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The Ensign Group (ENSG)
NASDAQ:ENSG
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The Ensign Group
(NASDAQ:ENSG)
Rating:79Outperform
Price Target:
$173.00
▲(20.16%Upside)
The Ensign Group (ENSG) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$8.38B
Dividend Yield0.17%
Average Volume (3M)325.13K
Price to Earnings (P/E)27.4
Beta (1Y)0.34
Revenue Growth16.80%
EPS Growth39.99%
CountryUS
Employees39,300
SectorHealthcare
Sector Strength39
IndustryMedical - Care Facilities
Share Statistics
EPS (TTM)1.52
Shares Outstanding57,492,350
10 Day Avg. Volume296,888
30 Day Avg. Volume325,134
Financial Highlights & Ratios
PEG Ratio1.59
Price to Book (P/B)4.16
Price to Sales (P/S)0.00
P/FCF Ratio28.07
Enterprise Value/Market Cap0.77
Enterprise Value/Revenue0.39
Enterprise Value/Gross Profit9.54
Enterprise Value/Ebitda3.92
Forecast
1Y Price Target
$175.00Price Target Upside21.54% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering4
The Ensign Group Business Overview & Revenue Model
Company DescriptionThe 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 MoneyThe Ensign Group generates revenue primarily through its skilled nursing and senior living facilities by providing healthcare services to residents and patients. The company earns money through payments from government healthcare programs like Medicare and Medicaid, as well as private pay and insurance sources. Additionally, The Ensign Group benefits from strategic acquisitions of underperforming facilities, which they integrate into their network to improve profitability. The company also collaborates with healthcare providers and payers to optimize service delivery and cost-efficiency, contributing to its financial performance.
The Ensign Group Earnings Call Summary
Earnings Call Date:Apr 29, 2025
(Q1-2025)
| % Change Since: 12.42%|
Next Earnings Date:Jul 24, 2025
Earnings Call Sentiment Positive
The earnings call highlighted significant achievements in revenue, occupancy, and expansion, alongside raising financial guidance. Despite the competitive environment and policy uncertainties, the company's strong financial position and growth opportunities present a positive outlook.Q1-2025 Updates
Positive Updates
Record-Setting Quarter
The company achieved all-time highs in same-store and transitioning occupancy, which increased to 82.6% and 83.5% respectively. Skilled census for same-store and transitioning operations increased by 7.6% and 9.9%, respectively.
Growth in Managed Care Census
Managed care census grew by 8.9% for same-store and 15.6% for transitioning operations over the prior year quarter.
Expansion and Acquisitions
The company added 47 new operations since January 2024, expanding across almost every market served.
Increased Earnings Guidance
Annual 2025 earnings guidance was raised to between $6.22 and $6.38 per diluted share, up from $6.16 to $6.34, representing a 14.5% increase over 2024 results.
Revenue Guidance Increase
Annual revenue guidance was increased to $4.89 billion to $4.94 billion, up from $4.83 billion to $4.91 billion.
Strong Financial Position
Lease adjusted net debt-to-EBITDA ratio of 2.13 times with over $1 billion in dry powder for future growth.
Dividend Increase
The company paid a quarterly cash dividend of $0.0625 per common share, marking 22 consecutive years of annual dividend increases.
Negative Updates
Staffing Challenges
The overall sector has not fully recovered the workforce levels lost during COVID-19, though the company itself has seen recovery.
Competitive Deal Environment
Competition for deals remains strong, primarily from private equity and family-based funds.
Policy Uncertainty
Ongoing policy discussions in Washington regarding Medicaid funding and provider tax present uncertainties.
Company Guidance
During The Ensign Group's first-quarter earnings call for fiscal year 2025, the company reported significant milestones and upward revised guidance metrics. The quarter saw record highs in same-store and transitioning occupancy rates, which reached 82.6% and 83.5%, respectively, representing substantial increases over the prior year. The skilled census for both same-store and transitioning operations rose by 7.6% and 9.9%, respectively, while managed care census grew by 8.9% and 15.6%. Additionally, the company announced an increase in its annual earnings guidance to between $6.22 and $6.38 per diluted share, up from the previous range of $6.16 to $6.34, marking a 14.5% increase over 2024 results and a 32% rise from 2023. The annual revenue guidance was also raised to between $4.89 billion and $4.94 billion, reflecting the quarter's growth and anticipated acquisitions. This optimistic outlook is supported by the company's ongoing strategic expansion, having added 47 new operations since January 2024, showcasing both organic growth potential and successful integration of new acquisitions.The Ensign Group Financial Statement Overview
Summary
The Ensign Group exhibits robust financial health supported by strong revenue and profit growth, efficient operations, and a balanced capital structure. While cash flow metrics are positive, enhancing free cash flow conversion remains an area for potential improvement.Income Statement
The Ensign Group shows a strong revenue growth trajectory with a 19.64% increase from 2023 to the TTM (Trailing-Twelve-Months) period. Gross profit margins have remained stable, and the net profit margin has improved to 7.00% in the TTM period, indicating enhanced profitability. EBIT and EBITDA margins are also well-maintained, showcasing operational efficiency.88
Very Positive
Balance Sheet
The company's balance sheet reflects a solid equity base with an equity ratio of 40.47% in the TTM period. The debt-to-equity ratio is moderate at 0.97, indicating a balanced approach to leveraging. Return on Equity (ROE) is healthy at 16.06%, showing effective use of shareholders' funds.84
Very Positive
Cash Flow
The Ensign Group has demonstrated consistent growth in free cash flow, with a 12.40% increase in the TTM period. The Operating Cash Flow to Net Income ratio is at 1.24, indicating strong cash generation relative to net income. However, the free cash flow to net income ratio is slightly lower at 0.69, suggesting room for improvement in turning profits into free cash flow.81
Very Positive
| Breakdown | TTM | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 | Dec 2020 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 4.42B | 4.26B | 3.73B | 3.03B | 2.63B | 2.40B |
| Gross Profit | 676.18M | 667.59M | 590.76M | 517.99M | 468.21M | 407.47M |
| EBITDA | 495.95M | 461.46M | 353.24M | 360.38M | 320.84M | 281.54M |
| Net Income | 309.42M | 297.97M | 209.40M | 224.68M | 194.65M | 170.48M |
Balance Sheet | ||||||
| Total Assets | 4.76B | 4.67B | 4.18B | 3.45B | 2.85B | 2.55B |
| Cash, Cash Equivalents and Short-Term Investments | 344.47M | 526.85M | 526.86M | 331.71M | 275.96M | 250.01M |
| Total Debt | 2.01B | 1.97B | 1.87B | 1.57B | 1.27B | 1.11B |
| Total Liabilities | 2.83B | 2.83B | 2.68B | 2.20B | 1.83B | 1.73B |
| Stockholders Equity | 1.93B | 1.84B | 1.49B | 1.25B | 1.02B | 818.23M |
Cash Flow | ||||||
| Free Cash Flow | 212.37M | 188.95M | 270.49M | 184.97M | 206.13M | 323.02M |
| Operating Cash Flow | 384.09M | 347.19M | 376.67M | 272.51M | 275.68M | 373.35M |
| Investing Cash Flow | -599.23M | -390.05M | -182.70M | -186.18M | -173.91M | -58.67M |
| Financing Cash Flow | -9.63M | -2.16M | -612.00K | -32.26M | -76.14M | -137.30M |
The Ensign Group Technical Analysis
Neutral
143.98
Price Trends
146.58
Negative
137.49
Positive
139.93
Positive
Market Momentum
-0.40
Positive
38.39
Neutral
9.72
Positive
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For ENSG, the sentiment is Neutral. The current price of 143.98 is below the 20-day moving average (MA) of 150.88, below the 50-day MA of 146.58, and above the 200-day MA of 139.93, indicating a neutral trend. The MACD of -0.40 indicates Positive momentum. The RSI at 38.39 is Neutral, neither overbought nor oversold. The STOCH value of 9.72 is Positive, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral sentiment for ENSG.
The Ensign Group Risk Analysis
The Ensign Group disclosed 54 risk factors in its most recent earnings report. The Ensign Group reported the most risks in the "Legal & Regulatory" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
The Ensign Group Peers Comparison
Overall Rating
UnderperformOutperform
Sector (46)
Financial Indicators
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
79 Outperform | $8.38B | 27.38 | 17.66% | 0.17% | 16.80% | 39.99% | |
78 Outperform | $1.61B | 15.05 | 11.19% | 2.48% | 19.16% | 31.92% | |
77 Outperform | $11.86B | 10.34 | 18.35% | 0.44% | 9.73% | 51.87% | |
75 Outperform | $11.84B | 24.25 | 25.33% | 0.57% | 11.21% | 30.38% | |
71 Outperform | $16.13B | 11.62 | 38.12% | ― | -1.79% | -41.85% | |
64 Neutral | $1.89B | 10.97 | 10.38% | 1.70% | -8.86% | -36.22% | |
46 Neutral | C$203.97M | -3.15 | -23.14% | 2.72% | 21.17% | -0.61% |
* Healthcare Sector Average
Performance Comparison
ENSG
The Ensign Group
143.98
9.04
6.70%
EHC
Encompass Health
118.43
33.51
39.46%
NHC
National Healthcare
103.26
-14.05
-11.98%
SEM
Select Medical
14.74
-5.22
-26.15%
THC
Tenet Healthcare
175.75
44.33
33.73%
UHS
Universal Health
182.52
4.56
2.56%
The Ensign Group Corporate Events
Executive/Board Changes
The Ensign Group Announces Leadership Transition Plans
Neutral
Jun 20, 2025
Christopher Christensen, who has been with The Ensign Group since 1999 and served as Executive Chairman since 2019, announced his retirement effective September 1, 2025. Barry Port, the current CEO, will take over as Chair of the Board. Additionally, Marivic S. Uychiat, a long-time executive with the company, will join the Board, bringing her extensive experience in clinical services and healthcare management. These changes mark a significant transition in the company’s leadership, potentially impacting its strategic direction and governance structure.
The most recent analyst rating on (ENSG) stock is a Buy with a $177.00 price target. To see the full list of analyst forecasts on The Ensign Group stock, see the ENSG Stock Forecast page.
Shareholder MeetingsBusiness Operations and Strategy
The Ensign Group Holds 2025 Annual Stockholders Meeting
Neutral
May 20, 2025
The Ensign Group held its 2025 Annual Meeting of Stockholders on May 15, 2025, where key decisions were made regarding the company’s governance and operational strategies. During the meeting, directors were elected, Deloitte & Touche LLP was ratified as the independent accounting firm for 2025, executive compensation was approved, and an amendment to the 2022 Omnibus Incentive Plan was passed, reflecting shareholder support for the company’s strategic direction.
The most recent analyst rating on (ENSG) stock is a Buy with a $177.00 price target. To see the full list of analyst forecasts on The Ensign Group stock, see the ENSG Stock Forecast page.
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.