The Ensign Group (ENSG) AI Stock Analysis

• Market Cap: $10.72B
• Dividend Yield: 0.14%
• Average Volume (3M): 459.36K
• Price to Earnings (P/E): 32.9
• Beta (1Y): 0.32
• Revenue Growth: 18.61%
• EPS Growth: 35.76%
• Country: US
• Employees: 39,300
• Sector: Healthcare
• Sector Strength: 45
• Industry: Medical - Care Facilities
• EPS (TTM): 1.64
• Shares Outstanding: 57,924,780
• 10 Day Avg. Volume: 439,179
• 30 Day Avg. Volume: 459,364
• PEG Ratio: 0.63
• Price to Book (P/B): 4.10
• Price to Sales (P/S): 1.77
• P/FCF Ratio: 39.84
• Enterprise Value/Market Cap: 1.10
• Enterprise Value/Revenue: 2.45
• Enterprise Value/Gross Profit: 15.66
• Enterprise Value/Ebitda: 21.98
• 1Y Price Target: $199.00
• Price Target Upside: 7.57% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 4
• EPS Forecast (FY): 6.51
• Revenue Forecast (FY): $5.05B

• Rating: 78 Outperform
• Price Target: $210.00 ▲(13.52% Upside)

The Ensign Group's strong financial performance and positive earnings call sentiment are the most significant factors driving the high overall score. The company's robust revenue growth, strategic acquisitions, and clinical excellence contribute to its strong market position. While the technical analysis supports a stable outlook, the high P/E ratio suggests potential overvaluation, which slightly tempers the overall score.

The Ensign Group Business Overview & Revenue Model

Company Description

The Ensign Group, Inc. provides health care services in the post-acute care continuum and other ancillary businesses. The company operates in two segments, Skilled Services and Real Estate. The company offers skilled services, which include short and long-term nursing care services for patients with chronic conditions, prolonged illness, and the elderly; and physical, occupational, and speech therapies and other rehabilitative and healthcare services. It also provides standard services, such as room and board, special nutritional programs, social, recreational, entertainment, and other services. In addition, the company offers senior living, as well as mobile diagnostics services; leases real estate properties; and provides other ancillary services consisting of digital x-ray, ultrasound, electrocardiogram, laboratory, sub-acute, and patient transportation services to people in their homes or at long-term care facilities. As of April 4, 2022, it operated 252 healthcare facilities in Arizona, California, Colorado, Idaho, Iowa, Kansas, Nebraska, Nevada, South Carolina, Texas, Utah, Washington, and Wisconsin. The company was incorporated in 1999 and is based in San Juan Capistrano, California.

How the Company Makes Money

The Ensign Group generates revenue primarily through the provision of skilled nursing and assisted living services. Its revenue model includes billing for patient care services, which are typically reimbursed by government programs such as Medicare and Medicaid, as well as private pay sources. Key revenue streams include daily room rates, therapy services, and ancillary services provided to residents. Additionally, Ensign has a strategy of acquiring and managing underperforming healthcare facilities, which allows it to improve operational efficiency and increase profitability over time. The company also benefits from partnerships with healthcare providers and payers, enhancing its service offerings and revenue potential.

The Ensign Group Financial Statement Overview

Summary

The Ensign Group exhibits strong financial health with consistent revenue and profit growth, efficient cost management, and a balanced capital structure. The company effectively generates cash, supporting its operational and strategic initiatives. While leverage is managed well, continued focus on maintaining margins and cash flow growth will be crucial for sustained performance.

Income Statement

The Ensign Group has demonstrated consistent revenue growth with a TTM revenue growth rate of 4.65%, building on previous annual growth. Gross profit and net profit margins have remained stable, indicating strong operational efficiency. The EBIT and EBITDA margins are healthy, reflecting effective cost management and profitability.

Balance Sheet

The company's debt-to-equity ratio has improved slightly to 1.01 in the TTM, indicating a balanced approach to leveraging. Return on equity is robust at 17.15%, showcasing effective use of equity to generate profits. The equity ratio is stable, reflecting a solid capital structure.

Cash Flow

Operating cash flow and free cash flow have shown positive growth, with a TTM free cash flow growth rate of 4.61%. The operating cash flow to net income ratio is healthy, indicating strong cash generation relative to net income. The free cash flow to net income ratio is also solid, supporting the company's ability to reinvest and distribute cash.

Breakdown	TTM	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020
Income Statement
Total Revenue	4.83B	4.26B	3.73B	3.03B	2.63B	2.40B
Gross Profit	756.03M	667.59M	590.76M	517.99M	468.21M	407.47M
EBITDA	538.71M	478.52M	353.24M	360.38M	320.84M	281.54M
Net Income	328.20M	297.97M	209.40M	224.68M	194.65M	170.48M
Balance Sheet
Total Assets	5.23B	4.67B	4.18B	3.45B	2.85B	2.55B
Cash, Cash Equivalents and Short-Term Investments	506.31M	526.85M	526.86M	331.71M	275.96M	250.01M
Total Debt	2.16B	1.97B	1.87B	1.57B	1.27B	1.11B
Total Liabilities	3.10B	2.83B	2.68B	2.20B	1.83B	1.73B
Stockholders Equity	2.12B	1.84B	1.49B	1.25B	1.02B	818.08M
Cash Flow
Free Cash Flow	289.53M	188.95M	270.49M	184.97M	206.13M	323.02M
Operating Cash Flow	481.41M	347.19M	376.67M	272.51M	275.68M	373.35M
Investing Cash Flow	-555.82M	-390.05M	-182.70M	-186.18M	-173.91M	-58.67M
Financing Cash Flow	-13.98M	-2.16M	-612.00K	-32.26M	-76.14M	-137.30M

The Ensign Group Technical Analysis

• Technical Analysis Sentiment: Positive
• Last Price: 184.99
• 50DMA: Positive
• 100DMA: Positive
• 200DMA: Positive
• MACD: Positive
• RSI: Neutral
• STOCH: Neutral

Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For ENSG, the sentiment is Positive. The current price of 184.99 is above the 20-day moving average (MA) of 181.57, above the 50-day MA of 177.47, and above the 200-day MA of 151.96, indicating a bullish trend. The MACD of 0.36 indicates Positive momentum. The RSI at 60.18 is Neutral, neither overbought nor oversold. The STOCH value of 53.31 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for ENSG.

The Ensign Group Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
ENSG	78 Outperform	$10.72B	32.92	16.98%	0.14%	18.61%	35.76%
UHS	78 Outperform	$14.76B	11.02	19.97%	0.35%	10.21%	39.58%
NHC	72 Outperform	$2.02B	20.12	9.94%	1.97%	23.74%	-18.99%
THC	70 Outperform	$16.87B	13.16	34.51%	―	-0.56%	-53.50%
EHC	62 Neutral	$11.51B	21.61	24.94%	0.55%	11.13%	27.53%
SGRY	52 Neutral	$2.05B	―	-9.45%	―	10.14%	-182.12%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%

The Ensign Group Corporate Events

The Ensign Group Raises 2025 Earnings Guidance

The Ensign Group, Inc. is a company that provides post-acute healthcare services, focusing on skilled nursing and senior living facilities, and invests in long-term healthcare real estate across the United States.

The Ensign Group’s Earnings Call Highlights Record Growth

The Ensign Group’s recent earnings call exuded a strong positive sentiment, underscored by record-breaking performance metrics, significant revenue and earnings growth, and strategic acquisitions. Despite some challenges in fluctuating deal markets and labor issues, the overall outlook remains optimistic, buoyed by strategic growth initiatives and clinical excellence.

The Ensign Group Board Member Resigns

Christopher Christensen, a founding member of The Ensign Group, resigned from the Board of Directors effective September 1, 2025. His departure was amicable, and in recognition of his service, the company accelerated the vesting of his stock awards and options, provided a substantial cash bonus, and arranged for health insurance subsidies. Additionally, the company repurchased Christensen’s shares in Standard Bearer Healthcare REIT, Inc., reflecting a strategic financial adjustment.

The most recent analyst rating on (ENSG) stock is a Buy with a $189.00 price target. To see the full list of analyst forecasts on The Ensign Group stock, see the ENSG Stock Forecast page.