We expect that Germany-based health care group Fresenius SE&Co. KGaA (FSE) will post robust 2019 results, supported by the return to growth of its dialysis business, and anticipate no further sizable acquisitions this year. As such, we expect debt to EBITDA of less than 3.5x at year-end 2019, and now see the risk of a transformative acquisition hurting the group's financial metrics as relatively remote in the near term. We are therefore removing our one-notch negative financial policy adjustment to the ratings and upgrading FSE and its dialysis care subsidiary Fresenius Medical Care AG&Co. KGaA (together the Fresenius group) to 'BBB/A-2' from 'BBB-/A-3'. The stable outlook reflects our expectations that the group will report continuous EBITDA