC Order) intended to resolve fully and finally the U.S. government allegations against the Company arising from the investigations that included provisions for penalties and disgorgement, self-reporting obligations and retention of an independent compliance monitor whose certification of the Company’s implementation of an effective anti-corruption compliance program was finalized in January 2023.The DOJ and SEC accepted the Monitor’s certification and the NPA and SEC Order expired on March 1, 2023 and March 29, 2023, respectively. In 2015, the Company self-reported certain legacy conduct with a potential nexus to Germany to the German prosecutor in the state of Hessen and continues to cooperate with government authorities in Germany in their review of the conduct that prompted the Company’s and United States government investigations. In September 2023, the Hessen prosecutor opened independent disgorgement proceedings against a German subsidiary of the Company relating to the aforementioned conduct in West Africa. Since 2012, the Company has made significant investments in its compliance and financial controls and in its compliance, legal and financial organizations and is continuing to further implement its compliance program in connection with the resolution with the DOJ and SEC. The Company continues to react to post-FCPA review matters on various levels. The Company also continues to be fully committed to compliance with the FCPA and other applicable anti-bribery laws. Personal injury and related litigation involving Fresenius Medical Care Holdings, Inc. (FMCH)’s acid concentrate product, labeled as Granuflo® or Naturalyte®, first arose in 2012. FMCH’s insurers agreed to the settlement in 2017 of personal injury litigation and funded $220,000 (€179,284) of the total $250,000 (€203,732) settlement under a reciprocal reservation of rights. FMCH accrued a net expense of $60,000 (€48,896) in connection with the settlement, encompassing its contribution of $30,000 (€24,448) to the personal injury settlement plus $30,000 (€24,448) in related but uninsured fees and costs. Following the settlement, FMCH’s insurers in the AIG group initiated litigation against FMCH seeking to be indemnified by FMCH for their $220,000 (€179,284) outlay and FMCH initiated litigation against the AIG group to recover defense and indemnification costs FMCH had borne. National Union Fire Insurance v. Fresenius Medical Care, 2016 Index No. 653108 (Supreme Court of New York for New York County). As litigation proceeded, the parties refined their positions, resulting in AIG requesting recovery of approximately $60,000 (€48,896) of its settlement outlay and FMCH requesting $108,000 (€88,012) in defense fees and costs. The parties filed multiple cross motions for summary judgment. On January 12, 2023, the trial court decided these motions. Among its rulings, the court largely rejected both FMCH’s theories for recovering defense costs and AIG’s theories for recovering settlement funding. However, the trial court denied both parties’ motions on one issue and severed and continued that issue for trial. The parties reached a settlement agreement in this matter and the litigation has been dismissed with prejudice. In August 2014, FMCH received a subpoena from the United States Attorney’s Office (USAO) for the District of Maryland inquiring into FMCH’s contractual arrangements with hospitals and physicians relating to the management of in-patient acute dialysis services. Thereafter, the USAO conducted an investigation, in which FMCH cooperated, and declined to intervene in the matter. After the United States District Court for Maryland unsealed the 2014 relator’s qui tam complaint that gave rise to the investigation, the relator served the complaint and proceeded on his own by filing an amended complaint, which FMCH moved to dismiss on multiple grounds. On October 5, 2021, on FMCH’s motion, the District Court for Maryland transferred the case to the United States District Court for Massachusetts. Flanagan v. Fresenius Medical Care Holdings, Inc., 1:21-cv-11627 (Flanagan). On December 5, 2022, the Massachusetts District Court granted FMCH’s motion and dismissed the case with prejudice. Relator has filed an appeal. On October 19, 2023, a subsidiary of the Company was served with a complaint alleging that an employee was terminated in retaliation for raising concerns similar to those raised in the Flanagan litigation. Rowe v. Fresenius Medical Care Holdings, Inc., et al, In 2014, two New York physicians filed under seal a qui tam complaint in the United States District Court for the Eastern District of New York (Brooklyn), alleging violations of the False Claims Act relating to FMCH’s vascular access line of business. As previously disclosed, on October 6, 2015, the United States Attorney for the Eastern District of New York (Brooklyn) issued subpoenas to FMCH indicating its investigation is now seen to be related to the two relators’ complaint. FMCH cooperated in the Brooklyn investigation, which was understood to be separate and distinct from settlements entered in 2015 in Connecticut, Florida and Rhode Island of allegations against American Access Care LLC (AAC) following FMCH’s 2011 acquisition of AAC. On July 12, 2022, after the Court denied the USAO’s motions to renew the sealing of the relators’ complaint, the USAO filed a complaint-in-intervention. United States ex rel. Pepe and Sherman v. Fresenius Vascular Care, Inc. et al, 1:14-cv-3505. On October 3, 2023, the states of New York, New Jersey and Georgia filed a consolidated complaint-in-intervention. The United States’s, the three states’, and relators’ complaints allege that the defendants billed and received government payment for surgery that was not medically necessary. FMCH will defend the allegations asserted in the litigation now proceeding. On November 18, 2016, FMCH received a subpoena under the False Claims Act from the United States Attorney for the Eastern District of New York (Brooklyn) seeking documents and information relating to the operations of Shiel Medical Laboratory, Inc. (Shiel), which FMCH acquired in October 2013. FMCH advised the USAO that, under the asset sale provisions of its 2013 Shiel acquisition, it was not responsible for Shiel’s conduct prior to the date of the acquisition. On December 12, 2017, FMCH sold to Quest Diagnostics certain Shiel operations. Nonetheless, FMCH cooperated in the Brooklyn USAO’s investigation. On June 14, 2022, the Brooklyn USAO declined to intervene on two relator complaints that underlay the investigation. The relators are proceeding with litigation at their own expense against both Shiel and FMCH entities, alleging that the defendants wrongly caused government payers to pay for laboratory tests that were falsely or improperly invoiced and retaliated against relators for objecting to the alleged misconduct. Relator v. Shiel Medical Laboratory, 1:16-cv-01090 (E.D.N.Y. 2016); Relator v. Shiel Holdings, 1:17-cv-02732 (E.D.N.Y. 2017). FMCH will defend allegations directed against entities it controls. In February 2022, the Company received a formal request for information from the Hessen Data Protection Authority (Hessischer Beauftragter für Datenschutz und Informationsfreiheit or HBDI). The information request relates to specific data processing functions of a few of the Company’s peritoneal dialysis devices. The Company is committed to comply with the HBDI’s request in good faith and cooperate with them, and it is working to provide the relevant information. Additionally, the Company is fully committed to safeguarding and protecting patients’ privacy as per applicable laws and privacy-by-design standards, as well as improving the devices continuously, considering technical, regulatory and privacy requirements. On March 20 and April 12, 2022, respectively, an attorney employed as general counsel for the Company’s North American operations from 2013 to 2016 filed a complaint with the Occupational Safety and Health Administration (OSHA) under the Sarbanes-Oxley Act of 2002 (SOX) and other anti-retaliation statutes, and a civil lawsuit in Suffolk County, Massachusetts, seeking compensation for personnel management decisions allegedly adverse to him. OSHA Case No. 1-076-22-049; Kott v. National Medical Care, Inc., Case No. 22-802 (Superior Court, Suffolk County, Mass.). On August 30, 2023, the OSHA investigator issued a finding that there is no reasonable cause to believe that the defendants/respondents violated SOX. The plaintiff/complainant has appealed this finding. In February 2024, the Company reached an agreement in principle to settle both the Massachusetts state court and OSHA proceedings, subject to the completion of definitive settlement documents. Subsequently, the parties executed a binding settlement agreement. Both the OSHA proceeding and the state court litigation have been dismissed with prejudice. On January 3, 2023, FMCH received a subpoena from the Attorney General for the District of Columbia related to the activities of the American Kidney Foundation (AKF) and grounded in anti-trust concerns, including market allocation within the District of Columbia. FMCH’s relationship with AKF was the subject of a previously reported and resolved investigation by agencies of the United States and litigation against United Healthcare. FMCH is cooperating in the District of Columbia investigation. Four plaintiffs have filed two actions for contestation and annulment ( Anfechtungs- und Nichtigkeitsklage Freigabe one one On April 5, 2024, Fresenius Medical Care Holdings, Inc. received two civil investigative demands (CIDs) from the U.S. Federal Trade Commission (FTC) indicating it was investigating whether FMCH, among others in the industry, has engaged in unfair or exclusionary conduct in violation of Section 5 of the FTC Act in the acquisition of Medical Director services or provision of dialysis services. The CIDs indicate they cover the period from January 1, 2016 to the present and generally request information related to FMCH’s dialysis services, including information related to restrictive covenants such as non-competes with physicians. The Company is cooperating with the investigation. From time to time, the Company is a party to or may be threatened with other litigation or arbitration, claims or assessments arising in the ordinary course of its business. Management regularly analyzes current information including, as applicable, the Company’s defenses and insurance coverage and, as necessary, provides accruals for probable liabilities for the eventual disposition of these matters. The Company, like other health care providers, insurance plans and suppliers, conducts its operations under intense government regulation and scrutiny. The Company must comply with regulations which relate to or govern the safety and efficacy of medical products and supplies, the marketing and distribution of such products, the operation of manufacturing facilities, laboratories, dialysis clinics and other health care facilities, and environmental and occupational health and safety. With respect to its development, manufacture, marketing and distribution of medical products, if such compliance is not maintained, the Company could be subject to significant adverse regulatory actions by the FDA and comparable regulatory authorities outside the U.S. These regulatory actions could include warning letters or other enforcement notices from the FDA, and/or comparable foreign regulatory authority which may require the Company to expend significant time and resources in order to implement appropriate corrective actions. If the Company does not address matters raised in warning letters or other enforcement notices to the satisfaction of the FDA and/or comparable regulatory authorities outside the U.S., these regulatory authorities could take additional actions, including product recalls, injunctions against the distribution of products or operation of manufacturing plants, civil penalties, seizures of the Company’s products and/or criminal prosecution. FMCH completed remediation efforts with respect to a pending FDA warning letter issued in 2011 and is awaiting confirmation as to whether the letter is now closed. FMCH has responded to a second warning letter issued in December 2023 and continues to update the FDA about continuing remediation efforts under that letter. The Company must also comply with the laws of the United States, including the federal Anti-Kickback Statute, the federal False Claims Act, the federal Stark Law, the federal Civil Monetary Penalties Law and the federal Foreign Corrupt Practices Act as well as other federal and state fraud and abuse laws. In Germany, where corporations are not subject to criminal law, management boards of companies must ensure business activities comply with the anti-corruption provisions of the criminal code, sections 331 et seq. ( Strafgesetzbuch The Company operates many facilities and handles the personal data of its patients and beneficiaries throughout the United States and other parts of the world and engages with other business associates to help it carry out its health care activities. In such a widespread, global system, it may be difficult to maintain the desired level of oversight and control over the thousands of individuals employed by many affiliated companies and its business associates. The Company recognizes that the laws, regulations and interpretative guidance on data privacy are evolving along with potential litigation and enforcement risks, and it continues to review its processes to adapt to those changes. On occasion, the Company or its business associates may experience a breach under the Health Insurance Portability and Accountability Act Privacy Rule and Security Rules, the EU’s General Data Protection Regulation or other similar laws (Data Protection Laws) when there has been impermissible use, access, or disclosure of unsecured personal data or when the Company or its business associates neglect to implement the required administrative, technical and physical safeguards of its electronic systems and devices, or a data breach that results in impermissible use, access or disclosure of personal identifying information of its employees, patients and beneficiaries. On those occasions, the Company is committed to compliance with applicable incident notification and/or information requirements and to take appropriate remedial and corrective action. Included within the Company’s notification requirements are new SEC rules that, commencing in December 2023, require the Company to report the occurrence of material cybersecurity incidents in a report on Form 6-K. Any such report could trigger litigation arising out of the incident. In 2023, the Company publicly disclosed one information security breach in a Form 6-K furnished to the SEC. On September 29, 2023, Cardiovascular Consultants, Ltd. (CCL), a former subsidiary of the Company located in the U.S., became aware that some of its computer systems in the U.S. were affected by a security incident. Subsequently, Fresenius Vascular Care, Inc. d/b/a Azura Vascular Care (Azura), a wholly owned subsidiary of the Company located in the U.S., became aware that some of its files had been affected by the same security incident. There are three putative class action lawsuits pending in connection with this incident: one in Arizona state court against CCL and two in Pennsylvania federal court against Azura. Initially, there were four federal purported class action lawsuits filed against CCL in Arizona, but all four cases were voluntarily dismissed and consolidated with the pending state court case. The complaints allege that CCL and Azura breached various duties relating to the safeguarding of confidential patient information and seek injunctive relief requiring that CCL and Azura implement various data protection processes and unspecified monetary damages. None of the actions has received class certification. Under the agreement for the sale of CCL, the Company retains responsibility for defending against these cases. The Company relies upon its management structure, regulatory and legal resources, and the effective operation of its compliance program to direct, manage and monitor the activities of its employees. On occasion, the Company may identify instances where employees or other agents deliberately, recklessly or inadvertently contravene the Company’s policies or violate applicable law and, in such instances, the Company will take appropriate corrective and/or disciplinary action. The actions of such persons may subject the Company and its subsidiaries to liability under the Anti-Kickback Statute, the Stark Law, the False Claims Act, Data Protection Laws, the Health Information Technology for Economic and Clinical Health Act and the FCPA, among other laws and comparable state laws or laws of other countries. Physicians, hospitals and other participants in the health care industry are also subject to a large number of lawsuits alleging professional negligence, malpractice, product liability, worker’s compensation or related claims, many of which involve large claims and significant defense costs. The Company has been and is currently subject to these suits due to the nature of its business and expects that those types of lawsuits may continue. Although the Company maintains insurance at a level which it believes to be prudent, it cannot assure that the coverage limits will be adequate or that insurance will cover all asserted claims. A successful claim against the Company or any of its subsidiaries in excess of insurance coverage could have a material adverse effect upon it and the results of its operations. Any claims, regardless of their merit or eventual outcome, could have a material adverse effect on the Company’s reputation and business. The Company has also had claims asserted against it and has had lawsuits filed against it relating to alleged patent infringements or businesses that it has acquired or divested. These claims and suits relate both to operation of the businesses and to acquisition and divestiture transactions. The Company has, when appropriate, asserted its own claims, and claims for indemnification. A successful claim against the Company or any of its subsidiaries could have a material adverse effect upon its business, financial condition, and the results of its operations. Any claims, regardless of their merit or eventual outcome, could have a material adverse effect on the Company’s reputation and business. The Company is subject to ongoing and future tax audits in the U.S., Germany and other jurisdictions in the ordinary course of business. Tax authorities routinely pursue adjustments to the Company’s tax returns and disallowances of claimed tax deductions. When appropriate, the Company defends these adjustments and disallowances and asserts its own claims. A successful tax related claim against the Company or any of its subsidiaries could have a material adverse effect upon its business, financial condition and results of operations. The German tax authorities re-qualified dividends received in connection with intercompany mandatorily redeemable preferred shares into fully taxable interest payments for the years 2006 until 2013, which could lead to additional tax payments in the mid-double-digit million range. Additionally, German tax authorities objected to the Company’s tax returns and took the position that income of one of the Company’s finance entities for 2017 and future periods should be subject to German Controlled Foreign Corporation taxation resulting in potential additional income tax payments in the very low end of triple-digit millions. In both cases, the Company will take any appropriate legal action to defend its position. The Company is subject to residual value guarantees in certain lease contracts, primarily real estate contracts, for which it is the lessee in the amount of $938,228 (€867,842). As of March 31, 2024, the estimated fair market value of the underlying leased assets exceeded the related residual value guarantees and, therefore, the Company did not have any risk exposure relating to these guarantees. Other than those individual contingent liabilities mentioned above, the current estimated amount of the Company’s other known individual contingent liabilities is immaterial. |
Financial instruments
Financial instruments | 3 Months Ended |
Mar. 31, 2024 | |
Financial instruments | |
Financial instruments | 11. Financial instruments The following tables show the carrying amounts and fair values of the Company’s financial instruments at March 31, 2024 and December 31, 2023: Carrying amount and fair value of financial instruments in € THOUS March 31, 2024 Carrying amount Fair value Amortized Not cost FVPL FVOCI classified Total Level 1 Level 2 Level 3 Cash and cash equivalents 969,823 178,438 — — 1,148,261 178,438 — — Trade accounts and other receivables from unrelated parties 3,919,126 — — 80,663 3,999,789 — — — Accounts receivable from related parties 50,247 — — — 50,247 — — — Derivatives - cash flow hedging instruments — — — 2,097 2,097 — 2,097 — Derivatives - not designated as hedging instruments — 17,028 — — 17,028 — 17,028 — Equity investments — 89,655 66,971 — 156,626 54,026 68,152 34,448 Debt securities — 86,891 326,674 — 413,565 413,565 — — Other financial assets (1) 142,316 102,225 — 105,804 350,345 — — 102,225 Other current and non-current assets 142,316 295,799 393,645 107,901 939,661 — — — Financial assets 5,081,512 474,237 393,645 188,564 6,137,958 — — — Accounts payable to unrelated parties 725,178 — — — 725,178 — — — Accounts payable to related parties 110,235 — — — 110,235 — — — Short-term debt 109,137 — — — 109,137 — — — Long-term debt 7,812,383 — — — 7,812,383 6,072,896 1,038,222 — Lease liabilities — — — 4,109,146 4,109,146 — — — Derivatives - cash flow hedging instruments — — — 4,058 4,058 — 4,058 — Derivatives - not designated as hedging instruments — 15,806 — — 15,806 — 15,806 — Variable payments outstanding for acquisitions — 16,705 — — 16,705 — — 16,705 Put option liabilities — — — 1,367,243 1,367,243 — — 1,367,243 Other financial liabilities (2) 999,699 — — — 999,699 — — — Other current and non-current liabilities 999,699 32,511 — 1,371,301 2,403,511 — — — Financial liabilities 9,756,632 32,511 — 5,480,447 15,269,590 — — — Carrying amount and fair value of financial instruments in € THOUS December 31, 2023 Carrying amount Fair value Amortized Not cost FVPL FVOCI classified Total Level 1 Level 2 Level 3 Cash and cash equivalents 1,205,030 198,462 — — 1,403,492 198,462 — — Trade accounts and other receivables from unrelated parties 3,389,314 — — 81,899 3,471,213 — — — Accounts receivable from related parties 165,299 — — — 165,299 — — — Derivatives - cash flow hedging instruments — — — 1,990 1,990 — 1,990 — Derivatives - not designated as hedging instruments — 20,295 — — 20,295 — 20,295 — Equity investments — 82,072 71,110 — 153,182 48,888 72,292 32,002 Debt securities — 80,145 341,074 — 421,219 421,219 — — Other financial assets (1) 146,748 — — 112,322 259,070 — — — Other current and non-current assets 146,748 182,512 412,184 114,312 855,756 — — — Financial assets 4,906,391 380,974 412,184 196,211 5,895,760 — — — Accounts payable to unrelated parties 762,068 — — — 762,068 — — — Accounts payable to related parties 123,081 — — — 123,081 — — — Short-term debt 456,904 — — — 456,904 — — — Long-term debt 7,447,562 — — — 7,447,562 5,972,767 767,328 — Lease liabilities — — — 4,145,946 4,145,946 — — — Derivatives - cash flow hedging instruments — — — 4,315 4,315 — 4,315 — Derivatives - not designated as hedging instruments — 4,890 — — 4,890 — 4,890 — Variable payments outstanding for acquisitions — 35,751 — — 35,751 — — 35,751 Put option liabilities — — — 1,372,008 1,372,008 — — 1,372,008 Other financial liabilities (2) 974,252 — — — 974,252 — — — Other current and non-current liabilities 974,252 40,641 — 1,376,323 2,391,216 — — — Financial liabilities 9,763,867 40,641 — 5,522,269 15,326,777 — — — (1) As of March 31, 2024 and December 31, 2023 other financial assets primarily include lease receivables, deposits, guarantees, securities, receivables from sale of investments, vendor and supplier rebates as well as notes receivable. Additionally, in 2024, other financial assets include receivables for royalty payments from one of the Company’s equity investments. (2) As of March 31, 2024 and December 31, 2023, other financial liabilities primarily include receivable credit balances and goods and services received. Derivative and non-derivative financial instruments are categorized in the following three-tier fair value hierarchy that reflects the significance of the inputs in making the measurements. Level 1 inputs are quoted prices for similar instruments in active markets. Level 2 is defined as using valuation models (i.e. mark-to-model) with input factors that are inputs other than quoted prices in active markets that are directly or indirectly observable. Level 3 is defined as using valuation models (i.e. mark-to-model) with input factors that are unobservable inputs for which little or no market data exists, therefore requiring the Company to develop its own assumptions. Fair value information is not provided for financial instruments, if the carrying amount is a reasonable estimate of fair value due to the relatively short period of maturity of these instruments. This includes cash and cash equivalents measured at amortized costs, trade accounts and other receivables from unrelated parties, accounts receivable from related parties, other financial assets as well as accounts payable to unrelated parties, accounts payable to related parties, short-term debt and other financial liabilities. Transfers between levels of the fair value hierarchy have not occurred as of March 31, 2024 or December 31, 2023. The Company accounts for transfers at the end of the reporting period. Derivative financial instruments In order to manage the risk of currency exchange rate and interest rate fluctuations, the Company enters into various hedging transactions by means of derivative instruments with highly rated financial institutions (generally investment grade) as authorized by the Company’s management. The Company primarily enters into foreign exchange forward contracts. In certain instances, the Company enters into derivative contracts that do not qualify for hedge accounting but are utilized for economic purposes (economic hedges). The Company does not use financial instruments for trading purposes. Non-derivative financial instruments The significant methods and assumptions used for the classification and measurement of non-derivative financial instruments are as follows: The Company assessed its business models and the cash flow characteristics of its financial assets. The vast majority of the non-derivative financial assets are held in order to collect contractual cash flows. The contractual terms of the financial assets allow the conclusion that the cash flows represent payment of principal and interest only. Trade accounts and other receivables from unrelated parties (including receivables related to the Accounts Receivable Facility, see note 8), Accounts receivable from related parties and Other financial assets are consequently measured at amortized cost. Cash and cash equivalents are comprised of cash funds and other short-term investments. Cash funds are measured at amortized cost. Short-term investments are highly liquid and readily convertible to known amounts of cash. Short-term investments are measured at fair value through profit or loss (FVPL). The risk of changes in fair value is insignificant. Equity investments are not held for trading. At initial recognition the Company elected, on an instrument-by-instrument basis, to represent subsequent changes in the fair value of individual strategic investments in other comprehensive income. If equity instruments are quoted in an active market, the fair value is based on price quotations at the period-end-date. As necessary, the Company engages external valuation firms to assist in determining the fair value of Level 3 equity investments. The external valuation uses a discounted cash flow model, which includes significant unobservable inputs such as investment specific forecasted financial statements and weighted average cost of capital, that reflects current market assessments as well as a terminal growth rate. The majority of the debt securities are held within a business model whose objective is achieving both contractual cash flows and selling securities. The standard coupon bonds give rise on specified dates to cash flows that are solely payments of principal and interest on the outstanding principal amount. Subsequently, these financial assets have been classified as fair value through other comprehensive income (FVOCI). The smaller part of debt securities does not give rise to cash flows that are solely payments of principal and interest. Consequently, these securities are measured at FVPL. In general, most of the debt securities are quoted in an active market. Long-term debt is initially recognized at its fair value and subsequently measured at amortized cost. The fair values of major long-term debt are calculated on the basis of market information. Liabilities for which market quotes are available are measured using these quotes. The fair values of the other long-term debt are calculated at the present value of the respective future cash flows. To determine these present values, the prevailing interest rates and credit spreads for the Company as of the balance sheet date are used. Variable payments outstanding for acquisitions are recognized at their fair value. The estimation of individual fair values is based on the key inputs of the arrangement that determine the future contingent payment as well as the Company’s expectation of these factors. The Company assesses the likelihood and timing of achieving the relevant objectives. The underlying assumptions are reviewed regularly. Put option liabilities are recognized at the present value of the exercise price of the option. The exercise price of the option is generally based on fair value and, in certain limited instances, might contain a fixed floor price. The methodology the Company uses to estimate the fair values assumes the greater of net book value or a multiple of earnings, based on historical earnings, development stage of the underlying business and other factors. From time to time the Company engages an external valuation firm to assist in the valuation of certain put options. The external valuation assists the Company in estimating the fair values using a combination of discounted cash flows and a multiple of earnings and/or revenue. Under those limited circumstances in which the put option might contain a fixed floor price, the external valuation firm may assist the Company with the valuation by performing a Monte Carlo Simulation analysis to simulate the exercise price. The put option liabilities are discounted at a pre-tax discount rate that reflects current market assessments of the time value of money and the risks specific to the liability. The estimated fair values of these put options can also fluctuate, and the discounted cash flows as well as the implicit multiple of earnings and/or revenue at which these obligations may ultimately be settled could vary significantly from the Company’s current estimates depending upon market conditions. For the purpose of analyzing the impact of changes in unobservable inputs on the fair value measurement of put option liabilities, the Company assumes an increase on earnings (or enterprise value, where applicable) of 10% compared to the actual estimation as of the balance sheet date. The corresponding increase in fair value of €99,149 is then compared to the total liabilities and the shareholder’s equity of the Company. This analysis shows that an increase of 10% in the relevant earnings (or enterprise value, where applicable) would have an effect of less than 1% on the total liabilities and less than 1% on the shareholder’s equity of the Company. The following table provides a reconciliation of Level 3 financial instruments at March 31, 2024 and December 31, 2023: Reconciliation from beginning to ending balance of level 3 financial instruments in € THOUS 2024 2023 Variable Variable payments Receivables payments outstanding from outstanding Equity for Put option licensing Equity for Put option investments acquisitions liabilities agreements investments acquisitions liabilities Beginning balance at January 1, 32,002 35,751 1,372,008 — 42,793 37,846 1,468,517 Increase 814 24 195 — 4,833 5,232 31,050 Decrease — (18,558) (1,711) — — (3,603) (42,490) Reclassifications — — — 90,457 (1) — — — Gain / loss recognized in profit or loss (2) 916 (754) — 9,726 (14,340) (3,366) — Gain / loss recognized in equity — — (32,967) — — — (28,034) Foreign currency translation and other changes 716 242 29,718 2,042 (1,284) (358) (57,035) Ending balance at March 31, and December 31, 34,448 16,705 1,367,243 102,225 32,002 35,751 1,372,008 (1) Receivables for royalty payments from one of the Company’s equity investments were previously recorded as a non-financial asset and were revised as of March 31, 2024. (2) Includes realized and unrealized gains / losses. |
Segment and corporate informati
Segment and corporate information | 3 Months Ended |
Mar. 31, 2024 | |
Segment and corporate information | |
Segment and corporate information | 12. Segment and corporate information The Company’s operating segments are determined based upon how the Company manages its businesses and allocates resources with responsibilities by products and services and is aligned to the financial information that is presented on a quarterly basis to the chief operating decision maker. The Care Enablement segment is primarily engaged in the distribution of products and equipment, including R&D, manufacturing, supply chain and commercial operations, as well as supporting functions, such as regulatory and quality management. The Care Delivery segment is primarily engaged in providing health care services for the treatment of chronic kidney disease, ESRD and other extracorporeal therapies, including value and risk-based care programs. Care Delivery also includes the pharmaceutical products business and the income from equity method investees related to the sale of certain renal pharmaceuticals from Vifor Fresenius Medical Care Renal Pharma Ltd., which are used in the Company’s clinics to provide health care services to its patients. The Company’s Global Medical Office, which seeks to optimize medical treatments and clinical processes within the Company and supports both Care Delivery and Care Enablement, is centrally managed and its profit and loss are allocated to the segments. Similarly, the Company allocates costs related primarily to headquarters’ overhead charges, including accounting and finance as well as certain human resources, legal and IT costs, as the Company believes that these costs are attributable to the segments and used in the allocation of resources to Care Delivery and Care Enablement. These costs are allocated at budgeted amounts, with the difference between budgeted and actual figures recorded at the corporate level. However, certain costs, which relate mainly to shareholder activities, management activities, global internal audit and the remeasurement of certain investments are not allocated to a segment but are accounted for as corporate expenses. These activities do not fulfill the definition of a segment according to IFRS 8, Operating Segments and are reported separately as Corporate (Corporate). Financing is a corporate function which is not controlled by the operating segments. Therefore, the Company does not include interest expense relating to financing as a segment measurement. In addition, the Company does not include income taxes as it believes taxes are outside the segments’ control. Management evaluates each segment using measures that reflect all of the segment’s controllable revenues and expenses. With respect to the performance of business operations, management believes that the most appropriate measures are revenue and operating income. The Company transfers products between segments at fair market value. The associated internal revenues and expenses and any remaining internally generated profit or loss for the product transfers are recorded within the operating segments initially, are eliminated upon consolidation and are included within “Inter-segment eliminations.” Capital expenditures for production are based on the expected demand of the segments and consolidated profitability considerations. Information pertaining to the Company’s segment and Corporate activities for the three months ended March 31, 2024 and 2023 is set forth below: Segment and corporate information in € THOUS Care Total Inter-segment Care Delivery Enablement Segment eliminations Corporate Total Three months ended March 31, 2024 Revenue from health care services (1) 3,365,334 — 3,365,334 — — 3,365,334 Revenue from health care products (1) 39,890 914,194 954,084 — — 954,084 Revenue from contracts with customers (1) 3,405,224 914,194 4,319,418 — — 4,319,418 Revenue from insurance contracts (1) 382,930 — 382,930 — — 382,930 Revenue from lease contracts (1) — 22,174 22,174 — — 22,174 Revenue from external customers 3,788,154 936,368 4,724,522 — — 4,724,522 Inter-segment revenue — 360,690 360,690 (360,690) — — Revenue 3,788,154 1,297,058 5,085,212 (360,690) — 4,724,522 Operating income (loss) 188,549 70,215 258,764 838 (13,589) 246,013 Interest (88,187) Income before income taxes 157,826 Depreciation and amortization (264,654) (115,365) (380,019) 10,332 (18,048) (387,735) Impairment loss (123,661) (1,047) (124,708) — — (124,708) Income (loss) from equity method investees 28,843 — 28,843 — — 28,843 Total assets (1) 44,033,238 13,640,881 57,674,119 (34,533,212) 11,195,192 34,336,099 thereof investment in equity method investees (1) 615,755 — 615,755 — — 615,755 Additions of property, plant and equipment, intangible assets and right-of-use assets (1) 188,950 85,846 274,796 (10,178) 20,420 285,038 Three months ended March 31, 2023 Revenue from health care services (1) 3,465,868 — 3,465,868 — — 3,465,868 Revenue from health care products (1) 42,816 933,753 976,569 — — 976,569 Revenue from contracts with customers (1) 3,508,684 933,753 4,442,437 — — 4,442,437 Revenue from insurance contracts (1) 246,863 — 246,863 — — 246,863 Revenue from lease contracts (1) — 14,918 14,918 — — 14,918 Revenue from external customers 3,755,547 948,671 4,704,218 — — 4,704,218 Inter-segment revenue — 361,858 361,858 (361,858) — — Revenue 3,755,547 1,310,529 5,066,076 (361,858) — 4,704,218 Operating income (loss) 284,485 (24,475) 260,010 (9,252) 10,179 260,937 Interest (82,572) Income before income taxes 178,365 Depreciation and amortization (288,229) (115,035) (403,264) 9,716 (18,057) (411,605) Impairment loss (1,916) (24,293) (26,209) — — (26,209) Income (loss) from equity method investees 26,101 1,413 27,514 — — 27,514 Total assets (1) 40,048,443 14,645,444 54,693,887 (27,595,235) 8,401,863 35,500,515 thereof investment in equity method investees (1) 463,839 334,186 798,025 — — 798,025 Additions of property, plant and equipment, intangible assets and right- of-use assets (1) 188,486 109,289 297,775 — 12,812 310,587 (1) These line items are included to comply with requirements under IFRS 8 and IFRS 15 or are provided on a voluntary basis, but not included in the information regularly reviewed by the chief operating decision maker. Additionally, the Company has adjusted the prior period financial information in order to include additional contracts identified during the course of the year ended December 31, 2023 which were subject to certain disclosures in accordance with IFRS 17. |
Events occurring after the bala
Events occurring after the balance sheet date | 3 Months Ended |
Mar. 31, 2024 | |
Events occurring after the balance sheet date | |
Events occurring after the balance sheet date | 13. Events occurring after the balance sheet date In April 2024, the Company signed several virtual power purchase agreements (vPPAs) with wind and solar energy project developers in Germany and in the U.S. with terms of up to 15 years . The German vPPA contracts have been signed with two developers for a total expected annual electricity production of 124 GWh which is equivalent to around 75% of the Company’s current electricity consumption in the European Union. The U.S. vPPA contract has been concluded with one developer and the forecasted annual electricity production amounts to 458 GWh/ year which corresponds to around 60% of the Company’s current electricity consumption in the U.S. The wind and solar parks are scheduled to become operational in 2024 and 2025. All contracts are designed as non-deliverable for the electricity produced and provide for the delivery of energy attribute certificates, commonly known in the U.S. and Germany as renewable energy certificates and guarantees of origin, respectively. All contracts are analyzed as physical host contracts to purchase the certificates and separable embedded electricity swaps to pay a fixed price for the electricity produced and to receive a variable spot energy price in the respective regions. The host contracts fulfill the “own-use” criteria in accordance with IFRS 9, Financial Instruments (IFRS 9). The derivatives embedded in the vPPAs are recognized separately at fair value through profit or loss. Due to the volatile nature of such instruments which may be considered to be speculative, it is difficult to accurately predict what impact the volatility of unobservable inputs, such as changes in expected energy prices or production volumes, may have on the valuation of such instruments in the future. The estimated fair values of these derivative instruments may fluctuate significantly from quarter to quarter, and the price at which these derivatives may ultimately be settled could vary significantly from the Company’s current estimates depending upon market conditions. No other significant events have taken place subsequent to the balance sheet date March 31, 2024 that have a material impact on the key figures and earnings presented. Other than the announcement made by the Company on March 13, 2024 regarding the appointment of Jörg Häring as a new member of the Management Board responsible for Legal, Compliance and Human Resources and as Labor Relations Director, each as of June 1, 2024, currently there are no significant changes in the Company’s structure, management, legal form or personnel. |
The Company and basis of pres_2
The Company and basis of presentation (Policies) | 3 Months Ended |
Mar. 31, 2024 | |
The Company and basis of presentation | |
Accounting policies and methods of computation followed in interim financial statements | The consolidated financial statements and other financial information included in the Company’s quarterly reports furnished under cover of Form 6-K and its Annual Report on Form 20-F are prepared solely in accordance with International Financial Reporting Standards (IFRS) as issued by the International Accounting Standards Board (IASB), the “IFRS® Accounting Standards”, using the euro as the Company’s reporting and functional currency. The interim financial report is prepared in accordance with International Accounting Standard (IAS) 34, Interim Financial Reporting, and contains condensed financial statements, in that it includes selected explanatory notes rather than all of the notes that would be required in a complete set of financial statements. However, the primary financial statements are presented in the format consistent with the consolidated financial statements as presented in the Company’s Annual Report on Form 20-F for the year ended December 31, 2023 (the 2023 Form 20-F) in accordance with IAS 1, Presentation of Financial Statements. |
Recent pronouncements | New accounting pronouncements Recently implemented accounting pronouncements The Company has prepared its interim consolidated financial statements at and for the three months ended March 31, 2024 in conformity with IFRS Accounting Standards that have to be applied for the interim periods starting on or after January 1, 2024. In the three months ended March 31, 2024, there were no recently implemented accounting pronouncements that materially affect the business. Recent accounting pronouncements not yet adopted The IASB issued the following new standard which is relevant for the Company: IFRS 18, Presentation and Disclosure in Financial Statements On April 9, 2024, the IASB issued IFRS 18, Presentation and Disclosure in Financial Statements (IFRS 18). IFRS 18 aims to improve how information is communicated in financial statements to give investors a more comparable basis to analyze companies’ performance. The standard introduces three sets of new requirements: new categories and subtotals in the consolidated statements of income, disclosure regarding management-defined performance measures and guidance related to the aggregation and disaggregation of certain information. The consolidated statements of income will be split into three newly defined categories (operating, investing and financing) and will include two newly defined subtotals (operating profit and profit before financing and income taxes). Management-defined performance measures are subtotals of income and expense used in public communication outside the financial statements and communicate management’s view of certain aspects of a company’s performance. Such measures are required to be described in a clear and understandable manner in a single note explaining how the measure is calculated, why it is useful, providing a reconciliation to the most directly comparable subtotal noted above, the income tax and non-controlling interest effect on each item and how the income tax effect was determined. Lastly, companies must disaggregate items if such information is material and avoid using the label “other” in financial statements. Certain additional details for depreciation and amortization, impairment and other expense classifications may be required. IFRS 18 is effective for fiscal periods commencing on or after January 1, 2027. Earlier adoption is permitted. The standard is expected to impact the Company’s presentation of items within the consolidated financial statements and its notes disclosures once implemented, though the standard is not expected to change how the Company recognizes or measures items in its consolidated financial statements. In the Company’s view, no other pronouncements issued by the IASB are expected to have a material impact on the consolidated financial statements. |
The Company and basis of pres_3
The Company and basis of presentation (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
The Company and basis of presentation | |
Schedule of inputs for the calculation of (gains) losses on net monetary positions | Inputs for the calculation of (gains) losses on net monetary positions Lebanon Turkiye Date of IAS 29 initial application December 31, 2020 June 30, 2022 Consumer price index Central Administration of Statistics Turkish Statistical Institute Index at March 31, 2024 6,321.2 2,137.5 Calendar year increase 6 % 15 % (Gain) loss on net monetary position in € THOUS 2 882 |
Schedule of key assumptions of value-in-use calculations upon goodwill impairment tests | Key assumptions in % Care Delivery Care Enablement March 31, 2024 December 31, 2023 March 31, 2024 December 31, 2023 Average revenue growth in ten year projection period mid-single-digit mid-single-digit mid-single-digit mid-single-digit Average operating income growth in ten year projection period high-single-digit high-single-digit low-double-digit low-double-digit Residual value growth 1.00 1.00 1.00 1.00 Pre-tax WACC 10.78 10.53 9.07 8.41 After-tax WACC 8.32 8.09 7.34 6.54 |
Schedule that shows the amounts by which the key assumptions would need to change individually that the recoverable amount equals the carrying amount | Sensitivity analysis (1) Change in percentage points Care Delivery Care Enablement March 31, December 31, March 31, December 2024 2023 2024 31, 2023 Pre-tax WACC 2.17 2.10 2.28 2.27 After-tax WACC 1.64 1.60 1.69 1.66 Residual value growth (7.49) (7.26) (5.42) (5.57) Operating income margin of each projection year (2.47) (2.35) (3.03) (3.02) (1) The sensitivity analysis is based upon the goodwill impairment tests performed as of March 31, 2024 and December 31, 2023. |
Disposal groups classified as_2
Disposal groups classified as held for sale (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Disposal groups classified as held for sale | |
Schedule of assets and liabilities of disposal groups classified as held for sale | Assets and liabilities of disposal groups classified as held for sale in € THOUS March 31, 2024 December 31, 2023 Cash and cash equivalents 43,734 23,733 Trade accounts and other receivables from unrelated parties 194,876 27,535 Property, plant and equipment 80,768 42,710 Right-of-use assets 124,776 114,602 Goodwill (1) 396,976 274,543 Other 55,401 24,477 Assets held for sale 896,531 507,600 Accounts payable to unrelated parties 22,620 12,880 Lease liabilities 153,313 128,653 Provisions and other liabilities 94,398 39,091 Liability directly associated with assets held for sale 270,331 180,624 (1) |
Notes to the consolidated sta_2
Notes to the consolidated statements of income (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Notes to the consolidated statements of income | |
Schedule of revenue | Revenue in € THOUS Revenue from Revenue from contracts with insurance Revenue from customers contracts lease contracts Total For the three months ended March 31, 2024 Health care services 3,365,334 382,930 — 3,748,264 Health care products 954,084 — 22,174 976,258 Total 4,319,418 382,930 22,174 4,724,522 For the three months ended March 31, 2023 Revenue from Revenue from contracts with insurance Revenue from customers contracts lease contracts Total Health care services 3,465,868 246,863 — 3,712,731 Health care products 976,569 — 14,918 991,487 Total 4,442,437 246,863 14,918 4,704,218 |
Schedule of disaggregation of revenue by categories | Disaggregation of revenue by categories in € THOUS For the three months ended March 31, 2024 2023 Care Delivery US 3,101,758 3,002,715 International 686,396 752,832 Total (1) 3,788,154 3,755,547 Care Enablement Total (including inter-segment revenues) (1) 1,297,058 1,310,529 Inter-segment eliminations (360,690) (361,858) Total Care Enablement revenue external customers 936,368 948,671 Total 4,724,522 4,704,218 (1) For further information on segment revenues, see note 12. |
Schedule of selling, general and administrative expenses | Selling, general and administrative expense in € THOUS For the three months ended March 31, 2024 2023 Distribution costs 190,562 203,278 General and administrative expense 585,082 578,876 Selling, general and administrative expense 775,644 782,154 |
Schedule of amounts included in other operating income | Other operating income in € THOUS For the three months ended March 31, 2024 2023 Foreign exchange gains 61,676 72,140 Gains on right-of-use assets, from the sale of fixed assets, clinics and investments 3,144 13,625 Revaluation of certain investments 15,197 19,286 Income from strategic transactions and programs 3,106 — Other 30,376 12,420 Other operating income 113,499 117,471 |
Schedule of amounts included in other operating expense | Other operating expense in € THOUS For the three months ended March 31, 2024 2023 Foreign exchange losses 70,415 84,403 Losses on right-of-use assets, from the sale of fixed assets, clinics and investments 2,064 10,539 Expenses from strategic transactions and programs 154,955 83,439 Other 19,101 16,895 Other operating expense 246,535 195,276 |
Schedule of expenses from strategic transactions and programs | Expenses from strategic transactions and programs in € THOUS For the three months ended March 31, 2024 2023 Derecognition of capitalized development costs and termination costs (1) — 59,113 Legacy Portfolio Optimization — 59,113 Impairment of intangible and tangible assets (2) 1,047 24,326 Legacy Portfolio Optimization — 24,326 FME25 Program 1,047 — Impairment resulting from the measurement of assets held for sale 123,552 — Legacy Portfolio Optimization 123,552 — Loss from the sale of business 24,988 — Legacy Portfolio Optimization 24,988 — Other (3) 5,368 — Legacy Portfolio Optimization 4,152 — Legal Form Conversion Costs 1,216 — Expenses from strategic transactions and programs 154,955 83,439 (1) Primarily R&D expense. (2) For the three months ended March 31, 2024 and 2023, the amounts relate primarily to cost of revenues and R&D expense, respectively. (3) Primarily selling, general and administrative expense. |
Schedule of reconciliation of basic and diluted earnings per share | Reconciliation of basic and diluted earnings per share in € THOUS, except share and per share data For the three months ended March 31, 2024 2023 Numerator: Net income attributable to shareholders of FME AG 70,959 86,362 Denominators: Weighted average number of shares outstanding 293,413,449 293,413,449 Potentially dilutive shares — — Basic earnings per share 0.24 0.29 Diluted earnings per share 0.24 0.29 |
Related party transactions (Tab
Related party transactions (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Related party transactions | |
Schedule of service agreements and products with related parties | Service agreements and products with related parties in € THOUS For the three months ended For the three months ended March 31, 2024 March 31, 2023 March 31, 2024 December 31, 2023 Sales of Purchases of Sales of Purchases of goods and goods and goods and goods and Accounts Accounts Accounts Accounts services services services services receivable payable receivable payable Service agreements (1) Fresenius SE — 5,289 35 8,067 1,472 395 10 1,778 Fresenius SE affiliates 155 23,616 1,942 14,558 2,512 8,514 589 14,299 Equity method investees (2) 1,209 — 1,078 — 28,820 — 51,442 — Total 1,364 28,905 3,055 22,625 32,804 8,909 52,041 16,077 Products Fresenius SE affiliates (2) 18,772 6,643 18,335 6,492 17,443 5,474 23,535 9,585 Equity method investees (2) — 96,383 — 111,164 — 69,201 — 67,403 Total 18,772 103,026 18,335 117,656 17,443 74,675 23,535 76,988 (1) In addition to the above shown accounts payable, accrued expenses for service agreements with related parties amounted to € 15,754 and € 5,172 at March 31, 2024 and December 31, 2023, respectively. (2) Sales of services and purchases of goods related to equity method investees for the three months ended March 31, 2023 in the amount of €6,539 and €23,873 as well as purchases of goods related to Fresenius SE affiliates for the three months ended March 31, 2023 in the amount of ( €4,246 ) were adjusted to correct for an error in presentation. The adjustment does not have an impact on the Company’s consolidated statements in income for the periods presented. |
Schedule of lease agreements with related parties | Lease agreements with related parties in € THOUS For the three months ended March 31, 2024 For the three months ended March 31, 2023 March 31, 2024 December 31, 2023 Interest Lease Interest Lease Right-of-use Lease Right-of-use Lease Depreciation expense expense (1) Depreciation expense expense (1) asset liability asset liability Fresenius SE 1,630 215 223 2,088 255 230 28,212 31,148 29,214 29,017 Fresenius SE affiliates 4,603 376 — 4,452 430 — 100,780 100,390 102,029 104,558 Total 6,233 591 223 6,540 685 230 128,992 131,538 131,243 133,575 (1) Short-term leases and expenses relating to variable lease payments as well as low value leases are exempted from balance sheet recognition. |
Insurance contracts (Tables)
Insurance contracts (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Insurance contracts | |
Schedule of reconciliation of insurance and reinsurance contracts receivables and liabilities | Reinsurance contract receivables and liabilities in € THOUS 2024 2023 Present Risk Present Risk value of adjustment value of adjustment future cash for non- future for non- flows financial risk Total cash flows financial risk Total Reinsurance contract receivables (liabilities) at the beginning of the period 53,137 (931) 52,206 23,925 (1,801) 22,124 Incurred claims and other directly attributable expenses (169,404) 174 (169,230) (166,161) 825 (165,336) Changes that relate to past service – changes in the fulfillment cash-flows relating to LIC (1) (18,517) — (18,517) 1,544 — 1,544 Claims and other directly attributable expenses paid — — — (387,949) — (387,949) Premium revenue 179,913 — 179,913 583,269 — 583,269 Foreign currency translation and other changes 1,139 (20) 1,119 (1,491) 45 (1,446) Reinsurance contract receivables (liabilities) at the end of the period 46,268 (777) 45,491 53,137 (931) 52,206 (1) Changes that relate to past service include premium revenue for past performance years of € 568 and € 9,038 as of March 31, 2024 and December 31, 2023, respectively. Insurance contract receivables and liabilities in € THOUS 2024 2023 Present Risk Present Risk value of adjustment value of adjustment future cash for non- future for non- flows financial risk Total cash flows financial risk Total Insurance contract receivables (liabilities) at the beginning of the period 27,389 (553) 26,836 20,669 (254) 20,415 Incurred claims and other directly attributable expenses (193,179) 84 (193,095) (208,884) (314) (209,198) Changes that relate to past service – changes in the fulfillment cash-flows relating to LIC (1) (2,891) — (2,891) (2,666) — (2,666) Claims and other directly attributable expenses paid — — — (423,377) — (423,377) Premium revenue 205,750 — 205,750 642,529 — 642,529 Foreign currency translation and other changes 648 (12) 636 (882) 15 (867) Insurance contract receivables (liabilities) at the end of the period 37,717 (481) 37,236 27,389 (553) 26,836 (1) Changes that relate to past service include a reduction in premium revenue for past performance years of € 3,303 and € 7,696 as of March 31, 2024 and December 31, 2023, respectively. |
Inventories (Tables)
Inventories (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Inventories | |
Schedule of inventories | Inventories in € THOUS March 31, December 31, 2024 2023 Finished goods 1,260,470 1,232,702 Health care supplies 437,373 451,316 Raw materials and purchased components 369,815 361,804 Work in process 148,743 133,353 Inventories 2,216,401 2,179,175 |
Short-term debt (Tables)
Short-term debt (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Short-term debt | |
Schedule of short-term debt | Short-term debt in € THOUS March 31, December 31, 2024 2023 Commercial paper program 85,580 399,078 Borrowings under lines of credit 23,544 57,754 Other 13 72 Short-term debt 109,137 456,904 |
Long-term debt (Tables)
Long-term debt (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Long-term debt | |
Schedule of long-term debt | Long-term debt in € THOUS March 31, December 31, 2024 2023 Schuldschein loans 226,035 228,759 Bonds 6,773,647 6,676,465 Accounts Receivable Facility 301,921 22,857 Other 510,780 519,481 Long-term debt 7,812,383 7,447,562 Less current portion (795,734) (487,699) Long-term debt, less current portion 7,016,649 6,959,863 |
Schedule of accounts receivable facility | Accounts Receivable Facility - maximum amount available and balance outstanding in THOUS Maximum amount available (1) Balance outstanding (2) March 31, 2024 March 31, 2024 Accounts Receivable Facility $ 900,000 € 832,485 $ 325,000 € 300,620 Maximum amount available (1) Balance outstanding (2) December 31, 2023 December 31, 2023 Accounts Receivable Facility $ 900,000 € 814,482 $ 25,000 € 22,624 (1) Subject to availability of sufficient accounts receivable meeting funding criteria. (2) Amounts shown are excluding debt issuance costs. |
Capital management (Tables)
Capital management (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Capital management | |
Schedule of Company's rating | Rating (1) Standard & Poor´s Moody´s Fitch Corporate credit rating BBB- Baa3 BBB- Outlook negative negative negative (1) A rating is not a recommendation to buy, sell or hold securities of the Company, and may be subject to suspension, change or withdrawal at any time by the assigning rating agency. |
Financial instruments (Tables)
Financial instruments (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Financial instruments | |
Schedule of carrying amount and fair value of financial instruments | Carrying amount and fair value of financial instruments in € THOUS March 31, 2024 Carrying amount Fair value Amortized Not cost FVPL FVOCI classified Total Level 1 Level 2 Level 3 Cash and cash equivalents 969,823 178,438 — — 1,148,261 178,438 — — Trade accounts and other receivables from unrelated parties 3,919,126 — — 80,663 3,999,789 — — — Accounts receivable from related parties 50,247 — — — 50,247 — — — Derivatives - cash flow hedging instruments — — — 2,097 2,097 — 2,097 — Derivatives - not designated as hedging instruments — 17,028 — — 17,028 — 17,028 — Equity investments — 89,655 66,971 — 156,626 54,026 68,152 34,448 Debt securities — 86,891 326,674 — 413,565 413,565 — — Other financial assets (1) 142,316 102,225 — 105,804 350,345 — — 102,225 Other current and non-current assets 142,316 295,799 393,645 107,901 939,661 — — — Financial assets 5,081,512 474,237 393,645 188,564 6,137,958 — — — Accounts payable to unrelated parties 725,178 — — — 725,178 — — — Accounts payable to related parties 110,235 — — — 110,235 — — — Short-term debt 109,137 — — — 109,137 — — — Long-term debt 7,812,383 — — — 7,812,383 6,072,896 1,038,222 — Lease liabilities — — — 4,109,146 4,109,146 — — — Derivatives - cash flow hedging instruments — — — 4,058 4,058 — 4,058 — Derivatives - not designated as hedging instruments — 15,806 — — 15,806 — 15,806 — Variable payments outstanding for acquisitions — 16,705 — — 16,705 — — 16,705 Put option liabilities — — — 1,367,243 1,367,243 — — 1,367,243 Other financial liabilities (2) 999,699 — — — 999,699 — — — Other current and non-current liabilities 999,699 32,511 — 1,371,301 2,403,511 — — — Financial liabilities 9,756,632 32,511 — 5,480,447 15,269,590 — — — Carrying amount and fair value of financial instruments in € THOUS December 31, 2023 Carrying amount Fair value Amortized Not cost FVPL FVOCI classified Total Level 1 Level 2 Level 3 Cash and cash equivalents 1,205,030 198,462 — — 1,403,492 198,462 — — Trade accounts and other receivables from unrelated parties 3,389,314 — — 81,899 3,471,213 — — — Accounts receivable from related parties 165,299 — — — 165,299 — — — Derivatives - cash flow hedging instruments — — — 1,990 1,990 — 1,990 — Derivatives - not designated as hedging instruments — 20,295 — — 20,295 — 20,295 — Equity investments — 82,072 71,110 — 153,182 48,888 72,292 32,002 Debt securities — 80,145 341,074 — 421,219 421,219 — — Other financial assets (1) 146,748 — — 112,322 259,070 — — — Other current and non-current assets 146,748 182,512 412,184 114,312 855,756 — — — Financial assets 4,906,391 380,974 412,184 196,211 5,895,760 — — — Accounts payable to unrelated parties 762,068 — — — 762,068 — — — Accounts payable to related parties 123,081 — — — 123,081 — — — Short-term debt 456,904 — — — 456,904 — — — Long-term debt 7,447,562 — — — 7,447,562 5,972,767 767,328 — Lease liabilities — — — 4,145,946 4,145,946 — — — Derivatives - cash flow hedging instruments — — — 4,315 4,315 — 4,315 — Derivatives - not designated as hedging instruments — 4,890 — — 4,890 — 4,890 — Variable payments outstanding for acquisitions — 35,751 — — 35,751 — — 35,751 Put option liabilities — — — 1,372,008 1,372,008 — — 1,372,008 Other financial liabilities (2) 974,252 — — — 974,252 — — — Other current and non-current liabilities 974,252 40,641 — 1,376,323 2,391,216 — — — Financial liabilities 9,763,867 40,641 — 5,522,269 15,326,777 — — — (1) As of March 31, 2024 and December 31, 2023 other financial assets primarily include lease receivables, deposits, guarantees, securities, receivables from sale of investments, vendor and supplier rebates as well as notes receivable. Additionally, in 2024, other financial assets include receivables for royalty payments from one of the Company’s equity investments. (2) As of March 31, 2024 and December 31, 2023, other financial liabilities primarily include receivable credit balances and goods and services received. |
Schedule of reconciliation of level 3 financial instruments | Reconciliation from beginning to ending balance of level 3 financial instruments in € THOUS 2024 2023 Variable Variable payments Receivables payments outstanding from outstanding Equity for Put option licensing Equity for Put option investments acquisitions liabilities agreements investments acquisitions liabilities Beginning balance at January 1, 32,002 35,751 1,372,008 — 42,793 37,846 1,468,517 Increase 814 24 195 — 4,833 5,232 31,050 Decrease — (18,558) (1,711) — — (3,603) (42,490) Reclassifications — — — 90,457 (1) — — — Gain / loss recognized in profit or loss (2) 916 (754) — 9,726 (14,340) (3,366) — Gain / loss recognized in equity — — (32,967) — — — (28,034) Foreign currency translation and other changes 716 242 29,718 2,042 (1,284) (358) (57,035) Ending balance at March 31, and December 31, 34,448 16,705 1,367,243 102,225 32,002 35,751 1,372,008 (1) Receivables for royalty payments from one of the Company’s equity investments were previously recorded as a non-financial asset and were revised as of March 31, 2024. (2) Includes realized and unrealized gains / losses. |
Segment and corporate informa_2
Segment and corporate information (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Segment and corporate information | |
Schedule of segment and corporate information | Segment and corporate information in € THOUS Care Total Inter-segment Care Delivery Enablement Segment eliminations Corporate Total Three months ended March 31, 2024 Revenue from health care services (1) 3,365,334 — 3,365,334 — — 3,365,334 Revenue from health care products (1) 39,890 914,194 954,084 — — 954,084 Revenue from contracts with customers (1) 3,405,224 914,194 4,319,418 — — 4,319,418 Revenue from insurance contracts (1) 382,930 — 382,930 — — 382,930 Revenue from lease contracts (1) — 22,174 22,174 — — 22,174 Revenue from external customers 3,788,154 936,368 4,724,522 — — 4,724,522 Inter-segment revenue — 360,690 360,690 (360,690) — — Revenue 3,788,154 1,297,058 5,085,212 (360,690) — 4,724,522 Operating income (loss) 188,549 70,215 258,764 838 (13,589) 246,013 Interest (88,187) Income before income taxes 157,826 Depreciation and amortization (264,654) (115,365) (380,019) 10,332 (18,048) (387,735) Impairment loss (123,661) (1,047) (124,708) — — (124,708) Income (loss) from equity method investees 28,843 — 28,843 — — 28,843 Total assets (1) 44,033,238 13,640,881 57,674,119 (34,533,212) 11,195,192 34,336,099 thereof investment in equity method investees (1) 615,755 — 615,755 — — 615,755 Additions of property, plant and equipment, intangible assets and right-of-use assets (1) 188,950 85,846 274,796 (10,178) 20,420 285,038 Three months ended March 31, 2023 Revenue from health care services (1) 3,465,868 — 3,465,868 — — 3,465,868 Revenue from health care products (1) 42,816 933,753 976,569 — — 976,569 Revenue from contracts with customers (1) 3,508,684 933,753 4,442,437 — — 4,442,437 Revenue from insurance contracts (1) 246,863 — 246,863 — — 246,863 Revenue from lease contracts (1) — 14,918 14,918 — — 14,918 Revenue from external customers 3,755,547 948,671 4,704,218 — — 4,704,218 Inter-segment revenue — 361,858 361,858 (361,858) — — Revenue 3,755,547 1,310,529 5,066,076 (361,858) — 4,704,218 Operating income (loss) 284,485 (24,475) 260,010 (9,252) 10,179 260,937 Interest (82,572) Income before income taxes 178,365 Depreciation and amortization (288,229) (115,035) (403,264) 9,716 (18,057) (411,605) Impairment loss (1,916) (24,293) (26,209) — — (26,209) Income (loss) from equity method investees 26,101 1,413 27,514 — — 27,514 Total assets (1) 40,048,443 14,645,444 54,693,887 (27,595,235) 8,401,863 35,500,515 thereof investment in equity method investees (1) 463,839 334,186 798,025 — — 798,025 Additions of property, plant and equipment, intangible assets and right- of-use assets (1) 188,486 109,289 297,775 — 12,812 310,587 (1) These line items are included to comply with requirements under IFRS 8 and IFRS 15 or are provided on a voluntary basis, but not included in the information regularly reviewed by the chief operating decision maker. Additionally, the Company has adjusted the prior period financial information in order to include additional contracts identified during the course of the year ended December 31, 2023 which were subject to certain disclosures in accordance with IFRS 17. |
The Company and basis of pres_4
The Company and basis of presentation (Details) € in Thousands, $ in Thousands | 3 Months Ended | ||||
Mar. 31, 2024 EUR (€) | Mar. 31, 2024 USD ($) | Mar. 31, 2023 EUR (€) | Mar. 31, 2024 USD ($) | Dec. 31, 2023 EUR (€) | |
The Company, basis of presentation and significant accounting policies | |||||
Other current financial liabilities | € 1,689,179 | € 1,675,556 | |||
Increase (decrease) in cash and cash equivalents | € (235,230) | € (49,897) | |||
Effective tax rate (as a percent) | 25% | 25% | 25% | ||
Cyber-attack on Company's third-party service provider | |||||
The Company, basis of presentation and significant accounting policies | |||||
Cash received, but not yet applied directly to customer accounts receivable, recorded as a contra-accounts receivable balance | € 222,463 | $ 240,505 | |||
Increase (decrease) in trade accounts and other receivables from unrelated parties, due to inability to raise claims | 272,571 | $ 294,677 | |||
Increase (decrease) in cash and cash equivalents | (58,127) | $ (62,841) | |||
Cyber-attack on Company's third-party service provider | U.S. Centers for Medicare & Medicaid Services (CMS) | |||||
The Company, basis of presentation and significant accounting policies | |||||
Contract liabilities | 162,070 | 175,214 | |||
Cyber-attack on Company's third-party service provider | Third-party service provider subject to cyber-attack | |||||
The Company, basis of presentation and significant accounting policies | |||||
Other current financial liabilities | € 52,638 | $ 56,907 | |||
Lebanon | |||||
The Company, basis of presentation and significant accounting policies | |||||
Index at March 31, 2024 | 6,321.2 | 6,321.2 | |||
Calendar year increase | 6% | 6% | |||
(Gain) loss on net monetary position in EUR | € 2 | ||||
Turkiye | |||||
The Company, basis of presentation and significant accounting policies | |||||
Index at March 31, 2024 | 2,137.5 | 2,137.5 | |||
Calendar year increase | 15% | 15% | |||
(Gain) loss on net monetary position in EUR | € 882 |
The Company and basis of pres_5
The Company and basis of presentation - Additional information (Details) - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Dec. 31, 2023 | |
Recoverability of Goodwill and Intangible Assets | ||
Goodwill | € 14,675,530 | € 14,650,008 |
Increase (decrease) in market capitalization | (6.00%) | |
Market capitalization | € 10,460,189 | 11,137,975 |
Increase (decrease) in FMC AG & Co. KGaA shareholders' equity | 2% | |
Total FMC AG & Co. KGaA shareholders' equity | € 13,907,356 | 13,620,261 |
Care Delivery | ||
Recoverability of Goodwill and Intangible Assets | ||
Goodwill | € 12,571,036 | € 12,573,423 |
Residual value growth | 1% | 1% |
Pre-tax WACC | 10.78% | 10.53% |
After-tax WACC | 8.32% | 8.09% |
Excess of recoverable amount over carrying amount | € 4,918,691 | € 4,740,257 |
Care Delivery | Pre-tax WACC | ||
Recoverability of Goodwill and Intangible Assets | ||
Amount by which value assigned to key assumption must change in order for unit's recoverable amount to be equal to carrying amount | 0.0217 | 0.0210 |
Care Delivery | After-tax WACC | ||
Recoverability of Goodwill and Intangible Assets | ||
Amount by which value assigned to key assumption must change in order for unit's recoverable amount to be equal to carrying amount | 0.0164 | 0.0160 |
Care Delivery | Residual value growth | ||
Recoverability of Goodwill and Intangible Assets | ||
Amount by which value assigned to key assumption must change in order for unit's recoverable amount to be equal to carrying amount | (0.0749) | (0.0726) |
Care Delivery | Operating income margin | ||
Recoverability of Goodwill and Intangible Assets | ||
Amount by which value assigned to key assumption must change in order for unit's recoverable amount to be equal to carrying amount | (0.0247) | (0.0235) |
Care Enablement | ||
Recoverability of Goodwill and Intangible Assets | ||
Goodwill | € 2,104,494 | € 2,076,585 |
Residual value growth | 1% | 1% |
Pre-tax WACC | 9.07% | 8.41% |
After-tax WACC | 7.34% | 6.54% |
Excess of recoverable amount over carrying amount | € 3,454,949 | € 3,285,391 |
Care Enablement | Pre-tax WACC | ||
Recoverability of Goodwill and Intangible Assets | ||
Amount by which value assigned to key assumption must change in order for unit's recoverable amount to be equal to carrying amount | 0.0228 | 0.0227 |
Care Enablement | After-tax WACC | ||
Recoverability of Goodwill and Intangible Assets | ||
Amount by which value assigned to key assumption must change in order for unit's recoverable amount to be equal to carrying amount | 0.0169 | 0.0166 |
Care Enablement | Residual value growth | ||
Recoverability of Goodwill and Intangible Assets | ||
Amount by which value assigned to key assumption must change in order for unit's recoverable amount to be equal to carrying amount | (0.0542) | (0.0557) |
Care Enablement | Operating income margin | ||
Recoverability of Goodwill and Intangible Assets | ||
Amount by which value assigned to key assumption must change in order for unit's recoverable amount to be equal to carrying amount | (0.0303) | (0.0302) |
Disposal groups classified as_3
Disposal groups classified as held for sale (Details) € in Thousands | Mar. 31, 2024 EUR (€) item | Dec. 31, 2023 EUR (€) | Mar. 31, 2023 EUR (€) |
Disposal groups classified as held for sale | |||
Assets | € 34,336,099 | € 33,929,808 | € 35,500,515 |
Disposal groups classified as held for sale | |||
Disposal groups classified as held for sale | |||
Assets | € 896,531 | € 507,600 | |
Disposal group classified as held for sale in Sub-Saharan Africa | Care Delivery | |||
Disposal groups classified as held for sale | |||
Number of renal dialysis clinics to be sold | item | 46 | ||
Disposal group classified as held for sale in Guatemala, Curacao, Peru, Turkiye, Brazil, Colombia and Ecuador | Care Delivery | Non-recurring fair value measurement | |||
Disposal groups classified as held for sale | |||
Assets | € 237,590 |
Disposal groups classified as_4
Disposal groups classified as held for sale - Assets and liabilities of disposal groups classified as held for sale (Details) - EUR (€) € in Thousands | Mar. 31, 2024 | Dec. 31, 2023 | Mar. 31, 2023 |
Disposal groups classified as held for sale | |||
Cash and cash equivalents | € 1,148,261 | € 1,403,492 | |
Trade accounts and other receivables from unrelated parties | 3,999,789 | 3,471,213 | |
Property, plant and equipment | 3,672,917 | 3,782,780 | |
Right-of-use assets | 3,633,509 | 3,671,241 | |
Goodwill | 14,675,530 | 14,650,008 | |
Total assets | 34,336,099 | 33,929,808 | € 35,500,515 |
Accounts payable to unrelated parties | 725,178 | 762,068 | |
Total liabilities | 19,203,772 | 19,103,273 | |
Disposal groups classified as held for sale | |||
Disposal groups classified as held for sale | |||
Cash and cash equivalents | 43,734 | 23,733 | |
Trade accounts and other receivables from unrelated parties | 194,876 | 27,535 | |
Property, plant and equipment | 80,768 | 42,710 | |
Right-of-use assets | 124,776 | 114,602 | |
Goodwill | 396,976 | 274,543 | |
Other | 55,401 | 24,477 | |
Total assets | 896,531 | 507,600 | |
Accounts payable to unrelated parties | 22,620 | 12,880 | |
Lease liabilities | 153,313 | 128,653 | |
Provisions and other liabilities | 94,398 | 39,091 | |
Total liabilities | 270,331 | € 180,624 | |
Accumulated foreign currency translation gains (losses) recognized in other comprehensive income | € (150,518) |
Notes to the consolidated sta_3
Notes to the consolidated statements of income - Revenue (Details) - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Revenue | ||
Revenue from contracts with customers | € 4,319,418 | € 4,442,437 |
Revenue from insurance contracts | 382,930 | 246,863 |
Revenue from lease contracts | 22,174 | 14,918 |
Revenue | 4,724,522 | 4,704,218 |
Health care services | ||
Revenue | ||
Revenue from contracts with customers | 3,365,334 | 3,465,868 |
Revenue from insurance contracts | 382,930 | 246,863 |
Revenue | 3,748,264 | 3,712,731 |
Health care products | ||
Revenue | ||
Revenue from contracts with customers | 954,084 | 976,569 |
Revenue from lease contracts | 22,174 | 14,918 |
Revenue | € 976,258 | € 991,487 |
Notes to the consolidated sta_4
Notes to the consolidated statements of income - Disaggregation of revenue by categories (Details) - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Revenue | ||
Revenue | € 4,724,522 | € 4,704,218 |
Inter-segment eliminations | ||
Revenue | ||
Revenue | (360,690) | (361,858) |
Care Delivery | ||
Revenue | ||
Revenue | 3,788,154 | 3,755,547 |
Care Delivery | Segments | ||
Revenue | ||
Revenue | 3,788,154 | 3,755,547 |
Care Delivery | United States | ||
Revenue | ||
Revenue | 3,101,758 | 3,002,715 |
Care Delivery | International | ||
Revenue | ||
Revenue | 686,396 | 752,832 |
Care Enablement | ||
Revenue | ||
Revenue | 936,368 | 948,671 |
Care Enablement | Segments | ||
Revenue | ||
Revenue | 1,297,058 | 1,310,529 |
Care Enablement | Inter-segment eliminations | ||
Revenue | ||
Revenue | € (360,690) | € (361,858) |
Notes to the consolidated sta_5
Notes to the consolidated statements of income - Selling, general and administrative expense (Details) - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Notes to the consolidated statements of income | ||
Distribution costs | € 190,562 | € 203,278 |
General and administrative expense | 585,082 | 578,876 |
Selling, general and administrative expense | € 775,644 | € 782,154 |
Notes to the consolidated sta_6
Notes to the consolidated statements of income - Research and development expenses (Details) - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Notes to the consolidated statements of income | ||
Research and development expense | € 47,801 | € 55,760 |
Notes to the consolidated sta_7
Notes to the consolidated statements of income - Other operating income and expense (Details) - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Notes to the consolidated statements of income | ||
Foreign exchange gains | € 61,676 | € 72,140 |
Gains on or from right-of-use assets, the sale of fixed assets, the sale of clinics and investments | 3,144 | 13,625 |
Revaluation of certain investments | 15,197 | 19,286 |
Income from strategic transactions and programs | 3,106 | |
Other | 30,376 | 12,420 |
Other operating income | 113,499 | 117,471 |
Foreign exchange losses | 70,415 | 84,403 |
Losses on right-of-use assets, from the sale of fixed assets, clinics and investments | 2,064 | 10,539 |
Expenses from strategic transactions and programs | 154,955 | 83,439 |
Other | 19,101 | 16,895 |
Other operating expense | € 246,535 | € 195,276 |
Notes to the consolidated sta_8
Notes to the consolidated statements of income - Expenses from strategic transactions and programs (Details) - EUR (€) € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Strategic transactions and programs | ||
Derecognition of capitalized development costs and termination costs | € 59,113 | |
Impairment of intangible and tangible assets | € 1,047 | 24,326 |
Impairment resulting from the measurement of assets held for sale | 123,552 | |
Loss from the sale of business | 24,988 | |
Other | 5,368 | |
Expenses from strategic transactions and programs | 154,955 | 83,439 |
Legacy Portfolio Optimization | ||
Strategic transactions and programs | ||
Derecognition of capitalized development costs and termination costs | 59,113 | |
Impairment of intangible and tangible assets | € 24,326 | |
Impairment resulting from the measurement of assets held for sale | 123,552 | |
Loss from the sale of business | 24,988 | |
Other | 4,152 | |
FME25 Program | ||
Strategic transactions and programs | ||
Impairment of intangible and tangible assets | 1,047 | |
Legal Form Conversion Costs | ||
Strategic transactions and programs | ||
Other | € 1,216 |
Notes to the consolidated sta_9
Notes to the consolidated statements of income - Reconciliation of basic and diluted earnings per share (Details) - EUR (€) € / shares in Units, € in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Numerator: | ||
Net income attributable to shareholders of FME AG | € 70,959 | € 86,362 |
Denominators: | ||
Weighted average number of shares outstanding | 293,413,449 | 293,413,449 |
Basic earnings per share | € 0.24 | € 0.29 |
Diluted earnings per share | € 0.24 | € 0.29 |
Related party transactions - Se
Related party transactions - Service agreements and products - General (Details) | 1 Months Ended | 11 Months Ended | ||
Dec. 31, 2010 | Dec. 31, 2023 | Nov. 30, 2023 | Mar. 31, 2024 | |
Vifor Fresenius Medical Care Renal Pharma Ltd. | ||||
Related party transactions | ||||
Ownership in associate (as a percent) | 45% | |||
Fresenius SE | ||||
Related party transactions | ||||
Proportion of ownership interest in reporting entity (as a percent) | 32.20% | |||
Fresenius SE Companies | Minimum | ||||
Related party transactions | ||||
Term of related party agreement to receive services | 1 year | |||
Fresenius SE Companies | Maximum | ||||
Related party transactions | ||||
Term of related party agreement to receive services | 2 years | 5 years | ||
Term of related party agreement to provide services | 1 year |
Related party transactions - _2
Related party transactions - Service agreements and products with related parties (Details) - EUR (€) € in Thousands | 3 Months Ended | ||
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | |
Service Agreements | |||
Related Party Transactions | |||
Sales of goods and services | € 1,364 | € 3,055 | |
Purchases of goods and services | 28,905 | 22,625 | |
Balances | |||
Accounts receivable | 32,804 | € 52,041 | |
Accounts payable | 8,909 | 16,077 | |
Accrued expenses | 15,754 | 5,172 | |
Products | |||
Related Party Transactions | |||
Sales of goods and services | 18,772 | 18,335 | |
Purchases of goods and services | 103,026 | 117,656 | |
Balances | |||
Accounts receivable | 17,443 | 23,535 | |
Accounts payable | 74,675 | 76,988 | |
Fresenius SE | Service Agreements | |||
Related Party Transactions | |||
Sales of goods and services | 35 | ||
Purchases of goods and services | 5,289 | 8,067 | |
Balances | |||
Accounts receivable | 1,472 | 10 | |
Accounts payable | 395 | 1,778 | |
Fresenius SE affiliates | Service Agreements | |||
Related Party Transactions | |||
Sales of goods and services | 155 | 1,942 | |
Purchases of goods and services | 23,616 | 14,558 | |
Balances | |||
Accounts receivable | 2,512 | 589 | |
Accounts payable | 8,514 | 14,299 | |
Fresenius SE affiliates | Products | |||
Related Party Transactions | |||
Sales of goods and services | 18,772 | 18,335 | |
Purchases of goods and services | 6,643 | 6,492 | |
Balances | |||
Accounts receivable | 17,443 | 23,535 | |
Accounts payable | 5,474 | 9,585 | |
Fresenius SE affiliates | Products | Increase (decrease) due to correction of error | |||
Related Party Transactions | |||
Purchases of goods and services | (4,246) | ||
Equity method investees | Service Agreements | |||
Related Party Transactions | |||
Sales of goods and services | 1,209 | 1,078 | |
Balances | |||
Accounts receivable | 28,820 | 51,442 | |
Equity method investees | Service Agreements | Increase (decrease) due to correction of error | |||
Related Party Transactions | |||
Sales of goods and services | 6,539 | ||
Equity method investees | Products | |||
Related Party Transactions | |||
Purchases of goods and services | 96,383 | 111,164 | |
Balances | |||
Accounts payable | € 69,201 | € 67,403 | |
Equity method investees | Products | Increase (decrease) due to correction of error | |||
Related Party Transactions | |||
Purchases of goods and services | € 23,873 |
Related party transactions - Le
Related party transactions - Lease Agreements - Summary (Details) - EUR (€) € in Thousands | 3 Months Ended | ||
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | |
Leases balances | |||
Right-of-use asset | € 3,633,509 | € 3,671,241 | |
Lease Agreements | |||
Lease Transactions | |||
Depreciation | 6,233 | € 6,540 | |
Interest expense | 591 | 685 | |
Lease expense | 223 | 230 | |
Leases balances | |||
Right-of-use asset | 128,992 | 131,243 | |
Lease liability | 131,538 | 133,575 | |
Fresenius SE | Lease Agreements | |||
Lease Transactions | |||
Depreciation | 1,630 | 2,088 | |
Interest expense | 215 | 255 | |
Lease expense | 223 | 230 | |
Leases balances | |||
Right-of-use asset | 28,212 | 29,214 | |
Lease liability | 31,148 | 29,017 | |
Fresenius SE affiliates | Lease Agreements | |||
Lease Transactions | |||
Depreciation | 4,603 | 4,452 | |
Interest expense | 376 | € 430 | |
Leases balances | |||
Right-of-use asset | 100,780 | 102,029 | |
Lease liability | € 100,390 | € 104,558 |
Related party transactions - Fi
Related party transactions - Financing (Details) - EUR (€) € in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Equity method investees | Cash pooling program | ||
Balances | ||
Accounts payable | € 26,651 | € 26,875 |
Related party transactions - Ke
Related party transactions - Key management personnel (Details) - General Partner - EUR (€) € in Thousands | 3 Months Ended | ||
Mar. 31, 2023 | Mar. 31, 2024 | Dec. 31, 2023 | |
Related Party Transactions | |||
Amount paid for services received from related party | € 7,675 | ||
Balances | |||
Accounts receivable | € 0 | € 89,723 | |
Accounts payable | € 0 | € 3,141 |
Insurance contracts (Details)
Insurance contracts (Details) - EUR (€) € in Thousands | 3 Months Ended | 12 Months Ended |
Mar. 31, 2024 | Dec. 31, 2023 | |
Reinsurance contracts | ||
Insurance and reinsurance contracts | ||
Insurance contract receivables (liabilities) at beginning of period | € 52,206 | € 22,124 |
Incurred claims and other directly attributable expenses | (169,230) | (165,336) |
Changes that relate to past service - changes in the fulfillment cash-flows relating to LIC | (18,517) | 1,544 |
Claims and other directly attributable expenses paid | (387,949) | |
Premium revenue | 179,913 | 583,269 |
Foreign currency translation and other changes | 1,119 | (1,446) |
Insurance contract receivables (liabilities) at end of period | 45,491 | 52,206 |
Premium revenue for past performance years | 568 | 9,038 |
Reinsurance contracts | Present value of future cash flows | ||
Insurance and reinsurance contracts | ||
Insurance contract receivables (liabilities) at beginning of period | 53,137 | 23,925 |
Incurred claims and other directly attributable expenses | (169,404) | (166,161) |
Changes that relate to past service - changes in the fulfillment cash-flows relating to LIC | (18,517) | 1,544 |
Claims and other directly attributable expenses paid | (387,949) | |
Premium revenue | 179,913 | 583,269 |
Foreign currency translation and other changes | 1,139 | (1,491) |
Insurance contract receivables (liabilities) at end of period | 46,268 | 53,137 |
Reinsurance contracts | Risk adjustment for non-financial risk | ||
Insurance and reinsurance contracts | ||
Insurance contract receivables (liabilities) at beginning of period | (931) | (1,801) |
Incurred claims and other directly attributable expenses | 174 | 825 |
Foreign currency translation and other changes | (20) | 45 |
Insurance contract receivables (liabilities) at end of period | (777) | (931) |
Insurance contracts | ||
Insurance and reinsurance contracts | ||
Insurance contract receivables (liabilities) at beginning of period | 26,836 | 20,415 |
Incurred claims and other directly attributable expenses | (193,095) | (209,198) |
Changes that relate to past service - changes in the fulfillment cash-flows relating to LIC | (2,891) | (2,666) |
Claims and other directly attributable expenses paid | (423,377) | |
Premium revenue | 205,750 | 642,529 |
Foreign currency translation and other changes | 636 | (867) |
Insurance contract receivables (liabilities) at end of period | 37,236 | 26,836 |
Premium revenue for past performance years | 3,303 | 7,696 |
Insurance contracts | Present value of future cash flows | ||
Insurance and reinsurance contracts | ||
Insurance contract receivables (liabilities) at beginning of period | 27,389 | 20,669 |
Incurred claims and other directly attributable expenses | (193,179) | (208,884) |
Changes that relate to past service - changes in the fulfillment cash-flows relating to LIC | (2,891) | (2,666) |
Claims and other directly attributable expenses paid | (423,377) | |
Premium revenue | 205,750 | 642,529 |
Foreign currency translation and other changes | 648 | (882) |
Insurance contract receivables (liabilities) at end of period | 37,717 | 27,389 |
Insurance contracts | Risk adjustment for non-financial risk | ||
Insurance and reinsurance contracts | ||
Insurance contract receivables (liabilities) at beginning of period | (553) | (254) |
Incurred claims and other directly attributable expenses | 84 | (314) |
Foreign currency translation and other changes | (12) | 15 |
Insurance contract receivables (liabilities) at end of period | € (481) | € (553) |
Inventories (Details)
Inventories (Details) - EUR (€) € in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Inventories | ||
Finished goods | € 1,260,470 | € 1,232,702 |
Health care supplies | 437,373 | 451,316 |
Raw materials and purchased components | 369,815 | 361,804 |
Work in process | 148,743 | 133,353 |
Inventories | € 2,216,401 | € 2,179,175 |
Short-term debt (Details)
Short-term debt (Details) - EUR (€) € in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Debt | ||
Short-term debt from unrelated parties | € 109,137 | € 456,904 |
Cash and cash equivalents before offset | 1,265,217 | 1,530,328 |
Short-term debt from unrelated parties before offset | 226,093 | 583,740 |
Commercial paper program | ||
Debt | ||
Short-term debt from unrelated parties | 85,580 | 399,078 |
Outstanding amount | 86,000 | 400,000 |
Commercial paper program | Maximum | ||
Debt | ||
Commercial paper borrowing limit | 1,500,000 | |
Borrowings under lines of credit | ||
Debt | ||
Short-term debt from unrelated parties | 23,544 | 57,754 |
Borrowings offset under cash management system | 116,956 | 126,836 |
Other | ||
Debt | ||
Short-term debt from unrelated parties | € 13 | € 72 |
Long-term debt (Details)
Long-term debt (Details) - EUR (€) € in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Long-term debt | ||
Long-term debt | € 7,812,383 | € 7,447,562 |
Less current portion | (795,734) | (487,699) |
Long-term debt, less current portion | 7,016,649 | 6,959,863 |
Schuldschein loans | ||
Long-term debt | ||
Long-term debt | 226,035 | 228,759 |
Bonds | ||
Long-term debt | ||
Long-term debt | 6,773,647 | 6,676,465 |
Accounts Receivable Facility | ||
Long-term debt | ||
Long-term debt | 301,921 | 22,857 |
Other long-term debt | ||
Long-term debt | ||
Long-term debt | € 510,780 | € 519,481 |
Long-term debt - Accounts Recei
Long-term debt - Accounts Receivable Facility (Details) - Accounts Receivable Facility € in Thousands, $ in Thousands | Mar. 31, 2024 USD ($) | Mar. 31, 2024 EUR (€) | Dec. 31, 2023 USD ($) | Dec. 31, 2023 EUR (€) | Aug. 11, 2021 USD ($) | Aug. 11, 2021 EUR (€) |
Long-term debt | ||||||
Maximum amount available | $ 900,000 | € 832,485 | $ 900,000 | € 814,482 | $ 900,000 | € 768,049 |
Balance outstanding | 325,000 | 300,620 | 25,000 | 22,624 | ||
Letters of credit outstanding | $ 28,332 | € 26,207 | $ 28,332 | € 25,640 |
Long-term debt - Syndicated Cre
Long-term debt - Syndicated Credit Facility and Others (Details) - EUR (€) € in Thousands | Jul. 01, 2027 | Mar. 31, 2024 |
Syndicated Credit Facility | ||
Long-term debt | ||
Maximum amount available | € 1,918,367 | € 2,000,000 |
Capital management (Details)
Capital management (Details) | Mar. 31, 2024 | Dec. 31, 2023 |
Capital management | ||
Total equity in % of total assets (equity ratio) | 44.10% | 43.70% |
Debt and lease liabilities (including amounts directly associated with assets held for sale) in % of total assets | 35.50% | 35.90% |
Commitments and contingencies (
Commitments and contingencies (Details) € in Thousands, $ in Thousands | 3 Months Ended | 12 Months Ended | ||||
Apr. 05, 2024 item | Mar. 31, 2024 USD ($) item | Dec. 31, 2017 USD ($) | Dec. 31, 2017 EUR (€) | Mar. 31, 2024 EUR (€) | Dec. 31, 2017 EUR (€) | |
Commitments and contingencies | ||||||
Number of publicly disclosed information security breaches | 1 | |||||
Residual value guarantees in lease contracts | $ 938,228 | € 867,842 | ||||
Acid Concentrate Products - Personal Injury | ||||||
Commitments and contingencies | ||||||
Settlement funded by insurers | $ 220,000 | € 179,284 | ||||
Settlement under a reciprocal reservation of rights | 250,000 | € 203,732 | ||||
Net litigation settlement expense recorded | 60,000 | € 48,896 | ||||
Contribution to personal injury settlement | 30,000 | 24,448 | ||||
Uninsured fees and costs accrued | $ 30,000 | € 24,448 | ||||
Amount to be recovered by AIG, if it prevails in all its remaining claims | 60,000 | 48,896 | ||||
Amount that FMCH claims to recover | $ 108,000 | € 88,012 | ||||
Conversion of Company into legal form of stock corporation | ||||||
Commitments and contingencies | ||||||
Number of plaintiffs who filed against resolution approving conversion of Company into legal form of stock corporation | 4 | |||||
Number of actions for contestation and annulment filed against resolution approving conversion of Company into legal form of stock corporation | 2 | |||||
Conversion of Company into legal form of stock corporation | Minimum | ||||||
Commitments and contingencies | ||||||
Period of proceedings regarding action for contestation and annulment against resolution, first instance | 1 year | |||||
Period of proceedings regarding action for contestation and annulment against resolution, second instance | 1 year | |||||
Unfair or exclusionary conduct in violation of Section 5 of the FTC act | ||||||
Commitments and contingencies | ||||||
Number of civil investigative demands (CIDs) from U.S. Federal Trade Commission | 2 | |||||
Information security breach at Cardiovascular Consultants, Ltd | ||||||
Commitments and contingencies | ||||||
Number of putative class action lawsuits | 3 | |||||
Number of federal purported class action lawsuits voluntarily dismissed and consolidated with pending state court case | 4 | |||||
Number of actions that received class certification | 0 | |||||
Arizona state court | ||||||
Commitments and contingencies | ||||||
Number of putative class action lawsuits | 1 | |||||
Pennsylvania federal court | ||||||
Commitments and contingencies | ||||||
Number of putative class action lawsuits | 2 |
Financial instruments - Carryin
Financial instruments - Carrying amount and fair value (Details) - EUR (€) € in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Financial instruments | ||
Carrying amount of financial assets | € 6,137,958 | € 5,895,760 |
Carrying amount of financial liabilities | 15,269,590 | 15,326,777 |
Amortized cost - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 9,756,632 | 9,763,867 |
FVPL - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 32,511 | 40,641 |
Not classified | ||
Financial instruments | ||
Carrying amount of financial liabilities | 5,480,447 | 5,522,269 |
Accounts payable to unrelated parties | ||
Financial instruments | ||
Carrying amount of financial liabilities | 725,178 | 762,068 |
Accounts payable to unrelated parties | Amortized cost - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 725,178 | 762,068 |
Accounts payable to related parties | ||
Financial instruments | ||
Carrying amount of financial liabilities | 110,235 | 123,081 |
Accounts payable to related parties | Amortized cost - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 110,235 | 123,081 |
Short-term debt | ||
Financial instruments | ||
Carrying amount of financial liabilities | 109,137 | 456,904 |
Short-term debt | Amortized cost - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 109,137 | 456,904 |
Long-term debt | ||
Financial instruments | ||
Carrying amount of financial liabilities | 7,812,383 | 7,447,562 |
Long-term debt | Level 1 | ||
Financial instruments | ||
Fair value of financial liabilities | 6,072,896 | 5,972,767 |
Long-term debt | Level 2 | ||
Financial instruments | ||
Fair value of financial liabilities | 1,038,222 | 767,328 |
Long-term debt | Amortized cost - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 7,812,383 | 7,447,562 |
Lease liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 4,109,146 | 4,145,946 |
Lease liabilities | Not classified | ||
Financial instruments | ||
Carrying amount of financial liabilities | 4,109,146 | 4,145,946 |
Other current and non-current liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 2,403,511 | 2,391,216 |
Other current and non-current liabilities | Amortized cost - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 999,699 | 974,252 |
Other current and non-current liabilities | FVPL - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 32,511 | 40,641 |
Other current and non-current liabilities | Not classified | ||
Financial instruments | ||
Carrying amount of financial liabilities | 1,371,301 | 1,376,323 |
Derivatives - cash flow hedging instruments | ||
Financial instruments | ||
Carrying amount of financial liabilities | 4,058 | 4,315 |
Derivatives - cash flow hedging instruments | Level 2 | ||
Financial instruments | ||
Fair value of financial liabilities | 4,058 | 4,315 |
Derivatives - cash flow hedging instruments | Not classified | ||
Financial instruments | ||
Carrying amount of financial liabilities | 4,058 | 4,315 |
Derivatives - not designated as hedging instruments | ||
Financial instruments | ||
Carrying amount of financial liabilities | 15,806 | 4,890 |
Derivatives - not designated as hedging instruments | Level 2 | ||
Financial instruments | ||
Fair value of financial liabilities | 15,806 | 4,890 |
Derivatives - not designated as hedging instruments | FVPL - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 15,806 | 4,890 |
Variable payments outstanding for acquisition | ||
Financial instruments | ||
Carrying amount of financial liabilities | 16,705 | 35,751 |
Variable payments outstanding for acquisition | Level 3 | ||
Financial instruments | ||
Fair value of financial liabilities | 16,705 | 35,751 |
Variable payments outstanding for acquisition | FVPL - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 16,705 | 35,751 |
Put option liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 1,367,243 | 1,372,008 |
Put option liabilities | Level 3 | ||
Financial instruments | ||
Fair value of financial liabilities | 1,367,243 | 1,372,008 |
Put option liabilities | Not classified | ||
Financial instruments | ||
Carrying amount of financial liabilities | 1,367,243 | 1,372,008 |
Other financial liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 999,699 | 974,252 |
Other financial liabilities | Amortized cost - Liabilities | ||
Financial instruments | ||
Carrying amount of financial liabilities | 999,699 | 974,252 |
Amortized cost - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 5,081,512 | 4,906,391 |
FVPL - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 474,237 | 380,974 |
FVOCI - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 393,645 | 412,184 |
Not classified | ||
Financial instruments | ||
Carrying amount of financial assets | 188,564 | 196,211 |
Cash and cash equivalents | ||
Financial instruments | ||
Carrying amount of financial assets | 1,148,261 | 1,403,492 |
Cash and cash equivalents | Level 1 | ||
Financial instruments | ||
Fair value of financial assets | 178,438 | 198,462 |
Cash and cash equivalents | Amortized cost - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 969,823 | 1,205,030 |
Cash and cash equivalents | FVPL - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 178,438 | 198,462 |
Trade accounts and other receivables from unrelated parties | ||
Financial instruments | ||
Carrying amount of financial assets | 3,999,789 | 3,471,213 |
Trade accounts and other receivables from unrelated parties | Amortized cost - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 3,919,126 | 3,389,314 |
Trade accounts and other receivables from unrelated parties | Not classified | ||
Financial instruments | ||
Carrying amount of financial assets | 80,663 | 81,899 |
Accounts receivable from related parties | ||
Financial instruments | ||
Carrying amount of financial assets | 50,247 | 165,299 |
Accounts receivable from related parties | Amortized cost - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 50,247 | 165,299 |
Other current and non-current assets | ||
Financial instruments | ||
Carrying amount of financial assets | 939,661 | 855,756 |
Other current and non-current assets | Amortized cost - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 142,316 | 146,748 |
Other current and non-current assets | FVPL - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 295,799 | 182,512 |
Other current and non-current assets | FVOCI - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 393,645 | 412,184 |
Other current and non-current assets | Not classified | ||
Financial instruments | ||
Carrying amount of financial assets | 107,901 | 114,312 |
Derivatives - cash flow hedging instruments | ||
Financial instruments | ||
Carrying amount of financial assets | 2,097 | 1,990 |
Derivatives - cash flow hedging instruments | Level 2 | ||
Financial instruments | ||
Fair value of financial assets | 2,097 | 1,990 |
Derivatives - cash flow hedging instruments | Not classified | ||
Financial instruments | ||
Carrying amount of financial assets | 2,097 | 1,990 |
Derivatives - not designated as hedging instruments | ||
Financial instruments | ||
Carrying amount of financial assets | 17,028 | 20,295 |
Derivatives - not designated as hedging instruments | Level 2 | ||
Financial instruments | ||
Fair value of financial assets | 17,028 | 20,295 |
Derivatives - not designated as hedging instruments | FVPL - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 17,028 | 20,295 |
Equity investments. | ||
Financial instruments | ||
Carrying amount of financial assets | 156,626 | 153,182 |
Equity investments. | Level 1 | ||
Financial instruments | ||
Fair value of financial assets | 54,026 | 48,888 |
Equity investments. | Level 2 | ||
Financial instruments | ||
Fair value of financial assets | 68,152 | 72,292 |
Equity investments. | Level 3 | ||
Financial instruments | ||
Fair value of financial assets | 34,448 | 32,002 |
Equity investments. | FVPL - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 89,655 | 82,072 |
Equity investments. | FVOCI - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 66,971 | 71,110 |
Debt securities | ||
Financial instruments | ||
Carrying amount of financial assets | 413,565 | 421,219 |
Debt securities | Level 1 | ||
Financial instruments | ||
Fair value of financial assets | 413,565 | 421,219 |
Debt securities | FVPL - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 86,891 | 80,145 |
Debt securities | FVOCI - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 326,674 | 341,074 |
Other financial assets | ||
Financial instruments | ||
Carrying amount of financial assets | 350,345 | 259,070 |
Other financial assets | Level 3 | ||
Financial instruments | ||
Fair value of financial assets | 102,225 | |
Other financial assets | Amortized cost - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 142,316 | 146,748 |
Other financial assets | FVPL - Assets | ||
Financial instruments | ||
Carrying amount of financial assets | 102,225 | |
Other financial assets | Not classified | ||
Financial instruments | ||
Carrying amount of financial assets | € 105,804 | € 112,322 |
Financial instruments - Derivat
Financial instruments - Derivative and non-derivative financial instruments (Details) - EUR (€) € in Thousands | 3 Months Ended | 12 Months Ended |
Mar. 31, 2024 | Dec. 31, 2023 | |
Reconciliation of changes in fair value measurement | ||
Assets at beginning of period | € 33,929,808 | |
Assets at end of period | 34,336,099 | € 33,929,808 |
Liabilities at beginning of period | 19,103,273 | |
Liabilities at end of period | 19,203,772 | 19,103,273 |
Equity investments | Fair Value | Level 3 | ||
Reconciliation of changes in fair value measurement | ||
Assets at beginning of period | 32,002 | 42,793 |
Increase | 814 | 4,833 |
Gain / loss recognised in profit or loss | 916 | (14,340) |
Foreign currency translation and other changes | 716 | (1,284) |
Assets at end of period | 34,448 | 32,002 |
Receivables from licensing agreements | Fair Value | Level 3 | ||
Reconciliation of changes in fair value measurement | ||
Reclassifications | 90,457 | |
Gain / loss recognised in profit or loss | 9,726 | |
Foreign currency translation and other changes | 2,042 | |
Assets at end of period | 102,225 | |
Variable payments outstanding for acquisition | Fair Value | Level 3 | ||
Reconciliation of changes in fair value measurement | ||
Liabilities at beginning of period | 35,751 | 37,846 |
Increase | 24 | 5,232 |
Decrease | (18,558) | (3,603) |
Gain / loss recognized in profit or loss | (754) | (3,366) |
Foreign currency translation and other changes | 242 | (358) |
Liabilities at end of period | 16,705 | 35,751 |
Put option liabilities | Fair Value | Level 3 | ||
Reconciliation of changes in fair value measurement | ||
Liabilities at beginning of period | 1,372,008 | 1,468,517 |
Increase | 195 | 31,050 |
Decrease | (1,711) | (42,490) |
Gain / loss recognized in equity | (32,967) | (28,034) |
Foreign currency translation and other changes | 29,718 | (57,035) |
Liabilities at end of period | € 1,367,243 | € 1,372,008 |
Put option liabilities | Fair Value | Level 3 | Assumed earnings or enterprise value | ||
Reconciliation of changes in fair value measurement | ||
Increase in input | 10% | |
Increase (decrease) in fair value due to increase in input | € 99,149 | |
Put option liabilities | Fair Value | Level 3 | Assumed earnings or enterprise value | Maximum | ||
Reconciliation of changes in fair value measurement | ||
Increase in fair value due to increase in input, as percentage of total liabilities | 1% | |
Increase in fair value due to increase in input, as percentage of equity | 1% |
Segment and corporate informa_3
Segment and corporate information (Details) - EUR (€) € in Thousands | 3 Months Ended | ||
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | |
Segment and corporate information | |||
Revenue from contracts with customers | € 4,319,418 | € 4,442,437 | |
Revenue from insurance contracts | 382,930 | 246,863 | |
Revenue from lease contracts | 22,174 | 14,918 | |
Revenue | 4,724,522 | 4,704,218 | |
Operating income (loss) | 246,013 | 260,937 | |
Interest | (88,187) | (82,572) | |
Income before income taxes | 157,826 | 178,365 | |
Depreciation and amortization | (387,735) | (411,605) | |
Impairment loss | (124,708) | (26,209) | |
Income (loss) from equity method investees | 28,843 | 27,514 | |
Total assets | 34,336,099 | 35,500,515 | € 33,929,808 |
thereof investment in equity method investees | 615,755 | 798,025 | € 642,928 |
Additions of property, plant and equipment, intangible assets and right-of-use assets | 285,038 | 310,587 | |
Health care services | |||
Segment and corporate information | |||
Revenue from contracts with customers | 3,365,334 | 3,465,868 | |
Revenue from insurance contracts | 382,930 | 246,863 | |
Revenue | 3,748,264 | 3,712,731 | |
Health care products | |||
Segment and corporate information | |||
Revenue from contracts with customers | 954,084 | 976,569 | |
Revenue from lease contracts | 22,174 | 14,918 | |
Revenue | 976,258 | 991,487 | |
Total Segment | |||
Segment and corporate information | |||
Revenue from contracts with customers | 4,319,418 | 4,442,437 | |
Revenue from insurance contracts | 382,930 | 246,863 | |
Revenue from lease contracts | 22,174 | 14,918 | |
Revenue | 4,724,522 | 4,704,218 | |
Total Segment | Health care services | |||
Segment and corporate information | |||
Revenue from contracts with customers | 3,365,334 | 3,465,868 | |
Total Segment | Health care products | |||
Segment and corporate information | |||
Revenue from contracts with customers | 954,084 | 976,569 | |
Care Delivery | |||
Segment and corporate information | |||
Revenue from contracts with customers | 3,405,224 | 3,508,684 | |
Revenue from insurance contracts | 382,930 | 246,863 | |
Revenue | 3,788,154 | 3,755,547 | |
Care Delivery | Health care services | |||
Segment and corporate information | |||
Revenue from contracts with customers | 3,365,334 | 3,465,868 | |
Care Delivery | Health care products | |||
Segment and corporate information | |||
Revenue from contracts with customers | 39,890 | 42,816 | |
Care Enablement | |||
Segment and corporate information | |||
Revenue from contracts with customers | 914,194 | 933,753 | |
Revenue from lease contracts | 22,174 | 14,918 | |
Revenue | 936,368 | 948,671 | |
Care Enablement | Health care products | |||
Segment and corporate information | |||
Revenue from contracts with customers | 914,194 | 933,753 | |
Operating Segments | Total Segment | |||
Segment and corporate information | |||
Revenue | 5,085,212 | 5,066,076 | |
Operating income (loss) | 258,764 | 260,010 | |
Depreciation and amortization | (380,019) | (403,264) | |
Impairment loss | (124,708) | (26,209) | |
Income (loss) from equity method investees | 28,843 | 27,514 | |
Total assets | 57,674,119 | 54,693,887 | |
thereof investment in equity method investees | 615,755 | 798,025 | |
Additions of property, plant and equipment, intangible assets and right-of-use assets | 274,796 | 297,775 | |
Operating Segments | Care Delivery | |||
Segment and corporate information | |||
Revenue | 3,788,154 | 3,755,547 | |
Operating income (loss) | 188,549 | 284,485 | |
Depreciation and amortization | (264,654) | (288,229) | |
Impairment loss | (123,661) | (1,916) | |
Income (loss) from equity method investees | 28,843 | 26,101 | |
Total assets | 44,033,238 | 40,048,443 | |
thereof investment in equity method investees | 615,755 | 463,839 | |
Additions of property, plant and equipment, intangible assets and right-of-use assets | 188,950 | 188,486 | |
Operating Segments | Care Enablement | |||
Segment and corporate information | |||
Revenue | 1,297,058 | 1,310,529 | |
Operating income (loss) | 70,215 | (24,475) | |
Depreciation and amortization | (115,365) | (115,035) | |
Impairment loss | (1,047) | (24,293) | |
Income (loss) from equity method investees | 1,413 | ||
Total assets | 13,640,881 | 14,645,444 | |
thereof investment in equity method investees | 334,186 | ||
Additions of property, plant and equipment, intangible assets and right-of-use assets | 85,846 | 109,289 | |
Operating Segments | Corporate | |||
Segment and corporate information | |||
Operating income (loss) | (13,589) | 10,179 | |
Depreciation and amortization | (18,048) | (18,057) | |
Total assets | 11,195,192 | 8,401,863 | |
Additions of property, plant and equipment, intangible assets and right-of-use assets | 20,420 | 12,812 | |
Inter-segment | |||
Segment and corporate information | |||
Revenue | (360,690) | (361,858) | |
Operating income (loss) | 838 | (9,252) | |
Depreciation and amortization | 10,332 | 9,716 | |
Total assets | (34,533,212) | (27,595,235) | |
Additions of property, plant and equipment, intangible assets and right-of-use assets | (10,178) | ||
Inter-segment | Total Segment | |||
Segment and corporate information | |||
Revenue | (360,690) | (361,858) | |
Inter-segment | Care Enablement | |||
Segment and corporate information | |||
Revenue | € (360,690) | € (361,858) |
Events occurring after the ba_2
Events occurring after the balance sheet date (Details) - Signing of virtual power purchase agreements | 1 Months Ended |
Apr. 30, 2024 GWh / yr item | |
Events after balance sheet date | |
Term of virtual power purchase agreement | 15 years |
Germany | |
Events after balance sheet date | |
Number of wind and solar energy project developers who signed contracts with company | item | 2 |
Expected annual electricity production | GWh / yr | 124 |
United States | |
Events after balance sheet date | |
Number of wind and solar energy project developers who signed contracts with company | item | 1 |
Expected annual electricity production | GWh / yr | 458 |
Percentage of Company's current electricity consumption | 60% |
European Union | |
Events after balance sheet date | |
Percentage of Company's current electricity consumption | 75% |