A Business at a Glance
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ENSIGN GROUP, INC
ENSG
$10.2B
Mkt Cap
$172.99
+3.27%
ENSIGN GROUP, INC (ENSG) has a current P/E ratio of 29.6, compared to its historical median P/E of 24.3. The stock is currently considered Expensive based on its historical valuation range.
ENSIGN GROUP, INC (ENSG) has a 5-year average return on invested capital (ROIC) of 21.5%. This indicates strong capital allocation and a potential competitive advantage.
ENSIGN GROUP, INC (ENSG) has a market capitalization of $10.1B. It is classified as a large-cap stock.
Yes, ENSIGN GROUP, INC (ENSG) pays a dividend with a trailing twelve-month yield of 0.14%. The company also returns capital through share buybacks, with a buyback yield of 0.09%.
Based on historical P/E analysis, ENSIGN GROUP, INC (ENSG) appears expensive. The current P/E of 29.6 is 22% above its historical median of 24.3. The estimated fair value CAGR (P/E method) is 16.1%.
ENSIGN GROUP, INC (ENSG) operates in the Services-Skilled Nursing Care Facilities industry, within the Healthcare sector.
ENSIGN GROUP, INC (ENSG) reported annual revenue of $5.1 billion in its most recent fiscal year, based on SEC EDGAR filings.
The Ensign Group is a holding company operating 373 skilled nursing and senior living facilities across 17 states, generating approximately 95.6% of revenue from skilled nursing operations with the remainder from real estate properties, senior living services, and ancillary businesses including mobile diagnostics and medical transportation. The company operates 253 facilities under long-term lease arrangements and owns 158 real estate properties, 120 of which it operates directly while 38 are leased to third-party operators; its real estate portfolio is held through Standard Bearer, a REIT formed in 2022 to highlight the value of owned properties and provide pathways for future acquisitions. Ensign's business model emphasizes a localized, field-driven organizational structure organized into portfolio companies, each led by operational CEOs responsible for recruiting talent, identifying acquisition targets, and driving growth within their markets; this approach encourages prospective patients and referral sources to choose local operations based on reputation for superior care and allows leaders to share real-time operating data and clinical benchmarks with peers to improve outcomes and operational efficiencies. The company's unit economics are characterized by recurring revenue from skilled nursing services with strong demographic tailwinds supporting census momentum, and it pursues a disciplined acquisition strategy focused on turnaround operations that are integrated through locally-led transition processes emphasizing clinical systems, cultural alignment, and frontline staff training. Ensign's competitive differentiation lies in its ability to build strong relationships with local healthcare communities, its proven track record of successfully integrating acquisitions ahead of schedule, and its commitment to setting industry standards for patient care and professional competence.
【Sustained acquisition momentum and organic growth】 Management expects to maintain a healthy pace of acquisitions while benefiting from powerful demographic tailwinds that support census momentum across the portfolio, with recently acquired operations already performing at or above expectations and contributing ahead of schedule. The company anticipates continued organic improvements driven by occupancy and skilled mix growth, supported by ongoing progress on labor management, agency cost reduction, and operational initiatives, with expectations that 2026 will mirror the positive trajectory seen in 2025 including similar occupancy progression. Management remains confident in executing its growth strategy while integrating newly acquired operations, and plans to continue its long history of paying dividends as liquidity remains strong. The company has over $1 billion in available dry powder for future investments and expects to benefit from hospitals increasingly focusing on core acute services, creating more opportunities to grow in the post-acute care continuum.
| Metric | Target | Period |
|---|---|---|
| Earnings per diluted share | $7.48–$7.62 | FY2026 |
| Revenue | $5.81 billion–$5.86 billion | FY2026 |
Earnings per diluted share (FY2026): “we are increasing our annual 2026 earnings guidance to $7.48-$7.62 per diluted share, up from our original guidance of $7.41-$7.61”
Revenue (FY2026): “We are also increasing our annual revenue guidance to $5.81 billion-$5.86 billion, up from $5.77 billion-$5.84 billion”
Generated solely from the company's own reports listed below — not from third-party data. Hallucination risk is low. · Sources: 10-K, Q4 FY2025 Earnings Call, Q3 FY2025 Earnings Call, Q2 FY2025 Earnings Call, Q1 FY2025 Earnings Call
| Metric | TTM | FY2025 | FY2024 | FY2023 | FY2022 | FY2021 |
|---|---|---|---|---|---|---|
| Revenue | 5.3B | 5.1B | 4.3B | 3.7B | 3.0B | 2.6B |
| Net Income | 363M | 344M | 298M | 209M | 225M | 195M |
| EPS | $6.26 | $5.84 | $5.12 | $3.65 | $3.95 | $3.42 |
| Free Cash Flow | 581M | 555M | 339M | 372M | 268M | 272M |
| ROIC | 17.9% | 19.7% | 21.5% | 17.9% | 23.3% | 25.0% |
| Gross Margin | - | 20.5% | 20.7% | 21.1% | 22.2% | 23.1% |
| Debt/Equity | 0.06 | 0.06 | 0.08 | 0.10 | 0.13 | 0.16 |
| Dividends/Share | $0.25 | $0.25 | $0.24 | $0.23 | $0.22 | $0.21 |
| Operating Income | 449M | 425M | 358M | 255M | 297M | 260M |
| Operating Margin | 8.5% | 8.4% | 8.4% | 6.8% | 9.8% | 9.9% |
| ROE | 15.4% | 16.9% | 17.9% | 15.3% | 19.8% | 21.2% |
| Shares Outstanding | 58M | 59M | 58M | 57M | 57M | 57M |
| Metric | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Income Statement | |||||||||||||
| Revenue | 1.0B | 1.3B | 1.7B | 1.8B | 1.8B | 2.0B | 2.4B | 2.6B | 3.0B | 3.7B | 4.3B | 5.1B | 5.3B |
| Gross Margin | 19.9% | 20.4% | 18.9% | 29.0% | 19.2% | 20.4% | 22.4% | 23.1% | 22.2% | 21.1% | 20.7% | 20.5% | N/A |
| R&D | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| SG&A | 57M | 64M | 69M | 74M | 91M | 111M | 130M | 152M | 159M | 263M | 225M | 270M | 281M |
| EBIT | 73M | 93M | 92M | 43M | 85M | 129M | 223M | 260M | 297M | 255M | 358M | 425M | 449M |
| Op. Margin | 7.1% | 6.9% | 5.6% | 2.3% | 4.8% | 6.3% | 9.3% | 9.9% | 9.8% | 6.8% | 8.4% | 8.4% | 8.5% |
| Net Income | 36M | 55M | 50M | 40M | 92M | 111M | 170M | 195M | 225M | 209M | 298M | 344M | 363M |
| Net Margin | 3.5% | 4.1% | 3.0% | 2.2% | 5.3% | 5.4% | 7.1% | 7.4% | 7.4% | 5.6% | 7.0% | 6.8% | 6.9% |
| Non-Recurring | 0 | 0 | 19M | 0 | 3.5M | 498K | 0 | 1.4M | 3.5M | 123K | 1.4M | 0 | 0 |
| Returns on Capital | |||||||||||||
| ROIC | 10.7% | 15.2% | 9.8% | 3.6% | 9.0% | 12.0% | 21.9% | 25.0% | 23.3% | 17.9% | 21.5% | 19.7% | 17.9% |
| ROE | 11.7% | 16.2% | 11.3% | 8.5% | 17.1% | 17.8% | 23.2% | 21.2% | 19.8% | 15.3% | 17.9% | 16.9% | 15.4% |
| ROA | 5.7% | 8.9% | 5.7% | 3.8% | 8.1% | 6.2% | 6.9% | 7.2% | 7.1% | 5.5% | 6.7% | 6.8% | 6.5% |
| Cash Flow | |||||||||||||
| Op. Cash Flow | 85M | 33M | 74M | 80M | 210M | 192M | 373M | 276M | 273M | 377M | 347M | 564M | 592M |
| Free Cash Flow | 31M | -27M | 8.2M | 25M | 159M | 121M | 370M | 272M | 268M | 372M | 339M | 555M | 581M |
| Owner Earnings | 53M | -1.4M | 26M | 30M | 157M | 130M | 304M | 201M | 187M | 274M | 227M | 412M | 432M |
| CapEx | 54M | 60M | 66M | 54M | 51M | 72M | 3.4M | 3.7M | 4.8M | 4.6M | 7.9M | 9.2M | 11M |
| Maint. CapEx | 26M | 28M | 39M | 42M | 45M | 51M | 55M | 56M | 62M | 72M | 84M | 104M | 109M |
| Growth CapEx | 27M | 32M | 27M | 12M | 6.0M | 20M | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| D&A | 26M | 28M | 39M | 42M | 45M | 51M | 55M | 56M | 62M | 72M | 84M | 104M | 109M |
| CapEx/OCF | 63.3% | 179.9% | 88.9% | 78.4% | 1.7% | 2.1% | 0.9% | 1.3% | 1.8% | 1.2% | 2.3% | 1.6% | 1.9% |
| Capital Allocation | |||||||||||||
| Dividends Paid | 6.3M | 7.5M | 8.2M | 8.7M | 9.4M | 10M | 11M | 12M | 12M | 13M | 14M | 14M | 15M |
| Dividend Yield | 1.0% | 0.3% | 0.8% | 0.9% | 0.6% | 0.4% | 0.4% | 0.2% | 0.3% | 0.2% | 0.2% | 0.2% | 0.1% |
| Share Buybacks | 0 | 0 | 30M | 7.3M | 0 | 6.4M | 25M | 10M | 30M | 0 | 0 | 20M | 9.2M |
| Buyback Yield | N/A | N/A | 2.7% | 0.6% | N/A | 0.3% | 0.6% | 0.2% | 0.6% | N/A | N/A | 0.2% | 0.1% |
| Stock-Based Comp | 5.2M | 6.7M | 9.1M | 7.8M | 8.4M | 11M | 15M | 19M | 23M | 31M | 36M | 48M | 51M |
| Debt Repayment | 331M | 314M | 660M | 990M | 915M | 1.3B | 630M | 3.1M | 4.1M | 4.0M | 4.3M | 4.1M | 4.1M |
| Balance Sheet | |||||||||||||
| Net Debt | 12M | 56M | 214M | 258M | 205M | 259M | -127M | -117M | -175M | -375M | -381M | -431M | -454M |
| Cash & Equiv. | 50M | 42M | 58M | 42M | 31M | 59M | 237M | 262M | 316M | 510M | 465M | 504M | 595M |
| Long-Term Debt | 68M | 99M | 275M | 303M | 233M | 330M | 118M | 153M | 149M | 145M | 142M | 138M | 136M |
| Debt/Equity | 0.26 | 0.23 | 0.62 | 0.64 | 0.41 | 0.51 | 0.15 | 0.16 | 0.13 | 0.10 | 0.08 | 0.06 | 0.06 |
| Interest Coverage | 5.6 | 32.9 | 12.9 | 3.2 | 5.6 | 8.2 | 23.8 | 38.0 | 33.2 | 31.6 | 43.2 | 53.2 | 56.9 |
| Equity | 259M | 427M | 456M | 492M | 591M | 654M | 818M | 1.0B | 1.2B | 1.5B | 1.8B | 2.2B | 2.4B |
| Total Assets | 494M | 748M | 1.0B | 1.1B | 1.2B | 2.4B | 2.5B | 2.9B | 3.5B | 4.2B | 4.7B | 5.5B | 5.6B |
| Total Liabilities | 236M | 321M | 541M | 602M | 580M | 1.7B | 1.7B | 1.8B | 2.2B | 2.7B | 2.8B | 3.2B | 3.2B |
| Intangibles | 36M | 45M | 35M | 33M | 31M | 3.4M | 2.9M | 2.7M | 6.4M | 6.5M | 7.3M | 6.4M | 6.3M |
| Retained Earnings | 146M | 193M | 235M | 265M | 345M | 392M | 551M | 734M | 946M | 1.1B | 1.4B | 1.8B | 1.9B |
| Working Capital | 83M | 100M | 122M | 142M | 79M | 68M | 21M | 117M | 199M | 312M | 414M | 378M | 472M |
| Current Assets | 214M | 280M | 334M | 368M | 348M | 411M | 583M | 640M | 781M | 1.0B | 1.2B | 1.3B | 1.3B |
| Current Liabilities | 130M | 180M | 212M | 226M | 269M | 343M | 562M | 523M | 582M | 735M | 743M | 894M | 848M |
| Per Share Data | |||||||||||||
| EPS | 0.80 | 0.53 | 0.96 | 0.77 | 1.70 | 1.97 | 3.06 | 3.42 | 3.95 | 3.65 | 5.12 | 5.84 | 6.26 |
| Owner EPS | 1.18 | -0.01 | 0.50 | 0.56 | 2.89 | 2.31 | 5.46 | 3.53 | 3.30 | 4.77 | 3.90 | 6.99 | 7.39 |
| Book Value | 5.73 | 4.09 | 8.77 | 9.37 | 10.88 | 11.66 | 14.68 | 17.93 | 21.93 | 26.00 | 31.57 | 37.89 | 40.50 |
| Cash Flow/Share | 1.88 | 0.32 | 1.42 | 1.51 | 3.87 | 3.43 | 6.70 | 4.84 | 4.79 | 6.57 | 5.97 | 9.58 | 8.08 |
| Dividends/Share | 0.14 | 0.08 | 0.16 | 0.17 | 0.18 | 0.19 | 0.20 | 0.21 | 0.22 | 0.23 | 0.24 | 0.25 | 0.25 |
| Shares Out. | 45.2M | 104.6M | 52.1M | 52.6M | 54.3M | 56.1M | 55.7M | 56.9M | 56.9M | 57.4M | 58.2M | 58.9M | 58.4M |
| Valuation | |||||||||||||
| P/E Ratio | 27.9 | 20.1 | 22.4 | 28.1 | 20.7 | 22.3 | 23.9 | 24.6 | 23.5 | 31.0 | 26.1 | 30.2 | 27.6 |
| P/FCF | 29.5 | N/A | 127.8 | 41.8 | 12.0 | 20.4 | 11.0 | 17.6 | 19.7 | 17.5 | 22.9 | 18.7 | 17.4 |
| EV/EBIT | 13.9 | 12.6 | 14.6 | 17.3 | 25.3 | 18.6 | 17.1 | 17.4 | 16.7 | 23.4 | 20.3 | 23.1 | 21.5 |
| Price/Book | 3.9 | 2.6 | 2.5 | 2.3 | N/A | 3.8 | 5.0 | 4.7 | 4.2 | 4.4 | 4.2 | 4.7 | 4.3 |
| Price/Sales | 0.6 | 0.9 | 0.6 | 0.6 | 1.0 | 1.3 | 1.1 | 1.8 | 1.6 | 1.5 | 1.8 | 1.8 | 1.9 |
| FCF Yield | 3.1% | -2.4% | 0.7% | 2.2% | 8.3% | 4.9% | 9.1% | 5.7% | 5.1% | 5.7% | 4.4% | 5.3% | 5.7% |
| Market Cap | 1.0B | 1.1B | 1.1B | 1.1B | 1.9B | 2.5B | 4.1B | 4.8B | 5.3B | 6.5B | 7.8B | 10.4B | 10.1B |
| Avg. Price | 13.43 | 20.63 | 18.81 | 18.79 | 31.35 | 45.45 | 49.49 | 82.06 | 82.90 | 95.42 | 131.46 | 152.80 | 172.99 |
| Year-End Price | 20.36 | 19.95 | 20.09 | 20.26 | 35.21 | 43.94 | 73.01 | 84.29 | 92.80 | 113.32 | 133.70 | 176.38 | 172.99 |
ENSIGN GROUP, INC passes 6 of 9 quality checks, suggesting mixed fundamentals.
ENSIGN GROUP, INC trades at 29.6x trailing earnings, compared to its 15-year median P/E of 24.3x, suggesting it is currently Expensive relative to its historical range. On a free-cash-flow basis, the stock trades at 18.1x vs a median of 18.7x. The company's 5-year average ROIC is 21.5% with a gross margin of 21.5%. Total shareholder yield (dividends) is 0.2%. At current prices, the estimated annualized return to fair value is +8.8%.
ENSIGN GROUP, INC (ENSG) has a net profit margin of 6.8%. This is a modest margin.
ENSIGN GROUP, INC (ENSG) generated $555 million in free cash flow in its most recent fiscal year. Positive free cash flow supports dividends, buybacks, and debt reduction.
ENSIGN GROUP, INC (ENSG) has a debt-to-equity ratio of 0.06. This indicates a conservatively financed balance sheet.
ENSIGN GROUP, INC (ENSG) reported earnings per share (EPS) of $5.84 in its most recent fiscal year.
ENSIGN GROUP, INC (ENSG) has a return on equity (ROE) of 16.9%. This indicates the company generates strong returns for shareholders.
ENSIGN GROUP, INC (ENSG) has a 5-year average gross margin of 21.5%. This lower margin is typical of capital-intensive or commodity businesses.
The Ledger Terminal provides 15 years of financial data for ENSIGN GROUP, INC (ENSG), sourced directly from SEC EDGAR filings. This includes income statements, balance sheets, cash flow statements, and key financial ratios.
ENSIGN GROUP, INC (ENSG) has a book value per share of $37.89, based on its most recent annual SEC filing.
Based on recent SEC filings and earnings disclosures, Management expects to maintain a healthy pace of acquisitions while benefiting from powerful demographic tailwinds that support census momentum across the portfolio, with recently acquired operations already performing at or above expectations and contributing ahead of schedule. The company anticipates continued organic improvements driven by occupancy and skilled mix growth, supported by ongoing progress on labor management, agency cost reduction, and operational initiatives, with expectations that 2026 will mirror the positive trajectory seen in 2025 including similar occupancy progression. Management remains confident in executing its growth strategy while integrating newly acquired operations, and plans to continue its long history of paying dividends as liquidity remains strong. The company has over $1 billion in available dry powder for future investments and expects to benefit from hospitals increasingly focusing on core acute services, creating more opportunities to grow in the post-acute care continuum.
Based on recent SEC filings and earnings calls, ENSIGN GROUP, INC (ENSG) has provided the following forward guidance: Earnings per diluted share: $7.48–$7.62 (FY2026); Revenue: $5.81 billion–$5.86 billion (FY2026).