"This purchase will enable Fresenius Medical Care to further expand the availability of the signature Acumen nEHR product, and other innovative clinical IT solutions to nephrologists, which will enhance their efficiency and ability to provide superior clinical care for their patients. With this strategic acquisition, we continue to deliver on our goal of bringing a comprehensive service portfolio to nephrologists, for the benefit of patients. Acumen nEHR is another important component in strengthening our comprehensive strategic information technology offerings," said Mats Wahlstrom, CO-CEO of Fresenius Medical Care North America (FMCNA).

"Since our strategic partnership with Fresenius Medical Care in 2007, we have experienced tremendous growth in the Acumen brand of nephrology-specific tools that enhance a provider's ability to deliver superior care to all of their patients with kidney disease," said Dr. Franklin W. Maddux, founder of HITSG. "Fresenius Medical Care and HITSG share a deep commitment in supporting high quality medical care for patients with renal disease and advancing the tools and methods nephrologists use to provide that care."

Dr. Maddux will become Senior Vice President and Chief Medical Information Officer (CMIO) for FMCNA, reporting to the Chief Medical Officer. "The appointment of Frank Maddux to this position emphasizes our belief that effective IT solutions create a strong competitive advantage for FMCNA and the physicians we support in providing excellent patient care." said Wahlstrom.

This acquisition positions FMCNA to help nephrologists respond to the concepts of meaningful use of electronic health records and health information exchange emerging from the HIT stimulus provisions of The American Recovery and Reinvestment Act of 2009 (ARRA). Additionally, the acquisition positions FMCNA to favorably respond to the evolving coordinated, preventive and chronic disease management care emphasized in the current healthcare reform provisions under legislative review.

About Fresenius Medical Care

Fresenius Medical Care North America is a subsidiary of Fresenius Medical Care AG & Co. KGaA, the world's largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 1,770,000 individuals worldwide. Through its network of 2,478 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to approximately 190,080 patients around the globe. Fresenius Medical Care is also the world's leading provider of dialysis products such as hemodialysis machines, dialyzers and related disposable products. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME, FME3) and the New York Stock Exchange (FMS, FMS-p). For more information about FMCNA's U.S. network of more than 1,700 dialysis facilities, visit the Company's website at www.ultracare-dialysis.com (in English and Spanish). For more information about Fresenius Medical Care, visit the Company's website: www.fmc-ag.com.

About Acumen nEHR

Acumen nEHR was created to develop and deliver intuitive software tools to assist nephrologists in the practice of medicine and to better manage their practices. The technology enhances the care team's ability to maintain, track, and communicate medical, patient, and business information. With ASP-based solutions designed by nephrologists, the integrated suite of clinical tools support workflow within the medical office, hospital and dialysis unit to effectively streamline the access, storage, and distribution of patient clinical information. For more information regarding Acumen nEHR go to www.AcumenEHR.com.

SOURCE: Fresenius Medical Care North America

Loomis Group 
Jaclyn Petros, 617-638-0022 / voice 
petrosj@loomisgroup.com 
or 
Fresenius Medical Care N.A. 
Rosemary Heinold, 781-699-4171 / voice 
rosemary.heinold@fmc-na.com

Summary First Nine Months 2009:
Net revenue                                                         $  8,212 million     + 4 %
Operating income (EBIT)                                             $  1,265 million     + 2 %
Net income attributable to Fresenius Medical Care AG & Co. KGaA     $  645 million       + 7 %
Earnings per share                                                  $  2.16              + 6 %

Fresenius Medical Care AG & Co. KGaA ("the Company" or "FMC AG & Co. KGaA"), the world's largest provider of dialysis products and services, today announced its results for the third quarter and first nine months of 2009.

Third Quarter 2009:

Revenue

Net revenue for the third quarter of 2009 increased by 6% to $2,889 million (10% at constant currency) compared to the third quarter of 2008. Organic revenue growth worldwide was 8%. Dialysis Services revenue grew by 8% to $2,147 million (10% at constant currency) in the third quarter of 2009. Dialysis Product revenue increased by 2% to $742 million (an increase of 8% at constant currency) in the same period.

North America revenue increased by 10% to $1,950 million. Organic revenue growth was 8%. Dialysis Services revenue grew by 10% to $1,741 million. Average revenue per treatment for the U.S. clinics increased to $348 in the third quarter of 2009 compared to $333 for the same quarter in 2008 and $344 for the second quarter of 2009. This development was mainly based on reimbursement increases and increased utilization of pharmaceuticals. Dialysis Product revenue increased by 14% to $209 million and was led by pharmaceutical sales, especially of the newly licensed intravenous iron products.

International revenue remained nearly unchanged at $939 million, compared to the third quarter of 2008. Based on constant currency, revenue grew by 9%. Organic revenue growth was 7%. Dialysis Services revenue was $406 million, an increase of 2% (+12% at constant currency). Dialysis Product revenue decreased by 2% to $533 million. Product sales grew by 6% based on constant currencies, led by increased pharmaceutical sales and sales of dialyzers.

Earnings

Operating income (EBIT) increased by 7% to $451 million compared to $422 million in the third quarter of 2008, resulting in an operating margin of 15.6%, equal to the operating margin for the third quarter of 2008. Compared to the second quarter of 2009 this represents a 50 basis points improvement. The third quarter operating margin was favorably impacted by an increase in revenue per treatment, an excellent cost management in the U.S. and a decrease in bad debt expenses. The operating margin development was negatively influenced by increased prices for pharmaceuticals, the impact of the launch of a generic version of PhosLo(R) in the U.S. market and unfavorable exchange rate effects in the International segment.

In North America, the operating margin was unchanged at 16.7%, as in the third quarter of 2008. The margin was favorably impacted by an increase in revenue per treatment, including commercial payor revenue, higher utilization of EPO and Medicare reimbursement increases, an excellent cost management in the U.S. and a decrease in bad debt expenses thanks to higher cash collections on receivables. This was offset by cost increases for pharmaceuticals related to both price and utilization, as well as the impact of the launch of a generic version of PhosLo(R) in the U.S. market and increased depreciation expense.

In the International segment, the operating margin increased by 60 basis points to 16.7% due to lower production costs resulting from lower prices for raw material and energy as well as economies of scale and lower bad debt expenses, which was partially offset by unfavorable foreign exchange rate effects.

Net interest expense for the third quarter of 2009 was $75 million compared to $87 million in the same quarter of 2008, mainly due to lower short-term interest rates.

Income tax expense was $131 million for the third quarter of 2009 compared to $120 million in the third quarter of 2008, reflecting effective tax rates of 35.0% and 35.7%, respectively.

Net income attributable to FMC AG & Co. KGaA for the third quarter of 2009 was $225 million, an increase of 9%.

Earnings per share (EPS) for the third quarter of 2009 rose by 9% to $0.76 per ordinary share compared to $0.69 for the third quarter of 2008. The weighted average number of shares outstanding for the third quarter of 2009 was approximately 298.3 million shares compared to 297.2 million shares for the third quarter of 2008. The increase in shares outstanding resulted from stock option exercises in the past twelve months.

Cash Flow

In the third quarter of 2009, the Company generated $443 million in cash from operations, an increase of 41% compared to the third quarter of 2008 and representing approximately 15% of revenue. The cash flow performance was positively influenced by increased earnings and a favorable development of the Days Sales Outstanding.

A total of $139 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions was $304 million compared to $155 million in the third quarter of 2008. A total of $26 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $278 million compared to $116 million in the third quarter of last year.

Nine Months Ended September 30, 2009:

Revenue and Earnings

Net revenue was $8,212 million, up 4% from the first nine months of 2008. At constant currency, net revenue rose 9%. Organic growth was 8% in the first nine months of 2009.

Operating income (EBIT) increased by 2% to $1,265 million compared to $1,240 million in the first nine months of 2008, resulting in an operating margin of 15.4% compared to 15.7% for the first nine months of 2008. This development was mainly due to higher personnel expenses, price increases for pharmaceuticals including Heparin as well as the impact of the launch of a generic version of PhosLo(R) in the U.S. market. These effects were partially offset by a strong performance of the dialysis product business, increased commercial payor revenue as well as the effect of cost control measures.

Net interest expense for the first nine months of 2009 was $225 million compared to $252 million in the same period of 2008, mainly due to lower short-term interest rates.

Income tax expense was $345 million in the first nine months of 2009 compared to $357 million in the same period in 2008, reflecting effective tax rates of 33.2% and 36.1%, respectively. Tax expense was positively impacted by a non-recurring revaluation of a tax claim recorded in the second quarter of 2009.

For the first nine months of 2009, net income attributable to FMC AG & Co. KGaA was $645 million, up 7% from the first nine months of 2008.

Earnings per ordinary share rose by 6% to $2.16. The weighted average number of shares outstanding during the first nine months of 2009 was approximately 298.0 million.

Cash Flow

Cash from operations during the first nine months of 2009 was $880 million compared to $716 million for the same period in 2008, representing approximately 11% of revenue. The cash flow generation benefited from increased earnings and the favorable development of the Days Sales Outstanding.

A total of $388 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions for the first nine months of 2009 was $492 million compared to $223 million in the same period in 2008. A total of $57 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $435 million compared to $93 million in the first nine months of last year.

Please refer to the attachments for a complete overview on the third quarter and first nine months of 2009 and the reconciliation of non-GAAP financial measures included in this release to the most comparable GAAP financial measures.

Patients -- Clinics -- Treatments

As of September 30, 2009, Fresenius Medical Care treated 192,804 patients worldwide, which represents a 6% increase compared to the same period last year. North America provided dialysis treatments for 130,522 patients, an increase of 4%. Including 31 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 132,158. The International segment served 62,282 patients, an increase of 10% over last year.

As of September 30, 2009, the Company operated a total of 2,509 clinics worldwide. This is comprised of 1,749 clinics in North America (1,780 including managed clinics), an increase of 5%, and 760 clinics in the International segment, an increase of 11%.

Fresenius Medical Care delivered approximately 21.84 million dialysis treatments worldwide during the first nine months of 2009. This represents an increase of 6% year over year. North America accounted for 14.75 million treatments, an increase of 4%, and the International segment delivered 7.09 million treatments, an increase of 10% over last year.

Employees

As of September 30, 2009, Fresenius Medical Care had 67,245 employees (full-time equivalents) worldwide compared to 63,990 employees as of September 30, 2008. This increase of over 3,200 employees is due to the overall growth in the Company's business.

Debt/EBITDA Ratio

The ratio of debt to Earnings before Interest, Taxes, Depreciation and Amortization (EBITDA) decreased from 2.71 at the end of the third quarter of 2008 to 2.62 at the end of the third quarter of 2009. At the end of 2008, the debt/EBITDA ratio was 2.69.

Rating

In the third quarter of 2009, Standard & Poor's Rating Services continued to rate the Company's corporate credit as 'BB' with a 'stable' outlook. Moody's also affirmed its rating of the Company's corporate credit as 'Ba1' with a 'stable' outlook. As in the previous quarter, Fitch rates the Company's corporate credit as 'BB' while revising its outlook from 'negative' to 'stable'. For further information on Fresenius Medical Care's credit ratings, maturity profiles and credit instruments, please visit our website at www.fmc-ag.com / Investor Relations / Credit Relations.

Outlook for 2009

For the full year of 2009, the Company now expects to achieve revenue of around $11.2 billion (previously $11.1 billion), an increase of around 8% in constant currency.

Net income attributable to FMC AG & Co. KGaA is now expected to be between $865 million and $890 million in 2009. Previously the Company expected the net income to be in the range of $850 million and $890 million for the full year 2009.

In addition, the Company expects to spend $550 to $650 million on capital expenditures and $200 to $250 million (previously $200 to $300 million) on acquisitions. The projected debt/EBITDA ratio has been retained unchanged at below 2.7.

Ben Lipps, Chief Executive Officer of Fresenius Medical Care, said: "We are very pleased with our results in the third quarter of 2009, which reflects an excellent performance by all regions. While we maintained our increased commitment to research and development, our sustained high organic growth globally and good cost containment accounted for this overall successful operating performance. The free cash flow for the third quarter exceeded our expectations and resulted from excellent cash collections in North America. Our strong performance in the quarter provides the basis for us to improve our guidance for the full year 2009."

Conference Call

Fresenius Medical Care will hold a conference call to discuss the results of the third quarter and the first nine months of 2009 on Tuesday, November 03, 2009, at 3:30 pm CET / 9:30 am EST. The Company invites investors to listen to the live webcast of the call at the Company's website www.fmc-ag.com in the "Investor Relations" section. A replay will be available shortly after the call.

Fresenius Medical Care is the world's largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 1,770,000 individuals worldwide. Through its network of 2,509 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to 192,804 patients around the globe. Fresenius Medical Care is also the world's leading provider of dialysis products such as hemodialysis machines, dialyzers and related disposable products. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME, FME3) and the New York Stock Exchange (FMS, FMS/P).

For more information about Fresenius Medical Care, visit the Company's website at www.fmc-ag.com.

This release contains forward-looking statements that are subject to various risks and uncertainties. Actual results could differ materially from those described in these forward-looking statements due to certain factors, including changes in business, economic and competitive conditions, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, and the availability of financing. These and other risks and uncertainties are detailed in Fresenius Medical Care AG & Co. KGaA's reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care AG & Co. KGaA does not undertake any responsibility to update the forward-looking statements in this release.

Fresenius Medical Care                                         Three Months Ended                     Nine Months Ended
Statement of Earnings                                          September 30,                          September 30,
(in US-$ thousands, except share and per share data)           2009          2008          % Change   2009          2008          % Change
(unaudited)
Net revenue
Dialysis Care                                                  2,146,349     1,984,938     8.1%       6,123,774     5,753,484     6.4%
Dialysis Products                                              742,320       728,327       1.9%       2,088,274     2,136,801     -2.3%
Total net revenue                                              2,888,669     2,713,265     6.5%       8,212,048     7,890,285     4.1%
Cost of revenue                                                1,910,168     1,803,886     5.9%       5,439,530     5,201,721     4.6%
Gross profit                                                   978,501       909,379       7.6%       2,772,518     2,688,564     3.1%
Selling, general and administrative                            504,520       466,983       8.0%       1,443,206     1,388,680     3.9%
Research and development                                       22,656        20,206        12.1%      64,508        59,978        7.6%
Operating income (EBIT)                                        451,325       422,190       6.9%       1,264,804     1,239,906     2.0%
Interest income                                                (4,624)       (6,467)       -28.5%     (16,797)      (19,266)      -12.8%
Interest expense                                               79,769        93,516        -14.7%     241,466       271,275       -11.0%
Interest expense, net                                          75,145        87,049        -13.7%     224,669       252,009       -10.8%
Income before taxes                                            376,180       335,141       12.2%      1,040,135     987,897       5.3%
Income tax expense(1))                                         131,687       119,492       10.2%      345,436       356,513       -3.1%
Net income                                                     244,493       215,649       13.4%      694,699       631,384       10.0%
Less: Net income attributable to Noncontrolling interest(1))   19,193        9,314         106.1%     50,180        28,088        78.7%
Net income attributable to FMC AG & Co. KGaA                   225,300       206,335       9.2%       644,519       603,296       6.8%
Operating income (EBIT)                                        451,325       422,190       6.9%       1,264,804     1,239,906     2.0%
Depreciation and amortization                                  118,291       107,897       9.6%       334,133       306,761       8.9%
EBITDA                                                         569,616       530,087       7.5%       1,598,937     1,546,667     3.4%
Total bad debt expenses                                        50,189        56,274                   159,078       157,922
Earnings per ordinary share                                    $0.76         $0.69         8.8%       $2.16         $2.03         6.4%
Earnings per ordinary ADS                                      $0.76         $0.69         8.8%       $2.16         $2.03         6.4%
Weighted average number of shares
Ordinary shares                                                294,443,038   293,417,973              294,181,563   293,030,503
Preference shares                                              3,857,335     3,802,913                3,832,367     3,790,298
Percentages of revenue
Cost of revenue                                                66.1%         66.5%                    66.2%         65.9%
Gross profit                                                   33.9%         33.5%                    33.8%         34.1%
Selling, general and administrative                            17.5%         17.2%                    17.6%         17.6%
Research and development                                       0.8%          0.7%                     0.8%          0.8%
Operating income (EBIT)                                        15.6%         15.6%                    15.4%         15.7%
Interest expense, net                                          2.6%          3.2%                     2.7%          3.2%
Income before taxes                                            13.0%         12.4%                    12.7%         12.5%
Income tax expense                                             4.6%          4.4%                     4.2%          4.5%
Net income attributable to Noncontrolling interest             0.7%          0.3%                     0.6%          0.4%
Net income attributable to FMC AG & Co. KGaA                   7.8%          7.6%                     7.8%          7.6%
EBITDA                                                         19.7%         19.5%                    19.5%         19.6%
(1)) Due to the adoption of the new accounting rule ASC
810 (US GAAP), tax expenses related to minority interests of
partnerships were reclassified to noncontrolling interest. The
effect is neutral to net income attributable to FMC AG & Co. KGaA.
The previous year's periods have been adjusted accordingly.

Fresenius Medical Care                      Three Months Ended         Nine Months Ended
Segment and Other Information               September 30,              September 30,
(in US-$ million)                           2009    2008    % Change   2009     2008     % Change
(unaudited)
Net revenue
North America                               1,950   1,771   10.1%      5,600    5,153    8.7%
International                               939     942     -0.3%      2,612    2,737    -4.6%
Total net revenue                           2,889   2,713   6.5%       8,212    7,890    4.1%
Operating income (EBIT)
North America                               325     296     9.8%       894      858      4.2%
International                               156     152     3.0%       457      462      -1.1%
Corporate                                   (30)    (26)    16.7%      (86)     (80)     7.3%
Total operating income (EBIT)               451     422     6.9%       1,265    1,240    2.0%
Operating income in percentage of revenue
North America                               16.7%   16.7%              16.0%    16.7%
International                               16.7%   16.1%              17.5%    16.9%
Total                                       15.6%   15.6%              15.4%    15.7%
Employees
Full-time equivalents                                                  67,245   63,990

Fresenius Medical Care
Reconciliation of non US-GAAP
financial measures to the most directly                                Three Months Ended   Nine Months Ended
comparable US-GAAP financial measures                                  September 30,        September 30,
(in US-$ million)                                                      2009    2008         2009    2008
(unaudited)
Segment information North America
Net revenue                                                            1,950   1,771
Costs of revenue and research and development                          1,309   1,187
Selling, general and administrative                                    316     288
Costs of revenue and operating expenses                                1,625   1,475
Operating income (EBIT)                                                325     296
Percent of revenue                                                     16.7%   16.7%
Dialysis Products revenue incl. and excl. internal sales
North America
Dialysis Products revenue incl. internal sales                         376     321
less internal sales                                                    (167)   (137)
Dialysis Products external sales                                       209     184
International
Dialysis Products revenue incl. internal sales                         613     622
less internal sales                                                    (80)    (78)
Dialysis Products external sales                                       533     544
Reconciliation of cash flow from operating activities to EBITDA (1))
Total EBITDA                                                                                1,599   1,547
Interest expense, net                                                                       (225)   (252)
Income tax expense                                                                          (345)   (357)
Change in working capital and other non cash items                                          (149)   (222)
Net cash provided by operating activities                                                   880     716
Annualized EBITDA
Operating income (EBIT) last twelve months                                                  1,697   1,668
Depreciation and amortization last twelve months                                            443     410
Non cash charges                                                                            48      44
Annualized EBITDA                                                                           2,188   2,122
(1)) EBITDA is the basis for determining compliance with
certain covenants in Fresenius Medical Care's long-term debt
instruments.

Fresenius Medical Care                                               September 30,   December 31,
Balance Sheet                                                        (unaudited)     (audited)
(in US-$ million)                                                    2009            2008
Assets
Current assets                                                       4,726           4,212
Intangible assets                                                    8,281           8,156
Other non-current assets                                             2,690           2,552
Total assets                                                         15,697          14,920
Liabilities and equity
Current liabilities                                                  2,642           3,145
Long-term liabilities                                                6,341           5,652
Total equity                                                         6,714           6,123
Total liabilities and equity                                         15,697          14,920
Equity/assets ratio:                                                 43%             41%
Debt
Short-term borrowings                                                312             684
Short-term borrowings from related parties                           43              1
Current portion of long-term debt and capital lease obligations      160             455
Long-term debt and capital lease obligations, less current portion   4,561           3,957
Trust Preferred Securities                                           663             641
Total debt                                                           5,739           5,738

Fresenius Medical Care
Cash Flow Statement
Nine Months Ended September 30,                        2009    2008
(in US-$ million)
(unaudited)
Operating activities
Net income                                             695     631
Depreciation / amortization                            334     307
Change in working capital and other non cash items     (149)   (222)
Cash Flow from operating activities                    880     716
Investing activities
Purchases of property, plant and equipment             (398)   (502)
Proceeds from sale of property, plant and equipment    10      9
Capital expenditures, net                              (388)   (493)
Free Cash Flow                                         492     223
Acquisitions and investments, net of cash acquired
and net purchases of intangible assets                 (109)   (176)
Proceeds from divestitures                             52      46
Acquisitions, net of divestitures                      (57)    (130)
Free Cash Flow after investing activities              435     93
Financing activities
Change in accounts receivable securitization program   (335)   452
Change in intercompany debt                            (68)    (1)
Change in other debt                                   212     310
Redemption of Trust Preferred Securities               -       (678)
Proceeds from exercise of stock options                26      38
Distributions to noncontrolling interest               (48)    (27)
Contributions from noncontrolling interest             8       -
Dividends paid                                         (232)   (252)
Cash Flow from financing activities                    (437)   (158)
Effects of exchange rates on cash                      4       -
Net increase (decrease) in cash                        2       (65)
Cash at beginning of period                            222     245
Cash at end of period                                  224     180

Fresenius Medical Care
Quarterly Performance Scorecard - Revenue
Three months ended September 30,                    2009        cc      2008        cc
(in US-$ thousands, except per-treatment revenue)
North America
Net revenue                                         1,949,384           1,770,820
Growth year-over-year                               10.1%               6.6%
Dialysis Care                                       1,740,040           1,586,594
Growth year-over-year                               9.7%                6.2%
U.S. per treatment                                  348                 333
Per treatment                                       342                 328
Sequential growth                                   1.2%                1.7%
Growth year-over-year                               4.1%                1.8%
Dialysis Products
incl. internal sales                                375,788             320,908
Growth year-over-year                               17.1%               8.1%
External sales                                      209,343             184,226
Growth year-over-year                               13.6%               10.5%
International
Net revenue                                         939,115             942,278
Growth year-over-year                               -0.3%       8.6%    23.1%       14.4%
Dialysis Care                                       406,309             398,345
Growth year-over-year                               2.0%        12.2%   29.8%       20.1%
Per treatment                                       167         184     179         166
Sequential growth                                   5.2%                -2.1%
Growth year-over-year                               -6.4%       2.9%    16.8%       8.1%
Dialysis Products
incl. internal sales                                612,631             622,010
Growth year-over-year                               -1.5%       7.2%    18.7%       10.3%
External sales                                      532,806             543,933
Growth year-over-year                               -2.0%       5.9%    18.6%       10.5%
cc = at constant exchange rates

Fresenius Medical Care
Quarterly Performance Scorecard - Dialysis Care Volume
Three months ended September 30,                       2009        2008
North America
Number of treatments                                   5,060,911   4,829,339
Treatments per day                                     64,062      61,131
Per day sequential growth                              1.0%        0.5%
Per day year-over-year growth                          4.8%        3.2%
Same market growth year-over-year                      3.6%        3.0%
International
Number of treatments                                   2,427,410   2,226,681
Same market growth year-over-year                      4.5%        9.5%
Fresenius Medical Care
Quarterly Performance Scorecard - Expenses
Three months ended September 30,                       2009        2008
North America
Costs of revenue and operating expenses
Percent of revenue                                     83.3%       83.3%
Selling, general and administrative
Percent of revenue                                     16.2%       16.3%
Bad debt expenses
Percent of revenue                                     2.5%        2.9%
Dialysis Care operating expenses/Treatment (in US-$)   283         274
Sequential growth                                      -0.6%       1.6%
Growth year-over-year                                  3.3%        2.1%
Total Group
Costs of revenue and operating expenses
Percent of revenue                                     84.4%       84.4%
Selling, general and administrative
Percent of revenue                                     17.5%       17.2%
Effective tax rate                                     35.0%       35.7%

Fresenius Medical Care
Quarterly Performance Scorecard - Cash Flow/Investing Activities
Three months ended September 30,                    2009        2008
(in US-$ thousands, except number of de novos)
Total Group
Operating Cash Flow                                 443,168     314,512
Percent of revenue                                  15.3%       11.6%
Free Cash Flow before acquisitions                  304,345     154,670
Percent of revenue                                  10.5%       5.7%
Acquisitions and investments, net of divestitures   26,742      39,034
Capital expenditures, net                           138,823     159,842
Percent of revenue                                  4.8%        5.9%
Maintenance                                         52,136      63,818
Percent of revenue                                  1.8%        2.4%
Growth                                              86,687      96,024
Percent of revenue                                  3.0%        3.5%
Number of de novos                                  23          29
North America                                       18          19
International                                       5           10
Fresenius Medical Care
Quarterly Performance Scorecard - Balance Sheet
Three months ended September 30,                    2009        2008
Total Group
Debt (in US-$ million)                              5,739       5,748
Debt/EBITDA                                         2.6         2.7
North America
Days sales outstanding                              55          60
International
Days sales outstanding                              112         108

Fresenius Medical Care
Quarterly Performance Scorecard
Three months ended September 30,         2009      2008
Clinical Performance
North America (U.S.)
Single Pool Kt/v > 1.2                   96%       95%
Hemoglobin = 10-12g/dl                   64%       58%
Hemoglobin = 10-13g/dl                   87%       86%
Albumin >= 3.5 g/dl (1))                 82%       81%
Phosphate 3.5-5.5mg/dl                   54%       53%
Hospitalization Days per patient (2) )   10.0      10.5
(12 months ending September 30)
Demographics
North America (U.S.)
Average age (in years)                   62        62
Average time on dialysis (in years)      3.6       3.6
Average body weight (in kg)              80        79
Prevalence of diabetes                   54%       53%
(1)) International standard BCR CRM470
(2)) Hospitalization data for 2009 includes legacy RCG
facilities
Fresenius Medical Care
Quarterly Performance Scorecard
Three months ended September 30,         2009      2008
Clinical Performance
Europe, Middle East and Africa
Single Pool Kt/v > 1.2                   95%       95%
Hemoglobin = 10-12g/dl                   53%       51%
Hemoglobin = 10-13g/dl                   74%       76%
Albumin >= 3.5 g/dl (1))                 85%       85%
Phosphate 3.5-5.5mg/dl                   58%       60%
Hospitalization Days per patient         7.8       7.6
(12 months ending September 30)
Demographics
Europe, Middle East and Africa
Average age (in years)                   64        63
Average time on dialysis (in years)      4.8       4.6
Average body weight (in kg)              70        69
Prevalence of diabetes                   28%       28%
(1) )International standard BCR CRM470

SOURCE: Fresenius Medical Care AG & Co. KGaA

Fresenius Medical Care AG & Co. KGaA 
Investor Relations 
Oliver Maier, + 49 6172 609 2601 
Fax: + 49 6172 609 2301 
ir@fmc-ag.com 
or 
North America: 
Terry L. Morris, + 1 800 948 2538 
Fax: + 1 615 345 5605 
ir@fmc-ag.com 
www.fmc-ag.com

The KidneyTel system combines home telehealth monitoring device technology with an integrated care management program specifically tailored to the kidney patient. KidneyTel provides interactive daily contact and education with dialysis patients by monitoring health issues through a series of interactive questions on key health risk areas. In addition, KidneyTel collects daily vital signs of blood pressure, weight, and blood glucose. This information is transmitted each day to the KidneyTel IT system and call center. The KidneyTel clinical team is alerted to identified health risks and trends and can determine an appropriate response with patients and their families; while coordinating with their dialysis clinic, nephrologist, and other healthcare providers. The KidneyTel system includes advanced clinical algorithms and care pathways using evidence based medicine.

"Our objective is to keep ESRD (End Stage Renal Disease) patients healthier, out of the hospital, and at home resulting in a better quality of life for patients and reduced cost to their payers. The telehealth platform which KidneyTel utilizes has been deployed in the heart failure, diabetes and chronic disease populations over the past several years with excellent results. In addition, the technology has been a success with kidney patients over the past three years in the Fresenius Medical Care Health Plan (a Medicare Advantage CSNP), within the CMS ESRD Demonstration Project," stated Stephen McMurray, M.D., Medical Director for the KidneyTel program and Fresenius Medical Care Health Plan.

Our customers can have confidence in the quality and value of this program. The KidneyTel integrated care program is fully accredited by both NCQA (National Committee for Quality Assurance) and URAC (Utilization Review Accreditation Commission) for disease management.

Health Plans interested in improving the quality of patient care and reducing costly hospitalizations by providing KidneyTel for your members please contact Dave Tigue, VP Sales and Marketing, at 781-699-2830.

Kidney patients, dialysis clinics and nephrologists interested in the KidneyTel program please contact Jeanne Karalus, Marketing Manager, at 781-699-2811 to request an informational brochure.

For more information regarding this press release please contact:

Robert Farrell
President
Integrated Care Management
Fresenius Medical Care North America
781-699-2813 or 1-800-662-1237 X2813
About Fresenius Medical Care North America

Fresenius Medical Care is the world's largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 1,770,000 individuals worldwide. Through its network of 2,471 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to 190,081 patients around the globe. Fresenius Medical Care is also the world's leading provider of dialysis products such as hemodialysis machines, dialyzers and related disposable products. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME, FME3) and the New York Stock Exchange (FMS, FMS/P).

For more information about Fresenius Medical Care, visit the company's websites: www.fmcna.com or www.fmc-ag.com.

For more information about the KidneyTel program visit the company's website: www.kidneytel.com

For more information about Fresenius Medical Care Health Plan visit the company's website: www.fmchp.com

SOURCE: Fresenius Medical Care

Fresenius Medical Care AG & Co. KGaA 
Investor Relations: 
North America: 
Terry L. Morris, + 1 800 948 2538 
Fax: + 1 615 345 5605 
E-mail: ir@fmc-ag.com 
Internet: www.fmc-ag.com

Patients, clinical staff or social workers can call the Patient Travel Service at 1-866-4DIALYSIS (1-866-434-2597, Option 2) to get help finding a convenient facility at their requested travel destination, or to get answers to general questions about traveling while on dialysis. This information service is free, and for the best results patients are encouraged to plan early.

"Fresenius Medical Care is dedicated to helping our patients live life to the fullest, and part of that means having the freedom to travel without worrying about where and how to get dialysis," said Patrick Henry, senior manager of the Fresenius Medical Care Patient Travel Service. "Our Patient Travel Service puts patients at ease and makes treatment while away from home as seamless as possible."

Here's how scheduling dialysis away from home works, in three easy steps:

Step 1: By calling the Fresenius Medical Care Patient Travel Service at 1-866-4DIALYSIS (1-866-434-2597, Option 2), a patient, the patient's social worker, or a clinical staff member can request dialysis treatment in a specific location in the U.S. or abroad.

Step 2: Once a clinic is located, the Patient Travel Service works directly with the destination's admissions office or with a partner organization to accommodate the traveling patient's request.

Step 3: The destination's admissions office works directly with the patient's home clinic to confirm travel information, treatment prescription, obtain all necessary medical documents and to secure placement.

All Fresenius Medical Care facilities share the company's UltraCare(R) mission of delivering excellent care to patients through innovative programs, the latest technology, continuous quality improvement and a focus on superior customer service.

Dialysis is a life-sustaining process that cleans waste products from the blood, removes extra fluids, and controls the body's chemistry when a person's kidneys fail. Dialysis patients typically require treatment on an ongoing basis unless they receive a kidney transplant.

About Fresenius Medical Care North America

Fresenius Medical Care North America is a subsidiary of Fresenius Medical Care AG & Co. KGaA, the world's largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 1,770,000 individuals worldwide. Through its network of 2,448 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to approximately 187,470 patients around the globe. Fresenius Medical Care is also the world's leading provider of dialysis products such as hemodialysis machines, dialyzers and related disposable products. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME, FME3) and the New York Stock Exchange (FMS, FMS-p).

For more information about Fresenius Medical Care's U.S. network of more than 1,700 dialysis facilities, visit the Company's website at www.ultracare-dialysis.com (in English and Spanish). For more information about Fresenius Medical Care, visit the Company's websites: www.fmcna.com or www.fmc-ag.com.

SOURCE: Fresenius Medical Care North America

Media contact: 
Loomis Group 
Jaclyn Petros, 617-638-0022 / voice 
petrosj@loomisgroup.com 
or 
Company contact: 
Fresenius Medical Care 
Rosemary Heinold, 781-699-4171 / voice 
rosemary.heinold@fmc-na.com