In its ruling of December 16, 2015 – XI R 52/13, BStBl II 202X p. XXX the BFH has ruled that a public corporation which, as a statutory social security institution, operates within the framework of the rehabilitation clinics it operates without medical necessity, accommodates patients’ companions for a separate fee agreed under private law, and and provides meals to its employees in return for payment of a separate fee, in this respect, is engaged in business activities and, as a result, generates sales taxable and and is subject to value-added tax if the aforementioned services are not indispensable for the activities at the rehabilitation clinics or are not intended to generate additional income for the rehabilitation clinics.
Source: bundesfinanzministerium.de