The Ensign Group (ENSG)
NASDAQ:ENSG
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The Ensign Group
(NASDAQ:ENSG)
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Rating:74Outperform
Price Target:
$221.00
▲(10.14% Upside)
Action:ReiteratedDate:02/06/26
The score is driven primarily by solid underlying financial performance (multi-year growth and a strong 2025 cash flow rebound) and a very positive earnings-call outlook with upbeat 2026 guidance. Technicals are supportive with price above major moving averages, though elevated RSI suggests the stock may be stretched short-term. Valuation is the main constraint given the higher P/E and minimal dividend yield.
Positive Factors
Sustained Revenue & Earnings Growth
Multi-year top-line and profit expansion demonstrates scalable core operations and durable demand for post-acute services. Consistent revenue and EPS growth indicates improving payer mix, referral traction and operational leverage that can sustain earnings over the next 2–6 months and beyond.
Negative Factors
Elevated Leverage
Material absolute debt and moderate leverage leave less cushion against reimbursement shocks or cyclical occupancy declines. Higher interest or refinancing needs could constrain capital allocation, making the balance sheet more sensitive to operational setbacks over the medium term.
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Positive Factors
Negative Factors
Sustained Revenue & Earnings Growth
Multi-year top-line and profit expansion demonstrates scalable core operations and durable demand for post-acute services. Consistent revenue and EPS growth indicates improving payer mix, referral traction and operational leverage that can sustain earnings over the next 2–6 months and beyond.
Read all positive factors
The Ensign Group (ENSG) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$11.66B
Dividend Yield0.14%
Average Volume (3M)350.77K
Price to Earnings (P/E)29.0
Beta (1Y)0.27
Revenue Growth18.61%
EPS Growth35.76%
CountryUS
Employees39,300
SectorHealthcare
Sector Strength45
IndustryMedical - Care Facilities
Share Statistics
EPS (TTM)1.82
Shares Outstanding58,112,780
10 Day Avg. Volume373,454
30 Day Avg. Volume350,771
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 Cap1.31
Enterprise Value/Revenue3.03
Enterprise Value/Gross Profit22.03
Enterprise Value/Ebitda26.96
Forecast
1Y Price Target
$222.33Price Target Upside10.80% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering4
EPS Forecast (FY)7.48
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
The Ensign Group generates revenue primarily through the provision of skilled nursing and assisted living services, billing government programs such as Medicare and Medicaid, as well as private pay sources. A significant portion of its revenue com...
The Ensign Group Earnings Call Summary
Earnings Call Date:Feb 04, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:Apr 23, 2026
Earnings Call Sentiment Positive
The call communicates a strongly positive performance profile: record quarterly and annual financial results, multi-year high growth rates, improving occupancy and skilled mix, robust liquidity and disciplined but active M&A and real estate expansion. Management acknowledges manageable headwinds — higher acquisition valuations, construction and CapEx needs, regulatory/reimbursement variability and remaining pockets of lower occupancy — but presents concrete operational progress (quality metrics, turnover reduction, specialty program wins) and ample capital to pursue opportunities. Overall, the positives — driven by double-digit revenue and earnings growth, strong cash flow, low leverage and demonstrated acquisition and transition capability — substantially outweigh the noted challenges.Positive Updates
Record Financial Performance (FY2025 and Q4)
FY2025 consolidated revenue $5.1B (+18.7% YoY); GAAP diluted EPS $5.84 (+14.1% YoY); adjusted diluted EPS $6.57 (+19.5% YoY); GAAP net income $344M (+15.4% YoY); adjusted net income $386.6M (+20.6% YoY). Q4 consolidated revenue $1.4B (+20.2% YoY); Q4 GAAP diluted EPS $1.61 (+18.4% YoY); Q4 adjusted diluted EPS $1.82 (+22.1% YoY); Q4 GAAP net income $95.5M (+19.8% YoY); Q4 adjusted net income $107.8M (+23.2% YoY).
Negative Updates
Rising M&A Valuations and Increased Acquisition Cost
Management noted a seller-friendly market with rising valuations. Higher-priced, newer assets may command premiums and certain deals require longer ramps; older assets can require heavy CapEx to modernize, increasing total acquisition cost and potentially extending payback periods.
Read all updates
Q4-2025 Updates
Positive
Negative
Record Financial Performance (FY2025 and Q4)
FY2025 consolidated revenue $5.1B (+18.7% YoY); GAAP diluted EPS $5.84 (+14.1% YoY); adjusted diluted EPS $6.57 (+19.5% YoY); GAAP net income $344M (+15.4% YoY); adjusted net income $386.6M (+20.6% YoY). Q4 consolidated revenue $1.4B (+20.2% YoY); Q4 GAAP diluted EPS $1.61 (+18.4% YoY); Q4 adjusted diluted EPS $1.82 (+22.1% YoY); Q4 GAAP net income $95.5M (+19.8% YoY); Q4 adjusted net income $107.8M (+23.2% YoY).
Read all positive updates
Company Guidance
Ensign guided 2026 diluted EPS of $7.41–$7.61 and revenue of $5.77B–$5.84B (midpoint +14.3% vs 2025 and +36.5% vs 2024), based on ~60 million diluted weighted shares, a 25% tax rate, and the inclusion of acquisitions closed/expected in Q1 while excluding stock‑based compensation and system implementation amortization; management noted this guidance reflects ongoing gains in occupancy, skilled mix and labor trends but remains subject to reimbursement, state budget, seasonality and acquisition timing risks. For context, 2025 results included GAAP EPS $5.84 (+14.1%), adjusted EPS $6.57 (+19.5%), consolidated revenue $5.1B (+18.7%), GAAP net income $344M (+15.4%) and adjusted net income $386.6M (+20.6%); Q4 results were GAAP EPS $1.61, adjusted EPS $1.82, Q4 revenue $1.4B and adjusted net income $107.8M. Balance‑sheet metrics cited to support the outlook included cash $504M, cash flow from operations $564M, >$590M available on the line of credit (over $1B total liquidity), lease‑adjusted net debt/EBITDA of 1.77x and >$500M invested in 2025.The Ensign Group Financial Statement Overview
Summary
Income Statement
78
Positive
Balance Sheet
66
Positive
Cash Flow
72
Positive
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 5.06B | 4.26B | 3.73B | 3.03B | 2.63B |
| Gross Profit | 695.13M | 667.59M | 590.76M | 517.99M | 468.21M |
| EBITDA | 567.94M | 478.52M | 353.24M | 360.38M | 320.84M |
| Net Income | 343.97M | 297.97M | 209.40M | 224.68M | 194.65M |
Balance Sheet | |||||
| Total Assets | 5.46B | 4.67B | 4.18B | 3.45B | 2.85B |
| Cash, Cash Equivalents and Short-Term Investments | 572.39M | 526.85M | 526.86M | 331.71M | 275.96M |
| Total Debt | 4.15B | 1.97B | 1.87B | 1.57B | 1.27B |
| Total Liabilities | 3.23B | 2.83B | 2.68B | 2.20B | 1.83B |
| Stockholders Equity | 2.23B | 1.84B | 1.49B | 1.25B | 1.02B |
Cash Flow | |||||
| Free Cash Flow | 370.71M | 188.95M | 270.49M | 184.97M | 206.13M |
| Operating Cash Flow | 564.27M | 347.19M | 376.67M | 272.51M | 275.68M |
| Investing Cash Flow | -513.18M | -390.05M | -182.70M | -186.18M | -173.91M |
| Financing Cash Flow | -11.81M | -2.16M | -612.00K | -32.26M | -76.14M |
The Ensign Group Technical Analysis
Neutral
200.66
Price Trends
198.77
Positive
188.88
Positive
176.07
Positive
Market Momentum
-0.18
Positive
43.21
Neutral
26.56
Neutral
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 200.66 is below the 20-day moving average (MA) of 207.15, above the 50-day MA of 198.77, and above the 200-day MA of 176.07, indicating a neutral trend. The MACD of -0.18 indicates Positive momentum. The RSI at 43.21 is Neutral, neither overbought nor oversold. The STOCH value of 26.56 is Neutral, 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 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 |
|---|---|---|---|---|---|---|---|
78 Outperform | $2.50B | 17.67 | 11.57% | 1.80% | 23.74% | -18.99% | |
74 Outperform | $11.66B | 29.02 | 16.58% | 0.14% | 18.61% | 35.76% | |
70 Outperform | $9.70B | 18.84 | 24.48% | 0.65% | 11.13% | 27.53% | |
69 Neutral | $16.68B | 12.83 | 34.82% | ― | -0.56% | -53.50% | |
66 Neutral | $11.24B | 9.31 | 21.03% | 0.35% | 10.21% | 39.58% | |
56 Neutral | $1.49B | -25.23 | -4.50% | ― | 10.14% | -182.12% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% |
* Healthcare Sector Average
ENSG
The Ensign Group
200.66
71.36
55.19%
EHC
Encompass Health
97.57
-3.07
-3.05%
NHC
National Healthcare
161.03
69.26
75.47%
THC
Tenet Healthcare
191.86
57.36
42.65%
UHS
Universal Health
184.04
-3.12
-1.67%
SGRY
Surgery Partners
11.49
-12.26
-51.62%
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.