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The Ensign Group
(NASDAQ:ENSG)
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Rating:71Outperform
Price Target:
$191.00
▲(10.41% Upside)
Action:Upgraded
Date:07/27/26
ENSG scores well primarily on solid financial performance (profitable growth with positive and improving TTM free cash flow) and a notably upbeat earnings update (raised guidance, strong operating metrics, and ample liquidity). The score is tempered by only mixed technical positioning (below the 100/200-day averages) and a higher P/E multiple that reduces valuation attractiveness.
Positive Factors
Revenue & free cash flow growth
Ensign has produced durable topline expansion from 2021–2025 with TTM revenue above 2025 and consistently positive free cash flow. Sustained cash generation supports reinvestment, M&A, buybacks and working capital needs, reducing reliance on external financing over the medium term.
Negative Factors
Leverage volatility and 2025 debt spike
Year-to-year swings in leverage, including a pronounced 2025 spike, indicate financing strategy variability. Persistent volatility in debt levels can raise refinancing and covenant risk, constrain capital allocation in downturns, and reduce resilience to reimbursement or operating shocks.
Read all positive and negative factors
Positive Factors
Negative Factors
Revenue & free cash flow growth
Ensign has produced durable topline expansion from 2021–2025 with TTM revenue above 2025 and consistently positive free cash flow. Sustained cash generation supports reinvestment, M&A, buybacks and working capital needs, reducing reliance on external financing over the medium term.
Read all positive factors
The Ensign Group Key Performance Indicators (KPIs)
Any
Income Before Taxes by Segment
Profitability by business unit before taxes, revealing which segments (for example skilled nursing, assisted living, home health, hospice, or management services) drive margins or generate losses. Highlights where management should allocate capital, which operations are most resilient to downturns, and where reimbursement or regulatory pressure could hit earnings.
Profitability by business unit before taxes, revealing which segments (for example skilled nursing, assisted living, home health, hospice, or management services) drive margins or generate losses. Highlights where management should allocate capital, which operations are most resilient to downturns, and where reimbursement or regulatory pressure could hit earnings.
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The Fly
The FlyThe Ensign Group (ENSG) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$10.59B
Dividend Yield0.14%
Average Volume (3M)891.21K
Price to Earnings (P/E)27.6
Beta (1Y)0.15
Revenue Growth18.89%
EPS Growth15.48%
CountryUS
Employees46,000
SectorHealthcare
Sector Strength45
IndustryMedical - Care Facilities
Share Statistics
EPS (TTM)6.57
Shares Outstanding58,282,433
10 Day Avg. Volume454,074
30 Day Avg. Volume891,208
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 Cap<0.01
Enterprise Value/Revenue<0.01
Enterprise Value/Gross Profit<0.01
Enterprise Value/Ebitda<0.01
Forecast
1Y Price Target
$217.50Price Target Upside25.73% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering4
EPS Forecast (FY)7.75
Revenue Forecast (FY)$5.90B
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:Jul 27, 2026
(Q2-2026)
| Next Earnings Date:Feb 10, 2027
Earnings Call Sentiment Positive
The call emphasized broad operational and financial momentum — double-digit revenue and earnings growth, raised full-year guidance, strong liquidity and demonstrable clinical outperformance across multiple metrics. Management acknowledged near-term integration challenges from recent acquisitions (notably Texas assets), exposure to CMS methodology changes and typical reimbursement/regulatory risks, but portrayed confidence in the leadership-driven transition model and balance sheet capacity to execute. Overall, the positives — durable clinical advantages, robust organic and acquisition-driven growth, tightened leverage and improved occupancy/skilled mix — materially outweigh the cited lowlights.Positive Updates
Strong Financial Performance — Revenue and Earnings Growth
Q2 consolidated GAAP and adjusted revenue: $1.4 billion, up 17.3% year-over-year. GAAP diluted EPS: $1.68, up 16.7%; adjusted diluted EPS: $1.92, up 20.8%. GAAP net income: $99.7 million, up 18.2%; adjusted net income: $114.3 million, up 22.5%.
Negative Updates
Integration and Near-Term Profitability Drag from Recent Acquisitions (Texas Portfolio)
Recent additions (notably higher-priced, newly constructed Texas assets) are generally lower-than-average occupancy and present significant clinical and operational hurdles. Management expects these turnaround assets will take more time and may not be accretive in the near term.
Read all updates
Q2-2026 Updates
Positive
Negative
Strong Financial Performance — Revenue and Earnings Growth
Q2 consolidated GAAP and adjusted revenue: $1.4 billion, up 17.3% year-over-year. GAAP diluted EPS: $1.68, up 16.7%; adjusted diluted EPS: $1.92, up 20.8%. GAAP net income: $99.7 million, up 18.2%; adjusted net income: $114.3 million, up 22.5%.
Read all positive updates
Company Guidance
Ensign raised 2026 guidance to $7.75–$7.85 of diluted EPS (up from $7.48–$7.62) and revenue to $5.87B–$5.92B (up from $5.81B–$5.86B); the midpoint of the EPS range implies an 18.7% increase versus 2025 and a 41.8% increase versus 2024. Management’s guidance assumes ~59.5 million diluted weighted shares, a 25% tax rate, inclusion of acquisitions closed and expected to close in Q3, and management’s reimbursement expectations, while excluding stock‑based compensation and amortization of system implementation costs. Supporting metrics called out on the call include Q2 GAAP diluted EPS of $1.68 (adjusted EPS $1.92), consolidated Q2 revenue of $1.4B (+17.3% y/y), cash of $262.3M, operating cash flow of $272.1M, >$460M invested in H1, lease‑adjusted net debt/EBITDA of 2.0x, and >$592M available on the line of credit (>$850M total liquidity); management noted the guidance already incorporates expected occupancy and skilled‑mix improvements in Q3/Q4 and said better‑than‑baked‑in performance would lead to further upward revisions.The Ensign Group Financial Statement Overview
Summary
Income Statement
78
Positive
Balance Sheet
63
Positive
Cash Flow
70
Positive
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 5.49B | 5.06B | 4.26B | 3.73B | 3.03B | 2.63B |
| Gross Profit | 775.91M | 799.45M | 667.59M | 590.76M | 517.99M | 468.21M |
| EBITDA | 621.28M | 567.94M | 478.52M | 353.24M | 360.38M | 320.84M |
| Net Income | 378.70M | 343.97M | 297.97M | 209.40M | 224.68M | 194.65M |
Balance Sheet | ||||||
| Total Assets | 5.75B | 5.46B | 4.67B | 4.18B | 3.45B | 2.85B |
| Cash, Cash Equivalents and Short-Term Investments | 320.84M | 572.39M | 526.85M | 526.86M | 331.71M | 275.96M |
| Total Debt | 2.25B | 4.15B | 1.97B | 1.87B | 1.57B | 1.27B |
| Total Liabilities | 3.30B | 3.23B | 2.83B | 2.68B | 2.20B | 1.83B |
| Stockholders Equity | 2.44B | 2.23B | 1.84B | 1.49B | 1.25B | 1.02B |
Cash Flow | ||||||
| Free Cash Flow | 419.09M | 370.71M | 188.95M | 270.49M | 184.97M | 206.13M |
| Operating Cash Flow | 608.43M | 564.27M | 347.19M | 376.67M | 272.51M | 275.68M |
| Investing Cash Flow | -680.15M | -513.18M | -390.05M | -182.70M | -186.18M | -173.91M |
| Financing Cash Flow | -29.95M | -11.81M | -2.16M | -612.00K | -32.26M | -76.14M |
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 |
|---|---|---|---|---|---|---|---|
77 Outperform | $12.19B | 19.87 | 23.14% | 0.67% | 9.47% | 19.85% | |
77 Outperform | $3.50B | 24.76 | 12.94% | 1.15% | 7.19% | 32.91% | |
73 Outperform | $21.57B | 10.26 | 50.63% | ― | 5.43% | 65.86% | |
71 Outperform | $10.59B | 27.65 | 16.53% | 0.15% | 18.89% | 15.48% | |
71 Outperform | $10.02B | 6.89 | 20.66% | 0.51% | 10.05% | 28.53% | |
53 Neutral | $1.97B | -21.78 | -5.21% | ― | 3.99% | 51.58% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% |
* Healthcare Sector Average
ENSG
The Ensign Group
181.65
17.83
10.88%
EHC
Encompass Health
123.59
4.23
3.54%
NHC
National Healthcare
223.59
117.66
111.06%
THC
Tenet Healthcare
267.90
96.57
56.36%
UHS
Universal Health
170.02
-6.83
-3.86%
SGRY
Surgery Partners
15.03
-7.46
-33.17%
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.