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                                              2. betting 365, as a health care Group, is aware of its responsibility of protecting nature and using its resources carefully. Environmental protection means monitoring and evaluating potential risks in our processes, and setting up proper measures to limit possible impacts.

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                                                      The business segments use the ISO 14001 standard as the basis for their environmental management. Further entities were included in the certification processes in 2019 and we aim to expand the scope going forward. We also made progress in each business segment in the implementation of energy management systems according to ISO standard 50001, and, where applicable, increased the number of certified locations.

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                                                        1. As the four business segments of the betting 365 Group align their environmental management to their individual business models, we present the environmental management approaches separately for each of them. Data on energy consumption1, water consumption1, and greenhouse gas emissions (GHG)1 is reported for all business segments. The consumption of resources varies depending on the business model. We also report the consumption by resource in relation to personnel (FTE) and sales.

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                                                              Water is an important resource for all four betting 365 business segments. betting 365 operates in highly regulated markets with regard to hygiene, sterility, and product quality. Water used in our health care facilities and production sites has to meet regulatory requirements. To safeguard our patients’ and employees’ health, we ensure that adequate management and control systems are in place. These include, for example, regular flushing of pipes in hospitals to prevent contamination, but also water treatment for production or dialysis.

                                                                  Water management and water treatment are controlled locally within the betting 365 Group. The business segments are responsible for ensuring compliance with all applicable laws and regulations. Their operational environmental protection measures provide the respective framework for all related activities. The same applies to wastewater: the business segments are expected to treat wastewater from their facilities in compliance with local laws and regulations and develop and implement corresponding management provisions if necessary.

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                                                                    m3 in millions 2019 2018 2017
                                                                    ­betting 365 Medical Care 43.2 42.1 n. a.
                                                                    ­betting 365 Kabi 9.6 9.7 9.8
                                                                    ­betting 365 Helios 3.8 3.7 3.2
                                                                    ­betting 365 Vamed 0.7 0.7 0.3
                                                                    Total 57.3 56.2 n. a.

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                                                                        in m3 2019 2018
                                                                        Water consumption / €1 million sales 1,612 1,676
                                                                        Water consumption / FTE 217.8 228.2

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                                                                                    betting 3651 consumed a total of 57.3 million m3 of water in fiscal year 2019 (2018: 56.2 million m3). About 91% came from the municipal water supply, and 7% was sourced from ground water. In the hospital setting, nearly all water consumed is sourced from the municipal water supply. To be compliant with existing regulations regarding hospital hygiene, we can only use, for example, rainwater in areas that pose no risk to our patients’ health.

                                                                                    Production processes and patient treatments in hospitals and other health care facilities require a large amount of energy. The structural condition of our health care facilities also has a direct impact on energy consumption. betting 365 continuously invests in new construction projects and modernizations in line with the current energy efficiency standards and applicable regulations. In fiscal year 2019, betting 3651 consumed, as in 2018, a total of approximately 5.3 million MWh of energy from different sources, the majority relating to electricity, natural gas, and district heating. Energy management focuses above all on our patients’ well-being and product safety. A safe and uninterruptible power supply is a top priority. Measures for saving energy are always considered with the utmost care. Furthermore, we continually optimize our energy procurement, based on consumption analysis and energy efficiency, and, where reasonable, evaluate the use of renewable energy. We also generate our own energy at numerous locations.

                                                                                    Among the aforementioned main energy sources, a major CO2 driver is the demand for electricity. Accordingly, Scope 2 emissions are higher than Scope 1 emissions in all business segments. In fiscal year 2019, betting 3651 generated a total of 1,509 thousand t CO2 equivalents (2018: 1,534 thousand t CO2 equivalents).

                                                                                    MWh in millions 2019 2018 2017
                                                                                    ­betting 365 Medical Care 2.42 2.38 n. a.
                                                                                    ­betting 365 Kabi 1.64 1.65 1.57
                                                                                    ­betting 365 Helios 1.09 1.14 0.95
                                                                                    ­betting 365 Vamed 0.16 0.17 0.05
                                                                                    Total 5.32 5.34 n. a.

                                                                                            in MWh 2019 2018
                                                                                            Energy consumption / €1 million sales 150 159
                                                                                            Energy consumption / FTE 20.2 21.7


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                                                                                              In the health care industry, waste is strictly regulated. All betting 365 locations have to adhere to applicable laws and regulations regarding waste disposal, as well as global or local standard operating procedures and environmental management provisions. There are important interfaces between professional, safe disposal and the requirements for hygiene and sterility in production processes and hospital treatments. These range from selecting suitable disposal containers, cleaning and sterilization procedures to the occupational safety of our employees in the disposal of hazardous – e.g., infectious – waste.

                                                                                              Where necessary, the business segments set out specific rules and requirements in internal guidelines and communicate them, for example in local training courses. There are also controls in place, for example in the area of hygiene in our acute care clinics, to ensure compliance with regulations.

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                                                                                                      t CO2 equivalents in thousands   2019 2018 2017
                                                                                                      ­betting 365 Medical Care Scope 1 227 219 n. a.
                                                                                                        Scope 2 547 557 n. a.
                                                                                                      ­betting 365 Kabi Scope 1 165 169 174
                                                                                                        Scope 2 249 255 248
                                                                                                      ­betting 365 Helios Scope 1 107 114 103
                                                                                                        Scope 2 178 182 152
                                                                                                      ­betting 365 Vamed Scope 1 18 19 3
                                                                                                        Scope 2 18 19 6
                                                                                                      Total Scope 1 517 521 n. a.
                                                                                                        Scope 2 992 1,013 n. a.

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                                                                                                        t CO2 equivalents 2019 2018
                                                                                                        t CO2 equivalents / € 1 million sales 42 46
                                                                                                        t CO2 equivalents / FTE 5.7 6.2


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                                                                                                                      1 betting 365 Medical Care figures include data on energy and water consumption provided by GMQ-coordinated manufacturing sites as well as data on electricity and water consumption from dialysis centers. Greenhouse gases are calculated based on energy data. Due to the timing of this publication and the availability of data sources such as energy or water bills, the company has performed a limited amount of extrapolations to complete this reporting year’s dataset. The data from betting 365 Helios contain all company-owned hospitals in Germany and Spain. betting 365 Kabi’s data include all facilities worldwide. betting 365 Vamed’s data include all fully consolidated health care facilities, and as of 2018 the German post-acute care business transferred from betting 365 Helios to betting 365 Vamed.

                                                                                                                      For more information about environmental management see the Non-financial Report.

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