The Ensign Group (ENSG) AI Stock Analysis

• Market Cap: $9.85B
• Dividend Yield: 0.14%
• Average Volume (3M): 466.41K
• Price to Earnings (P/E): 30.7
• Beta (1Y): 0.38
• Revenue Growth: 17.71%
• EPS Growth: 41.83%
• Country: US
• Employees: 39,300
• Sector: Healthcare
• Sector Strength: 47
• Industry: Medical - Care Facilities
• EPS (TTM): 1.59
• Shares Outstanding: 57,700,157
• 10 Day Avg. Volume: 342,594
• 30 Day Avg. Volume: 466,406
• PEG Ratio: N/A
• Price to Book (P/B): N/A
• Price to Sales (P/S): N/A
• P/FCF Ratio: N/A
• Enterprise Value/Market Cap: 1.08
• Enterprise Value/Revenue: 2.31
• Enterprise Value/Gross Profit: 12.59
• Enterprise Value/Ebitda: 20.45
• 1Y Price Target: $177.67
• Price Target Upside: 3.18% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 6

• Rating: 76 Outperform
• Price Target: $189.00 ▲(9.76% Upside)

The Ensign Group's strong financial performance and positive earnings call are significant strengths, contributing to a robust overall score. However, technical indicators suggest the stock may be overbought, and the high P/E ratio indicates potential overvaluation. These factors moderate the overall score.

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 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 Money

The Ensign Group generates revenue primarily through the provision of skilled nursing and assisted living services. Its revenue model includes billing for patient care services, which are typically reimbursed by government programs such as Medicare and Medicaid, as well as private pay sources. Key revenue streams include daily room rates, therapy services, and ancillary services provided to residents. Additionally, Ensign has a strategy of acquiring and managing underperforming healthcare facilities, which allows it to improve operational efficiency and increase profitability over time. The company also benefits from partnerships with healthcare providers and payers, enhancing its service offerings and revenue potential.

The Ensign Group Financial Statement Overview

Summary

The Ensign Group exhibits commendable financial health with strong revenue and profit growth, efficient cash management, and moderate leverage. The main area of focus should be optimizing the balance between debt and equity to further enhance financial stability.

Income Statement

The Ensign Group demonstrates strong revenue growth with a 9.1% increase in revenue over the TTM (Trailing-Twelve-Months) period. Gross profit margin improved to 17.1%, indicative of solid operational efficiency. Net profit margin increased to 7.0%, showing enhanced profitability. The EBIT and EBITDA margins are healthy at 8.6% and 11.2% respectively, reflecting effective cost management and earnings capability.

Balance Sheet

The company's balance sheet is robust with a debt-to-equity ratio of 0.94, indicating moderate leverage. Return on equity stands at 16.0%, showcasing effective utilization of shareholders' equity. The equity ratio of 40.9% suggests a stable asset base financed by equity, although there is room to reduce debt levels further.

Cash Flow

Free cash flow growth rate is strong at 46.5% over the last year, underpinning solid cash generation capability. The operating cash flow to net income ratio is 1.43, indicating efficient cash conversion. The free cash flow to net income ratio is 0.86, reflecting a healthy cash flow position relative to profits.

Breakdown	TTM	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020
Income Statement
Total Revenue	4.61B	4.26B	3.73B	3.03B	2.63B	2.40B
Gross Profit	847.08M	883.60M	590.76M	517.99M	468.21M	407.47M
EBITDA	521.53M	461.46M	353.24M	360.38M	320.84M	281.54M
Net Income	322.80M	297.97M	209.40M	224.68M	194.65M	170.48M
Balance Sheet
Total Assets	4.93B	4.67B	4.18B	3.45B	2.85B	2.55B
Cash, Cash Equivalents and Short-Term Investments	418.44M	526.85M	526.86M	331.71M	275.96M	250.01M
Total Debt	2.04B	1.97B	1.87B	1.57B	1.27B	1.11B
Total Liabilities	2.91B	2.83B	2.68B	2.20B	1.83B	1.73B
Stockholders Equity	2.02B	1.84B	1.49B	1.25B	1.02B	818.08M
Cash Flow
Free Cash Flow	276.76M	188.95M	270.49M	184.97M	206.13M	323.02M
Operating Cash Flow	462.89M	347.19M	376.67M	272.51M	275.68M	373.35M
Investing Cash Flow	-557.41M	-390.05M	-182.70M	-186.18M	-173.91M	-58.67M
Financing Cash Flow	-18.84M	-2.16M	-612.00K	-32.26M	-76.14M	-137.30M

The Ensign Group Technical Analysis

• Technical Analysis Sentiment: Positive
• Last Price: 172.19
• 50DMA: Positive
• 100DMA: Positive
• 200DMA: Positive
• MACD: Negative
• RSI: Negative
• STOCH: Neutral

Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For ENSG, the sentiment is Positive. The current price of 172.19 is above the 20-day moving average (MA) of 163.55, above the 50-day MA of 153.72, and above the 200-day MA of 141.00, indicating a bullish trend. The MACD of 5.80 indicates Negative momentum. The RSI at 73.24 is Negative, neither overbought nor oversold. The STOCH value of 76.02 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for ENSG.

The Ensign Group Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
UHS	78 Outperform	$11.54B	9.69	18.66%	0.44%	9.61%	39.65%
ENSG	76 Outperform	$9.85B	30.68	17.57%	0.14%	17.71%	41.83%
THC	75 Outperform	$15.91B	11.53	41.09%	―	-1.09%	-43.10%
EHC	73 Outperform	$12.28B	23.84	25.35%	0.55%	11.80%	30.02%
SEM	71 Outperform	$1.59B	12.03	8.15%	1.95%	-16.10%	-48.97%
NHC	69 Neutral	$1.73B	16.69	10.65%	2.21%	25.19%	13.44%
Sector *	51 Neutral	$7.83B	-0.18	-40.10%	2.29%	21.46%	-2.03%

The Ensign Group Corporate Events

The Ensign Group Announces Leadership Transition Plans

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.