Kazakh President Nursultan Nazarbayev was admitted to University Medical Center Hamburg-Eppendorf, a hospital in Hamburg, German newspaper Bild reported July 19, citing unnamed sources. The hospital has not confirmed the report, and there are no reports of the Kazakh leader’s condition or reason for being checked into the hospital. The German Foreign Ministry denied helping Nazarbayev get into the hospital, and the ministry said the Kazakh state has not informed it of Nazarbayev’s visit to the hospital.

Although it remains unclear whether Nazarbayev is in Germany for medical treatment, the report of his hospitalization follows reports from Nazarbayev’s press service July 11 that said Nazarbayev was taking a previously unscheduled and unexpected “short-term vacation” — something that in the past has meant either a real vacation or a visit to a hospital.

The German report also comes as the 71-year-old Nazarbayev is laying out a succession plan . The succession issue could destabilize Kazakhstan; Nazarbayev has been the country’s only ruler since the Soviet era, and thus his health status and possible visit to a German hospital is worth watching.