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The Ensign (ENSG)
NASDAQ:ENSG
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The Ensign Group (ENSG) AI Stock Analysis

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ENSG

The Ensign Group

(NASDAQ:ENSG)

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Neutral 69 (OpenAI - 5.2)
Rating:69Neutral
Price Target:
$164.00
▼(-18.05% Downside)
Action:Reiterated
Date:06/16/26
Overall score reflects solid underlying financial performance and a notably positive earnings update (raised guidance and strong operating metrics), tempered by very weak current technicals (price below key moving averages and oversold momentum) and only average valuation support with a minimal dividend yield.
Positive Factors
Revenue Growth & Profitability
Sustained multi-year revenue expansion to $5.27B TTM and a near-7% net margin reflect durable demand for post-acute care and successful scale. This scale supports recurring cash generation, service diversification and investment capacity for organic and acquisition-led growth over the next 2–6 months.
Negative Factors
Managed Care & Reimbursement Scrutiny
Elevated clinical reviews and managed-care scrutiny are structural industry headwinds that can persist, increasing claim denials, audit risk and revenue lag. Over the medium term this can pressure realized reimbursement rates and cash collections, creating durable volatility in margins.
Read all positive and negative factors
Positive Factors
Negative Factors
Revenue Growth & Profitability
Sustained multi-year revenue expansion to $5.27B TTM and a near-7% net margin reflect durable demand for post-acute care and successful scale. This scale supports recurring cash generation, service diversification and investment capacity for organic and acquisition-led growth over the next 2–6 months.
Read all positive factors

The Ensign Group (ENSG) vs. SPDR S&P 500 ETF (SPY)

The Ensign Group Business Overview & Revenue Model

Company Description
The Ensign Group, Inc. operates as a healthcare provider, primarily concentrating on post-acute care services, alongside other supporting business ventures. The company's activities are organized into two main divisions: Skilled Services and Real ...
How the Company Makes Money
ENSG primarily makes money by delivering patient care and housing/services through its skilled nursing facilities and senior living communities. Its largest revenue stream is patient service revenue generated from skilled nursing and post-acute ca...

The Ensign Group Earnings Call Summary

Earnings Call Date:Apr 30, 2026
(Q1-2026)
|
% Change Since: |
Next Earnings Date:Jul 23, 2026
Earnings Call Sentiment Positive
The call conveyed multiple strong operational and financial positives: record occupancy, meaningful year-over-year revenue and EPS growth, raised guidance, disciplined balance sheet with ample liquidity, accelerating M&A and strong clinical outcomes across the portfolio. Lowlights were largely forward-looking risks and transitional items (ERP implementation, short-term EPS drag from turnaround deals, seasonality and potential state budget uncertainty) rather than current performance shortfalls. Overall the positive items materially outweigh the manageable and disclosed risks.
Positive Updates
Record Occupancy and Census Momentum
Same-store occupancy reached a record 84.3% and transitioning occupancy 85.1% in Q1; same-store and transitioning managed care and Medicare census increased sequentially by 6.2% and 8.3% (Q4 to Q1), demonstrating strong demand and sequential growth.
Negative Updates
Industry Clinical Review & Managed Care Scrutiny (Risk)
Ongoing market commentary around increased clinical reviews and managed care scrutiny remains a potential risk; management reports no material system-wide impact to date but acknowledges heightened review intensity in the industry which could create volatility in reimbursement or claims.
Read all updates
Q1-2026 Updates
Negative
Record Occupancy and Census Momentum
Same-store occupancy reached a record 84.3% and transitioning occupancy 85.1% in Q1; same-store and transitioning managed care and Medicare census increased sequentially by 6.2% and 8.3% (Q4 to Q1), demonstrating strong demand and sequential growth.
Read all positive updates
Company Guidance
Ensign raised 2026 guidance to $7.48–$7.62 of diluted EPS (from $7.41–$7.61) and revenue to $5.81–$5.86 billion (from $5.77–$5.84B), with the midpoint representing ~15% growth vs. 2025 and ~37% vs. 2024; the raise follows a strong Q1 (GAAP diluted EPS $1.67, +21.9%; adjusted diluted EPS $1.85, +21.7%; consolidated revenue $1.4B, +18.4%; GAAP net income $99.7M, +24.2%; adjusted net income $110.2M, +23.9%), and management cites cash and liquidity strength (cash & equivalents $539.5M, cash flow from operations $100.2M, >$60M invested in Q1, lease‑adjusted net debt/EBITDA 1.73x, >$592M available on the revolver and >$1B total dry powder), plus guidance assumptions of ~60M diluted weighted shares, a 25% tax rate, inclusion of acquisitions closed/expected through Q2, exclusion of stock‑based comp and system implementation costs, and consistency with CMS’s proposed 2027 2.4% market‑basket increase.

The Ensign Group Financial Statement Overview

Summary
Strong multi-year revenue expansion and solid profitability (TTM net margin ~6.9%) support a good score, alongside improving leverage in TTM and growing operating/free cash flow. Offsetting factors are margin compression versus 2021–2022, uneven cash conversion (FCF ~69% of net income), and historical leverage volatility (notably the 2025 debt spike).
Income Statement
78
Positive
Balance Sheet
70
Positive
Cash Flow
73
Positive
BreakdownTTMDec 2025Dec 2024Dec 2023Dec 2022Dec 2021
Income Statement
Total Revenue5.27B5.06B4.26B3.73B3.03B2.63B
Gross Profit734.87M799.45M667.59M590.76M517.99M468.21M
EBITDA594.44M567.94M478.52M353.24M360.38M320.84M
Net Income363.36M343.97M297.97M209.40M224.68M194.65M
Balance Sheet
Total Assets5.61B5.46B4.67B4.18B3.45B2.85B
Cash, Cash Equivalents and Short-Term Investments595.17M572.39M526.85M526.86M331.71M275.96M
Total Debt2.24B4.15B1.97B1.87B1.57B1.27B
Total Liabilities3.24B3.23B2.83B2.68B2.20B1.83B
Stockholders Equity2.37B2.23B1.84B1.49B1.25B1.02B
Cash Flow
Free Cash Flow406.10M370.71M188.95M270.49M184.97M206.13M
Operating Cash Flow592.20M564.27M347.19M376.67M272.51M275.68M
Investing Cash Flow-340.56M-513.18M-390.05M-182.70M-186.18M-173.91M
Financing Cash Flow5.19M-11.81M-2.16M-612.00K-32.26M-76.14M

The Ensign Group Technical Analysis

Technical Analysis Sentiment
Negative
Last Price200.11
Price Trends
50DMA
176.21
Negative
100DMA
189.00
Negative
200DMA
183.04
Negative
Market Momentum
MACD
-7.00
Negative
RSI
36.07
Neutral
STOCH
47.56
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For ENSG, the sentiment is Negative. The current price of 200.11 is above the 20-day moving average (MA) of 161.78, above the 50-day MA of 176.21, and above the 200-day MA of 183.04, indicating a bearish trend. The MACD of -7.00 indicates Negative momentum. The RSI at 36.07 is Neutral, neither overbought nor oversold. The STOCH value of 47.56 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative sentiment for ENSG.

The Ensign Group Risk Analysis

The Ensign Group disclosed 53 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 (51)
Financial Indicators
Name
Overall Rating
Market Cap
P/E Ratio
ROE
Dividend Yield
Revenue Growth
EPS Growth
78
Outperform
$3.15B25.3311.68%1.80%11.40%13.96%
72
Outperform
$9.72B15.9625.35%0.65%10.05%23.59%
72
Outperform
$8.54B5.6720.93%0.35%10.42%33.92%
69
Neutral
$8.98B24.4316.63%0.14%19.23%15.67%
68
Neutral
$14.86B8.8040.55%4.56%27.14%
51
Neutral
$7.86B-0.30-43.30%2.27%22.53%-2.21%
51
Neutral
$1.90B-24.54-4.43%5.38%61.15%
* Healthcare Sector Average
Performance Comparison
Ticker
Company Name
Price
Change
% Change
ENSG
The Ensign Group
153.65
-2.48
-1.59%
EHC
Encompass Health
98.03
-20.93
-17.59%
NHC
National Healthcare
201.53
97.57
93.84%
THC
Tenet Healthcare
172.57
4.56
2.71%
UHS
Universal Health
141.17
-29.34
-17.21%
SGRY
Surgery Partners
14.55
-4.75
-24.61%

The Ensign Group Corporate Events

Business Operations and StrategyStock Buyback
Ensign Group Expands Stock Repurchase Authorization to $100M
Positive
Jun 15, 2026
On June 12, 2026, The Ensign Group’s board approved a $60 million increase to its stock repurchase authorization, boosting the total capacity of the program from $40 million to $100 million as disclosed in a June 15, 2026 announcement. The e...
Stock Buyback
Ensign Group Announces New $40 Million Share Repurchase
Positive
Jun 10, 2026
On May 13, 2026, The Ensign Group’s board authorized a new stock repurchase program of up to $40 million in common shares, set to begin after the current buyback plan expires. The authorization allows purchases in the open market or through ...
Executive/Board ChangesShareholder Meetings
The Ensign Group Stockholders Back Directors and Governance
Positive
May 18, 2026
At its 2026 Annual Meeting of Stockholders held on May 13, 2026, The Ensign Group, Inc. reported that 54,180,430 of 58,413,971 eligible shares were represented in person or by proxy, and shareholders elected three Class I directors to terms ending...
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.Date of analysis: Jun 16, 2026