Ladies and gentlemen, thank you for standing by. I'm Natalie, your conference call operator. Welcome, and thank you for joining the Fresenius Medical Care report on the Q3 2022. Throughout today's recorded presentation, all participants will be in a listen-only mode. The presentation will be followed by a question-and-answer session. If you would like to ask a question, you may press star followed by one on your touchtone telephone. Please press the star key followed by zero for operator assistance. I would now like to turn the conference over to Dominik, Head of Investor Relations. Please go ahead. Thank you, Natalie. As mentioned by Natalie, we would like to welcome you to our earnings call for the Q3, 2022, which is a day earlier than originally planned. I do apologize for the inconvenience it might have caused. We will start with our presentation, followed by a Q&A session. As always, I start out the call by mentioning our cautionary language that is in our safe harbor statement, as well as in our presentation and in all the materials that we have distributed yesterday. For further details concerning risks and uncertainties, please refer to these documents as well as to our SEC filings. We are aware that this is a call on short notice in your calendars in the middle of the reporting season. Therefore, we will try to keep the presentation short and leave time for questions. As always, we would like to limit the number of questions again to two in order to give everyone the chance to ask questions. Should there be further questions and time left, we are happy to go a second round. It would be great if we could make this work. The call is scheduled for 60 minutes. With us today for the first time is Carla Kriwet, our new CEO and Chair of the Management Board, who has started less than a month ago. Carla will share with you her first impressions of the company and initial strategic thinking. Of course, also with us is Helen Giza, our Deputy CEO, Chief Financial Officer, and Chief Transformation Officer. Helen will give you an update on the business development, financial performance, and outlook. This quarter, only Helen will be available for the Q&A. I will now hand over to Carla. The floor is yours. Thank you, Dominik. This is a first for me to say hello and welcome everyone to our Fresenius Medical Care earnings call. Thank you for joining our presentation. I'm very excited to be here today as CEO. Throughout my first month with the company, I have seen firsthand the incredible commitment of our employees around the world. The patient-centric mindset and clinical excellence is truly inspiring, and it is just one example of the many great assets we have to build on. At the same time, there's a clear urgency for bold interventions to drive business turnaround and to position Fresenius Medical Care for future sustainable and profitable growth. I would like to share what I'm focusing on, and will begin on slide three. Our FME25 transformation program is already underway and on track to deliver much-needed financial transparency and simplification. We are currently transitioning to our new global operating model centered around our business segments, Care Delivery and Care Enablement, and supported by global G&A functions and our global medical office. Furthermore, our execution plans are on track to deliver EUR 500 million of EBIT by 2025. Within Care Delivery, we have already started to address the substantial labor challenges. We are employing bold measures to fix our clinical operations to drive higher efficiency and productivity without sacrificing patient care. In addition, we will further consolidate our footprint. For Care Enablement, we are introducing mitigating initiatives, including pricing actions, to address impacts from inflation and supply chain constraints. We are advancing measures to reduce our costs of production, including platform strategies and optimization of our manufacturing footprint. Furthermore, we will regain innovation leadership and are developing a winning digital strategy that will leverage our unparalleled patient data sets to deliver unique value for our patients and customers. In SG&A, we are reducing overhead costs by optimizing shared services, utilizing automation, and transitioning basic operational tasks to low-cost locations. We will leverage business partnering and centers of excellence. Finally, we are reducing operational complexity by eliminating duplications. We are defining our future strategy with priorities becoming clearer. We will optimize our Care Delivery and Care Enablement business portfolio, allocating capital to growth areas with higher profitability. This also means that we will exit unprofitable businesses and apply a strict investment and return on invested capital discipline. We are planning additional structural savings beyond the current FME25 program derived from competitive benchmarks. At the same time, we will capture growth opportunities in attractive segments such as value-based care, home, health and assisted care, upstream CKD, critical care, and pharma. We will inspire around our vision and global strategy to foster a one FME winning high performance culture while ensuring role model accountability and teamwork at all levels. Finally, compliance, sustainability, inclusion, and diversity are all key requirements for our success. We will remain a mission-driven company striving to improve the lives of our patients. You will understand that one month is not enough time to have a full strategic plan detailed out, and I will not be in a position to answer questions today. We need to present this to our economic council first. I want to be very clear that speed is of utmost importance. There is an urgency to address our operational performance now, and interventions are already underway. I look forward to sharing more details with you in February when we present our results for 2022. At the same time, I will be very open to answering your questions. For the rest of today, I would like to hand it over to Helen, who will walk you through the developments of the quarter and will handle today's Q&A. Thank you. Over to you, Helen. Thanks, Carla. Hi, everyone. I'll pick up on slide four. I'd like to start my prepared remarks with the quarterly performance before we go to the update on our outlook and implications for 2023. In the Q3, our business delivered revenue growth of 15% reported due to the weak euro and 3% at constant currency. On a constant currency basis and before special items, the operating income declined by 18%. On the same basis, our net income declined by 25%, which brings us to an 18% decline year to date. Our business development continued to be impacted by the U.S. labor market situation and slower organic growth in healthcare services than anticipated. Additionally, the persistent challenging macroeconomic environment with inflationary pressures and global supply chain constraints continues to heavily impact our healthcare products business. COVID-19 related excess mortality was somewhat elevated during the Q3, but has broadly developed in line with our assumptions for the year. We are closely monitoring the development of infection rates in the fall. The closing of the InterWell Health merger during the Q3 marked an important milestone for our value-based care capabilities and our continued leadership in this highly relevant strategic area. The numerous challenges that we and many others in the healthcare industry need to master right now are unprecedented. Following our guidance revision in Q2, we immediately initiated necessary interventions in our North America healthcare services business. However, these initiatives are taking longer than anticipated to show the expected results. While we expect to see some benefit from these measures in the Q4, we are expecting a more meaningful contribution in 2023. We had assumed flat organic growth in healthcare services in North America for the second half of the year. It has sequentially improved, but not to the degree expected, and therefore, we now expect it to remain slightly negative. As a matter of caution, in light of the delayed improvements in North America and the associated impact on our downstream assets, continued labor challenges, accumulation of excess mortality, and the uncertainty in the macroeconomic environment, we are extending our guidance range for 2022. Carla already mentioned that we are working on a broader turnaround plan, which involves bolder interventions, including capacity adjustments. Turning to slide five. You all know me by now, and I do my utmost to be very transparent with the sizable moving parts. From the beginning of this year, we shared our assumptions on how actual developments we're tracking. I'd like to update you on where we now stand through the first nine months and how we see the full year finally shaping up. Unfortunately, the delta of the changes of our major headwinds and tailwinds is negative by around EUR 60 million. Starting with the headwinds of the EUR 450 million-EUR 460 million for the full year, we have already realized EUR 282 million. The macroeconomic inflationary environment remains challenging, and we continue to see elevated raw materials, logistics, and energy prices. Year to date, we have already realized EUR 175 million in macroeconomic inflationary headwinds. In accordance with the current run rate, we now expect this to be around EUR 10 million higher than previously assumed. We have guided COVID related excess mortality to impact us with a EUR 100 million headwind for the year. Through the Q3, we have realized EUR 84 million. In the Q3, we experienced COVID-related excess mortality of around 1,100, and the year-to-date number is around 4,300. While excess mortality was somewhat elevated in the Q3, it was not a huge spike like we saw with Omicron at the start of the year, and we would continue to support that our excess mortality for 2022 will end at or below 6,000, as we have previously guided. Of course, we are watching closely as we move into the winter months in the northern hemisphere. For labor costs beyond the typical 3% inflation, we assumed a EUR 100 million headwind net of U.S. Provider Relief Funds. Through the first nine months of the year, the relief we received offset these labor costs. There is now only EUR 9 million left from the Provider Relief Fund, leaving minimal offsets for the additional EUR 100 million labor costs assumed for the Q4. Following the analysis and interventions to address our clinic staffing situation in the US, we have adjusted how we manage these critical personnel vacancies through prioritization, focused recruiting efforts and tailored training programs. We are just starting to see these initiatives translate into improving trends in our labor KPIs. While the labor market remains challenging, during the Q3, we saw stabilization and net hires, and we have rebased the number of critical open positions to around 5,000. For the ballot initiative, we have spent EUR 23 million to make our case, and as the election is next week, we are comfortably within the assumed EUR 20-30 million range. Turning to tailwinds. Of the EUR 130 million-EUR 160 million we have assumed for the full year, we have only realized EUR 78 million through the first nine months. For business growth, we had previously assumed EUR 70 million and so far have only achieved EUR 15 million. For the full year, we now assume with EUR 20 million, a EUR 50 million lower tailwind for 2022. This development results mainly from a delay in our North American services recovery plan. Since we continue to face the challenging staffing and retention issues, this has limited our ability to realize the planned organic growth recovery and the delayed growth in our dialysis services business also has the knock on effect of impacting our downstream assets. For PPE cost reduction, we have realized a EUR 12 million tailwind compared to 2021. While we expect overall PPE spending to continue to decline, our clinics are not planning to modify our PPE policy for now due to the vulnerable nature of our patient population, especially as the annual influenza season is also underway. On our FME25 transformation program, we have continued to make important progress. Of the EUR 40 million-EUR 70 million in savings we assume for 2022, we have already realized a EUR 51 million tailwind through the first nine months of the year, demonstrating that we are well on track. Turning to slide six. On a reported basis, currency effects further extended our positive revenue development for both services and products during the Q3. On a constant currency basis, healthcare services delivered revenue growth of 2%. This was mainly driven by organic growth in the international markets. The positive effect was partially offset by negative organic growth in North America due to accumulated excess mortality, staffing challenges and capacity constraints in certain clinics. The products business delivered revenue growth of 4% constant currency, mainly driven by higher sales of in-center disposables and renal pharmaceuticals, and partially offset by lower sales of machines for chronic treatment. To give you an update on the US FDA machine shipping hold, this has just been lifted and we can now resume shipments. Next on slide seven. Here we show the operating income margin development for the Q3 on a reported basis. The largest negative impact on margins year-over-year, not surprisingly, relates to the unprecedented labor market challenges and macroeconomic inflation and supply chain disruption. The combination of business growth development along with COVID-related impacts also contributed to a negative margin development. During the Q3, we applied EUR 93 million of the U.S. Provider Relief Funds. We are not expecting further relief funds at this time, turning this into a significant headwind for next year. We also realized EUR 30 million of savings from FME25 during the quarter. Looking at the most pronounced special items for the quarter, we had EUR 53 million in FME25 costs, and with the closing of the InterWell Health merger, we realized a net gain of EUR 56 million before taxes. Next on slide eight. During the Q3, we generated operating cash flow of EUR 658 million. Year-over-year cash flow development was impacted by lower net income. Compared to last year, we had lower recoupment of the U.S. government advance payments received in 2020 under the CARES Act. EUR 44 million were recouped in the Q3, and the full recoupment effects were completed in October. We remain committed to our self-imposed leverage target of 3-3.5 times. While we are currently at the upper end of that range, we are reasonably comfortable with our positioning given our solid credit profile. Turning to slide 9. In September, we have proven our strong access to the capital markets with a successful issuance of a five-year bond with a volume of EUR 750 million. This has further strengthened our solid credit profile and contributes to our financing strategy of continuously ensuring financial flexibility, managing financial risks, and optimizing financing costs. With the issuance of the new euro bond, we have increased the percentage of fixed interest debt to 88% and have no major maturities to be refinanced until November 2023. This clearly underscores the long-term and sustainable nature of our well-balanced maturity profile. Following the refinancing of our syndicated credit facility in 2021, we are no longer subject to any active financial covenants. Moving on to slide 10. Like the rest of the healthcare market, we continue to face a high degree of uncertainty in the macroeconomic environment that impacts both the med tech and services sector in different ways. First, we are confirming our target for revenue growth at low single-digit percentage range. Worth pointing out is the really high financial sensitivity of changes to our current low net income base. Every 1% of change to net income equates to only EUR 10 million and also increases the tax rate due to a relatively higher proportionate share of the non-tax-deductible expenses. Our tax rate guidance for 2022 is now 25%-28%. Consequently, as a matter of caution to reflect the additional risks of the range of headwinds and tailwinds already outlined, we are extending our net income guidance range for 2022. We previously guided for a net income decline around a high teens% range, and are now extending that to a net income decline from a high teens to mid-20s% range. I'd like to finish my prepared remarks on slide 11. The budget process is currently underway, and as every year, we will provide 2023 guidance in February. However, I recognize there are already many questions about our expectations for next year, and I wanted to share with you what we are currently weighing up. I have to say, in this environment with a number of moving parts, it is really hard to anticipate future developments, and every month of additional insights is outstandingly valuable. Let's start with the tailwinds we expect in 2023. Within business growth, we are evaluating the potential accumulation effect from COVID and its impact on organic growth in 2023. We assume an increased ESRD PPS rate, hopefully today for our Medicare fee-for-service patients and a smaller but incremental increase in our Medicare Advantage book of business. We are also well-positioned for future expansion into value-based care and home dialysis. The contributions of the interventions to address our North America dialysis services business should have a greater impact to the business growth in 2023. Business growth will of course be impacted by the full reduction of sequestration relief. FME25 is well on track. We have said that we will achieve 50% of the savings by the end of 2023. As Carla has indicated at the start of the call, we are initiating a broader turnaround plan beyond what we have already defined in order to fix our operational core, simplify, and drive efficiencies. Although we have not reduced our PPE protocol yet, we do expect the overall costs to further decrease next year. We are not anticipating costs related to ballot initiatives to repeat in 2023 either. Turning to headwinds for next year. At this time, we do not have any reason to expect any further Provider Relief Funds to be made available. While we do expect some of the 2022 one-time measures for labor not to repeat, we do anticipate annualization of the temporary adjustments made in 2023. Higher margins than historical norms and potential mix changes from permanent to more temporary labor due to a persisting labor shortage are expected to overall result in a net headwind. Even though we have seen some stabilization, the pressure on the macroeconomic environment persists, and there is no indication that inflation, interest rates, and higher energy prices will abate by the start of the new year. Of course, we are diligently working on pricing action initiatives. Finally, our 2022 earnings benefited from some one-time items. For example, lower compensation for our broader leadership teams due to underperforming short- and long-term incentive plans. This will have to be rebased for 2023. Other examples are the partial reversal of an accrual related to a revenue recognition adjustment for accounts receivable in legal disputes and by increased income attributable to consent agreement on certain pharmaceuticals in North America. With that, I'm happy to take your questions. Next quarter, Carla will join us for the Q&A. With that, I'll hand back over to Dominik to start the questions. Thank you, Carla. Thank you, Helen, for the presentation. I'm happy to turn it over to Q&A. Natalie, could you please open the line? Thank you. Ladies and gentlemen, at this time, we will begin the question and answer session. Anyone who wishes to ask a question may press star followed by one on their touchtone telephone. If you wish to remove yourself from the question queue, you may press star followed by two. If you're using speaker equipment today, please lift the handset before making your selections. In the interest of time, please limit yourself to two questions only. Anyone who has a question may press star followed by one at this time. Our first question is from the line of Tom Jones from Berenberg. Please go ahead. Good afternoon. Thanks for taking my questions, Helen. I had two, really. We'll have more, but I'll stick to two. The first is on labor. Obviously it's been a bit of a headwind for everybody in the industry and many other healthcare businesses. You talked a fair bit about recruitment, but it also feels that employee retention has been a bit of an issue. So I just wondered if you could comment on what you've been doing to improve employee retention across the business. The second question was just on the cost savings. Forgive me, I know it's early in the process for you, so you may not be able to say too much. From my recollection, this will be the fifth cost saving program. We had GP one, GP two, the group optimization program, FME25. You know, one does have to start to wonder where the cost savings are gonna come from, given this is the fifth go round on trying to find incremental cost savings. You know, you've gone through the fat into the muscle, down to the bone. You know, where else is there to go short of chopping whole limbs off, I guess, is the question. Maybe it's just a bit of sort of broad high level color on how you're thinking about making yet more cost reductions across the business without meaningfully impacting the revenue growth of the business. Thanks, Tom. Great to hear from you. Let's start with labor. You said labor continues to be a headwind and also headache, I think, at this point. Clearly there's a lot going on in our efforts here on recruitment, as you said, but more importantly, retention. We are experiencing higher turnover and retention challenges with our newer tenured employees. We're really getting into a lot of the analysis, root cause and KPIs around that. We're really focusing on selecting the right focused and tailored training. We're adopting a buddy system in our clinics, and all of this is making sure we have the right leadership support within our clinics as well. I think a lot going on in that area, and I think we're starting to see the benefit of that pull through. On cost savings, you're right. We have done a number of cost saving programs. I know you've been here long enough to remember them all. Look, I think FME25 was more around the operating segments and organizational design and getting the structure set up. I think what we obviously need to do now, as we talk about a turnaround plan, is really focus on our structural cost. As we know, we have been you know with COVID for 2.5 years, and we haven't really adjusted our you know clinic structure as an example, because you know we know that we were leaking on operating leverage. I think, yeah, as Carla outlined the areas of focus, I think it's kinda just going more deeper now into the structural with this reduced kind of, you know, profit margin profile that we have. More to come in February. Yeah, I think we can clearly then speak to why it's different and where we're going to look at the cost. Sure. Maybe just a quick follow-up on the recruitment and retention side. You know, nurses in particular tend to boomerang a bit as the macroeconomic situation improves and then wanes again. Obviously, things have been pretty good for healthcare staff in the last couple of years, COVID aside, but pretty good financially for them. Are we starting to see any evidence yet that the more challenging, broader economic picture is pushing more nurses back into the workforce or encouraging the nurses you do have to work longer hours? I know I asked the question the last quarter, but it might be worth an update now as we move further on. Yeah. No, it is a metric that we track. We are seeing about 13% of our new hires actually coming from Boomerang. I think a testament to our strong employee base is about a third of our employees are coming from the retention, sorry, the referral program. Yeah, look, I think we are seeing some stabilization, as I mentioned. I think, you know, we're obviously looking at the, you know, kind of the macroeconomic environment from a recession perspective, which, you know, may additionally push more people into the workforce. It's nice to see this stabilize, and I think it's good for us to see this focus on this 5,000 priority positions that we can really bring in the right people. I think here, as you've already heard us say, the focus on the training is really important. Super. That's all very clear. I'll get back in the queue. The next question is from the line of Graham Doyle from UBS. Please go ahead. Afternoon, thanks for taking my questions. Just one on sort of Q4 and what's implied within that. We know you obviously flagged the Provider Relief Funds into Q4 as being, you know, clearly within the guidance. Is there anything else we should be thinking about? Should we look at Q4 as probably the best indicators to the sort of smooth running you have for next year? Maybe that should be our base for which to extrapolate 2023. Then just one question on vaccination rates. Can you give us any update in terms of the U.S. specifically around booster rates there in your patient population? Thank you. Hi, Graham. Thanks. Happy to take your question. Yes, as you mentioned, you know, in Q4, obviously, you know, kind of it, I think if you look about the midpoint of our guidance, that does translate into a lower Q4. I think there's a couple of things there. We did have some one-time items in Q3. One-time, maybe just unusual. We did have the long-term incentive plan benefit in Q3 as a result of the stock price. It kind of true-up and the short-term incentive true-ups. And then we also had a higher volume on a consent payment for pharmaceuticals hitting Q3. So I think that, you know, kind of artificially it lifted up Q3 as you compare it to Q4. Obviously, as you heard me speak on the call, for Q4, we are still expecting this lower organic growth to persist. As you also widely mentioned, the labor costs are totally naked, if you will, in Q4 with no offset. That, you know, kind of also impacts the quarter. You know, kind of obviously is that's kind of how we spoke about it on the headwind, tailwinds. I don't think it's. I mean, it's a hard question, I'm not gonna get into what you should start modeling for 2023. I think for 2023, what we do expect is a lot of these intervention measures that the North America team are executing on to really start to kick in in Q4, but more importantly through 2023. That obviously is an important driver for us. You know. On the vaccination rates, I mean, obviously we're in flu season and booster season. I don't have the exact numbers to hand on the percentages, but what we're seeing is just a slight increase in the vaccination rate, but nothing of note and nothing of concern, I would say. Okay. Super clear. Thank you. I'll jump back in the queue. The next question is from the line of James Vane-Tempest from Jefferies. Please go ahead. Hi. Thanks for taking my question. Two, if I may please. Firstly at 2Q, you mentioned how sort of delayed new starts, you know, were impacting the business. Just wondering how that's changed in Q3, and how that's impacted mix as we move through the year. As I imagine some of the new patients coming in are probably more commercial patients. Secondly, excuse me. Secondly, I know you're not gonna comment on 2023, but perhaps if I can keep my question to the nine months we've seen this year. I know you gave a net income bridge, but if we were to think about what the impact this year so far has been from the ballot costs and funding relief which you've received, are you able to give us a sense in terms of what the nine-month net income number would be excluding those two factors? Because I think from nine months in the release, I think the net income ex special items was EUR 660 million. Would that be closer to EUR 500 million? Thank you. Oh, I have a lot to absorb there, James. On your 2Q mix and commercial mix, like we're not really seeing any variation there. That's been very resilient and pretty stable. Nothing to note there as we kind of now look at, you know, Q3 and our guidance coming out. Gosh, I think I probably have to have Dominik and the team follow up with you on the net income bridge excluding those items. I don't have the- I think the ballot was 23 million. Oh, the balance I can speak to. Yeah, that one was EUR 23 million. Provider Relief Funds we received I think $280 or so. James, was your question what would net income be without those items? Exactly, yes. In terms of 'cause if we're gonna start thinking what the base is gonna be for this year for items not expected to come into next year, I think people are after a sense in terms of what the, you know, the floor is to kind of grow the business from into next year. Yeah. Let us follow up with you on that, James. Thank you. The next question is from the line of Hassan Al-Wakeel from Barclays. Please go ahead. Hi. Thank you for taking my questions. I have two, please. Firstly, following up on Q4 and into next year, could you elaborate and potentially help us quantify some of the building blocks for next year, given what is implied by your guidance for Q4 as an exit rate? Should we be thinking of a net headwind and earnings potentially being down in 2023, given the size of the provider relief funding, EUR 200 million plus, that is not recurring next year? Secondly, at Q2, Helen, you talked about wage inflation running at 9%-10% in aggregate. I wonder if this has changed at all and how you think about this into Q4 and next year. Where have open positions trended and how reliant are you still on contract staff? Thank you. Thanks, Hassan. You know what I'm gonna tell you about the guidance for 2023 and the building blocks. Like, literally we are in, you know, kind of budget meetings morning, noon, and night right now. Really too early to tell what that net outcome is going to be. We recognize that we have a number of headwinds to overcome. Obviously the kind of growth assumptions here are key. Also the turnaround plan and those kind of interventions are something that we need to spend more time on, so that we can, you know, realistically evaluate what contribution that can make in 2023. We will ask for your continued patience there. I think on wage inflation, you know, we are seeing it around six to seven percent currently, I would say. I know that's an average, and it's not necessarily net of efficiencies, but I think that's a good proxy for what we're seeing currently. On open positions, I know we have maybe in this call modified how we're thinking about open positions, and I think appropriately so, as we think about, you know, we always said 2,500-3,000 open positions was kind of a normal run rate for us. Then, you know, we started to track all open positions, and you know how that's trended over the last few quarters, 11,000 going to 8,000, and today we're talking about 5,000. I think what's really important there is that this is about the critical positions that we are focused on filling with the right capability to the right hiring standard. We feel really good about where we are there. Then you asked about wage inflation, open positions. Did I miss something else? Agency. That's right. Thank you. You all keeping me honest here today. The agency cost, obviously we're focused on. We are starting to see that overall cost come down. Not coming down as much as we need it to, but I think there's very concerted efforts on there. I think we're also seeing agency rates come down slightly too. So we have a volume and a weight there, but we are seeing the trends starting to come down. I think we'll see more impact of that reduction in Q4. That's really helpful, Helen. Maybe if I could just follow up on the first part. You talked about one-offs in the quarter. Could you help quantify? I think one was around pharmaceuticals and the other one was around remuneration. Yeah, I will. Happy to do so. The remuneration is around EUR 40 million, and the pharmaceutical higher volume consent payment is also around EUR 40 million. Excellent. Thank you. The next question is from the line of Veronika Dubajova from Citi. Please go ahead. Hi. Good afternoon. Carla, Helen, thank you for taking my questions. I'll keep it to two, please. One is, I guess, I mean, I'm gonna circle back to what everyone else has been trying to ask, but I'm gonna ask it differently, which is, Helen, if I look at your guidance and what it implies for the Q4, are there any reasons why that wouldn't be representative as a starting point for 2023? Are there, you know, positives or negatives that might make it not a fair and true account of where the business is as we move into next year? So that's my first question. My second question, and I appreciate, I think I ask you this every quarter so far. Neither you nor I have been able to predict this correctly. I'm just curious, Helen, with everything that you see, when you feel that we might return to a positive same market, or same store growth rate in the U.S.? Welcome back. It's great to hear your voice again. Yeah, Q4, is it representative? I mean, look, I think it's what we're thinking for Q4, it's like this, it's pretty stable to, you know, the kind of what we're seeing today. There's not much of an uplift really projected. I think the thing to think about for the quarter is, you know, what I touched on earlier with the previous question is we are expecting our efforts to take hold. I mean, there is a ton of work going on with the team tackling labor and growth and, you know, kind of the clinic operations and so on. We also, we've got a lot of volatility. We're waiting to see, you know, kind of what the COVID numbers play out with and so on. You know, you can kind of see it, why I kind of have widened the kind of range somewhat. Look, we're working hard on it. Hard to predict at this point, but we also hope for the improvements to start to take hold. Gosh, Veronika, your second question on when will we see same store growth. We're kind of in the low negatives, right? - 1%-ish. We hope that we will start to see that turn the corner, you know, early next year. You know, as you said, we've been wrong on it constantly. We keep trying to predict the impact of COVID and, you know, hard to imagine that since the start, we're just around 25,000 excess mortality at this point. Yeah, again, the winter is key on that, and maybe another one to ask for patience on and obviously more to come, a lot more to come in February. Understood. Thank you so much, Helen. The next question is from the line of Oliver Metzger from ODDO BHF. Please go ahead. Oh, hi. Two questions from my side. The first one is on your development in EMEA. It seems for me to be quite a good quarter on services as well as product. Last year was not ultra high, but could you also comment on underlying trends in which you expect to continue into Q4? Second question is following the closing of the InterWell Health merger. Where do you stand right now with medical costs under management at the moment, please? Thanks, Oliver. Good to hear you. On EMEA, I don't think there's anything of note to call out on the quarter itself. We have a comp year-over-year from a license from one of our partners. That's in the last year's results. So I think that's kind of assists the year-over-year growth, if you will. But nothing else of significance on the volumes. However, I would say, you know, clearly in EMEA, the inflation and supply chain challenges are something that we're watching and continuing probably into Q4. On your InterWell question, we are kind of looking at $5-$6 billion medical cost under management, and that 1% margin is fully on track. We're really excited about this merger and the possibilities here. Really important foundational building block of our strategy. May I ask one follow-up to your second answer? When you say EUR 5-6 billion medical customer management, I think you were at roughly EUR 6 billion at the beginning of the year. My thought was that the merger creates even more exposure to value-based care. Has anything changed over the last month? No, I think that was always the plan, and I think what I'm just speaking to is kind of currently what we're seeing it at EUR 5-6 billion. No cause for concern there, Oliver. Okay, great. Thank you. The next question is from the line of David Adlington from JPMorgan. Please go ahead. Afternoon. Thanks for taking the questions. Just coming back to those non-recurring positive items in the Q1 you've sort of quantified it. Just wondering if you could quantify those year to date or maybe perhaps better for the full year 2022. Second, just sort of conceptual one. Just wondered why you were recognizing those one-off gains within the kind of operating income. Were you assuming that those gains or those positive effects within your guidance at the start of the year? Thanks. No, it's pretty clean, David. Let me take both questions. The long-term incentive plan obviously tied to our performance and stock price that goes up and down every quarter. It just unfortunately with our Q2 announcement, we had a big drop in Q3, so that's obviously favorable to our P&L. Obviously, that fluctuation will go up or down at next quarter. It's not like a one time. It's just kind of an unusual. It's a big number, EUR 40 million in one quarter, but we do that kind of market price adjustment every quarter. The other one on payments for pharmaceuticals, that's also normal business. We have them every year. Normally they're in Q4. We have this one in Q3. They're not special items and don't need an adjustment. I think they're just large enough in nature and obviously impacting the quarter to be worth talking about. Excellent. I think there's an accrual on a legal dispute as well. Just able to quantify that. Yeah. That was the accrual on legal dispute that we did back in 2019. We were, you know, able to release some of that accrual in Q1. Trying to pull that number somewhere. Yeah. Roughly, yeah, maybe mid-30s. Yeah. EUR 35 million or something. I don't have the exact number to hand, but it sounds about right. That was in Q1. We took a big charge back in 2019. Sorry. EUR 36 million. Thank you. We took a big charge on that back in 2019. As that case continues, we have been able to release some of it. Perfect. That's helpful. Thank you very much. You bet. The next question is from the line of Robert Davies from Morgan Stanley. Please go ahead. Thank you for taking my questions. I'd just be interested if you could give us some sense across your facilities of the current capacity utilization. I ask in context of your scope to reduce either site locations or head count. I just wondered, obviously, you have certain minimum requirements of people or facilities in each location. Just wondered where capacity utilization sits, and where you see the most scope or if there is any scope to make changes there. The second one was just really if you could give us an update on what you're seeing on the home dialysis front. Are you still seeing continued uptick there? Is it as fast as you expected? Slower? Are the associated costs higher or lower than you previously thought? Those are my questions. Thank you. Hi, Robert. Good to have you on the call. I look forward to getting to know you better. Welcome. On the site location percentage, as you can imagine, that is part of our full assessment. We are doing a full scope analysis of all of our clinics and the utilization and the footprint. I think that will be part of our kind of footprint analysis and turnaround plan. I don't have the numbers, you know, kind of to hand off, you know, kind of the utilization of each clinic obviously, but something that we are doing a full assessment of. You can expect to be in scope for for part of that cost reduction and structural cost reduction plan. Obviously that has been hurting our operating leverage where we do have underutilization. On home, still growing, you know, it's kind of at 15.4% now of U.S. treatment. We're happy that it's growing. It is slower than we would like. Obviously, some of the training and so on has been impacted by the, you know, the kind of the lower staffing issues. You know, it does continue to grow more than in-center and will be a key growth area for us. You know, for us, you know, we've not necessarily seen the full benefit of the lower costs yet. We are absolutely, you know, kind of focused on that and continuing to pull that through as another one of our key strategies. Thank you. Maybe just as a follow-up to the first answer you gave. Do you have any sense of the variability of utilization levels? Is it sort of, you know, ±5% around a, you know, an 80% level? Is it, you know, some at 90%, some at 10%? Can you give us some sense of where there's real sort of low-hanging fruit across your business? It does vary by region and obviously the kind of geography of where our patients are. Look, I think it's too early to say. You know, the capacity is adequate to take new patients and, you know, obviously the goal here is to lose as few patients as possible as we do the consolidation. Yeah. More to come. Again, I'm asking everyone for a lot of patience today, I know. We're doing the analysis. We need to evaluate the outcome of the analysis and then make the decisions on the number of clinic closures that we are targeting. Understood. Okay. Thank you. The next question is from the line of Falko Friedrichs on Deutsche Bank. Please go ahead. Hello, thanks very much. I have two questions as well, please. Firstly, based on comments from your competitor, it seems that fewer patients are transitioning from CKD to ESRD. My question is whether you noticed that as well, and whether you have any potential explanations for that. Secondly, just a clarification question. Helen, did I understand you correctly that the number of job openings went from 8,000 in Q2 to 5,000 at the moment? Hi, Falko. Let me take your second question first. It, it's not that it dropped from 8,000 - 5,000. We are really, there was a lot of open reqs and a lot of open positions that were maybe not as priority and as focused in area, in you know, kind of where the postings were being targeted. We're just saying that, you know, for us, the relevant open position number is 5,000 now. It dropped a couple of hundred during the quarter, so we are hiring and bringing it down. You know, on the CKD to ESRD, I know we kind of heard what Javier had to say, and I think, you know, it's not data that we have or have insights into or something that we can point to. You know, we are just seeing less diagnosis from patients, COVID-related patients who are kind of maybe avoiding hospitals. You know, I think the question is, you know, if we've got lower volumes, where, you know, where are the patients going? There is some going into hospitals, some going into smaller dialysis clinics, but nothing that we are seeing, you know, kind of impacting that population. Our treatment numbers have been growing sequentially, Q1 to Q2 and Q3, so I think that's important. I think we're all continuing to dig into the data and the analysis of what, you know, of what's happening with our volume. As I said, that's a big component of our 2023 outlook, is getting the right organic growth assumptions for next year. Okay. Thanks, Helen. A quick follow-up on the first question for the job opening. Essentially, out of the 8,000 you had, you essentially closed a couple of job openings. Did I understand that correctly? Yeah, that's correct. It's like we had a lot of open recs, but now we've like really focused on all the recs that are top priority and then closed the recs that maybe are diluting our recruiting efforts. Rather than trying to do, maybe we don't need 8,000, but maybe trying to do 7,000 at once, we're trying to really focus on the 5,000 that have biggest impact. Okay. That makes sense. Thanks a lot. The next question is from the line of [Seve Slg] from HSBC. Please go ahead. Hi, thanks for taking my questions. I will also keep it quick please. First of all, in DaVita's call, I thought it was remarkable that they started closing some clinics, and I see that you still have an expansion. Is that the differentiation in strategy or should we expect to see more closings next year? And my second question, congratulations on the lift of the FDA hold. Can we expect to recover the entire lost business on the product side from the hold of the machines, or would you expect some of the lost market share to remain lost? Your thoughts on how you expect to recover from that would be good. Will be very welcome. Thanks. Yeah, happy to take those questions. No, I don't think our strategy is different. Maybe the announcement of timing is. No, we obviously saw that we have net five in the quarter of new clinics. That's kind of a function of where they were being built and where they are for our patient needs. I think the strategy is the same. We're all looking at our cost structure and looking to see how we can optimize our clinic structures overall. I think that will be part of our update in February. Then, yes, we're delighted with the FDA release. We have already started resuming shipment. I think we won't skip a beat. We have POs for those machines that were on hold. We already had assumed that we would resume shipment already in our outlook. We're just glad to have confirmation of the date, and you know, kind of get that product base back installed. Thank you. This concludes our Q&A session and I hand back to Dominik for closing comments. Thank you for being so flexible to join on short notice today. This is highly appreciated. Thank you for your questions and your interest, and if you have further questions, as always, reach out to us and we look forward to see you soon on the road at conferences and hopefully next year. Take care. Thanks, everyone. Bye-bye. Thank you. Ladies and gentlemen, the conference is now concluded and you may disconnect your telephone. Thank you for joining and have a pleasant day. Goodbye.