• Financial management policies and goals
• Financing
• Effect of off-balance-sheet financing instruments on our financial position and assets and liabilities
• Liquidity analysis
• Dividend
• Cash flow analysis
• Investments and acquisitions

Investments and acquisitions

In 2011, the Fresenius Group continued its growth path and invested €2,395 million (2010: €1,402 million). Investments in property, plant and equipment increased to €783 million (2010: €758 million). At 4.7% of sales, that was in line with the targeted level (2010: 4.7% of sales). This was well above the depreciation level of €674 million and serves as the basis for enabling expansion and preserving the Company’s value over the long term. €1,612 million was invested in acquisitions (2010: €644 million). Of the total capital expenditure in 2011, 33% was invested in property, plant and equipment; 67% was spent on acquisitions.

The table below shows the distribution of investments by business segment. The following chart shows the regional breakdown.

The cash outflows for acquisitions related mainly to Fresenius Medical Care in particular for the acquisition of the dialysis service business of Euromedic in Europe, the acquisition of a minority share in Renal Advantage, Inc., USA, and the take-over of American Access Care Holdings, LLC (AAC). AAC operates 28 out-patient centers primarily dedicated to serving vascular access needs of dialysis patients.

Fresenius Helios acquired the Katholische Klinikum Duisburg, a maximum care hospital, as well as two other acute care hospitals in Germany.

There were no major acquisitions at Fresenius Kabi and Fresenius Vamed. The largest single project at Fresenius Kabi was the acquisition of a compounding center in Germany.

In the fourth quarter of 2011, Fresenius SE & Co. KGaA acquired 1,399,996 ordinary shares of Fresenius Medical Care. At December 31, 2011, the voting interest in Fresenius Medical Care AG & Co. KGaA was 30.7%. After maturity of the Mandatory Exchangeable Bond in August 2011, Fresenius’ voting interest in Fresenius Medical Care was 30.3% as per September 30, 2011. By exercising options of Fresenius Medical Care’s stock option program, this percentage could have been diluted in the mid-term to up to 29.3%. The share purchase is meant to preserve a long-term voting interest in Fresenius Medical above 30%, maintaining the current ownership situation. The acquisition, which will comprise 3.5 million ordinary shares in total, is expected to be concluded in 2012.

The main investments in property, plant and equipment were as follows:

• start-up of 64 de novo dialysis clinics, of which 33 were in the United States, and expansion and modernization of existing clinics at Fresenius Medical Care.
• expansion and optimization of production facilities and expansion of warehouse capacity for Fresenius Medical Care, especially for dialysis products in Germany, and for Fresenius Kabi, primarily in Germany, India, South Africa and in the United States.
• hospital modernization at Fresenius Helios. The largest single project was the HELIOS clinic in Krefeld. The first construction phase of the new building project was completed in July 2011.

Investments in property, plant and equipment of €202 million will be made in 2012 to continue with major ongoing investment projects on the reporting date. These are investment obligations mainly for hospitals at Fresenius Helios as well as investments to expand and optimize production facilities for Fresenius Medical Care and Fresenius Kabi. These projects will be financed from operating cash flow.