The Ensign (ENSG)
NASDAQ:ENSG
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The Ensign Group
(NASDAQ:ENSG)
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Rating:69Neutral
Price Target:
$195.00
▼(-2.55% Downside)
Action:Downgraded
Date:05/19/26
ENSG earns a solid score driven primarily by strong financial performance and a notably upbeat earnings update with raised full-year guidance. The rating is held back by weak technical momentum (below major moving averages with negative MACD/low RSI) and a relatively rich valuation with a minimal dividend yield.
Positive Factors
Record occupancy
Sustained record occupancy and sequential census momentum indicate durable demand and improved utilization across facilities. Higher occupancy supports per-day revenue stability, enhances skilled mix exposure and underpins longer-term revenue visibility and pricing leverage within post-acute care.
Negative Factors
Margin compression & cash conversion
Eroding margins and only partial conversion of earnings to free cash flow make profits more sensitive to labor and reimbursement pressures. This reduces internal funding capacity, limits buffer against shocks and raises the importance of operational gains to sustain long-term profitability.
Read all positive and negative factors
Positive Factors
Negative Factors
Record occupancy
Sustained record occupancy and sequential census momentum indicate durable demand and improved utilization across facilities. Higher occupancy supports per-day revenue stability, enhances skilled mix exposure and underpins longer-term revenue visibility and pricing leverage within post-acute care.
Read all positive factors
The Ensign Group (ENSG) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$10.42B
Dividend Yield0.14%
Average Volume (3M)486.50K
Price to Earnings (P/E)29.2
Beta (1Y)0.19
Revenue Growth19.23%
EPS Growth15.67%
CountryUS
Employees39,300
SectorHealthcare
Sector Strength45
IndustryMedical - Care Facilities
Share Statistics
EPS (TTM)6.33
Shares Outstanding58,445,400
10 Day Avg. Volume638,538
30 Day Avg. Volume486,504
Financial Highlights & Ratios
PEG Ratio2.06
Price to Book (P/B)4.47
Price to Sales (P/S)1.97
P/FCF Ratio26.93
Enterprise Value/Market Cap1.16
Enterprise Value/Revenue2.30
Enterprise Value/Gross Profit16.50
Enterprise Value/Ebitda20.40
Forecast
1Y Price Target
$218.50Price Target Upside9.19% Upside
Rating ConsensusModerate Buy
Number of Analyst Covering3
EPS Forecast (FY)7.52
Revenue Forecast (FY)$5.79B
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 ...
How the Company Makes Money
ENSG makes money primarily by operating post-acute care facilities and being paid for the healthcare and custodial services delivered to patients and residents. The core revenue stream is patient/resident service revenue generated at its skilled n...
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
Positive
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
Income Statement
78
Positive
Balance Sheet
70
Positive
Cash Flow
73
Positive
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 5.27B | 5.06B | 4.26B | 3.73B | 3.03B | 2.63B |
| Gross Profit | 734.87M | 799.45M | 667.59M | 590.76M | 517.99M | 468.21M |
| EBITDA | 594.44M | 567.94M | 478.52M | 353.24M | 360.38M | 320.84M |
| Net Income | 363.36M | 343.97M | 297.97M | 209.40M | 224.68M | 194.65M |
Balance Sheet | ||||||
| Total Assets | 5.61B | 5.46B | 4.67B | 4.18B | 3.45B | 2.85B |
| Cash, Cash Equivalents and Short-Term Investments | 595.17M | 572.39M | 526.85M | 526.86M | 331.71M | 275.96M |
| Total Debt | 2.24B | 4.15B | 1.97B | 1.87B | 1.57B | 1.27B |
| Total Liabilities | 3.24B | 3.23B | 2.83B | 2.68B | 2.20B | 1.83B |
| Stockholders Equity | 2.37B | 2.23B | 1.84B | 1.49B | 1.25B | 1.02B |
Cash Flow | ||||||
| Free Cash Flow | 406.10M | 370.71M | 188.95M | 270.49M | 184.97M | 206.13M |
| Operating Cash Flow | 592.20M | 564.27M | 347.19M | 376.67M | 272.51M | 275.68M |
| Investing Cash Flow | -340.56M | -513.18M | -390.05M | -182.70M | -186.18M | -173.91M |
| Financing Cash Flow | 5.19M | -11.81M | -2.16M | -612.00K | -32.26M | -76.14M |
The Ensign Group Technical Analysis
Negative
200.11
Price Trends
192.87
Negative
192.06
Negative
183.50
Negative
Market Momentum
-4.84
Negative
41.03
Neutral
65.26
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 180.22, above the 50-day MA of 192.87, and above the 200-day MA of 183.50, indicating a bearish trend. The MACD of -4.84 indicates Negative momentum. The RSI at 41.03 is Neutral, neither overbought nor oversold. The STOCH value of 65.26 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
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
76 Outperform | $3.12B | 17.30 | 11.68% | 1.80% | 11.40% | 13.96% | |
74 Outperform | $10.51B | 12.33 | 25.35% | 0.65% | 10.05% | 23.59% | |
69 Neutral | $10.42B | 29.20 | 16.63% | 0.14% | 19.23% | 15.67% | |
67 Neutral | $16.14B | 5.83 | 40.55% | ― | 4.56% | 27.14% | |
64 Neutral | $9.95B | 7.84 | 20.93% | 0.35% | 10.42% | 33.92% | |
53 Neutral | $1.76B | -10.66 | -4.43% | ― | 5.38% | 61.15% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% |
* Healthcare Sector Average
ENSG
The Ensign Group
178.26
32.41
22.22%
EHC
Encompass Health
105.99
-13.07
-10.97%
NHC
National Healthcare
199.51
98.25
97.03%
THC
Tenet Healthcare
187.41
24.58
15.10%
UHS
Universal Health
164.32
-25.08
-13.24%
SGRY
Surgery Partners
13.49
-9.18
-40.49%
The Ensign Group Corporate Events
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.