KOS is the Italian leader in long-term care as measured in the number of structures and beds. Founded by CIR in 2002, the company operates mainly in nursing homes for the elderly, complex functional rehabilitation and psychiatric therapy.

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KOS at a glance

KOS manages 159 structures in the long-term care sector (nursing homes for the elderly, functional rehabilitation and psychiatric rehabilitation) with 13,500 beds in total. It operates in Italy, predominantly in the north and central regions, and in Germany.

The skills of KOS in the sector of care and assistance for the elderly, psychiatry and functional rehabilitation are enhanced thanks to the offer of new highly specialized services, such as virtual clinics, telemedicine and care at home. The company stands out for its high quality of service, maximum attention to patients’ needs and technological innovation. Since its beginning, the company has combined the goals typical of a private company with the desire to guarantee a service of quality, which always centered on people: patients, relatives, and employees. Its services complement and complete the full spectrum of offers from the Italian National Health Service.

KOS employs approximately 11,300 people. CIR controls 59.8% of the company and F2i Healthcare holds the remainder.

KOS posted revenues of € 683.5 million in 2022.

€ 683.5 M








The market in which KOS operates is growing fast for structural reasons, linked to the aging of the population, longer average life spans and the greater occurrence of certain pathologies. Since its launch in 2002, CIR has always supported its growth, both at the organic level and reinforcing its role as an aggregating hub.

Revenues by activity in 2022 (Million €)

Functional rehabilitation27.3%191.8 MLong-term care | : 91.8 % – 644.5 M
Homes for the elderly57.8%406.0 MLong-term care
Psychiatric rehabilitation6.6%46.6 MLong-term care
Oncological diagnosis and care2.6%18.4 M
Acute care5.6%39.0 M

Revenues by geographical area in 2022 (Million €)

Marche162.6 M
Lombardy156.0 M
Trentino-Alto Adige8.7M

Long-term care 

The area of long-term care, which represents 91.5% of KOS revenues, can be broken down into four branches and their four relative brands: Anni Azzurri, Santo Stefano, Neomesia and Charleston. KOS is the sector leader in Italy and continues to grow through selective acquisitions and the creation of green field structures.

In 2017, the Anni Azzurri, Santo Stefano and Neomesia brands were united in the KOS Care company, with the aim of giving all patients access to the group’s experience in various sectors.

Nursing homes for the non-self-sufficient elderlyBeds

With the Anni Azzurri brand, KOS is the first private operator in Italy in homes for the elderly. In a country facing an increasingly aging population – it is estimated that a quarter of the population will be elderly in 2027 – and as the demands of daily life do not always allow families to care for their relatives, the demand for dedicated structures is exponential. KOS homes – mainly located in northern and central Italy – represent an excellent answer to ever more complex challenges, allowing also for the acceptance of patients suffering from dementia and other complex degenerative pathologies. 

The company is evaluating the opportunity of further growth, particularly in Southern Italy.

Nursing homes for the non-self-sufficient elderlyBeds

KOS has operated in Germany since November 2019 through the Charleston group, which provides residential services to the elderly who are not self-sufficient and ancillary services to elderly patients with high levels of disability. With 47 nursing homes for the elderly, Charleston is one of the top ten German operators in the country’s western region and is a group structured for further growth in the German market. The country has approximately 880,000 residential beds, with around 40% managed by private operators. Germany is one of Europe’s key markets which, thanks to demographic factors and the solidity of its financial system, also offers interesting prospects in terms of stability and growth.

Outpatient rehabilitation and diagnostic centersBeds

With the Santo Stefano brand, KOS is one of the main operators in the management of structures for complex functional rehabilitation and the treatment of serious cerebral injury (for example, post coma or stroke), neurological pathologies, muscular and skeletal pathologies from trauma or chronic-degenerative. Santo Stefano stands at the sector’s cutting edge, with specialized structures for certain neuro-degenerative pathologies (multiple sclerosis, ALS, Parkinson’s disease).

KOS is evaluating the opportunity of further development in this field, also across other major European countries.

Specialized clinics and therapeutic rehabilitation

Through Neomesia, KOS is the first group in Italy to have a network of psychiatric structures on the national territory. It offers different therapeutic settings (from therapeutic communities to psychiatric clinics) to handle patients of differing ages suffering psychiatric pathologies. The KOS approach to psychiatry is biopsychosocial, which considers the person as a whole, taking into account the patient’s general state of health and needs in relation to the external environment where they will return to live.

Diagnostics and oncological treatments 

Hospitals where Medipass is present in IndiaHigh-technology medical outsourcing plans

Following the sale of Medipass on November 27, 2020, KOS exited the diagnostics and oncological treatment sector. Medipass’s residual activities in India, which represents around 3% of KOS’s revenues, are object of a process of divestment.

Acute care


KOS is present in the acute care sector managing, under concessions from the Lombard Regional government, with the Ospedale Fratelli Montecchi di Suzzara (123 beds). This sector accounts for 7% of KOS revenues.

Within the long-term care area, KOS manages the Villa dei Pini care home (177 beds) in Civitanova Marche, specializing in acute care.

KOS in the world

KOS operates mainly in Italy, in particular in 11 North and central regions: Lombardy, Piedmont, Veneto, Liguria, Trentino-Alto Adige, Tuscany, Emilia-Romagna, Marche, Umbria, Lazio and Campania. The company has also embarked on a development in long-term care in Germany.