6-K

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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 6-K

REPORT OF FOREIGN PRIVATE ISSUER

PURSUANT TO RULE 13A-16 OR 15D-16 OF THE
SECURITIES EXCHANGE ACT OF 1934

For the month of May 2019

FRESENIUS MEDICAL CARE AG & Co. KGaA
(Translation of registrant's name into English)

Else-Kröner Strasse 1
61346 Bad Homburg
Germany
(Address of principal executive offices)

        Indicate by check mark whether the registrant files or will file annual reports under cover of Form 20-F or Form 40-F.

        Form 20-F    ý                          Form 40-F    o

        Indicate by check mark if the registrant is submitting the Form 6-K in paper as permitted by Regulation S-T Rule 101(b)(1) :            

        Indicate by check mark if the registrant is submitting the Form 6-K in paper as permitted by Regulation S-T Rule 101(b)(7):            

        Indicate by check mark whether the registrant by furnishing the information contained in this Form is also thereby furnishing the information to the Commission pursuant to Rule 12g3-2(b) under the Securities Exchange Act of 1934.

        Yes    o                                         No    ý

        If "Yes" is marked, indicate below the file number assigned to the registrant in connection with Rule 12g3-2(b): 82-                        .

FRESENIUS MEDICAL CARE AG & Co. KGaA

Interim Report of Financial Condition and Results of Operations for the three months ended March 31, 2019 and 2018

	Page
FINANCIAL INFORMATION
Management's discussion and analysis
Forward-looking statements	1
Financial condition and results of operations	3
Discussion of measures	7
Business metrics for Care Coordination	12
Results of operations, financial position and net assets	13
Outlook	27
Recently issued accounting standards	28
Financial Statements (unaudited)
Consolidated statements of income	29
Consolidated statements of comprehensive income	30
Consolidated balance sheets	31
Consolidated statements of cash flows	32
Consolidated statement of shareholders' equity	33
Notes to consolidated financial statements	34
Quantitative and qualitative disclosures about market risk	62
Controls and procedures	63
OTHER INFORMATION
Legal and regulatory matters	64
Exhibits	65
Signatures	66

i

FINANCIAL INFORMATION

Management's discussion and analysis

In this report, "FMC-AG & Co. KGaA," or the "Company," "we," "us" or "our" refers to the Company or the Company and its subsidiaries on a consolidated basis, as the context requires. You should read the following discussion and analysis of the results of operations of the Company and its subsidiaries in conjunction with our unaudited consolidated financial statements and related notes contained elsewhere in this report and our disclosures and discussions in our consolidated financial statements for the year ended December 31, 2018 prepared in accordance with International Financial Reporting Standards ("IFRS") as issued by the International Accounting Standards Board ("IASB"), using the euro as our reporting currency. At March 31, 2019, there were no IFRS or International Financial Reporting Interpretation Committee ("IFRIC") interpretations as endorsed by the European Union relevant for interim reporting that differed from IFRS as issued by the IASB.

The term "North America Segment" refers to our North America operating segment, the term "EMEA Segment" refers to the Europe, Middle East and Africa operating segment, the term "Asia-Pacific Segment" refers to our Asia-Pacific operating segment, and the term "Latin America Segment" refers to our Latin America operating segment. The term "Corporate" includes certain headquarters' overhead charges, including accounting and finance, centrally managed production, asset management, quality management, procurement and research and development. The abbreviation "M" is used to denote the presentation of amounts in millions. The term "Constant Currency" or at "Constant Exchange Rates" means that we have translated local currency revenue, operating income, net income attributable to shareholders of FMC-AG & Co. KGaA and other items for the current reporting period into euro using the prior year exchange rates to provide a comparable analysis without effect from exchange rate fluctuations on translation, as described below under "Financial condition and results of operations—II. Discussion of measures—Non—IFRS measures—Constant currency information."

Forward-looking statements

This report contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended (the "Exchange Act"). When used in this report, the words "outlook," "expects," "anticipates," "intends," "plans," "believes," "seeks," "estimates" and similar expressions are generally intended to identify forward looking statements. Although we believe that the expectations reflected in such forward-looking statements are reasonable, forward-looking statements are inherently subject to risks and uncertainties, many of which cannot be predicted with accuracy and some of which might not even be anticipated, and future events and actual results, financial and otherwise, could differ materially from those set forth in or contemplated by the forward-looking statements contained elsewhere in this report. We have based these forward-looking statements on current estimates and assumptions made to the best of our knowledge. By their nature, such forward-looking statements involve risks, uncertainties, assumptions and other factors which could cause actual results, including our financial condition and profitability, to differ materially, positively or negatively, relative to the results expressly or implicitly described in or suggested by these statements. Moreover, forward-looking estimates or predictions derived from third parties' studies or information may prove to be inaccurate. Consequently, we cannot give any assurance regarding the future accuracy of the opinions set forth in this report or the actual occurrence of the projected developments described herein. In addition, even if our future results meet the expectations expressed here, those results may not be indicative of our performance in future periods.

These risks, uncertainties, assumptions, and other factors, including associated costs, could cause actual results to differ from our projected results and include, among others, the following:

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changes in governmental and commercial insurer reimbursement for our complete products and services portfolio, including the United States ("U.S.") Medicare reimbursement system for dialysis and other health care services, including potentially significant changes that could be enacted due to the announced intention of the Trump administration to continue its efforts to repeal and replace the Patient Protection and Affordable Care Act;

•

the outcome of government and internal investigations as well as litigation;

•

risks relating to compliance with current and future government regulations applicable to our business including, in the U.S., the Anti-Kickback Statute, the False Claims Act, the Stark Law, the Health Insurance Portability and Accountability Act, the Health Information Technology for Economic and

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Clinical Health Act, the Foreign Corrupt Practices Act, the Food, Drug and Cosmetic Act, and outside the U.S., the EU Medical Device Directive, the EU General Data Protection Regulation, the two invoice policy and the Tendering and Bidding Law in China and other related local legislation as well as other comparable regulatory regimes in many of the countries where we supply health care services and/or products;

•

possible future disruptions in federal government agencies' operations and funding that could negatively impact regulatory approvals for our pharmaceutical products, medical devices and regulatory guidance;

•

the influence of commercial insurers and integrated care organizations, including efforts by these organizations to manage costs by limiting healthcare benefits, reducing provider reimbursement and/or restricting options for patient funding of health insurance premiums;

•

the impact of health care, tax and trade law reforms and regulation, including those proposed and enacted by the Trump administration in the U.S.;

•

product liability risks;

•

risks relating to our ability to continue to make acquisitions;

•

risks relating to our ability to attract and retain skilled employees, including shortages of skilled clinical personnel;

•

the impact of currency fluctuations;

•

potential impairment loss on assets in the Latin America Segment due to decreases in the recoverable amount of those assets relative to their book value;

•

our ability to protect our information technology systems against cyber security attacks or prevent other data privacy or security breaches;

•

changes in our costs of purchasing and utilization patterns for pharmaceuticals;

•

introduction of generic or new pharmaceuticals that compete with our products or services or the development of pharmaceuticals that greatly reduce the progression of chronic kidney disease;

•

launch of new technology, or advances in medical therapies, that compete with our medical businesses;

•

changes in raw material and energy costs or the inability to procure raw materials;

•

collectability of our receivables, which depends primarily on the efficacy of our billing practices and the financial stability and liquidity of our governmental and commercial payors;

•

our ability to achieve cost savings in various health care risk management programs in which we participate or intend to participate; and

•

the greater size, market power, experience and product offerings of certain competitors in certain geographic regions and business lines.

Important factors that could contribute to such differences are noted in "Financial condition and results of operations—I. Overview" below, in note 12 of the notes to consolidated financial statements (unaudited) included in this report, in note 22 of the notes to consolidated financial statements included in our Annual Report on Form 20-F for the year ended December 31, 2018, as well as under "Risk Factors," "Business overview," "Operating and financial review and prospects," and elsewhere in that report.

Our business is also subject to other risks and uncertainties that we describe from time to time in our public filings. Developments in any of these areas could cause our results to differ materially from the results that we or others have projected or may project.

Our reported financial condition and results of operations are sensitive to accounting methods, assumptions and estimates that are the basis of our financial statements. The actual accounting policies, the judgments made in the selection and application of these policies as well as the sensitivities of reported results to changes in accounting policies, assumptions and estimates are factors to be considered along with our financial statements and the discussion under "Results of operations, financial position and net assets" below.

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IFRS 16, Leases ("IFRS 16") replaces the straight-line operating lease expense for former leases under IAS 17, Leases ("IAS 17") with a depreciation charge for the lease asset and an interest expense on the lease liability as well as the classification of certain IAS 17 leases ("IFRS 16 Implementation"). As a result of the implementation of IFRS 16, we have updated our accounting policies accordingly. Please refer to note 1 of the notes to consolidated financial statements (unaudited) included in this report for further details on the updated policies. Excluding the policy update for IFRS 16, there have been no significant changes during the three months ended March 31, 2019 to the items disclosed within the critical accounting policies and estimates in notes 1 and 2 to the consolidated financial statements in our annual report on Form 20-F for the year ended December 31, 2018 in accordance with IFRS as issued by the IASB.

Rounding adjustments applied to individual numbers and percentages shown in this and other reports may result in these figures differing immaterially from their absolute values.

Financial condition and results of operations

I.     Overview

We are the world's largest kidney dialysis company, based on publicly reported sales and number of patients treated. We provide dialysis care and related services to persons who suffer from end stage renal disease ("ESRD") as well as other health care services. We develop and manufacture a wide variety of health care products, which includes both dialysis and non-dialysis products. Our dialysis products include dialysis machines, water treatment systems and disposable products while our non-dialysis products include acute cardiopulmonary and apheresis products. We sell our health care products to customers in around 150 countries and we also use them in our own health care service operations. Our dialysis business is therefore vertically integrated. We describe certain other health care services that we provide in our North America Segment and our Asia-Pacific Segment as "Care Coordination." Care Coordination currently includes, but is not limited to, coordinated delivery of pharmacy services, vascular, cardiovascular and endovascular specialty services as well as ambulatory surgery center services, physician nephrology and cardiology services, health plan services, urgent care services and ambulant treatment services. Until June 28, 2018, Care Coordination also included the coordinated delivery of emergency, intensivist and hospitalist physician services as well as transitional care which we refer to as "hospital related physician services" (see note 2 (b) of the notes to the consolidated financial statements (unaudited) included in this report). All of these Care Coordination services together with dialysis care and related services represent our health care services. We estimated the volume of the global dialysis market was approximately €71 billion in 2018. Due to the complexity and evolving nature of Care Coordination services, we are currently unable to estimate the global volume of this market. Dialysis patient growth results from factors such as the aging population and increased life expectancies; shortage of donor organs for kidney transplants; increasing incidence of kidney disease and better treatment of and survival of patients with diabetes, hypertension and other illnesses, which frequently lead to the onset of chronic kidney disease; improvements in treatment quality, new pharmaceuticals and product technologies, which prolong patient life; and improving standards of living in developing countries, which make life-saving dialysis treatment available. We are also engaged in different areas of health care research.

As a global company delivering health care services and products, we face the challenge of addressing the needs of a wide variety of stakeholders, such as patients, customers, payors, regulators and legislators in many different economic environments and health care systems. In general, government-funded programs (in some countries in coordination with private insurers) pay for certain health care items and services provided to their citizens. Not all health care systems provide for dialysis treatment. Therefore, the reimbursement systems and ancillary services utilization environment in various countries significantly influence our business.

Premium assistance programs

On August 18, 2016, the Centers for Medicare and Medicaid Services ("CMS") issued a request for information ("RFI") seeking public comment about providers' alleged steering of patients inappropriately to individual plans offered on the Patient Protection and Affordable Care Act individual health insurance market. Fresenius Medical Care Holdings, Inc. ("FMCH") and other dialysis providers, commercial insurers and other industry participants responded to the RFI, and in that response, we reported that we do not engage in such steering. On December 14, 2016, CMS published an Interim Final Rule ("IFR") titled "Medicare Program; Conditions for Coverage for End-Stage Renal Disease Facilities-Third Party

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Payment" that would amend the Conditions for Coverage for dialysis providers, like FMCH. The IFR would have effectively enabled insurers to reject premium payments made by patients who received grants for individual market coverage from the American Kidney Fund ("AKF") and, therefore, could have resulted in those patients losing their individual market health insurance coverage. The loss of individual market coverage for these patients would have had a material and adverse impact on our operating results. On January 25, 2017, a federal district court in Texas, responsible for litigation initiated by a patient advocacy group and dialysis providers including FMCH, preliminarily enjoined CMS from implementing the IFR (Dialysis Patient Citizens v. Burwell (E.D. Texas, Sherman Div.)). The preliminary injunction was based on CMS' failure to follow appropriate notice-and-comment procedures in adopting the IFR. The injunction remains in place and the court retains jurisdiction over the dispute. On June 22, 2017, CMS requested a stay of proceedings in the litigation pending further rulemaking concerning the IFR. CMS stated, in support of its request that it expects to publish a Notice of Proposed Rulemaking in the Federal Register and otherwise pursue a notice-and-comment process in the fall of 2017 which they ultimately did not publish. Plaintiffs in the litigation, including FMCH, consented to the stay, which was granted by the court.

Separately, the United States Department of Health and Human Services ("HHS") announced in its fall 2018 semi-annual review of agency actions, or "unified agenda," that it was considering the publication of a new proposed rule, ostensibly consistent with the Court's order on the IFR, that would establish requirements for third parties that provide financial assistance to patients for premiums to enroll in coverage provided by an individual market plan (RIN 0938-AT11). The unified agenda identified "11/00/18" as a target publication date for the proposed rule, but no proposed rule has been published for comment.

The operation of charitable assistance programs like that of the AKF is also receiving increased attention by state insurance regulators and legislators. The result may be a regulatory framework that differs from state to state. Even in the absence of the IFR or similar administrative actions, insurers are likely to continue efforts to thwart charitable premium assistance to our patients for individual market plans and other insurance coverages. If successful, these efforts would have a material adverse impact on our operating results.

On January 3, 2017, FMCH received a subpoena from the United States Attorney for the District of Massachusetts inquiring into its interactions and relationships with AKF, including its charitable contributions to the Fund and the Fund's financial assistance to patients for insurance premiums. FMCH is cooperating with the investigation.

For further information on these and other legal proceedings, please see note 12 of the notes to consolidated financial statements (unaudited) found elsewhere in this report.

U.S. ballot initiatives and other legislation

Further federal or state legislation or regulations may be enacted in the future through legislative and public referendum processes that could substantially modify or reduce the amounts paid for services and products offered by us and our subsidiaries and/or mandate new or alternative operating models and payment models that could present more risk to our healthcare service operations. Ballot initiatives that are successfully introduced at the state level in the United States require the vote of state citizens to directly adopt or reject proposed new legislation. These ballot initiatives require a material expenditure of resources by us to participate in public discourse regarding the proposed new legislation underlying the initiatives, which if passed, could further regulate multiple aspects of our operations including, for instance, clinic staffing requirements, state inspection requirements and profit margins on commercial business. Efforts to enact new state laws regarding our operations are continuing. State regulation at this level would introduce an unprecedented level of oversight and additional expense at the clinic level which could have a material adverse effect on our business in the impacted states. It is also possible that statutes may be adopted or regulations may be promulgated in the future that impose additional eligibility requirements for participation in the federal and state healthcare programs. Such new legislation or regulations could, depending upon the detail of the provisions, have positive or adverse effects, possibly material, on our businesses and results of operations.

Significant U.S. reimbursement developments

The majority of health care services we provide are paid for by governmental institutions. For the three months ended March 31, 2019, approximately 34% of our consolidated revenue is attributable to U.S.

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federally-funded health care benefit programs, such as Medicare and Medicaid reimbursement, under which reimbursement rates are set by CMS. Legislative changes could affect Medicare reimbursement rates for a significant portion of the services we provide. To date, the stability of reimbursement in the U.S. has been affected by (i) the implementation of the ESRD prospective payment system ("ESRD PPS") in January 2011, (ii) the U.S. federal government across the board spending cuts in payments to Medicare providers commonly referred to as "U.S. Sequestration," (iii) the reduction to the ESRD PPS rate to account for the decline in utilization of certain drugs and biologicals associated with dialysis pursuant to the American Taxpayer Relief Act of 2012 ("ATRA") as subsequently modified under the Protecting Access to Medicare Act of 2014 ("PAMA") and (iv) CMS' 2017 final rule on the Physician Fee Schedule, which partially corrected reimbursement for certain procedures that were materially undervalued in 2016. Please see the detailed discussions on these and further legislative developments below:

•

Under the Medicare Improvements for Patients and Providers Act of 2008 ("MIPPA"), for patients with Medicare coverage, all ESRD payments for dialysis treatments are made under a single bundled payment rate which provides a fixed payment rate, the ESRD PPS, to encompass substantially all goods and services provided during the dialysis treatment. MIPPA further created the ESRD quality incentive program ("QIP") which provides that dialysis facilities that fail to achieve quality standards established by CMS could have payments reduced, determined on an annual basis, by up to 2%.

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MIPPA also includes a provision for an annual adjustment to the ESRD PPS base rate based on changes in the costs of a "market basket" of certain healthcare items and services, less a productivity adjustment.

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Additionally, as a result of the Budget Control Act of 2011 ("BCA") and subsequent activity in Congress, U.S. Sequestration ($1.2 trillion in across-the-board spending cuts in discretionary programs) took effect on March 1, 2013 and is expected to continue through mid-2024. In particular, a 2% reduction to Medicare payments took effect on April 1, 2013 and continues in force. Spending cuts pursuant to U.S. Sequestration have adversely affected and will continue to adversely affect our operating results.

•

In 2014, as mandated by ATRA, CMS issued a final rule for the ESRD PPS, which phased in payment reductions to account for changes in utilization of certain drugs and biologicals that are included in the ESRD PPS, which were subsequently modified by PAMA. These reductions reduced our market basket inflation adjustment by 1.25% in 2016 and 2017, and reduced our inflation adjustment by 1% in 2018.

•

On November 1, 2018, CMS issued the final rule and updated the ESRD PPS rate for 2019. We and other large dialysis organizations will experience a 1.6% increase in payments under this final rule. The base rate per treatment is $235.27 which represents a 1.2% increase from the 2018 base rate including the adjustment for the wage index budget-neutrality factor. The 2019 final rule reflects a market basket increase of 1.3% (2.1% market basket increase that is partially offset by a 0.8% multifactor productivity adjustment as mandated by the ACA) and application of the wage index budget-neutrality adjustment factor of 0.999506. The 2019 ESRD PPS rate contains an increase to the wage index floor of 0.1, for a 2019 wage index floor of 0.5000. CMS updated the acute kidney injury dialysis payment rate for calendar year ("CY") 2019 to $235.27, which is the same as the base rate finalized under the ESRD PPS for CY 2019. In the final rule, effective January 1, 2020, CMS also expanded the transitional drug add-on payment adjustment ("TDAPA") to all new renal dialysis drugs and biological products, not just those in new ESRD PPS functional categories. CMS changed the basis of payment for the TDAPA from pricing methodologies under section 1847A of the Act, which includes ASP+6, to ASP+0. CMS will continue to pay for Sensipar and Parsabiv™ for the remainder of the transition period based on the average sales price plus 6% (4.3% after giving effect to the U.S. sequestration).

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The ESRD PPS final rule, released on November 1, 2018, also updated the ESRD QIP, for payment years 2021 and 2022, under which payments made to dialysis facilities are subject to reduction based on clinical measures. The final rule includes QIP alignments for the payment year 2021 to the CMS Meaningful Measures Initiatives. Specifically, for Payment Year 2021, the rule finalizes measure removal factors, removes four measures, and makes changes to the measure domain categories including establishment of Patient and Family Engagement/Care Coordination and the Clinical Care as individual domains. The rule also establishes new domain and measure weights. The rule delays reporting of QIP data for new facilities until four months after the CMS certification number becomes effective in an effort to provide facilities with more time to learn how to report the required data. The

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rule also finalizes proposed increases to the number of facilities selected for National Healthcare Safety Networks data validation study from 35 to 150 as well as making the Consolidated Renal Operations in a Web-Enabled Network data validation study into a permanent program requirement. For Payment Year 2022, the ruling finalizes the adoption of the Percentage of Prevalent Patients Waitlisted Measure within the proposed Care Coordination Measure Domain as well as a proposal to adopt the Medication Reconciliation for Patients Receiving Care at Dialysis Facilities Measure within the Safety Measure Domain.

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On November 2, 2018, CMS issued the CY 2019 final rule for hospital outpatient and ambulatory surgery center payment systems. CMS did not finalize the proposal to designate certain other dialysis vascular access codes as office based procedures, which would have capped reimbursement for those codes at the Medicare physician fee schedule rate. For CY 2019, those dialysis vascular access codes will continue to be paid at the ASC rate. The final rule updating the ASC Fee Schedule for CY 2019 decreased the reimbursement rates for certain vascular access services. For the range of procedures provided in an ASC, these cuts represent an average decrease of 3.3% compared to the prior year. For the most common dialysis access related procedures, the average decrease was also 3.3% compared to the prior year. CMS also updated the Physician Fee Schedule for CY 2019. For the range of procedures provided in a physician office, the CY 2019 Physician Fee Schedule represents an average increase of 0.06% compared to the prior year and for the most common dialysis access related procedures, an increase of 0.3% compared to the prior year.

Presently, there is considerable uncertainty regarding possible future changes in health care regulation, including the regulation of reimbursement for dialysis services. See "Risk factors—We operate in a highly regulated industry such that the potential for legislative reform provides uncertainty and potential threats to our operating models and results" which is included in our Annual Report on Form 20-F for the year ended December 31, 2018.

In a final rule published on November 6, 2015, CMS provided for implementation of the PAMA oral-only provision. CMS clarified that once any non-oral ESRD-related drug in a category previously considered oral only is approved by the U.S. Food and Drug Administration ("FDA"), such category of drugs will cease to be considered oral only. However, for at least two years, CMS will pay for both oral and non-oral versions of the drug using a TDAPA. During this transition period, CMS will not pay outlier payments for these drugs, but the agency will collect data reflecting utilization of both the oral and injectable or intravenous forms of the drugs, as well as payment patterns, in order to help determine how to appropriately adjust the ESRD PPS payment rate as these drugs are included in the payment bundle. At the end of this transition period, CMS will incorporate payment for the oral and non-oral versions of the drug in the ESRD PPS payment rates, utilizing a public rulemaking process.

The introduction of Parsabiv™ will also result in changes in how some payors, other than Medicare, arrange for the provision of calcimimetics for their patients. While some patients will continue to receive calcimimetics from their pharmacies as a pharmacy benefit, other patients may receive calcimimetics from their dialysis providers, as a medical benefit. While we anticipate receiving additional reimbursement from payors when these drugs are provided by our clinics, this type of transition from an oral-only drug has not occurred previously and the reimbursement landscape for non-Medicare payors is still being developed.

Several generic calcimimetic products have been approved by the FDA. Fresenius Medical Care Holdings, Inc., "FMCH") has been able to purchase certain of these generic calcimemetic products at rates that are lower than the rate paid for the brand name calcimemetic, Sensipar. As a result, FMCH has been able to realize a savings in cost. Amgen, Inc. ("Amgen"), the manufacturer of Sensipar, has taken steps to prevent the continued sale of the generic products through settlement and legal action. If Amgen is successful in preventing the continued sale of generic calcimemetics, FMCH might not be able to purchase a lower priced alternative and continue to realize cost savings, which could have an adverse effect on our business, results of operations and financial condition.

If we are unable to secure and maintain appropriate reimbursement arrangements for calcimimetics when provided by our dialysis clinics, we could experience a material adverse effect on our business, results of operations and financial condition.

Participation in new Medicare payment arrangements

Under CMS' Comprehensive ESRD Care Model (the "Model"), dialysis providers and physicians can form entities known as ESRD Seamless Care Organizations, or "ESCOs," as part of a new payment and

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care delivery model that seeks to deliver better health outcomes for Medicare ESRD patients while lowering CMS' costs. Following our initial participation in six ESCOs, we are presently participating in the Model through 24 ESCOs formed at our dialysis facilities. ESCOs that achieve the program's minimum quality thresholds and generate reductions in CMS' cost of care above certain thresholds for the ESRD patients covered by the ESCO will receive a share of the cost savings, which is adjusted based on the ESCO's performance on certain quality metrics. ESCOs that include dialysis chains with more than 200 facilities are required to share in the risk of cost increases and to reimburse CMS a share of any such increases if actual costs rise above set thresholds. The number of patients participating in our ESCOs increased from approximately 46,000 as of January 1, 2019 to approximately 48,000 as of March 31, 2019.

In November 2017, we announced the results from the first performance year from our ESCOs. The results, which cover the period from October 2015 through December 2016, show improved health outcomes for patients receiving coordinated care through the ESCOs. This success was validated by an independent report, which showed a nearly 9% decrease in hospitalization rates for these patients during the same time. As a result, the Company's ESCOs together generated more than $43 M in gross savings, an average 5.47% reduction in expenditures per patient, with all six of its first-year ESCOs exceeding the shared savings benchmark. Final performance year settlement reports have not yet been provided by CMS to finalize ESCO performance results for 2017.

As of January 1, 2019, we no longer provide any Medicare Advantage ESRD Chronic Conditions Special Needs Plan ("MA-CSNP") products.

We have also entered into sub-capitation and other risk-based and value-based arrangements with certain payors to provide care to commercial and Medicare Advantage ESRD patients. Under these arrangements, a baseline per patient per month amount is established. If we provide complete care for less than the baseline, we retain the difference. If the cost of complete care exceeds the baseline, we may owe the payor the difference.

Company structure

Our operating segments are the North America Segment, the EMEA Segment, the Asia-Pacific Segment and the Latin America Segment. The operating segments are determined based upon how we manage our businesses with geographical responsibilities. All segments are primarily engaged in providing health care services and the distribution of products and equipment for the treatment of ESRD and other extracorporeal therapies. 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 IFRS measures are revenue, operating income and operating income margin. We do not include income taxes as we believe this is outside the segments' control. Financing is a corporate function which our segments do not control. Therefore, we do not include interest expense relating to financing as a segment measurement. Similarly, we do not allocate certain costs which relate primarily to certain headquarters' overhead charges, including accounting and finance, because we believe that these costs are also not within the control of the individual segments. Production of products, production asset management, quality and supply chain management as well as procurement related to production are centrally managed at Corporate. Global research and development is also centrally managed at Corporate. These corporate activities do not fulfill the definition of a segment according to IFRS 8. Products are transferred to the segments at cost; therefore, no internal profit is generated. The associated internal revenue for the product transfers and their elimination are recorded as corporate activities (see note 14 of the notes to consolidated financial statements (unaudited) found elsewhere in this report). Capital expenditures for production are based on the expected demand of the segments and consolidated profitability considerations. In addition, certain revenues, investments and intangible assets, as well as any related expenses, are not allocated to a segment but accounted for as Corporate. Accordingly, all of these items are excluded from our analysis of segment results and are discussed below in the discussion of our consolidated results of operations.

II.    Discussion of measures

Non-IFRS measures

Certain of the following key performance indicators and other financial information as well as discussions and analyses set out in this report include measures that are not defined by IFRS ("Non-IFRS Measure"). We believe this information, along with comparable IFRS measurements, is useful to our investors as it provides a basis for assessing our performance, payment obligations related to performance-based

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compensation as well as our compliance with financial covenants. Non-IFRS financial measures should not be viewed or interpreted as a substitute for financial information presented in accordance with IFRS.

Delivered EBIT (Non-IFRS Measure)

As a result of the significance of noncontrolling interest holders in our operations, we believe a measure that is meaningful to investors is operating income less noncontrolling interests ("Delivered EBIT"). Delivered EBIT approximates the operating income attributable to the shareholders of FMC-AG & Co. KGaA. As such, we believe that operating income, or EBIT, is the closest comparable IFRS measure. Delivered EBIT is also benchmarked based on movement at constant exchange rates. See "Constant currency information" below.

Below is a table showing the reconciliation of operating income to Delivered EBIT on a consolidated basis and for our reporting segments:

Delivered EBIT reconciliation

in € M

	Three months ended March 31
	2019			2018
Total
Operating income (EBIT)		537			497
less noncontrolling interests		(57	)		(51	)
Delivered EBIT		480			446
North America
Operating income (EBIT)		372			362
less noncontrolling interests		(53	)		(48	)
Delivered EBIT		319			314
Dialysis
Operating income (EBIT)		332			349
less noncontrolling interests		(47	)		(45	)
Delivered EBIT		285			304
Care Coordination
Operating income (EBIT)		40			13
less noncontrolling interests		(6	)		(3	)
Delivered EBIT		34			10
EMEA
Operating income (EBIT)		138			109
less noncontrolling interests		(2	)		(1	)
Delivered EBIT		136			108
Asia-Pacific
Operating income (EBIT)		95			74
less noncontrolling interests		(2	)		(2	)
Delivered EBIT		93			72
Dialysis
Operating income (EBIT)		89			68
less noncontrolling interests		(2	)		(2	)
Delivered EBIT		87			66
Care Coordination
Operating income (EBIT)		6			6
less noncontrolling interests		—			0
Delivered EBIT		6			6
Latin America
Operating income (EBIT)		11			14
less noncontrolling interests		0			0
Delivered EBIT		11			14

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Net cash provided by (used in) operating activities in % of revenue

Our consolidated statement of cash flows indicates how we generated and used cash and cash equivalents. In conjunction with our other primary financial statements, it provides information that helps us evaluate changes to our net assets and our financial structure (including liquidity and solvency). Net cash provided by (used in) operating activities is applied to assess whether a business can generate the cash required to make the necessary replacement and expansion of investments. This indicator is impacted by the profitability of our business and the development of working capital, mainly receivables. Net cash provided by (used in) operating activities in percent of revenue shows the percentage of our revenue that is available in terms of financial resources. It is an indicator of our operating financial strength.

Free cash flow in % of revenue (Non-IFRS Measure)

Free cash flow (net cash provided by (used in) operating activities after capital expenditures, before acquisitions and investments) refers to the cash flow we have at our disposal. This indicator shows the percentage of revenue available for acquisitions and investments, dividends to shareholders, reducing debt financing or for repurchasing shares.

The following table shows the cash flow key performance indicators for the three months ended March 31, 2019 and 2018 and reconciles free cash flow and free cash flow in percent of revenue to Net cash provided by (used in) operating activities and Net cash provided by (used in) operating activities in percent of revenue, respectively:

Cash flow measures

in € M, except where otherwise specified

	For the three months ended March 31,
	2019			2018
Revenue		4,133			3,976
Net cash provided by (used in) operating activities		76			(45	)
Capital expenditures		(201	)		(221	)
Proceeds from sale of property, plant and equipment		2			3
Capital expenditures, net		(199	)		(218	)
Free cash flow		(123	)		(263	)
Net cash provided by (used in) operating activities in % of revenue		1.8	%		(1.1	)%
Free cash flow in % of revenue		(3.0	)%		(6.6	)%

Net leverage ratio (Non-IFRS Measure)

The Net Leverage Ratio is a key performance indicator used for internal management. To determine the Net Leverage Ratio, debt less cash and cash equivalents (net debt) is compared to EBITDA (earnings before interest, taxes, depreciation and amortization) (adjusted for acquisitions and divestitures made for the last twelve months with a purchase price above a €50 M threshold as defined in our Amended 2012 Credit Agreement and non-cash charges). The ratio is an indicator of the length of time the Company needs to service the net debt out of its own resources. We believe that the Net Leverage Ratio provides more reliable information about the extent to which we are able to meet our payment obligations rather than considering only the absolute amount of our debt. We have a strong market position in a growing, global and mainly non-cyclical market. Furthermore, most of our customers have a high credit rating as the dialysis industry is characterized by stable and sustained cash flows. We believe this enables us to work with a relatively large share of debt capital compared with companies in other industries. The following table shows the reconciliation of Net Leverage Ratio as of March 31, 2019 and December 31, 2018.

9

Reconciliation of net leverage ratio

in € M, except where otherwise specified

			Adjusted for IFRS 16
	March 31, 2019		March 31, 2019		December 31, 2018
Debt		13,232		8,633		7,546
Cash and cash equivalents		959		959		2,146
Net Debt		12,273		7,674		5,400
Operating Income(1)(2)(3)		2,898		2,244		2,215
Depreciation and amortization(1)(2)		937		770		716
Non-cash charges(2)		45		45		45
EBITDA(1)(2)(3)		3,880		3,059		2,976
Net leverage ratio(1)(3)		3.2		2.5		1.8

(1)

Including adjustments for acquisitions and divestitures made for the last twelve months with a purchase price above a €50 M threshold as defined in the Amended 2012 Credit Agreement.

(2)

Last 12 months.

(3)

Excluding the loss related to divestitures of Care Coordination activities (see note 2 b) of the notes to the consolidated financial statements (unaudited) included in this report) and excluding NxStage related transaction costs.

Return on invested capital ("ROIC") (Non-IFRS Measure)

ROIC is the ratio of operating income, for the last twelve months, after tax ("net operating profit after tax" or "NOPAT") to the average invested capital of the last five quarter closing dates and expresses how efficiently we allocate the capital under our control or how well we employ our capital with regard to a specific investment project. The following table shows the reconciliation of average invested capital to total assets, which we believe to be the most directly comparable IFRS financial measure, and how ROIC is calculated:

Reconciliation of Average Invested Capital and ROIC

in € M, except where otherwise specified

2019	March 31, 2019(1)			December 31, 2018(2)			September 30, 2018(2)			June 30, 2018(2)			March 31, 2018(2)
Total assets		28,125			28,193			27,516			26,960			24,903
Plus: Cumulative goodwill amortization		419			413			407			405			385
Minus: Cash and cash equivalents		(959	)		(2,187	)		(1,795	)		(1,698	)		(838	)
Minus: Loans to related parties		(81	)		(80	)		(112	)		(117	)		(109	)
Minus: Deferred tax assets		(303	)		(346	)		(328	)		(334	)		(325	)
Minus: Accounts payable		(708	)		(658	)		(628	)		(576	)		(511	)
Minus: Accounts payable to related parties		(210	)		(154	)		(194	)		(183	)		(236	)
Minus: Provisions and other current liabilities(3)		(2,748	)		(2,771	)		(2,791	)		(2,732	)		(2,447	)
Minus: Income tax payable		(162	)		(166	)		(209	)		(330	)		(239	)
Invested capital		23,373			22,244			21,866			21,395			20,583
Average invested capital as of March 31, 2019		21,892
Operating income(1)(2)(4)		2,965
Income tax expense(1)(2)(4)(5)		(798	)
NOPAT(4)		2,167
ROIC in %		9.9	%

10

2018	December 31, 2018			September 30, 2018(2)			June 30, 2018(2)			March 31, 2018(2)			December 31, 2017(2)
Total assets		26,242			25,587			25,045			23,091			22,930
Plus: Cumulative goodwill amortization		413			407			405			385			395
Minus: Cash and cash equivalents		(2,146	)		(1,754	)		(1,657	)		(800	)		(931	)
Minus: Loans to related parties		(81	)		(112	)		(118	)		(109	)		(92	)
Minus: Deferred tax assets		(345	)		(328	)		(334	)		(325	)		(315	)
Minus: Accounts payable		(641	)		(611	)		(559	)		(496	)		(577	)
Minus: Accounts payable to related parties		(154	)		(194	)		(183	)		(236	)		(147	)
Minus: Provisions and other current liabilities(3)		(2,728	)		(2,748	)		(2,689	)		(2,406	)		(2,565	)
Minus: Income tax payable		(165	)		(209	)		(330	)		(239	)		(194	)
Invested capital		20,395			20,038			19,580			18,865			18,504
Average invested capital as of December 31, 2018		19,476
Operating income(2)		3,024
Income tax expense(2)(5)		(617	)
NOPAT		2,407
ROIC in %		12.4	%

(1)

Adjusted for the impact of the IFRS 16 implementation.

(2)

Including adjustments for acquisitions and divestitures made for the last twelve months with a purchase price above a € 50 M threshold as defined in the Amended 2012 Credit Agreement.

(3)

Including non-current provisions, non-current labor expenses and variable payments outstanding for acquisitions and excluding pension liabilities and noncontrolling interests subject to put provisions.

(4)

Last 12 months.

(5)

Adjusted for noncontrolling partnership interests.

EBITDA (Non-IFRS)

EBITDA is the basis for determining compliance with certain covenants contained in our Amended 2012 Credit Agreement and may also be relevant in other major financing arrangements. You should not consider EBITDA to be an alternative to net earnings determined in accordance with IFRS or to cash flow from operations, investing activities or financing activities. In addition, not all funds depicted by EBITDA are available for management's discretionary use. For example, a substantial portion of such funds are subject to contractual restrictions and functional requirements to fund debt service, capital expenditures and other commitments from time to time as described in more detail elsewhere in this report. A reconciliation of EBITDA to cash flow provided by (used in) operating activities, which we believe to be the most directly comparable IFRS financial measure, is calculated as follows:

Reconciliation of EBITDA to net cash provided by (used in) operating activities

in € M

	For the three months ended March 31,
	2019			2018
Total EBITDA		899			672
Interest expense (net of interest income)		(108	)		(83	)
Income tax expense		(101	)		(84	)
Change in deferred taxes, net		54			(8	)
Changes in operating assets and liabilities		(682	)		(584	)
Compensation expense related to share-based plans		1			19
(Gain) loss on sale of fixed assets, investments and divestitures		(9	)		2
Other items, net		22			21
Net cash provided by (used in) operating activities		76			(45	)

11

Constant currency information (Non-IFRS)

Some key performance indicators and other financial measures used in this report such as changes in revenue, operating income and net income attributable to shareholders of FMC-AG & Co. KGaA include the impact of translating local currencies to our reporting currency for financial reporting purposes. We calculate these Non-IFRS financial measures at constant exchange rates in our filings to show changes in our revenue, operating income, net income attributable to shareholders of FMC-AG & Co. KGaA and other items without giving effect to period-to-period currency fluctuations. Under IFRS, amounts received in local (non-euro) currency are translated into euro at the average exchange rate for the period presented. Once we translate the local currency for the constant currency, we then calculate the change, as a percentage, of the current period calculated using the prior period exchange rates versus the prior period. This resulting percentage is a Non-IFRS Measure referring to a change as a percentage at constant currency. These currency-adjusted financial measures are identifiable by the designated terms "Constant Exchange Rates" or "Constant Currency."

We believe that the measures at Constant Currency (Non-IFRS Measure) are useful to investors, lenders and other creditors because such information enables them to gauge the impact of currency fluctuations on our revenue, operating income, net income attributable to shareholders of FMC-AG & Co. KGaA and other items from period to period. However, we limit our use of Constant Currency period-over-period changes to a measure for the impact of currency fluctuations on the translation of local currency into euro. We do not evaluate our results and performance without considering both Constant Currency period-over-period changes in Non-IFRS revenue, operating income, net income attributable to shareholders of FMC-AG & Co. KGaA and other items and changes in revenue, operating income, net income attributable to shareholders of FMC-AG & Co. KGaA and other items prepared in accordance with IFRS. We caution the readers of this report to follow a similar approach by considering data on Constant Currency period-over-period changes only in addition to, and not as a substitute for or superior to, changes in revenue, operating income, net income attributable to shareholders of FMC-AG & Co. KGaA and other items prepared in accordance with IFRS. We present the growth rate derived from IFRS measures next to the growth rate derived from Non-IFRS measures such as revenue, operating income, net income attributable to shareholders of FMC-AG & Co. KGaA and other items. As the reconciliation is inherent in the disclosure, we believe that a separate reconciliation would not provide any additional benefit.

Business metrics for Care Coordination

The measures for the North America Segment and the Asia-Pacific Segment discussed below include prior programs in which we participated and current and future programs that we will be participating in and will be reflected in the discussion of our business. Currently, in our North America Segment, sub-capitation, BPCI (until June 28, 2018—see note 2 of the notes to the consolidated financial statements (unaudited) included in this report), ESCO programs, MA-CSNPs (until December 31, 2018) and other shared savings programs are included within the Member Months and Medical Cost Under Management calculations below. In the future, other programs may be included in the metrics below. Note that due to the timing required by CMS to review the BPCI and ESCO program data that we provide, estimates have been used to report these metrics in a timely manner. The Asia-Pacific Segment Care Coordination metric currently used for discussion purposes is patient encounters. These metrics may be developed further in future periods. These metrics are neither IFRS measures nor non-IFRS measures, and are therefore not accompanied by or reconciled to IFRS measures.

Member months under medical cost management

In our North America Segment, member months under medical cost management is calculated by multiplying the number of members included in value-based reimbursement programs, such as Medicare Advantage plans or other value-based programs in the U.S., by the corresponding number of months these members participate in those programs ("Member Months"). In the aforementioned programs, we assume the risk of generating savings. The financial results are recorded in earnings as our performance is determined. The membership offerings within Care Coordination are sub-capitation arrangements, MA-CSNPs (until December 31, 2018), ESCO and BPCI (until June 28, 2018—see note 2 of the notes to the consolidated financial statements (unaudited) included in this report) programs as well as other shared savings programs. An increase in patient membership may indicate future earnings or losses as our performance is determined through these managed care programs.

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Medical cost under management

In our North America Segment, medical cost under management represents the management of medical costs associated with our patient membership in value-based programs. For ESCO, BPCI (until June 28, 2018—see note 2 of the notes to the consolidated financial statements (unaudited) included in this report) and other shared savings programs, this is calculated by multiplying the Member Months in each program by the benchmark of expected medical costs per member per month. The sub-capitation and MA-CSNPs calculation multiplies the premium per member of the program per month by the number of Member Months associated with the plan, as noted above.

Care coordination patient encounters

Care Coordination patient encounters represents the total patient encounters and procedures conducted by certain of our Care Coordination activities and, we believe, is an indicator of the revenue generated. Care Coordination patient encounters in the North America Segment is the sum of all encounters and procedures completed during the period by Sound Inpatient Physicians, Inc. ("Sound") until June 28, 2018 (see note 2 of the notes to the consolidated financial statements (unaudited) included in this report), MedSpring Urgent Care Centers, Azura Vascular Care, and National Cardiovascular Partners, the trade name of Laurus Healthcare L.P., as well as patients in our Fresenius Medical Care Rx Bone Mineral Metabolism ("Rx BMM") program. Care Coordination patient encounters in the Asia-Pacific Segment is the sum of all encounters for the following services: ambulant treatment services in day care hospitals, comprehensive and specialized health check-ups, inpatient and outpatient services, vascular access and other chronic treatment services.

III.  Results of operations, financial position and net assets

The following sections summarize our results of operations, financial position and net assets as well as key performance indicators by reporting segment, as well as Corporate, for the periods indicated. We prepared the information using a management approach, consistent with the manner in which management internally disaggregates financial information to assist in making operating decisions and evaluating management performance.

Results of operations

Segment data (including Corporate)

in € M

	For the three months ended March 31,
	2019			2018
Total revenue
North America		2,887			2,774
EMEA		653			636
Asia-Pacific		428			392
Latin America		161			170
Corporate		4			4
Total		4,133			3,976
Operating income
North America		372			362
EMEA		138			109
Asia-Pacific		95			74
Latin America		11			14
Corporate		(79	)		(62	)
Total		537			497
Interest income		28			25
Interest expense		(136	)		(108	)
Income tax expense		(101	)		(84	)
Net Income		328			330
Net Income attributable to noncontrolling interests		(57	)		(51	)
Net Income attributable to shareholders of FMC-AG & Co. KGaA		271			279

13

Revenue and operating income generated in countries outside the eurozone are subject to currency fluctuations. The three months ended March 31, 2019 and 2018 were positively impacted by the development of the euro against the U.S. dollar. For the three-months ended March 31, 2019, approximately 70% of revenue and approximately 69% of operating income were generated in U.S. dollars.

Three months ended March 31, 2019 compared to three months ended March 31, 2018

Consolidated financials

Key indicators for the consolidated financial statements

in € M, except where otherwise specified

	For the three months ended March 31						Change in %
							As reported			Constant Currency(1)
	2019			2018
Revenue		4,133			3,976			4	%		(1	)%
Health care services		3,317			3,209			3	%		(2	)%
Health care products		816			767			6	%		4	%
Number of dialysis treatments		12,561,531			12,154,164			3	%
Same market treatment growth in %		3.5	%		2.3	%
Gross profit as a % of revenue		30.6	%		30.3	%
Selling, general and administrative costs as a % of revenue		17.3	%		17.1	%
Operating income		537			497			8	%		3	%
Operating income margin in %		13.0	%		12.5	%
Delivered EBIT(2)		480			446			8	%		3	%
Net income attributable to shareholders of FMC-AG & Co. KGaA		271			279			(3	)%		(6	)%
Basic earnings per share		0.88			0.91			(3	)%		(7	)%

(1)

For further information on Constant Exchange Rates, see "—II. Discussion of Measures—Non—IFRS Measures—Constant currency information" above.

(2)

For further information on Delivered EBIT, including a reconciliation of Delivered EBIT to Operating Income on a consolidated basis and for each of our operating segments, see "—II. Discussion of Measures—Non—IFRS Measures—Delivered EBIT" above.

Health care services revenue increased by 3% including a 5% positive impact from foreign currency translation effects. At Constant Exchange Rates, health care services revenue decreased by 2% largely due to decreases attributable to prior year revenue associated with the divested Sound activities as well as the effect of closed or sold clinics (8%) and a decrease in dialysis days (1%), partially offset by growth in same market treatments (3%), increases in organic revenue per treatment (3%) and contributions from acquisitions (1%).

Dialysis treatments increased by 3% as a result of growth in same market treatments (3%) and contributions from acquisitions (2%), partially offset by a decrease in dialysis days (1%) and the effect of closed or sold clinics (1%).

At March 31, 2019, we owned, operated or managed (excluding those managed but not consolidated in the U.S.) 3,971 dialysis clinics compared to 3,790 dialysis clinics at March 31, 2018. During the three months ended March 31, 2019, we acquired 25 dialysis clinics, opened 29 dialysis clinics and combined or closed 11 clinics. The number of patients treated in dialysis clinics that we own, operate or manage (excluding patients of dialysis clinics managed but not consolidated in the U.S.) increased by 4% to 336,716 at March 31, 2019 from 322,253 at March 31, 2018.

Health care product revenue increased by 6% including a 2% positive impact from foreign currency translation. At Constant Exchange Rates, health care product revenue increased by 4%. Dialysis product revenue increased by 7%, including a 2% positive impact from foreign currency translation. At Constant Exchange Rates, dialysis product revenue increased by 5% driven by higher sales of home hemodialysis products (largely as a result of the acquisition of NxStage Medical Inc. ("NxStage")), dialyzers, products for acute care treatments, solutions and concentrates, and bloodlines, partially offset by lower sales of machines as a result of changes in the accounting treatment for sale-leaseback transactions due to the IFRS 16 Implementation. Non-dialysis product revenue decreased by 3% to €19 M from €20 M with no

14

foreign currency translation effects. The non-dialysis product revenue decrease was due to slightly lower sales volumes.

The increase period over period in the gross profit margin was 0.3 percentage points with virtually no effect from foreign currency translation. The increase primarily reflects increases in the North America Segment and the Asia-Pacific Segment, partially offset by a decrease in the EMEA Segment. The increase in the North America Segment was mainly attributable to the positive current year effect from the divestiture of Sound which operated at lower margins, a favorable effect from the IFRS 16 Implementation (see note 1 of the notes to the consolidated financial statements (unaudited) included in this report) and a positive impact from manufacturing, partially offset by higher personnel expense. The increase in the Asia-Pacific Segment was driven by a favorable impact from business growth, partially offset by an unfavorable mix effect from acquisitions with lower margins. The decrease in the EMEA Segment was mainly driven by higher rent expense, unfavorable foreign currency transaction effects, the impact from one less dialysis day, acquisitions with lower margins, and higher personnel expense in certain countries, as well as other smaller cost increases.

The increase period over period in selling, general and administrative ("SG&A") expenses as a percentage of revenue was 0.2 percentage points. Foreign currency translation effects represented a 0.1 percentage point negative effect in the current period. The increase was primarily driven by increases in the North America Segment and at Corporate as well as an unfavorable impact of varying margins across the four operating segments, partially offset by decreases in the EMEA Segment and the Asia-Pacific Segment. The increase in the North America Segment was due to the integration and operational costs associated with NxStage, higher personnel expense, an unfavorable impact from legal settlements, and higher stock compensation expense, partially offset by the positive impact from income attributable to a consent agreement on certain pharmaceuticals. The increase at Corporate was mainly driven by higher stock compensation expense, unfavorable foreign currency transaction effects and higher project costs. The decrease in the EMEA Segment was due to a reduction of a contingent consideration liability related to Xenios AG ("Xenios"), favorable foreign currency transaction effects, and a positive impact from acquisitions, partially offset by higher bad debt expense. The decrease in the Asia-Pacific Segment was due to favorable foreign currency transaction effects.

Research and development expenses increased by 5% to €34 M from €32 M. Period over period, as a percentage of revenue, research and development expenses remained stable.

Income from equity method investees increased by 12% to €20 M from €18 M. The increase was primarily driven by higher income from Vifor Fresenius Medical Care Renal Pharma Ltd., an entity in which we have ownership of 45%, mainly due to higher sales of renal pharmaceuticals.

The increase period over period in the operating income margin was 0.5 percentage points with virtually no effect from foreign currency translation. The increase in the current period was largely driven by the increase in the gross profit margin as well as the loss related to the divestiture of Care Coordination activities in the first quarter of 2018, partially offset by the increase in SG&A expenses, as discussed above.

Delivered EBIT increased by 8% including a 5% positive impact from foreign currency translation effects. At Constant Exchange Rates, Delivered EBIT increased by 3% largely driven by increased operating income, partially offset by an increase in income attributable to noncontrolling interests.

Net interest expense increased by 30% to €108 M from €83 M, including a 6% negative impact from foreign currency translation effects. At Constant Exchange Rates, net interest expense increased by 24%, primarily due to a higher debt level driven by the IFRS 16 Implementation and the acquisition of NxStage, partially offset by the replacement of high interest bearing senior notes repaid in 2018 by debt instruments at lower interest rates and interest income from the investment of the Sound proceeds.

Income tax expense increased by 20% to €101 M from €84 M. The effective tax rate increased to 23.5% from 20.3% for the same period of 2018 largely driven by the prior year impact in 2018 caused by favorable implications of the US Tax Reform.

Net income attributable to noncontrolling interests increased by 11% to €57 M from €51 M, including an 8% negative impact resulting from foreign currency translation effects. At Constant Exchange Rates, net income attributable to noncontrolling interests increased by 3% driven by higher earnings from Care Coordination in the United States.

15

Net income attributable to shareholders of FMC-AG & Co. KGaA decreased by 3% to €271 M from €279 M including a 3% positive impact resulting from foreign currency translation. At Constant Exchange Rates, net income attributable to shareholders of FMC-AG & Co. KGaA decreased by 6% due to the combined effects of the items discussed above.

Basic earnings per share decreased by 3%, including a 4% positive impact resulting from foreign currency translation. At Constant Exchange Rates, basic earnings per share decreased by 7%. The average weighted number of shares outstanding for the period was approximately 306.7 M in 2019 (306.5 M in 2018).

We employed 118,308 people (full-time equivalents) as of March 31, 2019 compared to 114,831 as of March 31, 2018, an increase of 3%, primarily due to the NxStage acquisition.

Consolidated operating performance on an adjusted basis

Management believes that there are certain distinct transactions or events for which the operating results should be adjusted to enhance transparency and comparability. We believe the following results (adjusted to exclude these items) should be analyzed in connection with the results presented above. For the three months ended March 31, 2019 and 2018, we have identified the following transactions that, when excluded from the results disclosed above, may provide a reader with further useful information in assessing our performance:

•

IFRS 16 Implementation

•

an adjustment to remove the contribution of NxStage during the first quarter of 2019 to conform to the 2018 presentation ("NxStage Operations")

•

the integration costs related to the acquisition of NxStage on February 21, 2019 ("NxStage Costs")

•

costs associated with the sustainable improvement of our cost base ("Cost Optimization Costs")

•

an adjustment to remove the contribution of Sound during the first quarter of 2018 to conform to the 2019 presentation ("Q1 Sound")

•

the gain related to divestitures of Care Coordination activities (see note 2 (b) of the notes to the consolidated financial statements (unaudited) included in this report) ("(Gain) loss related to divestitures of Care Coordination activities")

The following table reconciles the key indicators for the consolidated financial statements in accordance with IFRS to the key indicators adjusted for the items described above. While we believe these adjustments provide additional clarity to the discussion of our operating results, the following table should only be viewed as a supplement to our results disclosed in accordance with IFRS above.

Consolidated operating performance on an adjusted basis

in € M, except where otherwise specified

																	Change in % as adjusted
	Results 2019			IFRS 16 Implementation			NxStage operations			NxStage costs		Cost optimization costs		Results 2019 Adjusted			Current rate			Constant Currency(1)
Three months ended March 31
Total revenue		4,133			22			(30	)		—		—		4,125			11	%		6	%
Health Care Services		3,317			—			(1	)		—		—		3,316			12	%		6	%
Health Care Products		816			22			(29	)		—		—		809			5	%		4	%
Total operating income (EBIT)		537			(17	)		11			16		4		551			9	%		4	%
Operating income (EBIT) Margin		13.0	%												13.4	%
Interest expense, net		108			(42	)		(8	)		—		—		58			–19	%		–23	%
Income tax expense		101			7			5			4		1		118			37	%		31	%
Net income attributable to noncontrolling interests		57			—			—			—		—		57			11	%		3	%
Net income(2)		271			18			14			12		3		318			8	%		3	%
Basic earnings per share		0.88			0.06			0.05			0.04		0.01		1.04			8	%		3	%

16

Consolidated operating performance on a comparable basis and adjusted

	Results 2018			Q1 Sound(3)			(Gain) loss related to divestitures of Care Coordination activities		Results 2018 Adjusted
Three months ended March 31
Total revenue		3,976			(251	)		—		3,725
Health Care Services		3,209			(251	)		—		2,958
Health Care Products		767			—			—		767
Total operating income (EBIT)		497			(4	)		13		506
Operating income (EBIT) Margin		12.5	%							13.6	%
Interest expense, net		83			(10	)		—		73
Income tax expense		84			2			—		86
Net income attributable to noncontrolling interests		51			—			—		51
Net income(2)		279			4			13		296
Basic earnings per share		0.91			0.01			0.04		0.96

(1)

For further information on Constant Exchange Rates, see "—II. Discussion of measures—Non-IFRS measures—Constant currency information" above.

(2)

Attributable to shareholders of FMC-AG & Co. KGaA.

(3)

Contribution of Sound Physicians.

The following discussions pertain to the North America Segment, the EMEA Segment, the Asia-Pacific Segment and the Latin America Segment and the measures we use to manage these segments.

North America Segment

Key indicators and business metrics for the North America Segment

in € M, except where otherwise specified

	For the three months ended March 31						Change in %
										Constant Currency(1)
	2019			2018			As Reported
Total North America Segment
Revenue		2,887			2,774			4	%		(4	)%
Health care services		2,680			2,590			3	%		(4	)%
Health care products		207			184			12	%		4	%
Operating income		372			362			3	%		(4	)%
Operating income margin in %		12.9	%		13.1	%
Delivered EBIT(2)		319			314			2	%		(4	)%
Dialysis
Revenue		2,579			2,259			14	%		5	%
Number of dialysis treatments		7,707,848			7,473,764			3	%
Same market treatment growth in %		3.3	%		2.3	%
Operating income		332			349			(5	)%		(10	)%
Operating income margin in %		12.9	%		15.4	%
Delivered EBIT(2)		285			304			(6	)%		(12	)%
Care Coordination
Revenue		308			515			(40	)%		(45	)%
Operating income		40			13			203	%		180	%
Operating income margin in %		13.0	%		2.6	%
Delivered EBIT(2)		34			10			253	%		226	%
Member Months Under Medical Cost Management(3)(4)		170,903			165,797			3	%
Medical Cost Under Management(3)(4)		1,071			1,189			(10	)%		(17	)%
Care Coordination Patient Encounters(3)(4)		272,353			1,957,694			(86	)%

(1)

For further information on Constant Exchange Rates, see "—II. Discussion of Measures—Non-IFRS Measures—Constant currency information" above.

(2)

For further information on Delivered EBIT, including a reconciliation of Delivered EBIT to Operating Income on a consolidated basis and for each of our operating segments, see "—II. Discussion of Measures—Non-IFRS Measures—Delivered EBIT" above.

(3)

For further information on these metrics, please refer to the discussion above of our Care Coordination measures under "Business Metrics for Care Coordination."

(4)

The metrics may be understated due to a physician mapping issue related to the BPCI program within a CMS system which has not yet been resolved. Additionally, data presented for the BPCI and ESCO metrics are subject to finalization by CMS, which may result in changes from previously reported metrics.

17

Dialysis

Revenue

Dialysis revenue increased by 14% including a 9% positive impact resulting from foreign currency translation. At Constant Exchange Rates, dialysis revenue increased by 5%. Dialysis revenue is comprised of dialysis care revenue and health care product revenue.

Dialysis care revenue increased by 14% to €2,372 M from €2,075 M, including an 8% positive impact resulting from foreign currency translation. At Constant Exchange Rates, dialysis care revenue increased by 6% mainly due to increases in organic revenue per treatment (3%), growth in same market treatments (3%), and contributions from acquisitions (1%), partially offset by a decrease in dialysis days (1%).

Dialysis treatments increased by 3% largely due to growth in same market treatments (3%) and contributions from acquisitions (1%), partially offset by a decrease in dialysis days (1%). At March 31, 2019, 205,775 patients (4% increase from March 31, 2018) were being treated in the 2,559 dialysis clinics that we own or operate in the North America Segment, compared to 197,339 patients treated in 2,419 dialysis clinics at March 31, 2018.

In the U.S., the average revenue per treatment increased to $355 (€289 at Constant Exchange Rates) from $348 (€283). The development was mainly attributable to higher utilization of oral based ancillaries and the impact from an increase in the ESRD PPS base rate, partially offset by lower revenue from commercial payors.

Cost per treatment in the U.S., adjusted for the effects from the IFRS 16 Implementation, increased to $301 (€245 at Constant Exchange Rates) from $289 (€235). This increase was largely driven by higher utilization of oral based ancillaries and higher personnel expense.

Health care product revenue increased by 12% including an 8% positive impact resulting from foreign currency translation. At Constant Exchange Rates, health care product revenue increased by 4% driven by higher sales of home hemodialysis products, products for acute care, and bloodlines, all largely as a result of the NxStage acquisition, partially offset by lower sales of machines as a result of changes in the accounting treatment for sale-leaseback transactions due to the IFRS 16 Implementation.

Operating income margin

The decrease period over period in the dialysis operating income margin was 2.5 percentage points. Foreign currency translation effects represented a 0.2 percentage point decrease in the current period. At Constant Exchange Rates, the decrease was due to higher personnel expense, the integration and operational costs associated with NxStage, an unfavorable impact from legal settlements, and higher stock compensation expense, partially offset by the positive impact from income attributable to a consent agreement on certain pharmaceuticals, a favorable effect from the IFRS 16 Implementation and a favorable impact from manufacturing.

Delivered EBIT

Dialysis Delivered EBIT decreased by 6%, including a 6% positive impact from foreign currency translation effects. At Constant Exchange Rates, dialysis Delivered EBIT decreased by 12% mainly as a result of decreased operating income coupled with an increase in income attributable to noncontrolling interests.

Care Coordination

Revenue

Care Coordination revenue decreased by 40%, including a 5% positive impact resulting from foreign currency translation. At Constant Exchange Rates, Care Coordination revenue decreased by 45% driven by decreases attributable to prior year revenue associated with the divested Sound activities (53%), partially offset by an increase in organic revenue growth (7%) and contributions from acquisitions (1%).

Operating income margin

The increase period over period in the Care Coordination operating income margin was 10.4 percentage points with virtually no effect from foreign currency translation. The increase at Constant Exchange Rates was mainly due to the loss related to divestiture of Care Coordination activities in the first quarter of 2018,

18

increased member months for health plan services, increased volumes for vascular services, and a positive effect from the IFRS 16 Implementation.

Delivered EBIT

Care Coordination Delivered EBIT increased by 253% including a 27% positive impact resulting from foreign currency translation. At Constant Exchange Rates, Care Coordination delivered EBIT increased by 226% mainly as the result of increased operating income, partially offset by an increase in income attributable to noncontrolling interests.

Care Coordination business metrics

Member months under medical cost management remained stable primarily due to the expansion of our existing ESCOs through the addition of new physician practice partners and dialysis facilities, offset by the divestment of our controlling interest in Sound on June 28, 2018 and, as a result, the conclusion of our participation in BPCI. See note 2 (b) of the notes to consolidated financial statements (unaudited) included in this report) and note 4 to the table "Key indicators and business metrics for the North America Segment," above.

Care Coordination's medical cost under management decreased by 10%, including a 7% positive impact from foreign currency translation in the current period. At Constant Exchange Rates, Care Coordination's medical cost under management decreased by 17% due to the divestment of our controlling interest in Sound on June 28, 2018 (see note 2 (b) of the notes to consolidated financial statements (unaudited) included in this report) and, as a result, the conclusion of our participation in BPCI. This decrease was partially offset by our expansion of our existing ESCOs through the addition of new physician practice partners and dialysis facilities. See note 4 to the table "Key indicators and business metrics for the North America Segment" above.

The decrease in patient encounters was primarily driven by decreased encounters for hospital related physician services as a result of our divesting our controlling interest in Sound on June 28, 2018. See note 2 (b) of the notes to consolidated financial statements (unaudited) included in this report) and note 4 to the table "Key indicators and business metrics for the North America Segment" above.

North America Segment operating performance on an adjusted basis

Management believes that there are certain distinct transactions or events for which the operating results should be adjusted to enhance transparency and comparability. We believe the following results (adjusted to exclude these items) should be analyzed in connection with the results presented above. For the three months ended March 31, 2019 and 2018, we have identified the following transactions that, when excluded from the results disclosed above, may provide a reader with further useful information in assessing our performance:

•

IFRS 16 Implementation

•

NxStage Operations

•

NxStage Costs

•

Cost Optimization Costs

•

Q1 Sound

•

(Gain) loss related to divestitures of Care Coordination activities

19

The following table reconciles the key indicators for the North America Segment in accordance with IFRS to the key indicators adjusted for the items described above. While we believe these adjustments provide additional clarity to the discussion of our operating results, the following table should only be viewed as a supplement to our results disclosed in accordance with IFRS above.

FRESENIUS MEDICAL CARE AG & Co. KGaA

North America Segment operating performance on an adjusted basis

in € M, except where otherwise specified

																	Change in % as adjusted
	Results 2019			IFRS 16 Implementation			NxStage operations			NxStage costs		Cost optimization costs		Results 2019 Adjusted			Current rate			Constant Currency(1)
Three months ended March 31
Revenue		2,887			22			(30	)		—		—		2,879			14	%		5	%
Health Care Services		2,680			—			(1	)		—		—		2,679			14	%		6	%
thereof Dialysis Care		2,372			—			(1	)		—		—		2,371			14	%		6	%
thereof Care Coordination		308			—			—			—		—		308			17	%		8	%
Health Care Products		207			22			(29	)		—		—		200			9	%		0	%
Operating income (EBIT)		372			(13	)		11			16		4		390			5	%		–1	%
Operating income margin (EBIT)		12.9	%												13.6	%
Dialysis		332			(11	)		11			16		4		352			1	%		–5	%
Dialysis operating income margin (EBIT)		12.9	%												13.7	%
Care Coordination		40			(2	)		—			—		—		38			72	%		59	%
Care Coordination operating income margin (EBIT)		13.0	%												12.3	%

North America Segment operating performance on an adjusted basis

	Results 2018			Q1 Sound(2)			(Gain) loss related to divestitures of Care Coordination activities		Results 2018 Adjusted
Three months ended March 31
Revenue		2,774			(251	)		—		2,523
Health Care Services		2,590			(251	)		—		2,339
thereof Dialysis Care		2,075			—			—		2,075
thereof Care Coordination		515			(251	)		—		264
Health Care Products		184			—			—		184
Operating income (EBIT)		362			(4	)		13		371
North America operating income margin (EBIT)		13.1	%							14.7	%
Dialysis		349			—			—		349
Dialysis operating income margin (EBIT)		15.4	%							15.4	%
Care Coordination		13			(4	)		13		22
Care Coordination operating income margin (EBIT)		2.6	%							8.3	%

(1)

For further information on Constant Exchange Rates, see "—II. Discussion of measures—Non-IFRS measures—Constant currency information" above.

(2)

Contribution of Sound Physicians.

20

EMEA Segment

Key indicators for the EMEA Segment

in € M, except where otherwise specified

	For the three months ended March 31,						Change in %
							As Reported			Constant Currency(1)
	2019			2018
Revenue		653			636			3	%		4	%
Health care services		324			314			3	%		5	%
Health care products		329			322			2	%		3	%
Number of dialysis treatments		2,475,702			2,387,160			4	%
Same market treatment growth in %		3.9	%		2.4	%
Operating income		138			109			26	%		27	%
Operating income margin in %		21.1	%		17.1	%
Delivered EBIT(2)		136			108			26	%		27	%

(1)

For further information on Constant Exchange Rates, see "—II. Discussion of Measures—Non—IFRS Measures—Constant currency information" above.

(2)

For further information on Delivered EBIT, including a reconciliation of Delivered EBIT to Operating Income on a consolidated basis and for each of our operating segments, see "—II. Discussion of Measures—Non—IFRS Measures—Delivered EBIT" above.

Revenue

Health care service revenue increased by 3%, including a 2% negative impact resulting from foreign currency translation. At Constant Exchange Rates, health care service revenue increased by 5% as a result of growth in same market treatments (4%), contributions from acquisitions (3%), and increases in organic revenue per treatment (1%), partially offset by a decrease in dialysis days (2%), and the effect of closed or sold clinics (1%).

Dialysis treatments increased by 4% mainly due to growth in same market treatments (4%) and contributions from acquisitions (2%), partially offset by the effect of closed or sold clinics (1%) and a decrease in dialysis days (1%). As of March 31, 2019, we had 65,833 patients (4% increase from March 31, 2018) being treated at the 782 dialysis clinics that we own, operate or manage in the EMEA Segment compared to 63,114 patients treated at 754 clinics at March 31, 2018.

Health care product revenue increased by 2%, including a 1% negative impact resulting from foreign currency translation. At Constant Exchange Rates, health care product revenue increased by 3%. Dialysis product revenue increased by 3% with virtually no effect from foreign currency translation. The increase was due to higher sales of machines, dialyzers, hemodialysis solutions and concentrates, and renal pharmaceuticals, partially offset by lower sales of products for acute care treatments. Non-Dialysis product revenue decreased by 3% to €19 M from €20 M with virtually no impact from foreign currency translation effects. The non-dialysis product revenue decrease was due to slightly lower sales volumes.

Operating income margin

The increase period over period in the operating income margin was 4.0 percentage points. Foreign currency translation effects represented a 0.1 percentage point increase in the operating income margin. At Constant Exchange Rates, operating income margin increased mainly due to a reduction of a contingent consideration liability related to Xenios, partially offset by higher bad debt expense, higher rent expense, and the impact from one less dialysis day.

Delivered EBIT

Delivered EBIT increased by 26%, including a 1% negative impact resulting from foreign currency translation. At Constant Exchange Rates, the Delivered EBIT increased by 27% primarily due to increased operating income, partially offset by an increase in income attributable to noncontrolling interests.

21

Asia-Pacific Segment

Key indicators for the Asia-Pacific Segment

in € M, except where otherwise specified

	For the three months ended March 31,						Change in %
							As Reported			Constant Currency(1)
	2019			2018
Total Asia-Pacific Segment
Revenue		428			392			9	%		6	%
Health care services		199			184			8	%		4	%
Health care products		229			208			10	%		8	%
Operating income		95			74			28	%		25	%
Operating income margin in %		22.1	%		19.0	%
Delivered EBIT(2)		93			72			29	%		26	%
Dialysis
Revenue		376			346			9	%		5	%
Number of dialysis treatments		1,099,404			1,060,114			4	%
Same market treatment growth in %		7.1	%		4.2	%
Operating income		89			68			31	%		27	%
Operating income margin in %		23.6	%		19.7	%
Delivered EBIT(2)		87			66			31	%		28	%
Care Coordination
Revenue		52			46			14	%		12	%
Operating income		6			6			(6	)%		(5	)%
Operating income margin in %		11.3	%		13.7	%
Delivered EBIT(2)		6			6			(3	)%		(2	)%
Care Coordination Patient Encounters(3)		216,320			200,138			8	%

(1)

For further information on Constant Exchange Rates, see "—II. Discussion of Measures—Non—IFRS Measures—Constant currency information" above.

(2)

For further information on Delivered EBIT, including a reconciliation of Delivered EBIT to Operating Income on a consolidated basis and for each of our operating segments, see "—II. Discussion of Measures—Non-IFRS Measures—Delivered EBIT" above.

(3)

For further information on patient encounters, please refer to the discussion above of our Care Coordination measures under "Business Metrics for Care Coordination."

Dialysis

Revenue

Dialysis revenue increased by 9% including a 4% positive impact resulting from foreign currency translation. At Constant Exchange Rates, dialysis revenue increased by 5%. Dialysis revenue is comprised of dialysis care revenue and health care product revenue.

Dialysis care revenue increased by 7% to €147 M from €138 M including a 6% positive impact resulting from foreign currency translation effects. At Constant Exchange Rates, dialysis care revenue increased by 1% as a result of growth in same market treatments (7%), and contributions from acquisitions (1%), partially offset by the effect of closed or sold clinics (4%), a decrease in organic revenue per treatment (2%) and a decrease in dialysis days (1%).

Dialysis treatments increased by 4% mainly due to growth in same market treatments (7%), and contributions from acquisitions (1%), partially offset by the effect of closed or sold clinics (3%) and a decrease in dialysis days (1%). As of March 31, 2019, we had 31,674 patients (5% increase from March 31, 2018) being treated at the 398 dialysis clinics that we own, operate or manage in the Asia-Pacific Segment compared to 30,194 patients treated at 385 clinics at March 31, 2018.

Health care product revenue increased by 10% including a 2% positive impact resulting from foreign currency translation. At Constant Exchange Rates, health care product revenue increased by 8% as a result of increased sales of dialyzers, machines, hemodialysis solutions and concentrates, and products for acute care treatments.

22

Operating income margin

The increase period over period in the operating income margin was 3.9 percentage points. Foreign currency translation effects represented a 0.2 percentage point decrease in the operating income margin. At Constant Exchange Rates, the operating income margin increased due to favorable foreign currency transaction effects and a favorable impact from business growth.

Delivered EBIT

Delivered EBIT increased by 31%, including a 3% positive impact resulting from foreign currency translation. At Constant Exchange Rates, Delivered EBIT increased by 28% mainly due to increased operating income.

Care Coordination

Revenue

Care Coordination revenue increased by 14%, including a 2% positive impact resulting from foreign currency translation. At Constant Exchange Rates, Care Coordination revenue increased by 12% driven by contributions from acquisitions (7%) and organic revenue growth (5%).

Operating income margin

The decrease period over period in the Care Coordination operating income margin was 2.4 percentage points. Foreign currency translation effects represented a 0.3 percentage point decrease in the operating income margin. At Constant Exchange Rates, the operating income margin decrease was driven by higher start-up and operating costs.

Delivered EBIT

Care Coordination Delivered EBIT decreased by 3%, including a 1% negative impact resulting from foreign currency translation. At Constant Exchange Rates, Care Coordination Delivered EBIT decreased by 2% mainly as the result of decreased operating income.

Care Coordination business metrics

The number of patient encounters increased due to increased encounters for comprehensive and specialized health check-ups as well as ambulant treatment services, inpatient and outpatient services, vascular access and other chronic treatment services.

Latin America Segment

Key indicators for the Latin America Segment

in € M, except where otherwise specified

	For the three months ended March 31,						Change in %
							As Reported			Constant Currency(1)
	2019			2018
Revenue		161			170			(5	)%		14	%
Health care services		114			121			(5	)%		20	%
Health care products		47			49			(5	)%		1	%
Number of dialysis treatments		1,278,577			1,233,126			4	%
Same market treatment growth in %		0.7	%		1.1	%
Operating income		11			14			(19	)%		(24	)%
Operating income margin in %		7.1	%		8.3	%
Delivered EBIT(2)		11			14			(21	)%		(26	)%

(1)

For further information on Constant Exchange Rates, see "—II. Discussion of Measures—Non—IFRS Measures—Constant currency information" above.

(2)

For further information on Delivered EBIT, including a reconciliation of Delivered EBIT to Operating Income on a consolidated basis and for each of our operating segments, see "—II. Discussion of Measures—Non-IFRS Measures—Delivered EBIT" above.

23

Revenue

Health care service revenue decreased by 5%, including a 25% negative impact resulting from foreign currency translation. At Constant Exchange Rates, health care service revenue increased by 20% as a result of increases in organic revenue per treatment (16%), contributions from acquisitions (5%) and growth in same market treatments (1%), partially offset by the effect of closed or sold clinics (1%), and a decrease in dialysis days (1%).

Dialysis treatments increased by 4% mainly due to contributions from acquisitions (5%) and growth in same market treatments (1%), partially offset by the effect of closed or sold clinics (1%) and a decrease in dialysis days (1%). As of March 31, 2019, we had 33,434 patients (a 6% increase from March 31, 2018) being treated at the 232 dialysis clinics that we own, operate or manage in the Latin America Segment compared to 31,606 patients treated at 232 clinics at March 31, 2018.

Health care product revenue decreased by 5%, including a 6% negative impact resulting from foreign currency translation. At Constant Exchange Rates, health care product revenue remained relatively stable with a slight increase of 1%.

Operating income margin

The decrease period over period in the operating income margin was 1.2 percentage points. Foreign currency translation effects represented a 1.6 percentage point increase in the operating income margin. At Constant Exchange Rates, the operating income margin decreased mainly due to the impact from hyperinflation in Argentina, partially offset by favorable foreign currency transaction effects.

Delivered EBIT

Delivered EBIT decreased by 21% including a 5% positive impact resulting from foreign currency translation. At Constant Exchange Rates, Delivered EBIT decreased by 26% mainly due to decreased operating income.

Financial position

Sources of liquidity

Our primary sources of liquidity are typically cash provided by operating activities, cash provided by short-term debt from third parties and related parties, as well as proceeds from the issuance of long-term debt (including the issuance of bonds under our debt issuance program) and equity securities as well as divestitures. We require this capital primarily to finance working capital needs, fund acquisitions and clinics in which we have ownership of less than 100%, develop free-standing renal dialysis clinics and other health care facilities, purchase equipment for existing or new renal dialysis clinics and production sites, repay debt, pay dividends and repurchase shares, (see "Net cash provided by (used in) investing activities" and "Net cash provided by (used in) financing activities" below).

In our long-term financial planning, we focus primarily on the Net Leverage Ratio, a Non-IFRS Measure, see "—II. Discussion of Measures—Non-IFRS Measures—Net leverage ratio (Non-IFRS Measure)" above. At March 31, 2019 and December 31, 2018, the Net Leverage Ratio was 3.2 and 1.8, respectively. Adjusted for IFRS 16, the Net Leverage Ratio was 2.5 at March 31, 2019.

At March 31, 2019, we had cash and cash equivalents of €959 M compared to €2,146 M at December 31, 2018.

Free cash flow (Net cash provided by (used in) operating activities, after capital expenditures, before acquisitions and investments) amounted to €(123) M and €(263) M for the three months ended March 31, 2019 and March 31, 2018, respectively. Free cash flow is a Non-IFRS measure reconciled to net cash provided by (used in) operating activities, the most directly comparable IFRS measure, see "—II. Discussion of measures—Non-IFRS measures—Cash flow measures" above. Free cash flow in percent of revenue was (3.0%) and (6.6%) for the three months ended March 31, 2019 and 2018, respectively.

Net cash provided by (used in) operating activities

In the first three months of 2019, net cash provided by operating activities was €76 M as compared to net cash used in operating activities of €45 M in the first three months of 2018. Net cash provided by (used in)

24

operating activities in percent of revenue increased to 2% for the first three months of 2019 as compared to (1%) for 2018. Cash provided by (used in) operating activities is impacted by the profitability of our business, the development of our working capital, principally inventories, receivables and cash outflows that occur due to a number of specific items as discussed below. The increase in net cash provided by operating activities was largely driven by the IFRS 16 Implementation leading to a reclassification of the repayment portion of rent to financing activities.

The profitability of our business depends significantly on reimbursement rates. Approximately 80% of our revenue is generated by providing health care services, a major portion of which is reimbursed by either public health care organizations or private insurers. For the three months ended March 31, 2019, approximately 34% of our consolidated revenue was attributable to U.S. federal health care benefit programs, such as Medicare and Medicaid reimbursement. Legislative changes could affect Medicare reimbursement rates for a significant portion of the services we provide as well as the scope of Medicare coverage. A decrease in reimbursement rates or the scope of coverage could have a material adverse effect on our business, financial condition and results of operations and thus on our capacity to generate cash flow. See "I. Overview," above.

We intend to continue to address our current cash and financing requirements using cash provided by operating activities, our existing and future credit agreements, issuances under the commercial paper program (see note 8 of the notes to the consolidated financial statements (unaudited) included in this report) as well as the utilization of the Accounts Receivable Facility. In addition, when funds are required for acquisitions or to meet other needs, we expect to successfully complete long-term financing arrangements, such as the issuance of bonds. We aim to preserve financial resources with a minimum of €500 M of committed and unutilized credit facilities.

Net cash provided by (used in) operating activities depends on the collection of accounts receivable. Commercial customers and governments generally have different payment cycles. Lengthening their payment cycles could have a material adverse effect on our capacity to generate cash flow. In addition, we could face difficulties in enforcing and collecting accounts receivable under some countries' legal systems and due to the economic conditions in some countries. Accounts receivable balances, net of valuation allowances, represented Days Sales Outstanding ("DSO") of 83 days at March 31, 2019, an increase as compared to 75 days at December 31, 2018.

DSO by segment is calculated by dividing the segment's accounts and other receivable and contract liabilities, converted to euro using the average exchange rate for the period presented, less any sales or value added tax included in the receivables, by the average daily sales for the last twelve months of that segment, converted to euro using the average exchange rate for the period. Receivables and sales are adjusted for amounts related to acquisitions and divestitures made within the reporting period with a purchase price above a €50 M threshold as defined in the Amended 2012 Credit Agreement. The development of DSO by reporting segment is shown in the table below:

DSO by reporting segment

	March 31 2019		December 31, 2018
North America Segment		72		60
EMEA Segment		96		98
Asia-Pacific Segment		117		116
Latin America Segment		120		119
FMC-AG & Co. KGaA average days sales outstanding		83		75

The DSO increase in the North America Segment was largely due to seasonality in invoicing. The DSO decrease in the EMEA Segment primarily reflects the improved collection efforts from health care organizations. The Asia-Pacific Segment's DSO increase primarily reflects delays in payment collections in China. The increase in the Latin America Segment reflects periodic fluctuations in payment of public health care organizations in certain countries.

Due to the fact that a large portion of our reimbursement is provided by public health care organizations and private insurers, we expect that most of our accounts receivable will be collectible.

25

Net cash provided by (used in) investing activities

In the first three months of 2019, net cash used in investing activities was €2,016 M as compared to net cash used in investing activities of €400 M in the comparable period of 2018. The following table shows our capital expenditures for property, plant and equipment, net of proceeds from sales of property, plant and equipment as well as acquisitions, investments and purchases of intangible assets for first three months of 2019 and 2018:

Capital expenditures (net), acquisitions, investments and purchases of intangible assets

in € M

	Capital expenditures, net				Acquisitions, investments and purchases of intangible assets
	For the three months ended March 31
	2019		2018		2019			2018
North America Segment		95		137		1,782	(1)		159
Thereof investments in debt securities		—		—		—			146
EMEA Segment		25		28		19			17
Asia-Pacific Segment		9		9		1			—
Latin America Segment		5		2		20			4
Corporate		65		42		7			1
Total		199		218		1,829			181

(1)

Primarily related to the acquisition of NxStage on February 21, 2019.

The majority of our capital expenditures in the first three months of 2019 was used for maintaining existing clinics, equipping new clinics, maintaining and expanding production facilities (primarily in the North America Segment, France, and Germany), capitalization of machines provided to our customers and for Care Coordination as well as capitalization of certain development costs. Capital expenditures remained stable at approximately 5% of total revenue in the first three months of 2019 as compared to the same period in 2018.

Investments in the first three months of 2018 were primarily driven by debt securities in the North America Segment. The remaining investments in the North America Segment, the EMEA Segment and the Latin America Segment were largely acquisitions of dialysis clinics.

We anticipate capital expenditures of €1.0 to €1.2 billion and expect to make acquisitions and investments, excluding investments in securities, of approximately €400 to €600 M in 2019 as described in the "Outlook" below.

Net cash provided by (used in) financing activities

In the first three months of 2019 and 2018, net cash provided by financing activities was €722 M and €338 M, respectively.

In the first three months of 2019, cash was mainly provided by the utilization of the accounts receivable facility, proceeds from long-term debt (including additional drawings under the U.S. dollar and euro revolving credit facility of the Amended 2012 Credit Agreement) and short-term debt, partially offset by repayments of lease liabilities, shares repurchased as part of a share buy-back program, and repayments of short-term debt, including repayments from related parties as well as distributions to noncontrolling interests.

In the first three months of 2018, cash was mainly provided by proceeds from short-term debt including drawings under the commercial paper program as well as proceeds from long-term debt and capital lease obligations including additional drawings under the U.S. dollar revolving credit facility of the Amended 2012 Credit Agreement, partially offset by distributions to noncontrolling interests.

Balance sheet structure

Total assets as of March 31, 2019 increased by 23% to €32.4 billion from €26.2 billion as compared to December 31, 2018, including a 2% positive impact resulting from foreign currency translation, largely due to the implementation of the IFRS 16 in 2019. At Constant Exchange Rates, total assets increased by 21% to €31.8 billion from €26.2 billion.

26

Current assets as a percent of total assets decreased to 23% at March 31, 2019 as compared to 30% at December 31, 2018. The equity ratio, the ratio of our equity divided by total liabilities and shareholders' equity, decreased to 41% at March 31, 2019 as compared to 49% at December 31, 2018. ROIC decreased to 9.9% at March 31, 2019, adjusted for the implementation of IFRS 16, as compared to 12.4% at December 31, 2018.

Report on post-balance sheet date events

No significant activities have taken place subsequent to the balance sheet date March 31, 2019 that have a material impact on the key figures and earnings presented. Currently, there are no other significant changes in our structure, management, legal form or personnel.

Outlook

Below is a table showing our growth outlook for 2019 and 2020 which are determined by reference to target results determined in accordance with IFRS and presented in euro. The targets indicated for 2019 and 2020 are calculated and presented at Constant Exchange Rates with reliance on Item 10(e)(1)(i)(B) of SEC Regulation S-K as it is impossible to predict currency exchange movements over the course of an entire year. These targets as well as the 2018 base are and will be adjusted in order to make the business performance in the respective periods comparable for items such as: lower additions to provisions related to FCPA in 2018 ("FCPA Related Charges"), the IFRS 16 Implementation, the contributions from Sound in the first half year of 2018, the gain (loss) related to divestitures of Care Coordination activities and expenses for the cost optimization program. All effects from the acquisition of NxStage Medical Inc. are excluded from the Outlook 2019 and 2020.

Outlook

In € billions ("BN"), except where otherwise noted

	Outlook 2019 (at Constant Currency)(1)	Outlook 2020 (at Constant Currency)(1)
Revenue(2)	Growth 3 - 7%	mid to high single digit growth rate
Operating income(2)	Growth (1) - 3%	mid to high single digit growth rate
Delivered EBIT(2)	Growth (1) - 3%	mid to high single digit growth rate
Net income growth at Constant Currency(2)(3)	Growth (2) - 2%	mid to high single digit growth rate
Basic earnings per share growth at Constant Currency(2)(3)	assessed based on expected development of net income and shares outstanding	assessed based on expected development of net income and shares outstanding
Capital expenditures	€1.0 - €1.2 BN	n.a.
Acquisitions and investments(4)	€0.4 - €0.6 BN	n.a.
Net cash provided by (used in) operating activities in % of revenue	> 10%	n.a.
Free cash flow in % of revenue	> 4%	n.a.
Net leverage ratio	< 2.5	n.a.
ROIC	³ 8.0%	n.a.
Dividend per share	assessed based on expected development of net income and shares outstanding	n.a.
Employees(5)	> 117,000	n.a.
Research and development expenses	€160 - €170 M	n.a.

(1)

Outlook 2019 and 2020 are and will be adjusted in order to make the business performance comparable to results 2018 adjusted for items such as: FCPA Related Charges, the IFRS 16 Implementation, the gain (loss) related to divestitures of Care Coordination activities and expenses for the cost optimization program. All effects from the acquisition of NxStage Medical Inc. are excluded from the Outlook 2019 and 2020.

(2)

Results 2018 adjusted for the (gain) loss related to divestitures of Care Coordination activities, the 2018 FCPA Related Charge and the contributions from Sound in the first half year of 2018.

(3)

Net income attributable to shareholders of FMC-AG & Co. KGaA.

(4)

Excluding investments in securities.

(5)

Full-time equivalents.

27

NxStage Estimate

Below is a table showing the estimated effects of the NxStage acquisition on our business in 2019 and 2020, excluding integration costs of approximately €50 M to €75 M over the three years following the closing of the transaction. These effects are determined in accordance with IFRS and presented in euro. The estimates indicated for 2019 and 2020 are calculated and presented at Constant Exchange Rates with reliance on Item 10(e)(1)(i)(B) of SEC Regulation S-K as it is impossible to predict currency exchange movements over the course of an entire year.

NxStage Estimate⁽¹⁾

In € M

	Estimate 2019 (at Constant Currency)	Estimate 2020 (at Constant Currency)
Revenue	240 - 260	310 - 330
Operating income	(30) - (20)	20 - 30
Interest	(75) - (65)	(85) - (75)
Net income	(75) - (65)	(40) - (30)

(1)

The numbers are excluding effects from the implementation of IFRS 16 and excluding integration costs. The 2019 estimates cover the period starting on February 21, 2019 (closing date) until year-end 2019.

Recently issued accounting standards

Refer to note 1 of the notes to the consolidated financial statements (unaudited) in this report for information regarding recently issued accounting standards.

28

FRESENIUS MEDICAL CARE AG & Co. KGaA

Financial statements

Consolidated statements of income

(unaudited)

Consolidated statements of income

in € thousands ("THOUS"), except per share data

		For the three months ended March 31,
	Note	2019			2018
Revenue:
Health care services			3,317,308			3,208,795
Health care products			815,249			766,834
	2 a, 14		4,132,557			3,975,629
Costs of revenue:
Health care services			2,505,423			2,434,324
Health care products			361,846			338,556
			2,867,269			2,772,880
Gross profit			1,265,288			1,202,749
Operating (income) expenses:
Selling, general and administrative			715,157			678,777
(Gain) loss related to divestitures of Care Coordination activities	2 b		0			13,103
Research and development	2 c		33,614			31,897
Income from equity method investees			(20,033	)		(17,904	)
Operating income			536,550			496,876
Other (income) expense:
Interest income			(27,944	)		(24,836	)
Interest expense			135,792			107,769
Income before income taxes			428,702			413,943
Income tax expense			100,944			84,234
Net income			327,758			329,709
Net income attributable to noncontrolling interests			57,009			51,154
Net income attributable to shareholders of FMC-AG & Co. KGaA			270,749			278,555
Basic earnings per share	2 d		0.88			0.91
Fully diluted earnings per share	2 d		0.88			0.91

See accompanying notes to unaudited consolidated financial statements.

29

FRESENIUS MEDICAL CARE AG & Co. KGaA

Consolidated statements of comprehensive income

(unaudited)

Consolidated statements of comprehensive income

in € THOUS

			For the three months ended March 31,
	Note		2019			2018
Net income				327,758			329,709
Other comprehensive income (loss):
Components that may be reclassified subsequently to profit or loss:
Gain (loss) related to foreign currency translation				269,741			(265,041	)
Gain (loss) related to cash flow hedges(1)		13		(1,296	)		7,834
Income tax (expense) benefit related to components of other comprehensive income that may be reclassified				426			(2,218	)
Other comprehensive income (loss), net of tax				268,871			(259,425	)
Total comprehensive income				596,629			70,284
Comprehensive income attributable to noncontrolling interests				78,004			25,776
Comprehensive income attributable to shareholders of FMC-AG & Co. KGaA				518,625			44,508

(1)

Including cost of hedging in the amount of €(893) and €(630) for the three months ended March 31, 2019 and 2018.

See accompanying notes to unaudited consolidated financial statements.

30

FRESENIUS MEDICAL CARE AG & Co. KGaA

Consolidated balance sheets

Consolidated balance sheets

in € THOUS, except share data

	Note	March 31, 2019			December 31, 2018
		(unaudited)			(audited)
Assets
Cash and cash equivalents	5		958,788			2,145,632
Trade accounts and other receivables	6		3,856,891			3,337,706
Accounts receivable from related parties	4		95,281			92,662
Inventories	7		1,695,658			1,466,803
Other current assets			894,229			804,083
Total current assets			7,500,847			7,846,886
Property, plant and equipment			3,949,557			3,836,010
Right of use assets	1		4,310,976			—
Intangible assets			1,430,970			681,331
Goodwill			13,561,939			12,209,606
Deferred taxes			308,530			345,686
Investment in equity method investees	14		630,439			649,780
Other non-current assets			659,946			672,969
Total non-current assets			24,852,357			18,395,382
Total assets			32,353,204			26,242,268
Liabilities
Accounts payable			707,774			641,271
Accounts payable to related parties	4		210,384			153,781
Current provisions and other current liabilities			2,809,937			2,904,288
Short-term debt	8		1,319,997			1,205,294
Short-term debt from related parties	8		107,400			188,900
Current portion of long-term debt	9		1,511,815			1,106,519
Current portion of long-term lease liabilities	1		615,011			—
Current portion of long-term lease liabilities from related parties	1		16,489			—
Income tax payable			64,627			68,229
Total current liabilities			7,363,434			6,268,282
Long-term debt, less current portion	9		5,681,163			5,045,515
Long-term lease liabilities, less current portion	1		3,863,651			—
Long-term lease liabilities from related parties, less current portion	1		116,913			—
Non-current provisions and other non-current liabilities			718,895			750,738
Pension liabilities			563,538			551,930
Income tax payable			96,247			97,324
Deferred taxes			722,859			626,521
Total non-current liabilities			11,763,266			7,072,028
Total liabilities			19,126,700			13,340,310
Shareholders' equity:
Ordinary shares, no par value, €1.00 nominal value, 384,822,972 shares authorized, 307,907,293 issued and 305,278,102 outstanding as of March 31, 2019 and 384,822,972 shares authorized, 307,878,652 issued and 306,878,701 outstanding as of December 31, 2018			307,907			307,879
Treasury stock, at cost			(164,809	)		(50,993	)
Additional paid-in capital			3,871,908			3,873,345
Retained earnings			8,991,461			8,831,930
Accumulated other comprehensive income (loss)			(955,874	)		(1,203,750	)
Total FMC-AG & Co. KGaA shareholders' equity			12,050,593			11,758,411
Noncontrolling interests			1,175,911			1,143,547
Total equity			13,226,504			12,901,958
Total liabilities and equity			32,353,204			26,242,268

See accompanying notes to unaudited consolidated financial statements.

31

FRESENIUS MEDICAL CARE AG & Co. KGaA

Consolidated statements of cash flows

(unaudited)

Consolidated statements of cash flows

in € THOUS

			For the three months ended March 31,
	Note		2019			2018
Operating activities
Net income				327,758			329,709
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		14		362,376			174,994
Change in deferred taxes, net				53,960			(8,147	)
(Gain) loss on sale of fixed assets, right of use assets, investments and divestitures				(8,563	)		2,028
Compensation expense related to share-based plans				1,380			18,656
Investments in equity method investees, net				20,894			22,303
Interest expense, net				107,848			82,933
Changes in assets and liabilities, net of amounts from businesses acquired:
Trade accounts and other receivables				(430,041	)		(462,386	)
Inventories				(141,258	)		(84,210	)
Other current and non-current assets				(70,828	)		9,537
Accounts receivable from related parties				(2,476	)		(10,370	)
Accounts payable to related parties				54,840			90,081
Accounts payable, provisions and other current and non-current liabilities				(67,346	)		(152,973	)
Paid interest				(135,041	)		(110,178	)
Received interest				12,644			6,436
Income tax payable				69,244			98,507
Paid income taxes				(79,832	)		(51,728	)
Net cash provided by (used in) operating activities				75,559			(44,808	)
Investing activities
Purchases of property, plant and equipment				(200,849	)		(221,486	)
Proceeds from sale of property, plant and equipment				1,911			3,095
Acquisitions and investments, net of cash acquired, and purchases of intangible assets		15		(1,828,525	)		(181,403	)
Proceeds from divestitures		15		11,012			158
Net cash provided by (used in) investing activities				(2,016,451	)		(399,636	)
Financing activities
Proceeds from short-term debt				175,009			268,785
Repayments of short-term debt				(64,027	)		(18,889	)
Proceeds from short-term debt from related parties				—			31,800
Repayments of short-term debt from related parties				(81,500	)		—
Proceeds from long-term debt				414,458			105,899
Repayments of long-term debt				(17,421	)		(15,027	)
Repayments of lease liabilities				(151,856	)		—
Repayments of lease liabilities from related parties				(4,066	)		—
Increase (decrease) of accounts receivable securitization program				584,185			9,356
Proceeds from exercise of stock options				148			562
Purchase of treasury stock				(89,446	)		—
Distributions to noncontrolling interests				(54,873	)		(50,951	)
Contributions from noncontrolling interests				11,545			6,303
Net cash provided by (used in) financing activities				722,156			337,838
Effect of exchange rate changes on cash and cash equivalents				31,892			(25,125	)
Cash and cash equivalents:
Net increase (decrease) in cash and cash equivalents				(1,186,844	)		(131,731	)
Cash and cash equivalents at beginning of period				2,145,632			978,109
Cash and cash equivalents at end of period		5		958,788			846,378

See accompanying notes to unaudited consolidated financial statements.

32

FRESENIUS MEDICAL CARE AG & Co. KGaA
Consolidated statement of shareholders' equity
For the three months ended March 31, 2019 and 2018 (unaudited)

Consolidated statements of shareholders' equity
in € THOUS, except share data
																			Accumulated other comprehensive income (loss)
			Ordinary shares				Treasury stock																					Total FMC-AG & Co. KGaA shareholders' equity
	Note		Number of shares		No par value		Number of shares			Amount			Additional paid in capital			Retained earnings			Foreign currency translation			Cash flow hedges			Pensions						Noncontrolling interests			Total equity
Balance at December 31, 2017				308,111,000		308,111		(1,659,951	)		(108,931	)		3,969,245			7,137,255			(1,203,904	)		(18,336	)		(263,338	)		9,820,102			1,008,084			10,828,186
Adjustment due to initial application of IFRS 9				—		—		—			—			—			(5,076	)		—			—			—			(5,076	)		—			(5,076	)
Adjusted Balance at December 31, 2017				308,111,000		308,111		(1,659,951	)		(108,931	)		3,969,245			7,132,179			(1,203,904	)		(18,336	)		(263,338	)		9,815,026			1,008,084			10,823,110
Proceeds from exercise of options and related tax effects				10,322		10		—			—			476			—			—			—			—			486			—			486
Compensation expense related to stock options				—		—		—			—			2,014			—			—			—			—			2,014			—			2,014
Purchase/ sale of noncontrolling interests				—		—		—			—			2,835			—			—			—			—			2,835			(11,199	)		(8,364	)
Contributions from/ to noncontrolling interests				—		—		—			—			—			—			—			—			—			—			(43,702	)		(43,702	)
Noncontrolling interests subject to put provisions		13		—		—		—			—			—			67,120			—			—			—			67,120			—			67,120
Net Income				—		—		—			—			—			278,555			—			—			—			278,555			51,154			329,709
Other comprehensive income (loss) related to:
Foreign currency translation				—		—		—			—			—			—			(243,632	)		13			3,956			(239,663	)		(25,378	)		(265,041	)
Cash flow hedges, net of related tax effects				—		—		—			—			—			—			—			5,616			—			5,616			—			5,616
Comprehensive income				—		—		—			—			—			—			—			—			—			44,508			25,776			70,284
Balance at March 31, 2018				308,121,322		308,121		(1,659,951	)		(108,931	)		3,974,570			7,477,854			(1,447,536	)		(12,707	)		(259,382	)		9,931,989			978,959			10,910,948
Balance at December 31, 2018				307,878,652		307,879		(999,951	)		(50,993	)		3,873,345			8,831,930			(911,473	)		(1,528	)		(290,749	)		11,758,411			1,143,547			12,901,958
Adjustment due to initial application of IFRS 16				—		—		—			—			—			(115,219	)		—			—			—			(115,219	)		(15,508	)		(130,727	)
Adjusted balance at December 31, 2018				307,878,652		307,879		(999,951	)		(50,993	)		3,873,345			8,716,711			(911,473	)		(1,528	)		(290,749	)		11,643,192			1,128,039			12,771,231
Proceeds from exercise of options and related tax effects				28,641		28		—			—			(1,326	)		—			—			—			—			(1,298	)		—			(1,298	)
Compensation expense related to stock options				—		—		—			—			1,380			—			—			—			—			1,380			—			1,380
Purchase of treasury stock		2d		—		—		(1,629,240	)		(113,816	)		—			—			—			—			—			(113,816	)		—			(113,816	)
Purchase/ sale of noncontrolling interests				—		—		—			—			(1,491	)		—			—			—			—			(1,491	)		16,142			14,651
Contributions from/ to noncontrolling interests				—		—		—			—			—			—			—			—			—			—			(46,274	)		(46,274	)
Noncontrolling interests subject to put provisions		13		—		—		—			—			—			4,001			—			—			—			4,001			—			4,001
Net Income				—		—		—			—			—			270,749			—			—			—			270,749			57,009			327,758
Other comprehensive income (loss) related to:
Foreign currency translation				—		—		—			—			—			—			251,734			(6	)		(2,982	)		248,746			20,995			269,741
Cash flow hedges, net of related tax effects				—		—		—			—			—			—			—			(870	)		—			(870	)		—			(870	)
Comprehensive income				—		—		—			—			—			—			—			—			—			518,625			78,004			596,629
Balance at March 31, 2019				307,907,293		307,907		(2,629,191	)		(164,809	)		3,871,908			8,991,461			(659,739	)		(2,404	)		(293,731	)		12,050,593			1,175,911			13,226,504

See accompanying notes to unaudited consolidated financial statements.

33

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements

(unaudited)

(in THOUS, except share and per share data)

1. The Company and basis of presentation

The Company

Fresenius Medical Care AG & Co. KGaA ("FMC-AG & Co. KGaA" or the "Company"), a German partnership limited by shares (Kommanditgesellschaft auf Aktien) registered in the commercial registry of Hof an der Saale under HRB 4019, with its business address at Else-Kröner-Str. 1, 61352 Bad Homburg v. d. Höhe, is the world's largest kidney dialysis company, based on publicly reported sales and number of patients treated. The Company provides dialysis treatment and related dialysis care services to persons who suffer from end-stage renal disease ("ESRD"), as well as other health care services. The Company also develops and manufactures a wide variety of health care products, which includes dialysis and non-dialysis products. The Company's dialysis products include hemodialysis machines, peritoneal cyclers, dialyzers, peritoneal solutions, hemodialysis concentrates, solutions and granulates, bloodlines, renal pharmaceuticals and systems for water treatment. The Company's non-dialysis products include acute cardiopulmonary and apheresis products. The Company supplies dialysis clinics it owns, operates or manages with a broad range of products and also sells dialysis products to other dialysis service providers. The Company describes certain of its other health care services as "Care Coordination." Care Coordination currently includes, but is not limited to, the coordinated delivery of pharmacy services, vascular, cardiovascular and endovascular specialty services as well as ambulatory surgery center services, physician nephrology and cardiology services, health plan services, urgent care services and ambulant treatment services. Until June 28, 2018, Care Coordination also included the coordinated delivery of emergency, intensivist and hospitalist physician services as well as transitional care which the Company refers to as "hospital related physician services." All of these Care Coordination services together with dialysis care and related services represent the Company's health care services.

In these unaudited consolidated financial statements, "FMC-AG & Co. KGaA," or the "Company" refers to the Company or the Company 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 AG" and the "General Partner" refer to Fresenius Medical Care Management AG which is FMC-AG & Co. KGaA's general partner and is wholly owned by Fresenius SE. "Management Board" refers to the members of the management board of Management AG and, except as otherwise specified, "Supervisory Board" refers to the supervisory board of FMC-AG & Co. KGaA. The term "North America Segment" refers to the North America operating segment, the term "EMEA Segment" refers to the Europe, Middle East and Africa operating segment, the term "Asia-Pacific Segment" refers to the Asia-Pacific operating segment, and the term "Latin America Segment" refers to the Latin America operating segment. For further discussion of the Company's operating segments, see note 14.

Basis of presentation

The consolidated financial statements and other financial information included in the Company's quarterly reports on Form 6-K and its Annual Report on Form 20-F for 2018 were prepared solely in accordance with IFRS as issued by the International Accounting Standards Board ("IASB"), using the euro as the Company's reporting currency. At March 31, 2019, there were no IFRS or International Financial Reporting Interpretation Committee ("IFRIC") interpretations as endorsed by the European Union relevant for interim reporting that differed from IFRS as issued by the IASB. As such, the accompanying condensed interim report complies with the requirements of International Accounting Standard ("IAS") 34, Interim Financial Reporting as well as with the rules concerning interim reporting as issued by the IASB.

The consolidated financial statements at March 31, 2019 and for the three months ended March 31, 2019 and 2018 contained in this report are unaudited and should be read in conjunction with the consolidated financial statements contained in the Company's 2018 Annual Report on Form 20-F. The preparation of consolidated financial statements in conformity with IFRS requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets

34

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

and liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expense during the reporting period. Actual results could differ from those estimates. Such financial statements reflect all adjustments that, in the opinion of management, are necessary for a fair presentation of the results of the periods presented. All such adjustments are of a normal recurring nature.

Starting on July 1, 2018, the Company's subsidiaries in Argentina applied IAS 29, Financial Reporting in Hyperinflationary Economies, due to the inflation in Argentina. Pursuant to IAS 29, the Company recorded a loss on its net monetary position of €5,189 for the three months ended March 31, 2019. The Company calculated the loss with the use of the Consumer Price Index (Índice de precios al consumidor) as published by the Argentine Statistics and Census Institute for the first three months ended March 31, 2019, which lists the level at 206 index points, a 12% increase since January 1, 2019.

As a result of the implementation of IFRS 16, Leases, the Company updated its accounting policies. Refer to "Recently implemented accounting pronouncements" below for further details on the updated policies. Excluding the policies update for IFRS 16, the accounting policies applied in the accompanying consolidated financial statements are the same as those applied in the consolidated financial statements as of December 31, 2018.

As of December 31, 2018, "Property, plant and equipment" included leased fixed assets of €36,402 recognized in accordance with IAS 17, Leases. These are transferred to the line item "Right-of-use assets" as of the beginning of fiscal year 2019.

As of December 31, 2018, "Current portion of long-term debt" included current lease liabilities from capital leases in accordance with IAS 17 of €9,387. From 2019, these are included in the balance sheet item "Current portion of long-term lease liabilities".

As of December 31, 2018, "Long-term debt, less current portion" included non-current lease liabilities from capital leases in accordance with IAS 17 of €26,757. From 2019, these are included in the balance sheet item "Long-term lease liabilities, less current portion".

In the consolidated statement of cash flows, in the comparative information for the period from January 1, 2018 to March 31, 2018, the line item "Repayments of long-term debt" included repayments of lease liabilities from capital leases in accordance with IAS 17 of €2,724. In the previous periods this line item was labeled as "Repayments of long-term debt and capital lease obligations". From 2019, these repayments are included in the line item "Repayments of lease liabilities" in accordance with IFRS 16.

Based on the IFRIC agenda decision relating to the applicability of IAS 12, Income Taxes, to the accounting for interest and penalties related to income taxes and an interpretation issued by the Accounting Standards Committee of Germany approved in September 2018, interest and penalties related to income taxes have been reclassified from income tax expense to interest expense, net in the amount of €2,957 for the three months ended March 31, 2018.

The results of operations for the three months ended March 31, 2019 are not necessarily indicative of the results of operations for the year ending December 31, 2019.

Recently implemented accounting pronouncements

The Company has prepared its consolidated financial statements at March 31, 2019 in conformity with IFRS in force for the interim periods on January 1, 2019. In the first quarter of 2019, the Company applied the following new standard relevant for its business for the first time:

IFRS 16

In January 2016, the IASB issued IFRS 16, which supersedes the current standard on lease-accounting, IAS 17, as well as the interpretations IFRIC 4, Determining whether an arrangement contains a lease, Standing Interpretations Committee ("SIC")-15, Operating leases—incentives and SIC-27, Evaluating the substance of transactions in the legal form of a lease.

35

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

IFRS 16 significantly changes lessee accounting. For almost all leases, a lessee is required to recognize a right-of-use asset representing its right to use the underlying leased asset and a lease liability representing its obligation to make lease payments.

Leases with a total maximum term of twelve months (short-term leases) and leases for underlying assets of low-value may be exempt from balance sheet recognition by applying an accounting policy choice. Depreciation of the right-of-use asset and interest on the lease liability must be recognized in the income statement for every on-balance lease contract. Therefore, straight-line rental expenses will no longer be shown for the vast majority of the leases. The lessor accounting requirements in IAS 17 are substantially carried forward.

The Company applies the modified retrospective method in accordance with IFRS 16 as the transition method. Accordingly, the cumulative effect from first-time application is recognized in the opening balance of retained earnings as of January 1, 2019 without adjustments to the comparative information of the previous period. In the application of the modified retrospective method, the carrying amount of the lease liability at the date of the initial application is determined by discounting the remaining lease payments of lease agreements that were classified as operating leases under IAS 17 using the term-, country-, and currency-specific incremental borrowing rate at date of initial application. Furthermore, right-of-use assets are to be recognized. In the application of the modified retrospective method, the carrying amount of the right-of-use asset equals the carrying amount of the lease liability adjusted for any prepaid or accrued lease payments. For a part of the existing contracts, the Company recognizes the right-of-use asset with its carrying amount assuming the new standard had been applied since the commencement date of the lease discounted using its term-, country-, and currency-specific incremental borrowing rate at the date of initial application.

Regarding the options and exemptions available upon the initial application of IFRS 16, the Company adopted the following approach:

•

IFRS 16 is only applied to contracts that were previously identified as leases under IAS 17 and IFRIC 4.

•

Recognition, valuation and disclosure principles of IFRS 16 are not applied to lease contracts with a lease term ending in less than 12 months from the date of the initial application. The respective lease contracts are accounted for as if they were short term leases and recognized as an expense accordingly.

•

Material initial direct costs are included in the measurement of a right-of-use asset with the carrying amount assuming the new standard was applied since the commencement date of the lease.

•

Upon initial recognition no impairment review is performed. The right-of-use assets are adjusted for onerous contract provisions, recognized on the consolidated balance sheet immediately before the date of initial application.

Right-of-use assets from lease contracts are classified in accordance with the Company's classification of property, plant and equipment:

•

Right-of-use assets: Land

•

Right-of-use assets: Buildings and improvements

•

Right-of-use assets: Machinery and equipment

In addition to the right-of-use asset categories above, prepayments on right-of-use assets are presented separately. Right-of-use assets from lease contracts and lease obligations are presented separately from property, plant and equipment and other financial debt in the consolidated balance sheet.

For lease contracts that include both lease and non-lease components that are not separable from lease components, no allocation is performed. Each lease component and any associated non-lease components are accounted for as a single lease.

36

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

Upon the initial application of IFRS 16 as of January 1, 2019, the Company recognized right-of-use assets of €4,266,753 and lease liabilities from third and related parties of €4,547,535. The cumulative effect from the first-time application is recognized in the opening balance of retained earnings (€115,219) as well as in non-controlling interests (€15,508) as of January 1, 2019.

The following table shows a reconciliation of the future minimum rental payments as of December 31, 2018 to the lease liabilities as of January 1, 2019:

Reconciliation of lease liabilities upon the initial application of IFRS 16

in € THOUS

Future minimum rental payments as of December 31, 2018 (IAS 17)	5,527,638
less short-term leases	(21,936	)
less leases of low-value assets	(34,145	)
other	(30,066	)
Gross lease liabilities as of January 1, 2019	5,441,491
Discounting	(893,957	)
Lease liabilities as a result of the initial application of IFRS 16 as of January 1, 2019	4,547,534
Lease liabilities from capital leases as of December 31, 2018 (IAS 17)	36,144
Lease liabilities as of January 1, 2019	4,583,678

The lease liabilities were discounted using the term-, country-, and currency-specific incremental borrowing rate as of January 1, 2019. The weighted average discount rate was 3.69%.

Leasing in the consolidated statements of income

The Company decided not to apply the guidance within IFRS 16 to short-term leases as well as leases for underlying assets of low-value. These lease payments will be recognized as expenses over the lease term.

The following table shows the effects from lease agreements on the consolidated statements of income in the first three months of fiscal year 2019:

Leasing in the consolidated statements of income

in € THOUS

	For the three months ended March 31, 2019
Depreciation on right-of-use assets	168,893
Expenses relating to short-term leases	12,211
Expenses relating to leases of low-value assets	6,139
Expenses relating to variable lease payments	6,680
Income from subleasing right-of-use asset	55
Interest expense on lease liabilities	41,106

37

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

Leasing in the consolidated balance sheets

At March 31, 2019, the book values of right-of-use assets consisted of the following:

Right-of-use assets

in € THOUS

	March 31, 2019
Right-of-use assets: Land		29,144
Right-of-use assets: Buildings and improvements		3,871,970
Right-of-use assets: Machinery and equipment		409,862
Right-of-use assets		4,310,976

In the first three months of fiscal year 2019, additions to right-of-use assets were €104,131.

Recent accounting pronouncements not yet adopted

The IASB issued the following new standard which is relevant for the Company:

IFRS 17, Insurance Contracts

In May 2017, the IASB issued IFRS 17, Insurance Contracts. IFRS 17 establishes principles for the recognition, measurement, presentation and disclosure related to the issuance of insurance contracts. IFRS 17 replaces IFRS 4, Insurance Contracts, which was brought in as an interim standard in 2004. IFRS 4 permitted the use of national accounting standards for the accounting of insurance contracts under IFRS. As a result of the varied application for insurance contracts there was a lack of comparability among peer groups. IFRS 17 eliminates this diversity in practice by requiring all insurance contracts to be accounted for using current values. The frequent updates to the insurance values are expected to provide more useful information to users of financial statements. IFRS 17 is effective for fiscal years beginning on or after January 1, 2021. Earlier adoption is permitted for entities that have also adopted IFRS 9, Financial Instruments and IFRS 15, Revenue from Contracts with Customers. The Company is evaluating the impact of IFRS 17 on the consolidated financial statements.

In the Company's view, all other pronouncements issued by the IASB do not have a material impact on the consolidated financial statements.

38

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

2. Notes to the consolidated statements of income

a)    Revenue

The Company has recognized the following revenue in the consolidated statement of income for the three months ended March 31, 2019 and 2018:

Revenue

in € THOUS

	For the three months ended March 31,
	2019						2018
	Revenue from contracts with customers		Other revenue		Total		Revenue from contracts with customers		Other revenue		Total
Health care services
Dialysis services		2,957,381		—		2,957,381		2,648,293		—		2,648,293
Care Coordination		299,544		60,383		359,927		507,244		53,258		560,502
		3,256,925		60,383		3,317,308		3,155,537		53,258		3,208,795
Health care products
Dialysis products		762,885		33,790		796,675		729,956		17,736		747,692
Non-dialysis products		18,574		—		18,574		19,142		—		19,142
		781,459		33,790		815,249		749,098		17,736		766,834
Total		4,038,384		94,173		4,132,557		3,904,635		70,994		3,975,629

b)    (Gain) loss related to divestitures of Care Coordination activities

On April 20, 2018, the Company signed a definitive agreement to divest its controlling interest in Sound Inpatient Physicians, Inc. ("Sound") to an investment consortium led by Summit Partners, L.P., ("Summit Consortium"). Upon receipt of the required regulatory approvals under the Hart-Scott-Rodino Antitrust Improvements Acts of 1976, as amended, and the satisfaction of customary closing conditions, the divestiture was consummated on June 28, 2018. The total transaction proceeds were $1,770,516 (€1,531,109), net of related tax payments. For the three months ended March 31, 2018, the pre-tax loss related to divestitures for Care Coordination activities was €13,103, which primarily related to the initial increase in valuation of Sound's share based payment program. Sound was included in Care Coordination within the North America Segment. The Company's history with Sound, prior to divestment, includes the following milestones:

•

In July 2014, the Company made an investment for a majority interest in Sound, a physician services organization focused on hospitalist, emergency, intensivist and post-acute care services, furthering its strategic investments and expanding the health care services we offer.

•

In November 2014, Sound acquired Cogent Healthcare, expanding Sound to serve over 180 hospitals in 35 states with more than 1,750 providers.

•

In 2017, the Company increased its interest in Sound raising the Company majority interest to almost 100% during the first half of 2017.

c)     Research and development expenses

Research and development expenses of €33,614 for the three months ended March 31, 2019 (for the three months ended March 31, 2018: €31,897) include expenditure for research and non-capitalizable development costs as well as depreciation and amortization expenses related to capitalized development costs of €92 (for the three months ended March 31, 2018: €80).

39

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

d)    Earnings per share

The following table contains reconciliations of the numerators and denominators of the basic and fully diluted earnings per share computations for 2019 and 2018:

Reconciliation of Basic and Diluted Earnings per Share

in € THOUS, except share and per share data

	For the three months ended March 31,
	2019		2018
Numerator:
Net income attributable to shareholders of FMC-AG & Co. KGaA		270,749		278,555
Denominators:
Weighted average number of shares outstanding		306,659,364		306,453,070
Potentially dilutive shares		—		986,454
Basic earnings per share		0.88		0.91
Fully diluted earnings per share		0.88		0.91

Share buy-back program

In 2019, the Company will utilize the authorization granted by the Company's Annual General Meeting on May 12, 2016 to conduct a share buy-back program. The 2019 share buy-back program allows for a maximum of 6,000,000 shares to be repurchased at a total purchase price, excluding ancillary transaction costs, of up to €330,000 between March 12, 2019 and May 10, 2019. For the period ending March 31, 2019, the Company repurchased 1,629,240 shares, at an average weighted stock purchase price of €69.86.

As of March 31, 2019, the Company holds 2,629,191 treasury shares. These shares will be used solely to reduce the registered share capital of the Company by cancellation of the acquired shares.

The following tabular disclosure provides the number of shares acquired in the context of the share buy-back programs as well as the retired treasury stock:

Treasury Stock

Period	Average price paid per share		Total number of shares purchased and retired as part of publicly announced plans or programs		Total value of shares(1)
	in €				in € THOUS
December 31, 2017		65.63		1,659,951		108,931
Purchase of Treasury Stock
May 2018		86.69		173,274		15,020
June 2018		86.14		257,726		22,201
Repurchased Treasury Stock		86.37		431,000		37,221
Retirement of repurchased Treasury Stock
December 2018		87.23		1,091,000		95,159
December 31, 2018		51.00		999,951		50,993
Purchase of Treasury Stock
March 2019		69.86		1,629,240		113,816
March 31, 2019		62.69		2,629,191		164,809

(1)

The value of shares repurchased is inclusive of fees (net of taxes) paid in the amount of approximately €11, respectively, for services rendered.

40

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

3. Acquisition of NxStage Medical, Inc.

On February 21, 2019, the Company acquired all of the outstanding shares of NxStage for $30.00 per common share. The total acquisition value of this business combination, net of cash acquired, is $1,976,235 (€1,740,563 at date of closing). NxStage is a leading medical technology company that develops, produces and markets an innovative product portfolio of medical devices for use in home dialysis and in the critical care setting. This acquisition is part of the Company's stated strategy to expand and complement its existing business through acquisitions. Generally, these acquisitions do not change the Company's business model and are easy to integrate without disruption to its existing business, requiring little or no realignment of its structures. The NxStage acquisition is consistent in this regard as it supplements the Company's existing business.

The following table summarizes the estimated fair values, as of the date of acquisition based upon information available, as of March 31, 2019, of assets acquired and liabilities assumed at the date of the acquisition. Any adjustments to acquisition accounting, net of related income tax effects, will be recorded with a corresponding adjustment to goodwill:

Estimated Fair Values of Assets Acquired and Liabilities Assumed—Preliminary

in $ THOUS

	in USD
Cash and cash equivalents		47,203
Trade accounts and other receivables		34,062
Other current assets		88,987
Property, plant and equipment		85,470
Intangible assets and other assets		818,150
Goodwill		1,165,289
Accounts payable, current provisions and other current liabilities		(69,456	)
Income tax payable and deferred taxes		(119,086	)
Other liabilities		(23,118	)
Noncontrolling interests (subject and not subject to put provisions)		(4,063	)
Total acquisition cost		2,023,438
Less:
Cash acquired		(47,203	)
Net Cash paid		1,976,235

As of the acquisition date, it is estimated that amortizable intangible assets acquired in this acquisition will have weighted average useful lives of 13 years.

Goodwill in the amount of $1,165,289 was acquired as part of the NxStage acquisition and is allocated to the North America Segment.

NxStage's results have been included in the Company's consolidated statement of income since February 21, 2019. Specifically, NxStage has contributed revenue and an operating loss in the amount of $33,805 (€29,764) and $12,655 (€11,142) respectively, to the Company's consolidated operating income. This operating loss amount does not include synergies which may have resulted at consolidated entities outside NxStage since the acquisition closed.

Pro forma financial information

The following financial information, on a pro forma basis, reflects the consolidated results of operations for the three months ended March 31, 2019 as if the NxStage acquisition had been consummated on January 1, 2019 and excludes related transaction costs. The pro-forma financial information is not

41

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

necessarily indicative of the results of operations as it would have been had the transactions been consummated on January 1, 2019.

Pro forma financial Information

in € THOUS, except per share data

	2019
	in EUR
Pro forma revenue		4,176,790
Pro forma net income attributable to shareholders of FMC-AG & Co. KGaA		254,538
Basic earnings per share		0.83
Fully diluted earnings per share		0.83

4. Related party transactions

Fresenius SE is the Company's largest shareholder and owns 30.92% of the Company's outstanding shares, excluding treasury shares held by the Company, at March 31, 2019. 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 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. Our related party transactions are settled through Fresenius SE's cash management system where appropriate.

a)    Service agreements and products

The Company is party to service agreements with Fresenius SE and certain of its affiliates (collectively the "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. The Company also provides central purchasing services to the Fresenius SE Companies. These related party agreements generally have a duration of 1 to 5 years and are renegotiated on an as needed basis when the agreement comes due. The Company provides administrative services to one of its equity method investees.

The Company sold products to the Fresenius SE Companies and made purchases from the Fresenius SE Companies and equity method investees. In addition, Fresenius Medical Care Holdings, Inc. ("FMCH") purchases heparin supplied by Fresenius Kabi USA, Inc. ("Kabi USA"), through an independent group purchasing organization ("GPO"). Kabi USA is an indirect, wholly-owned subsidiary of Fresenius SE. The Company has no direct supply agreement with Kabi USA and does not submit purchase orders directly to Kabi USA. FMCH acquires heparin from Kabi USA, through the GPO contract, which was negotiated by the GPO at arm's length on behalf of all members of the GPO.

The Company entered into a ten year agreement with a Fresenius SE Company for the manufacturing of infusion bags. In order to establish the new production line, the Company purchased machinery from the Fresenius SE company in the amount of €250 during the three months ended March 31, 2019.

In December 2010, the Company and Galenica Ltd. (now known as Vifor Pharma Ltd.) formed the renal pharmaceutical company Vifor Fresenius Medical Care Renal Pharma Ltd., ("VFMCRP"), an equity method investee of which the Company owns 45%. The Company has entered into exclusive supply agreements to purchase certain pharmaceuticals from VFMCRP.

42

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

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 March 31, 2019				For the three months ended March 31, 2018				March 31, 2019				December 31, 2018
	Sales of goods and services		Purchases of goods and services		Sales of goods and services		Purchases of goods and services		Accounts receivable		Accounts payable		Accounts receivable		Accounts payable
Service agreements(1)
Fresenius SE		32		5,182		70		5,724		1,064		3,149		378		4,019
Fresenius SE affiliates		940		24,652		876		24,455		849		7,946		681		8,470
Equity method investees		730		—		5,060		—		78		—		2,449		—
Total		1,702		29,834		6,006		30,179		1,991		11,095		3,508		12,489
Products
Fresenius SE affiliates		9,862		8,290		7,907		9,075		11,062		3,699		8,750		3,658
Equity method investees		—		151,645		—		121,021		—		112,907		—		57,975
Total		9,862		159,935		7,907		130,096		11,062		116,606		8,750		61,633

(1)

In addition to the above shown accounts payable, accrued expenses for service agreements with related parties amounted to €6,687 and €9,376 at March 31, 2019 and December 31, 2018, respectively.

b)    Lease agreements

In addition to the above-mentioned product and service agreements, the Company is a party to real estate lease agreements with the 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 majority of the leases expire at the end of 2026.

Below is a summary resulting from the above described lease agreements with related parties. For information on the implementation of IFRS 16, see note 1.

Lease agreements with related parties

in € THOUS

	For the three months ended March 31, 2019						For the three months ended March 31, 2018				March 31, 2019
	Depreciation		Interest expense		Lease expense(1)		Lease income		Lease expense		Right-of-use asset		Lease liability
Fresenius SE		1,214		137		854		—		2,069		35,219		35,286
Fresenius SE affiliates		3,089		353		161		—		3,692		97,966		98,116
Total		4,303		490		1,015		—		5,761		133,185		133,402

(1)

Short-term leases and expenses relating to variable lease payments are exempted from balance sheet recognition.

c)     Financing

The Company receives short-term financing from and provides short-term financing to Fresenius SE. The Company also utilizes Fresenius SE's cash management system for the settlement of certain intercompany receivables and payables with its subsidiaries and other related parties. As of March 31, 2019 and December 31, 2018, the Company had accounts receivable from Fresenius SE related to short-term financing in the amount of €80,388 and €80,228, respectively. As of March 31, 2019 and December 31, 2018, the Company had accounts payable to Fresenius SE related to short-term financing in the amount of €76,784 and €32,454, respectively. The interest rates for these cash management arrangements are set on a

43

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

daily basis and are based on the then-prevailing overnight reference rate, with a floor of zero, for the respective currencies.

On August 19, 2009, the Company borrowed €1,500 from the General Partner on an unsecured basis at 1.335%. The loan repayment has been extended periodically and is currently due August 22, 2019 with an interest rate of 0.825%. On November 28, 2013, the Company borrowed an additional €1,500 with an interest rate of 1.875% from the General Partner. The loan repayment has been extended periodically and is currently due on November 23, 2019 with an interest rate of 0.825%.

At March 31, 2019 and December 31, 2018, a subsidiary of Fresenius SE held unsecured bonds issued by the Company in the amount of €5,000 and €6,000, respectively. The bonds were issued in 2011 and 2012, mature in 2021 and 2019, respectively, and each has a coupon rate of 5.25% with interest payable semiannually.

At March 31, 2019 and December 31, 2018, the Company borrowed from Fresenius SE in the amount of €104,400 on an unsecured basis at an interest rate of 0.825% and €185,900 on an unsecured basis at an interest rate of 0.825%, respectively. For further information on this loan agreement, see note 8.

d)    Key management personnel

Due to the Company's legal form of a German partnership limited by shares, the General Partner holds a key management position within the Company. In addition, as key management personnel, members of the Management Board and the Supervisory Board, as well as their close relatives, are considered related parties.

The Company's Articles of Association provide that the General Partner shall be reimbursed for any and all expenses in connection with 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. The aggregate amount reimbursed to the General Partner was €8,028 and €4,016, respectively, for its management services during the three months ended March 31, 2019 and 2018. As of March 31, 2019 and December 31, 2018, the Company had accounts receivable from the General Partner in the amount of €1,840 and €176, respectively. As of March 31, 2019 and December 31, 2018, the Company had accounts payable to the General Partner in the amount of €5,899 and €47,205, respectively.

5. Cash and cash equivalents

As of March 31, 2019 and December 31, 2018, cash and cash equivalents are as follows:

Cash and cash equivalents

in € THOUS

	March 31, 2019		December 31, 2018
Cash		705,731		831,885
Securities and time deposits		253,057		1,313,747
Cash and cash equivalents		958,788		2,145,632

The cash and cash equivalents disclosed in the table above, and in the consolidated statements of cash flows, include at March 31, 2019 an amount of €5,740 (December 31, 2018: €5,002) from collateral requirements towards an insurance company in North America that are not available for use.

44

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

6. Trade accounts and other receivables

As of March 31, 2019 and December 31, 2018, trade accounts and other receivables are as follows:

Trade accounts and other receivables

in € THOUS

	March 31, 2019						December 31, 2018
				thereof Credit- Impaired						thereof Credit- Impaired
Trade accounts and other receivables, gross		3,980,307			387,850			3,455,721			325,240
thereof Finance Lease Receivables		44,037			—			28,726			—
less allowances		(123,416	)		(87,056	)		(118,015	)		(85,775	)
Trade accounts and other receivables		3,856,891			300,794			3,337,706			239,465

The other receivables in the amount of €79,627 include receivables from finance leases, operating leases and insurance contracts (December 31, 2018: €66,496).

All trade accounts and other receivables are due within one year. A small portion of the trade account receivables are subject to factoring agreements.

Trade accounts receivables and finance lease receivables with a term of more than one year in the amount of €120,479 (December 31, 2018: €120,668) are included in the balance sheet item "Other non-current assets."

7. Inventories

At March 31, 2019 and December 31, 2018, inventories consisted of the following:

Inventories

in € THOUS

	March 31, 2019		December 31, 2018
Finished goods		895,533		774,133
Health care supplies		470,202		391,593
Raw materials and purchased components		237,664		224,054
Work in process		92,259		77,023
Inventories		1,695,658		1,466,803

45

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

8. Short-term debt and short-term debt from related parties

At March 31, 2019 and December 31, 2018, short-term debt and short-term debt from related parties consisted of the following:

Short-term debt and short-term debt from related parties

in € THOUS

	March 31, 2019		December 31, 2018
Commercial paper program		999,834		999,873
Borrowings under lines of credit		318,540		204,491
Other		1,623		930
Short-term debt		1,319,997		1,205,294
Short-term debt from related parties (see note 4c)		107,400		188,900
Short-term debt and short-term debt from related parties		1,427,397		1,394,194

The Company and certain consolidated entities operate a multi-currency notional pooling cash management system. The Company met the conditions to offset balances within this cash pool for reporting purposes. At March 31, 2019, cash and borrowings under lines of credit in the amount of €113,238 (December 31, 2018: €122,256) were offset under this cash management system.

Commercial paper program

The Company maintains a commercial paper program under which short-term notes of up to €1,000,000 can be issued. At March 31, 2019, the outstanding commercial paper amounted to €1,000,000 (December 31, 2018: €1,000,000).

Other

At March 31, 2019, the Company had €1,623 (December 31, 2018: €930) of other debt outstanding related to fixed payments outstanding for acquisitions.

Short-term debt from related parties

The Company is party to an unsecured loan agreement with Fresenius SE under which the Company or FMCH may request and receive one or more short-term advances up to an aggregate amount of $400,000 until maturity on July 31, 2022. For further information on short-term debt from related parties, see note 4 c).

46

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

9. Long-term debt

As of March 31, 2019 and December 31, 2018, long-term debt consisted of the following:

Long-term debt

in € THOUS

	March 31, 2019			December 31, 2018
Amended 2012 Credit Agreement		2,296,088			1,887,357
Bonds		3,752,592			3,700,446
Convertible Bonds		394,794			393,232
Accounts Receivable Facility		589,779			—
Capital lease obligations(1)		—			36,144
Other		159,725			134,855
Long-term debt(2)		7,192,978			6,152,034
Less current portion		(1,511,815	)		(1,106,519	)
Long-term debt, less current portion(2)		5,681,163			5,045,515

(1)

As of December 31, 2018, this line item included lease liabilities from capital leases in accordance with IAS 17. From 2019, these are transferred to balance sheet items "Current portion of long-term lease liabilities" and "Long-term lease liabilities, less current portion" (see Note 1).

(2)

Labeled as "Long-term debt and capital lease obligations" as of December 31, 2018, this line item included lease liabilities from capital leases in accordance with IAS 17. From 2019, these are transferred to balance sheet item "Long-term lease liabilities, less current portion" (see Note 1).

Amended 2012 Credit Agreement

The following table shows the available and outstanding amounts under the Amended 2012 Credit Agreement at March 31, 2019 and December 31, 2018:

Amended 2012 Credit Agreement—Maximum amount available and balance outstanding

in THOUS

	Maximum amount available March 31, 2019				Balance outstanding March 31, 2019(1)
Revolving credit USD 2017 / 2022	$	900,000	€	801,068	$	246,345	€	219,266
Revolving credit EUR 2017 / 2022	€	600,000	€	600,000	€	200,000	€	200,000
USD term loan 2017 / 2022	$	1,320,000	€	1,174,900	$	1,320,000	€	1,174,900
EUR term loan 2017 / 2022	€	308,000	€	308,000	€	308,000	€	308,000
EUR term loan 2017 / 2020	€	400,000	€	400,000	€	400,000	€	400,000
			€	3,283,968			€	2,302,166

	Maximum amount available December 31, 2018				Balance outstanding December 31, 2018(1)
Revolving credit USD 2017 / 2022	$	900,000	€	786,026	$	—	€	—
Revolving credit EUR 2017 / 2022	€	600,000	€	600,000	€	—	€	—
USD term loan 2017 / 2022	$	1,350,000	€	1,179,039	$	1,350,000	€	1,179,039
EUR term loan 2017 / 2022	€	315,000	€	315,000	€	315,000	€	315,000
EUR term loan 2017 / 2020	€	400,000	€	400,000	€	400,000	€	400,000
			€	3,280,065			€	1,894,039

(1)

Amounts shown are excluding debt issuance costs.

47

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

Accounts Receivable Facility

The following table shows the available and outstanding amounts under the Accounts Receivable Facility at March 31, 2019 and at December 31, 2018:

Accounts Receivable Facility—Maximum amount available and balance outstanding

in THOUS

	Maximum amount available March 31, 2019(1)				Balance outstanding March 31, 2019(2)
Accounts Receivable Facility	$	900,000	€	801,068	$	663,500	€	590,565

	Maximum amount available December 31, 2018(1)				Balance outstanding December 31, 2018(2)
Accounts Receivable Facility	$	900,000	€	786,026	$	—	€	—

(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 $26,631 and $26,631 (€23,704 and €23,259) at March 31, 2019 and December 31, 2018, respectively. These letters of credit are not included above as part of the balance outstanding at March 31, 2019 and December 31, 2018; however, they reduce available borrowings under the Accounts Receivable Facility.

10. Supplementary information on capital management

As of March 31, 2019 and December 31, 2018 the total equity in percent of total assets was 40.9% and 49.2%, respectively, and the debt in percent of total assets was 40.9% and 28.8%, respectively.

Further information on the Company's capital management is available in the Annual Report on Form 20-F as of December 31, 2018.

The Company's financing structure and business model are reflected in the investment grade ratings. The Company is covered and rated investment grade by the three leading rating agencies, Moody's, Standard & Poor's and Fitch.

Rating⁽¹⁾

	Standard & Poor's	Moody's	Fitch
Corporate Credit Rating	BBB–	Baa3	BBB–
Outlook	positive	stable	stable

(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.

11. Employee benefit plans

The Company currently has five principal pension plans, one for German employees, three for French employees and the other covering employees in the United States, the last of which was curtailed in 2002. Plan benefits are generally based on years of service and final salary. As there is no legal requirement in Germany to fund defined benefit plans, the Company's pension obligations in Germany are unfunded. Each year FMCH contributes to the plan covering United States employees at least the minimum required by the Employee Retirement Income Security Act of 1974, as amended. In 2019, FMCH did not have a minimum funding requirement. For the first three months of 2019, the Company voluntarily provided €294

48

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

to the defined benefit plan. For the remaining period of 2019, the Company expects further voluntarily contributions of €812.

The following table provides the calculations of net periodic benefit cost for the three months ended March 31, 2019 and 2018, respectively.

Net periodic benefit cost

in € THOUS

	For the three months ended March 31,
	2019		2018
Current service cost		7,444		6,794
Net interest cost		3,454		3,208
Net periodic benefit costs		10,898		10,002

12. 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 probability is remote 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.

On February 15, 2011, a whistleblower (relator) action under the False Claims Act against FMCH was unsealed by order of the United States District Court for the District of Massachusetts and served by the relator. United States ex rel. Chris Drennen v. Fresenius Medical Care Holdings, Inc., 2009 Civ. 10179 (D. Mass.). The relator's complaint, which was first filed under seal in February 2009, alleged that FMCH sought and received reimbursement from government payors for serum ferritin and multiple forms of hepatitis B laboratory tests that were medically unnecessary or not properly ordered by a physician. Discovery on the relator's complaint closed in May 2015. Although the United States initially declined to intervene in the case, the government subsequently changed position. On April 3, 2017, the court allowed the government to intervene with respect only to certain hepatitis B surface antigen tests performed prior to 2011, when Medicare reimbursement rules for such tests changed. The court has subsequently rejected government requests to conduct new discovery and to add counts to its complaint-in-intervention that would expand upon the relator's complaint, but has allowed FMCH to take discovery against the government as if the government had intervened at the outset.

Beginning in 2012, the Company received certain communications alleging conduct in countries outside the United States that might violate the Foreign Corrupt Practices Act 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 and the United States Department of Justice (collectively and interchangeably the "government") about these investigations. The government also conducted its own investigations, in which the Company cooperated.

49

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

In the course of this dialogue, the Company identified and reported to the government, and took remedial actions including employee disciplinary actions with respect to, conduct that resulted in the government 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 recorded charges of €200,000 in 2017 and €77,200 in 2018 encompassing estimates for the government's claims for profit disgorgement, penalties, certain legal expenses, and other related costs or asset impairments believed likely to be necessary for full and final resolution, by litigation or settlement, of the claims and issues arising from the investigation. The increase recorded in 2018 took into consideration preliminary understandings with the government on the financial terms of a potential settlement. Following this increase, which takes into account incurred and anticipated legal expenses, impairments and other costs, the provision totals €223,980 as of December 31, 2018.

On March 29, 2019, the Company entered into a non-prosecution agreement with the DOJ and a separate agreement with the SEC intended to resolve fully and finally the government's claims against the Company arising from the investigations. The Company agreed to pay a combined total in penalties and disgorgement of approximately $231,700 to the government in connection with these agreements. As part of the settlement, the Company further agreed to retain an independent compliance monitor for a period of two years and to an additional year of self-reporting.

The Company continues to cooperate with government authorities in Germany in their review of the issues resolved in the U.S. settlement.

The Company continues to implement enhancements to its anti-corruption compliance program, including internal controls related to compliance with international anti-bribery laws. The Company continues to be fully committed to compliance with the Foreign Corrupt Practices Act and other applicable anti-bribery laws.

Personal injury litigation involving the Company's acid concentrate product, labeled as Granuflo® or Naturalyte®, first arose in 2012 and was substantially resolved by settlement agreed in principle in February 2016 and consummated in November 2017. Remaining individual personal injury cases do not present material risk.

The Company's affected insurers agreed to the settlement of the acid concentrate personal injury litigation and funded $220,000 of the settlement fund under a reciprocal reservation of rights encompassing certain coverage issues raised by insurers and the Company's claims for indemnification of defense costs. The Company accrued a net expense of $60,000 in connection with the settlement, including legal fees and other anticipated costs. Following entry into the settlement, the Company's insurers in the AIG group and the Company each initiated litigation against the other relating to the AIG group's coverage obligations under applicable policies. In the coverage litigation, the AIG group seeks to be indemnified by the Company for a portion of its $220,000 outlay; the Company seeks to confirm the AIG group's $220,000 funding obligation, to recover defense costs already incurred by the Company, and to compel the AIG group to honor defense and indemnification obligations, if any, required for resolution of cases not participating in the settlement. As a result of decisions on issues of venue, the coverage litigation is proceeding in the New York state trial court for Manhattan. (National Union Fire Insurance v. Fresenius Medical Care, 2016 Index No. 653108 (Supreme Court of New York for New York County)).

Four institutional plaintiffs filed complaints against FMCH or its affiliates under state deceptive practices statutes resting on certain background allegations common to the GranuFlo®/NaturaLyte® personal injury litigation but seeking as a remedy the repayment of sums paid to FMCH that are attributable to the GranuFlo®/NaturaLyte® products. These cases implicate different legal standards, theories of liability and forms of potential recovery from those in the personal injury litigation and their claims were not extinguished by the personal injury litigation settlement described above. The four plaintiffs were the Attorneys General for the States of Kentucky, Louisiana and Mississippi and the commercial insurance company Blue Cross Blue Shield of Louisiana in its private capacity. State of Mississippi ex rel. Hood, v. Fresenius Medical Care Holdings, Inc., No. 14-cv-152 (Chancery Court, DeSoto County); State of Louisiana

50

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

ex re. Caldwell and Louisiana Health Service & Indemnity Company v. Fresenius Medical Care Airline, et al 2016 Civ. 11035 (U.S.D.C. D. Mass.); Commonwealth of Kentucky ex rel. Beshear v. Fresenius Medical Care Holdings, Inc. et al., No. 16-CI-00946 (Circuit Court, Franklin County). On February 12, 2019, agreement was reached to settle and resolve Kentucky's claims in Beshear in exchange for FMCH´s payment of $10,300 and the case has been dismissed. On April 1, 2019, agreement was reached to settle and resolve Mississippi's claims in Hood for $15,700 and activity has ceased in that case pending the court's expected approval. The Caldwell and Blue Cross Louisiana cases remain unresolved and are proceeding together in federal court in Boston but are subject to undecided motions for severance and remand. There is no trial date in either case. The Company has additionally increased its litigation reserves to account for anticipated settlement of some, but not all, of the remaining payor cases. However, at the present time there are no agreements in principle for resolving the remaining cases and litigation through final adjudication may be required in all of them.

On September 6, 2018, a special-purpose entity organized under Delaware law for the purpose of pursuing litigation filed a Pure Bill of Discovery in a Florida county court seeking discovery from FMCH related to the personal injury settlement, but no other relief. MSP Recovery Claims Series LLC v. Fresenius Medical Care Holdings, No. 2018-030366-CA-01 (11th Judicial Circuit, Dade County, Florida). The Pure Bill was thereafter removed to federal court and transferred into the multidistrict Fresenius Granuflo/Naturalyte Dialysate Products Liability Litigation in Boston. No.1:13-MD-02428-DPW (D. Mass. 2013). On March 12, 2019, plaintiff amended its Pure Bill by filing a complaint claiming rights to recover monetary damages on behalf of various persons and entities who are alleged to have assigned to plaintiff their rights to recover monetary damages arising from their having provided or paid for medical services for dialysis patients receiving treatments using FMCH's acid concentrate product. FMCH is responding to the amended complaint.

In August 2014, FMCH received a subpoena from the United States Attorney for the District of Maryland inquiring into FMCH's contractual arrangements with hospitals and physicians involving contracts relating to the management of in-patient acute dialysis services. FMCH is cooperating in the investigation.

In July 2015, the Attorney General for Hawaii issued a civil complaint under the Hawaii False Claims Act alleging a conspiracy pursuant to which certain Liberty Dialysis subsidiaries of FMCH overbilled Hawaii Medicaid for Liberty's Epogen® administrations to Hawaii Medicaid patients during the period from 2006 through 2010, prior to the time of FMCH's acquisition of Liberty. Hawaii v. Liberty Dialysis—Hawaii, LLC et al., Case No. 15-1-1357-07 (Hawaii 1^st Circuit). The State alleges that Liberty acted unlawfully by relying on incorrect and unauthorized billing guidance provided to Liberty by Xerox State Healthcare LLC, which acted as Hawaii's contracted administrator for its Medicaid program reimbursement operations during the relevant period. The amount of the overpayment claimed by the State is approximately $8,000, but the State seeks civil remedies, interest, fines, and penalties against Liberty and FMCH under the Hawaii False Claims Act substantially in excess of the overpayment. After prevailing on motions by Xerox to preclude it from doing so, FMCH is pursuing third-party claims for contribution and indemnification against Xerox. The State's False Claims Act complaint was filed after Liberty initiated an administrative action challenging the State's recoupment of alleged overpayments from sums currently owed to Liberty. The civil litigation and administrative action are proceeding in parallel. Trial in the civil litigation is scheduled for April 2020.

On August 31, 2015, FMCH received a subpoena under the False Claims Act from the United States Attorney for the District of Colorado (Denver) inquiring into FMCH's participation in and management of dialysis facility joint ventures in which physicians are partners. FMCH continues to cooperate in the Denver United States Attorney's Office ("USAO") investigation, which has come to focus on purchases and sales of minority interests in ongoing outpatient facilities between FMCH and physician groups.

On November 25, 2015, FMCH received a subpoena under the False Claims Act from the United States Attorney for the Eastern District of New York (Brooklyn) also inquiring into FMCH's involvement in certain dialysis facility joint ventures in New York. On September 26, 2018, the Brooklyn USAO declined to intervene on the qui tam complaint filed under seal in 2014 that gave rise to this investigation. CKD

51

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

Project LLC v. Fresenius Medical Care, 2014 Civ. 6646 (E.D.N.Y. November 12, 2014). The court unsealed the complaint, allowing the relator to serve and proceed on its own. The relator—a special-purpose entity formed by law firms to pursue qui tam proceedings—has served its complaint and litigation is proceeding.

Beginning October 6, 2015, the United States Attorney for the Eastern District of New York (Brooklyn) has led an investigation, through subpoenas issued under the False Claims Act, utilization and invoicing by the Company's subsidiary Azura Vascular Care for a period beginning after the Company's acquisition of American Access Care LLC ("AAC") in October 2011. The Company has cooperated in the Brooklyn USAO investigation, which is continuing. Allegations against AAC arising in districts in Connecticut, Florida and Rhode Island relating to utilization and invoicing were settled in 2015.

On October 22, 2018, the United States Attorney for the Southern District of New York (Manhattan) announced a False Claims Act settlement for up to $18,400 with Vascular Access Centers LP, a competitor of AAC and Azura. Simultaneously, the 2012 qui tam (whistleblower) complaint that gave rise to the investigation was unsealed. Levine v. Vascular Access Centers, 2012 Civ. 5103 (S.D.N.Y.). That qui tam complaint names as defendants, among others in the dialysis industry, subsidiaries and employees of the Company engaged in the vascular access business. The Manhattan USAO did not intervene against non-settling defendants, allowing the relator to proceed on his own against those defendants. The relator subsequently dismissed with prejudice the defendants related to FMCH.

On June 30, 2016, FMCH received a subpoena from the United States Attorney for the Northern District of Texas (Dallas) seeking information under the False Claims Act about the use and management of pharmaceuticals including Velphoro®. The investigation encompasses DaVita, Amgen, Sanofi, and other pharmaceutical manufacturers and includes inquiries into whether certain compensation transfers between manufacturers and pharmacy vendors constituted unlawful kickbacks. The Company understands that this investigation is substantively independent of the $63,700 settlement by DaVita Rx announced on December 14, 2017 in the matter styled United States ex rel. Gallian v. DaVita Rx, 2016 Civ. 0943 (N.D. Tex.). FMCH is cooperating in the investigation.

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., which FMCH acquired in October 2013. In the course of cooperating in the investigation and preparing to respond to the subpoena, FMCH identified falsifications and misrepresentations in documents submitted by a Shiel salesperson that relate to the integrity of certain invoices submitted by Shiel for laboratory testing for patients in long term care facilities. On February 21, 2017, FMCH terminated the employee and notified the United States Attorney of the termination and its circumstances. The terminated employee's conduct is expected to result in demands for the Company to refund overpayments and to pay related penalties under applicable laws, but the monetary value of such payment demands cannot yet be reasonably estimated. The Brooklyn USAO continues to investigate a range of issues involving Shiel, including allegations of improper compensation (kickbacks) to physicians, and has disclosed that multiple sealed qui tam complaints underlie the investigation.

On December 12, 2017, the Company sold to Quest Diagnostics certain Shiel operations that are the subject of this Brooklyn subpoena, including the misconduct reported to the United States Attorney. Under the sale agreement, the Company retains responsibility for the Brooklyn investigation and its outcome. The Company continues to cooperate in the ongoing investigation.

On December 14, 2016, the Center for Medicare & Medicaid Services ("CMS"), which administers the federal Medicare program, published an Interim Final Rule ("IFR") titled "Medicare Program; Conditions for Coverage for End-Stage Renal Disease Facilities-Third Party Payment." The IFR would have amended the Conditions for Coverage for dialysis providers, like FMCH and would have effectively enabled insurers to reject premium payments made by or on behalf of patients who received grants for individual market coverage from the American Kidney Fund ("AKF" or "the Fund"). The IFR could thus have resulted in those patients losing individual insurance market coverage. The loss of coverage for these patients would have had a material and adverse impact on the operating results of FMCH.

52

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

On January 25, 2017, a federal district court in Texas responsible for litigation initiated by a patient advocacy group and dialysis providers including FMCH preliminarily enjoined CMS from implementing the IFR. Dialysis Patient Citizens v. Burwell, 2017 Civ. 0016 (E.D. Texas, Sherman Div.). The preliminary injunction was based on CMS' failure to follow appropriate notice-and-comment procedures in adopting the IFR. The injunction remains in place and the court retains jurisdiction over the dispute.

On June 22, 2017, CMS requested a stay of proceedings in the litigation pending further rulemaking concerning the IFR. CMS stated, in support of its request, that it expects to publish a Notice of Proposed Rulemaking in the Federal Register and otherwise pursue a notice-and-comment process. Plaintiffs in the litigation, including FMCH, consented to the stay, which was granted by the court on June 27, 2017.

On January 3, 2017, FMCH received a subpoena from the United States Attorney for the District of Massachusetts under the False Claims Act inquiring into FMCH's interactions and relationships with the AKF, including FMCH's charitable contributions to the Fund and the Fund's financial assistance to patients for insurance premiums. FMCH is cooperating in the investigation, which is part of a broader investigation into charitable contributions in the medical industry. The Company believes that the investigation revolves around conduct alleged to be unlawful in United Healthcare v. American Renal Associates, 2018 Civ. 10622 (D. Mass.), but believes that such unlawful conduct was not undertaken by the Company. On July 2, 2018, American Renal Associates announced that it had reached a settlement in principle of the United Healthcare litigation. The Company lacks information necessary to assess how the American Renal Associates settlement may impact the United States Attorney's investigation.

On April 8, 2019, United Healthcare served a demand for arbitration against FMCH. The demand asserts that FMCH unlawfully "steered" patients by waiving co-payments and other means away from coverage under government-funded insurance plans including Medicare into United's commercial plans, including Affordable Care Act exchange plans. FMCH is contesting United's claims and demands.

In early May 2017, the United States Attorney for the Middle District of Tennessee (Nashville) issued identical subpoenas to FMCH and two subsidiaries under the False Claims Act concerning the Company's retail pharmaceutical business. The investigation is exploring allegations related to improper inducements to dialysis patients to fill oral prescriptions through FMCH's pharmacy service, improper billing for returned pharmacy products and other allegations similar to those underlying the $63,700 settlement by DaVita Rx in Texas announced on December 14, 2017. United States ex rel. Gallian, 2016 Civ. 0943 (N.D. Tex.). FMCH is cooperating in the investigation.

On March 12, 2018, Vifor Fresenius Medical Care Renal Pharma Ltd. and Vifor Fresenius Medical Care Renal Pharma France S.A.S. (collectively, "VFMCRP") (the joint venture between Galenica (Vifor) and FMC-AG & Co. KGaA), filed a complaint for patent infringement against Lupin Atlantis Holdings SA and Lupin Pharmaceuticals Inc. (collectively, "Lupin"), and Teva Pharmaceuticals USA, Inc. ("Teva") in the U.S. District Court for the District of Delaware (Case 1:18-cv-00390-LPS). The patent infringement action is in response to Lupin and Teva's filings of Abbreviated New Drug Applications (ANDA) with the FDA for generic versions of Velphoro®. Velphoro® is protected by patents listed in the FDA's Approved Drug Products with Therapeutic Equivalence Evaluations, also known as the Orange Book. The complaint was filed within the 45-day period provided for under the Hatch-Waxman legislation, and triggered a stay of FDA approval of the ANDAs for 30 months (2.5 years) (specifically, up to July 29, 2020 for Lupin's ANDA; and August 6, 2020 for Teva's ANDA), or a shorter time if a decision in the infringement suit is reached that the patents-at-issue are invalid or not infringed. Recently, in response to another ANDA being filed for a generic Velphoro®, VFMCRP filed a complaint for patent infringement against Annora Pharma Private Ltd., and Hetero Labs Ltd. (collectively, "Annora"), in the U.S. District Court for the District of Delaware on December 17, 2018. A 30-month stay of FDA approval of Annora's ANDA will run through to May 30, 2021.

On December 17, 2018, FMCH was served with a subpoena under the False Claims Act from the United States Attorney for the District of Colorado (Denver) as part of an investigation of allegations against DaVita, Inc. involving transactions between FMCH and DaVita. The subject transactions include sales and

53

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

purchases of dialysis facilities, dialysis-related products and pharmaceuticals, including dialysis machines and dialyzers, and contracts for certain administrative services. FMCH is cooperating in 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 healthcare providers, insurance plans and suppliers, conducts its operations under intense government regulation and scrutiny. It 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 U.S. Food and Drug Administration ("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 is currently engaged in remediation efforts with respect to one pending FDA warning 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. Applicable laws or regulations may be amended, or enforcement agencies or courts may make interpretations that differ from the Company's interpretations or the manner in which it conducts its business. Enforcement has become a high priority for the federal government and some states. In addition, the provisions of the False Claims Act authorizing payment of a portion of any recovery to the party bringing the suit encourage private plaintiffs to commence whistleblower actions. By virtue of this regulatory environment, the Company's business activities and practices are subject to extensive review by regulatory authorities and private parties, and continuing audits, subpoenas, other inquiries, claims and litigation relating to the Company's compliance with applicable laws and regulations. The Company may not always be aware that an inquiry or action has begun, particularly in the case of whistleblower actions, which are initially filed under court seal.

The Company operates many facilities and handles the personal data ("PD") 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 decentralized system, it is often difficult to maintain the desired level of oversight and control over the thousands of individuals employed by many affiliated companies and its business associates. 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 and or other similar laws ("Data Protection Laws") when there has been impermissible use, access, or disclosure of unsecured PD 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 must comply with applicable breach notification requirements.

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. The actions of such persons may subject the Company and its subsidiaries to liability under the Anti-Kickback Statute, the Stark Law, the

54

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

False Claims Act, Data Protection Laws, the Health Information Technology for Economic and Clinical Health Act and the Foreign Corrupt Practices Act, among other laws and comparable state laws or laws of other countries.

Physicians, hospitals and other participants in the healthcare 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 the 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.

In Germany, the tax audits for the years 2006 through 2009 have been substantially completed. The German tax authorities have indicated a re-qualification of dividends received in connection with intercompany mandatorily redeemable preferred shares into fully taxable interest payments for these and subsequent years until 2013. The Company has defended its position and will avail itself of appropriate remedies. An adverse determination with respect to fully taxable interest payments related to intercompany mandatorily redeemable preferred shares and the disallowance of certain other tax deductions could have a material adverse effect on the Company's financial condition and results of operations.

The Company is also 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. Any claims, regardless of their merit or eventual outcome, could have a material adverse effect on the Company's reputation and business.

Other than those individual contingent liabilities mentioned above, the current estimated amount of the Company's other known individual contingent liabilities is immaterial.

55

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

13. Financial instruments

The following tables show the carrying amounts and fair values of the Company's financial instruments at March 31, 2019 and December 31, 2018:

Carrying amount and fair value of financial instruments

in € THOUS

	Carrying amount										Fair value
March 31, 2019	Amortized cost		FVPL		FVOCI		Not classified		Total		Level 1		Level 2		Level 3
Cash and cash equivalents(1)		705,731		253,057		—		—		958,788		—		253,057		—
Trade accounts and other receivables		3,801,501		—		—		55,390		3,856,891		—		—		—
Accounts receivable from related parties		95,281		—		—		—		95,281		—		—		—
Derivatives—cash flow hedging instruments		—		—		—		1,232		1,232		—		1,232		—
Derivatives—not designated as hedging instruments		—		29,646		—		—		29,646		—		29,646		—
Equity investments		—		113,668		33,608		—		147,276		13,045		134,231		—
Debt securities		—		94,223		256,902		—		351,125		346,508		4,617		—
Other financial assets		127,088		—		—		105,063		232,151		—		—		—
Other current and non-current assets		127,088		237,537		290,510		106,295		761,430		—		—		—
Financial assets		4,729,601		490,594		290,510		161,685		5,672,390		—		—		—
Accounts payable		707,774		—		—		—		707,774		—		—		—
Accounts payable to related parties		210,384		—		—		—		210,384		—		—		—
Short-term debt and short-term debt from related parties		1,427,397		—		—		—		1,427,397		—		—		—
Long-term debt		7,192,978		—		—		—		7,192,978		4,331,857		3,049,725		—
Long-term lease liabilities and long-term lease liabilities from related parties		—		—		—		4,612,064		4,612,064		—		—		—
Derivatives—cash flow hedging instruments		—		—		—		4,874		4,874		—		4,874		—
Derivatives—not designated as hedging instruments		—		40,184		—		—		40,184		—		40,184		—
Variable payments outstanding for acquisitions		—		135,161		—		—		135,161		—		—		135,161
Noncontrolling interest subject to put provisions		—		—		—		831,630		831,630		—		—		831,630
Other financial liabilities		1,275,539		—		—		—		1,275,539		—		—		—
Other current and non-current liabilities		1,275,539		175,345		—		836,504		2,287,388		—		—		—
Financial liabilities		10,814,072		175,345		—		5,448,568		16,437,985		—		—		—

(1)

Highly liquid short-term investments are categorized in level 2 of the fair value hierarchy. Other cash and cash equivalents is not categorized.

56

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

Carrying amount and fair value of financial instruments

in € THOUS

	Carrying amount										Fair value
December 31, 2018	Amortized cost		FVPL		FVOCI		Not classified		Total		Level 1		Level 2		Level 3
Cash and cash equivalents(1)		831,885		1,313,747		—		—		2,145,632		—		1,313,747		—
Trade accounts and other receivables		3,288,258		—		—		49,448		3,337,706		—		—		—
Accounts receivable from related parties		92,662		—		—		—		92,662		—		—		—
Derivatives—cash flow hedging instruments		—		—		—		1,492		1,492		—		1,492		—
Derivatives—not designated as hedging instruments		—		18,222		—		—		18,222		—		18,222		—
Equity investments		—		106,350		34,377		—		140,727		13,869		126,858		—
Debt securities		—		83,213		250,822		—		334,035		329,821		4,214		—
Other financial assets		144,838		—		—		107,125		251,963		—		—		—
Other current and non-current assets		144,838		207,785		285,199		108,617		746,439		—		—		—
Financial assets		4,357,643		1,521,532		285,199		158,065		6,322,439		—		—		—
												—		—		—
Accounts payable		641,271		—		—		—		641,271		—		—		—
Accounts payable to related parties		153,781		—		—		—		153,781		—		—		—
Short-term debt and short-term debt from related parties		1,394,194		—		—		—		1,394,194		—		—		—
Long-term debt and capital lease obligations		6,115,890		—		—		36,144		6,152,034		4,227,684		2,022,057		—
Derivatives—cash flow hedging instruments		—		—		—		1,125		1,125		—		1,125		—
Derivatives—not designated as hedging instruments		—		18,911		—		—		18,911		—		18,911		—
Variable payments outstanding for acquisitions		—		172,278		—		—		172,278		—		—		172,278
Noncontrolling interest subject to put provisions		—		—		—		818,871		818,871		—		—		818,871
Other financial liabilities		1,467,767		—		—		—		1,467,767		—		—		—
Other current and non-current liabilities		1,467,767		191,189		—		819,996		2,478,952		—		—		—
Financial liabilities		9,772,903		191,189		—		856,140		10,820,232		—		—		—

(1)

Highly liquid short-term investments are categorized in level 2 of the fair value hierarchy. Other cash and cash equivalents is not categorized.

Derivative and non-derivative financial instruments are categorised in the following three-tier fair value hierarchy that reflects the significance of the inputs in making the measurements. Level 1 is defined as observable inputs, such as quoted prices in active markets. Level 2 is defined as inputs other than quoted prices in active markets that are directly or indirectly observable. Level 3 is defined as 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 lease liabilities and 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. Transfers between levels of the fair value hierarchy have not occurred as of March 31, 2019 and December 31, 2018. The Company accounts for possible transfers at the end of the reporting period.

Derivative financial instruments

In order to manage the risk of currency exchange rate fluctuations and interest rate fluctuations, the Company enters into various hedging transactions by means of derivative instruments with highly rated financial institutions. The Company primarily enters into foreign exchange forward contracts and interest rate swaps. Derivative contracts that do not qualify for hedge accounting are utilized for economic purposes. The Company does not use financial instruments for trading purposes. Additionally the Company purchased share options in connection with the issuance of the Convertible Bonds. Any change in the Company's share price above the conversion price would be offset by a corresponding value change in the share options.

57

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

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 the contractual cash flows. The contractual terms of the financial assets allow the conclusion that the cash flows represent payment of principle and interest only. Trade accounts and other receivables, 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 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 OCI. If equity instruments are quoted in an active market, the fair value is based on price quotations at the period-end-date.

The majority of the debt securities are held within a business model whose objective is achieving both contractual cash flows and sell the 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 FVOCI. The smaller part of debt securities do not give rise to cash flows that are solely payments of principle 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 recognized at its carrying amount. 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 the 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.

Noncontrolling interests subject to put provisions are recognized at their fair value. 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. Additionally, there are put provisions that are valued by an external valuation firm. The external valuation estimates the fair values using a combination of discounted cash flows and a multiple of earnings and/or revenue. When applicable, the obligations 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 the noncontrolling interests subject to these put provisions can also fluctuate, and the discounted cash flows as well as the implicit multiple of earnings and/or revenue at which these noncontrolling interest obligations may ultimately be settled could vary significantly from the Company's current estimates depending upon market conditions.

58

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

Following is a roll forward of variable payments outstanding for acquisitions and noncontrolling interests subject to put provisions at March 31, 2019 and December 31, 2018:

Reconciliation from beginning to ending balance of level 3 financial instruments

in € THOUS

	2019						2018
	Variable payments outstanding for acquisitions			Noncontrolling interests subject to put provisions			Variable payments outstanding for acquisitions			Noncontrolling interests subject to put provisions
Beginning balance at January 1,		172,278			818,871			205,792			830,773
Increase		83			15,997			19,051			53,731
Decrease		(3,653	)		(968	)		(15,734	)		(50,706	)
(Gain) Loss recognized in profit or loss		(34,666	)		32,586			(36,327	)		142,279
(Gain) Loss recognized in equity		—			(26,895	)		—			(50,612	)
Dividends		—			(28,287	)		—			(139,742	)
Foreign currency translation and other changes		1,119			20,326			(504	)		33,148
Ending balance at March 31, and December 31,		135,161			831,630			172,278			818,871

14. Segment and corporate information

The Company's operating segments are the North America Segment, the EMEA Segment, the Asia-Pacific Segment and the Latin America Segment. The operating segments are determined based upon how the Company manages its businesses with geographical responsibilities. All segments are primarily engaged in providing health care services and the distribution of products and equipment for the treatment of ESRD and other extracorporeal therapies.

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, operating income and operating income margin. The Company does not include income taxes as it believes this is outside the segments' control. Financing is a corporate function, which the Company's segments do not control. Therefore, the Company does not include interest expense relating to financing as a segment measurement. Similarly, the Company does not allocate certain costs, which relate primarily to certain headquarters' overhead charges, including accounting and finance, because the Company believes that these costs are also not within the control of the individual segments. Production of products, production asset management, quality and supply chain management as well as procurement related to production are centrally managed at Corporate. The Company's global research and development is also centrally managed at Corporate. These corporate activities do not fulfill the definition of a segment according to IFRS 8, Operating Segments. Products are transferred to the segments at cost; therefore, no internal profit is generated. The associated internal revenue for the product transfers and their elimination are recorded as corporate activities. Capital expenditures for production are based on the expected demand of the segments and consolidated profitability considerations. In addition, certain revenues, investments and intangible assets, as well as any related expenses, are not allocated to a segment but are accounted for as Corporate.

59

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

Information pertaining to the Company's segment and Corporate activities for the three months ended March 31, 2019 and 2018 is set forth below:

Segment and corporate information

in € THOUS

	North America Segment			EMEA Segment			Asia- Pacific Segment			Latin America Segment			Total Segment			Corporate			Total
Three months ended March 31, 2019
Revenue from contracts with customers		2,826,212			635,800			411,603			160,601			4,034,216			4,168			4,038,384
Other revenue external customers		60,564			16,813			15,971			825			94,173			—			94,173
Revenue external customers		2,886,776			652,613			427,574			161,426			4,128,389			4,168			4,132,557
Inter-segment revenue		576			1			234			65			876			(876	)		—
Revenue		2,887,352			652,614			427,808			161,491			4,129,265			3,292			4,132,557
Operating income		372,394			137,776			94,702			11,395			616,267			(79,717	)		536,550
Interest																				(107,848	)
Income before income taxes																				428,702
Depreciation and amortization		(228,735	)		(46,973	)		(22,601	)		(8,363	)		(306,672	)		(55,704	)		(362,376	)
Income (loss) from equity method investees		21,362			(1,317	)		(294	)		282			20,033			—			20,033
Total assets		21,513,220			4,232,196			2,669,344			821,984			29,236,744			3,116,460			32,353,204
thereof investment in equity method investees		332,184			177,658			96,641			23,956			630,439			—			630,439
Additions of property, plant and equipment, intangible assets and right of use assets		188,150			47,114			13,743			14,783			263,790			73,487			337,277
Three months ended March 31, 2018
Revenue from contracts with customers		2,719,627			631,224			380,801			169,340			3,900,992			3,643			3,904,635
Other revenue external customers		54,835			4,584			10,661			914			70,994			—			70,994
Revenue external customers		2,774,462			635,808			391,462			170,254			3,971,986			3,643			3,975,629
Inter-segment revenue		400			303			187			39			929			(929	)		—
Revenue		2,774,862			636,111			391,649			170,293			3,972,915			2,714			3,975,629
Operating income		362,208			108,934			74,220			14,114			559,476			(62,600	)		496,876
Interest																				(82,933	)
Income before income taxes																				413,943
Depreciation and amortization		(90,655	)		(28,861	)		(11,159	)		(4,580	)		(135,255	)		(39,739	)		(174,994	)
Income (loss) from equity method investees		18,801			(1,334	)		335			102			17,904			—			17,904
Total assets		15,408,120			3,640,775			2,081,140			694,375			21,824,410			2,332,651			24,157,061
thereof investment in equity method investees		316,916			181,938			96,961			23,915			619,730			—			619,730
Additions of property, plant and equipment and intangible assets		141,821			30,405			10,034			3,796			186,056			45,114			231,170

60

FRESENIUS MEDICAL CARE AG & Co. KGaA

Notes to consolidated financial statements (Continued)

(unaudited)

(in THOUS, except share and per share data)

15. Supplementary cash flow information

The following additional information is provided with respect to net cash provided by (used in) investing activities:

Details for net cash provided by (used in) investing activities

in € THOUS

	For the three months ended March 31,
	2019			2018
Details for acquisitions
Assets acquired		(2,082,291	)		(36,062	)
Liabilities assumed		190,406			2,608
Noncontrolling interests subject to put provisions		12,679			—
Noncontrolling interests		10,492			—
Non-cash consideration		6,518			2,864
Cash paid		(1,862,196	)		(30,590	)
Less cash acquired		42,496			252
Net cash paid for acquisitions		(1,819,700	)		(30,338	)
Cash paid for investments		(282	)		(146,867	)
Cash paid for intangible assets		(8,543	)		(4,198	)
Total cash paid for acquisitions and investments, net of cash acquired, and purchases of intangible assets		(1,828,525	)		(181,403	)
Details for divestitures
Cash received from sale of subsidiaries or other businesses, less cash disposed		6,782			—
Cash received from divestitures of securities		4,230			82
Cash received from repayment of loans		—			76
Proceeds from divestitures		11,012			158

Acquisitions of the last twelve months decreased net income (net income attributable to shareholders of FMC-AG & Co. KGaA) for the three months ended March 31, 2019 by €12,593 (excluding the costs of the acquisitions).

16. Events occurring after the balance sheet date

No significant activities have taken place subsequent to the balance sheet date March 31, 2019 that have a material impact on the key figures and earnings presented. Currently, there are no other significant changes in the Company's structure, management, legal form or personnel.

61

Quantitative and qualitative disclosures about market risk

The information in note 13 of the notes to consolidated financial statements (unaudited), presented elsewhere in this report is incorporated by this reference.

62

Controls and procedures

The Company is a "foreign private issuer" within the meaning of Rule 3b-4(c) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"). As such, the Company is not required to file quarterly reports with the Securities and Exchange Commission and is required to provide an evaluation of the effectiveness of its disclosure controls and procedures, to disclose significant changes in its internal control over financial reporting and to provide certifications of its Chief Executive Officer and Chief Financial Officer under Sections 302 and 906 of the Sarbanes-Oxley Act of 2002 only in its Annual Report on Form 20-F. The Company furnishes quarterly financial information to the Securities and Exchange Commission (the "Commission") and such certifications under cover of Form 6-K on a voluntary basis and pursuant to the provisions of the Company's pooling agreement entered into for the benefit of the public holders of our shares. In connection with such voluntary reporting, the Company's management, including the Chief Executive Officer and the Chief Financial Officer of the Company's General Partner, has conducted an evaluation of the effectiveness of the Company's disclosure controls and procedures as of the end of the period covered by this report, of the type contemplated by Securities Exchange Act Rule 13a-15. Based on that evaluation, the Chief Executive Officer and the Chief Financial Officer concluded in connection with the furnishing of this report, that the Company's disclosure controls and procedures are designed to ensure that the information the Company is required to disclose in the reports filed or furnished under the Act is recorded, processed, summarized and reported within the time periods specified in the Commission's rules and forms and are effective to ensure that the information the Company is required to disclose in its reports is accumulated and communicated to the General Partner's Management Board, including the General Partner's Chief Executive Officer and the Chief Financial Officer, as appropriate to allow timely decisions regarding required disclosure. During the past fiscal quarter, there have been no significant changes in internal controls, or in factors that could significantly affect internal controls.

On March 29, 2019, the Company entered into a non-prosecution agreement with the DOJ and a separate agreement with the SEC intended to resolve fully and finally the government's claims against the Company arising from the investigations, see note 12 of the notes to the consolidated financial statements (unaudited) presented elsewhere in this Report. The Company continues to implement enhancements to its anti-corruption compliance program, including internal controls related to compliance with international anti-bribery laws. The Company continues to be fully committed to compliance with the Foreign Corrupt Practices Act and other applicable anti-bribery laws.

63

OTHER INFORMATION

Legal and regulatory matters

The information in note 12 of the notes to consolidated financial statements (unaudited), presented elsewhere in this report is incorporated by this reference.

64

Exhibits

Exhibit No.
	4.15	Non-Prosecution Agreement with the U.S. Department of Justice dated February 25, 2019
	4.16	Corrected Order Instituting Cease-And-Desist Proceedings Pursuant to Section 21C of the Securities Exchange Act of 1934, Making Findings, And Imposing a Cease-And-Desist Order from the U.S. Securities and Exchange Commission
	31.1	Certification of Chief Executive Officer and Chairman of the Management Board of the Company's General Partner Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
	31.2	Certification of Chief Financial Officer and member of the Management Board of the Company's General Partner Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
	32.1	Certification of Chief Executive Officer and Chairman of the Management Board of the Company's General Partner and Chief Financial Officer and member of the Management Board of the Company's General Partner Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 (this exhibit accompanies this report as required by the Sarbanes-Oxley Act of 2002 and is not to be deemed "filed" for purposes of Section 18 of the Securities Exchange Act of 1934, as amended).
	101	The following financial statements as of and for the three-months periods ended March 31, 2019 from FMC-AG & Co. KGaA's Report on Form 6-K for the month of May 2019, formatted in XBRL (eXtensible Business Reporting Language): (i) Consolidated Statements of Income, (ii) Consolidated Statements of Comprehensive Income, (iii) Consolidated Balance Sheets, (iv) Consolidated Statements of Cash Flows, (v) Consolidated Statements of Shareholders' Equity and (vi) Notes to Consolidated Financial Statements.

65

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

DATE: May 2, 2019

FRESENIUS MEDICAL CARE AG & Co. KGaA a partnership limited by shares, represented by:
FRESENIUS MEDICAL CARE MANAGEMENT AG, its General Partner
By:	/s/ RICE POWELL
	Name:	Rice Powell
	Title:	Chief Executive Officer and Chairman of the Management Board of the General Partner
By:	/s/ MICHAEL BROSNAN
	Name:	Michael Brosnan
	Title:	Chief Financial Officer and member of the Management Board of the General Partner

66

EX-4.15

Exhibit 4.15

	United States Department of Justice
	Criminal Division
	February 25, 2019

Maxwell Carr-Howard

Partner

Dentons US LLP

1900 K Street N.W.

Washington, D.C. 20006

Re:          Fresenius Medical Care AG & Co. KGaA

Dear Mr. Carr-Howard:

The United States Department of Justice, Criminal Division, Fraud Section and the United States Attorney’s Office for the District of Massachusetts (collectively, the “Department”) and Fresenius Medical Care AG & Co. KGaA (the “Company”) pursuant to authority granted by the Company’s Management Board, enter into this Non-Prosecution Agreement (the “Agreement”). On the understandings specified below, the Department will not criminally prosecute the Company for any crimes (except for criminal tax violations, as to which the Department does not make any agreement) relating to any of the conduct described in the Statement of Facts attached hereto as Attachment A. To the extent there is conduct disclosed by the Company that does not relate to any of the conduct described in the attached Statement of Facts, such conduct will not be exempt from prosecution and is not within the scope of or relevant to this Agreement. The Company, pursuant to authority granted by the Company’s Management Board, also agrees to certain terms and obligations of the Agreement as described below.

The Department enters into this Agreement based on the individual facts and circumstances presented by this case and the Company, including:

(a)           the Company did receive voluntary disclosure credit because it voluntarily and timely disclosed to the Department the conduct described in the Statement of Facts attached hereto as Attachment A (“Statement of Facts”);

(b)           the Company received partial credit for its cooperation with the Department’s investigation, including: conducting a thorough internal investigation; making regular factual presentations to the Department; providing facts learned during witness interviews; voluntarily making foreign-based employees available for interviews in the United States; producing documents to the Department from foreign countries in ways that did not implicate foreign data privacy laws; collecting, analyzing, and organizing voluminous evidence and information from multiple jurisdictions for the Department, including translating key documents; and disclosing conduct to the Department that was outside the scope of its initial voluntary self-disclosure; however, the Company did not receive full cooperation credit because it did not timely respond to

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requests by the Department and, at times, did not provide fulsome responses to requests for information;

(c)           the Company provided to the Department all relevant facts known to it, including information about the individuals involved in the conduct described in the attached Statement of Facts and conduct disclosed to the Department prior to the Agreement;

(d)           the Company engaged in remedial measures, including: (1) causing at least ten employees who were involved in or failed to detect the misconduct described in the Statement of Facts to be removed from the Company, because their employment was terminated, they resigned after being asked to leave, or they voluntarily left once the Company’s internal investigation began; (2) enhancing its compliance program, controls, and anti-corruption training; (3) terminating business relationships with the third party agents and distributors who participated in the misconduct described in the Statement of Facts; (4) adopting heightened controls on the selection and use of third parties, to include third party due diligence; and (5) withdrawing from consideration of pending public contracts potentially related to the misconduct described in the Statement of Facts;

(e)           the Company has enhanced, and has committed to continuing to enhance, its compliance program and internal controls, including by taking steps to ensure that its compliance program satisfies the minimum elements set forth in Attachment B to this Agreement (Corporate Compliance Program);

(f)            misconduct continued to occur at the Company until 2016, thus the parties have agreed that to ensure and test the effectiveness of the Company’s enhanced compliance program and to prevent a reoccurrence of the conduct outlined in the Statement of Facts, an independent compliance monitor shall be appointed for a term of two years;

(g)           the nature and seriousness of the offense conduct, including: the amount of illegal payments to foreign officials; conduct in multiple, high-risk jurisdictions; the pervasiveness throughout a business unit of the Company responsible for the conduct described in the Statement of Facts; the continuation of unlawful conduct until 2016; and the involvement of certain high-level executives;

(h)           the Company has agreed to disgorge $147 million in profits and prejudgment interest to the Securities and Exchange Commission (the “SEC”) in connection with the conduct described in the Statement of Facts;

(i)            the Company has agreed to continue to cooperate with the Department in any ongoing investigation of the conduct of the Company; and

(j)            accordingly, after considering (a) through (i) above, the Department believes that the appropriate resolution of this case is a non-prosecution agreement with the Company, a criminal penalty with an aggregate discount of 40% off of the bottom of the U.S. Sentencing Guidelines fine range, and an independent compliance monitor for a term of two years, followed by self-monitoring for the remainder of the Agreement.

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The Company admits, accepts, and acknowledges that it is responsible under United States law for the acts of its officers, directors, employees, and agents as set forth in the attached Statement of Facts, and that the facts described therein are true and accurate and constitute a willful violation of the Foreign Corrupt Practices Act (“FCPA”), 15 U.S.C. §§ 78dd-1, et seq. The Company expressly agrees that it shall not, through present or future attorneys, officers, directors, employees, agents or any other person authorized to speak for the Company make any public statement, in litigation or otherwise, contradicting the acceptance of responsibility under U.S. law by the Company set forth above or the facts described in the attached Statement of Facts. The Company agrees that if it or any of its direct or indirect subsidiaries or affiliates issues a press release or holds any press conference in connection with this Agreement, the Company shall first consult the Department to determine (a) whether the text of the release or proposed statements at the press conference are true and accurate with respect to matters between the Department and the Company; and (b) whether the Department has any objection to the release.

The Company’s obligations under this Agreement shall have a term of three years from the later of the date on which the Agreement is executed or the date on which the independent compliance monitor (the “Monitor”) is retained by the Company, as described below (the “Term”). The Company agrees, however, that, in the event the Department determines, in its sole discretion, that the Company has knowingly violated any provision of this Agreement or has failed to completely perform or fulfill each of the Company’s obligations under this Agreement, an extension or extensions of the Term may be imposed by the Department, in its sole discretion, for up to a total additional time period of one year, without prejudice to the Department’s right to proceed as provided in the breach provisions of this Agreement below. Any extension of the Agreement extends all terms of this Agreement, including the terms of the monitorship in Attachment C, for an equivalent period. Conversely, in the event the Department finds, in its sole discretion, that there exists a change in circumstances sufficient to eliminate the need for the monitorship in Attachment C, and that the other provisions of this Agreement have been satisfied, the Agreement may be terminated early.

The Company shall cooperate fully with the Department in any and all matters relating to the conduct described in this Agreement and the attached Statement of Facts and other conduct under investigation by the Department at any time during the Term, subject to applicable law and regulations, until the later of the date upon which all investigations and prosecutions arising out of such conduct are concluded, or the end of the Term. At the request of the Department, the Company shall also cooperate fully with other domestic or foreign law enforcement and regulatory authorities and agencies, as well as with Multilateral Development Banks (“MDBs”), in any investigation of the Company, its parent company or its affiliates, or any of its present or former officers, directors, employees, agents, and consultants, or any other party, in any and all matters relating to the conduct described in this Agreement and the attached Statement of Facts and other conduct under investigation by the Department or any other component of the Department of Justice at any time during the Term. The Company’s cooperation pursuant to this Paragraph is subject to applicable law and regulations, including relevant data privacy, national security laws and regulations, and labor laws, as well as valid claims of attorney-client privilege or attorney work product doctrine; however, the Company must provide to the Department a log of any information or cooperation that is not provided based on an assertion of law, regulation, or

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privilege, and the Company bears the burden of establishing the validity of any such assertion. The Company agrees that its cooperation shall include, but not be limited to, the following:

a.             The Company shall truthfully disclose all factual information with respect to its activities, those of its parent company and affiliates, and those of its present and former directors, officers, employees, agents, and consultants, including any evidence or allegations and internal or external investigations, about which the Company has any knowledge or about which the Department may inquire. This obligation of truthful disclosure includes, but is not limited to, the obligation of the Company to provide to the Department, upon request, any document, record or other tangible evidence about which the Department may inquire of the Company.

b.             Upon request of the Department, the Company shall designate knowledgeable employees, agents or attorneys to provide to the Department the information and materials described above on behalf of the Company. It is further understood that the Company must at all times provide complete, truthful, and accurate information.

c.             The Company shall use its best efforts to make available for interviews or testimony, as requested by the Department, present or former officers, directors, employees, agents, and consultants of the Company. This obligation includes, but is not limited to, sworn testimony before a federal grand jury or in federal trials, as well as interviews with domestic or foreign law enforcement and regulatory authorities. Cooperation shall include identification of witnesses who, to the knowledge of the Company, may have material information regarding the matters under investigation.

d.             With respect to any information, testimony, documents, records or other tangible evidence provided to the Department pursuant to this Agreement, the Company consents to any and all disclosures to other governmental authorities, including United States authorities and those of a foreign government, of such materials as the Department, in its sole discretion, shall deem appropriate.

In addition, during the Term, should the Company learn of any evidence or allegation that may constitute a violation of the FCPA anti-bribery or accounting provisions had the conduct occurred within the jurisdiction of the United States, or any evidence or allegation of a violation of a Federal health care fraud offense, as that term is defined in Title 18, United States Code, Section 24, the Company shall promptly report such evidence or allegation to the Department. On the date that the Term expires, the Company, by the Chief Executive Officer of the Company and the Chief Financial Officer of the Company, will certify to the Department that the Company has met its disclosure obligations pursuant to this Agreement. Each certification will be deemed a material statement and representation by the Company to the executive branch of the United States for purposes of 18 U.S.C. § 1001.

The Company represents that it has implemented and will continue to implement a compliance and ethics program designed to prevent and detect violations of the FCPA and other applicable anti-corruption laws throughout its operations, including those of its affiliates, agents, and joint ventures, and those of its contractors and subcontractors whose responsibilities include interacting with foreign officials or other activities carrying a high risk of corruption, including,

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but not limited to, the minimum elements set forth in Attachment B (Corporate Compliance Program).

In order to address any deficiencies in its internal accounting controls, policies, and procedures, the Company represents that it has undertaken, and will continue to undertake in the future, in a manner consistent with all of its obligations under this Agreement, a review of its existing internal accounting controls, policies, and procedures regarding compliance with the FCPA and other applicable anti-corruption laws as set forth within the scope of the Mandate and Corporate Compliance Program (Attachments B and C). Where necessary and appropriate, the Company agrees to adopt a new compliance program, or to modify its existing one, including internal controls, compliance policies, and procedures in order to ensure that it maintains: (a) an effective system of internal accounting controls designed to ensure the making and keeping of fair and accurate books, records, and accounts; and (b) a rigorous anti-corruption compliance program that incorporates relevant internal accounting controls, as well as policies and procedures designed to effectively detect and deter violations of the FCPA and other applicable anti-corruption laws. The compliance program, including the internal accounting controls system will include, but not be limited to, the minimum elements set forth in Attachment B. In assessing the company’s compliance program, the Department, in its sole discretion, may consider the Monitor’s certification decision.

The Company agrees to retain a Monitor for the term of two years from the date on which the Monitor is retained by the Company, subject to extension or early termination as described above. The Monitor’s duties and authority, and the obligations of the Company with respect to the Monitor and the Department, are set forth in Attachment C, which is incorporated by reference into this Agreement. No later than the date of execution of this Agreement, the Company will propose to the Department a pool of three qualified candidates to serve as the Monitor. The Monitor candidates or their team members shall have, at a minimum, the following qualifications:

a.demonstrated expertise with respect to the FCPA and other applicable anti- corruption laws, including experience counseling on FCPA issues;

b.experience designing and/or reviewing corporate compliance policies, procedures and internal controls, including FCPA and anti-corruption policies, procedures and internal controls;

c.the ability to access and deploy resources as necessary to discharge the Monitor’s duties as described in the Agreement; and

d.sufficient independence from the Company to ensure effective and impartial performance of the Monitor’s duties as described in the Agreement.

The Department retains the right, in its sole discretion, to choose the Monitor from among the candidates proposed by the Company, though the Company may express its preference(s) among the candidates. Monitor selections shall be made in keeping with the Department of Justice’s commitment to diversity and inclusion. If the Department determines, in its sole discretion, that any of the candidates are not, in fact, qualified to serve as the Monitor, or if the

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Department, in its sole discretion, is not satisfied with the candidates proposed, the Department reserves the right to request that the Company nominate additional candidates. In the event the Department rejects any proposed Monitors, the Company shall propose additional candidates within twenty business days after receiving notice of the rejection so that three qualified candidates are proposed. This process shall continue until a Monitor acceptable to both parties is chosen. The Department and the Company will use their best efforts to complete the selection process within sixty calendar days of the execution of this Agreement. If the Monitor resigns or is otherwise unable to fulfill his or her obligations as set out herein and in Attachment C, the Company shall within twenty business days recommend a pool of three qualified Monitor candidates from which the Department will choose a replacement.

The Monitor’s powers, duties, and responsibilities, as well as additional circumstances that may support an extension of the Monitor’s term, are set forth in Attachment C. The Company agrees that it will not employ or be affiliated with the Monitor or the Monitor’s firm for a period of not less than two years from the date on which the Monitor’s term expires. Nor will the Company discuss with the Monitor or the Monitor’s firm the possibility of further employment or affiliation during the Monitor’s term.

At the end of the monitorship, provided all requirements set forth in Paragraphs 19-20 of Attachment C are met, the Company will report on its compliance to the Department periodically, every six-months, for the remainder of this Agreement, regarding remediation and implementation of the enhanced compliance measures set forth by the Monitor as described in Paragraph 21 of Attachment C.

The Company agrees to pay a monetary penalty in the amount of $84,715,273 to the United States Treasury no later than five business days after the Agreement is fully executed, and to pay disgorgement and prejudgment interest in the amount of $147 million. The monetary penalty is based upon profits of approximately $141,192,121 as a result of the offense conduct, and reflects a discount of 40% off of the bottom of the U.S. Sentencing Guidelines fine range. The Department will credit the $147 million in disgorgement and prejudgment interest that the Company is paying to the SEC. The Company acknowledges that no tax deduction may be sought in connection with the payment of any part of this $84,715,273 penalty. The Company shall not seek or accept directly or indirectly reimbursement or indemnification from any source with regard to the penalty or disgorgement amounts that the Company pays pursuant to this Agreement or any other agreement entered into with an enforcement authority or regulator concerning the facts set forth in the attached Statement of Facts.

The Department agrees, except as provided herein, that it will not bring any criminal or civil case (except for criminal tax violations, as to which the Department does not make any agreement) against the Company relating to any of the conduct described in the attached Statement of Facts. The Department, however, may use any information related to the conduct described in the attached Statement of Facts against the Company: (a) in a prosecution for perjury or obstruction of justice; (b) in a prosecution for making a false statement; (c) in a prosecution or other proceeding relating to any crime of violence; or (d) in a prosecution or other proceeding relating to a violation of any provision of Title 26 of the United States Code. This Agreement does not provide any protection against prosecution for any future conduct by the Company or any of its present or

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former parents or subsidiaries. In addition, this Agreement does not provide any protection against prosecution of any individuals, regardless of their affiliation with the Company or any of its present or former parents or subsidiaries.

If, during the Term, the Company (a) commits any felony under U.S. federal law; (b) provides in connection with this Agreement deliberately false, incomplete, or misleading information, including in connection with its disclosure of information about individual culpability; (c) fails to cooperate as set forth in this Agreement; (d) fails to implement a compliance program as set forth in this Agreement and Attachment B; (e) commits any acts that, had they occurred within the jurisdictional reach of the FCPA, would be a violation of the FCPA; or (f) otherwise fails to completely perform or fulfill each of the Company’s obligations under the Agreement, regardless of whether the Department becomes aware of such a breach after the Term is complete, the Company shall thereafter be subject to prosecution for any federal criminal violation of which the Department has knowledge, including, but not limited to, the conduct described in the attached Statement of Facts, which may be pursued by the Department in the U.S. District Court for the District of Massachusetts or any other appropriate venue. Determination of whether the Company has breached the Agreement and whether to pursue prosecution of the Company shall be in the Department’s sole discretion. Any such prosecution may be premised on information provided by the Company or its personnel. Any such prosecution relating to the conduct described in the attached Statement of Facts or relating to conduct known to the Department prior to the date on which this Agreement was signed that is not time-barred by the applicable statute of limitations on the date of the signing of this Agreement may be commenced against the Company, notwithstanding the expiration of the statute of limitations, between the signing of this Agreement and the expiration of the Term plus one year. Thus, by signing this Agreement, the Company agrees that the statute of limitations with respect to any such prosecution that is not time-barred on the date of the signing of this Agreement shall be tolled for the Term plus one year. In addition, the Company agrees that the statute of limitations as to any violation of U.S. federal law that occurs during the Term will be tolled from the date upon which the violation occurs until the earlier of the date upon which the Department is made aware of the violation or the duration of the Term plus five years, and that this period shall be excluded from any calculation of time for purposes of the application of the statute of limitations.

In the event the Department determines that the Company has breached this Agreement, the Department agrees to provide the Company with written notice of such breach prior to instituting any prosecution resulting from such breach. Within thirty days of receipt of such notice, the Company shall have the opportunity to respond to the Department in writing to explain the nature and circumstances of such breach, as well as the actions the Company has taken to address and remediate the situation, which explanation the Department shall consider in determining whether to pursue prosecution of the Company.

In the event that the Department determines that the Company has breached this Agreement: (a) all statements made by or on behalf of the Company to the Department or to the Court, including the attached Statement of Facts and any testimony given by the Company before a grand jury, a court, or any tribunal, or at any legislative hearings, whether prior or subsequent to this Agreement, and any leads derived from such statements or testimony, shall be admissible in evidence in any and all criminal proceedings brought by the Department against the Company;

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and (b) the Company shall not assert any claim under the United States Constitution, Rule 11(f) of the Federal Rules of Criminal Procedure, Rule 410 of the Federal Rules of Evidence, or any other federal rule that any such statements or testimony made by or on behalf of the Company prior or subsequent to this Agreement, or any leads derived therefrom, should be suppressed or are otherwise inadmissible. The decision whether conduct or statements of any current director, officer or employee, or any person acting on behalf of, or at the direction of, the Company, will be imputed to the Company for the purpose of determining whether the Company has violated any provision of this Agreement shall be in the sole discretion of the Department.

Except as may otherwise be agreed by the parties in connection with a particular transaction, the Company agrees that in the event that, during the Term, it undertakes any change in corporate form, including if it sells, merges, or transfers business operations that are material to the Company’s consolidated operations, or to the operations of any subsidiaries or affiliates involved in the conduct described in the attached Statement of Facts, as they exist as of the date of this Agreement, whether such change is structured as a sale, asset sale, merger, transfer, or other change in corporate form, it shall include in any contract for sale, merger, transfer, or other change in corporate form a provision binding the purchaser, or any successor in interest thereto, to the obligations described in this Agreement. The purchaser or successor in interest must also agree in writing that the Department’s ability to determine there has been a breach under this Agreement is applicable in full force to that entity. The Company agrees that the failure to include this Agreement’s breach provisions in the transaction will make any such transaction null and void. The Company shall provide notice to the Department at least thirty (30) days prior to undertaking any such sale, merger, transfer, or other change in corporate form. The Department shall notify the Company prior to such transaction (or series of transactions) if it determines that the transaction(s) will have the effect of circumventing or frustrating the enforcement purposes of this Agreement. If at any time during the Term the Company engages in a transaction(s) that has the effect of circumventing or frustrating the enforcement purposes of this Agreement, the Department may deem it a breach of this Agreement pursuant to the breach provisions of this Agreement. Nothing herein shall restrict the Company from indemnifying (or otherwise holding harmless) the purchaser or successor in interest for penalties or other costs arising from any conduct that may have occurred prior to the date of the transaction, so long as such indemnification does not have the effect of circumventing or frustrating the enforcement purposes of this Agreement, as determined by the Department.

This Agreement is binding on the Company and the Department but specifically does not bind any other component of the Department of Justice, other federal agencies, or any state, local or foreign law enforcement or regulatory agencies, or any other authorities, although the Department will bring the cooperation of the Company and its compliance with its other obligations under this Agreement to the attention of such agencies and authorities if requested to do so by the Company.

It is further understood that the Company and the Department may disclose this Agreement to the public.

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This Agreement sets forth all the terms of the agreement between the Company and the Department. No amendments, modifications or additions to this Agreement shall be valid unless they are in writing and signed by the Department, the attorneys for the Company, and a duly authorized representative of the Company.

			Sincerely,
			ROBERT ZINK
			Acting Chief, Fraud Section
			Criminal Division
			United States Department of Justice
Date:	28 March 2019	BY:	/s/ Paul A. Hayden
			Paul A. Hayden
			Sonali D. Patel
			Trial Attorneys
			ANDREW E. LELLING
			United States Attorney
			District of Massachusetts
Date:	28 Mar 2019	BY:	/s/ Jordi de Llano
			Jordi de Llano
			Assistant United States Attorney
AGREED AND CONSENTED TO:
Fresenius Medical Care AG & Co. KGaA
Date:	25 Feb 2019	BY:	/s/ Rice Powell
			Rice Powell
			Chief Executive Officer
			Fresenius Medical Care AG & Co. KGaA
Date:	25 Feb 2019	BY:	/s/ Mike Brosnan
			Mike Brosnan
			Chief Financial Officer
			Fresenius Medical Care AG & Co. KGaA
Date:	25 Feb 2019	BY:	/s/ Maxwell Carr-Howard
			Dentons US LLP
			Maxwell Carr-Howard

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ATTACHMENT A

STATEMENT OF FACTS

The following Statement of Facts is incorporated by reference as part of the non-prosecution agreement (the “Agreement”) between the United States Department of Justice, Criminal Division, Fraud Section and the United States Attorney’s Office for the District of Massachusetts (collectively, the “Department”) and Fresenius Medical Care AG & Co. KGaA (“FMC” or the “Company”). FMC hereby agrees and stipulates that the following information is true and accurate. FMC admits, accepts, and acknowledges that it is responsible for the acts of its officers, directors, employees, and agents as set forth below:

Relevant Entities and Individuals

1.FMC, a German Corporation headquartered in Bad Homburg, Germany, was a leading provider of products and services for people with chronic kidney failure. FMC engaged in its business through various subsidiaries around the world, and FMC maintained separate geographic divisions which oversaw operations of its subsidiaries in the carrying out of FMC’s business. FMC’s American Depositary Receipt shares were publicly traded on the New York Stock Exchange under the ticker “FMS” and it was an “issuer” within the meaning of the Foreign Corrupt Practices Act (“FCPA”), Title 15, United States Code, Sections 78 dd-1(a) and 78m(b).

2.FMC’s Europe, Middle East, and Africa (“EMEA”) division includes Fresenius Medical Care Deutschland GmbH (“FMC-D”), a limited liability company organized under the federal laws of Germany. The EMEA division was responsible for FMC’s operations of its subsidiaries in those areas and its leadership and staff were based in Bad Homburg, Germany.

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3.“FMC Executive 1,” an individual whose identity is known to the Department and to FMC, was a high-level executive within the EMEA division whose responsibilities included business development.

4.“FMC Employee 1,” an individual whose identity is known to the Department and to FMC, was a sales manager within the EMEA division whose responsibilities included sales in North and West Africa.

Overview of the Schemes

5.Between in or around 2007 and in or around 2016, FMC, through its agents and employees, engaged in various schemes to pay bribes to publicly-employed health and/or government officials to obtain or retain business for and on behalf of FMC. In Angola and Saudi Arabia, these agents and employees utilized the means and instrumentalities of U.S. interstate commerce, including the use of internet-based email accounts hosted by numerous service providers located in the United States. With respect to these schemes, as well as in connection with conduct in Morocco, Spain, Turkey, and West Africa, FMC, through its agents and employees, knowingly and willfully failed to implement reasonable internal accounting controls over financial transactions or failed to maintain books and records that accurately and fairly reflected the transactions.

FCPA Anti-Bribery Violations

Angola

Relevant Entities and Individuals

6.FMC Portugal was a wholly owned subsidiary of FMC under the responsibility of FMC’s EMEA Division. FMC operated in Portugal and Angola, through FMC Portugal. FMC Portugal provided FMC services and products in Portugal and sold FMC products for use in

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Angola. FMC Portugal and its employees were “agents” of an issuer within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(a).

7.“FMC Portugal Executive 1,” an individual whose identity is known to the Department and to FMC, was a high-level executive at FMC Portugal whose responsibilities included business development.

8.FMC and FMC Portugal operated in Angola through FMC Angola, which was established for the purpose of expanding FMC into the Angolan dialysis market. FMC Angola was overseen by FMC Portugal. FMC Angola and its employees were “agents” of an issuer within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(a).

9.“Angolan State-Owned Clinic 1,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled medical clinic in Angola that performed functions that Angola treated as its own, and thus was an instrumentality within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1).

10.“Angolan State-Owned Clinic 2,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled medical clinic in Angola that performed functions that Angola treated as its own, and thus was an instrumentality within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1).

11.“Angolan State-Owned Military Hospital,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled hospital in Angola that performed functions that Angola treated as its own, and thus was an instrumentality within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1).

12.“Angolan Military Health Officer,” an individual whose identity is known to the Department and to FMC, was a high-ranking officer in the Medical Services Division of the

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Angolan Armed Forces and a “foreign official” within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1).

13.“Shareholder Company,” an entity whose identity is known to the Department and to FMC, was owned by the sons of the Angolan Military Health Officer. One of the owners of Shareholder Company was also a shareholder in FMC Angola.

14.“Angolan Doctor 1,” an individual whose identity is known to the Department and to FMC, was a top nephrologist in Angola, a Director at the Angolan State-Owned Military Hospital, an employee of Angolan State-Owned Clinic 2, and a “foreign official” within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1).

15.“Angolan Doctor 2,” an individual whose identity is known to the Department and to FMC, was a top nephrologist in Angola, an employee of Angolan State-Owned Clinic 1 and Angolan State-Owned Clinic 2, and a “foreign official” within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1).

Conduct Relevant to Angola

16.Between approximately 2010 and 2014, FMC, through FMC Portugal and FMC Angola, offered or provided things of value to the Angolan Military Health Officer and his family, as well as prominent Angolan government-employed nephrologists, specifically shares in a joint venture, storage contracts, and consultancy agreements, for the purpose of securing an improper advantage and assisting FMC with obtaining and retaining business in Angola.

17.For example, in developing the FMC Angola joint venture, on or about August 4, 2010, FMC Portugal Executive 1 emailed FMC Executive 1 explaining the intention to attribute 35% of the share capital of FMC Angola to certain “local partners” as minority shareholders — specifically “15% to [Angolan Military Health Officer who was listed by his military rank], 15% to [Angolan Doctor 1] and 5% to NefroAngola - a local company which owners are all the Angolan nephrologists.”

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18.On or about August 24, 2010, FMC Portugal Executive 1 emailed another FMC Portugal executive requesting that she update the drafts of the proposal to sell shares of FMC Angola for FMC Executive 1 and another FMC executive to consider. This new configuration assigned 15% of the share capital of FMC Angola to the Angolan Military Health Officer, who was identified as “Dr.” instead of by his military rank as in previous emails; 12.5% of the share capital to Angolan Doctor 1; 2.5% of the share capital to Angolan Doctor 2; and 5% of the share capital to NefroAngola. This email also explained that the payment for share acquisition on the part of the new minority shareholders would be made when the first dividends were distributed.

19.In or around September 2010, FMC Executive 1 prepared and presented the proposal to sell shares in FMC Angola to “local partners” to the FMC Board of Management (“BoM”) in Germany. The JVA did not disclose that the minority shareholders included an Angolan military health officer and Angolan government-employed doctors. Rather the JVA simply identified the Angolan Military Health Officer as a “Doctor.” Ultimately, no shares were provided to the Angolan Military Health Officer.

20.During the same time period, in or around September 2010, FMC Angola started selling products to Angolan State-Owned Clinic 1, where Angolan Doctor 2 (a proposed shareholder) was employed, and Angolan State-Owned Military Hospital, where Angolan Doctor 1 (another proposed shareholder) was employed. Further, FMC entered into a contract for services with Angolan State-Owned Clinic 2, where both Angolan Doctor 1 and Angolan Doctor 2 were also employed.

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21.Approximately one month later, in or around October 2010, the FMC BoM approved the JVA and valued the minority shareholders’ stake at $35,000. The JVA was structured so that the shares would be purchased with proceeds from the first dividends issued by FMC Angola. On or about October 27, 2011, FMC Portugal Executive 1 emailed a spreadsheet with the total number of shares that each shareholder would receive to the Angolan Military Health Officer and copied Angolan Doctor 1 on his internet-based email account. The JVA was not finalized until January 2012, when shares of FMC Angola were formally transferred to the minority shareholders, including the foreign officials identified above.

22.In or around January 2012, the shareholder agreement between FMC, the son of the Angolan Military Health Officer (who was appointed in place of the Angolan Military Health Officer), Angolan Doctor 1, Angolan Doctor 2, and NefroAngola was finalized. The minority shareholders never paid for their shares in FMC Angola, nor did they ever receive dividends

23.In exchange for their shares, the minority shareholders directed customers to FMC Angola. For example, in or around June 2012, FMC executives and FMC Portugal executives received an internal audit report highlighting a conflict of interest that existed in FMC Angola, specifically “two Angolan shareholders brought customers to FMC Angola” and that these shareholders “also work for these customers as doctors.” As discussed above, Angolan Doctors 1 and 2 were both shareholders in FMC Angola and both employed by Angolan state-owned entities. Further, the Angolan Military Health Officer, whose son was a designated shareholder of FMC Angola, exercised authority over the Angolan State-Owned Military Hospital in his role as an officer in the Medical Services Division of the Angolan Armed Forces. Thus, FMC was made aware that the minority shareholders were foreign officials.

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24.In or around late 2010, FMC Angola entered into an oral contract with the Shareholder Company, which was owned by the sons of the Angolan Military Health Officer, to provide warehousing space. In or around December 2011, FMC Angola paid approximately $560,000 to the Shareholder Company for purported “Temporary Storage Services,” however, no FMC Angola products were ever stored at the Shareholder Company warehouse.

25.After the June 2012 internal audit report identified this temporary storage contract as a conflict of interest, in or around July 2012, FMC Angola (through a FMC Portugal executive and FMC Portugal Executive 1) executed a written contract with the Shareholder Company to provide temporary storage services for approximately $77,000 per month from January 2012 to January 2013. During that time period, no FMC Angola products were ever stored at the Shareholder Company warehouse. FMC Angola did not ultimately pay the storage fees associated with the written contract due to the initiation of the Company’s internal investigation.

26.In addition to the temporary storage contract with the Shareholder Company, FMC Angola entered into a separate distribution arrangement with the Shareholder Company in which the Shareholder Company would serve as the sole distributor for FMC products sold to Angolan State-Owned Clinic 1. In or around July 2012, FMC Portugal Executive 1 emailed the Shareholder Company, wherein he stated that “[FMC Angola] might be able to move the contracts from [Angolan State-Owned Clinic 1] into [Shareholder Company] before the end of the year!!” In or around 2013, Angolan State-Owned Clinic 1 notified FMC Angola that it was no longer on the list of authorized suppliers for certain consumable products and that Angolan State-Owned Clinic 1 could only purchase these products through the Shareholder Company because Shareholder Company was on the list of authorized dealers. Thereafter, FMC Angola sold the designated products to the Shareholder Company without a written contract, while FMC Angola continued to

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supply other products directly to Angolan State-Owned Clinic 1. The Shareholder Company never paid FMC Angola for the products purportedly purchased for distribution to Angolan State-Owned Clinic 1. FMC terminated the distribution to Shareholder Company in or around 2014.

27.Finally, FMC Portugal and FMC Angola also made improper payments to government doctors through sham consulting contracts for which no services were ever performed. For example, beginning in or around January 2011, FMC Portugal entered into a contract with Angolan Doctor 1 for purported consulting services for €5,000 per month. On or about May 24, 2011, FMC Portugal Executive 1 emailed Angolan Doctor 1 on his internet-based email account discussing his consultancy payments for January 2011 until April 2011. In or around October 2011, after the initial consulting contract was terminated, FMC Angola entered into a second consulting contract with Angolan Doctor 1. The second contract was for purported consulting services to provide information about the Angolan dialysis market for $7,500 per month. The second contract was terminated in or around November 2012. Angolan Doctor 1, however, never provided any services related to these consulting agreements.

28.In addition, beginning in or around April 2010, NefroCare Portugal (a subsidiary of FMC Portugal) entered into a contract with Angolan Doctor 2 to provide purported consultancy services related to the Angolan health industry for which Angolan Doctor 2 was paid approximately €2,500 per month, which increased to €3,500 per month in or around January 2011. In or around August 2012 and continuing until in or around November 2012, FMC Portugal entered into a separate contract with Angolan Doctor 2 to provide purported consultancy services for the Angolan health industry for which Angolan Doctor 2 was paid approximately €4,230 per month. Angolan Doctor 2, however, never provided any services related to these consulting agreements.

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29.As a result of improper payments made to Angolan health officials, FMC benefited by approximately $12.6 million during the relevant time period.

Saudi Arabia

Relevant Entities and Individuals

30.“Saudi Distributor,” an entity whose identity is known to the Department and to FMC, was a third-party distributor. FMC’s operations in the Kingdom of Saudi Arabia (“KSA”) were conducted through Saudi Distributor pursuant to a Management Assistance Agreement and an Agency and Distributorship Agreement with FMC. The Management Assistance Agreement and Agency and Distribution Agreement provided that Saudi Distributor would sell products on behalf of FMC and pursuant to specific terms and conditions set by FMC. In addition, Saudi Distributor’s finances were fully consolidated within FMC’s. Thus, Saudi Distributor and its employees were “agents” of an issuer within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(a).

31.“Saudi Distributor GM,” an individual whose identity is known to the Department and to FMC, was the General Manager of Saudi Distributor.

32.“Saudi Technical Organization,” an entity whose identity is known to the Department and to FMC, received funds from the Kingdom of Saudi Arabia and was acting in an official capacity for or on behalf of a foreign government within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1). Saudi Technical Organization was involved in nephrology-related activities in KSA, including the coordination of dialysis treatments in KSA.

33.“Saudi Medical Services Group,” an entity whose identity is known to the Department and to FMC, was a medical services company. Saudi Medical Services Group was the authorized KSA distributor for products for a German company, which developed and sold

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products that could be used in connection with dialysis equipment (“German Company 1”). Saudi Medical Services Group had a contract pursuant to which it would receive a commission on sales of products purchased by FMC from German Company 1. FMC purchased certain assets and products of German Company 1 in 2004, after which it ceased operations.

34.“Saudi JV,” an entity whose identity is known to the Department and to FMC, was a joint venture in which FMC was a 25% shareholder. Saudi JV manufactured dialyzers at a production plant in KSA. FMC served as the primary source of raw materials for the dialyzers produced by Saudi JV.

35.“Saudi Doctor 1,” an individual whose identity is known to the Department and to FMC, was a prominent doctor in KSA, the Chairman and Director General of Saudi Technical Organization, and a “foreign official” within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1). Saudi Doctor 1 is also affiliated with Saudi Medical Services Group.

36.“Saudi Doctor 2,” an individual whose identity is known to the Department and to FMC, was also a prominent doctor in KSA, the Deputy Director General of Saudi Technical Organization, and a “foreign official” within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1). Saudi Doctor 2 is also affiliated with Saudi Medical Services Group and Saudi JV.

37.“Saudi Doctor 3,” an individual whose identity is known to the Department and to FMC, was the Chief Executive Officer of a government owned and operated charity that focused on medical care for patients in renal failure.

Conduct Relevant to Saudi Arabia

38.Between 2007 and 2012, FMC, through Saudi Distributor, made improper payments to publicly-employed doctors and others in order to expand its market share in KSA.

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39.During the relevant period, Saudi Distributor GM employed a check cashing scheme in order to funnel cash to publicly-employed doctors. Specifically, Saudi Distributor GM instructed employees to cash checks that had been made payable in their names and return the cash to him. Saudi Distributor GM then arranged to have the cash delivered to Saudi government doctors and others.

40.Saudi Distributor GM concealed the true purpose of these transactions by falsely recording them as “Project Marketing Expenses” or “Collection Commissions” in Saudi Distributor’s financial records, which were ultimately consolidated with FMC’s. In total, FMC made approximately $1.7 million in payments through the check writing scheme.

41.Saudi Distributor also often made improper payments to government doctors through sham consulting and commission agreements for which no services were ever performed. For example, Saudi Distributor entered into a “Sales Support” consultancy agreement with Saudi Doctor 1 pursuant to which Saudi Doctor 1 received a $68,000 commission purportedly for services rendered in connection with a 2007 tender for dialysis equipment won by Saudi Distributor. Saudi Doctor 1, however, provided no services in connection with that tender. The agreement was prepared after the tender had been awarded. A June 14, 2007 FMC email shows that the FMC Project Director responsible for the business explained to his regional supervisor that winning this tender was “compensation” from Saudi Technical Organization for losing an earlier tender. In addition, on or about June 24, 2010, Saudi Distributor GM emailed Saudi Doctor 1 on his internet-based email account, wherein he discussed getting Saudi Doctor 1 his commission payments.

42.Saudi Doctor 2 was paid over $220,000 through “commission” agreements. Internal FMC communications show that these payments to Saudi Doctor 2 were viewed as

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necessary to continue to do business in KSA. In 2011, for example, an email sent from Saudi JV’s plant manager to FMC employees in Germany explained that Saudi Doctor 2 assisted in avoiding a government inspection of its factory that “could have shut down the factory or made it ineligible for tenders.”

43.Saudi Distributor paid more than $90,000 to a government charity run by Saudi Doctor 3. Saudi Distributor GM understood that such payments were necessary in order to win contracts. In fact, in one November 2008 email from Saudi Distributor GM to FMC personnel, he explains that Saudi Doctor 3 “informed [] frankly that who will support the Association will get the orders as simple as that[.]” In addition, on or about March 15, 2012, Saudi Doctor 3, using his internet-based email account, emailed Saudi Distributor GM a draft commission contract for helping to secure tenders for FMC. That agreement was never executed.

44.FMC also channeled improper payments through fake collection commission agreements. Despite having salaried employees responsible for collecting outstanding debts, Saudi Distributor entered into a commission collection agreement with the relative of a Ministry of Health (“MOH”) official in connection with bidding on MOH dialysis machine tenders, which FMC ultimately won. In total, Saudi Distributor made over $200,000 in improper payments in connection with this contract.

45.Another method by which Saudi Distributor made improper payments to Saudi government doctors was by providing gifts and paying for travel with no business or educational justification. Often times, the payments were made using the credit card of Saudi Distributor GM and included luxury accommodations for the doctors and their families.

46.For example, Saudi Distributor purchased laptops as gifts for two nurses at government hospitals. According to FMC emails, the nurses specifically requested the laptops as

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gifts and an FMC consultant recommended Saudi Distributor make the purchases because otherwise the nurses could report to MOH the fact that their hospitals did not receive certain parts from Saudi Distributor. Emails show that the consultant also recommended the purchase of the laptops because “otherwise we will lost the IA tender of 2008.” Saudi Distributor GM authorized the purchase for a cost of $1,165.33.

47.In other instance, which occurred in or around January 2010, Saudi Distributor paid for a six-night stay at the Atlantis Palm Hotel in Dubai for Saudi Doctor 2 and his wife. The trip was recorded as related to a medical congress in Saudi Distributor records, but no evidence exists that Saudi Doctor 2 participated or attended any such congress. The total cost of the trip was $7,579.20.

48.In addition to the payments discussed above, Saudi Distributor also steered improper payments to customs officials in order to clear shipments more quickly and avoid or reduce associated fees. The improper payments were made through a third-party freight and logistics company that served as a customs clearance agent (“Customs Agent”) and were mischaracterized on invoices as “handling charges” and “miscellaneous expenses.” For example, in or around July 2011, Saudi Distributor learned of the detention of a shipment by Saudi customs officials for lack of country-of-origin documentation. In order to release the shipment, Customs Agent sought the approval of a $3,200.00 payment. Saudi Distributor approved the charge for the stated purpose of “expediting the mentioned shipment.” Records of the transaction show that the payment was subsequently booked as a miscellaneous “handling charge.” In total, there were over $1.7 million in payments to Customs Agent that lacked supporting documentation for the services rendered.

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49.Finally, in addition to the conduct discussed above, there is evidence demonstrating that numerous documents and other records were altered or destroyed. After the FMC internal investigation commenced in late 2012, Saudi Distributor GM directed employees to destroy or alter company documents, to create additional fictitious records, and to lie to investigators.

50.As a result of improper payments made in Saudi Arabia, FMC benefitted by approximately $42.7 million during the relevant period.

FCPA Accounting Violations

Morocco

Relevant Entities and Individuals

51.FMC Morocco was a wholly owned subsidiary of FMC under the responsibility of FMC’s EMEA division. FMC operated in Morocco through FMC Morocco, and FMC Morocco provided FMC services and products in Morocco. FMC Morocco and its employees were “agents” of an issuer within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(a).

52.“FMC Morocco Executive 1,” an individual whose identity is known to the Department and to FMC, was a high-level executive at FMC Morocco with decision-making authority.

53.“Morocco State-Owned Military Hospital 1,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled medical clinic in Morocco and performed functions that Morocco treated as its own, and thus was an instrumentality within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1).

54.“Morocco State-Owned Military Hospital 2,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled medical clinic in Morocco and

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performed functions that Morocco treated as its own, and thus was an instrumentality within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1).

55.“Morocco State-Official 1,” an individual whose identity is known to the Department and to FMC, was a nephrologist and was responsible for the creation of dialysis centers at Morocco State-Owned Military Hospital 1 and Morocco State-Owned Military Hospital 2 and a “foreign official” within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(f)(1).

56.“Company A” is an entity whose identity is known to the Department and to FMC and was created to conceal payments intended for Morocco State-Official 1.

Conduct Relevant to Morocco

57.Between in or around October 2006 and in or around 2010, FMC and FMC Morocco paid bribes to Morocco State-Official 1 for the purpose of securing an improper advantage and assisting FMC with obtaining and retaining business in Morocco.

58.During the relevant period, in preparing a bid to develop a dialysis center at Morocco State-Owned Military Hospital 1, FMC Employee 1 and FMC Morocco Executive 1 devised a financial model that included provisions to pay Morocco State-Official 1 a “commission” that was 10% of the total order value, 50% of which would be paid during the first year (2007) and 12.5% annually thereafter. This commission was, in fact, a bribe to be paid in exchange for Morocco State-Official 1 selecting FMC Morocco to develop the dialysis center at Morocco State-Owned Military Hospital 1. In discussing the commission payment, FMC Employee 1 sent an email saying he would meet with Morocco State-Official 1 in order to discuss and obtain additional development projects, such as Morocco State-Owned Military Hospital 2 and Marrakesh for which “[FMC Employee 1] insisted to get a certain support…” In addition, FMC Employee 1 emailed

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Morocco State-Official 1 wherein he stated that 50% of Morocco State-Official 1’s “commission” amount would be given as soon as possible.

59.In or around January 2007, FMC Employee 1, FMC Morocco Executive 1, and Morocco State-Employee 1 signed a €1.8 million contract relating to the Morocco State-Owned Military Hospital 1 project. FMC received payments in connection with this contract until in or around December 2010.

60.In or around January 2007, FMC Employee 1 and others concealed the first payment to Morocco State-Official 1 by amending and backdating another FMC employee’s contract which allowed him to receive a bonus of €90,000 (half of the 10% “commission” for the €1.8 million project). The remaining “commission” payments were disguised as bonus payments and paid out to Morocco State-Official 1 at approximately €22,500 for each of the next four years between in or around 2008 and in or around 2011 for a total of approximately €90,000. Each of these payments were falsely recorded as “commissions” in the books and records of FMC and FMC Morocco.

61.Additionally, in or around 2009, FMC and FMC Morocco were preparing to make an offer on the Morocco State-Owned Military Hospital 2 project to develop a dialysis center. In or around January 2009, employees of FMC Morocco and FMC Germany discussed the use of a consultant in “promoting” FMC Morocco’s interest in the project, which was intended to pay bribes to Morocco-State Official 1 in exchange for selecting FMC Morocco to develop the dialysis center. In an email dated on or about August 27, 2009, FMC Morocco Executive 1 suggested to FMC Germany employees that they not specify the purpose of the consultancy contract, noting that they “keep it as is, we both know the objective of this contract.”

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62.On or about September 15, 2009, Morocco State-Official 1 and FMC Morocco Executive 1 signed a €1.4 million contract for the Morocco State-Owned Military Hospital 2 project.

63.Shortly after FMC Morocco was awarded the Morocco State-Owned Military Hospital 2 project, an FMC executive and FMC Morocco Executive 1 signed a service agreement with Company A, an entity that was created in or around February or March 2009 with a stated business purpose of providing staffing and miscellaneous services. The contract provided a vague description of services and, although it was signed on or about September 30, 2009, it was backdated to June 20, 2009.

64.Between in or around October 2009 and December 2010, FMC Morocco paid Company A approximately €170,000 in improper payments intended for Morocco State-Official 1.

65.As a result of improper payments made to Morocco State-Official 1, FMC benefitted by approximately $3.7 million during the relevant period.

Spain

Relevant Entities and Individuals

66.FMC Spain was a wholly owned subsidiary of FMC under the responsibility of FMC’s EMEA Division. FMC operated in Spain through FMC Spain, and FMC Spain provided FMC services and products in Spain. FMC Spain and its employees were “agents” of an issuer within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(a).

67.“Spanish State-Owned Hospital 1,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled hospital in Barcelona, Spain.

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68.“Spanish State-Owned Hospital 2,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled hospital located in Valencia, Spain.

69.“Spanish State-Owned Hospital 3,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled hospital located in Torrecardenas, Spain.

70.“Spanish State-Owned Hospital 4,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled hospital located in Santander, Spain.

71.“Spanish Doctor 1,” an individual whose identity is known to the Department and to FMC, was the head of the Nephrology Department at Spanish State-Owned Hospital 2.

72.“Spanish Doctor 2,” an individual whose identity is known to the Department and to FMC, was the head of the Nephrology Department at Spanish State-Owned Hospital 3.

73.“Spanish Doctor 3,” an individual whose identity is known to the Department and to FMC, was the head of the dialysis section at Spanish State-Owned Hospital 1 and served as a member of FMC Spain’s scientific advisory committee.

Conduct Relevant to Spain

74.Beginning in at least 2007 and continuing until approximately 2014, FMC Spain made payments to publicly-employed doctors and other healthcare professionals in Spain, in connection with public tenders in which FMC Spain sought to compete. Among other things, FMC Spain sometimes accomplished this through (i) fake consulting agreements with publicly-employed doctors or professionals who could influence or provide information about public tenders; (ii) gifts or other benefits such as travel to medical conferences; and (iii) donations to fund projects for the doctors.

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75.In certain public tenders, FMC Spain received advance information about tender specifications from publicly-employed doctors or administrators, some of whom received payments from FMC Spain. In some tenders, FMC Spain intended to influence the publicly-employed doctors or administrators to modify aspects of the tenders before they were publicly announced. For example, between 2008 and 2011, FMC Spain paid Spanish Doctor 1 more than €81,000 without a consulting agreement or contract in place. In addition, from 2012 through 2014, FMC Spain had a consulting contract with Spanish Doctor 1 which resulted in over €39,000 in payments, and provided Spanish Doctor 1 with travel sponsorships.

76.In connection with a 2011 tender held by Spanish State-Owned Hospital 2, FMC Spain submitted draft technical specifications and improvements, a draft tender scoring methodology, and proposed scores to Spanish Doctor 1. FMC Spain was awarded the tender in March 2011. Ultimately, this tender resulted in more than €1.7 million in revenue to FMC Spain.

77.FMC Spain also provided money and benefits to Spanish Doctor 2. In connection with a 2015 tender held by Spanish State-Owned Hospital 3, FMC Spain suggested to Spanish Doctor 2 how the tender should be drafted. According to a December 2014 email from FMC Spain’s Sales Director, FMC “got [Spanish Doctor 2] to decide to ‘support [FMC Spain]’ to obtain 60% of the adjudication.” FMC Spain was later awarded 60% of the tender, which was valued at approximately €2.66 million.

78.FMC Spain also entered into consulting agreements with doctors in Spain and provided them with other financial incentives in an effort to get the doctors to influence FMC Spain business. For example, from 2008 to 2014, pursuant to various consulting agreements, FMC Spain paid Spanish Doctor 3 approximately €340,000, paid for his travel to various medical congresses and for a trip to the United States, and paid for a two-week English language course.

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79.FMC Spain also made improper payments to doctors in exchange for patient referrals to FMC Spain clinics. The payments were channeled to the doctors through consulting agreements with entities owned by the same doctors. In other instances, FMC Spain purchased businesses from the doctors and, thereafter, paid the doctors for use of the buildings in which the businesses were located.

80.For example, FMC Spain made payments and provided benefits to six publicly-employed doctors at Spanish State-Owned Hospital 4. FMC Spain paid approximately €5 million plus 5% of sales for five years for a clinic that was owned by the doctors. FMC Spain also entered into a lease agreement with another entity owned by the six doctors to rent the space in which the original clinic was located.

81.As a result of FMC Spain’s failure to implement reasonable internal controls, the improper payments to doctors continued until 2014. Many of these payments were improperly recorded as consulting expenses in the books and records of FMC and FMC Spain. During the relevant time period, FMC benefitted by approximately $23.8 million as a result of these payments.

Turkey

Relevant Entities and Individuals

82.FMC Turkey was a wholly owned subsidiary of FMC under the responsibility of FMC’s EMEA Division. FMC operated in Turkey through FMC Turkey, and FMC Turkey provided FMC services and products in Turkey. FMC Turkey and its employees were “agents” of an issuer within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(a).

83.“FMC Turkey Executive 1,” an individual whose identity is known to the Department and to FMC, was a high-level executive at FMC Turkey.

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84.“Turkish Doctor 1,” an individual whose identity is known to the Department and to FMC, was a prominent nephrology doctor, a professor at a public university.

85.“Joint Venture 1,” an entity whose identity is known to the Department and to FMC, was a partnership between FMC Turkey and Turkish Doctor 1.

86.“FMC Turkey Distributor,” an individual whose identity is known to the Department and to FMC, was a former distributor of FMC Turkey products.

87.“Turkish Doctor 2,” an individual whose identity is known to the Department and to FMC, was a prominent nephrologist at a Turkish state-owned hospital.

88.“Joint Venture 2,” an entity whose identity is known to the Department and to FMC, was a partnership between FMC Turkey and Turkish Doctor 2.

Conduct Relevant to Turkey

89.Between in or around 2005 until in or around 2014, FMC Turkey entered into joint ventures with publicly-employed doctors in exchange for those doctors directing business from their public employer to FMC Turkey clinics.

90.Although FMC Turkey primarily developed and proposed the joint ventures, in some instances, FMC Turkey sought approval from FMC managers in Germany, including the FMC Acquisition Investment Committee (“AIC”) and, in some cases, the FMC BoM to establish the joint ventures.

91.In a presentation from approximately 2007, FMC Turkey Executive 1 set forth FMC Turkey’s strategy to increase patient volumes and growth, and discussed a need “to select and find ways to work with nephrologists who refer the patients from the important state hospitals.” The presentation also included a proposal to pay salaries and bonuses to publicly-employed doctors or enter into joint ventures in which the doctors would be given “20-30% shares.”

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92.For example, in or around 2006, FMC Turkey entered into Joint Venture 1 with Turkish Doctor 1, who received 35% of the joint venture shares (worth approximately $74,000 at the time) at the time it was formed. Employees of FMC Turkey understood that Turkish Doctor 1’s shares were held in the name of a former FMC Turkey distributor, as demonstrated through numerous emails. For example, on or about November 25, 2008, FMC Turkey Executive 1 emailed FMC Executive 1 and another FMC executive, noting that they had established the joint venture and given a 35% share to Turkish Doctor 1 in the name of former FMC Turkey distributor.

93.Similarly, in another email sent on or about November 25, 2008, FMC Turkey Executive 1 noted to FMC Executive 1 and another FMC executive that Turkish Doctor 1 would not be able to contribute to a capital increase in Joint Venture 1 and, as a result, they intended to decrease his shares from 35% to 25%. When the other FMC executive questioned why “they have to be so cooperative to keep [Turkish Doctor 1] when he’s not paying anything,” FMC Turkey Executive 1 responded that Turkish Doctor 1 has strong relations with state hospitals and that they are “not in the position to start a fight with this professor by diluting his shares.”

94.In or around 2010, FMC Turkey purchased Turkish Doctor 1’s shares in the joint venture for approximately $356,000 (which was concealed by paying Turkish Doctor 1 through a former FMC Turkey distributor), in part based on patient enrollment. FMC Turkey and FMC never required Turkish Doctor 1 to pay for his shares in the joint venture resulting in $356,000 profit to Turkish Doctor 1.

95.In another example, in or around June 2012, FMC Turkey entered into Joint Venture 2 with Turkish Doctor 2. FMC Turkey understood that it could not hire Turkish Doctor 2 as an employee, but evaded this issue by entering into a joint venture relationship with him. Indeed, FMC Turkey paid for Turkish Doctor 2’s initial capital contribution for the 20% position,

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which was valued at approximately $111,000. FMC Turkey’s approval request to the FMC BoM stated that Turkish Doctor 2 would pay for his shares through a deduction of proceeds from the future sale of the 20% interest in the venture instead of paying up front. Turkish Doctor 2 never paid for his shares through this proposed deduction.

96.In or around August 2012, FMC Turkey entered into a share purchase agreement to purchase Turkish Doctor 2’s 20% interest, which was predicated on Turkish Doctor 2 doubling the number of patients being treated at the clinic. Pursuant to the share purchase agreement Turkish Doctor 2 also received approximately $63,000 in payments between 2012 and 2013 based on the number of patients treated. In addition to these payments, in or around 2014, FMC Turkey purchased Turkish Doctor 2’s shares in the joint venture for approximately $451,000 without requiring Turkish Doctor 2 to pay for his shares. Thus, the joint venture served as a means for FMC to pay Turkish Doctor 2 approximately $451,000 at the same time he was involved in referring patients from his state-owned employer to the clinic.

97.As a result of FMC’s lack of reasonable internal controls, improper payments were made to publicly-employed doctors in Turkey through joint ventures and FMC benefitted by approximately $1.3 million during the relevant period.

West Africa

Relevant Entities and Individuals

98.FMC’s operation in West Africa fell under the responsibility of FMC’s EMEA division. FMC operated in West Africa through FMC employees based in Germany and Morocco and these FMC employees provided FMC services and products in French-speaking West Africa, including Benin, Burkina Faso, Cameroon, Ivory Coast, Niger, Gabon, Chad, and Senegal. FMC

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Germany and its employees were “agents” of an issuer within the meaning of the FCPA, Title 15, United States Code, Section 78dd-1(a).

99.“Gabon State-Owned Hospital 1,” an entity whose identity is known to the Department and to FMC, was a state-owned and controlled hospital located in Libreville, Gabon.

100.“Gabon State-Owned Hospital Employee 1,” an individual whose identity is known to the Department and to FMC, is a high-level executive at Gabon State-Owned Hospital 1 responsible for finances.

101.“Gabon State-Owned Hospital Employee 2,” an individual whose identity is known to the Department and to FMC, is a high-level executive at Gabon State-Owned Hospital 1 responsible for accounting.

102.“Gabon State-Owned Hospital Employee 3,” an individual whose identity is known to the Department and to FMC, is a high-level executive Gabon State-Owned Hospital 1 responsible for accounting.

103.“Gabon State-Owned Hospital Employee 4,” an individual whose identity is known to the Department and to FMC, is a technician at Gabon State-Owned Hospital 1.

Conduct Relevant to West Africa

104.Between in or around 2007 and in or around 2016, FMC knowingly paid bribes to publicly-employed health officials in Gabon and other West African countries to obtain and retain business, specifically consisting of direct payments, concealing payments through third parties, and concealing payments through a third-party distributorship.

105.For example, as part of the scheme, FMC employees met with representatives of Gabon State-Owned Hospital 1 and proposed a five-year agreement that would include the “prices plus the commission” that the officials would receive for each kit sold. On or about October 20,

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2006 an FMC employee responsible for sales in West Africa reported to FMC Employee 1, stating that the agreement would provide for a €12 commission for each kit sold, which was intended as a “commission for the three persons who sign the contract with us.”

106.In or around January 2007, FMC and Gabon State-Owned Hospital 1 entered into a five year contract in which FMC would provide 10,000 kits per year, priced at €72 per kit. The contract was signed by FMC Employee 1, another FMC employee, Gabon State-Owned Hospital Employee 1, Gabon State-Owned Hospital Employee 2, and Gabon State-Owned Hospital Employee 3. In exchange for their assistance in obtaining this contract, FMC employees directed approximately $400,000 to the officials employed by Gabon State-Owned Hospital 1 through sham consultancy agreements designed to hide the “commissions.”

107.The commission payments were booked to the General Ledger account, as translated into English, as “Provision for export commissions” when in fact they were bribes.

108.In or around February 2009, FMC entered into a new contract with Gabon State-Owned Hospital 1. The contract provided a minimum purchase by Gabon State-Owned Hospital of 13,000 kits per year, over five years, with a new cost per kit of €92.5.

109.In or around the summer of 2010, FMC entered into a service agreement with Company B. The service agreement was signed by two FMC executives and a Company B Executive, and was backdated to January 2009. Under the agreement, FMC paid Company B €800 per day for purported services in West Africa. In reality, the payments to Company B were intended to paper over the “commissions” to state-owned employees who previously received direct payments from FMC, as well as a 15% fee for Company B.

110.In addition to the conduct described above for Gabon, between in or around 2010 until in or around 2013, FMC paid Company B to make similar improper “commission” payments

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to state-owned hospital employees in the West African countries of Benin, Burkina Faso, Senegal, Ivory Coast, and Niger. Further, between in or around 2010 and in or around 2012, FMC also paid Company C to make improper “commission” payments to state-owned hospital employees in Cameroon.

111.Finally, in or around August 2012, FMC shifted its scheme from service agreements to a distributorship model with Company B and entered into a new contract with the MOH for Gabon specifying that sales may go through Company B. Under this contract, Company B would now distribute FMC products to the MOH of Gabon as a conduit entity. Records show that Company B did not actually distribute FMC products and that FMC continued to ship the products directly to the MOH. The improper “commission” payments to state-owned hospital employees continued with the cost now concealed within the price per kit. For example, Company B invoiced Gabon State-Owned Hospital 1 €92.50 per kit while FMC invoiced Company B only € 54 per kit, allowing Company B to keep the difference of €38.50 per kit. FMC’s relationship with Company B continued until in or around 2016.

112.As a result of improper payments made to publicly-employed doctors in West Africa through direct payments, concealing payments through third parties, and concealing payments through a third-party distributorship, FMC benefitted by approximately $56.7 million during the relevant period.

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ATTACHMENT B

CORPORATE COMPLIANCE PROGRAM

In order to address any deficiencies in its internal controls, compliance code, policies, and procedures regarding compliance with the Foreign Corrupt Practices Act (“FCPA”), 15 U.S.C. §§ 78dd-1, et seq., and other applicable anti-corruption laws, Fresenius Medical Care AG & Co. KGaA (the “Company”) agrees to continue to conduct, in a manner consistent with all of its obligations under this Agreement, appropriate reviews of its existing internal controls, policies, and procedures.

Where necessary and appropriate, the Company agrees to adopt new or to modify existing internal controls, compliance code, policies, and procedures in order to ensure that it maintains: (a) a system of internal accounting controls designed to ensure that the Company makes and keeps fair and accurate books, records, and accounts; and (b) a rigorous anti-corruption compliance program that includes policies and procedures designed to detect and deter violations of the FCPA and other applicable anti-corruption laws. At a minimum, this should include, but not be limited to, the following elements to the extent they are not already part of the Company’s existing internal controls, compliance code, policies, and procedures:

High-Level Commitment

1.The Company will ensure that its Management Board provides strong, explicit, and visible support and commitment to its corporate policy against violations of the anti-corruption laws and its compliance code.

Policies and Procedures

2.The Company will develop and promulgate a clearly articulated and visible corporate policy against violations of the FCPA and other applicable foreign law counterparts

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(collectively, the “anti-corruption laws,”), which policy shall be memorialized in a written compliance code.

3.The Company will develop and promulgate compliance policies and procedures designed to reduce the prospect of violations of the anti-corruption laws and the Company’s compliance code, and the Company will take appropriate measures to encourage and support the observance of ethics and compliance policies and procedures against violation of the anti-corruption laws by personnel at all levels of the Company. These anti-corruption policies and procedures shall apply to all directors, officers, and employees and, where necessary and appropriate, outside parties acting on behalf of the Company in a foreign jurisdiction, including but not limited to, agents and intermediaries, consultants, representatives, distributors, teaming partners, contractors and suppliers, consortia, and joint venture partners (collectively, “agents and business partners”). The Company shall notify all employees that compliance with the policies and procedures is the duty of individuals at all levels of the company. Such policies and procedures shall address:

a.gifts;

b.hospitality, entertainment, and expenses;

c.customer travel;

d.political contributions;

e.charitable donations and sponsorships;

f.facilitation payments; and

g.solicitation and extortion.

4.The Company will ensure that it has a system of financial and accounting procedures, including a system of internal controls, reasonably designed to ensure the maintenance

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of fair and accurate books, records, and accounts. This system should be designed to provide reasonable assurances that:

a.transactions are executed in accordance with management’s general or specific authorization;

b.transactions are recorded as necessary to permit preparation of financial statements in conformity with generally accepted accounting principles or any other criteria applicable to such statements, and to maintain accountability for assets;

c.access to assets is permitted only in accordance with management’s general or specific authorization; and

d.the recorded accountability for assets is compared with the existing assets at reasonable intervals and appropriate action is taken with respect to any differences.

Periodic Risk-Based Review

5.The Company will develop these compliance policies and procedures on the basis of a periodic risk assessment addressing the individual circumstances of the Company, in particular the foreign bribery risks facing the Company, including, but not limited to, its geographical organization, interactions with various types and levels of government officials, industrial sectors of operation, involvement in joint venture arrangements, importance of licenses and permits in the Company’s operations, degree of governmental oversight and inspection, and volume and importance of goods and personnel clearing through customs and immigration.

6.The Company shall review its anti-corruption compliance policies and procedures no less than annually and update them as appropriate to ensure their continued effectiveness, taking into account relevant developments in the field and evolving international and industry standards.

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Proper Oversight and Independence

7.The Company will assign responsibility to one or more senior corporate executives of the Company for the implementation and oversight of the Company’s anti-corruption compliance code, policies, and procedures. Such corporate official(s) shall have the authority to report directly to independent monitoring bodies, including internal audit, the Company’s Management Board, or any appropriate committee of the Management Board, and shall have an adequate level of autonomy from management as well as sufficient resources and authority to maintain such autonomy.

Training and Guidance

8.The Company will implement mechanisms designed to ensure that its anti-corruption compliance code, policies, and procedures are effectively communicated to all directors, officers, employees, and, where necessary and appropriate, agents and business partners. These mechanisms shall include: (a) periodic training for all directors and officers, all employees in positions of leadership or trust, positions that require such training (e.g., internal audit, sales, legal, compliance, finance), or positions that otherwise pose a corruption risk to the Company, and, where necessary and appropriate, agents and business partners; and (b) corresponding certifications by all such directors, officers, employees, agents, and business partners, certifying compliance with the training requirements.

9.The Company will maintain, or where necessary establish, an effective system for providing guidance and advice to directors, officers, employees, and, where necessary and appropriate, agents and business partners, on complying with the Company’s anti-corruption compliance code, policies, and procedures, including when they need advice on an urgent basis or in any foreign jurisdiction in which the Company operates.

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Internal Reporting and Investigation

10.The Company will maintain, or where necessary establish, an effective system for internal and, where possible, confidential reporting by, and protection of, directors, officers, employees, and, where appropriate, agents and business partners concerning violations of the anti-corruption laws or the Company’s anti-corruption compliance code, policies, and procedures.

11.The Company will maintain, or where necessary establish, an effective and reliable process with sufficient resources for responding to, investigating, and documenting allegations of violations of the anti-corruption laws or the Company’s anti-corruption compliance code, policies, and procedures.

Enforcement and Discipline

12.The Company will implement mechanisms designed to effectively enforce its compliance code, policies, and procedures, including appropriately incentivizing compliance and disciplining violations.

13.The Company will institute appropriate disciplinary procedures to address, among other things, violations of the anti-corruption laws and the Company’s anti-corruption compliance code, policies, and procedures by the Company’s directors, officers, and employees. Such procedures should be applied consistently and fairly, regardless of the position held by, or perceived importance of, the director, officer, or employee. The Company shall implement procedures to ensure that where misconduct is discovered, reasonable steps are taken to remedy the harm resulting from such misconduct, and to ensure that appropriate steps are taken to prevent further similar misconduct, including assessing the internal controls, compliance code, policies, and procedures and making modifications necessary to ensure the overall anti-corruption compliance program is effective.

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Third-Party Relationships

14.The Company will institute appropriate risk-based due diligence and compliance requirements pertaining to the retention and oversight of all agents and business partners, including:

a.properly documented due diligence pertaining to the hiring and appropriate and regular oversight of agents and business partners;

b.informing agents and business partners of the Company’s commitment to abiding by anti-corruption laws, and of the Company’s anti-corruption compliance code, policies, and procedures; and

c.seeking a reciprocal commitment from agents and business partners.

15.Where necessary and appropriate, the Company will include standard provisions in agreements, contracts, and renewals thereof with all agents and business partners that are reasonably calculated to prevent violations of the anti-corruption laws, which may, depending upon the circumstances, include: (a) anti-corruption representations and undertakings relating to compliance with the anti-corruption laws; (b) rights to conduct audits of the books and records of the agent or business partner to ensure compliance with the foregoing; and (c) rights to terminate an agent or business partner as a result of any breach of the anti-corruption laws, the Company’s compliance code, policies, or procedures, or the representations and undertakings related to such matters.

Mergers and Acquisitions

16.The Company will develop and implement policies and procedures for mergers and acquisitions requiring that the Company conduct appropriate risk-based due diligence on

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potential new business entities, including appropriate FCPA and anti-corruption due diligence by legal, accounting, and compliance personnel.

17.The Company will ensure that the Company’s compliance code, policies, and procedures regarding the anti-corruption laws apply as quickly as is practicable to newly acquired businesses or entities merged with the Company and will promptly:

a.train the directors, officers, employees, agents, and business partners consistent with Paragraph 8 above on the anti-corruption laws and the Company’s compliance code, policies, and procedures regarding anti-corruption laws; and

b.where warranted, conduct an FCPA-specific audit of all newly acquired or merged businesses as quickly as practicable.

Monitoring and Testing

18.The Company will conduct periodic reviews and testing of its anti-corruption compliance code, policies, and procedures designed to evaluate and improve their effectiveness in preventing and detecting violations of anti-corruption laws and the Company’s anti-corruption code, policies, and procedures, taking into account relevant developments in the field and evolving international and industry standards.

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ATTACHMENT C

CORPORATE COMPLIANCE REPORTING

INDEPENDENT COMPLIANCE MONITOR

The duties and authority of the Independent Compliance Monitor (the “Monitor”), and the obligations of Fresenius Medical Care AG & Co. KGaA (the “Company”), on behalf of itself and its subsidiaries and affiliates, with respect to the Monitor and the United States Department of Justice, Criminal Division, Fraud Section and the United States Attorney’s Office for the District of Massachusetts (collectively, the “Department”), are as described below:

1.The Company will retain the Monitor for a period of not less than two years (the “Term of the Monitorship”), unless the early termination provisions of Paragraph 3 of the Non- Prosecution Agreement (the “Agreement”) are triggered. Subject to certain conditions specified below that would, in the sole discretion of the Department, allow for an extension of the Term of the Monitorship, the Monitor shall be retained until the criteria in Paragraphs 19-20 below are satisfied or the Agreement expires, whichever occurs first.

Monitor’s Mandate

2.The Monitor’s primary responsibility is to assess and monitor the Company’s compliance with the terms of the Agreement, including the Corporate Compliance Program in Attachment B, so as to specifically address and reduce the risk of any recurrence of the Company’s misconduct. During the Term of the Monitorship, the Monitor will evaluate, in the manner set forth below, the effectiveness of the internal accounting controls, record-keeping, and financial reporting policies and procedures of the Company as they relate to the Company’s current and ongoing compliance with the FCPA and other applicable anti-corruption laws (collectively, the “anti-corruption laws”), except for Fresenius Medical Care Holdings, Inc. and its subsidiaries, to

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the extent that those entities and/or their employees and agents operate exclusively within the United States, and take such reasonable steps as, in his or her view, may be necessary to fulfill the foregoing mandate (the “Mandate”). Nothing in this Mandate precludes the Monitor from seeking a briefing on the Company’s compliance program in the United States. This Mandate shall include an assessment of the Management Board’s and senior management’s commitment to, and effective implementation of, the corporate compliance program described in Attachment B of the Agreement.

Company’s Obligations

3.The Company shall cooperate fully with the Monitor, and the Monitor shall have the authority to take such reasonable steps as, in his or her view, may be necessary to be fully informed about the Company’s compliance program in accordance with the principles set forth herein and applicable law, including applicable data protection and labor laws and regulations. To that end, the Company shall: facilitate the Monitor’s access to the Company’s documents and resources; not limit such access, except as provided in Paragraphs 5-6; and provide guidance on applicable local law (such as relevant data protection and labor laws). The Company shall provide the Monitor with access to all information, documents, records, facilities, and employees, as reasonably requested by the Monitor, that fall within the scope of the Mandate of the Monitor under the Agreement. The Company shall use its best efforts to provide the Monitor with access to the Company’s former employees and its third-party vendors, agents, and consultants.

4.Any disclosure by the Company to the Monitor concerning corrupt payments, false books and records, and internal accounting control failures shall not relieve the Company of any otherwise applicable obligation to truthfully disclose such matters to the Department, pursuant to the Agreement.

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Withholding Access

5.The parties agree that no attorney-client relationship shall be formed between the Company and the Monitor. In the event that the Company seeks to withhold from the Monitor access to information, documents, records, facilities, or current or former employees of the Company that may be subject to a claim of attorney-client privilege or to the attorney work-product doctrine, or where the Company reasonably believes production would otherwise be inconsistent with applicable law, the Company shall work cooperatively with the Monitor to resolve the matter to the satisfaction of the Monitor.

6.If the matter cannot be resolved, at the request of the Monitor, the Company shall promptly provide written notice to the Monitor and the Department. Such notice shall include a general description of the nature of the information, documents, records, facilities or current or former employees that are being withheld, as well as the legal basis for withholding access. The Department may then consider whether to make a further request for access to such information, documents, records, facilities, or employees.

Monitor’s Coordination with the
Company and Review Methodology

7.In carrying out the Mandate, to the extent appropriate under the circumstances, the Monitor should coordinate with Company personnel, including in-house counsel, compliance personnel, and internal auditors, on an ongoing basis. The Monitor may rely on the product of the Company’s processes, such as the results of studies, reviews, sampling and testing methodologies, audits, and analyses conducted by or on behalf of the Company, as well as the Company’s internal resources (e.g., legal, compliance, and internal audit), which can assist the Monitor in carrying out the Mandate through increased efficiency and Company-specific expertise, provided that the Monitor has confidence in the quality of those resources.

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8.The Monitor’s reviews should use a risk-based approach, and thus, the Monitor is not expected to conduct a comprehensive review of all business lines, all business activities, or all markets. In carrying out the Mandate, the Monitor should consider, for instance, risks presented by: (a) the countries and industries in which the Company operates, other than Fresenius Medical Care Holdings, Inc. and its subsidiaries, to the extent that those entities and/or their employees and agents operate exclusively within the United States; (b) current and future business opportunities and transactions; (c) current and potential business partners, including third parties and joint ventures, and the business rationale for such relationships; (d) the Company’s gifts, travel, and entertainment interactions with foreign officials; and (e) the Company’s involvement with foreign officials, including the amount of foreign government regulation and oversight of the Company, such as licensing and permitting, and the Company’s exposure to customs and immigration issues in conducting its business affairs.

9.In undertaking the reviews to carry out the Mandate, the Monitor shall formulate conclusions based on, among other things: (a) inspection of relevant documents, including the Company’s current anti-corruption policies and procedures; (b) on-site observation of selected systems and procedures of the Company at sample sites, including internal accounting controls, record-keeping, and internal audit procedures; (c) meetings with, and interviews of, relevant current and, where appropriate, former directors, officers, employees, business partners, agents, and other persons at mutually convenient times and places; and (d) analyses, studies, and testing of the Company’s compliance program.

Monitor’s Written Work Plans

10.To carry out the Mandate, during the Term of the Monitorship, the Monitor shall conduct an initial review and prepare an initial report, followed by at least one follow-up review

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and report as described in Paragraphs 16-18 below. With respect to the initial report, after consultation with the Company and the Department, the Monitor shall prepare the first written work plan within thirty (30) calendar days of being retained, and the Company and the Department shall provide comments within fifteen (15) calendar days after receipt of the written work plan. With respect to each follow-up report, after consultation with the Company and the Department, the Monitor shall prepare a written work plan at least thirty (30) calendar days prior to commencing a review, and the Company and the Department shall provide comments within fifteen calendar days after receipt of the written work plan. Any disputes between the Company and the Monitor with respect to any written work plan shall be decided by the Department in its sole discretion.

11.All written work plans shall identify with reasonable specificity the activities the Monitor plans to undertake in execution of the Mandate, including a written request for documents. The Monitor’s work plan for the initial review shall include such steps as are reasonably necessary to conduct an effective initial review in accordance with the Mandate, including by developing an understanding, to the extent the Monitor deems appropriate, of the facts and circumstances surrounding any prior FCPA violations that gave rise to this Agreement or other applicable anti- corruption laws. In developing such understanding the Monitor is to rely to the extent possible on available information and documents provided by the Company. The Monitor shall not conduct his or her own inquiry into the historical events that gave rise to the Agreement.

Initial Review

12.The initial review shall commence no later than sixty (60) calendar days from the date of the engagement of the Monitor (unless otherwise agreed by the Company, the Monitor, and the Department). The Monitor shall issue a written report within one hundred twenty calendar days of commencing the initial review, setting forth the Monitor’s assessment and, if necessary,

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making recommendations reasonably designed to improve the effectiveness of the Company’s program for ensuring compliance with the anti-corruption laws. The Monitor should consult with the Company concerning his or her findings and recommendations on an ongoing basis and should consider the Company’s comments and input to the extent the Monitor deems appropriate. The Monitor may also choose to share a draft of his or her reports with the Company and the Department prior to finalizing them. The Monitor’s reports need not recite or describe comprehensively the Company’s history or compliance policies, procedures and practices, but rather may focus on those areas with respect to which the Monitor wishes to make recommendations, if any, for improvement or which the Monitor otherwise concludes merit particular attention. The Monitor shall provide the report to the Company’s Management Board and contemporaneously transmit copies to both the (a) Deputy Chief — FCPA Unit, Fraud Section, Criminal Division, U.S. Department of Justice, 1400 New York Avenue N.W., Bond Building, Eleventh Floor, Washington, D.C. 20005; and (b) Chief — Economic Crimes Unit, United States Attorney’s Office, District of Massachusetts, 1 Courthouse Way, Suite 9200, Boston, MA 02210. After consultation with the Company, the Monitor may extend the time period for issuance of the initial report for a brief period of time with prior written approval of the Department.

13.Within one hundred twenty (120) calendar days after receiving the Monitor’s initial report, the Company shall adopt and implement all recommendations in the report, unless, within thirty (30) calendar days of receiving the report, the Company notifies in writing the Monitor and the Department of any recommendations that the Company considers unduly burdensome, inconsistent with applicable law or regulation, impractical, excessively expensive, or otherwise inadvisable. With respect to any such recommendation, the Company need not adopt that recommendation within the one hundred twenty (120) calendar days of receiving the report but

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shall propose in writing to the Monitor and the Department an alternative policy, procedure, or system designed to achieve the same objective or purpose. As to any recommendation on which the Company and the Monitor do not agree, such parties shall attempt in good faith to reach an agreement within fifteen (15) calendar days after the Company serves the written notice.

14.In the event the Company and the Monitor are unable to agree on an acceptable alternative proposal, the Company shall promptly consult with the Department. The Department may consider the Monitor’s recommendation and the Company’s reasons for not adopting the recommendation in determining whether the Company has fully complied with its obligations under the Agreement. Pending such determination, the Company shall not be required to implement any contested recommendation(s).

15.With respect to any recommendation that the Monitor determines cannot reasonably be implemented within one hundred twenty (120) calendar days after receiving the report, the Monitor may extend the time period for implementation with prior written approval of the Department.

Follow-Up Review

16.The follow-up review shall commence no later than one hundred twenty (120) calendar days after the issuance of the initial report (unless otherwise agreed by the Company, the Monitor and the Department). The Monitor shall issue a written follow-up report within one hundred fifty (150) calendar days of commencing the follow-up review, setting forth the Monitor’s assessment and, if necessary, making recommendations in the same fashion as set forth in Paragraph 12 with respect to the initial review. The Monitor shall also certify whether the Company’s compliance program, including its policies and procedures, is reasonably designed and implemented to prevent and detect violations of the anti-corruption laws. After consultation with

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the Company, the Monitor may extend the time period for issuance of the follow-up report for a brief period of time with prior written approval of the Department.

17.Within one hundred twenty (120) calendar days after receiving the Monitor’s follow-up report, the Company shall adopt and implement all recommendations in the report, unless, within thirty (30) calendar days after receiving the report, the Company notifies in writing the Monitor and the Department concerning any recommendations that the Company considers unduly burdensome, inconsistent with applicable law or regulation, impractical, excessively expensive, or otherwise inadvisable. With respect to any such recommendation, the Company need not adopt that recommendation within the one hundred twenty (120) calendar days of receiving the report but shall propose in writing to the Monitor and the Department an alternative policy, procedure, or system designed to achieve the same objective or purpose. As to any recommendation on which the Company and the Monitor do not agree, such parties shall attempt in good faith to reach an agreement within fifteen (15) calendar days after the Company serves the written notice.

18.In the event the Company and the Monitor are unable to agree on an acceptable alternative proposal, the Company shall promptly consult with the Department. The Department may consider the Monitor’s recommendation and the Company’s reasons for not adopting the recommendation in determining whether the Company has fully complied with its obligations under the Agreement. Pending such determination, the Company shall not be required to implement any contested recommendation(s).

Certification of Compliance
and Termination of the Monitorship

19.At the conclusion of the ninety (90) calendar day period following the issuance of the follow-up report, if the Monitor believes that the Company’s compliance program is reasonably

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designed and implemented to detect and prevent violations of the anti-corruption laws and is functioning effectively, the Monitor shall certify the Company’s compliance with its compliance obligations under the Agreement. The Monitor shall then submit to the Department a written report (“Certification Report”) within forty (40) calendar days. The Certification Report shall set forth an overview of the Company’s remediation efforts to date, including the implementation status of the Monitor’s recommendations, and an assessment of the sustainability of the Company’s remediation efforts. The Certification Report should also recommend the scope of the Company’s future self-reporting. Also at the conclusion of the one hundred twenty (120) calendar day period following the issuance of the follow-up report, the Company shall certify in writing to the Department, with a copy to the Monitor, that the Company has adopted and implemented all of the Monitor’s recommendations in the initial and follow-up report(s), or the agreed-upon alternatives. The Monitor or the Company may extend the time period for issuance of the Certification Report or the Company’s certification, respectively, with prior written approval of the Department.

20.At such time as the Department approves the Certification Report and the Company’s certification, the monitorship shall be terminated, and the Company will be permitted to self-report to the Department on its enhanced compliance obligations for the remainder of the term of the Agreement. The Department, however, reserves the right to terminate the monitorship absent certification by the Monitor, upon a showing by the Company that termination is, nevertheless, in the interests of justice.

21.If permitted to self-report to the Department, the Company shall thereafter submit to the Department a written report every six months setting forth a complete description of its remediation efforts to date, its proposals to improve the Company’s internal accounting controls,

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policies, and procedures for ensuring compliance with the anti-corruption laws, and the proposed scope of the subsequent reviews. The report shall be transmitted to both the (a) Deputy Chief — FCPA Unit, Fraud Section, Criminal Division, U.S. Department of Justice, 1400 New York Avenue, N.W., Bond Building, Eleventh Floor, Washington, D.C. 20005, or his or her designee; and (b) Chief — Economic Crimes Unit, United States Attorney’s Office, District of Massachusetts, 1 Courthouse Way, Suite 9200, Boston, MA 02210, or his or her designee. The Company may extend the time period for issuance of the self-report with prior written approval of the Department.

Extension of the Term of the Monitorship

22.If, however, at the conclusion of the ninety (90) calendar-day period following the issuance of the follow-up report, the Department concludes that the Company has not by that time successfully satisfied its compliance obligations under the Agreement, the Term of the Monitorship shall be extended for a reasonable period of time not to exceed one year.

23.Under such circumstances, the Monitor shall commence the second follow-up review no later than sixty (60) calendar days after the Department concludes that the Company has not successfully satisfied its compliance obligations under the Agreement (unless otherwise agreed by the Company, the Monitor, and the Department). The Monitor shall issue a written follow-up report within one hundred twenty (120) calendar days of commencing the second follow-up review in the same fashion as set forth in Paragraph 12 with respect to the initial review and in accordance with the procedures for follow-up reports set forth in Paragraphs 16-18. A determination to terminate the monitorship shall then be made in accordance with Paragraphs 19-20.

24.If, after completing the second follow-up review, the Department again concludes that the Company has not successfully satisfied its obligations under the Agreement with respect to the Monitor’s Mandate, the Term of the Monitorship shall be extended until expiration of the

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Agreement, and the Monitor shall commence a third follow-up review within sixty (60) calendar days after the Department concludes that the Company has not successfully satisfied its compliance obligations under the Agreement (unless otherwise agreed by the Company, the Monitor, and the Department). The Monitor shall issue a written follow-up report within one hundred twenty (120) calendar days of commencing the third follow-up review in the same fashion as set forth in Paragraph 12 with respect to the initial review and in accordance with the procedures for follow-up reports set forth in Paragraphs 16-18.

Monitor’s Discovery of Potential or Actual Misconduct

25.(a)Except as set forth below in sub-paragraphs (b) and (c), should the Monitor discover during the course of his or her engagement that:

·improper payments or anything else of value may have been offered, promised, made, or authorized by any entity or person within the Company or any entity or person working, directly or indirectly, for or on behalf of the Company;

·the Company may have maintained false books, records or accounts; or,

·the Company may have failed to implement a system of internal accounting controls that is sufficient to accurately record the Company’s transactions (collectively, “Potential Misconduct”), the Monitor shall immediately report the Potential Misconduct to the Company’s General Counsel, Chief Compliance Officer, and/or Audit Committee for further action, unless the Potential Misconduct was already so disclosed. The Monitor also may report Potential Misconduct to the Department at any time, and shall report Potential Misconduct to the Department when it requests the information.

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(b)If the Monitor believes that any Potential Misconduct actually occurred or may constitute a criminal or regulatory violation (“Actual Misconduct”), the Monitor shall immediately report the Actual Misconduct to the Department. When the Monitor discovers Actual Misconduct, the Monitor shall disclose the Actual Misconduct solely to the Department, and, in such cases, disclosure of the Actual Misconduct to the General Counsel, Chief Compliance Officer, and/or the Audit Committee of the Company should occur as the Department and the Monitor deem appropriate under the circumstances.

(c)The Monitor shall address in his or her reports the appropriateness of the Company’s response to disclosed Potential Misconduct or Actual Misconduct, whether previously disclosed to the Department or not. Further, if the Company or any entity or person working directly or indirectly on behalf of the Company withholds information necessary for the performance of the Monitor’s responsibilities and the Monitor believes that such withholding is without just cause, the Monitor shall also immediately disclose that fact to the Department and address the Company’s failure to disclose the necessary information in his or her reports.

(d)The Company nor anyone acting on its behalf shall take any action to retaliate against the Monitor for any such disclosures or for any other reason.

Meetings During Pendency of Monitorship

26.The Monitor shall meet with the Department within thirty (30) calendar days after providing each report to the Department to discuss the report, to be followed by a meeting between the Department, the Monitor, and the Company.

27.At least annually, and more frequently if appropriate, representatives from the Company and the Department will meet together to discuss the monitorship and any suggestions,

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comments, or improvements the Company may wish to discuss with or propose to the Department, including with respect to the scope or costs of the monitorship.

Contemplated Confidentiality of Monitor’s Reports

28.The reports will likely include proprietary, financial, confidential, and competitive business information. Moreover, public disclosure of the reports could discourage cooperation, or impede pending or potential government investigations and thus undermine the objectives of the monitorship. For these reasons, among others, the reports and the contents thereof are intended to remain and shall remain non-public, except as otherwise agreed to by the parties in writing, or except to the extent that the Department determines in its sole discretion that disclosure would be in furtherance of the Department’s discharge of its duties and responsibilities or is otherwise required by law.

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EX-4.16

Exhibit 4.16

UNITED STATES OF AMERICA

Before the

SECURITIES AND EXCHANGE COMMISSION

SECURITIES EXCHANGE ACT OF 1934

Release No. 85468 / March 29, 2019

ACCOUNTING AND AUDITING ENFORCEMENT

Release No. 4033 / March 29, 2019

ADMINISTRATIVE PROCEEDING

File No. 3-19126

	CORRECTED ORDER INSTITUTING
In the Matter of	CEASE-AND-DESIST PROCEEDINGS
	PURSUANT TO SECTION 21C OF THE
Fresenius Medical Care AG	SECURITIES EXCHANGE ACT OF 1934,
& Co. KGaA	MAKING FINDINGS, AND IMPOSING A
	CEASE-AND-DESIST ORDER
Respondent.

I.

The Securities and Exchange Commission (“Commission”) deems it appropriate that cease-and-desist proceedings be, and hereby are, instituted pursuant to Section 21C of the Securities Exchange Act of 1934 (“Exchange Act”), against Fresenius Medical Care AG & Co. KGaA (“FMC” or “Respondent”).

II.

In anticipation of the institution of these proceedings, Respondent has submitted an Offer of Settlement (the “Offer”) which the Commission has determined to accept. Solely for the purpose of these proceedings and any other proceedings brought by or on behalf of the Commission, or to which the Commission is a party, Respondent admits the Commission’s jurisdiction over it and the subject matter of these proceedings, and consents to the entry of this Order Instituting Cease-and-Desist Proceedings Pursuant to Section 21C of the Securities

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Exchange Act of 1934, Making Findings, and Imposing a Cease-and-Desist Order (“Order”), as set forth below.

III.

On the basis of this Order and Respondent’s Offer, the Commission finds that:

Summary

1.This matter concerns violations of the anti-bribery, books and records and internal accounting controls provisions of the Foreign Corrupt Practices Act of 1977 (the “FCPA”) [15 U.S.C. 78dd] by FMC, a world-wide provider of products and services for individuals with chronic kidney failure headquartered in Bad Homburg, Germany. From at least 2009 through 2016, millions of dollars in bribes were paid to procure business throughout its operations, including in Saudi Arabia, Angola, and eight countries in the West African region. Further, in FMC’s operations in those countries, as well as Turkey, Spain, China, Serbia, Bosnia, and Mexico, payments were not accurately reflected in FMC’s books and records. FMC also failed to have sufficient internal accounting controls in place, which contributed to the misconduct continuing for many years across multiple continents. In connection with the misconduct described in Saudi Arabia, West Africa, and Angola, FMC employees and agents utilized the means and instrumentalities of U.S. interstate commerce, including the use of internet-based email accounts hosted by numerous service providers located in the United States. The company benefitted by over $135 million as a result of the improper payments.

Respondent

2.FMC is a provider of products and services for individuals with chronic kidney failure. FMC, operating in over 150 countries, is incorporated under the federal laws of Germany and is headquartered in Bad Homburg. Since 1996, FMC’s American Depositary Shares traded on the New York Stock Exchange under the ticker “FMS” and are registered with the Commission pursuant to Section 12(b). The company files periodic reports, including Form 20-F, with the Commission pursuant to Section 13(a) of the Exchange Act.

Relevant Entities

3.The misconduct took place in FMC subsidiaries in Morocco, Portugal, Angola, Turkey, Spain, China, Serbia, Bosnia, and Mexico. During the relevant time period FMC’s West Africa business was managed and operated from Fresenius Medical Care Deutschland GmbH, a limited liability company organized under the federal laws of Germany, and was later operated from FMC Morocco. The financials for each subsidiary were consolidated with those of FMC.

4.Saudi Advanced Renal Services Ltd. (“SRS”) is a wholly consolidated distributor that promotes and sells FMC’s products in the Kingdom of Saudi Arabia pursuant to a Management Assistance Agreement and an Agency and Distributorship Agreement with FMC. SRS’s financial statements are consolidated with those of FMC.

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FACTS

Background

5.FMC failed to promptly address numerous red flags of corruption in its operations that were known since the early 2000s. This includes employees making improper payments through a variety of schemes, including using sham consulting contracts, falsifying documents, and funneling bribes through a system of third party intermediaries. FMC failed to properly assess and manage its worldwide risks, and devoted insufficient resources to compliance. In many instances, senior management actively thwarted compliance efforts, personally engaging in corruption schemes and directing employees to destroy records of the misconduct. The improper conduct continued for years in Saudi Arabia, Morocco, eight countries in the West African region, Angola, Turkey, Spain, China, Serbia, Bosnia, and Mexico.

Conduct Relevant to Saudi Arabia

6.From 2007 to 2012, FMC’s wholly consolidated distributor Saudi Advanced Renal Services (“SRS”) paid over $4.9 million in improper payments to publicly-employed doctors (“HCPs”), government officials and others in Saudi Arabia to retain or obtain business. FMC knew of the high risks in the business, but failed to ensure that sufficient internal accounting controls were in place. FMC also failed to assign a compliance officer to the region. In 2009 and early 2011, senior officials at FMC’s German headquarters received reports from a senior SRS finance officer that the SRS General Manager (“GM”) submitted false invoices and that there was a practice of making improper marketing and travel expenditures without proper documentation. The conduct continued and by December 2011, the SRS finance officer elevated his complaints to the FMC controller and the head of Internal Audit. The conduct continued until late 2012 when remedial action was first initiated and the GM was terminated in 2013. Overall, FMC benefitted by over $40 million as a result of the corruption schemes in Saudi Arabia.

7.Payments were made to private and public HCPs, other government officials, and high ranking officials at a Saudi Technical Organization that was acting in an official capacity for or on behalf of the Kingdom of Saudi Arabia when it reviewed and approved dialysis products for use in tenders. Between 2007 and 2012, SRS generated approximately $1.77 million through a check writing scheme. Checks were written to SRS employees who cashed the checks and handed the cash to the SRS GM. SRS employees sometimes stored bags of cash in a safe without proper documentation. The transactions were falsely recorded as project marketing expenses and collection commissions in SRS’ books and records, which FMC consolidated. In addition to false descriptions, the transactions lacked appropriate support for the accounting entries.

8.Through another scheme, SRS entered into a purported collection commission agreement with the relative of a MOH employee in connection with bidding on MOH dialysis machine tenders. While SRS had salaried employees that collected overdue receivables from FMC

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customers, the MOH relative was paid over $200,000 for work already performed by these employees — which was more than the combined total salary paid to these same employees. As a result, FMC won the tender.

9.A variety of other questionable business schemes included: i) sham consulting agreements with doctors for services never performed, ii) payments to third party agents in which doctors had beneficial interest, and iii) improper travel, entertainment, and gifts to doctors. FMC failed to conduct due diligence on the doctors and agents, or take steps to ensure that agreed upon services were provided.

10.Some specific examples of the methods used by FMC to make illicit payments to doctors in Saudi Arabia are as follows:

·Improper payments to Doctor A, a high-ranking official at Saudi Technical Organization, who according to one email, played a critical role in FMC’s factory avoiding an inspection that “could have shut down the factory or made it ineligible for tenders.” FMC payments to Doctor A were made through commission agreements with no evidence of services provided. On at least one occasion, it was communicated to SRS and FMC that Doctor A would not sign necessary papers for FMC products because he had not been paid. Doctor A received over $220,000. FMC also employed two of Doctor A’s family members despite knowledge that they were low performers in order to keep the doctor happy.

·Doctor B, another high-ranking official of Saudi Technical Organization and who served as a board member of a prominent charity founded by the Saudi government as well as a director of a company that provided FMC dialyzers to KSA hospitals, received payments pursuant to contracts with entities owned by the doctor or consulting contracts in which there was no evidence that services were performed. Once the contracts expired in 2008, SRS continued to make payments through late 2011 despite the lack of services rendered. Doctor B was paid over $190,000.

·Payments were also made to Doctor C, the CEO of a charity established by a senior Saudi Official and an organization very influential in determining MOH tender award recipients. In one email, the GM stated that Doctor C had informed SRS that those who “will support the charity will get the [MOH] orders as simple as that.” Doctor C and his family were also provided with travel that had no business purpose. In addition on March 15, 2012, Doctor C, using an internet-based email account, emailed SRS GM a draft commission contract for his assistance in securing contracts on behalf of FMC. Doctor C received over $93,000.

·Head Nurse D, for a military hospital, also received cash payments over $213,000 through both the check-to-cash scheme and payments as a purported consultant with no proof of services rendered. SRS made product sales valued at approximately $1.467 million and won three MOH tenders for the military hospital.

·Improper gifts valued over $330,000 were provided to doctors and customers without adequate supporting documentation with the more expensive gifts given to the more influential customers.

11.SRS also made at least $31,000 in improper payments to Saudi customs officials through a third-party agent to avoid or reduce penalties and fees. Invoices from the customs agent mischaracterized the payments as handling charges or miscellaneous expenses. SRS accounting

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records show that $1.76 million of additional payments to the customs agent lacked supporting documentation of services it rendered.

12.Numerous documents were altered, destroyed and falsified in the company’s accounting records to conceal the bribes. The falsification and destruction of records intensified once the company’s internal investigation began. For example, employees created fake accounting records to support a $100,000 check-to-cash transaction related to a bid for a multi-billion dollar MOH tender. The discovery of the $100,000 payment led FMC to withdraw from the tender.

Conduct Relevant to Morocco

13.From 2006 to 2010, an FMC Senior Officer and FMC Sales Manager in Germany engaged in a scheme to pay bribes to a Moroccan Official, the chief nephrologist at two state owned military hospitals, to obtain contracts. They entered into a sham marketing agreement with Moroccan Official to pay him a 10% commission on a contract with Agadir Military Hospital with half to be paid in 2007 and afterwards 12.5% annually. They also agreed to pay him bribes on future projects in Morocco including Rabat Military Hospital.

14.In order to get $123,000 in cash for the Moroccan Official, they devised a scheme in which they paid a fake bonus to a West Africa manager who had a German bank account. The senior FMC Germany managers assisted in backdating the fake bonus payment and amending West Africa manager’s employment contract. West Africa manager then traveled to Germany with the brother of Morocco Official to retrieve the cash from his German bank, which he then gave to the brother for the Moroccan Official. Numerous red flags were overlooked in connection with the bonus payment, including that the bonus payment order and contract amendment were clearly backdated and didn’t have any relevance to the Moroccan business.

15.Less than one month later, in February 2007, FMC Morocco and the Agadir Military Hospital entered into a contract to build and provide products for a dialysis center. From 2008 through March 2012, FMC paid the Moroccan Official an additional $111,000 that was also funneled through fake bonus payments to another FMC manager. All the bribe payments were falsely recorded as commission payments. FMC earned over $2.3 million in revenue from the Agadir hospital project as a result of its bribery scheme.

16.FMC also paid bribes to the Moroccan Official to obtain a 2009 contract at the Rabat Military Hospital, this time using a sham consultant contract with a Moroccan agent associated with Moroccan Official. FMC failed to identify numerous red flags of the corruption, including the fact that the contract was backdated and the purported invoices and endorsed checks from the Moroccan agent were signed by Moroccan Official’s brother, who was also a FMC Morocco manager. Between 2009 and 2010, FMC paid the agent approximately $221,000 intended for Moroccan Official and falsely recorded as marketing expenses.

17.In April 2012, FMC received a whistleblower email raising various allegations about payments to government officials in Morocco. In May 2013, FMC received an anonymous

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complaint about improper payments related to military hospitals located in Agadir and Rabat. Despite the 2012 allegations, and a subsequent email received in July 2013, FMC did not initiate an investigation until January 2014, almost eight months later. After receiving preservation notices in January 2014, some FMC managers destroyed records and deleted files from computers. Overall, FMC benefited by over $3 million as a result of the corruption schemes in Morocco.

Conduct Relevant to Eight West African Countries

18.From 2007 to at least 2016, the same FMC Senior Officer and FMC Sales Manager who orchestrated the bribe schemes in Morocco also engaged in schemes to bribe publicly-employed hospital doctors and administrators in eight West African countries to win FMC business. The countries include Gabon, Cameroon, Benin, Burkina Faso, Chad, Ivory Coast, Niger, and Senegal.

19.In Gabon for example, from October 2007 to 2009, FMC entered into sham consultant agreements with three government hospital executives in return for their assistance in obtaining business and timely payments from product sales to Centre Hospitalier de Libreville (“CHL”), a public hospital. FMC agreed to pay the executives a kickback from each dialysis kit sold to the hospital, paying the executives over $420,000. The bribe payments were falsely recorded as “export commissions.”

20.Beginning in 2009, a third party agent (“West African Supplier”) was used as a conduit for the payments. FMC paid sham “service fees” to West African Supplier, who passed the funds to public HCPs and hospital administrators who had previously been paid through fake consultancy agreements. In May 2010, FMC backdated a service agreement with West African Supplier to January 1, 2009 to better conceal the scheme. From 2009 to 2012, FMC paid West African Supplier over $807,000 intended for the three Gabonese hospital executives, and over $2.1 million intended for doctors in other West African countries.

21.In 2013, West African Supplier’s relationship with FMC was changed from a third party agent to a purported distributor. Rather than pay West African Supplier a service fee, it was provided with a significant margin on sales to the Ministry of Health, CHL, and other West African hospitals to fund the payments to HCPs. Numerous red flags were present that West African Supplier was not a true distributor, including the facts that FMC continued to pay for the delivery of its products to customers and that products were sold to West African Supplier at a greatly reduced price.

22.A FMC Sales Manager raised concerns about FMC’s loss of revenue using West African Supplier as a distributor since they were receiving almost 50% less than what had been invoiced to the hospitals under the prior scheme. The FMC finance director for West Africa explained the loss of revenue was justified since West African Supplier was absorbing the costs of making the phony commission payments to the doctors. With the costs shifted to West African Supplier, FMC books showed expenses were significantly lower, which enabled FMC executives to conceal the bribe payments to the hospital officials. From 2007 to 2016, FMC made improper

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payments in Gabon of approximately $2.3 million either directly to hospital executives or through West African Supplier.

23.FMC also used West African Supplier as a distributor to funnel improper commission payments to doctors in return for product sales with public hospitals in Benin, Burkina Faso, Ivory Coast, Niger, and Senegal. The conduct started in 2007 and continued through at least 2016 when FMC finally terminated the relationship. Throughout the schemes, an FMC West Africa manager used his personal internet-based email accounts to send spreadsheets of bribe payments to hospital employees to FMC Germany supervisors, who ensured that the improper payments were made.

24.From 2007 through 2012, FMC engaged in a similar bribery scheme in Cameroon, but used a different distributor. For example, FMC gave one hospital official 15% of all hospital sales and gave another doctor five euros per dialysis kit sold. From 2007 to 2016, approximately $1.7 million in improper payments to publicly-employed doctors were made from Cameroon Distributor’s margin on the resale of the FMC products.

25.Despite the ongoing investigations of known corruption in multiple nearby countries, FMC failed to implement a sufficient system of internal accounting controls. The bribery schemes in West Africa continued by many of the same FMC managers involved in schemes in other countries. The books and records often lacked adequate documentary support and records were falsified. At the direction of more senior FMC managers, employees altered and destroyed documents and deleted files from computers. Efforts were made to align fictitious stories about the misuse of company funds and lower-level employees were berated if they didn’t destroy their laptops or delete emails. Despite multiple red flags of bribery, FMC’s legal, compliance, and internal audit functions failed to detect and prevent the bribery. Employees were inadequately trained on the company’s anti-corruption policies, and due diligence on third parties was minimal. Overall, FMC benefited by over $40 million as a result of the corruption schemes in West African countries.

Conduct Relevant to Angola

26.In 2004, FMC South Africa explored entering the Angolan dialysis market and generated a report, which was circulated to several FMC employees, including FMC EMEA Executive Vice President, that raised red flags about corruption, most notably that Angola’s Director of Military Services (“Military Official”) received a 20% commission on all dialysis kits sold to military hospitals and that Angolan Reseller was partially owned by government officials. An August 7, 2007 email also warned of “concerns about this direct market entry …. [that] will require some extra precaution, documentation, and management attention.”

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27.In 2008, FMC Portugal began selling products into Angola through Angolan Reseller, which was partly owned by Military Official. Further, FMC did not adequately train its FMC Portugal employees about their dealings with government officials until late 2012. As a result, from 2008 to 2010, bribes were paid in the form of 20% commissions to Military Official through Angolan Reseller.

28.In 2008, FMC created FMC Angola, a separate legal entity intended to make sales into Angola with FMC Portugal retaining management. By 2010, FMC’s relationship with its reseller became fractured. In June 2010, FMC Portugal orchestrated a scheme by which it provided a 35% stake in FMC Angola to prominent Angolan nephrologists, including Military Official, as well as to Angolan Doctor A, a key nephrologist at several Angolan public hospitals that were state-owned entities. In April 2011, FMC granted a power of attorney to execute the share transfer, signed by FMC’s senior legal and compliance officer and an FMC Board of Management member. In January 2012, the shares were transferred to the Angolan officials without their having paid anything in exchange and without any due diligence conducted on the transaction.

29.FMC Angola also entered into a business relationship with Angolan Distributor, owned equally by the sons of Military Officer. First, FMC Angola paid Angolan Distributor $559,972 for “temporary storage” services without a contract or actual services performed. FMC Angola also entered into a contract with Angolan Distributor for “the Provision of Logistics Services” whereby Angolan Distributor was to provide warehousing storage for $77,300 per month, which it received despite never providing the warehousing. FMC Angola in fact already had a lease agreement with another warehouse for the same services at a cost three times less than the costs charged by Angolan Distributor.

30.In June 2012, a draft internal audit report identified that in Angola “overall controls are not functioning as intended” and flagged the Angolan Distributor temporary storage arrangement as a problem since (1) the owner of the company was a shareholder of FMC Angola and (2) there was a total lack of written documentation relating to the services. FMC Legal and Compliance issued a directive in October 2012 freezing all payments to Angolan Distributor. Despite the directive, FMC Angola continued to accrue an additional $878,900 on its books for storage services never rendered, but ultimately was prevented from making the payment.

31.During the freeze period, in addition to the temporary storage contract with Angolan Distributor, FMC made Angolan Distributor its exclusive distributor in Angola of certain products and gave Angolan Distributor one of FMC’s largest clients as a customer. The distributor arrangement thereby created a significant margin, approximately 60% of sales, that was provided to the government officials on over $433,000 in sales.

32.FMC’s senior managers both in Portugal and at the parent level failed to take any timely steps to put a stop to the numerous conflicts raised by the Angolan Distributor relationship. FMC Portugal misled FMC’s internal audit team when they tried to determine if additional relationships with the Angolan Distributor existed. Only upon being instructed in July 2013 to

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“Please freeze the contract” did a senior FMC Portugal manager report that Angolan Distributor had been made a distributor for certain sales without any written contract.

33.Despite this new information, it took until November 2013 for an FMC Legal and Compliance team to review the relationship with Military Officer and the other minority shareholders, including examining “the applicability and justification of dividends for shareholders who have not paid for their interest in the company yet.” FMC Legal and Compliance ultimately concluded in December 2013 that these facts raised “a serious issue under our company’s government procedures and a problematic behavior …. it cannot be questioned that a clear management board directive” was not followed.

34.During the entire time, FMC Angola also made payments to the other minority shareholders, Angolan Doctor A and Angolan Doctor B, both government officials, by entering into consulting contracts with each doctor. Per contracts, Angolan Doctor A was paid $7,500 per month while Angolan Doctor B was paid $3,140 monthly. Angolan Doctor A discussed his consultancy payments with FMC using his personal internet-based email account. Pursuant to these contracts and other salary payments, the doctors received a total of approximately $400,000 from FMC. There was no review of the contracts, no apparent due diligence for conflicts of interest, and no documentation of services. Overall, FMC benefited by over $10 million as a result of the corruption schemes in Angola.

Conduct Relevant to Turkey

35.Between 2005 and 2014, FMC Turkey entered into four separate joint ventures with publicly employed doctors in exchange for those doctors directing business from their public employer to FMC clinics. The doctors did not provide any capital in exchange for their shares. In some cases, doctors’ shares were held in the names of other individuals.

36.In a 2007 internal presentation by a FMC Turkey Vice-President, FMC Turkey set forth a strategy to “select and find ways to work with nephrologists who refer the patients from the important state hospitals.” The presentation included a proposal to pay salaries and bonuses to doctors and provide them with 20-30% shares in joint ventures in exchange for the doctors directing patients to FMC Turkey clinics.

37.In one joint venture involving a prominent doctor at a public hospital in Diyarbakir, a senior manager at FMC Germany wrote: “The professor who is our shareholder has very strong relations with all state authorities including the university and other state hospitals. He is in a way protector of our interests, benefits and operation in the city…. It is very hard to compete and operate in this city if a powerful local is not backing you…. He should stay as our doctor for the health and wellbeing of our system in this city.”

38.After recapitalizing the JV, FMC paid that same doctor over $350,000 for his unpaid interest in the JV, a payment that was based in part on patient enrollment. Then in 2013, FMC Turkey sold the clinic’s assets to the doctor for $830,000. The FMC AG Board of

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Management approved the sale to the doctor in June 2013. As early as at least 2008, FMC senior management were aware that the doctor did not pay for his initial 35% stake in the clinic, and that his shares were being held in someone else’s name.

39.In Erzurum, FMC gave shares to a professor with ties to the Turkish Minister of Health, for referring patients from the university’s clinics. The professor didn’t make any capital contributions for his shares. Ultimately, the professor was paid $323,000 for his 40% stake despite having an outstanding $1,553,000 receivable. FMC Turkey managers discussed the need to make the payment to the professor despite the outstanding receivable. In one exchange among FMC managers, they noted that if they pushed for payment the “[Professor] would immediately turn his back to us and fight with us. Knowing his before mentioned local and country level power, … he would ask the doctors to refer back their patients to state hospital clinic and would also ask the doctors to change to [a FMC competitor] all our PD patients.”

40.In one JV that should have raised significant red flags, the approval request to the FMC Board of Management stated that three doctors “currently working in the dialysis unit of the State Hospital will participate in the startup both as shareholders and employees. It is expected that on opening 60 patients will be referred from the State Hospital to the new clinic.” An email among FMC Turkey senior management noted “Our expectations regarding [Yalova] are high as we have very powerful doctors as partners in these startups. So after a year’s time we expect high patient numbers and at least breakeven results in two years and a profitable operation after then.” None of the doctors contributed capital for their shares.

41.In another example, in Kayseri, FMC Turkey entered into a joint venture with a nephrologist at the state hospital, noting “After 2 years, when the patient number increases preset levels, [the doctor] will sell their shares at preset amounts and their debt to the company will be deducted from this amount and the rest will be paid to them.” In August 2012, FMC Turkey entered into a share purchase agreement to purchase the doctor’s 20% interest, which provided for a purchase price predicated on the number of patients at the clinic. Between 2012 and 2013, the doctor received $63,000. In 2014, he received $451,000 in cash and debt reductions, including debts unrelated to the transaction, for his 20% stake. The payment was based principally on the number of patients enrolled at the clinic at the time of the sale. Overall, FMC benefited by over $1 million as a result of the improper conduct in Turkey.

Conduct Relevant to Spain

42.In certain public tenders between 2007 and 2014, FMC Spain received advance information about tender specifications from publicly employed doctors or administrators. Some of those doctors received improper payments from FMC Spain, including pursuant to consulting agreements, or other benefits such as travel to medical congresses, trips to the United States, donations to fund projects for the doctors, and gifts. In some of these tenders, FMC Spain sought to have the doctors modify aspects of the tenders before the tenders were publicly announced or to direct hospital sales to FMC.

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43.FMC Spain entered into numerous consulting agreements with publicly employed doctors with limited or no due diligence or compliance review. FMC Spain failed to adequately document services performed by doctors who also assisted in obtaining or retaining business. Per the agreements, fixed amounts to be paid to the doctors as “consultants” ranged from $16,000 to approximately $187,000 per year. Sometimes payments were made without a written agreement.

44.For example, in connection with a 2011 tender held by a Valencia state-owned hospital, FMC Spain provided Spain Doctor A with draft tender technical specifications and improvements, a draft scoring methodology, and proposed scores to win the tender. The doctor used his personal email account to agree to some of the proposals with FMC winning the $2 million tender. FMC Spain paid Spain Doctor A over $114,000 between 2008 and 2011. A donation of over $40,000 was made to the hospital’s foundation for the doctor’s training programs, and additional payments were made to the doctor between 2012 and 2014 of $51,600, along travel sponsorships and gifts.

45.According to a December 2014 email between senior FMC managers discussing influencing a 2015 tender at a state-owned hospital in Torrecardenas, the company “got [Spain Doctor B] to decide to support [FMC Spain] to obtain 60% of the adjudication.” Afterward, FMC won 60% of the tender, valued at approximately $3 million. Spain Doctor B received payments from FMC, as well as travel sponsorships and gifts.

46.In some instances, FMC Spain made improper payments to doctors to refer patients to FMC clinics or to use more expensive FMC products. Payments were sometimes made to the doctors indirectly through consortiums owned by the doctors, or by FMC acquiring businesses from the doctors and, thereafter, paying for the use of the buildings in which the businesses were located.

47.For example, FMC Spain made improper payments and provided benefits to six publicly-employed doctors at a Spanish state-owned hospital. FMC Spain acquired a clinic owned by the doctors and then paid them 5% of all subsequent sales, and then later leased space from the doctors. FMC Spain provided additional compensation to the six doctors by entering into a consulting agreement with various forms of businesses owned by the doctors. In total, FMC paid the doctors over $3 million.

48.In 2010, FMC’s Internal Audit team found FMC Spain failed to comply with the company’s policy concerning dealings with foreign officials. In 2014, another Internal Audit report, sent to the same recipients as the 2010 report and the entire FMC Management Board, raised significant red flags about FMC Spain’s payments to public officials, including a lack of documentation for payments related to gifts, donations, sponsorships, commissions, and consultancy payments. The payments to doctors continued until 2015. Many of these payments were improperly recorded as consulting expenses in the books and records of FMC and FMC Spain. Overall, FMC benefited by over $20 million as a result of the improper conduct.

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Conduct Relevant to China

49.From 2007 to 2014, FMC China’s clinic business, Nephrocare, planned and implemented incentive programs in which bonus payments were provided to publicly-employed HCPs with which FMC China had supply agreements. The amounts of the payments were based in part on the number of treatments provided and/or the number of new patients treated, and were taken into consideration in the clinics’ financial models. Certain emails between FMC China personnel suggest that the purpose of the bonus payments was to influence clinic procurement decisions.

50.During this time period, approximately $6.4 million in expense accrual entries were related to such bonuses. However, only $1.7 million of the $6.4 million were reconciled to specific payments. Of the remaining $4.7 million in accruals, the FMC China accounting records failed to adequately tie the accruals and payments. They were recorded either in the year-end bonus or other promotional expenses general ledger accounts, and were generally described in underlying accounting records as “center marketing fees.” The inaccurate record-keeping can be attributed to a senior FMC China manager, who cautioned a fellow employee in 2011 to avoid the use of the term bonus due to “internal legal compliance” concerns when describing these payments.

51.As a general practice, these bonuses would be paid once FMC China received payments it was owed from hospitals for equipment purchases. Payments were made directly to the doctors and nurses responsible for managing the clinics and in positions to influence clinic procurement decisions. Some payments were made in cash, while others were made by wire transfer, and later by a third party agent. FMC China stopped using the third party agent in 2014 after an internal audit report raised concerns that the agent was being paid without corresponding reports showing proof of services rendered. Overall, FMC benefited by over $10 million as a result of the improper conduct.

Conduct Relevant to the Balkan Region (Serbia and Bosnia)

52.From 2007 to 2014, four doctors were paid over $329,000 by FMC while serving on the Serbian Health Fund (“RFZO”) commission or other public tender commission while FMC sought business from those same public commissions. FMC also paid for side trips and extra day accommodations for publicly-employed doctors in connection with travel to medical conferences. For example in 2008, FMC paid $393,000 for travel and accommodations for those same four dual-employed doctors and their spouses to attend a conference in Philadelphia, PA, which included non-business side trips to New York City and Cancun, Mexico. Doctors were also provided laptops and GPS devices.

53.FMC paid dual-employed doctors through a Serbian Agent. In 2010, FMC compliance issued a directive prohibiting the use of Serbian Agent and requiring that service contracts have more specificity to support payments. The directive was circumvented when an FMC Serbia executive approved payments through a third-party transport vendor, who then paid over $170,000 to the dual-employed doctors. FMC also made over $1 million in payments to

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“speed up” the clinic privatization process for four clinics. The consultant’s quarterly reports used to support the payments were drafted by FMC senior managers. In another instance, FMC senior managers gave a distributor, operated by a Serbian doctor, cash payments of over $62,000 plus 10 dialysis machines free of charge, which he resold to FMC for $139,500 to prolong a tender silently and avoid import taxes.

54.In Bosnia, FMC also made improper payments to a prominent Bosnian government doctor to support FMC’s bid to win a government tender to establish and operate clinics in the regions of Srpska and Brcko. In November 2008, the doctor was elected to the Brcko Assembly. A 2008 fourth quarter activity report from the doctor to FMC listed as an achievement for the quarter “removing all problems regarding the tender in Brcko.” FMC initially failed to investigate the meaning of that entry and instead paid the doctor $80,850 in December 2008. In February 2009, the doctor was elected the mayor of Brcko and thereafter the consultant agreement was placed in the name of the doctor’s wife. By 2009, FMC paid the doctor over $1.3 million to successfully win the bid. FMC also made over $957,000 in payments to a Bosnian healthcare executive to assist FMC’s establishment of clinics in Brcko and Hercegovina, without any evidence of services performed. Overall, FMC benefited by over $10 million as a result of the improper conduct in Serbia and Bosnia.

Conduct Relevant to Mexico

55.In 2010, FMC Mexico engaged in a scheme to increase the price per dialysis kit for a tender with one of its largest customers in Mexico, Instituto Mexicano del Seguro Social (“IMSS”), Mexico’s state-run social insurance agency. FMC Mexico employed the services of a third party agent, Mexican Distributor, to pay kickbacks to IMSS officials relating to the tender bid. Among other products, Mexican Distributor sold medical kits used in hemodialysis treatments.

56.In January 2010, FMC Mexico was awarded a portion of an IMSS subrogation tender, at an agreed reimbursement price of $92 per treatment, which reflected a price increase that Mexican Distributor supposedly negotiated for its kits. On December 8, 2010, almost a full year after the IMSS tender award, FMC Mexico’s General Director and Chief Financial Officer executed a contract with Mexican Distributor, agreeing to pay Mexican Distributor a commission of $0.40 per treatment performed on IMSS patients in 2010 and $0.20 per treatment in 2011. The retroactive contract improperly identified the commissions as being for “advice.”

57.An FMC internal audit report found several problems with this arrangement, including insufficient evidence that Mexican Distributor rendered services that contributed to the increase in price, the contract was signed a year after services were supposedly rendered, and monetary payments were made retroactively. The audit identified $213,500 in improper commissions paid to Mexican Distributor intended in part for IMSS officials in 2010 and 2011. Overall, FMC benefited by over $2 million as a result of the improper conduct.

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Legal Standards and Violations

58.Under Section 21C of the Exchange Act, the Commission may impose a cease-and-desist order upon any person who is violating, has violated, or is about to violate any provision of the Exchange Act or any rule or regulation thereunder, and upon any other person that is, was, or would be a cause of the violation, due to an act or omission the person knew or should have known would contribute to such violation.

59.As a result of conduct described above in Saudi Arabia, Angola and West Africa, FMC violated Section 30A of the Exchange Act, which in relevant part makes it unlawful for an issuer with securities registered under Section 12 of the Exchange Act or which is required to file reports under Section 15(d) of the Exchange Act, or any employee or agent acting on its behalf, to make use of the mails or any means or instrumentality of interstate commerce corruptly in furtherance of an effort to pay or offer to pay anything of value to foreign officials for the purpose of influencing their official decision-making, in order to assist in obtaining or retaining business. Finally, each FMC subsidiary and entity was also an “agent” of FMC within the meaning of the Foreign Corrupt Practices Act.

60.Further, as a result of the conduct described in each of the countries above, FMC violated Section 13(b)(2)(A) of the Exchange Act, which requires issuers to make and keep books, records, and accounts which, in reasonable detail, accurately and fairly reflect their transactions and dispositions of the assets of the issuer.

61.In addition, as a result of the conduct described in each of the countries above, FMC violated Section 13(b)(2)(B) of the Exchange Act, which requires issuers to devise and maintain a system of internal accounting controls sufficient to provide reasonable assurances that (i) transactions are executed in accordance with management’s general or specific authorization; (ii) transactions are recorded as necessary (I) to permit preparation of financial statements in conformity with generally accepted accounting principles or any other criteria applicable to such statements, and (II) to maintain accountability for assets; (iii) access to assets is permitted only in accordance with management’s general or specific authorization; and (iv) the recorded accountability for assets is compared with the existing assets at reasonable intervals and appropriate action is taken with respect to any differences.

FMC’s Self-Disclosure, Cooperation, and Remedial Efforts

62.In determining to accept the Offer, the Commission considered remedial acts promptly undertaken by Respondent and cooperation afforded the Commission staff. FMC self- reported certain misconduct and voluntarily provided facts developed during its internal investigation. FMC’s cooperation with the Commission’s investigation varied at times. FMC produced documents, including key document binders and translations as needed, and made current or former employees available to the Commission staff, including those who needed to travel to the United States.

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63.FMC’s remediation included the termination of employees and third parties responsible for the misconduct and enhancements to its internal accounting controls. FMC strengthened its global compliance organization; enhanced its policies and procedures regarding the due diligence process and the use of third parties; created positions to address potential risks; and increased training of employees on anti-bribery issues.

Undertakings

64.Respondent undertakes to engage an Independent Compliance Monitor and report to the Commission staff periodically pursuant to the provisions set forth in Attachment A of the Order.

65.Respondent undertakes to require the Independent Compliance Monitor to enter into an agreement that provides that for the period of engagement and for a period of two years from completion of the engagement, the Independent Compliance Monitor shall not enter into any employment, consultant, attorney-client, auditing or other professional relationship with Respondent, or any of its present or former affiliates, directors, officers, employees, or agents acting in their capacity. The agreement will also provide that the Independent Compliance Monitor will require that any firm with which he/she is affiliated or of which he/she is a member, and any person engaged to assist the Independent Compliance Monitor in performance of his/her duties under this Order shall not, without prior written consent of the Division of Enforcement, enter into any employment, consultant, attorney-client, auditing or other professional relationship with Respondent, or any of its present or former affiliates, directors, officers, employees, or agents acting in their capacity as such for the period of the engagement and for a period of two years after the engagement.

66.Certify, in writing, compliance with the undertaking(s) set forth above. The certification shall identify the undertaking(s), provide written evidence of compliance in the form of a narrative, and be supported by exhibits sufficient to demonstrate compliance. The Commission staff may make reasonable requests for further evidence of compliance, and Respondent agrees to provide such evidence. The certification and supporting material shall be submitted to Tracy L. Price, Deputy Chief, FCPA Unit, Division of Enforcement, U.S. Securities and Exchange Commission, 100 F Street, N.E., Mail Stop 5631, Washington, D.C. 20549, with a copy to the Office of Chief Counsel of the Enforcement Division, no later than sixty (60) days from the date of the completion of the undertakings.

67.Respondent undertakes to do the following: in connection with this action and any related judicial or administrative proceeding or investigation commenced by the Commission or to which the Commission is a party, Respondent (i) agrees to appear and be interviewed by Commission staff at such times and places as the staff requests upon reasonable notice; (ii) will accept service by mail or facsimile transmission of notices or subpoenas issued by the Commission for documents or testimony at depositions, hearings, or trials, or in connection with any related investigation by Commission staff; (iii) appoints Respondent’s undersigned attorney as agent to receive service of such notices and subpoenas; (iv) with respect to such notices and subpoenas,

15

waives the territorial limits on service contained in Rule 45 of the Federal Rules of Civil Procedure and any applicable local rules, provided that the party requesting the testimony reimburses Respondent’s travel, lodging, and subsistence expenses at the then-prevailing U.S. Government per diem rates; and (v) consents to personal jurisdiction over Respondent in any United States District Court for purposes of enforcing any such subpoena.

Non-Prosecution Agreement

68.FMC has entered into a three-year non-prosecution agreement with the United States Department of Justice that acknowledges responsibility for criminal conduct relating to certain findings in the Order.

Non-Imposition of a Civil Penalty

69.FMC acknowledges that the Commission is not imposing a civil penalty based upon the imposition of an $84.7 million criminal fine as part of its resolution with the Department of Justice.

IV.

In view of the foregoing, the Commission deems it appropriate to impose the sanctions agreed to in Respondent FMC’s Offer.

Accordingly, pursuant to Section 21C of the Exchange Act, it is hereby ORDERED that:

A.Respondent FMC cease-and-desist from committing or causing any violations and any future violations of Sections 30A, 13(b)(2)(A) and 13(b)(2)(B) of the Exchange Act [15 U.S.C. §§ 78m(b)(2)(A), 78m(b)(2)(B), and 78dd-1].

B.Respondent shall comply with its Undertakings as enumerated in paragraphs 64 to 67 above.

C.Respondent shall, within fourteen days of the entry of this Order, pay disgorgement of $135 million and prejudgment interest of $12 million, for total payment of $147 million to the Securities and Exchange Commission for transfer to the general fund of the United States Treasury, subject to Exchange Act Section 21F(g)(3). If payment of disgorgement and prejudgment interest is not made by the date the payment is required by this Order, additional interest shall accrue pursuant to SEC Rule of Practice 600.

Payment must be made in one of the following ways:

(1)Respondent may transmit payment electronically to the Commission, which will provide detailed ACH transfer/Fedwire instructions upon request;

16

(2)Respondent may make direct payment from a bank account via Pay.gov through the SEC website at http://www.sec.gov/about/offices/ofm.htm; or

(3)Respondent may pay by certified check, bank cashier’s check, or United States postal money order, made payable to the Securities and Exchange Commission and hand-delivered or mailed to:

Enterprise Services Center

Accounts Receivable Branch

HQ Bldg., Room 181, AMZ-341

6500 South MacArthur Boulevard

Oklahoma City, OK 73169

Payments by check or money order must be accompanied by a cover letter identifying FMC as a Respondent in these proceedings, and the file number of these proceedings; a copy of the cover letter and check or money order must be sent to Tracy L. Price, Deputy Chief, FCPA Unit, Division of Enforcement, Securities and Exchange Commission, 100 F St., NE, Washington, DC 20549-5631.

D.Respondent acknowledges that the Commission is not imposing a civil penalty based in part upon its cooperation in a Commission investigation and related enforcement action. If at any time following the entry of the Order, the Division of Enforcement (“Division”) obtains information indicating that Respondent knowingly provided materially false or misleading information or materials to the Commission, or in a related proceeding, the Division may, at its sole discretion and with prior notice to the Respondent, petition the Commission to reopen this matter and seek an order directing that the Respondent pay an additional civil penalty. Respondent may contest by way of defense in any resulting administrative proceeding whether it knowingly provided materially false or misleading information, but may not: (1) contest the findings in the Order; or (2) assert any defense to liability or remedy, including, but not limited to, any statute of limitations defense.

By the Commission.

Vanessa A. Countryman

Acting Secretary

17

Attachment A

Independent Compliance Monitor

Retention of Monitor and Term of Engagement

1.Fresenius Medical Care AG & Co. KGaA (“Company”) shall engage an independent compliance monitor (the “Monitor”) not unacceptable to the staff of the Commission within sixty (60) calendar days of the issuance of the Order. The Monitor shall have, at a minimum, the following qualifications: (i) demonstrated expertise with respect to the FCPA and other applicable anti-corruption laws, including experience counseling on FCPA issues; (ii) experience designing or reviewing corporate compliance policies, procedures, and internal accounting controls, including FCPA and anti-corruption policies and procedures; (iii) the ability to access and deploy resources as necessary to discharge the Monitor’s duties; and (iv) sufficient independence from the Company to ensure effective and impartial performance of the Monitor’s duties. The Commission staff may extend the Company’s time period to retain the Monitor, in its sole discretion. If the Monitor resigns or is otherwise unable to fulfill the obligations herein, the Company shall within thirty (30) days retain a successor Monitor that has the same minimum qualifications as the original monitor and that is not unacceptable to the Commission staff.

2.The Company shall retain the Monitor for a period of not less than twenty-four (24) months from the date the Monitor is retained (the “Term of the Monitorship”), unless the Commission staff finds, in its sole discretion, that there exists a change in circumstances sufficient to terminate the Monitorship early or extend the Monitorship as set forth in paragraphs 24-25 (Termination or Extension of Monitorship).

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Company’s Obligations

3.The Company shall cooperate fully with the Monitor and provide the Monitor with access to all non-privileged information, documents, books, records, facilities, and personnel as reasonably requested by the Monitor, which fall within the Monitor’s mandate; such access shall be provided consistent with the Company’s and the Monitor’s obligations under applicable local laws and regulations, including but not limited to, applicable data privacy and national security laws and regulations. The Company shall use its best efforts, to the extent reasonably requested, to provide the Monitor with access to the Company’s former employees, third party vendors, agents, and consultants. The Company does not intend to waive the protection of the attorney work product doctrine, attorney-client privilege, or any other privilege applicable as to third parties.

4.The parties agree that no attorney-client relationship shall be formed between the Company and the Monitor. In the event that the Company seeks to withhold from the Monitor access to information, documents, books, records, facilities, current or former personnel of the Company, its third-party vendors, agents, or consultants that may be subject to a claim of attorney-client privilege or to the attorney work-product doctrine, or where the Company reasonably believes production would otherwise be inconsistent with the applicable law, the Company shall work cooperatively with the Monitor to resolve the matter to the satisfaction of the Monitor. If, during the Term of the Monitorship, the Monitor believes that the Company is unreasonably withholding access on the basis of a claim of attorney-client privilege, attorney work-product doctrine, or other asserted applicable law, and cannot resolve the matter cooperatively with the Company, the Monitor shall notify the Commission staff.

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5.Upon entry of this Order and during the Term of the Monitorship, should the Company learn of credible evidence or allegations of corrupt payments, false books, records, or accounts, or the failure to implement adequate internal accounting controls, the Company shall promptly report such credible evidence or allegations to the Commission staff. Any disclosure by the Company to the Monitor concerning credible evidence of corrupt payments, false books and records, or internal accounting control issues shall not relieve the Company of any otherwise applicable obligation to truthfully disclose such matters to the Commission staff.

Monitor’s Mandate

6.The Monitor shall review and evaluate the effectiveness of the Company’s policies, procedures, practices, internal accounting controls, recordkeeping, SOX controls, and financial reporting processes (collectively, “Policies and Procedures”), as they relate to the Company’s current and ongoing compliance with the anti-bribery, books and records, and internal accounting controls provisions of the FCPA and other applicable anti-corruption laws (collectively, “Anti-corruption Laws”), and make recommendations reasonably designed to improve the effectiveness of the Company’s Policies and Procedures and FCPA corporate compliance program (the “Mandate”). This Mandate shall include an assessment of the Management and Supervisory Boards and senior management’s commitment to, and effective implementation of, the Policies and Procedures and FCPA corporate compliance program. In carrying out the Mandate, to the extent appropriate under the circumstances, the Monitor may coordinate with the Company personnel, including in-house counsel or through designated outside counsel, compliance personnel, and internal auditors. To the extent the Monitor deems appropriate, it may rely on the Company’s processes, and on sampling and testing methodologies. The Monitor is not expected to conduct a

20

comprehensive review of all business lines, all business activities, and all markets. This Mandate shall not apply to Fresenius Medical Care Holdings, Inc. and its subsidiaries, to the extent that those entities and/or their employees and agents operate exclusively within the United States. Nonetheless, the Monitor may seek a briefing on the regulatory environment and the structure of the compliance program in the United States. If requested by the Monitor, the Company shall provide such a briefing, with reasonable consideration of the scope of the Mandate. Any disputes between the Company and the Monitor with respect to the Work Plan shall be decided by the Commission staff in its sole discretion.

7.During the Term of the Monitorship, the Monitor shall conduct an initial review and two follow-up reviews and prepare an initial report and a first and second follow-up report, and issue a Certification Report if appropriate, as described below.

Initial Review and Report

8.Promptly upon being retained, the Monitor shall prepare a written Work Plan, which shall be submitted to the Company and the Commission staff for comment no later than thirty (30) days after being retained.

9.In order to conduct an effective Initial Review and to understand fully any existing deficiencies in the Company’s Policies and Procedures and FCPA corporate compliance program, the Monitor’s Work Plan shall include such steps as are reasonably necessary to understand the Company’s business and its global anti-corruption risks. The steps shall include:

(a)inspection of relevant documents, including the internal accounting controls, recordkeeping, and financial reporting policies and procedures as they relate to the Company’s compliance with the books and records,

21

internal accounting controls, and anti-bribery provisions of the FCPA and other applicable anti-corruption laws;

(b)onsite observation of selected systems and procedures comprising the Company’s Policies and Procedures and FCPA corporate compliance program, including anti-corruption compliance procedures, internal accounting controls, recordkeeping, due diligence, and internal audit procedures, including at sample sites;

(c)meetings with, and interviews of, as relevant, the Company employees, officers, directors, and, where appropriate and feasible, its third-party vendors, agents, or consultants and other persons at mutually convenient times and places; and

(d)risk-based analyses, studies, and testing of the Company’s FCPA corporate compliance program.

10.The Monitor may take steps as reasonably necessary to develop an understanding of the facts and circumstances surrounding prior FCPA violations that gave rise to this action or violations of other applicable Anti-corruption Laws, but shall not conduct his or her own inquiry into those historical events.

11.After receiving the Initial Review Work Plan, the Company and Commission staff shall provide any comments concerning the Initial Review Work Plan within fifteen (15) days to the Monitor. Any disputes between the Company and the Monitor with respect to the Initial Review Work Plan shall be decided by the Commission staff in its sole discretion. Following

22

comments by the Company and Commission staff, the Monitor will have ten (10) days to submit a Final Initial Review Work Plan.

12.The Initial Review shall commence no later than sixty (60) days from the date of the engagement of the Monitor (unless otherwise agreed by the Company, the Monitor, and the Commission staff). The Monitor shall issue a written report within one hundred twenty (120) days of commencing the Initial Review, setting forth the Monitor’s assessment and, if necessary, making recommendations reasonably designed to improve the effectiveness of the Company’s Policies and Procedures and FCPA corporate compliance program as they relate to the Company’s compliance with the FCPA and other applicable Anti-corruption Laws. The Monitor should consult with the Company concerning his or her findings and recommendations on an ongoing basis and should consider the Company’s comments and input to the extent the Monitor deems appropriate. The Monitor may also choose to share a draft of his or her report with the Company and Commission staff prior to finalizing it. The Monitor shall provide the report to the Management Board of the Company and contemporaneously transmit a copy to Commission staff.

13.Within ninety (90) days after receiving the Monitor’s Initial Review Report, the Company shall adopt and implement all recommendations in the report, provided, however, that as to any recommendation that the Company considers unduly burdensome, impractical, costly, or inconsistent with applicable law or regulation, the Company need not adopt that recommendation at that time, but may submit in writing to the Monitor and the Commission staff within fifteen (15) days of receiving the report, an alternative policy, procedure, or system designed to achieve the same objective or purpose.

23

14.In the event the Company and the Monitor are unable to agree on an acceptable alternative proposal, the Company shall promptly consult with the Commission staff. Any disputes between the Company and the Monitor with respect to the recommendations shall be decided by the Commission staff in its sole discretion. The Commission staff shall consider the Monitor’s recommendation and the Company’s reasons for not adopting the recommendation in determining whether the Company has fully complied with its obligations. Pending such determination, the Company shall not be required to implement any contested recommendation(s).

15.With respect to any recommendation that the Monitor determines cannot reasonably be implemented within ninety (90) days after receiving the report, the Monitor may extend the time period for implementation with prior written approval of the Commission staff.

Follow Up Reviews

16.The Monitor shall conduct a minimum of two Follow-Up Reviews. The Monitor shall submit a written work plan for each follow-up review to the Company and Commission staff within sixty (60) calendar days after the issuance of either the initial report, or the applicable follow-up report. The Company and Commission staff shall provide any comments concerning the work plan within fifteen (15) calendar days in writing to the Monitor. Any disputes between the Company and the Monitor with respect to the written work plan shall be decided by the Commission staff in its sole discretion. Following comments by the Company and Commission staff, the Monitor will have ten (10) calendar days to make revisions to the follow-up work plan.

17.The Monitor shall commence the follow-up review pursuant to the work plan no later than ninety (90) calendar days after the issuance of the initial report, or applicable follow-up

24

report, (unless otherwise agreed by the Company, the Monitor and the Commission staff). The Monitor shall issue its written follow-up report within one hundred-twenty (120) calendar days of commencing the follow-up review. The follow-up report shall set forth the Monitor’s assessment of, and any additional recommendations regarding, the Policies and Procedures as they relate to the Company’s compliance with the Anti-corruption Laws; the Monitor’s assessment of the implementation by the Company of any recommendations made in the initial report, or follow-up report if applicable; and the Monitor’s assessment of the commitment of the Company’s Supervisory and Management Boards and senior management to compliance with the FCPA.

18.Within ninety (90) days after receiving the Monitor’s follow up report, the Company shall adopt and implement all recommendations in the report, provided, however, that as to any recommendation that the Company considers unduly burdensome, impractical, costly, or inconsistent with applicable law or regulation, the Company need not adopt that recommendation at that time, but may submit in writing to the Monitor and the Commission staff within fifteen (15) days of receiving the report, an alternative policy, procedure, or system designed to achieve the same objective or purpose.

19.In the event the Company and the Monitor are unable to agree on an acceptable alternative proposal within fifteen (15) days, the Company shall promptly consult with the Commission staff. Any disputes between the Company and the Monitor with respect to the recommendations shall be decided by the Commission staff in its sole discretion. The Commission staff shall consider the Monitor’s recommendation and the Company’s reasons for not adopting the recommendation in determining whether the Company has fully complied with

25

its obligations. Pending such determination, the Company shall not be required to implement any contested recommendation(s). The Monitor shall repeat the process of Follow-Up Reviews until the terms in paragraph 21 (Certification of Compliance) or paragraphs 24-25 (Termination or Extension of Monitorship) are met.

20.Throughout the Term of the Monitorship, the Monitor shall disclose to the Commission staff any credible evidence that corrupt or otherwise suspicious transactions occurred, or payments of things of value were offered, promised, made or authorized by any entity or person within the Company, or any entity or person working directly or indirectly for or on behalf of the Company, or that related false books and records may have been maintained by or on behalf of the Company. The Monitor shall contemporaneously notify the Company’s Global General Counsel, Chief Compliance Officer, or Audit Committee for further action unless at the Monitor’s discretion he or she believes disclosure to the Company would be inappropriate under the circumstances. The Monitor shall address in his or her reports the appropriateness of the Company’s response to all improper activities, whether previously disclosed to the Commission staff or not.

Certification of Compliance

21.At the conclusion of the ninety (90) calendar day period following the issuance of the second follow-up report, or later follow-up report if applicable, if the Monitor believes that the Company’s Policies and Procedures and FCPA compliance program are reasonably designed and implemented to detect and prevent violations of the Anti-corruption Laws and are functioning effectively, the Monitor shall certify the Company’s compliance with its compliance obligations under the Order. The Monitor shall then submit to the Commission staff a written

26

report (“Certification Report”) within forty (40) calendar days. The Certification Report shall set forth an overview of the Company’s remediation efforts to date, including the implementation status of the Monitor’s recommendations, and an assessment of the sustainability of the Company’s remediation efforts. The Certification Report should also recommend the scope of the Company’s future self-reporting. Also at the conclusion of the ninety (90) calendar day period following the issuance of the second follow-up report, the Company shall certify in writing to the Commission staff, with a copy to the Monitor, that the Company has adopted and implemented all of the Monitor’s recommendations in the initial and follow-up report(s), or the agreed-upon alternatives. The Monitor or the Company may extend the time period for issuance of the Certification Report or the Company’s certification, respectively, with prior written approval of the Commission staff.

Self-Reporting Period

22.At such time as the Commission staff approves the Certification Report and the Company’s certification, the monitorship shall be terminated, and the Company will be permitted to self-report to the Commission staff on its enhanced compliance obligations for the remainder of the term of the Order. The Commission staff, however, reserves the right to terminate the monitorship absent certification by the Monitor, upon a showing by the Company that termination is, nevertheless, in the interests of justice.

23.If permitted to self-report to the Commission staff, the Company shall thereafter submit to the Commission staff a written Initial Self-Report and Follow Up Self-Report at six (6) month intervals, setting forth a complete description of its remediation efforts to date, its proposals to improve the Company’s Policies and Procedures and FCPA compliance program for

27

ensuring compliance with the Anti-corruption Laws, and the proposed scope of the subsequent reviews. The Company shall disclose any credible evidence that corrupt or otherwise suspicious transactions occurred, or payments of things of value were offered, promised, or provided to foreign officials, that it learns of that occurred after the date of this Consent. The Company may extend the time period for issuance of the self-report with prior written approval of the Commission staff.

Termination or Extension of the Monitorship

24.If at the conclusion of the ninety (90) calendar-day period following the issuance of the second follow-up report, or later follow-up report if applicable, the Commission staff concludes in its sole discretion that the Company has not by that time successfully satisfied its compliance obligations under the Order, the Term of the Monitorship shall be extended for twelve (12) months. Under such circumstances, the Monitor shall commence additional Follow-Up Reviews in accordance with Paragraphs 16-19.

25.If at the conclusion of the thirty-six (36) month period the Commission staff concludes the Company has not met its obligations under the Order, the Commission staff in its sole discretion may extend the Monitorship or Self-Reporting requirements up to forty-eight (48)

months from the issuance of the Order, and require reporting as set forth for Follow-Up Reviews or Self-Reporting.

Extensions of Time

26.Upon request by the Monitor or the Company, the Commission staff may extend any procedural time period set forth above for good cause shown.

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Confidentiality of Reports

27.The reports submitted by the Monitor and the periodic reviews and reports submitted by the Company will likely include confidential financial, proprietary, competitive business, or commercial information. Public disclosure of the reports could discourage cooperation, impede pending or potential government investigations, or undermine the objective of the reporting requirement. For these reasons, among others, the reports and the contents thereof are intended to remain and shall remain non-public, except (i) pursuant to court order, (ii) as agreed to by the parties in writing, (iii) to the extent that the Commission determines in its sole discretion that disclosure would be in furtherance of the Commission’s discharge of its duties and responsibilities, or (iv) as is otherwise required by law.

Address for All Written Communications and Reports

28.All reports or other written communications by the Monitor or the Company directed to the Commission staff shall be transmitted to Tracy L. Price, FCPA Unit, Deputy Chief, Division of Enforcement, U.S. Securities and Exchange Commission, 100 F Street NE, Washington D.C. 20549.

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EX-31.1

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Exhibit 31.1

CERTIFICATION PURSUANT TO SECTION 302
OF THE SARBANES-OXLEY ACT OF 2002

I, Rice Powell, certify that:

1.

I have reviewed this report on Form 6-K of Fresenius Medical Care AG & Co. KGaA (the "Report").

2.

Based on my knowledge, this Report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this Report;

3.

Based on my knowledge, the financial statements, and other financial information included in this Report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this Report;

4.

The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and we have:

a)

designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this Report is being prepared;

b)

designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c)

evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this Report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this Report based on such evaluation; and

d)

disclosed in this Report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5.

The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of registrant's board of directors (or persons performing the equivalent functions):

a)

all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

b)

any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date: May 2, 2019

By:	/s/ RICE POWELL
	Rice Powell Chief Executive Officer and Chairman of the Management Board of the General Partner

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Exhibit 31.1

CERTIFICATION PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

EX-31.2

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Exhibit 31.2

CERTIFICATION PURSUANT TO SECTION 302
OF THE SARBANES-OXLEY ACT OF 2002

I, Michael Brosnan, certify that:

6.

I have reviewed this report on Form 6-K of Fresenius Medical Care AG & Co. KGaA (the "Report");

7.

Based on my knowledge, this Report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this Report;

8.

Based on my knowledge, the financial statements, and other financial information included in this Report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this Report;

9.

The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and we have:

a)

designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this Report is being prepared;

b)

designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c)

evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this Report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this Report based on such evaluation; and

d)

disclosed in this Report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

10.

The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of registrant's board of directors (or persons performing the equivalent function):

e)

all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

f)

any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date: May 2, 2019

By:	/s/ MICHAEL BROSNAN
	Michael Brosnan Chief Financial Officer and member of the Management Board of the General Partner

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Exhibit 31.2

CERTIFICATION PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

EX-32.1

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Exhibit 32.1

CERTIFICATION PURSUANT TO
18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the report of Fresenius Medical Care AG & Co. KGaA (the "Company") on Form 6-K furnished for the month of May 2019 containing its unaudited financial statements as of March 31, 2019 and for the three-months periods ending March 31, 2019 and 2018, as submitted to the Securities and Exchange Commission on the date hereof (the "Report"), the undersigned, Rice Powell, Chief Executive Officer and Michael Brosnan, Chief Financial Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, that:

(1)

The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2)

The information contained in the Report fairly presents, in all material respects, the financial condition and result of operations of the Company.

By:	/s/ RICE POWELL
	Rice Powell Chief Executive Officer and Chairman of the Management Board of the General Partner
May 2, 2019
By:	/s/ MICHAEL BROSNAN
	Michael Brosnan Chief Financial Officer and member of the Management Board of the General Partner
May 2, 2019

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Exhibit 32.1

CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

XML

Document and Entity Information	3 Months Ended
	Mar. 31, 2019
Document And Entity Information [Abstract]
Document Period End Date	Mar. 31, 2019
Entity Registrant Name	FRESENIUS MEDICAL CARE AG & Co. KGaA
Entity Central Index Key	0001333141
Document Type	6-K
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Amendment Flag	false
Document Period Start Date	Jan. 01, 2019

XML

Consolidated statements of income - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenue Table
Health care services	€ 3,317,308,000	€ 3,208,795,000
Health care products	815,249,000	766,834,000
Revenue	4,132,557,000	3,975,629,000
Costs of revenue:
Health care services	2,505,423,000	2,434,324,000
Health care products	361,846,000	338,556,000
Costs of revenue	2,867,269,000	2,772,880,000
Gross Profit	1,265,288,000	1,202,749,000
Operating (income) expenses:
Selling, general and administrative	715,157,000	678,777,000
(Gain) loss related to divestiture of Care Coordination activities	0	(13,103,000)
Research and development	33,614,000	31,897,000
Income from equity method investees	(20,033,000)	(17,904,000)
Operating income	536,550,000	496,876,000
Other (income) expense:
Interest income	(27,944,000)	(24,836,000)
Interest expense	135,792,000	107,769,000
Income before income taxes	428,702,000	413,943,000
Income tax expense	100,944,000	84,234,000
Net income	327,758,000	329,709,000
Net income attributable to noncontrolling interests	57,009,000	51,154,000
Net income attributable to shareholders of FMC-AG & Co. KGaA	€ 270,749,000	€ 278,555,000
Basic earnings per share (in dollars per share)	€ 0.88	€ 0.91
Fully diluted earnings per share (in dollars per share)	€ 0.88	€ 0.91

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Consolidated statements of comprehensive income - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Consolidated statements of comprehensive income
Net income	€ 327,758,000	€ 329,709,000
Components that may be reclassified subsequently to profit or loss:
Gain (loss) related to foreign currency translation	269,741,000	(265,041,000)
Gain (loss) related to cash flow hedges	(1,296,000)	7,834,000
Income tax (expense) benefit related to components of other comprehensive income that may be reclassified	(426,000)	2,218,000
Other comprehensive income	268,871,000	(259,425,000)
Total comprehensive income	596,629,000	(70,284,000)
Comprehensive income attributable to noncontrolling interests	(78,004,000)	25,776,000
Comprehensive income attributable to shareholders of FMC-AG & Co. KGaA	€ 518,625,000	€ (44,508,000)

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Consolidated balance sheets - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Assets
Cash and cash equivalents	€ 958,788,000	€ 2,145,632,000
Trade accounts receivable, less allowance for doubtful accounts of 474,891 in 2017 and 482,461 in 2016	3,856,891,000	3,337,706,000
Accounts receivable from related parties	95,281,000	92,662,000
Inventories	1,695,658,000	1,466,803,000
Other current assets	894,229,000	804,083,000
Total current assets	7,500,847,000	7,846,886,000
Property, plant and equipment	3,949,557,000	3,836,010,000
Right of Use Assets	4,310,976,000	0
Intangible assets	1,430,970,000	681,331,000
Goodwill	13,561,939,000	12,209,606,000
Deferred taxes assets	308,530,000	345,686,000
Investment in equity method investees	630,439,000	649,780,000
Other non-current assets	659,946,000	672,969,000
Total non-current assets	24,852,357,000	18,395,382,000
Total assets	32,353,204,000	26,242,268,000
Liabilities
Accounts payable	707,774,000	641,271,000
Accounts payable to related parties	210,384,000	153,781,000
Current provisions and other current liabilities	2,809,937,000	2,904,288,000
Short-term debt	1,319,997,000	1,205,294,000
Short-term debt from related parties	107,400,000	188,900,000
Current portion of long-term debt	1,511,815,000	1,106,519,000
current portion of of long-term lease liabilities	615,011,000	0
Current Portion of Long Term Lease Liability From Related Party	16,489,000	0
Income tax payable	64,627,000	68,229,000
Total current liabilities	7,363,434,000	6,268,282,000
Long-term debt, less current portion	5,681,163,000	5,045,515,000
Long-term lease liabilities, less current portion	3,863,651,000	0
Long Term Debt From Related Party	0	0
Long Term Lease Liabilities From Related Parties Less Current Portion	116,913,000	0
Non-current provisions and other noncurrent liabilities	718,895,000	750,738,000
Pension liabilities	563,538,000	551,930,000
Income tax payable	96,247,000	97,324,000
Deferred taxes liabilities	722,859,000	626,521,000
Total non-current liabilities	11,763,266,000	7,072,028,000
Total liabilities	19,126,700,000	13,340,310,000
Shareholders' equity
Ordinary shares, no par value, 1.00 nominal value, 385,913,972 shares authorized, 308,111,000 issued and 306,451,049 outstanding as of December 31, 2017 and 385,913,972 shares authorized, 307,221,791 issued and 306,221,840 outstanding as of December 31, 2016 respectively	307,907,000	307,879,000
Treasury stock, at cost	164,809,000	50,993,000
Additional paid-in capital	3,871,908,000	3,873,345,000
Retained earnings	8,991,461,000	8,831,930,000
Accumulated other comprehensive income (loss)	(955,874,000)	(1,203,750,000)
Total FMC-AG & Co. KGaA shareholders' equity	12,050,593,000	11,758,411,000
Noncontrolling interests	1,175,911,000	1,143,547,000
Total equity	13,226,504,000	12,901,958,000
Total liabilities and equity	€ 32,353,204,000	€ 26,242,268,000

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Consolidated balance sheets (Parenthetical) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Consolidated balance sheets
Allowance for doubtful accounts	€ 123,416,000	€ 118,015,000

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Consolidated statements of cash flows - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Operating activities
Net income	€ 327,758,000	€ 329,709,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	362,376,000	174,994,000
Change in deferred taxes, net	53,960,000	(8,147,000)
(Gain) loss on sale of fixed assets and investments	8,563,000	(2,028,000)
Compensation expense related to share-based plans	1,380,000	18,656,000
Investments in equity method investees, net	(20,894,000)	(22,303,000)
Interest expense, net	107,848,000	82,933,000
Changes in assets and liabilities, net of amounts from businesses acquired:
Trade accounts receivable, net	(430,041,000)	(462,386,000)
Inventories	(141,258,000)	(84,210,000)
Other current and non-current assets	(70,828,000)	9,537,000
Accounts receivable from related parties	(2,476,000)	(10,370,000)
Accounts payable to related parties	54,840,000	90,081,000
Accounts payable, provisions and other current and non-current liabilities	(67,346,000)	(152,973,000)
Paid interest	135,041,000	110,178,000
Received interest	12,644,000	6,436,000
Income tax payable	69,244,000	98,507,000
Paid income taxes	79,832,000	51,728,000
Net cash provided by (used in) operating activities	75,559,000	(44,808,000)
Investing activities
Purchases of property, plant and equipment	200,849,000	221,486,000
Proceeds from sale of property, plant and equipment	1,911,000	3,095,000
Acquisitions and investments, net of cash acquired, and purchases of intangible assets	1,828,525,000	181,403,000
Proceeds from divestitures	(11,012,000)	(158,000)
Net cash provided by (used in) investing activities	(2,016,451,000)	(399,636,000)
Financing activities
Proceeds from short-term debt	175,009,000	268,785,000
Repayments of short-term debt	64,027,000	18,889,000
Proceeds from short-term debt from related parties	0	31,800,000
Repayments of short-term debt from related parties	81,500,000	0
Proceeds from long-term debt	414,458,000	105,899,000
Repayments of long-term debt	17,421,000	15,027,000
Repayments of lease liabilities	151,856,000	0
Repayments of lease liabilities from related parties	4,066,000	0
Increase (decrease) of accounts receivable securitization program	(584,185,000)	(9,356,000)
Proceeds from exercise of stock options	148,000	562,000
Purchase of treasury stock	89,446,000	0
Distributions to noncontrolling interests	54,873,000	50,951,000
Contributions from noncontrolling interests	11,545,000	6,303,000
Net cash provided by (used in) financing activities	722,156,000	337,838,000
Effect of exchange rate changes on cash and cash equivalents	31,892,000	(25,125,000)
Cash and cash equivalents:
Net increase (decrease) in cash and cash equivalents	(1,186,844,000)	(131,731,000)
Cash and cash equivalents at beginning of period	2,145,632,000
Cash and cash equivalents at end of period	€ 958,788,000	€ 846,378,000

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Consolidated statements of shareholders' equity - EUR (€)	Total	Equity Attributable To Owners Of Parent [Member]	Issued Capital [Member]	Treasury Shares [Member]	Share Premium [Member]	Retained Earnings [Member]	Reserve Of Exchange Differences On Translation [Member]	Reserve Of Cash Flow Hedges [Member]	Reserve Of Remeasurements Of Defined Benefit Plans [Member]	Noncontrolling Interests [Member]
Balance at beginning of period at Dec. 31, 2017	€ 10,823,110,000	€ 9,815,026,000	€ 308,111,000	€ (108,931,000)	€ 3,969,245,000	€ 7,132,179,000	€ (1,203,904,000)	€ (18,336,000)	€ (263,338,000)	€ 1,008,084,000
Balance at beginning of period (in shares) at Dec. 31, 2017			308,111,000	(1,659,951)
Proceeds from exercise of options and related tax effects	2,014,000	486,000	€ 10,322,000		476,000
Proceeds from exercise of options and related tax effects (in shares)			10
Compensation expense related to stock options	2,014,000	2,014,000			2,014,000
Purchase of treasury stock	0
Purchase/sale of noncontrolling interests	(8,364,000)	2,835,000			2,835,000					(11,199,000)
Contributions from/to noncontrolling interests	(43,702,000)									(43,702,000)
Net income	329,709,000	278,555,000				278,555,000				51,154,000
Other comprehensive income (loss) related to:
Foreign currency translation	(265,041,000)	(239,663,000)					(243,632,000)	13,000	3,956,000	(25,378,000)
Cash flow hedges, net of related tax effects	5,616,000	5,616,000						5,616,000
Total comprehensive income	(70,284,000)	44,508,000								25,776,000
Balance at end of period at Mar. 31, 2018	10,910,948,000		€ 308,121,000	€ (108,931,000)	3,974,570,000	7,477,854,000	(1,447,536,000)	(12,707,000)	(259,382,000)	978,959,000
Balance at end of period (in shares) at Mar. 31, 2018			308,121,322	(1,659,951)
Balance at beginning of period at Dec. 31, 2017	10,823,110,000	9,815,026,000	€ 308,111,000	€ (108,931,000)	3,969,245,000	7,132,179,000	(1,203,904,000)	(18,336,000)	(263,338,000)	1,008,084,000
Balance at beginning of period (in shares) at Dec. 31, 2017			308,111,000	(1,659,951)
Purchase of treasury stock				€ 50,993,000
Balance at end of period at Dec. 31, 2018	12,901,958,000	11,758,411,000	€ 307,879,000	€ (50,993,000)	3,873,345,000	8,831,930,000	(911,473,000)	(1,528,000)	(290,749,000)	1,143,547,000
Balance at end of period (in shares) at Dec. 31, 2018			307,878,652	(999,951)
Noncontrolling interests subject to put provisions	(67,120,000)	(67,120,000)				(67,120,000)
Adjusted balance application IFRS 9	(130,727,000)	(115,219,000)				(115,219,000)
Noncontrolling interests subject to put provisions	(818,871,000)
Proceeds from exercise of options and related tax effects	(1,298,000)	(1,298,000)	€ 28,000		(1,326,000)
Proceeds from exercise of options and related tax effects (in shares)			28,641
Compensation expense related to stock options	1,380,000	1,380,000			1,380,000
Purchase of treasury stock	(89,446,000)	(113,816,000)		€ (113,816,000)
Purchase of treasury shares (in shares)				1,629,240
Withdrawal of treasury stock	(113,816,000)	(113,816,000)		€ (113,816,000)
Purchase/sale of noncontrolling interests	14,651,000	(1,491,000)			(1,491,000)					16,142,000
Contributions from/to noncontrolling interests	(46,274,000)
Net income	327,758,000	270,749,000				270,749,000				57,009,000
Other comprehensive income (loss) related to:
Foreign currency translation	269,741,000	248,746,000					251,734,000	(6,000)	(2,982,000)	20,995,000
Cash flow hedges, net of related tax effects	(870,000)	(870,000)						(870,000)
Total comprehensive income	596,629,000	518,625,000								78,004,000
Balance at end of period at Mar. 31, 2019	13,226,504,000	12,050,593,000	€ 307,907,000	€ (164,809,000)	€ 3,871,908,000	8,991,461,000	€ (659,739,000)	€ (2,404,000)	€ (293,731,000)	€ 1,175,911,000
Balance at end of period (in shares) at Mar. 31, 2019			307,907,293	(2,629,191)
Noncontrolling interests subject to put provisions	€ (4,001,000)	€ (4,001,000)				€ (4,001,000)

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The Company, basis of presentation and significant accounting policies

3 Months Ended

Mar. 31, 2019

The Company, basis of presentation and significant accounting policies

The Company, basis of presentation and significant accounting policies

1. The Company and basis of presentation

The Company

Fresenius Medical Care AG & Co. KGaA (“FMC-AG & Co. KGaA” or the “Company”), a German partnership limited by shares (Kommanditgesellschaft auf Aktien) registered in the commercial registry of Hof an der Saale under HRB 4019, with its business address at Else-Kröner-Str. 1, 61352 Bad Homburg v. d. Höhe, is the world’s largest kidney dialysis company, based on publicly reported sales and number of patients treated. The Company provides dialysis treatment and related dialysis care services to persons who suffer from end-stage renal disease (“ESRD”), as well as other health care services. The Company also develops and manufactures a wide variety of health care products, which includes dialysis and non-dialysis products. The Company’s dialysis products include hemodialysis machines, peritoneal cyclers, dialyzers, peritoneal solutions, hemodialysis concentrates, solutions and granulates, bloodlines, renal pharmaceuticals and systems for water treatment. The Company’s non-dialysis products include acute cardiopulmonary and apheresis products. The Company supplies dialysis clinics it owns, operates or manages with a broad range of products and also sells dialysis products to other dialysis service providers. The Company describes certain of its other health care services as “Care Coordination.” Care Coordination currently includes, but is not limited to, the coordinated delivery of pharmacy services, vascular, cardiovascular and endovascular specialty services as well as ambulatory surgery center services, physician nephrology and cardiology services, health plan services, urgent care services and ambulant treatment services.Until June 28, 2018, Care Coordination also included the coordinated delivery of emergency, intensivist and hospitalist physician services as well as transitional care which the Company refers to as “hospital related physician services.” All of these Care Coordination services together with dialysis care and related services represent the Company’s health care services.

In these unaudited consolidated financial statements, “FMC-AG & Co. KGaA,” or the “Company” refers to the Company or the Company 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 AG” and the “General Partner” refer to Fresenius Medical Care Management AG which is FMC-AG & Co. KGaA’s general partner and is wholly owned by Fresenius SE. “Management Board” refers to the members of the management board of Management AG and, except as otherwise specified, “Supervisory Board” refers to the supervisory board of FMC-AG & Co. KGaA. The term “North America Segment” refers to the North America operating segment, the term “EMEA Segment” refers to the Europe, Middle East and Africa operating segment, the term “Asia-Pacific Segment” refers to the Asia-Pacific operating segment, and the term “Latin America Segment” refers to the Latin America operating segment. For further discussion of the Company’s operating segments, see note 14.

Basis of presentation

The consolidated financial statements and other financial information included in the Company’s quarterly reports on Form 6-K and its Annual Report on Form 20-F for 2018were prepared solely in accordance with IFRS as issued by the International Accounting Standards Board (“IASB”), using the euro as the Company’s reporting currency. At March 31, 2019, there were no IFRS or International Financial Reporting Interpretation Committee (“IFRIC”) interpretations as endorsed by the European Union relevant for interim reporting that differed from IFRS as issued by the IASB. As such, the accompanying condensed interim report complies with the requirements of International Accounting Standard (“IAS”) 34, Interim Financial Reporting as well as with the rules concerning interim reporting as issued by the IASB.

The consolidated financial statements at March 31, 2019and for the three monthsended March 31, 2019and 2018 contained in this report are unaudited and should be read in conjunction with the consolidated financial statements contained in the Company's 2018Annual Report on Form 20-F.The preparation of consolidated financial statements in conformity with IFRS 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 revenue and expense during the reporting period. Actual results could differ from those estimates. Such financial statements reflect all adjustments that, in the opinion of management, are necessary for a fair presentation of the results of the periods presented. All such adjustments are of a normal recurring nature.

Starting on July 1, 2018, the Company’s subsidiaries in Argentina applied IAS 29, Financial Reporting in Hyperinflationary Economies, due to the inflation in Argentina. Pursuant to IAS 29, the Company recorded a loss on its net monetary position of €5,189for thethree months ended March 31, 2019. The Company calculated the loss with the use of the Consumer Price Index (Índice de precios al consumidor) as published by the Argentine Statistics and Census Institute for the first three months ended March 31, 2019, which lists the level at 206 index points, a 12% increase since January 1, 2019.

As a result of the implementation of IFRS 16, Leases, the Company updated its accounting policies. Refer to “Recently implemented accounting pronouncements” below for further details on the updated policies. Excluding the policies update for IFRS 16, the accounting policies applied in the accompanying consolidated financial statements are the same as those applied in the consolidated financial statements as of December 31, 2018.

As of December 31, 2018, “Property, plant and equipment” included leased fixed assets of €36,402 recognized in accordance with IAS 17, Leases. These are transferred to the line item “Right-of-use assets” as of the beginning of fiscal year 2019.

As of December 31, 2018, “Current portion of long-term debt” included current lease liabilities from capital leases in accordance with IAS 17 of €9,387. From 2019, these are included in the balance sheet item “Current portion of long-term lease liabilities”.

As of December 31, 2018, “Long-term debt, less current portion” included non-current lease liabilities from capital leases in accordance with IAS 17 of €26,757. From 2019, these are included in the balance sheet item “Long-term lease liabilities, less current portion”.

In the consolidated statement of cash flows, in the comparative information for the period from January 1, 2018 to March 31, 2018, the line item “Repayments of long-term debt”included repayments of lease liabilities from capital leases in accordance with IAS 17 of €2,724.In the previous periods this line item was labeled as “Repayments of long-term debt and capital lease obligations”. From 2019, these repayments are included in the line item “Repayments of lease liabilities” in accordance with IFRS 16.

Based on the IFRIC agenda decision relating to the applicability of IAS 12, Income Taxes, to the accounting for interest and penalties related to income taxes and an interpretation issued by the Accounting Standards Committee of Germany approved in September 2018, interest and penalties related to income taxes have been reclassified from income tax expense to interest expense, net in the amount of €2,957 for the three months ended March 31, 2018.

The results of operations for the three monthsended March 31, 2019 are not necessarily indicative of the results of operations for the year ending December 31, 2019.

Recently implemented accounting pronouncements

The Company has prepared its consolidated financial statements at March 31, 2019in conformity with IFRS in force for the interim periods on January 1, 2019. In the first quarter of 2019, the Company applied the following new standard relevant for its business for the first time:

IFRS 16

In January 2016, the IASB issued IFRS 16, which supersedes the current standard on lease-accounting, IAS 17, as well as the interpretations IFRIC 4, Determining whether an arrangement contains a lease, Standing Interpretations Committee (“SIC”)-15, Operating leases - incentives and SIC-27, Evaluating the substance of transactions in the legal form of a lease.

IFRS 16 significantly changes lessee accounting. For almost all leases, a lessee is required to recognize a right-of-use asset representing its right to use the underlying leased asset and a lease liability representing its obligation to make lease payments.

Leases with a total maximum term of twelve months (short-term leases) and leases for underlying assets of low-value may be exempt from balance sheet recognition by applying an accounting policy choice. Depreciation of the right-of-use asset and interest on the lease liability must be recognized in the income statement for everyon-balance lease contract. Therefore, straight-line rental expenses will no longer be shown for the vast majority of the leases. The lessor accounting requirements in IAS 17 are substantially carried forward.

The Company applies the modified retrospective method in accordance with IFRS 16 as the transition method. Accordingly, the cumulative effect from first-time application is recognized in the opening balance of retained earnings as of January 1, 2019 without adjustments to the comparative information of the previous period. In the application of the modified retrospective method, the carrying amount of the lease liability at the date of the initial application is determined by discounting the remaining lease payments of lease agreements that were classified as operating leases under IAS 17 using the term-, country-, and currency-specific incremental borrowing rate at date of initial application. Furthermore, right-of-use assets are to be recognized. In the application of the modified retrospective method, the carrying amount of the right-of-use asset equals the carrying amount of the lease liability adjusted for any prepaid or accrued lease payments. For a part of the existing contracts, the Company recognizes the right-of-use asset with its carrying amount assuming the new standard had been applied since the commencement date of the lease discounted using its term-, country-, and currency-specific incremental borrowing rate at the date of initial application.

Regarding the options and exemptions available upon the initial application of IFRS 16, the Company adopted the following approach:

• IFRS 16 is only applied to contracts that were previously identified as leases under IAS 17 and IFRIC 4.
• Recognition, valuation and disclosure principles of IFRS 16 are not applied to lease contracts with a lease term ending in less than 12 months from the date of the initial application. The respective lease contracts are accounted for as if they were short term leases and recognized as an expense accordingly.
• Material initial direct costs are included in the measurement of a right-of-use asset with the carrying amount assuming the new standard was applied since the commencement date of the lease.
• Upon initial recognition no impairment review is performed. The right-of-use assets are adjusted for onerous contract provisions, recognized on the consolidated balance sheet immediately before the date of initial application.

Right-of-use assets from lease contracts are classified in accordance with the Company’s classification of property, plant and equipment:

• Right-of-use assets: Land
• Right-of-use assets: Buildings and improvements
• Right-of-use assets: Machinery and equipment

In addition to the right-of-use asset categories above, prepayments on right-of-use assets are presented separately. Right-of-use assets from lease contracts and lease obligations are presented separately from property, plant and equipment and other financial debt in the consolidated balance sheet.

For lease contracts that include both lease and non-lease components that are not separable from lease components, no allocation is performed. Each lease component and any associated non-lease components are accounted for as a single lease.

Upon the initial application of IFRS 16 as of January 1, 2019, the Company recognized right-of-use assets of €4,266,753 and lease liabilities from third and related parties of €4,547,535. The cumulative effect from the first-time application is recognized in the opening balance of retained earnings (€115,219) as well as in non-controlling interests (€15,508) as of January 1, 2019.

The following table shows a reconciliation of the future minimum rental payments as of December 31, 2018 to the lease liabilities as of January 1, 2019:

Reconciliation of lease liabilities upon the initial application of IFRS 16
in € THOUS
Future minimum rental payments as of December 31, 2018 (IAS 17)	5.527.638
less short-term leases	(21.936)
less leases of low-value assets	(34.145)
other	(30.066)
Gross lease liabilities as of January 1, 2019	5.441.491
Discounting	(893.957)
Lease liabilities as a result of the initial application of IFRS 16 as of January 1, 2019	4.547.534
Lease liabilities from capital leases as of December 31, 2018 (IAS 17)	36.144
Lease liabilities as of January 1, 2019	4.583.678

The lease liabilities were discounted using the term-, country-, and currency-specific incremental borrowing rate as of January 1, 2019. The weighted average discount rate was 3.69%.

Leasing in the consolidated statements of income

The Company decided not to apply the guidance within IFRS 16 to short-term leases as well as leases for underlying assets of low-value. These lease payments will be recognized as expenses over the lease term.

The following table shows the effects from lease agreements on the consolidated statements of income in the first three months of fiscal year 2019:

Leasing in the consolidated statements of income
in € THOUS
	For the three months ended March 31,
	2019
Depreciation on right-of-use assets	168.893
Expenses relating to short-term leases	12.211
Expenses relating to leases of low-value assets	6.139
Expenses relating to variable lease payments	6.680
Income from subleasing right-of-use asset	55
Interest expense on lease liabilities	41.106

Leasing in the consolidated balance sheets

At March 31, 2019, the book values of right-of-use assets consisted of the following:

Right-of-use assets
in € THOUS
	March 31,
	2019
Right-of-use assets: Land	29.144
Right-of-use assets: Buildings and improvements	3.871.970
Right-of-use assets: Machinery and equipment	409.862
Right-of-use assets	4.310.976

In the first three months of fiscal year 2019, additions to right-of-use assets were €104,131.

Recent accounting pronouncements not yet adopted

The IASB issued the following new standard which is relevant for the Company:

IFRS 17, Insurance Contracts

In May 2017, the IASB issued IFRS 17, Insurance Contracts. IFRS 17 establishes principles for the recognition, measurement, presentation and disclosure related to the issuance of insurance contracts. IFRS 17 replaces IFRS 4, Insurance Contracts, which was brought in as an interim standard in 2004. IFRS 4 permitted the use of national accounting standards for the accounting of insurance contracts under IFRS. As a result of the varied application for insurance contracts there was a lack of comparability among peer groups. IFRS 17 eliminates this diversity in practice by requiring all insurance contracts to be accounted for using current values. The frequent updates to the insurance values are expected to provide more useful information to users of financial statements. IFRS 17 is effective for fiscal years beginning on or after January 1, 2021. Earlier adoption is permitted for entities that have also adopted IFRS 9, Financial Instruments and IFRS 15, Revenue from Contracts with Customers. The Company is evaluating the impact of IFRS 17 on the consolidated financial statements.

In the Company’s view, all other pronouncements issued by the IASB do not have a material impact on the consolidated financial statements.

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Notes to the consolidated statements of income

3 Months Ended

Mar. 31, 2019

Notes to the consolidated statements of income

Notes to the consolidated statements of income

2. Notes to the consolidated statements of income

Revenue

The Company has recognized the following revenue in the consolidated statement of income for thethree months ended March 31, 2019and2018:

Revenue
in € THOUS
		For the three months endedMarch 31,
		2019			2018
		Revenue from contracts with customers	Other revenue	Total	Revenue from contracts with customers	Other revenue	Total
Health care services
	Dialysis services	2.957.381	-	2.957.381	2.648.293	-	2.648.293
	Care Coordination	299.544	60.383	359.927	507.244	53.258	560.502
		3.256.925	60.383	3.317.308	3.155.537	53.258	3.208.795
Health care products
	Dialysis products	762.885	33.790	796.675	729.956	17.736	747.692
	Non-dialysis products	18.574	-	18.574	19.142	-	19.142
		781.459	33.790	815.249	749.098	17.736	766.834
Total		4.038.384	94.173	4.132.557	3.904.635	70.994	3.975.629

(Gain) loss related to divestitures of Care Coordination activities

On April 20, 2018, the Company signed a definitive agreement to divest its controlling interest in Sound Inpatient Physicians, Inc. (“Sound”) to an investment consortium led by Summit Partners, L.P., (“Summit Consortium”). Upon receipt of the required regulatory approvals under the Hart-Scott-Rodino Antitrust Improvements Acts of 1976, as amended, and the satisfaction of customary closing conditions, the divestiture was consummated on June 28, 2018. The total transaction proceeds were $1,770,516 (€1,531,109), net of related tax payments. For the three months ended March 31, 2018, the pre-tax loss related to divestitures for Care Coordination activities was €13.103, which primarily related to the initial increase in valuation of Sound’s share based payment program. Sound was included in Care Coordination within the North America Segment. The Company’s history with Sound, prior to divestment, includes the following milestones:

• In July 2014, the Company made an investment for a majority interest in Sound, a physician services organization focused on hospitalist, emergency, intensivist and post-acute care services, furthering its strategic investments and expanding the health care services we offer.

• In November 2014, Sound acquired Cogent Healthcare, expanding Sound to serve over 180 hospitals in 35 states with more than 1,750 providers.

• In 2017, the Company increased its interest in Sound raising the Company majority interest to almost 100% during the first half of 2017.

Research and development expenses

Research and development expenses of €33.614 for the three months ended March 31, 2019(for the three monthsended March 31, 2018: €31.897) include expenditure for research and non-capitalizable development costs as well as depreciation and amortization expenses related to capitalized development costs of €92 (for the three months ended March 31, 2018: €80).

Earnings per share

The following table contains reconciliations of the numerators and denominators of the basic and fully diluted earnings per share computations for 2019 and 2018:

Reconciliation of Basic and Diluted Earnings per Share
in € THOUS, except share and per share data
	For the three months ended March 31,
	2019		2018
Numerator:
Net income attributable to shareholders of FMC-AG & Co. KGaA		270.749		278.555
Denominators:
Weighted average number of shares outstanding		306.659.364		306.453.070
Potentially dilutive shares		-		986.454
Basic earnings per share		0,88		0,91
Fully diluted earnings per share		0,88		0,91

Share buy-back program

In 2019, the Company will utilize the authorization granted by the Company’s Annual General Meeting on May 12, 2016 to conduct a share buy-back program. The 2019 share buy-back program allows for a maximum of 6,000,000 shares to be repurchased at a total purchase price, excluding ancillary transaction costs, of up to €330,000 between March 12, 2019 and May 10, 2019. For the period ending March 31, 2019, the Company repurchased 1,629,240 shares, at an average weighted stock purchase price of €69.86.

As of March 31, 2019, the Company holds 2.629.191 treasury shares. These shares will be used solely to reduce the registered share capital of the Company by cancellation of the acquired shares.

The following tabular disclosure provides the number of shares acquired in the context of the share buy-back programs as well as the retired treasury stock:

Treasury Stock
Period		Average price paid per share	Total number of shares purchased and retired as part of publicly announced plans or programs	Total value of shares (1)
		in €		in € THOUS
December 31, 2017		65,63	1.659.951	108.931
Purchase of Treasury Stock
	May 2018	86,69	173.274	15.020
	June 2018	86,14	257.726	22.201
	Repurchased Treasury Stock	86,37	431.000	37.221
Retirement of repurchased Treasury Stock
	December 2018	87,23	1.091.000	95.159
December 31, 2018		51,00	999.951	50.993
Purchase of Treasury Stock
	March 2019	69,86	1.629.240	113.816
March 31, 2019		62,69	2.629.191	164.809
(1) The value of shares repurchased is inclusive of fees (net of taxes) paid in the amount of approximately €11, respectively, for services rendered.

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Acquisitions, investments, purchases of intangible assets and divestitures

3 Months Ended

Mar. 31, 2019

Acquisitions, investments, purchases of intangible assets and divestitures

Acquisitions, investments, purchases of intangible assets and divestitures

3. Acquisition of NxStage Medical, Inc.

On February 21, 2019, the Company acquired all of the outstanding shares of NxStage for $30.00 per common share. The total acquisition value of this business combination, net of cash acquired, is $1,976,235 (€1,740,563 at date of closing). NxStage is a leading medical technology company that develops, produces and markets an innovative product portfolio of medical devices for use in home dialysis and in the critical care setting. This acquisition is part of the Company’s stated strategy to expand and complement its existing business through acquisitions. Generally, these acquisitions do not change the Company’s business model and are easy to integrate without disruption to its existing business, requiring little or no realignment of its structures. The NxStage acquisition is consistent in this regard as it supplements the Company’s existing business.

The following table summarizes the estimated fair values, as of the date of acquisition based upon information available, as of March 31, 2019, of assets acquired and liabilities assumed at the date of the acquisition. Any adjustments to acquisition accounting, net of related income tax effects, will be recorded with a corresponding adjustment to goodwill:

Estimated Fair Values of Assets Acquired and Liabilities Assumed - Preliminary
in $ THOUS
	in USD
Cash and cash equivalents	47.203
Trade accounts and other receivables	34.062
Other current assets	88.987
Property, plant and equipment	85.470
Intangible assets and other assets	818.150
Goodwill	1.165.289
Accounts payable, current provisions and other current liabilities	(69.456)
Income tax payable and deferred taxes	(119.086)
Other liabilities	(23.118)
Noncontrolling interests (subject and not subject to put provisions)	(4.063)
Total acquisition cost	2.023.438
Less:
Cash acquired	(47.203)
Net Cash paid	1.976.235

As of the acquisition date,it is estimated that amortizable intangible assets acquired in this acquisition will have weighted average useful lives of 13 years.

Goodwill in the amount of $1,165,289 was acquired as part of the NxStage acquisition and is allocated to the North America Segment.

NxStage’s results have been included in the Company’s consolidated statement of income since February 21, 2019. Specifically, NxStage has contributed revenue and an operating loss in the amount of $33,805 (€29,764) and $12,655 (€11,142) respectively, to the Company’s consolidated operating income. This operating loss amount does not include synergies which may have resulted at consolidated entities outside NxStage since the acquisition closed.

Pro forma financial information

The following financial information, on a pro forma basis, reflects the consolidated results of operations for the three months ended March 31, 2019 as if the NxStage acquisition had been consummated on January 1, 2019and excludes related transaction costs. The pro-forma financial information is not necessarily indicative of the results of operations as it would have been had the transactions been consummated on January 1, 2019.

Pro forma financial Information
in € THOUS, except per share data
	2019
	in EUR
Pro forma revenue	4.176.790
Pro forma net income attributable to shareholders of FMC-AG & Co. KGaA	254.538
Basic earnings per share	0,83
Fully diluted earnings per share	0,83

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Related party transactions

3 Months Ended

Mar. 31, 2019

Related party transactions

Related party transactions

4. Related party transactions

Fresenius SE is the Company’s largest shareholder and owns 30,92% of the Company’s outstanding shares, excluding treasury shares held by the Company, at March 31, 2019. 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 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. Our related party transactions are settled through Fresenius SE’s cash management system where appropriate.

a) Service agreements and products

The Company is party to service agreements with Fresenius SE and certain of its affiliates (collectively the “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. The Company also provides central purchasing services to the Fresenius SE Companies. These related party agreements generally have a duration of 1 to 5 years and are renegotiated on an as needed basis when the agreement comes due. The Company provides administrative services to one of its equity method investees.

The Company sold products to the Fresenius SE Companies and made purchases from the Fresenius SE Companies and equity method investees. In addition, Fresenius Medical Care Holdings, Inc. (“FMCH”) purchases heparin supplied by Fresenius Kabi USA, Inc. (“Kabi USA”), through an independent group purchasing organization (“GPO”). Kabi USA is an indirect, wholly-owned subsidiary of Fresenius SE. The Company has no direct supply agreement with Kabi USA and does not submit purchase orders directly to Kabi USA. FMCH acquires heparin from Kabi USA, through the GPO contract, which was negotiated by the GPO at arm’s length on behalf of all members of the GPO.

The Company entered into a ten year agreement with a Fresenius SE Company for the manufacturing of infusion bags. In order to establish the new production line, the Company purchased machinery from the Fresenius SE company in the amount of €250 during the three monthsended March 31, 2019.

In December 2010, the Company and Galenica Ltd. (now known as Vifor Pharma Ltd.) formed the renal pharmaceutical company Vifor Fresenius Medical Care Renal Pharma Ltd., (“VFMCRP”), an equity method investee of which the Company owns 45%. The Company has entered into exclusive supply agreements to purchase certain pharmaceuticals from VFMCRP.

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 endedMarch 31, 2019				For the three months endedMarch 31, 2018				March 31, 2019				December 31, 2018
		Sales of goods and services		Purchases of goods and services		Sales of goods and services		Purchases of goods and services		Accounts receivable		Accounts payable		Accounts receivable		Accounts payable
Service agreements(1)
	Fresenius SE		32		5.182		70		5.724		1.064		3.149		378		4.019
	Fresenius SE affiliates		940		24.652		876		24.455		849		7.946		681		8.470
	Equity method investees		730		-		5.060		-		78		-		2.449		-
	Total		1.702		29.834		6.006		30.179		1.991		11.095		3.508		12.489
Products
	Fresenius SE affiliates		9.862		8.290		7.907		9.075		11.062		3.699		8.750		3.658
	Equity method investees		-		151.645		-		121.021		-		112.907		-		57.975
	Total		9.862		159.935		7.907		130.096		11.062		116.606		8.750		61.633
	(1) In addition to the above shown accounts payable, accrued expenses for service agreements with related parties amounted to €6,687 and €9,376 at March 31, 2019 and December 31, 2018, respectively.

b)Lease agreements

In addition to the above-mentioned product and service agreements, the Company is a party to real estate lease agreements with the 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 majority of the leases expire at the end of 2026.

Below is a summary resulting from the above described lease agreements with related parties. For information on the implementation of IFRS 16, see note 1.

Lease agreements with related parties
in € THOUS
		For the three months endedMarch 31, 2019				For the three months endedMarch 31, 2018		March 31, 2019
		Depreciation		Interest expense	Lease expense (1)	Lease income	Lease expense	Right-of-use asset		Lease liability
	Fresenius SE		1.214	137	854	-	2.069		35.219	35.286
	Fresenius SE affiliates		3.089	353	161	-	3.692		97.966	98.116
	Total		4.303	490	1.015	-	5.761		133.185	133.402
	(1) Short-term leases and expenses relating to variable lease payments are exempted from balance sheet recognition.

c) Financing

The Company receives short-term financing from and provides short-term financing to Fresenius SE. The Company also utilizes Fresenius SE’s cash management system for the settlement of certain intercompany receivables and payables with its subsidiaries and other related parties. As of March 31,2019and December 31, 2018, the Company had accounts receivable from Fresenius SE related to short-term financing in the amount of €80.388and €80.228,respectively. As of March 31, 2019and December 31, 2018, the Company had accounts payable to Fresenius SE related to short-term financing in the amount of €76.784and €32.454, respectively. The interest rates for these cash management arrangements are set on a daily basis and are based on the then-prevailing overnight reference rate, with a floor of zero, for the respective currencies.

On August 19, 2009, the Company borrowed €1.500from the General Partner on an unsecured basis at 1,335%. The loan repayment has been extended periodically and is currently due August 22, 2019 with an interest rate of 0,825%. On November 28, 2013, the Company borrowed an additional €1.500with an interest rate of 1,875%from the General Partner. The loan repayment has been extended periodically and is currently due on November 23, 2019with an interest rate of 0,825%.

At March 31, 2019and December 31, 2018, a subsidiary of Fresenius SE held unsecured bonds issued by the Company in the amount of €5.000and €6.000,respectively. The bonds were issued in 2011 and 2012, mature in 2021 and 2019, respectively, and each has a coupon rate of 5.25% with interest payable semiannually.

At March 31, 2019 and December 31, 2018, the Company borrowed from Fresenius SE in the amount of €104.400on an unsecured basis at an interest rate of 0,825% and €185.900on an unsecured basis at an interest rate of 0,825%, respectively. For further information on this loan agreement, see note 8.

d) Key management personnel

Due to the Company’s legal form of a German partnership limited by shares, the General Partner holds a key management position within the Company. In addition, as key management personnel, members of the Management Board and the Supervisory Board, as well as their close relatives, are considered related parties.

The Company’s Articles of Association provide that the General Partner shall be reimbursed for any and all expenses in connection with 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. The aggregate amount reimbursed to the General Partner was €8.028and €4.016, respectively, for its management services during the three months ended March 31, 2019 and 2018. As of March 31,2019and December 31, 2018, the Company had accounts receivable from the General Partner in the amount of €1.840 and €176, respectively. As of March 31,2019and December 31,2018, the Company had accounts payable to the General Partner in the amount of €5.899 and €47.205, respectively.

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Cash and cash equivalents

3 Months Ended

Mar. 31, 2019

Cash and cash equivalents

Cash and cash equivalents

5. Cash and cash equivalents

As ofMarch 31, 2019 and December 31, 2018, cash and cash equivalents are as follows:

Cash and cash equivalents
in € THOUS
	March 31,	December 31,
	2019	2018
Cash	705.731	831.885
Securities and time deposits	253.057	1.313.747
Cash and cash equivalents	958.788	2.145.632

The cash and cash equivalents disclosed in the table above, and in the consolidated statements of cash flows, include atMarch 31, 2019an amount of €5,740 (December 31, 2018: €5,002) from collateral requirements towards an insurance company in North America that are not available for use.

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Trade accounts receivable

3 Months Ended

Mar. 31, 2019

Trade accounts receivable

Trade accounts receivable

6. Trade accounts and other receivables

As ofMarch 31, 2019 and December 31, 2018, trade accounts and other receivablesare as follows:

Trade accounts and other receivables
in € THOUS
		March 31,		December 31,
		2019		2018
			thereof Credit-Impaired		thereof Credit-Impaired
Trade accounts and other receivables, gross		3.980.307	387.850	3.455.721	325.240
	thereof Finance Lease Receivables	44.037	-	28.726	-
less allowances		(123.416)	(87.056)	(118.015)	(85.775)
Trade accounts and other receivables		3.856.891	300.794	3.337.706	239.465

The other receivables in the amount of €79,627 include receivables from finance leases, operating leases and insurance contracts (December 31, 2018: €66,496).

All trade accounts and other receivables are due within one year. A small portion of the trade account receivables are subject to factoring agreements.

Trade accounts receivables and finance lease receivables with a term of more than one year in the amount of €120,479 (December 31, 2018: €120,668) are included in the balance sheet item "Other non-current assets."

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Inventories

3 Months Ended

Mar. 31, 2019

Inventories

Inventories

7. Inventories

At March 31, 2019 and December 31, 2018, inventories consisted of the following:

Inventories
in € THOUS
	March 31,	December 31,
	2019	2018
Finished goods	895.533	774.133
Health care supplies	470.202	391.593
Raw materials and purchased components	237.664	224.054
Work in process	92.259	77.023
Inventories	1.695.658	1.466.803

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Short-term debt and short-term debt from related parties

3 Months Ended

Mar. 31, 2019

Short-term debt and short-term debt from related parties

Short-term debt and short-term debt from related parties

8. Short-term debt and short-term debt from related parties

At March 31, 2019 and December 31, 2018, short-term debt and short-term debt from related parties consisted of the following:

Short-term debt and short-term debt from related parties
in € THOUS
	March 31,	December 31,
	2019	2018
Commercial paper program	999.834	999.873
Borrowings under lines of credit	318.540	204.491
Other	1.623	930
Short-term debt	1.319.997	1.205.294
Short-term debt from related parties (see note 4c)	107.400	188.900
Short-term debt and short-term debt from related parties	1.427.397	1.394.194

The Company and certain consolidated entities operate a multi-currency notional pooling cash management system. The Company met the conditions to offset balances within this cash pool for reporting purposes. At March 31, 2019, cash and borrowings under lines of credit in the amount of €113.238 (December 31, 2018: €122.256) were offset under this cash management system.

Commercial paper program

The Company maintains a commercial paper program under which short-term notes of up to €1,000,000 can be issued. At March 31, 2019, the outstanding commercial paper amounted to €1.000.000 (December 31, 2018: €1.000.000).

Other

At March 31,2019, the Company had €1.623 (December 31, 2018:€930) of other debt outstanding related to fixed payments outstanding for acquisitions.

Short-term debt from related parties

The Company is party to an unsecured loan agreement with Fresenius SE under which the Company or FMCH may request and receive one or more short-term advances up to an aggregate amount of $400,000 until maturity on July 31, 2022. For further information on short-term debt from related parties, see note 4 c).

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Long-term debt and capital lease obligations

3 Months Ended

Mar. 31, 2019

Long-term debt and capital lease obligations

Long-term debt and capital lease obligations

9. Long-term debt

As of March 31, 2019 and December 31, 2018, long-term debt consisted of the following:

Long-term debt
in € THOUS
	March 31,	December 31,
	2019	2018
Amended 2012 Credit Agreement	2.296.088	1.887.357
Bonds	3.752.592	3.700.446
Convertible Bonds	394.794	393.232
Accounts Receivable Facility	589.779	-
Capital lease obligations(1)	-	36.144
Other	159.725	134.855
Long-term debt(2)	7.192.978	6.152.034
Less current portion	(1.511.815)	(1.106.519)
Long-term debt, less current portion(2)	5.681.163	5.045.515
1) As of December 31, 2018, this line item included lease liabilities from capital leases in accordance with IAS 17. From 2019, these are transferred to balance sheet items "Current portion of long-term lease liabilities" and "Long-term lease liabilities, less current portion" (see Note 1).
2) Labeled as "Long-term debt and capital lease obligations" as of December 31, 2018, this line item included lease liabilities from capital leases in accordance with IAS 17. From 2019, these are transferred to balance sheet item "Long-term lease liabilities, less current portion" (see Note 1).

Amended 2012 Credit Agreement

The following table shows the available and outstanding amounts under the Amended 2012 Credit Agreement at March 31, 2019 andDecember 31, 2018:

Amended 2012 Credit Agreement - Maximum amount available and balance outstanding
in THOUS
	Maximum amount available				Balance outstanding
	March 31, 2019				March 31, 2019 (1)
Revolving credit USD 2017 / 2022	$	900.000	€	801.068	$	246.345	€	219.266
Revolving credit EUR 2017 / 2022	€	600.000	€	600.000	€	200.000	€	200.000
USD term loan 2017 / 2022	$	1.320.000	€	1.174.900	$	1.320.000	€	1.174.900
EUR term loan 2017 / 2022	€	308.000	€	308.000	€	308.000	€	308.000
EUR term loan 2017 / 2020	€	400.000	€	400.000	€	400.000	€	400.000
			€	3.283.968			€	2.302.166
	Maximum amount available				Balance outstanding
	December 31, 2018				December 31, 2018 (1)
Revolving credit USD 2017 / 2022	$	900.000	€	786.026	$	-	€	-
Revolving credit EUR 2017 / 2022	€	600.000	€	600.000	€	-	€	-
USD term loan 2017 / 2022	$	1.350.000	€	1.179.039	$	1.350.000	€	1.179.039
EUR term loan 2017 / 2022	€	315.000	€	315.000	€	315.000	€	315.000
EUR term loan 2017 / 2020	€	400.000	€	400.000	€	400.000	€	400.000
			€	3.280.065			€	1.894.039
(1) Amounts shown are excluding debt issuance costs.

Accounts Receivable Facility

The following table shows the available and outstanding amounts under the Accounts Receivable Facility at March 31, 2019 and at December 31, 2018:

Accounts Receivable Facility - Maximum amount available and balance outstanding
in THOUS
	Maximum amount available				Balance outstanding
	March 31, 2019 (1)				March 31, 2019 (2)
Accounts Receivable Facility	$	900.000	€	801.068	$	663.500	€	590.565
	Maximum amount available				Balance outstanding
	December 31, 2018 (1)				December 31, 2018 (2)
Accounts Receivable Facility	$	900.000	€	786.026	$	-	€	-
(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 $26.631 and $26.631(€23.704 and €23.259) at March 31, 2019andDecember 31, 2018, respectively. These letters of credit are not included above as part of the balance outstanding at March 31, 2019 and December 31, 2018; however, they reduce available borrowings under the Accounts Receivable Facility.

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Employee benefit plans

3 Months Ended

Mar. 31, 2019

Employee benefit plans

Employee benefit plans

11. Employee benefit plans

The Company currently has five principal pension plans, one for German employees, three for French employees and the other covering employees in the United States, the last of which was curtailed in 2002. Plan benefits are generally based on years of service and final salary. As there is no legal requirement in Germany to fund defined benefit plans, the Company's pension obligations in Germany are unfunded. Each year FMCH contributes to the plan covering United States employees at least the minimum required by the Employee Retirement Income Security Act of 1974, as amended. In 2019, FMCH did not have a minimum funding requirement. For the first three monthsof2019, the Company voluntarily provided €294 to the defined benefit plan. For the remaining period of 2019, the Company expects further voluntarily contributions of €812.

The following table provides the calculations of net periodic benefit cost for the three months ended March 31, 2019 and 2018, respectively.

Net periodic benefit cost
in € THOUS
	For the three months ended March 31,
	2019	2018
Current service cost	7.444	6.794
Net interest cost	3.454	3.208
Net periodic benefit costs	10.898	10.002

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Supplementary information on capital management

3 Months Ended

Mar. 31, 2019

Supplementary information on capital management

Supplementary information on capital management

10. Supplementary information on capital management

As of March 31, 2019 and December 31, 2018the total equity in percent of total assets was 40,9%and 49,2%, respectively, and the debt in percent of total assets was 40,9%and 28,8%, respectively.

Further information on the Company’s capital management is available in the Annual Report on Form 20-F as of December 31, 2018.

The Company’s financing structure and business model are reflected in the investment grade ratings.The Company is coveredand rated investment grade by the three leading rating agencies, Moody’s, Standard & Poor’s and Fitch.

Rating (1)
	Standard & Poor´s	Moody´s	Fitch
Corporate Credit Rating	BBB-	Baa3	BBB-
Outlook	positive	stable	stable
(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.

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Earnings per share

3 Months Ended

Mar. 31, 2019

Earnings per share

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,
	2019		2018
Numerator:
Net income attributable to shareholders of FMC-AG & Co. KGaA		270.749		278.555
Denominators:
Weighted average number of shares outstanding		306.659.364		306.453.070
Potentially dilutive shares		-		986.454
Basic earnings per share		0,88		0,91
Fully diluted earnings per share		0,88		0,91

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Commitments and contingencies

3 Months Ended

Mar. 31, 2019

Commitments and contingencies

Commitments and contingencies

12. 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 probability is remote 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.

On February 15, 2011, a whistleblower (relator) action under the False Claims Act against FMCH was unsealed by order of the United States District Court for the District of Massachusetts and served by the relator. United States ex rel. Chris Drennen v. Fresenius Medical Care Holdings, Inc., 2009 Civ. 10179 (D. Mass.). The relator's complaint, which was first filed under seal in February 2009, alleged that FMCH sought and received reimbursement from government payors for serum ferritin and multiple forms of hepatitis B laboratory tests that were medically unnecessary or not properly ordered by a physician. Discovery on the relator's complaint closed in May 2015. Although the United States initially declined to intervene in the case, the government subsequently changed position. On April 3, 2017, the court allowed the government to intervene with respect only to certain hepatitis B surface antigen tests performed prior to 2011, when Medicare reimbursement rules for such tests changed. The court has subsequently rejected government requests to conduct new discovery and to add counts to its complaint-in-intervention that would expand upon the relator's complaint, but has allowed FMCH to take discovery against the government as if the government had intervened at the outset.

Beginning in 2012, the Company received certain communications alleging conduct in countries outside the United States that might violate the Foreign Corrupt Practices Act 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 and the United States Department of Justice (collectively and interchangeably the "government") about these investigations. The government also conducted its own investigations, in which the Company cooperated.

In the course of this dialogue, the Company identified and reported to the government, and took remedial actions including employee disciplinary actions with respect to, conduct that resulted in the government 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 recorded charges of €200,000 in 2017 and €77,200 in 2018 encompassing estimates for the government’s claims for profit disgorgement, penalties, certain legal expenses, and other related costs or asset impairments believed likely to be necessary for full and final resolution, by litigation or settlement, of the claims and issues arising from the investigation. The increase recorded in 2018 took into consideration preliminary understandings with the government on the financial terms of a potential settlement. Following this increase, which takes into account incurred and anticipated legal expenses, impairments and other costs, the provision totals €223,980 as of December 31, 2018.

On March 29, 2019, the Company entered into a non-prosecution agreement with the DOJ and a separate agreement with the SEC intended to resolve fully and finally the government’s claims against the Company arising from the investigations. The Company agreed to pay a combined total in penalties and disgorgement of approximately $231,700 to the government in connection with these agreements. As part of the settlement, the Company further agreed to retain an independent compliance monitor for a period of two years and to an additional year of self-reporting.The Company continues to cooperate with government authorities in Germany in their review of the issues resolved in the U.S. settlement.

The Company continues to implement enhancements to its anti-corruption compliance program, including internal controls related to compliance with international anti-bribery laws. The Company continues to be fully committed to compliance with the Foreign Corrupt Practices Act and other applicable anti-bribery laws.

Personal injury litigation involving the Company's acid concentrate product, labeled as Granuflo® or Naturalyte®, first arose in 2012 and was substantially resolved by settlement agreed in principle in February 2016 and consummated in November 2017. Remaining individual personal injury cases do not present material risk.

The Company's affected insurers agreed to the settlement of the acid concentrate personal injury litigation and funded $220,000 of the settlement fund under a reciprocal reservation of rights encompassing certain coverage issues raised by insurers and the Company's claims for indemnification of defense costs. The Company accrued a net expense of $60,000 in connection with the settlement, including legal fees and other anticipated costs. Following entry into the settlement, the Company's insurers in the AIG group and the Company each initiated litigation against the other relating to the AIG group's coverage obligations under applicable policies. In the coverage litigation, the AIG group seeks to be indemnified by the Company for a portion of its $220,000 outlay; the Company seeks to confirm the AIG group's $220,000 funding obligation, to recover defense costs already incurred by the Company, and to compel the AIG group to honor defense and indemnification obligations, if any, required for resolution of cases not participating in the settlement. As a result of decisions on issues of venue, the coverage litigation is proceeding in the New York state trial court for Manhattan. (National Union Fire Insurance v. Fresenius Medical Care, 2016 Index No. 653108 (Supreme Court of New York for New York County)).

Four institutional plaintiffs filed complaints against FMCH or its affiliates under state deceptive practices statutes resting on certain background allegations common to the GranuFlo®/NaturaLyte® personal injury litigation but seeking as a remedy the repayment of sums paid to FMCH that are attributable to the GranuFlo®/NaturaLyte® products. These cases implicate different legal standards, theories of liability and forms of potential recovery from those in the personal injury litigation and their claims were not extinguished by the personal injury litigation settlement described above. The four plaintiffs were the Attorneys General for the States of Kentucky, Louisiana and Mississippi and the commercial insurance company Blue Cross Blue Shield of Louisiana in its private capacity. State of Mississippi ex rel. Hood, v. Fresenius Medical Care Holdings, Inc., No. 14-cv-152 (Chancery Court, DeSoto County); State of Louisiana ex re. Caldwell and Louisiana Health Service & Indemnity Company v. Fresenius Medical Care Airline,et al 2016 Civ. 11035 (U.S.D.C. D. Mass.); Commonwealth of Kentucky ex rel. Beshear v. Fresenius Medical Care Holdings, Inc. et al., No. 16-CI-00946 (Circuit Court, Franklin County). On February 12, 2019, agreement was reached to settle and resolve Kentucky’s claims in Beshear in exchange for FMCH´s payment of $10,300 and the case has been dismissed. On April 1, 2019, agreement was reached to settle and resolve Mississippi’s claims in Hood for $15,700 and activity has ceased in that case pending the court’s expected approval. The Caldwell and Blue Cross Louisiana cases remain unresolved and are proceeding together in federal court in Boston but are subject to undecided motions for severance and remand. There is no trial date in either case.The Company has additionally increased its litigation reserves to account for anticipated settlement of some, but not all, of the remaining payor cases. However, at the present time there are no agreements in principle for resolving the remaining cases and litigation through final adjudication may be required in all of them.

On September 6, 2018, a special-purpose entity organized under Delaware law for the purpose of pursuing litigation filed a Pure Bill of Discovery in a Florida county court seeking discovery from FMCH related to the personal injury settlement, but no other relief.MSP Recovery Claims Series LLC v. Fresenius Medical Care Holdings, No. 2018-030366-CA-01 (11th Judicial Circuit, Dade County, Florida). The Pure Bill was thereafter removed to federal court and transferred into the multidistrict Fresenius Granuflo/Naturalyte Dialysate Products Liability Litigation in Boston. No.1:13-MD-02428-DPW (D. Mass. 2013). On March 12, 2019, plaintiff amended its Pure Bill by filing a complaint claiming rights to recover monetary damages on behalf of various persons and entities who are alleged to have assigned to plaintiff their rights to recover monetary damages arising from their having provided or paid for medical services for dialysis patients receiving treatments using FMCH’s acid concentrate product. FMCH is responding to the amended complaint.

In August 2014, FMCH received a subpoena from the United States Attorney for the District of Maryland inquiring into FMCH's contractual arrangements with hospitals and physicians involving contracts relating to the management of in-patient acute dialysis services. FMCH is cooperating in the investigation.

In July 2015, the Attorney General for Hawaii issued a civil complaint under the Hawaii False Claims Act alleging a conspiracy pursuant to which certain Liberty Dialysis subsidiaries of FMCH overbilled Hawaii Medicaid for Liberty's Epogen® administrations to Hawaii Medicaid patients during the period from 2006 through 2010, prior to the time of FMCH's acquisition of Liberty. Hawaii v. Liberty Dialysis – Hawaii, LLC et al., Case No. 15-1-1357-07 (Hawaii 1^st Circuit). The State alleges that Liberty acted unlawfully by relying on incorrect and unauthorized billing guidance provided to Liberty by Xerox State Healthcare LLC, which acted as Hawaii's contracted administrator for its Medicaid program reimbursement operations during the relevant period. The amount of the overpayment claimed by the State is approximately $8,000, but the State seeks civil remedies, interest, fines, and penalties against Liberty and FMCH under the Hawaii False Claims Act substantially in excess of the overpayment. After prevailing on motions by Xerox to preclude it from doing so, FMCH is pursuing third-party claims for contribution and indemnification against Xerox. The State's False Claims Act complaint was filed after Liberty initiated an administrative action challenging the State's recoupment of alleged overpayments from sums currently owed to Liberty. The civil litigation and administrative action are proceeding in parallel. Trial in the civil litigation is scheduled for April 2020.

On August 31, 2015, FMCH received a subpoena under the False Claims Act from the United States Attorney for the District of Colorado (Denver) inquiring into FMCH's participation in and management of dialysis facility joint ventures in which physicians are partners. FMCH continues to cooperate in the Denver United States Attorney’s Office (“USAO”) investigation, which has come to focus on purchases and sales of minority interests in ongoing outpatient facilities between FMCH and physician groups.

On November 25, 2015, FMCH received a subpoena under the False Claims Act from the United States Attorney for the Eastern District of New York (Brooklyn) also inquiring into FMCH’s involvement in certain dialysis facility joint ventures in New York. On September 26, 2018, the Brooklyn USAO declined to intervene on the qui tam complaint filed under seal in 2014 that gave rise to this investigation. CKD Project LLC v. Fresenius Medical Care, 2014 Civ. 6646 (E.D.N.Y. November 12, 2014). The court unsealed the complaint, allowing the relator to serve and proceed on its own. The relator — a special-purpose entity formed by law firms to pursue qui tam proceedings — has served its complaint and litigation is proceeding.

Beginning October 6, 2015, the United States Attorney for the Eastern District of New York (Brooklyn) has led an investigation, through subpoenas issued under the False Claims Act, utilization and invoicing by the Company's subsidiary Azura Vascular Care for a period beginning after the Company's acquisition of American Access Care LLC ("AAC") in October 2011. The Company has cooperated in the Brooklyn USAO investigation, which is continuing. Allegations against AAC arising in districts in Connecticut, Florida and Rhode Island relating to utilization and invoicing were settled in 2015.

On October 22, 2018, the United States Attorney for the Southern District of New York (Manhattan) announced a False Claims Act settlement for up to $18,400 with Vascular Access Centers LP, a competitor of AAC and Azura. Simultaneously, the 2012 qui tam (whistleblower) complaint that gave rise to the investigation was unsealed. Levine v. Vascular Access Centers, 2012 Civ. 5103 (S.D.N.Y.). That qui tam complaint names as defendants, among others in the dialysis industry, subsidiaries and employees of the Company engaged in the vascular access business. The Manhattan USAO did not intervene against non-settling defendants, allowing the relator to proceed on his own against those defendants. The relator subsequently dismissed with prejudice the defendants related to FMCH.

On June 30, 2016, FMCH received a subpoena from the United States Attorney for the Northern District of Texas (Dallas) seeking information under the False Claims Act about the use and management of pharmaceuticals including Velphoro®. The investigation encompasses DaVita, Amgen, Sanofi, and other pharmaceutical manufacturers and includes inquiries into whether certain compensation transfers between manufacturers and pharmacy vendors constituted unlawful kickbacks. The Company understands that this investigation is substantively independent of the $63,700 settlement by DaVita Rx announced on December 14, 2017 in the matter styled United States ex rel. Gallian v. DaVita Rx, 2016 Civ. 0943 (N.D. Tex.). FMCH is cooperating in the investigation.

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., which FMCH acquired in October 2013. In the course of cooperating in the investigation and preparing to respond to the subpoena, FMCH identified falsifications and misrepresentations in documents submitted by a Shiel salesperson that relate to the integrity of certain invoices submitted by Shiel for laboratory testing for patients in long term care facilities. On February 21, 2017, FMCH terminated the employee and notified the United States Attorney of the termination and its circumstances. The terminated employee's conduct is expected to result in demands for the Company to refund overpayments and to pay related penalties under applicable laws, but the monetary value of such payment demands cannot yet be reasonably estimated. The Brooklyn USAO continues to investigate a range of issues involving Shiel, including allegations of improper compensation (kickbacks) to physicians, and has disclosed that multiple sealed qui tam complaints underlie the investigation.

On December 12, 2017, the Company sold to Quest Diagnostics certain Shiel operations that are the subject of this Brooklyn subpoena, including the misconduct reported to the United States Attorney. Under the sale agreement, the Company retains responsibility for the Brooklyn investigation and its outcome. The Company continues to cooperate in the ongoing investigation.

On December 14, 2016, the Center for Medicare & Medicaid Services ("CMS"), which administers the federal Medicare program, published an Interim Final Rule ("IFR") titled "Medicare Program; Conditions for Coverage for End-Stage Renal Disease Facilities-Third Party Payment." The IFR would have amended the Conditions for Coverage for dialysis providers, like FMCH and would have effectively enabled insurers to reject premium payments made by or on behalf of patients who received grants for individual market coverage from the American Kidney Fund ("AKF" or "the Fund"). The IFR could thus have resulted in those patients losing individual insurance market coverage. The loss of coverage for these patients would have had a material and adverse impact on the operating results of FMCH.

On January 25, 2017, a federal district court in Texas responsible for litigation initiated by a patient advocacy group and dialysis providers including FMCH preliminarily enjoined CMS from implementing the IFR. Dialysis Patient Citizens v. Burwell, 2017 Civ. 0016 (E.D. Texas, Sherman Div.). The preliminary injunction was based on CMS' failure to follow appropriate notice-and-comment procedures in adopting the IFR. The injunction remains in place and the court retains jurisdiction over the dispute.

On June 22, 2017, CMS requested a stay of proceedings in the litigation pending further rulemaking concerning the IFR. CMS stated, in support of its request, that it expects to publish a Notice of Proposed Rulemaking in the Federal Register and otherwise pursue a notice-and-comment process. Plaintiffs in the litigation, including FMCH, consented to the stay, which was granted by the court on June 27, 2017.

On January 3, 2017, FMCH received a subpoena from the United States Attorney for the District of Massachusetts under the False Claims Act inquiring into FMCH’s interactions and relationships with the AKF, including FMCH's charitable contributions to the Fund and the Fund's financial assistance to patients for insurance premiums. FMCH is cooperating in the investigation, which is part of a broader investigation into charitable contributions in the medical industry. The Company believes that the investigation revolves around conduct alleged to be unlawful in United Healthcare v. American Renal Associates, 2018 Civ. 10622 (D. Mass.), but believes that such unlawful conduct was not undertaken by the Company. On July 2, 2018, American Renal Associates announced that it had reached a settlement in principle of the United Healthcare litigation. The Company lacks information necessary to assess how the American Renal Associates settlement may impact the United States Attorney's investigation.

On April 8, 2019, United Healthcare served a demand for arbitration against FMCH. The demand asserts that FMCH unlawfully “steered” patients by waiving co-payments and other means away from coverage under government-funded insurance plans including Medicare into United’s commercial plans, including Affordable Care Act exchange plans. FMCH is contesting United’s claims and demands.

In early May 2017, the United States Attorney for the Middle District of Tennessee (Nashville) issued identical subpoenas to FMCH and two subsidiaries under the False Claims Act concerning the Company's retail pharmaceutical business. The investigation is exploring allegations related to improper inducements to dialysis patients to fill oral prescriptions through FMCH's pharmacy service, improper billing for returned pharmacy products and other allegations similar to those underlying the $63,700 settlement by DaVita Rx in Texas announced on December 14, 2017. United States ex rel. Gallian, 2016 Civ. 0943 (N.D. Tex.). FMCH is cooperating in the investigation.

On March 12, 2018, Vifor Fresenius Medical Care Renal Pharma Ltd. and Vifor Fresenius Medical Care Renal Pharma France S.A.S. (collectively, “VFMCRP”) (the joint venture between Galenica (Vifor) and FMC-AG & Co. KGaA), filed a complaint for patent infringement against Lupin Atlantis Holdings SA and Lupin Pharmaceuticals Inc. (collectively, “Lupin”), and Teva Pharmaceuticals USA, Inc. (“Teva”) in the U.S. District Court for the District of Delaware (Case 1:18-cv-00390-LPS). The patent infringement action is in response to Lupin and Teva’s filings of Abbreviated New Drug Applications (ANDA) with the FDA for generic versions of Velphoro®. Velphoro® is protected by patents listed in the FDA’s Approved Drug Products with Therapeutic Equivalence Evaluations, also known as the Orange Book. The complaint was filed within the 45-day period provided for under the Hatch-Waxman legislation, and triggered a stay of FDA approval of the ANDAs for 30 months (2.5 years) (specifically, up to July 29, 2020 for Lupin’s ANDA; and August 6, 2020 for Teva’s ANDA), or a shorter time if a decision in the infringement suit is reached that the patents-at-issue are invalid or not infringed. Recently, in response to another ANDA being filed for a generic Velphoro®, VFMCRP filed a complaint for patent infringement against Annora Pharma Private Ltd., and Hetero Labs Ltd. (collectively, “Annora”), in the U.S. District Court for the District of Delaware on December 17, 2018. A 30-month stay of FDA approval of Annora’s ANDA will run through to May 30, 2021.

On December 17, 2018, FMCH was served with a subpoena under the False Claims Act from the United States Attorney for the District of Colorado (Denver) as part of an investigation of allegations against DaVita, Inc. involving transactions between FMCH and DaVita. The subject transactions include sales and purchases of dialysis facilities, dialysis-related products and pharmaceuticals, including dialysis machines and dialyzers, and contracts for certain administrative services. FMCH is cooperating in 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 healthcare providers, insurance plans and suppliers, conducts its operations under intense government regulation and scrutiny. It 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 U.S. Food and Drug Administration ("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 is currently engaged in remediation efforts with respect to one pending FDA warning 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. Applicable laws or regulations may be amended, or enforcement agencies or courts may make interpretations that differ from the Company's interpretations or the manner in which it conducts its business. Enforcement has become a high priority for the federal government and some states. In addition, the provisions of the False Claims Act authorizing payment of a portion of any recovery to the party bringing the suit encourage private plaintiffs to commence whistleblower actions. By virtue of this regulatory environment, the Company's business activities and practices are subject to extensive review by regulatory authorities and private parties, and continuing audits, subpoenas, other inquiries, claims and litigation relating to the Company's compliance with applicable laws and regulations. The Company may not always be aware that an inquiry or action has begun, particularly in the case of whistleblower actions, which are initially filed under court seal.

The Company operates many facilities and handles the personal data ("PD") 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 decentralized system, it is often difficult to maintain the desired level of oversight and control over the thousands of individuals employed by many affiliated companies and its business associates. 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 and or other similar laws ("Data Protection Laws") when there has been impermissible use, access, or disclosure of unsecured PD 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 must comply with applicable breach notification requirements.

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. 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 Foreign Corrupt Practices Act, among other laws and comparable state laws or laws of other countries.

Physicians, hospitals and other participants in the healthcare 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 the 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.

In Germany, the tax audits for the years 2006 through 2009 have been substantially completed. The German tax authorities have indicated a re-qualification of dividends received in connection with intercompany mandatorily redeemable preferred shares into fully taxable interest payments for these and subsequent years until 2013. The Company has defended its position and will avail itself of appropriate remedies. An adverse determination with respect to fully taxable interest payments related to intercompany mandatorily redeemable preferred shares and the disallowance of certain other tax deductions could have a material adverse effect on the Company's financial condition and results of operations.

The Company is also 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. Any claims, regardless of their merit or eventual outcome, could have a material adverse effect on the Company's reputation and business.

Other than those individual contingent liabilities mentioned above, the current estimated amount of the Company's other known individual contingent liabilities is immaterial.

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Financial instruments

3 Months Ended

Mar. 31, 2019

Financial instruments

Financial instruments

13. Financial instruments

The following tables show the carrying amounts and fair values of the Company’s financial instruments at March 31, 2019 and December 31,2018:

Carrying amount and fair value of financial instruments
in € THOUS
March 31, 2019	Carrying amount					Fair value
	Amortized cost	FVPL	FVOCI	Not classified	Total	Level 1	Level 2	Level 3
Cash and cash equivalents (1)	705.731	253.057	-	-	958.788	-	253.057	-
Trade accounts and other receivables	3.801.501	-	-	55.390	3.856.891	-	-	-
Accounts receivable from related parties	95.281	-	-	-	95.281	-	-	-
Derivatives - cash flow hedging instruments	-	-	-	1.232	1.232	-	1.232	-
Derivatives - not designated as hedging instruments	-	29.646	-	-	29.646	-	29.646	-
Equity investments	-	113.668	33.608	-	147.276	13.045	134.231	-
Debt securities	-	94.223	256.902	-	351.125	346.508	4.617	-
Other financial assets	127.088	-	-	105.063	232.151	-	-	-
Other current and non-current assets	127.088	237.537	290.510	106.295	761.430	-	-	-
Financial assets	4.729.601	490.594	290.510	161.685	5.672.390	-	-	-
Accounts payable	707.774	-	-	-	707.774	-	-	-
Accounts payable to related parties	210.384	-	-	-	210.384	-	-	-
Short-term debt and short-term debt from related parties	1.427.397	-	-	-	1.427.397	-	-	-
Long-term debt	7.192.978	-	-	-	7.192.978	4.331.857	3.049.725	-
Long-term lease liabilities and long-term lease liabilities from related parties	-	-	-	4.612.064	4.612.064	-	-	-
Derivatives - cash flow hedging instruments	-	-	-	4.874	4.874	-	4.874	-
Derivatives - not designated as hedging instruments	-	40.184	-	-	40.184	-	40.184	-
Variable payments outstanding for acquisitions	-	135.161	-	-	135.161	-	-	135.161
Noncontrolling interest subject to put provisions	-	-	-	831.630	831.630	-	-	831.630
Other financial liabilities	1.275.539	-	-	-	1.275.539	-	-	-
Other current and non-current liabilities	1.275.539	175.345	-	836.504	2.287.388	-	-	-
Financial liabilities	10.814.072	175.345	-	5.448.568	16.437.985	-	-	-
(1) Highly liquid short-term investments are categorized in level 2 of the fair value hierarchy. Other cash and cash equivalents is not categorized.

Carrying amount and fair value of financial instruments
in € THOUS
December 31, 2018	Carrying amount					Fair value
	Amortized cost	FVPL	FVOCI	Not classified	Total	Level 1	Level 2	Level 3
Cash and cash equivalents (1)	831.885	1.313.747	-	-	2.145.632	-	1.313.747	-
Trade accounts and other receivables	3.288.258	-	-	49.448	3.337.706	-	-	-
Accounts receivable from related parties	92.662	-	-	-	92.662	-	-	-
Derivatives - cash flow hedging instruments	-	-	-	1.492	1.492	-	1.492	-
Derivatives - not designated as hedging instruments	-	18.222	-	-	18.222	-	18.222	-
Equity investments	-	106.350	34.377	-	140.727	13.869	126.858	-
Debt securities	-	83.213	250.822	-	334.035	329.821	4.214	-
Other financial assets	144.838	-	-	107.125	251.963	-	-	-
Other current and non-current assets	144.838	207.785	285.199	108.617	746.439	-	-	-
Financial assets	4.357.643	1.521.532	285.199	158.065	6.322.439	-	-	-
						-	-	-
Accounts payable	641.271	-	-	-	641.271	-	-	-
Accounts payable to related parties	153.781	-	-	-	153.781	-	-	-
Short-term debt and short-term debt from related parties	1.394.194	-	-	-	1.394.194	-	-	-
Long-term debt and capital lease obligations	6.115.890	-	-	36.144	6.152.034	4.227.684	2.022.057	-
Derivatives - cash flow hedging instruments	-	-	-	1.125	1.125	-	1.125	-
Derivatives - not designated as hedging instruments	-	18.911	-	-	18.911	-	18.911	-
Variable payments outstanding for acquisitions	-	172.278	-	-	172.278	-	-	172.278
Noncontrolling interest subject to put provisions	-	-	-	818.871	818.871	-	-	818.871
Other financial liabilities	1.467.767	-	-	-	1.467.767	-	-	-
Other current and non-current liabilities	1.467.767	191.189	-	819.996	2.478.952	-	-	-
Financial liabilities	9.772.903	191.189	-	856.140	10.820.232	-	-	-
(1) Highly liquid short-term investments are categorized in level 2 of the fair value hierarchy. Other cash and cash equivalents is not categorized.

Derivative and non-derivative financial instruments are categorised in the following three-tier fair value hierarchy that reflects the significance of the inputs in making the measurements. Level 1 is defined as observable inputs, such as quoted prices in active markets. Level 2 is defined as inputs other than quoted prices in active markets that are directly or indirectly observable. Level 3 is defined as 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 lease liabilities and 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. Transfers between levels of the fair value hierarchy have not occurred as of March 31, 2019 and December 31,2018. The Company accounts for possible transfers at the end of the reporting period.

Derivative financial instruments

In order to manage the risk of currency exchange rate fluctuations and interest rate fluctuations, the Company enters into various hedging transactions by means of derivative instruments with highly rated financial institutions. The Company primarily enters into foreign exchange forward contracts and interest rate swaps. Derivative contracts that do not qualify for hedge accounting are utilized for economic purposes. The Company does not use financial instruments for trading purposes. Additionally the Company purchased share options in connection with the issuance of the Convertible Bonds. Any change in the Company’s share price above the conversion price would be offset by a corresponding value change in the share options.

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 the contractual cash flows. The contractual terms of the financial assets allow the conclusion that the cash flows represent payment of principle and interest only. Trade accounts and other receivables, 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 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 OCI. If equity instruments are quoted in an active market, the fair value is based on price quotations at the period-end-date.

The majority of the debt securities are held within a business model whose objective is achieving both contractual cash flows and sell the 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 FVOCI. The smaller part of debt securities do not give rise to cash flows that are solely payments of principle 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 recognized at its carrying amount. 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 the 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.

Noncontrolling interests subject to put provisions are recognized at their fair value. 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. Additionally, there are put provisions that are valued by an external valuation firm. The external valuation estimates the fair values using a combination of discounted cash flows and a multiple of earnings and/or revenue. When applicable, the obligations 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 the noncontrolling interests subject to these put provisions can also fluctuate, and the discounted cash flows as well as the implicit multiple of earnings and/or revenue at which these noncontrolling interest obligations may ultimately be settled could vary significantly from the Company’s current estimates depending upon market conditions.

Following is a roll forward of variable payments outstanding for acquisitions and noncontrolling interests subject to put provisions at March 31, 2019 and December 31,2018:

Reconciliation from beginning to ending balance of level 3 financial instruments
in € THOUS
	2019		2018
	Variable payments outstanding for acquisitions	Noncontrolling interests subject to put provisions	Variable payments outstanding for acquisitions	Noncontrolling interests subject to put provisions
Beginning balance at January 1,	172.278	818.871	205.792	830.773
Increase	83	15.997	19.051	53.731
Decrease	(3.653)	(968)	(15.734)	(50.706)
(Gain) Loss recognized in profit or loss	(34.666)	32.586	(36.327)	142.279
(Gain) Loss recognized in equity	-	(26.895)	-	(50.612)
Dividends	-	(28.287)	-	(139.742)
Foreign currency translation and other changes	1.119	20.326	(504)	33.148
Ending balance at March 31, and December 31,	135.161	831.630	172.278	818.871

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Supplementary cash flow information

3 Months Ended

Mar. 31, 2019

Supplementary cash flow information

Supplementary cash flow information

15. Supplementary cash flow information

The following additional information is provided with respect to net cash provided by (used in) investing activities:

Details for net cash provided by (used in) investing activities
in € THOUS
	For the three months ended March 31,
	2019	2018
Details for acquisitions
Assets acquired	(2.082.291)	(36.062)
Liabilities assumed	190.406	2.608
Noncontrolling interests subject to put provisions	12.679	-
Noncontrolling interests	10.492	-
Non-cash consideration	6.518	2.864
Cash paid	(1.862.196)	(30.590)
Less cash acquired	42.496	252
Net cash paid for acquisitions	(1.819.700)	(30.338)
Cash paid for investments	(282)	(146.867)
Cash paid for intangible assets	(8.543)	(4.198)
Total cash paid for acquisitions and investments, net of cash acquired, and purchases of intangible assets	(1.828.525)	(181.403)
Details for divestitures
Cash received from sale of subsidiaries or other businesses, less cash disposed	6.782	-
Cash received from divestitures of securities	4.230	82
Cash received from repayment of loans	-	76
Proceeds from divestitures	11.012	158

Acquisitions of the last twelve months decreasednet income (net income attributable to shareholders of FMC-AG & Co. KGaA) for the three months ended March 31, 2019by €12,593 (excluding the costs of the acquisitions).

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Segment and corporate information

3 Months Ended

Mar. 31, 2019

Segment and corporate information

Segment and corporate information

14. Segment and corporate information

The Company’s operating segments are the North America Segment, the EMEA Segment, the Asia-Pacific Segment and the Latin America Segment. The operating segments are determined based upon how the Company manages its businesses with geographical responsibilities. All segments are primarily engaged in providing health care services and the distribution of products and equipment for the treatment of ESRD and other extracorporeal therapies.

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, operating income and operating income margin. The Company does not include income taxes as it believes this is outside the segments’ control. Financing is a corporate function, which the Company’s segments do not control. Therefore, the Company does not include interest expense relating to financing as a segment measurement. Similarly, the Company does not allocate certain costs, which relate primarily to certain headquarters’ overhead charges, including accounting and finance, because the Company believes that these costs are also not within the control of the individual segments. Production of products, production asset management, quality and supply chain management as well as procurement related to production are centrally managed at Corporate. The Company’s global research and development is also centrally managed at Corporate. These corporate activities do not fulfill the definition of a segment according to IFRS 8, Operating Segments. Products are transferred to the segments at cost; therefore, no internal profit is generated. The associated internal revenue for the product transfers and their elimination are recorded as corporate activities. Capital expenditures for production are based on the expected demand of the segments and consolidated profitability considerations. In addition, certain revenues, investments and intangible assets, as well as any related expenses, are not allocated to a segment but are accounted for as Corporate.

Information pertaining to the Company’s segment and Corporate activities for the three months ended March 31, 2019 and 2018 is set forth below:

Segment and corporate information
in € THOUS
	North America Segment	EMEA Segment	Asia-Pacific Segment		Latin America Segment	Total Segment	Corporate	Total
Three months ended March 31, 2019
Revenue from contracts with customers	2.826.212	635.800	411.603		160.601	4.034.216	4.168	4.038.384
Other revenue external customers	60.564	16.813	15.971		825	94.173	-	94.173
Revenue external customers	2.886.776	652.613	427.574		161.426	4.128.389	4.168	4.132.557
Inter-segment revenue	576	1	234		65	876	(876)	-
Revenue	2.887.352	652.614	427.808		161.491	4.129.265	3.292	4.132.557
Operating income	372.394	137.776	94.702		11.395	616.267	(79.717)	536.550
Interest								(107.848)
Income before income taxes								428.702
Depreciation and amortization	(228.735)	(46.973)	(22.601)		(8.363)	(306.672)	(55.704)	(362.376)
Income (loss) from equity method investees	21.362	(1.317)	(294)		282	20.033	-	20.033
Total assets	21.513.220	4.232.196	2.669.344		821.984	29.236.744	3.116.460	32.353.204
thereof investment in equity method investees	332.184	177.658	96.641		23.956	630.439	-	630.439
Additions of property, plant and equipment, intangible assets and right of use assets	188.150	47.114	13.743		14.783	263.790	73.487	337.277
				´´
Three months ended March 31, 2018
Revenue from contracts with customers	2.719.627	631.224	380.801		169.340	3.900.992	3.643	3.904.635
Other revenue external customers	54.835	4.584	10.661		914	70.994	-	70.994
Revenue external customers	2.774.462	635.808	391.462		170.254	3.971.986	3.643	3.975.629
Inter-segment revenue	400	303	187		39	929	(929)	-
Revenue	2.774.862	636.111	391.649		170.293	3.972.915	2.714	3.975.629
Operating income	362.208	108.934	74.220		14.114	559.476	(62.600)	496.876
Interest								(82.933)
Income before income taxes								413.943
Depreciation and amortization	(90.655)	(28.861)	(11.159)		(4.580)	(135.255)	(39.739)	(174.994)
Income (loss) from equity method investees	18.801	(1.334)	335		102	17.904	-	17.904
Total assets	15.408.120	3.640.775	2.081.140		694.375	21.824.410	2.332.651	24.157.061
thereof investment in equity method investees	316.916	181.938	96.961		23.915	619.730	-	619.730
Additions of property, plant and equipment and intangible assets	141.821	30.405	10.034		3.796	186.056	45.114	231.170

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Subsequent events

3 Months Ended

Mar. 31, 2019

Subsequent events

Subsequent events

16. Events occurring after the balance sheet date

Nosignificant activities have taken place subsequent to the balance sheet date March 31, 2019that have a material impact on the key figures and earnings presented. Currently, there are no other significant changes in the Company’s structure, management, legal form or personnel.

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The Company, basis of presentation and significant accounting policies (Tables)

3 Months Ended

Mar. 31, 2019

The Company, basis of presentation and significant accounting policies

Reconciliation of IFRS 16 Lease Liabilities

Reconciliation of lease liabilities upon the initial application of IFRS 16
in € THOUS
Future minimum rental payments as of December 31, 2018 (IAS 17)	5.527.638
less short-term leases	(21.936)
less leases of low-value assets	(34.145)
other	(30.066)
Gross lease liabilities as of January 1, 2019	5.441.491
Discounting	(893.957)
Lease liabilities as a result of the initial application of IFRS 16 as of January 1, 2019	4.547.534
Lease liabilities from capital leases as of December 31, 2018 (IAS 17)	36.144
Lease liabilities as of January 1, 2019	4.583.678

Leasing on the consolidated statements of income

Leasing in the consolidated statements of income
in € THOUS
	For the three months ended March 31,
	2019
Depreciation on right-of-use assets	168.893
Expenses relating to short-term leases	12.211
Expenses relating to leases of low-value assets	6.139
Expenses relating to variable lease payments	6.680
Income from subleasing right-of-use asset	55
Interest expense on lease liabilities	41.106

Leasing on the consolidated balance sheet

Right-of-use assets
in € THOUS
	March 31,
	2019
Right-of-use assets: Land	29.144
Right-of-use assets: Buildings and improvements	3.871.970
Right-of-use assets: Machinery and equipment	409.862
Right-of-use assets	4.310.976

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Notes to the consolidated statements of income (Tables)

3 Months Ended

Mar. 31, 2019

Notes to the consolidated statements of income

Disclosure of earnings per share [text block]

Reconciliation of Basic and Diluted Earnings per Share
in € THOUS, except share and per share data
	For the three months ended March 31,
	2019		2018
Numerator:
Net income attributable to shareholders of FMC-AG & Co. KGaA		270.749		278.555
Denominators:
Weighted average number of shares outstanding		306.659.364		306.453.070
Potentially dilutive shares		-		986.454
Basic earnings per share		0,88		0,91
Fully diluted earnings per share		0,88		0,91

Disclosure of Revenue

Revenue
in € THOUS
		For the three months endedMarch 31,
		2019			2018
		Revenue from contracts with customers	Other revenue	Total	Revenue from contracts with customers	Other revenue	Total
Health care services
	Dialysis services	2.957.381	-	2.957.381	2.648.293	-	2.648.293
	Care Coordination	299.544	60.383	359.927	507.244	53.258	560.502
		3.256.925	60.383	3.317.308	3.155.537	53.258	3.208.795
Health care products
	Dialysis products	762.885	33.790	796.675	729.956	17.736	747.692
	Non-dialysis products	18.574	-	18.574	19.142	-	19.142
		781.459	33.790	815.249	749.098	17.736	766.834
Total		4.038.384	94.173	4.132.557	3.904.635	70.994	3.975.629

Treasury Shares [Table Text Block]

Treasury Stock
Period		Average price paid per share	Total number of shares purchased and retired as part of publicly announced plans or programs	Total value of shares (1)
		in €		in € THOUS
December 31, 2017		65,63	1.659.951	108.931
Purchase of Treasury Stock
	May 2018	86,69	173.274	15.020
	June 2018	86,14	257.726	22.201
	Repurchased Treasury Stock	86,37	431.000	37.221
Retirement of repurchased Treasury Stock
	December 2018	87,23	1.091.000	95.159
December 31, 2018		51,00	999.951	50.993
Purchase of Treasury Stock
	March 2019	69,86	1.629.240	113.816
March 31, 2019		62,69	2.629.191	164.809
(1) The value of shares repurchased is inclusive of fees (net of taxes) paid in the amount of approximately €11, respectively, for services rendered.

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Acquisitions - Estimated Fair Values of Assets Acquired and Liabilities Assumed - Preliminary (Tables)

3 Months Ended

Mar. 31, 2019

Estimated Fair Values of Assets Acquired and Liabilities Assumed

Summary of Estimated Fair Values of Assets Acquired and Liabilities Assumed

Estimated Fair Values of Assets Acquired and Liabilities Assumed - Preliminary
in $ THOUS
	in USD
Cash and cash equivalents	47.203
Trade accounts and other receivables	34.062
Other current assets	88.987
Property, plant and equipment	85.470
Intangible assets and other assets	818.150
Goodwill	1.165.289
Accounts payable, current provisions and other current liabilities	(69.456)
Income tax payable and deferred taxes	(119.086)
Other liabilities	(23.118)
Noncontrolling interests (subject and not subject to put provisions)	(4.063)
Total acquisition cost	2.023.438
Less:
Cash acquired	(47.203)
Net Cash paid	1.976.235

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Acquisitions - Pro Forma financial Information (Tables)

3 Months Ended

Mar. 31, 2019

Pro forma Financial Information

Summary of Pro forma financial information

Pro forma financial Information
in € THOUS, except per share data
	2019
	in EUR
Pro forma revenue	4.176.790
Pro forma net income attributable to shareholders of FMC-AG & Co. KGaA	254.538
Basic earnings per share	0,83
Fully diluted earnings per share	0,83

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Related party transactions (Tables)

3 Months Ended

Mar. 31, 2019

Related party transactions

Schedule of Related Party Transactions

Service agreements and products with related parties
in € THOUS
		For the three months endedMarch 31, 2019				For the three months endedMarch 31, 2018				March 31, 2019				December 31, 2018
		Sales of goods and services		Purchases of goods and services		Sales of goods and services		Purchases of goods and services		Accounts receivable		Accounts payable		Accounts receivable		Accounts payable
Service agreements(1)
	Fresenius SE		32		5.182		70		5.724		1.064		3.149		378		4.019
	Fresenius SE affiliates		940		24.652		876		24.455		849		7.946		681		8.470
	Equity method investees		730		-		5.060		-		78		-		2.449		-
	Total		1.702		29.834		6.006		30.179		1.991		11.095		3.508		12.489
Products
	Fresenius SE affiliates		9.862		8.290		7.907		9.075		11.062		3.699		8.750		3.658
	Equity method investees		-		151.645		-		121.021		-		112.907		-		57.975
	Total		9.862		159.935		7.907		130.096		11.062		116.606		8.750		61.633
	(1) In addition to the above shown accounts payable, accrued expenses for service agreements with related parties amounted to €6,687 and €9,376 at March 31, 2019 and December 31, 2018, respectively.

Schedule of Related Party Lease Transactions

Lease agreements with related parties
in € THOUS
		For the three months endedMarch 31, 2019				For the three months endedMarch 31, 2018		March 31, 2019
		Depreciation		Interest expense	Lease expense (1)	Lease income	Lease expense	Right-of-use asset		Lease liability
	Fresenius SE		1.214	137	854	-	2.069		35.219	35.286
	Fresenius SE affiliates		3.089	353	161	-	3.692		97.966	98.116
	Total		4.303	490	1.015	-	5.761		133.185	133.402
	(1) Short-term leases and expenses relating to variable lease payments are exempted from balance sheet recognition.

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Cash and cash equivalents (Tables)

3 Months Ended

Mar. 31, 2019

Cash and cash equivalents

Summary of Cash and cash equivalents

Cash and cash equivalents
in € THOUS
	March 31,	December 31,
	2019	2018
Cash	705.731	831.885
Securities and time deposits	253.057	1.313.747
Cash and cash equivalents	958.788	2.145.632

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Trade accounts receivable (Tables)

3 Months Ended

Mar. 31, 2019

Trade accounts receivable

Components of trade accounts receivable

Trade accounts and other receivables
in € THOUS
		March 31,		December 31,
		2019		2018
			thereof Credit-Impaired		thereof Credit-Impaired
Trade accounts and other receivables, gross		3.980.307	387.850	3.455.721	325.240
	thereof Finance Lease Receivables	44.037	-	28.726	-
less allowances		(123.416)	(87.056)	(118.015)	(85.775)
Trade accounts and other receivables		3.856.891	300.794	3.337.706	239.465

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Inventories (Tables)

3 Months Ended

Mar. 31, 2019

Inventories

Summary of Inventories

Inventories
in € THOUS
	March 31,	December 31,
	2019	2018
Finished goods	895.533	774.133
Health care supplies	470.202	391.593
Raw materials and purchased components	237.664	224.054
Work in process	92.259	77.023
Inventories	1.695.658	1.466.803

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Short-term debt and short-term debt from related parties (Tables)

3 Months Ended

Mar. 31, 2019

Short-term debt and short-term debt from related parties

Schedule of short-term debt and short-term debt from related parties

Short-term debt and short-term debt from related parties
in € THOUS
	March 31,	December 31,
	2019	2018
Commercial paper program	999.834	999.873
Borrowings under lines of credit	318.540	204.491
Other	1.623	930
Short-term debt	1.319.997	1.205.294
Short-term debt from related parties (see note 4c)	107.400	188.900
Short-term debt and short-term debt from related parties	1.427.397	1.394.194

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Long-term debt and capital lease obligations (Tables)

3 Months Ended

Mar. 31, 2019

Long-term debt and capital lease obligations

Schedule of long-term debt and capital lease obligations

Long-term debt
in € THOUS
	March 31,	December 31,
	2019	2018
Amended 2012 Credit Agreement	2.296.088	1.887.357
Bonds	3.752.592	3.700.446
Convertible Bonds	394.794	393.232
Accounts Receivable Facility	589.779	-
Capital lease obligations(1)	-	36.144
Other	159.725	134.855
Long-term debt(2)	7.192.978	6.152.034
Less current portion	(1.511.815)	(1.106.519)
Long-term debt, less current portion(2)	5.681.163	5.045.515
1) As of December 31, 2018, this line item included lease liabilities from capital leases in accordance with IAS 17. From 2019, these are transferred to balance sheet items "Current portion of long-term lease liabilities" and "Long-term lease liabilities, less current portion" (see Note 1).
2) Labeled as "Long-term debt and capital lease obligations" as of December 31, 2018, this line item included lease liabilities from capital leases in accordance with IAS 17. From 2019, these are transferred to balance sheet item "Long-term lease liabilities, less current portion" (see Note 1).

Schedule of available and outstanding amounts under the Amended 2012 Credit Agreement

Amended 2012 Credit Agreement - Maximum amount available and balance outstanding
in THOUS
	Maximum amount available				Balance outstanding
	March 31, 2019				March 31, 2019 (1)
Revolving credit USD 2017 / 2022	$	900.000	€	801.068	$	246.345	€	219.266
Revolving credit EUR 2017 / 2022	€	600.000	€	600.000	€	200.000	€	200.000
USD term loan 2017 / 2022	$	1.320.000	€	1.174.900	$	1.320.000	€	1.174.900
EUR term loan 2017 / 2022	€	308.000	€	308.000	€	308.000	€	308.000
EUR term loan 2017 / 2020	€	400.000	€	400.000	€	400.000	€	400.000
			€	3.283.968			€	2.302.166
	Maximum amount available				Balance outstanding
	December 31, 2018				December 31, 2018 (1)
Revolving credit USD 2017 / 2022	$	900.000	€	786.026	$	-	€	-
Revolving credit EUR 2017 / 2022	€	600.000	€	600.000	€	-	€	-
USD term loan 2017 / 2022	$	1.350.000	€	1.179.039	$	1.350.000	€	1.179.039
EUR term loan 2017 / 2022	€	315.000	€	315.000	€	315.000	€	315.000
EUR term loan 2017 / 2020	€	400.000	€	400.000	€	400.000	€	400.000
			€	3.280.065			€	1.894.039
(1) Amounts shown are excluding debt issuance costs.

Schedule of accounts receivable facility

Accounts Receivable Facility - Maximum amount available and balance outstanding
in THOUS
	Maximum amount available				Balance outstanding
	March 31, 2019 (1)				March 31, 2019 (2)
Accounts Receivable Facility	$	900.000	€	801.068	$	663.500	€	590.565
	Maximum amount available				Balance outstanding
	December 31, 2018 (1)				December 31, 2018 (2)
Accounts Receivable Facility	$	900.000	€	786.026	$	-	€	-
(1) Subject to availability of sufficient accounts receivable meeting funding criteria.
(2) Amounts shown are excluding debt issuance costs.

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Employee benefit plans (Tables)

3 Months Ended

Mar. 31, 2019

Employee benefit plans

Schedule of components of net periodic benefit cost

Net periodic benefit cost
in € THOUS
	For the three months ended March 31,
	2019	2018
Current service cost	7.444	6.794
Net interest cost	3.454	3.208
Net periodic benefit costs	10.898	10.002

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Supplementary information on capital management (Tables)

3 Months Ended

Mar. 31, 2019

Supplementary information on capital management

Schedule of credit ratings

Rating (1)
	Standard & Poor´s	Moody´s	Fitch
Corporate Credit Rating	BBB-	Baa3	BBB-
Outlook	positive	stable	stable
(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.

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Financial instruments (Tables)

3 Months Ended

12 Months Ended

Mar. 31, 2019

Dec. 31, 2018

Dec. 31, 2018

Dec. 31, 2017

Financial instruments

Schedule of carrying value and fair value of financial instruments

Carrying amount and fair value of financial instruments
in € THOUS
March 31, 2019	Carrying amount					Fair value
	Amortized cost	FVPL	FVOCI	Not classified	Total	Level 1	Level 2	Level 3
Cash and cash equivalents (1)	705.731	253.057	-	-	958.788	-	253.057	-
Trade accounts and other receivables	3.801.501	-	-	55.390	3.856.891	-	-	-
Accounts receivable from related parties	95.281	-	-	-	95.281	-	-	-
Derivatives - cash flow hedging instruments	-	-	-	1.232	1.232	-	1.232	-
Derivatives - not designated as hedging instruments	-	29.646	-	-	29.646	-	29.646	-
Equity investments	-	113.668	33.608	-	147.276	13.045	134.231	-
Debt securities	-	94.223	256.902	-	351.125	346.508	4.617	-
Other financial assets	127.088	-	-	105.063	232.151	-	-	-
Other current and non-current assets	127.088	237.537	290.510	106.295	761.430	-	-	-
Financial assets	4.729.601	490.594	290.510	161.685	5.672.390	-	-	-
Accounts payable	707.774	-	-	-	707.774	-	-	-
Accounts payable to related parties	210.384	-	-	-	210.384	-	-	-
Short-term debt and short-term debt from related parties	1.427.397	-	-	-	1.427.397	-	-	-
Long-term debt	7.192.978	-	-	-	7.192.978	4.331.857	3.049.725	-
Long-term lease liabilities and long-term lease liabilities from related parties	-	-	-	4.612.064	4.612.064	-	-	-
Derivatives - cash flow hedging instruments	-	-	-	4.874	4.874	-	4.874	-
Derivatives - not designated as hedging instruments	-	40.184	-	-	40.184	-	40.184	-
Variable payments outstanding for acquisitions	-	135.161	-	-	135.161	-	-	135.161
Noncontrolling interest subject to put provisions	-	-	-	831.630	831.630	-	-	831.630
Other financial liabilities	1.275.539	-	-	-	1.275.539	-	-	-
Other current and non-current liabilities	1.275.539	175.345	-	836.504	2.287.388	-	-	-
Financial liabilities	10.814.072	175.345	-	5.448.568	16.437.985	-	-	-
(1) Highly liquid short-term investments are categorized in level 2 of the fair value hierarchy. Other cash and cash equivalents is not categorized.

Carrying amount and fair value of financial instruments
in € THOUS
December 31, 2018	Carrying amount					Fair value
	Amortized cost	FVPL	FVOCI	Not classified	Total	Level 1	Level 2	Level 3
Cash and cash equivalents (1)	831.885	1.313.747	-	-	2.145.632	-	1.313.747	-
Trade accounts and other receivables	3.288.258	-	-	49.448	3.337.706	-	-	-
Accounts receivable from related parties	92.662	-	-	-	92.662	-	-	-
Derivatives - cash flow hedging instruments	-	-	-	1.492	1.492	-	1.492	-
Derivatives - not designated as hedging instruments	-	18.222	-	-	18.222	-	18.222	-
Equity investments	-	106.350	34.377	-	140.727	13.869	126.858	-
Debt securities	-	83.213	250.822	-	334.035	329.821	4.214	-
Other financial assets	144.838	-	-	107.125	251.963	-	-	-
Other current and non-current assets	144.838	207.785	285.199	108.617	746.439	-	-	-
Financial assets	4.357.643	1.521.532	285.199	158.065	6.322.439	-	-	-
						-	-	-
Accounts payable	641.271	-	-	-	641.271	-	-	-
Accounts payable to related parties	153.781	-	-	-	153.781	-	-	-
Short-term debt and short-term debt from related parties	1.394.194	-	-	-	1.394.194	-	-	-
Long-term debt and capital lease obligations	6.115.890	-	-	36.144	6.152.034	4.227.684	2.022.057	-
Derivatives - cash flow hedging instruments	-	-	-	1.125	1.125	-	1.125	-
Derivatives - not designated as hedging instruments	-	18.911	-	-	18.911	-	18.911	-
Variable payments outstanding for acquisitions	-	172.278	-	-	172.278	-	-	172.278
Noncontrolling interest subject to put provisions	-	-	-	818.871	818.871	-	-	818.871
Other financial liabilities	1.467.767	-	-	-	1.467.767	-	-	-
Other current and non-current liabilities	1.467.767	191.189	-	819.996	2.478.952	-	-	-
Financial liabilities	9.772.903	191.189	-	856.140	10.820.232	-	-	-
(1) Highly liquid short-term investments are categorized in level 2 of the fair value hierarchy. Other cash and cash equivalents is not categorized.

Carrying amount and fair value of financial instruments
in € THOUS
December 31, 2018	Carrying amount					Fair value
	Amortized cost	FVPL	FVOCI	Not classified	Total	Level 1	Level 2	Level 3
Cash and cash equivalents (1)	831.885	1.313.747	-	-	2.145.632	-	1.313.747	-
Trade accounts and other receivables	3.288.258	-	-	49.448	3.337.706	-	-	-
Accounts receivable from related parties	92.662	-	-	-	92.662	-	-	-
Derivatives - cash flow hedging instruments	-	-	-	1.492	1.492	-	1.492	-
Derivatives - not designated as hedging instruments	-	18.222	-	-	18.222	-	18.222	-
Equity investments	-	106.350	34.377	-	140.727	13.869	126.858	-
Debt securities	-	83.213	250.822	-	334.035	329.821	4.214	-
Other financial assets	144.838	-	-	107.125	251.963	-	-	-
Other current and non-current assets	144.838	207.785	285.199	108.617	746.439	-	-	-
Financial assets	4.357.643	1.521.532	285.199	158.065	6.322.439	-	-	-
						-	-	-
Accounts payable	641.271	-	-	-	641.271	-	-	-
Accounts payable to related parties	153.781	-	-	-	153.781	-	-	-
Short-term debt and short-term debt from related parties	1.394.194	-	-	-	1.394.194	-	-	-
Long-term debt and capital lease obligations	6.115.890	-	-	36.144	6.152.034	4.227.684	2.022.057	-
Derivatives - cash flow hedging instruments	-	-	-	1.125	1.125	-	1.125	-
Derivatives - not designated as hedging instruments	-	18.911	-	-	18.911	-	18.911	-
Variable payments outstanding for acquisitions	-	172.278	-	-	172.278	-	-	172.278
Noncontrolling interest subject to put provisions	-	-	-	818.871	818.871	-	-	818.871
Other financial liabilities	1.467.767	-	-	-	1.467.767	-	-	-
Other current and non-current liabilities	1.467.767	191.189	-	819.996	2.478.952	-	-	-
Financial liabilities	9.772.903	191.189	-	856.140	10.820.232	-	-	-
(1) Highly liquid short-term investments are categorized in level 2 of the fair value hierarchy. Other cash and cash equivalents is not categorized.

Carrying amount and fair value of financial instruments
in € THOUS
December 31, 2018	Carrying amount					Fair value
	Amortized cost	FVPL	FVOCI	Not classified	Total	Level 1	Level 2	Level 3
Cash and cash equivalents (1)	831.885	1.313.747	-	-	2.145.632	-	1.313.747	-
Trade accounts and other receivables	3.288.258	-	-	49.448	3.337.706	-	-	-
Accounts receivable from related parties	92.662	-	-	-	92.662	-	-	-
Derivatives - cash flow hedging instruments	-	-	-	1.492	1.492	-	1.492	-
Derivatives - not designated as hedging instruments	-	18.222	-	-	18.222	-	18.222	-
Equity investments	-	106.350	34.377	-	140.727	13.869	126.858	-
Debt securities	-	83.213	250.822	-	334.035	329.821	4.214	-
Other financial assets	144.838	-	-	107.125	251.963	-	-	-
Other current and non-current assets	144.838	207.785	285.199	108.617	746.439	-	-	-
Financial assets	4.357.643	1.521.532	285.199	158.065	6.322.439	-	-	-
						-	-	-
Accounts payable	641.271	-	-	-	641.271	-	-	-
Accounts payable to related parties	153.781	-	-	-	153.781	-	-	-
Short-term debt and short-term debt from related parties	1.394.194	-	-	-	1.394.194	-	-	-
Long-term debt and capital lease obligations	6.115.890	-	-	36.144	6.152.034	4.227.684	2.022.057	-
Derivatives - cash flow hedging instruments	-	-	-	1.125	1.125	-	1.125	-
Derivatives - not designated as hedging instruments	-	18.911	-	-	18.911	-	18.911	-
Variable payments outstanding for acquisitions	-	172.278	-	-	172.278	-	-	172.278
Noncontrolling interest subject to put provisions	-	-	-	818.871	818.871	-	-	818.871
Other financial liabilities	1.467.767	-	-	-	1.467.767	-	-	-
Other current and non-current liabilities	1.467.767	191.189	-	819.996	2.478.952	-	-	-
Financial liabilities	9.772.903	191.189	-	856.140	10.820.232	-	-	-
(1) Highly liquid short-term investments are categorized in level 2 of the fair value hierarchy. Other cash and cash equivalents is not categorized.

Schedule of non-controlling interests subject to put provisions

Reconciliation from beginning to ending balance of level 3 financial instruments
in € THOUS
	2019		2018
	Variable payments outstanding for acquisitions	Noncontrolling interests subject to put provisions	Variable payments outstanding for acquisitions	Noncontrolling interests subject to put provisions
Beginning balance at January 1,	172.278	818.871	205.792	830.773
Increase	83	15.997	19.051	53.731
Decrease	(3.653)	(968)	(15.734)	(50.706)
(Gain) Loss recognized in profit or loss	(34.666)	32.586	(36.327)	142.279
(Gain) Loss recognized in equity	-	(26.895)	-	(50.612)
Dividends	-	(28.287)	-	(139.742)
Foreign currency translation and other changes	1.119	20.326	(504)	33.148
Ending balance at March 31, and December 31,	135.161	831.630	172.278	818.871

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Supplementary cash flow information (Tables)

3 Months Ended

Mar. 31, 2019

Supplementary cash flow information

Schedule of reconciliation of debt to net cash provided by (used in) financing activities

Details for net cash provided by (used in) investing activities
in € THOUS
	For the three months ended March 31,
	2019	2018
Details for acquisitions
Assets acquired	(2.082.291)	(36.062)
Liabilities assumed	190.406	2.608
Noncontrolling interests subject to put provisions	12.679	-
Noncontrolling interests	10.492	-
Non-cash consideration	6.518	2.864
Cash paid	(1.862.196)	(30.590)
Less cash acquired	42.496	252
Net cash paid for acquisitions	(1.819.700)	(30.338)
Cash paid for investments	(282)	(146.867)
Cash paid for intangible assets	(8.543)	(4.198)
Total cash paid for acquisitions and investments, net of cash acquired, and purchases of intangible assets	(1.828.525)	(181.403)
Details for divestitures
Cash received from sale of subsidiaries or other businesses, less cash disposed	6.782	-
Cash received from divestitures of securities	4.230	82
Cash received from repayment of loans	-	76
Proceeds from divestitures	11.012	158

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Segment and corporate information (Tables)

3 Months Ended

Mar. 31, 2019

Segment and corporate information

Schedule of segment and corporate activity

Segment and corporate information
in € THOUS
	North America Segment	EMEA Segment	Asia-Pacific Segment		Latin America Segment	Total Segment	Corporate	Total
Three months ended March 31, 2019
Revenue from contracts with customers	2.826.212	635.800	411.603		160.601	4.034.216	4.168	4.038.384
Other revenue external customers	60.564	16.813	15.971		825	94.173	-	94.173
Revenue external customers	2.886.776	652.613	427.574		161.426	4.128.389	4.168	4.132.557
Inter-segment revenue	576	1	234		65	876	(876)	-
Revenue	2.887.352	652.614	427.808		161.491	4.129.265	3.292	4.132.557
Operating income	372.394	137.776	94.702		11.395	616.267	(79.717)	536.550
Interest								(107.848)
Income before income taxes								428.702
Depreciation and amortization	(228.735)	(46.973)	(22.601)		(8.363)	(306.672)	(55.704)	(362.376)
Income (loss) from equity method investees	21.362	(1.317)	(294)		282	20.033	-	20.033
Total assets	21.513.220	4.232.196	2.669.344		821.984	29.236.744	3.116.460	32.353.204
thereof investment in equity method investees	332.184	177.658	96.641		23.956	630.439	-	630.439
Additions of property, plant and equipment, intangible assets and right of use assets	188.150	47.114	13.743		14.783	263.790	73.487	337.277
				´´
Three months ended March 31, 2018
Revenue from contracts with customers	2.719.627	631.224	380.801		169.340	3.900.992	3.643	3.904.635
Other revenue external customers	54.835	4.584	10.661		914	70.994	-	70.994
Revenue external customers	2.774.462	635.808	391.462		170.254	3.971.986	3.643	3.975.629
Inter-segment revenue	400	303	187		39	929	(929)	-
Revenue	2.774.862	636.111	391.649		170.293	3.972.915	2.714	3.975.629
Operating income	362.208	108.934	74.220		14.114	559.476	(62.600)	496.876
Interest								(82.933)
Income before income taxes								413.943
Depreciation and amortization	(90.655)	(28.861)	(11.159)		(4.580)	(135.255)	(39.739)	(174.994)
Income (loss) from equity method investees	18.801	(1.334)	335		102	17.904	-	17.904
Total assets	15.408.120	3.640.775	2.081.140		694.375	21.824.410	2.332.651	24.157.061
thereof investment in equity method investees	316.916	181.938	96.961		23.915	619.730	-	619.730
Additions of property, plant and equipment and intangible assets	141.821	30.405	10.034		3.796	186.056	45.114	231.170

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The Company, basis of presentation and significant accounting policies - Principles of consolidation and composition (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Jan. 01, 2019	Dec. 31, 2018
The Company, basis of presentation and significant accounting policies
loss on net monetary position for hyperinflation in Argentina		€ 5,189,000
IFRIC Reclassification IAS 12		2,957,000
Property Plant Equipment Leased Fixed Assets				€ 36,402,000
Long Term Debt To Long Term Lease Liability				9,387,000
Long Term Debt Less Current Portion To Long Term Lease Liabilities Less Current Portion				26,757,000
Repayments Of Long Term Debt To Repayments Of Lease Liabilities		2,724,000
Right of use assets recognized at January 1	€ 4,266,753,000	104,131,000
Initial Application Of Lease Liabilities			€ 4,547,535,000
IFRS 16 Cumulative Effect Retained Earnings			(115,219,000)
IFRS 16 Cumulative Effect Non Controlling Interests			(15,508,000)
Lease Liability Weighted Average Discount Rate	369.00%
Reconciliation Lease Liability [Abstract]
Future Minimum Rental Payments				5,527,638,000
Short Term Leases			21,936,000
Leases Low Value Assets			34,145,000
Payments Future Lease Agreements			0
Other Lease Liability			30,065,575.0000021
Gross Lease Liability			5,441,491,425
Discounting Lease Liability			893,957,425
Lease Liability IFRS 16			4,547,534,000
Capital Lease Liabilities			36,144,000
Lease Liabilities IFRS 16			€ 4,583,678,000
Leasing In The Consolidated Statement Of Income [Abstract]
Right of use asset depreciation	€ 168,893,000
Right Of Use Asset Impairment	0
short term lease expense	12,211,000
Expenses related to low-value assets	6,139,000
Expenses relating to variable lease payments	6,680,000
Other Leasing Expense	0
sublease income	55,000
Interest Expense On Lease Liabilities	41,106,000
Leasing In The Consolidated Balance Sheet [Abstract]
Right Of Use Asset Land	29,144,000
Right Of Use Assets Buildings And Improvements	3,871,970,000
Right Of Use Assets Machinery And Improvements	409,862,000
Right Of Use Assets Advanced Payments	0
Right of Use Assets	4,310,976,000			€ 0
Additions to right of use assets	€ 4,266,753,000	€ 104,131,000

XML

The Company, basis of presentation and significant accounting policies - Financial instruments (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Disclosure of detailed information about financial instruments [line items]
Potential obligations put provisions, current and non-current	€ 16,437,985,000	€ 10,820,232,000

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Discretionary decisions and sources of estimation uncertainties - Trade accounts receivable and allowance for doubtful accounts (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Trade accounts Receivable and Allowance for Doubtful Accounts
Trade accounts receivable, less allowance for doubtful accounts of 482,461 in 2016 and 427,841 in 2015	€ 3,856,891,000	€ 3,337,706,000
Allowance for doubtful accounts	€ 123,416,000	€ 118,015,000

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Notes to the consolidated statements of income - Revenue (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenue [Line Items]
Health Care Services	€ 3,317,308,000	€ 3,208,795,000
Dialysis services	2,957,381,000	2,648,293,000
Care Coordination Revenue	359,927,000	560,502,000
Health Care Products	815,249,000	766,834,000
Dialysis Products Revenue	796,675,000	747,692,000
Non-dialysis Product Revenue	18,574,000	19,142,000
Revenue	4,132,557,000	3,975,629,000
Revenue from contracts with customers (IFRS 15) [Member]
Revenue [Line Items]
Health Care Services	3,256,925,000	3,155,537,000
Dialysis services	2,957,381,000	2,648,293,000
Care Coordination Revenue	299,544,000	507,244,000
Health Care Products	781,459,000	749,098,000
Dialysis Products Revenue	762,885,000	729,956,000
Non-dialysis Product Revenue	18,574,000	19,142,000
Revenue	4,038,384,000	3,904,635,000
Other revenue [Member]
Revenue [Line Items]
Health Care Services	60,383,000	53,258,000
Dialysis services	0
Care Coordination Revenue	60,383,000	53,258,000
Health Care Products	33,790,000	17,736,000
Dialysis Products Revenue	33,790,000	17,736,000
Non-dialysis Product Revenue	0
Revenue	€ 94,173,000	€ 70,994,000

XML

Notes to the consolidated statements of income - Selling, general and administrative expenses (Details) - EUR (€)	3 Months Ended		12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017
Selling, general and administrative expenses
FCPA related charge	€ 231,700,000	€ 77,200,000	€ 223,980,000	€ 77,200,000

XML

Notes to the consolidated statements of income - Research and development expenses (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disclosure of detailed information about intangible assets [line items]
Research and development expense	€ 33,614,000	€ 31,897,000
Depreciation and amortisation expense	(362,376,000)	(174,994,000)
Capitalized development costs
Disclosure of detailed information about intangible assets [line items]
Depreciation and amortisation expense	€ 92,000	€ 80,000

XML

Earnings per share (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Numerators:
Net income attributable to shareholders of FMC-AG & Co. KGaA	€ 270,749,000	€ 278,555,000
Denominators:
Weighted average number of shares outstanding	306,659,364	306,453,070
Potentially dilutive shares	0	986,454
Basic earnings per share (in dollars per share)	€ 0.88	€ 0.91
Fully diluted earnings per share (in dollars per share)	€ 0.88	€ 0.91

XML

Shareholders' equity - Treasury stock (Details) - EUR (€)			1 Months Ended		3 Months Ended		12 Months Ended
	Jun. 08, 2018	May 31, 2018	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017
Treasury stock
Average price paid per share			€ 62.69
Total number of shares purchased and retired as part of publicly announced plans or programs			2,629,191
Total value of shares purchased			€ 164,809,000		€ (89,446,000)	€ 0
Cancellation of treasury shares					(113,816,000)
Treasury shares			€ (164,809,000)	€ (50,993,000)	(164,809,000)		€ (50,993,000)
Treasury Stock
Treasury stock
Average price paid per share	€ 86.14	€ 86.69	€ 69.8577964081412				€ 51	€ 65.63
Total number of shares purchased and retired as part of publicly announced plans or programs	257,726	173,274	1,629,240				999,951	1,659,951
Total value of shares purchased	€ 22,201,000	€ 15,020,000	€ 113,816,000		(113,816,000)		€ 50,993,000	€ 108,931,000
Retired treasury stock average price paid per share				€ 87.23
Number of shares retired				1,091,000
Cancellation of treasury shares				€ 95,159,000	(113,816,000)
Repurchase of shares fees, net of taxes					€ 11,000

XML

Notes to the consolidated statements of income - Net interest (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Notes to the consolidated statements of income
Interest expense	€ 135,792,000	€ 107,769,000
Interest income	€ 27,944,000	€ 24,836,000

XML

Notes to the consolidated statements of income - Income taxes geographical (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disclosure of geographical areas [line items]
Income before income taxes	€ 428,702,000	€ 413,943,000
income tax expense (benefit)
Total tax expense (income)	€ 100,944,000	€ 84,234,000

XML

Notes to the consolidated statements of income - Income taxes reconciliation (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Tax reconciliation
Total tax expense (income)	€ 100,944,000	€ 84,234,000

XML

Notes to the consolidated statements of income - Net deferred income tax assets and liabilities (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Notes to the consolidated statements of income
Deferred taxes assets	€ 308,530,000	€ 345,686,000
Deferred taxes liabilities	€ 722,859,000	€ 626,521,000

XML

Notes to the consolidated statements of income - Sound (Details)	3 Months Ended
	Mar. 31, 2018 EUR (€)
Notes to the consolidated statements of income
Procees from the sale of an investment	€ 1,531,109,000
Expected Pre Tax Loss On Sale of Investment	€ 13,103,000

XML

Acquisitions, investments, purchases of intangible assets and divestitures - Acquisitions and Investments (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Disclosure of detailed information about business combination [line items]
Cash consideration, net of cash acquired	€ (1,828,525,000)	€ (181,403,000)
Acquisitions
Cash consideration, net of cash acquired	(1,819,700,000)	€ (30,338,000)
Goodwill.	€ 13,561,939,000		€ 12,209,606,000

XML

Acquisitions, investments, purchases of intangible assets and divestitures - Proceeds from divestitures (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Acquisitions, investments, purchases of intangible assets and divestitures
Cash portion of proceeds from divestitures	€ (11,012,000)	€ (158,000)

XML

Acquisitions - Estimated Fair Values of Assets Acquired and Liabilities Assumed - Preliminary (Details)	3 Months Ended
	Mar. 31, 2019 EUR (€) € / shares	Mar. 31, 2019 USD ($)
Estimated Fair Values of Assets Acquired and Liabilities Assumed Details
Proforma assets held for sale	€ 47,203,000
Proforma trade accounts and other receivables	34,062,000
proforma other current assets	88,987,000
Proforma deferred tax assets	0
Proforma PP&E	85,470,000
Proforma Intangible Assets and other assets	818,150,110
Proforma Goodwill	1,165,289,000
Proforma accounts payable, current provisions, and other current liabilities	(69,456,000)
Proforma income tax payable and deferred taxes	(119,086,000)
Proforma short term debt, long term debt and lease liabilities	0
Proforma other liabilities	(23,118,220)
Proforma noncontrolling interest	(4,063,000)
Proforma total acquisition cost	2,023,437,890
Proforma non cash contributions	0
Proforma Investment at acquisition date	0
Proforma long term notes receivable	0
Proforma total noncash items	0
Proforma Cash acquired	(47,203,000)
Proforma net cash paid	€ 1,976,234,890
Proforma weighted average useful lives of intangibles	13	13
Proforma NxStage Goodwill	€ 1,165,289,000
Proforma NxStage contributed revenue	€ 29,764,000
NxStage Purchase Price per share | € / shares	€ 30
Proforma NxStage contributed operating income	€ (11,142,000)
NxStage Total Purchase Price | $		$ 1,740,563,000

XML

Acquisitions - Pro Forma financial Information (Details)	3 Months Ended
	Mar. 31, 2019 EUR (€) € / shares
Proforma financial information details
Proforma revenue | €	€ 4,176,790,134.49733
Proforma net income | €	€ 254,537,741.800771
Proforma basic eps | € / shares	€ 0.83
Proforma fully diluted eps | € / shares	€ 0.83

XML

Related party transactions - Service agreements, lease agreements and products - General (Details)	Mar. 31, 2019
Disclosure of transactions between related parties [line items]
Proportion of ownership interest in reporting entity (as a percent)	30.92%

XML

Related party transactions - Service agreements and products - Summary (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Balances
Accounts Payables	€ 210,384,000		€ 153,781,000
Service Agreements
Transactions
Sales of goods and services	1,702,000	€ 6,006,000
Purchases of goods and services	29,834,000	30,179,000
Balances
Accounts Receivable	1,991,000		3,508,000
Accounts Payables	11,095,000		12,489,000
Accrued Expenses	6,687,000		9,376,000
Products
Transactions
Sales of goods and services	9,862,000	7,907,000
Purchases of goods and services	159,935,000	130,096,000
Balances
Accounts Receivable	11,062,000		8,750,000
Accounts Payables	116,606,000		61,633,000
Fresenius SE (largest shareholder)
Balances
Accounts Receivable	80,388,000		80,228,000
Accounts Payables	76,784,000		32,454,000
Fresenius SE (largest shareholder) | Service Agreements
Transactions
Sales of goods and services	32,000	70,000
Purchases of goods and services	5,182,000	5,724,000
Balances
Accounts Receivable	1,064,000		378,000
Accounts Payables	3,149,000		4,019,000
Fresenius SE (largest shareholder) | Lease Agreements
Transactions
Purchases of goods and services	0
Fresenius SE (largest shareholder) | Products
Transactions
Sales of goods and services	9,862,000	7,907,000
Purchases of goods and services	8,290,000	9,075,000
Balances
Accounts Receivable	11,062,000		8,750,000
Accounts Payables	3,699,000		3,658,000
Affiliates of Fresenius SE
Transactions
Purchases of goods and services	250,000
Affiliates of Fresenius SE | Service Agreements
Transactions
Sales of goods and services	940,000	876,000
Purchases of goods and services	24,652,000	24,455,000
Balances
Accounts Receivable	849,000		681,000
Accounts Payables	7,946,000		8,470,000
Equity method investees | Service Agreements
Transactions
Sales of goods and services	730,000	5,060,000
Balances
Accounts Receivable	78,000		2,449,000
Equity method investees | Products
Transactions
Purchases of goods and services	151,645,000	€ 121,021,000
Balances
Accounts Payables	€ 112,907,000		€ 57,975,000

XML

Related Party Transactions - Lease Agreements - Summary (Details) - EUR (€)	Mar. 31, 2019	Jan. 01, 2019	Dec. 31, 2018
Lease Balances [Abstract]
Right of Use Assets	€ 4,310,976,000		€ 0
Lease Liability IFRS 16		€ 4,547,534,000

XML

Related party transactions - Financing (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Balances
Accounts Payables	€ 210,384,000	€ 153,781,000
Transactions
Outstanding borrowings	7,192,978,000	6,152,034,000
Bonds
Transactions
Outstanding borrowings	3,752,592,000	3,700,446,000
Fresenius SE (largest shareholder)
Balances
Accounts Receivable	80,388,000	80,228,000
Accounts Payables	€ 76,784,000	€ 32,454,000
Fresenius SE (largest shareholder) | Short-term financing
Transactions
Interest rate on borrowings (as a percent)	0.825%	0.825%
Outstanding borrowings	€ 104,400,000	€ 185,900,000
General Partner
Balances
Accounts Receivable	1,840,000	176,000
Accounts Payables	€ 5,899,000	€ 47,205,000
General Partner | Unsecured debt - originated in 2009
Transactions
Interest rate on borrowings (as a percent)	0.825%
Outstanding borrowings	€ 1,500,000
General Partner | Unsecured debt - originated in 2013
Transactions
Interest rate on borrowings (as a percent)	0.825%
Outstanding borrowings	€ 1,500,000
Subsidiary of Fresenius SE | Bonds
Transactions
Interest rate on borrowings (as a percent)	5.25%	5.25%
Outstanding borrowings	€ 5,000,000	€ 6,000,000

XML

Related party transactions - Key management personnel (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Transactions
Capital	€ 307,907,000		€ 307,879,000
Balances
Accounts Payables	210,384,000		153,781,000
General Partner
Transactions
Reimbursements paid to related party for management services	8,028,000	€ 4,016,000
Balances
Accounts Receivable	1,840,000		176,000
Accounts Payables	€ 5,899,000		€ 47,205,000

XML

Cash and cash equivalents (Details) - EUR (€)	Mar. 31, 2019	Jan. 01, 2019	Dec. 31, 2018	Mar. 31, 2018	Jan. 01, 2018	Jan. 01, 2017
Cash and cash equivalents
Cash	€ 705,731,000		€ 831,885,000
Securities and time deposits	253,057,000		1,313,747,000
Cash and cash equivalents	958,788,000	€ 958,788,000	2,145,632,000	€ 846,378,000	€ 2,145,632,000	€ 978,109,000
Restricted cash	€ 5,740,000		€ 5,002,000

XML

Trade accounts receivable - Trade accounts receivable, less allowance for doubtful accounts (Details) - EUR (€)	12 Months Ended
	Dec. 31, 2017	Mar. 31, 2019	Dec. 31, 2018
Trade accounts receivable [Line Items]
Trade accounts receivable		€ 3,980,307,000	€ 3,455,721,000
finance lease receivables		44,037,000	28,726,000
less allowance for doubtful accounts		123,416,000	118,015,000
Trade accounts receivable, net		3,856,891,000	3,337,706,000
Collection period for trade accounts receivable	1 year
Trade accounts receivable included in other non-current assets		120,479,000	120,668,000
other receivables		79,627,000
Credit impaired trade AR [Member]
Trade accounts receivable [Line Items]
Trade accounts receivable		387,850,000	325,240,000
less allowance for doubtful accounts		87,056,000	(85,775,000)
Trade accounts receivable, net		€ 300,794,000	€ 239,465,000

XML

Trade accounts receivable - Development of allowance for doubtful accounts (Details)	Mar. 31, 2019 EUR (€)
Development of Allowance For Doubtful Accounts
Allowance for doubtful accounts, beginning of period	€ 118,015,000
Allowance for doubtful accounts, end of period	€ 123,416,000

XML

Trade Accounts Receivable - Aging Analysis of Trade Accounts Receivable and the Allowance For Doubtful Accounts (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Aging Analysis of Trade Accounts Receivable
Trade accounts receivable	€ 3,980,307,000	€ 3,455,721,000
less allowance for doubtful accounts	(123,416,000)	(118,015,000)
Trade accounts receivable, net	€ 3,856,891,000	€ 3,337,706,000

XML

Inventories (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Inventories [Line Items]
Finished Goods	€ 895,533,000	€ 774,133,000
Health care supplies	470,202,000	391,593,000
Raw materials and purchased components	237,664,000	224,054,000
Work in process	92,259,000	77,023,000
Inventories	€ 1,695,658,000	€ 1,466,803,000

XML

Other current assets (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Other current assets
Other current assets	€ 894,229,000	€ 804,083,000

XML

Property, plant and equipment (Details)	Mar. 31, 2019 EUR (€)
Changes in property, plant, and equipment:
Balance, beginning of period	€ 3,836,010,000
Balance, ending of period	3,949,557,000
Property, plant and equipment	€ 3,836,010,000

XML

Intangible assets and goodwill - Acquisition or manufacturing costs of intangible assets and goodwill (Details)	Mar. 31, 2019 EUR (€)
Detailed information on intangible assets
Intangible assets other than goodwill	€ 681,331,000
Goodwill	12,209,606,000
Reconciliation of intangible assets other than goodwill
Balance at the beginning of the period	681,331,000
Balance at the end of the period	1,430,970,000
Reconciliation of goodwill
Balance at the beginning of the period	12,209,606,000
Balance at the end of the period	€ 13,561,939,000

XML

Intangible assets and goodwill - Goodwill and intangible assets with indefinite useful Life (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Disclosure of geographic region
Goodwill	€ 13,561,939,000	€ 12,209,606,000
Intangible assets other than goodwill	€ 1,430,970,000	€ 681,331,000

XML

Current provisions and other current liabilities (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Miscellaneous current liabilities
Variable payments outstanding for acquisitions	€ 135,161,000	€ 172,278,000

XML

Short-term debt and short-term debt from related parties (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Long-term Debt and Capital Lease Obligations.
Short-term debt	€ 1,319,997,000	€ 1,205,294,000
Short-term debt from related parties	107,400,000	188,900,000
Short-term debt and short-term debt from related parties	1,427,397,000	1,394,194,000
Commercial paper borrowing limit	1,000,000,000	1,000,000,000
Remaining borrowing capacity	0	0
Offset amount	113,238,000	122,256,000
Short term borrowing from related party	400,000,000
Commercial paper program
Long-term Debt and Capital Lease Obligations.
Short-term debt	999,834,000	999,873,000
Borrowings under lines of credit
Long-term Debt and Capital Lease Obligations.
Short-term debt	318,540,000	204,491,000
Other
Long-term Debt and Capital Lease Obligations.
Short-term debt	€ 1,623,000	€ 930,000

XML

Long-term debt and capital lease obligations - Long-term debt and capital lease obligations (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Long-term Debt and Capital Lease Obligations.
Total long-term debt and capital lease obligations	€ 7,192,978,000	€ 6,152,034,000
Less current portion	(1,511,815,000)	(1,106,519,000)
Long-term debt, less current portion	5,681,163,000	5,045,515,000
Amended 2012 credit agreement
Long-term Debt and Capital Lease Obligations.
Total long-term debt and capital lease obligations	2,296,088,000	1,887,357,000
Bonds
Long-term Debt and Capital Lease Obligations.
Total long-term debt and capital lease obligations	3,752,592,000	3,700,446,000
Convertible Bonds
Long-term Debt and Capital Lease Obligations.
Total long-term debt and capital lease obligations	394,794,000	393,232,000
Accounts Receivable Facility
Long-term Debt and Capital Lease Obligations.
Total long-term debt and capital lease obligations	589,779,000
Capital lease obligations
Long-term Debt and Capital Lease Obligations.
Total long-term debt and capital lease obligations		36,144,000
Other
Long-term Debt and Capital Lease Obligations.
Total long-term debt and capital lease obligations	€ 159,725,000	€ 134,855,000

XML

Long-term debt and capital lease obligations - Amended 2012 credit agreement (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Amended 2012 credit agreement
Long-term Debt and Capital Lease Obligations.
Entered in to credit facility / Maximum amount available		€ 3,280,065,000
Balance outstanding		1,894,039,000
Revolving credit facility
Long-term Debt and Capital Lease Obligations.
Entered in to credit facility / Maximum amount available	€ 3,283,968,000
Balance outstanding	2,302,165,554.0721
Letters of credit outstanding	1,059,000	1,476,000
Revolving credit facility USD
Long-term Debt and Capital Lease Obligations.
Entered in to credit facility / Maximum amount available	801,068,000	786,026,000
Balance outstanding	219,265,687.583445	0
Revolving credit facility EUR
Long-term Debt and Capital Lease Obligations.
Entered in to credit facility / Maximum amount available	600,000,000	600,000,000
Balance outstanding	200,000,000
USD term loan 5-year
Long-term Debt and Capital Lease Obligations.
Entered in to credit facility / Maximum amount available	1,174,900,000	1,179,039,000
Balance outstanding	1,174,899,866.48865	1,179,039,000
EUR term loan 5-year
Long-term Debt and Capital Lease Obligations.
Entered in to credit facility / Maximum amount available	308,000,000	315,000,000
Balance outstanding	308,000,000	315,000,000
EUR term loan 3-year
Long-term Debt and Capital Lease Obligations.
Entered in to credit facility / Maximum amount available	400,000,000	400,000,000
Balance outstanding	€ 400,000,000	€ 400,000,000

XML

Long-term debt and capital lease obligations - Bonds (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Long-term Debt and Capital Lease Obligations.
Outstanding borrowings	€ 7,192,978,000	€ 6,152,034,000
Bonds
Long-term Debt and Capital Lease Obligations.
Outstanding borrowings	€ 3,752,592,000	€ 3,700,446,000

XML

Long-term debt and capital lease obligations - Accounts Receivable Facility, Other and Secured debt (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Long-term Debt and Capital Lease Obligations.
Current Portion of long term borrowings	€ 1,511,815,000	€ 1,106,519,000
Amended 2012 credit agreement
Long-term Debt and Capital Lease Obligations.
Maximum amount available		3,280,065,000
Balance outstanding		1,894,039,000
Accounts Receivable Facility
Long-term Debt and Capital Lease Obligations.
Maximum amount available	801,068,000	786,026,000
Balance outstanding	590,565,000
Letters of credit outstanding	€ 23,704,000	€ 23,259,000

XML

Non-current provisions and other non-current liabilities (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Disclosure of non-current provisions and other provisions [line items]
Noncurrent provisions and other noncurrent liabilities	€ 718,895,000	€ 750,738,000

XML

Employee benefit plans - Defined benefit pension plans (Details)	3 Months Ended
	Mar. 31, 2019 EUR (€)
Defined benefit pension plans
Company contribution to plan	€ 294,218.926367134
Expected funding for next fiscal year	€ 812,145.114576346

XML

Employee benefit plans - Funded status (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Net defined benefit liability and asset
Employer contributions	€ 294,218.926367134
Non-current portion of pension liability	€ 563,538,000	€ 551,930,000

XML

Employee benefit plans - Components of net periodic benefit cost (Details) - Defined Benefit Pension Plans - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disclosure of defined benefit plans [line items]
Service cost	€ 7,444,000	€ 6,794,000
Net interest cost	3,454,000	3,208,000
Net periodic benefit costs	€ 10,898,000	€ 10,002,000

XML

Shareholders' equity - Conditional capital (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disclosure of classes of share capital [line items]
Increase in capital stock from exercise of stock options	€ (1,298,000)	€ 2,014,000

XML

Supplementary information on capital management (Details) - EUR (€)	3 Months Ended			12 Months Ended
	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018	Dec. 31, 2017
Supplementary information on capital management
Total equity including noncontrolling interests	€ 13,226,504,000	€ 12,901,958,000	€ 10,910,948,000	€ 10,823,110,000
Debt	13,232,439,000
Total assets	€ 32,353,204,000	€ 26,242,268,000	€ 24,157,061,000
Debt in % of total assets	40.90%	28.80%	28.80%	30.99%
Total equity in % of total assets	40.90%	49.20%	49.20%	45.07%

XML

Share-based Plans - Stock Options Other Disclosure (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disclosure of terms and conditions of share-based payment arrangement [line items]
Proceeds from exercise of stock options	€ 148,000	€ 562,000

XML

Commitments and contingencies (Details)	3 Months Ended		12 Months Ended
	Mar. 31, 2019 EUR (€)	Mar. 31, 2018 EUR (€)	Dec. 31, 2018 EUR (€)	Dec. 31, 2017 EUR (€)	Apr. 01, 2019 EUR (€)	Mar. 31, 2019 USD ($)	Feb. 12, 2019 EUR (€)
Disclosure Of Contingent Liabilities Line Items
FCPA related charge	€ 231,700,000	€ 77,200,000	€ 223,980,000	€ 77,200,000
Litigation settlement amount | $						$ 250,000,000
Litigation settlement insurance recovery | $						220,000,000
Net litigation settlement expense recorded	60,000,000
Acid Concentrate Products - Personal Injury
Disclosure Of Contingent Liabilities Line Items
Litigation settlement amount					€ 15,700,000
Acid Concentrate Products - Deceptive Practices
Disclosure Of Contingent Liabilities Line Items
Litigation settlement amount							€ 10,300,000
Subpoena from the United States Attorney for the Northern District of Texas
Disclosure Of Contingent Liabilities Line Items
Litigation settlement amount | $						63,700,000
Hawaii Medicaid False Claims
Disclosure Of Contingent Liabilities Line Items
Litigation settlement amount | $						$ 8,000,000
Levine False Claims Act [Member]
Disclosure Of Contingent Liabilities Line Items
Litigation settlement amount	€ 18,400,000

XML

Financial instruments - Categories (Details) - EUR (€)	Mar. 31, 2019	Jan. 01, 2019	Dec. 31, 2018	Mar. 31, 2018	Jan. 01, 2018	Jan. 01, 2017
Category Disclosure of detailed information about financial instruments [line items]
Cash and cash equivalents.	€ 958,788,000	€ 958,788,000	€ 2,145,632,000	€ 846,378,000	€ 2,145,632,000	€ 978,109,000
trade accounts receivable and other receivables	3,856,891,000		3,337,706,000
accounts receivable related parties	95,281,000		92,662,000
Derivatives cash flow hedging instruments	1,232,000		1,492,000
Derivatives not designated as hedging instruments	29,646,000		18,222,000
Equity investments	147,276,000		140,727,000
Debt securities	351,125,000		334,035,000
Other financial assets	232,151,000		251,963,000
Financial assets	€ 5,672,390,000		4,839,973,000		4,834,897,000
Financial Assets At Amortised Cost [Member] | Financial Instruments Not Assigned To Category [Member]
Category Disclosure of detailed information about financial instruments [line items]
Cash and cash equivalents.			620,145,000		620,145,000
Financial Assets At Amortised Cost [Member] | Loans And Receivables Category [Member]
Category Disclosure of detailed information about financial instruments [line items]
trade accounts receivable and other receivables			3,330,990,000		3,327,692,000
accounts receivable related parties			111,643,000		111,643,000
Other financial assets			130,964,000		129,614,000
Financial Assets At Fair Value Through Profit Or Loss Category [Member] | Financial Instruments Not Assigned To Category [Member]
Category Disclosure of detailed information about financial instruments [line items]
Cash and cash equivalents.			357,964,000		357,964,000
Equity investments			7,259,000		7,259,000
Financial Assets At Fair Value Through Profit Or Loss Category [Member] | Financial Assets At Fair Value Through Profit Or Loss Category [Member]
Category Disclosure of detailed information about financial instruments [line items]
Derivatives not designated as hedging instruments			113,713,000		113,713,000
Assets And Liabilities Not Classified As Held For Sale [Member] | Financial Instruments Not Assigned To Category [Member]
Category Disclosure of detailed information about financial instruments [line items]
trade accounts receivable and other receivables			58,336,000		58,144,000
Derivatives cash flow hedging instruments					561,000
Derivatives not designated as hedging instruments			561,000
Other financial assets			78,368,000		78,132,000
Assets And Liabilities Not Classified As Held For Sale [Member] | Financial Assets Availableforsale Category [Member]
Category Disclosure of detailed information about financial instruments [line items]
Debt securities			833,000		833,000
Financial Assets At Fair Value Through Other Comprehensive Income Category [Member] | Financial Instruments Not Assigned To Category [Member]
Category Disclosure of detailed information about financial instruments [line items]
Equity investments			10,537,000		10,537,000
Financial Assets At Fair Value Through Other Comprehensive Income Category [Member] | Financial Assets Availableforsale Category [Member]
Category Disclosure of detailed information about financial instruments [line items]
Equity investments			€ 16,010,000		16,010,000
Debt securities					€ 2,650,000

XML

Financial instruments - Carrying amount and fair value (Details) - EUR (€)	Mar. 31, 2019	Jan. 01, 2019	Dec. 31, 2018	Mar. 31, 2018	Jan. 01, 2018	Jan. 01, 2017
Disclosure of detailed information about financial instruments [line items]
Cash and cash equivalents.	€ 958,788,000	€ 958,788,000	€ 2,145,632,000	€ 846,378,000	€ 2,145,632,000	€ 978,109,000
trade accounts receivable and other receivables	3,856,891,000		3,337,706,000
accounts receivable related parties	95,281,000		92,662,000
Derivatives cash flow hedging instruments	1,232,000		1,492,000
Derivatives not designated as hedging instruments	29,646,000		18,222,000
Equity investments	147,276,000		140,727,000
Debt securities	351,125,000		334,035,000
Other financial assets	232,151,000		251,963,000
Other Current and Non Current Financial Assets	761,430,000		746,439,000
Financial assets	5,672,390,000		4,839,973,000		€ 4,834,897,000
accounts payable	707,774,000		641,271,000
Amounts payable, related party transactions	210,384,000		153,781,000
Current Debt Instruments Issued	1,427,397,000		1,394,194,000
Noncurrent Debt Instruments Issued	7,192,978,000		6,152,034,000
Lease Liability Related Party	4,612,064,000
Derivatives cash flow hedging instruments liabilities	4,874,000		1,125,000
Derivatives not designated as hedging instruments liabilities	40,184,000		18,911,000
Current variable payments outstanding for acquisitions	135,161,000		172,278,000
Noncontrolling Interest Subject To Put provisions	4,001,000		818,871,000	€ 67,120,000
other current financial liabilities	1,275,539,000		1,467,767,000
other current and noncurrent financial liabilities	2,287,388,000		2,478,952,000
Financial liabilities	16,437,985,000		10,820,232,000
Level 1
Disclosure of detailed information about financial instruments [line items]
Cash and cash equivalents.			0
trade accounts receivable and other receivables			0
accounts receivable related parties			0
Derivatives cash flow hedging instruments			0
Derivatives not designated as hedging instruments			0
Equity investments	13,045,000		13,869,000
Debt securities	346,508,000		329,821,000
Other financial assets			0
Other Current and Non Current Financial Assets			0
Financial assets			0
accounts payable			0
Amounts payable, related party transactions			0
Current Debt Instruments Issued			0
Noncurrent Debt Instruments Issued	4,331,857,000		4,227,684,000
Derivatives cash flow hedging instruments liabilities			0
Derivatives not designated as hedging instruments liabilities			0
Current variable payments outstanding for acquisitions			0
Noncontrolling Interest Subject To Put provisions			0
other current financial liabilities			0
other current and noncurrent financial liabilities			0
Financial liabilities			0
Level 2
Disclosure of detailed information about financial instruments [line items]
Cash and cash equivalents.	253,057,000		1,313,747,000
trade accounts receivable and other receivables			0
accounts receivable related parties			0
Derivatives cash flow hedging instruments	1,232,000		1,492,000
Derivatives not designated as hedging instruments	29,646,000		18,222,000
Equity investments	134,231,000		126,858,000
Debt securities	4,617,000		4,214,000
Other financial assets			0
Other Current and Non Current Financial Assets			0
Financial assets			0
Noncurrent Debt Instruments Issued	3,049,725,000		2,022,057,000
Derivatives cash flow hedging instruments liabilities	4,874,000		1,125,000
Derivatives not designated as hedging instruments liabilities	40,184,000		18,911,000
Level 3
Disclosure of detailed information about financial instruments [line items]
Current variable payments outstanding for acquisitions	135,161,000		172,278,000
Noncontrolling Interest Subject To Put provisions	831,630,000		818,871,000
Financial Assets At Fair Value Through Profit Or Loss Category [Member]
Disclosure of detailed information about financial instruments [line items]
Cash and cash equivalents.	253,057,000		1,313,747,000
trade accounts receivable and other receivables			0
accounts receivable related parties			0
Derivatives cash flow hedging instruments			0
Derivatives not designated as hedging instruments	29,646,000		18,222,000
Equity investments	113,668,000		106,350,000
Debt securities	94,223,000		83,213,000
Other financial assets	0		0
Other Current and Non Current Financial Assets	237,537,000		207,785,000
Financial assets	490,594,000		1,521,532,000
Financial Liabilities At Fair Value Through Profit Or Loss Category [Member]
Disclosure of detailed information about financial instruments [line items]
accounts payable			0
Amounts payable, related party transactions			0
Current Debt Instruments Issued			0
Noncurrent Debt Instruments Issued			0
Derivatives cash flow hedging instruments liabilities			0
Derivatives not designated as hedging instruments liabilities	40,184,000		18,911,000
Current variable payments outstanding for acquisitions	135,161,000		172,278,000
Noncontrolling Interest Subject To Put provisions			0
other current financial liabilities			0
other current and noncurrent financial liabilities	175,345,000		191,189,000
Financial liabilities	175,345,000		191,189,000
Financial Instruments Not Assigned To Category [Member]
Disclosure of detailed information about financial instruments [line items]
Cash and cash equivalents.			0
trade accounts receivable and other receivables	55,390,000		49,448,000
accounts receivable related parties			0
Derivatives cash flow hedging instruments	1,232,000		1,492,000
Derivatives not designated as hedging instruments			0
Equity investments			0
Debt securities			0
Other financial assets	105,063,000		107,125,000
Other Current and Non Current Financial Assets	106,295,000		108,617,000
Financial assets	161,685,000		158,065,000
accounts payable			0
Amounts payable, related party transactions			0
Current Debt Instruments Issued			0
Noncurrent Debt Instruments Issued	0		36,144,000
Lease Liability Related Party	4,612,064,000
Derivatives cash flow hedging instruments liabilities	4,874,000		1,125,000
Derivatives not designated as hedging instruments liabilities			0
Current variable payments outstanding for acquisitions			0
Noncontrolling Interest Subject To Put provisions	831,630,000		818,871,000
other current financial liabilities			0
other current and noncurrent financial liabilities	836,504,000		819,996,000
Financial liabilities	5,448,568,000		856,140,000
Financial Assets At Amortised Cost [Member]
Disclosure of detailed information about financial instruments [line items]
Cash and cash equivalents.	705,731,000		831,885,000
trade accounts receivable and other receivables	3,801,501,000		3,288,258,000
accounts receivable related parties	95,281,000		92,662,000
Other financial assets	127,088,000		144,838,000
Other Current and Non Current Financial Assets	127,088,000		144,838,000
Financial assets	4,729,601,000		4,357,643,000
Financial Liabilities At Amortised Cost [Member]
Disclosure of detailed information about financial instruments [line items]
accounts payable	707,774,000		641,271,000
Amounts payable, related party transactions	210,384,000		153,781,000
Current Debt Instruments Issued	1,427,397,000		1,394,194,000
Noncurrent Debt Instruments Issued	7,192,978,000		6,115,890,000
Derivatives cash flow hedging instruments liabilities			0
Derivatives not designated as hedging instruments liabilities			0
Current variable payments outstanding for acquisitions			0
Noncontrolling Interest Subject To Put provisions			0
other current financial liabilities	1,275,539,000		1,467,767,000
other current and noncurrent financial liabilities	1,275,539,000		1,467,767,000
Financial liabilities	10,814,072,000		9,772,903,000
Financial Assets At Fair Value Through Other Comprehensive Income Category [Member]
Disclosure of detailed information about financial instruments [line items]
Equity investments	33,608,000		34,377,000
Debt securities	256,902,000		250,822,000
Other financial assets			0
Other Current and Non Current Financial Assets	290,510,000		285,199,000
Financial assets	€ 290,510,000		€ 285,199,000

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Financial instruments - Noncontrolling interests subject to put provisions (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018	Jan. 01, 2019	Jan. 01, 2018	Jan. 01, 2017
Reconciliation of changes in fair value measurement, liabilities [abstract]
Beginning balance	€ 19,126,700,000	€ 13,340,310,000
Dividends paid to non-controlling interests, classified as financing activities	(54,873,000)		€ (50,951,000)
Net income	57,009,000		51,154,000
Ending balance	19,126,700,000	13,340,310,000
Noncontrolling interests subject to put provisions
Reconciliation of changes in fair value measurement, liabilities [abstract]
Beginning balance	831,630,000	818,871,000		€ 818,871,000	€ 830,773,000	€ 830,773,000
Purchase of noncontrolling interests	(15,997,000)	(53,731,000)
Sale of noncontrolling interests	(968,000)	(50,706,000)
Changes in fair value of noncontrolling interests	32,586,000	142,279,000
Gain (Loss) recognized in equity	(26,895,000)	(50,612,000)	€ (50,612,000)
Dividends paid to non-controlling interests, classified as financing activities	(28,287,000)	(139,742,000)
Foreign currency translation	20,326,000	33,148,000
Ending balance	831,630,000	818,871,000		818,871,000	830,773,000	830,773,000
Variable Payments Outstanding For Acquisitions [Member]
Reconciliation of changes in fair value measurement, liabilities [abstract]
Beginning balance	135,161,000	172,278,000		172,278,000	205,792,000	205,792,000
Purchase of noncontrolling interests	(83,000)	(19,051,000)
Sale of noncontrolling interests	(3,653,000)	(15,734,000)
Changes in fair value of noncontrolling interests	(34,666,000)	(36,327,000)
Foreign currency translation	1,119,000	(504,000)
Ending balance	€ 135,161,000	€ 172,278,000		€ 172,278,000	€ 205,792,000	€ 205,792,000

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Financial instruments - Effect of derivatives on consolidated financial statements (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disclosure of detailed information about financial instruments [line items]
Interest income recorded as an effect of financial instruments	€ 27,944,000	€ 24,836,000
Interest expense recorded as an effect of financial instruments	€ 135,792,000	€ 107,769,000

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Supplementary cash flow information (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Supplementary cash flow information
Assets acquired	€ (2,082,291,000)	€ (36,062,000)
Liabilities assumed	190,406,000	2,608,000
Noncontrolling interest subject to put provisions	12,679,000
Noncontrolling interests	10,492,000
Non-cash consideration	6,518,000	2,864,000
Cash paid	1,862,196,000	30,590,000
Less cash acquired	42,496,000	252,000
Net cash paid for acquisitions	1,819,700,000	30,338,000
Cash paid for investments	282,000	146,867,000
Cash paid for intangible assets	8,543,000	4,198,000
Total cash paid for acquisitions and investments, net of cash acquired and purchases of intangible assets	1,828,525,000	181,403,000
Details for divestitures
Cash received from sale of subsidiaries or other businesses, less cash disposed	6,782,000
Cash received from divestitures of available for sale financial assets	4,230,000	82,000
Cash received from repayment of loans		76,000
Proceeds from divestitures	(11,012,000)	€ (158,000)
Acquisition effect net income shareholders	€ 12,593,000

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Segment and corporate information- Segment Activities (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Disclosure of operating segments [line items]
Revenue from contracts with external customers	€ 4,038,384,000	€ 3,904,635,000
other revenue	94,173,000	70,994,000
Revenue external customers	4,132,557,000	3,975,629,000
Inter - segment revenue		0
Revenue	4,132,557,000	3,975,629,000
Segment operating income	536,550,000	496,876,000
Interest	107,848,000	82,933,000
Income before income taxes	428,702,000	413,943,000
Depreciation and amortization	362,376,000	174,994,000
Income (loss) from equity method investees	20,033,000	17,904,000
Total assets	32,353,204,000	24,157,061,000	€ 26,242,268,000
thereof investments in equity method investees	630,439,000	619,730,000	€ 649,780,000
Additions of property, plant and equipment and intangible assets	337,277,000	231,170,000
North America Segment
Disclosure of operating segments [line items]
Revenue from contracts with external customers	2,826,212,000	2,719,627,000
other revenue	60,564,000	54,835,000
Revenue external customers	2,886,776,000	2,774,462,000
Inter - segment revenue	576,000	400,000
Revenue	2,887,352,000	2,774,862,000
Segment operating income	372,394,000	362,208,000
Depreciation and amortization	228,735,000	90,655,000
Income (loss) from equity method investees	21,362,000	18,801,000
Total assets	21,513,220,000	15,408,120,000
thereof investments in equity method investees	332,184,000	316,916,000
Additions of property, plant and equipment and intangible assets	188,150,000	141,821,000
EMEA Segment
Disclosure of operating segments [line items]
Revenue from contracts with external customers	635,800,000	631,224,000
other revenue	16,813,000	4,584,000
Revenue external customers	652,613,000	635,808,000
Inter - segment revenue	1,000	303,000
Revenue	652,614,000	636,111,000
Segment operating income	137,776,000	108,934,000
Depreciation and amortization	46,973,000	28,861,000
Income (loss) from equity method investees	(1,317,000)	(1,334,000)
Total assets	4,232,196,000	3,640,775,000
thereof investments in equity method investees	177,658,000	181,938,000
Additions of property, plant and equipment and intangible assets	47,114,000	30,405,000
Asia-Pacific Segment
Disclosure of operating segments [line items]
Revenue from contracts with external customers	411,603,000	380,801,000
other revenue	15,971,000	10,661,000
Revenue external customers	427,574,000	391,462,000
Inter - segment revenue	234,000	187,000
Revenue	427,808,000	391,649,000
Segment operating income	94,702,000	74,220,000
Depreciation and amortization	22,601,000	11,159,000
Income (loss) from equity method investees	(294,000)	335,000
Total assets	2,669,344,000	2,081,140,000
thereof investments in equity method investees	96,641,000	96,961,000
Additions of property, plant and equipment and intangible assets	13,743,000	10,034,000
Latin America Segment
Disclosure of operating segments [line items]
Revenue from contracts with external customers	160,601,000	169,340,000
other revenue	825,000	914,000
Revenue external customers	161,426,000	170,254,000
Inter - segment revenue	65,000	39,000
Revenue	161,491,000	170,293,000
Segment operating income	11,395,000	14,114,000
Depreciation and amortization	8,363,000	4,580,000
Income (loss) from equity method investees	282,000	102,000
Total assets	821,984,000	694,375,000
thereof investments in equity method investees	23,956,000	23,915,000
Additions of property, plant and equipment and intangible assets	14,783,000	3,796,000
Operating Segments
Disclosure of operating segments [line items]
Revenue from contracts with external customers	4,034,216,000	3,900,992,000
other revenue	94,173,000	70,994,000
Revenue external customers	4,128,389,000	3,971,986,000
Inter - segment revenue	876,000	929,000
Revenue	4,129,265,000	3,972,915,000
Segment operating income	616,267,000	559,476,000
Depreciation and amortization	306,672,000	135,255,000
Income (loss) from equity method investees	20,033,000	17,904,000
Total assets	29,236,744,000	21,824,410,000
thereof investments in equity method investees	630,439,000	619,730,000
Additions of property, plant and equipment and intangible assets	263,790,000	186,056,000
Corporate
Disclosure of operating segments [line items]
Revenue from contracts with external customers	4,168,000	3,643,000
Revenue external customers	4,168,000	3,643,000
Inter - segment revenue	(876,000)	(929,000)
Revenue	3,292,000	2,714,000
Segment operating income	(79,717,000)	(62,600,000)
Depreciation and amortization	55,704,000	39,739,000
Total assets	3,116,460,000	2,332,651,000
Additions of property, plant and equipment and intangible assets	€ 73,487,000	€ 45,114,000

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Segment and corporate information - Geographic Information (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disclosure of geographical areas [line items]
Revenue external customers	€ 4,132,557,000	€ 3,975,629,000

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Proposal for the distribution of earnings (Details) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
Disclosure of classes of share capital [line items]
Capital	€ 307,907,000	€ 307,879,000

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Employee Benefit Plans - Funded Status (Details) (Calc 2) - EUR (€)	Mar. 31, 2019	Dec. 31, 2018
SurplusDeficitInPlanAbstract
Non-current provisions for employee benefits	€ 563,538,000	€ 551,930,000

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Segment and Corporate Information - Segment Activities Calc2 (Details) - EUR (€)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenue Table
Revenue	€ 4,132,557,000	€ 3,975,629,000
Inter-segment revenue		0
Revenue external customers	€ 4,132,557,000	€ 3,975,629,000

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Subsequent Events (Details)	3 Months Ended
	Mar. 31, 2018 EUR (€)
Subsequent events
Procees from the sale of an investment	€ 1,531,109,000
Expected Pre Tax Loss On Sale of Investment	€ 13,103,000

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Label	Element	Value
Related Party Lease Agreement [Member]
Lease And Sublease Payments Recognised As Expense	ifrs-full_LeaseAndSubleasePaymentsRecognisedAsExpense	€ 5,761,000
Lease And Sublease Payments Recognised As Expense	ifrs-full_LeaseAndSubleasePaymentsRecognisedAsExpense	1,015,000
Lease Depreciation	fms_LeaseDepreciation	4,303,000
Interest Expense On Finance Leases	ifrs-full_InterestExpenseOnFinanceLeases	490,000
Right of Use Assets	ifrs-full_RightofuseAssets	133,185,000
Lease Liability IFRS 16	fms_LeaseLiabilityIFRS16	133,402,000
Fresenius Se [Member] | Related Party Lease Agreement [Member]
Lease And Sublease Payments Recognised As Expense	ifrs-full_LeaseAndSubleasePaymentsRecognisedAsExpense	2,069,000
Lease And Sublease Payments Recognised As Expense	ifrs-full_LeaseAndSubleasePaymentsRecognisedAsExpense	854,000
Lease Depreciation	fms_LeaseDepreciation	1,214,000
Interest Expense On Finance Leases	ifrs-full_InterestExpenseOnFinanceLeases	137,000
Right of Use Assets	ifrs-full_RightofuseAssets	35,219,000
Lease Liability IFRS 16	fms_LeaseLiabilityIFRS16	35,286,000
Affiliates Of Largest Shareholder [Member] | Related Party Lease Agreement [Member]
Lease And Sublease Payments Recognised As Expense	ifrs-full_LeaseAndSubleasePaymentsRecognisedAsExpense	3,692,000
Lease And Sublease Payments Recognised As Expense	ifrs-full_LeaseAndSubleasePaymentsRecognisedAsExpense	161,000
Lease Depreciation	fms_LeaseDepreciation	3,089,000
Interest Expense On Finance Leases	ifrs-full_InterestExpenseOnFinanceLeases	353,000
Right of Use Assets	ifrs-full_RightofuseAssets	97,966,000
Lease Liability IFRS 16	fms_LeaseLiabilityIFRS16	€ 98,116,000