EX-99.1 2 ex99_1.htm EXHIBIT 99.1 Unassociated Document
 
Exhibit 99.1
 

 
Contact:
 
Fresenius Medical Care AG & Co. KGaA
Oliver Maier
 
Else-Kröner-Str.1
Phone:
+ 49 6172 609 2601
 
61352 Bad Homburg
Fax:
+ 49 6172 609 2301
 
Germany
     
www.fmc-ag.com
North America:
   
Terry L. Morris
   
Phone:
+ 1 800 948 2538
   
Fax:
+ 1 615 345 5605
   
       
E-mail: ir@fmc-ag.com
 
August 2, 2011

Investor News

Fresenius Medical Care Reports Strong Second Quarter and Half Year Results; c onfirms Outlook for 2011 and plans to acquire Liberty Dialysis as well as American Access Care

2nd Quarter 2011 Summary:

Net revenue
 
3,194 million
    +8 %
Operating income (EBIT)
 
510 million
    +9 %
Net income attributable to Fresenius Medical Care AG & Co. KGaA
 
261 million
    +5 %
Earnings per share
  $ 0.86     +4 %

First Half 2011 Summary:

Net revenue
 
6,230 million
    +7 %
Operating income (EBIT)
 
955 million
    +7 %
Net income attributable to Fresenius Medical Care AG & Co. KGaA
 
481 million
    +5 %
Earnings per share
  $ 1.59     +4 %

 
Fresenius Medical Care AG & Co. KGaA, August 2, 2011
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Bad Homburg, Germany – Fresenius Medical Care AG & Co. KGaA (“the company” or “Fresenius Medical Care”; Frankfurt Stock Exchange: FME / New York Stock Exchange: FMS), the world’s largest provider of dialysis products and services, today announced its results for the second quarter and first half of 2011.

2nd Quarter 2011:

Revenue

Net revenue for the second quarter of 2011 increased by 8% to $3,194 million (+5% at constant currency) compared to the second quarter of 2010. Organic revenue growth worldwide was 3%. Dialysis services revenue grew by 6% to $2,362 million (+4% at constant currency) and dialysis product revenue increased by 15% to $832 million (+7% at constant currency).

North America revenue for the second quarter of 2011  was at the same level as the corresponding quarter last year at $2,027 million including the impact of the new Medicare end-stage renal disease prospective payment system in the United States. Dialysis services revenue grew by 1% to $1,828 million with a same market growth of 3%. Average revenue per treatment for U.S. clinics decreased to $348 in the second quarter of 2011 compared to $356 for the corresponding quarter in 2010 reflecting the targeted implementation of the new prospective payment system. Dialysis product revenue decreased by 5% to $199 million, as increased sales of dialysis products could not entirely offset lower pricing of renal drugs.

International revenue increased by 26% to $1,163 million (+15% at constant currency). Organic revenue growth was 8%. Dialysis services revenue increased by 31% to $534 million (+20% at constant currency). Dialysis product revenue increased by 23% to $629 million and increased by 11% at constant currency, mainly driven by higher sales of peritoneal dialysis products, dialyzers, products for acute care treatments and dialysis machines.
 
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Earnings

Operating income (EBIT) for the second quarter of 2011 increased by 9% to $510 million compared to $467 million in the second quarter of 2010. This resulted in an operating margin of 16.0% for the second quarter of 2011 compared to 15.8% for the corresponding quarter in 2010.

In North America the operating margin increased from 16.4% in the second quarter of 2010 to 17.2% in the second quarter of 2011. This increase was mainly favorably influenced by the development of pharmaceutical costs and higher income from the joint venture with Vifor Pharma. Average costs per treatment for U.S. clinics decreased to $283 in the second quarter of 2011 compared to $292 for the corresponding quarter in 2010.

In the International segment, the operating margin decreased from 18.8% to 17.5% mainly due to unfavorable currency effects.

Net interest expense for the second quarter of 2011 was $75 million compared to $68 million in the second quarter of 2010. This development was mainly attributable to a higher debt level.

Income tax expense was $149 million for the second quarter of 2011 compared to $129 million in the second quarter of 2010. The effective tax rate increased to 34.2% from 32.4% mainly as a result of the positive effect in the second quarter of 2010 of the release of a $10 million valuation allowance.

Net income attributable to Fresenius Medical Care AG & Co. KGaA for the second quarter of 2011 was $261 million, an increase of 5% compared to the corresponding quarter of 2010 . Net income increased by  10% if adjusted by the positive tax effect in the second quarter of 2010.

Earnings per share (EPS) for the second quarter of 2011 rose by 4% to $0.86 per ordinary share compared to $0.83 for the second quarter of 2010. The weighted average number of shares outstanding for the second quarter of 2011 was approximately 302.5 million shares compared to 300.0 million shares for the second quarter of 2010. The increase in shares outstanding resulted from stock option exercises in the past 12 months.
 
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Cash flow

In the second quarter of 2011, the company generated $311 million in cash from operations,  accomplishing the targeted  10% of revenue. The cash flow generation was supported by increased earnings and negatively influenced by an unfavorable development of days sales outstanding (DSO) and raised inventory levels.

A total of $117 million in cash  was spent for capital expenditures, net of disposals. Free cash flow before acquisitions was $194 million compared to $175 million in the second quarter of 2010. A total of $784 million in cash was spent for acquisitions and investments, net of divestitures.

Free cash flow after acquisitions, investments and divestitures was -$590 million, compared to -$26 million in the second quarter of 2010 . This reflects the cash outflow related to the closing of the acquisition of Euromedic´s dialysis service business.

First Half 2011:

Revenue and Earnings

Net revenue for the first half of 2011 increased by 7% to $6,230 million (+5% at constant currencies) compared to the first half of 2010. Organic revenue growth was 3% in the first half of 2011.
 
Operating income (EBIT) for the first half of 2011 increased by 7% to $955 million compared to $892 million in the first half of 2010. The operating income margin remained constant at 15.3% for the first half of 2011 as compared to the same period in 2010.

Net interest expense for the first half of 2011 was $146 million compared to $135 million in the same period of 2010.
 
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Income tax expense was for the half of 2011 $273 million compared to $257 million in the same period in 2010, reflecting effective tax rates of 33.8% and 33.9%, respectively.

For the first half of 2011, net income attributable to Fresenius Medical Care AG & Co. KGaA was $481 million, up by 5% from the first half of 2010.

In the first half of 2011, earnings per ordinary share rose by 4% to $1.59. The weighted average number of shares outstanding during the first half of 2011 was approximately 302.4 million.

Cash Flow

Cash from operations during the first half of 2011 was $487 million compared to $643 million for the same period in 2010, representing approximately 8% of revenue.

A total of $231 million in cash  was spent for capital expenditures, net of disposals. Free cash flow before acquisitions for the first  half of 2011 was $256 million compared to $425 million in the same period in 2010. A total of $1,122 million in cash was spent for acquisitions, net of divestitures. Free cash flow after acquisitions and divestitures was -$866 million compared to $142 million in the first half of last year.

Please refer to the attachments for a complete overview on the second quarter and first half of 2011 and the reconciliation of non-GAAP financial measures included in this release to the most comparable GAAP financial measures.
 
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Patients – Clinics – Treatments

As of June 30, 2011, Fresenius Medical Care treated 225,909 patients worldwide, which represents a 12% increase compared to the previous year’s figure. North America provided dialysis treatments for 139,906 patients, an increase of 4%. Including 23 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 141,420. The International segment  provided dialysis treatments to  86,003 patients, an increase of 28% over the prior year’s figure.

As of June 30, 2011, the company operated a total of 2,838 clinics worldwide, which represents a 10% increase compared to the previous year’s figure. The number of clinics is comprised of 1,826 clinics in North America (1,849 including managed clinics), and 1,012 clinics in the International segment, representing an increase of 2% and 26%, respectively.

During the first half of 2011, Fresenius Medical Care delivered approximately 16.56 million dialysis treatments worldwide. This represents an increase of 9% compared to last year’s figure. North America accounted for 10.62 million treatments, an increase of 4%. The International segment delivered 5.94 million treatments, an increase of 18%.

Employees

As of June 30, 2011, Fresenius Medical Care had 77,081 employees (full-time equivalents) worldwide compared to 73,452 employees at the end of 2010. This increase of more than 3,600 employees is due to overall growth in the company’s business and acquisitions.

Debt/EBITDA ratio

The ratio of debt to Earnings before interest, taxes, depreciation and amortization (EBITDA) increased from 2.46 at the end of the second quarter of 2010 to 2.77 at the end of the second quarter of 2011. The debt/EBITDA ratio at the end of 2010 was 2.38.
 
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Rating

Standard & Poor’s Ratings Services rates the company’s corporate credit as ‘BB’ with a ‘positive’ outlook. Moody’s rates the company’s corporate credit as ‘Ba1’ with a ‘stable’ outlook, and Fitch rates the company’s corporate credit as ‘BB’ with a ‘positive’ outlook. For further information on Fresenius Medical Care’s credit ratings, maturity profiles and credit instruments, please visit our website at www.fmc-ag.com / Investor Relations / Credit Relations.

Acquisition of Euromedic’s dialysis service business completed

On July 1, 2011, Fresenius Medical Care announced that it has completed the acquisition of Euromedic’s dialysis service business effective June 30, 2011. This follows final regulatory approvals by the relevant antitrust authorities except Portugal, where the review by the relevant antitrust authority is still ongoing.

Acquisition of Liberty Dialysis Holdings, Inc.

Fresenius Medical Care has executed a merger agreement with Liberty Dialysis Holdings, Inc., the holding company for Liberty Dialysis and Renal Advantage. The investment, including assumed debt, will be approximately $1.7 billion. In addition, Fresenius Medical Care previously invested approximately $300 million in Renal Advantage. The merger is subject to clearance under the Hart–Scott–Rodino Antitrust Improvements Act and is expected to close in early 2012. Liberty Dialysis Holdings, Inc. has annual sales of approximately $1 billion and operates approximately 260 dialysis clinics. Fresenius Medical Care anticipates that facilities may need to be divested to secure regulatory clearance of the transaction. The transaction will be financed from cash flow from operations and debt and is expected to be accretive to earnings in the first year after closing of the transaction.
 
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Rice Powell, chief executive officer of Fresenius Medical Care North America and deputy chairman of Fresenius Medical Care, commented: “We are very pleased with this agreement. Both companies, Liberty Dialysis and Fresenius Medical Care, have three key assets in common: a strong commitment to continuous quality improvement, dedicated and highly-motivated staff and excellent physician partners .”

Mark Caputo, chief executive officer and president of Liberty Dialysis Holdings, Inc, commented: “This combination  of Liberty’s model of integrating physicians into the clinical and operational management of the facilities with Fresenius Medical Care’s focus on technology and experience with integrated delivery systems clearly gives us an opportunity to create a superior platform for innovation in the delivery of services and products and will further enhance the lives of patients entrusted to our care and reduce costs for the healthcare system.”

Acquisition of American Access Care

Fresenius Medical Care has executed an agreement to acquire the U.S. based company American Access Care Holdings, LLC (AAC) for $385 million . AAC operates 28 freestanding out-patient primarily dedicated to serving vascular access needs of dialysis patients.  Fresenius Medical Care currently operates 13 vascular access centers. The transaction is subject to clearance under the Hart–Scott–Rodino Antitrust Improvements Act and is expected to close in the fourth quarter of 2011. On completion, the acquired operations would add approximately $175 million in annual revenue and are expected to be accretive to earnings in the first year after closing of the transaction. The transaction will be financed from cash flow from operations debt.

The acquisition enables Fresenius Medical Care to achieve critical mass in its vascular access business and has strategic importance by virtue of the scale, resources and operational efficiency it brings to its vascular access operations, particularly when considering the U.S. Government’s proposal to include the type of access and the frequency of access-related infections within the quality outcome component of the dialysis bundled reimbursement by system 2014.
 
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Sales and earnings outlook for 2011 confirmed

For the full year 2011, the company confirms its sales and earnings outlook.

Revenue is expected to grow to above $13 billion.

Net income attributable to Fresenius Medical Care AG & Co. KGaA is expected to be between $1.070 billion and $1.090 billion.

For 2011, the company expects to spend around 5% of revenue on capital expenditures and approximately $1.9 billion on acquisitions. Previously the company expected to spend approximately $1.2 billion on acquisitions. The debt/EBITDA ratio is expected to be below 3.0 by the end of 2011 (previously below or equal to 2.8).

“Thanks to a consistent focus on quality, sustainable growth and expense control, we have maintained a strong operational performance this second quarter. We are particularly pleased with the success of our international region, given a persistently challenging business environment with the current debt crisis worldwide and the successful expansion of our clinic network in Asia Pacific and Europe. North America continued to improve its operating margin and successfully cope with the challenges of the ongoing implementation of the new Medicare end-stage renal disease prospective payment system”, said Dr. Ben Lipps, chief executive officer of Fresenius Medical Care. “Our acquisitions of Liberty Dialysis and American Access Care in the U.S. are important steps in our strategy of expanding our service network to achieve excellent patient care in a more cost effective integrated model.”

Conference call

Fresenius Medical Care will hold a conference call to discuss the results of the second quarter and first half of 2011 on Tuesday, August 2, 2011, at 3:30 p.m. CEDT / 9:30 a.m. EDT. The company invites investors to view the live webcast of the call at the company’s website www.fmc-ag.com in the “Investor Relations” section. A replay will be available shortly after the call.
 
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About Fresenius Medical Care
Fresenius Medical Care is the world’s largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 2 million individuals worldwide. Through its network of 2,838 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to 225,909 patients around the globe. Fresenius Medical Care is also the world’s leading provider of dialysis products such as hemodialysis machines, dialyzers and related disposable products.

Disclaimer
This release contains forward-looking statements that are subject to various risks and uncertainties. Actual results could differ materially from those described in these forward-looking statements due to certain factors, including changes in business, economic and competitive conditions, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, and the availability of financing. These and other risks and uncertainties are detailed in Fresenius Medical Care AG & Co. KGaA’s reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care AG & Co. KGaA does not undertake any responsibility to update the forward-looking statements in this release.
 
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Fresenius Medical Care
                                   
Statement of Earnings
 
Three months ended June 30,
 
Six months ended June 30,
(in US-$ thousands, except share data)
 
2011
   
2010
   
Change
 
2011
   
2010
   
Change
(unaudited)
                                   
                                     
Net revenue
                                   
Dialysis care
    2,361,563       2,224,321     6.2 %     4,646,879       4,395,105     5.7 %
Dialysis products
    832,489       721,878     15.3 %     1,583,561       1,433,223     10.5 %
Total net revenue
    3,194,052       2,946,199     8.4 %     6,230,440       5,828,328     6.9 %
                                             
Cost of revenue
    2,072,125       1,934,591     7.1 %     4,073,414       3,852,428     5.7 %
Gross profit
    1,121,927       1,011,608     10.9 %     2,157,026       1,975,900     9.2 %
Selling, general and administrative
    594,480       525,584     13.1 %     1,165,928       1,043,321     11.8 %
Research and development
    26,783       21,373     25.3 %     52,932       44,462     19.0 %
Income from equity method investees
    (8,880 )     (1,914 )   364.0 %     (16,462 )     (3,627 )   353.9 %
Operating income (EBIT)
    509,544       466,565     9.2 %     954,628       891,744     7.1 %
                                             
Interest income
    (15,579 )     (8,244 )   89.0 %     (26,000 )     (14,083 )   84.6 %
Interest expense
    90,183       76,468     17.9 %     172,169       149,732     15.0 %
Interest expense, net
    74,604       68,224     9.4 %     146,169       135,649     7.8 %
Income before taxes
    434,940       398,341     9.2 %     808,459       756,095     6.9 %
Income tax expense
    148,856       129,075     15.3 %     273,260       256,603     6.5 %
Net income
    286,084       269,266     6.2 %     535,199       499,492     7.1 %
Less: Net income attributable to Noncontrolling interest
    25,323       20,997     20.6 %     53,737       40,107     34.0 %
Net income attributable to FMC AG & Co. KGaA
    260,761       248,269     5.0 %     481,462       459,385     4.8 %
                                             
Operating income (EBIT)
    509,544       466,565     9.2 %     954,628       891,744     7.1 %
Depreciation and amortization
    136,289       120,907     12.7 %     272,273       245,365     11.0 %
EBITDA
    645,833       587,472     9.9 %     1,226,901       1,137,109     7.9 %
                                             
Total bad debt expenses
    57,435       55,426             110,119       115,697        
                                             
Earnings per ordinary share
  $ 0.86     $ 0.83     4.2 %   $ 1.59     $ 1.53     3.9 %
Earnings per ordinary ADS
  $ 0.86     $ 0.83     4.2 %   $ 1.59     $ 1.53     3.9 %
                                             
Weighted average number of shares
                                           
Ordinary shares
    298,559,749       296,104,554             298,427,098       295,926,583        
Preference shares
    3,958,515       3,899,075             3,957,978       3,894,560        
                                             
In percent of revenue
                                           
Cost of revenue
    64.9 %     65.7 %           65.4 %     66.1 %      
Gross profit
    35.1 %     34.3 %           34.6 %     33.9 %      
Selling, general and administrative
    18.6 %     17.8 %           18.7 %     17.9 %      
Research and development
    0.8 %     0.7 %           0.8 %     0.8 %      
Income from equity method investees
    -0.3 %     -0.1 %           -0.3 %     -0.1 %      
Operating income (EBIT)
    16.0 %     15.8 %           15.3 %     15.3 %      
Interest expense, net
    2.3 %     2.3 %           2.3 %     2.3 %      
Income before taxes
    13.6 %     13.5 %           13.0 %     13.0 %      
Income tax expense
    4.7 %     4.4 %           4.4 %     4.4 %      
Net income attributable to Noncontrolling interest
    0.8 %     0.7 %           0.9 %     0.7 %      
Net income attributable to FMC AG & Co. KGaA
    8.2 %     8.4 %           7.7 %     7.9 %      
                                             
EBITDA
    20.2 %     19.9 %           19.7 %     19.5 %      
 
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Fresenius Medical Care
                                   
Segment and Other Information
 
Three months ended June 30,
 
Six months ended June 30,
(in US-$ million)
 
2011
 
2010
 
Change
 
2011
 
2010
 
Change
(unaudited)
                                   
                                     
Net revenue
                                   
North America
  2,027     2,027     0.0 %   4,005     3,986     0.5 %
International
  1,163     919     26.4 %   2,217     1,842     20.4 %
Corporate
  4         4,405.6 %   8         2,492.3 %
Total net revenue
  3,194     2,946     8.4 %   6,230     5,828     6.9 %
                                     
Operating income (EBIT)
                                   
North America
  348     332     4.9 %   661     640     3.2 %
International
  203     173     17.4 %   374     324     15.5 %
Corporate
  (41 )   (38 )   8.9 %   (80 )   (72 )   10.8 %
Total operating income (EBIT)
  510     467     9.2 %   955     892     7.1 %
                                     
Operating income in percent of revenue
                                   
North America
  17.2 %   16.4 %         16.5 %   16.1 %      
International
  17.5 %   18.8 %         16.9 %   17.6 %      
Total
  16.0 %   15.8 %         15.3 %   15.3 %      
                                     
Employees
                                   
Full-time equivalents
                    77,081     70,096        
 
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Fresenius Medical Care
                       
Reconciliation of non US-GAAP
                       
financial measures to the most directly
                       
comparable US-GAAP financial measures
 
Three months ended June 30,
   
Six months ended June 30,
 
(in US-$ million)
 
2011
   
2010
   
2011
   
2010
 
(unaudited)
                       
                         
Segment information North America
                       
Net revenue
    2,027       2,027              
Costs of revenue and research and development
    1,321       1,349              
Selling, general and administrative
    367       348              
Income from equity method investees
    (9 )     (2 )            
Costs of revenue and operating expenses
    1,679       1,695              
Operating income (EBIT)
    348       332              
In percent of revenue
    17.2 %     16.4 %            
                             
Dialysis products revenue incl. and excl. internal sales
                           
North America
                           
Dialysis products revenue incl. internal sales
    394       390              
Less internal sales
    (195 )     (180 )            
Dialysis products external sales
    199       210              
International
                           
Dialysis products revenue incl. internal sales
    728       594              
Less internal sales
    (99 )     (82 )            
Dialysis products external sales
    629       512              
Reconciliation of cash flow from operating activities to EBITDA 1)
                           
                             
Total EBITDA
                    1,227       1,137  
Interest expense, net
                    (146 )     (135 )
Income tax expense
                    (273 )     (257 )
Change in working capital and other non cash items
                    (320 )     (102 )
Net cash provided by operating activities
                    487       643  
                                 
Annualized EBITDA
                               
Operating income (EBIT) last twelve months
                    1,987       1,834  
Depreciation and amortization last twelve months
                    530       487  
Non cash charges
                    50       49  
Annualized EBITDA
                    2,567       2,370  

1) EBITDA is the basis for determining compliance with certain covenants in Fresenius Medical Care’s long-term debt instruments.
 
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Fresenius Medical Care
 
June 30,
   
December 31,
 
Balance Sheet
 
(unaudited)
   
(audited)
 
(in US-$ million)
 
2011
   
2010
 
             
Assets
           
Current assets
    5,822       5,153  
Intangible assets
    9,599       8,833  
Other non-current assets
    3,632       3,109  
Total assets
    19,053       17,095  
                 
Liabilities and equity
               
Current liabilities
    3,618       3,790  
Long-term liabilities
    7,207       5,501  
Noncontrolling interest subject to put provisions
    307       280  
Total equity
    7,921       7,524  
Total liabilities and equity
    19,053       17,095  
                 
Equity/assets ratio:
    42 %     44 %
                 
Debt
               
Short-term borrowings
    761       671  
Short-term borrowings from related parties
    161       10  
Current portion of long-term debt and capital lease obligations
    231       264  
Trust Preferred Securities
          625  
Long-term debt and capital lease obligations, less current portion
    5,961       4,310  
Total debt
    7,114        5,880  
 
Fresenius Medical Care AG & Co. KGaA, August 2, 2011
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Fresenius Medical Care
           
Cash Flow Statement
           
Six months ended June 30,
 
2011
   
2010
 
(in US-$ million)
           
(unaudited)
           
             
Operating activities
           
Net income
    535       499  
Depreciation / amortization
    272       246  
Change in working capital and other non cash items
    (320 )     (102 )
Cash Flow from operating activities
    487       643  
                 
Investing activities
               
Purchases of property, plant and equipment
    (238 )     (227 )
Proceeds from sale of property, plant and equipment
    7       9  
Capital expenditures, net
    (231 )     (218 )
Free Cash Flow
    256       425  
                 
Acquisitions and investments, net of cash acquired and net purchases of intangible assets
    (1,122 )     (158 )
Proceeds from divestitures
          8  
Acquisitions, net of divestitures
    (1,122 )     (150 )
Free Cash Flow after investing activities
    (866 )     275  
Investments, net of repayments
          (133 )
Free Cash Flow after investing activities
    (866 )     142  
                 
Financing activities
               
Change in accounts receivable securitization program
    130       86  
Change in intercompany debt
    146        
Change in other debt
    1,419       341  
Proceeds from exercise of stock options
    32       28  
Redemption of Trust Preferred Securities
    (654 )      
Distributions to noncontrolling interest
    (62 )     (68 )
Contributions from noncontrolling interest
    12       15  
Dividends paid
    (281 )     (232 )
Cash Flow from financing activities
    742       170  
                 
Effects of exchange rates on cash
    50       (40 )
Net increase (decrease) in cash
    (74 )     272  
                 
Cash at beginning of period
    523       301  
Cash at end of period
    449        573  
 
Fresenius Medical Care AG & Co. KGaA, August 2, 2011
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Fresenius Medical Care
                       
Quarterly Performance Scorecard - Revenue
                       
Three months ended June 30,
 
2011
   
cc
 
2010
   
cc
(in US-$ thousands, except per-treatment revenue)
                       
(unaudited)
                       
                         
North America
                       
Net revenue
    2,027,419             2,026,582        
Growth year-over-year
    0.0 %           8.0 %      
                             
Dialysis Care
    1,827,944             1,817,266        
Growth year-over-year
    0.6 %           8.3 %      
U.S. per treatment
    348             356        
Per treatment
    340             349        
Sequential growth
    -0.1 %           0.2 %      
Growth year-over-year
    -2.4 %           3.2 %      
                             
Dialysis Products
                           
incl. internal sales
    394,413             389,547        
Growth year-over-year
    1.2 %           8.3 %      
External sales
    199,475             209,316        
Growth year-over-year
    -4.7 %           5.1 %      
                             
International
                           
Net revenue
    1,162,448             919,524        
Growth year-over-year
    26.4 %   14.8 %     3.7 %   4.6 %
                             
Dialysis Care
    533,618             407,055        
Growth year-over-year
    31.1 %   19.6 %     8.0 %   8.6 %
Per treatment
    178     162       159     160  
Sequential growth
    3.5 %           -4.2 %      
Growth year-over-year
    11.7 %   1.9 %     0.0 %   0.5 %
                             
Dialysis Products
                           
incl. internal sales
    728,130             593,794        
Growth year-over-year
    22.6 %   10.9 %     2.0 %   3.1 %
External sales
    628,830             512,469        
Growth year-over-year
    22.7 %   10.9 %     0.4 %   1.7 %
                             
cc = at constant exchange rates
                           
 
Fresenius Medical Care AG & Co. KGaA, August 2, 2011
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Fresenius Medical Care
           
Quarterly Performance Scorecard - Dialysis Care Volume
           
Three months ended June 30,
 
2011
   
2010
 
(unaudited)
           
             
North America
           
Number of treatments
    5,379,508       5,189,159  
Treatments per day
    68,968       66,528  
Per day sequential growth
    1.3 %     1.8 %
Per day year-over-year growth
    3.7 %     4.9 %
Same market growth year-over-year
    3.2 %     4.2 %
                 
International
               
Number of treatments
    3,004,965       2,560,425  
Same market growth year-over-year
    5.2 %     4.4 %

Fresenius Medical Care
           
Quarterly Performance Scorecard - Expenses
           
Three months ended June 30,
 
2011
   
2010
 
(unaudited)
           
             
North America
           
Costs of revenue and operating expenses and income from equity method investees
           
In percent of revenue
    82.8 %     83.6 %
Selling, general and administrative
               
In percent of revenue
    18.1 %     17.2 %
Bad debt expenses
               
In percent of revenue
    2.8 %     2.7 %
Dialysis care operating expenses/treatment (in US-$)
    277       287  
Sequential growth
    -2.0 %     -0.9 %
Growth year-over-year
    -3.5 %     0.9 %
U.S. Dialysis Care operating expenses/treatment (in US-$)
    283       292  
Sequential growth
    -1.9 %     -0.9 %
Growth year-over-year
    -3.3 %     1.1 %
                 
Total Group
               
Costs of revenue and operating expenses and income from equity method investees
               
In percent of revenue
    84.0 %     84.2 %
Selling, general and administrative
               
In percent of revenue
    18.6 %     17.8 %
Effective tax rate
    34.2 %     32.4 %

 
Fresenius Medical Care AG & Co. KGaA, August 2, 2011
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Fresenius Medical Care
           
Quarterly Performance Scorecard - Cash Flow/Investing Activities
           
Three months ended June 30,
 
2011
   
2010
 
(in US-$ thousands, except number of de novos)
           
(unaudited)
           
             
Total Group
           
Operating Cash Flow
    311,244       294,375  
In percent of revenue
    9.7 %     10.0 %
                 
Free Cash Flow before acquisitions
    194,108       175,363  
In percent of revenue
    6.1 %     6.0 %
                 
Acquisitions and Investments, net of divestitures
    783,666       201,802  
                 
Capital expenditures, net
    117,136       119,012  
In percent of revenue
    3.7 %     4.0 %
                 
Maintenance
    66,615       68,856  
In percent of revenue
    2.1 %     2.3 %
                 
Growth
    50,521       50,156  
In percent of revenue
    1.6 %     1.7 %
                 
Number of de novos
    7       27  
North America
    4       20  
International
    3       7  

Fresenius Medical Care
           
Quarterly Performance Scorecard - Balance Sheet
           
June 30,
 
2011
   
2010
 
(unaudited)
           
             
Total Group
           
Debt (in US-$ million)
    7,114       5,827  
Debt/EBITDA
    2.8       2.5  
                 
North America
               
Days sales outstanding
    59       51  
                 
International
               
Days sales outstanding
    121       113  
 
Fresenius Medical Care AG & Co. KGaA, August 2, 2011
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Fresenius Medical Care
           
Quarterly Performance Scorecard
           
Three months ended June 30,
 
2011
   
2010
 
             
Clinical Performance
           
North America (U.S.)
           
Single Pool Kt/v > 1.2
    97 %     97 %
Hemoglobin = 10-12g/dl
    75 %     68 %
Hemoglobin = 10-13g/dl
    89 %     88 %
Calcium = 8.4-10.2mg/dl
    79 %     79 %
Albumin >= 3.5 g/dl 1)
    84 %     81 %
No catheter
    77 %     74 %
Phosphate <= 5.5mg/dl
    63 %     61 %
Hospitalization days per patient
(12 months ending June 30)
    9.8       9.9  
                 
Demographics
               
North America (U.S.)
               
Average age (in years)
    62       62  
Average time on dialysis (in years)
    3.7       3.7  
Average body weight (in kg)
    81       81  
Prevalence of diabetes
    56 %     55 %

1) International standard BCR CRM470

Fresenius Medical Care
           
Quarterly Performance Scorecard
           
Three months ended June 30,
 
2011
   
2010
 
             
Clinical Performance
           
Europe, Middle East and Africa
           
Single Pool Kt/v > 1.2
    96 %     95 %
Hemoglobin = 10-12g/dl
    56 %     55 %
Hemoglobin = 10-13g/dl
    78 %     77 %
Calcium = 8.4-10.2mg/dl
    77 %     76 %
Albumin >= 3.5 g/dl 1)
    89 %     87 %
No catheter
    81 %     81 %
Phosphate <= 5.5mg/dl
    76 %     76 %
Hospitalization days per patient
(12 months ending June 30)
    9.6       9.1  
                 
Demographics
               
Europe, Middle East and Africa
               
Average age (in years)
    64       64  
Average time on dialysis (in years)
    4.9       4.8  
Average body weight (in kg)
    71       70  
Prevalence of diabetes
    28 %     28 %

1) International standard BCR CRM470
 
Fresenius Medical Care AG & Co. KGaA, August 2, 2011
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