olivLaw · US equity research
The Ensign Group, Inc. ENSG
Services-Skilled Nursing Care Facilities · SIC 8051 · Vertical: Health services (SIC 805x)
The Ensign Group is a post-acute care company that operates through independent subsidiaries in 17 states, focused on skilled nursing and senior living services. It matters now because it is in a growth phase through acquisitions, with second quarter 2026 consolidated revenue of $1.44 billion and raised annual guidance.
The AI analysis may be outdated: new filings came after its sources (see the «AI analysis» section).
At the close of 04 Nov 2026, The Ensign Group, Inc. (ENSG) stock was 188.31 USD (+3.35% on the day), with market capitalisation 11.0 bn USD, P/E 28.0 on diluted EPS of 6.72 USD over the last 12 months, dividend yield 0.14%, beta 0.29, 52-week range 147.13–215.83 USD. Latest reported quarter (Q3 2026): revenue of 1.5 bn USD (+14.5% YoY), net income of 104.3 m USD (+24.4% YoY), diluted EPS 1.76 USD.
Data as of · AI analysis dated · Source: SEC filings and closing prices, computed by olivLaw.
Price history
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Technical reading
- RSI (14)
- 61.6
- strong (55–70)
- Bollinger (20, 2)
- 167.38 – 187.16
- above the upper band · %B 1.06 · band width 11.2%
- SMA 50 / 200
- 175.02 / 181.68
- mixed trend
- MACD (12, 26, 9)
- 2.56 / 1.47
- MACD above signal
Indicators describe past prices; on their own they do not predict direction. On our history the RSI ≤ 40 filter added no return (see the signals methodology).
Performance
| Company | S&P 500 | vs S&P 500 | Vertical median | |
|---|---|---|---|---|
| 1 month | +8.9% | −1.1% | +10.0 pp | — |
| 3 months | +5.4% | −0.5% | +5.9 pp | — |
| 6 months | +7.0% | +4.4% | +2.6 pp | — |
| Year to date | +8.1% | +12.3% | −4.2 pp | — |
| 1 year | +2.4% | +13.5% | −11.2 pp | +41.3% |
| 3 years | +84.6% | +76.4% | +8.2 pp | +175.4% |
| 5 years | +126.5% | +63.7% | +62.9 pp | — |
Price returns, dividends excluded.
Quarterly results
Latest quarter: Q3 2026 · 30 Sept 2026
Quarterly margins
Quarterly statements · USD
| Fiscal year | Q4 '24 | Q1 '25 | Q2 '25 | Q3 '25 | Q4 '25 | Q1 '26 | Q2 '26 | Q3 '26 |
|---|---|---|---|---|---|---|---|---|
| Revenue | 1.1 bn | 1.2 bn | 1.2 bn | 1.3 bn | 1.4 bn | 1.4 bn | 1.4 bn | 1.5 bn |
| Cost of revenue | 897.3 m | 927.8 m | 971.8 m | 1.0 bn | 1.1 bn | 1.1 bn | 1.1 bn | 1.2 bn |
| Operating income | 100.8 m | 101.4 m | 103.9 m | 96.2 m | 123.8 m | 124.9 m | 122.5 m | 138.0 m |
| Depreciation & amortisation | 22.5 m | 24.2 m | 25.8 m | 26.6 m | 27.7 m | 28.8 m | 31.4 m | 32.6 m |
| Interest expense | 2.3 m | 2.0 m | 2.0 m | 2.0 m | 2.0 m | 1.9 m | 1.9 m | 2.3 m |
| Pre-tax income | 105.8 m | 106.6 m | 112.4 m | 106.6 m | 130.1 m | 128.6 m | 133.7 m | 140.2 m |
| Income tax | 26.0 m | 26.2 m | 27.9 m | 22.7 m | 34.6 m | 28.8 m | 33.8 m | 35.8 m |
| Net income | 79.7 m | 80.3 m | 84.4 m | 83.8 m | 95.5 m | 99.7 m | 99.7 m | 104.3 m |
| Diluted EPS | 1.36 ≈ | 1.37 | 1.44 | 1.42 | 1.61 ≈ | 1.67 | 1.68 | 1.76 |
| Operating cash flow | 100.5 m | 72.2 m | 155.7 m ≈ | 153.0 m ≈ | 183.3 m | 100.2 m | 172.0 m ≈ | 240.2 m ≈ |
| Dividends paid | 3.4 m | 3.6 m | 3.6 m ≈ | 3.6 m ≈ | 3.6 m | 3.8 m | 3.8 m ≈ | 3.8 m ≈ |
| Share repurchases | 0 | 10.8 m | 9.2 m ≈ | 0 ≈ | 0 | 0 | 40.0 m ≈ | 7.4 m ≈ |
≈ derived quarter (cumulative difference / share-days average)
E/P over time
E/P = trailing-12-month diluted EPS / price at quarter end. E/P is the inverse of P/E and stays defined when earnings are negative.
Today's P/E sits at the 78 percentile of its own 40-quarter history (min 17.0, median 24.5, max 34.8; quarters with earnings only).
Fiscal years
| Fiscal year | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|---|---|---|
| Revenue | 1.8 bn | 2.0 bn | 2.4 bn | 2.6 bn | 3.0 bn | 3.7 bn | 4.3 bn | 5.1 bn |
| Revenue YoY | +9.8% | +16.1% | +18.0% | +9.4% | +15.1% | +23.3% | +14.2% | +18.7% |
| Net income | 92.4 m | 110.5 m | 170.5 m | 194.7 m | 224.7 m | 209.4 m | 298.0 m | 344.0 m |
| Net income YoY | +128.2% | +19.7% | +54.2% | +14.2% | +15.4% | −6.8% | +42.3% | +15.4% |
| Diluted EPS | 1.70 | 1.97 | 3.06 | 3.42 | 3.95 | 3.65 | 5.12 | 5.84 |
| Diluted EPS YoY | +120.8% | +15.9% | +55.3% | +11.8% | +15.5% | −7.6% | +40.3% | +14.1% |
| net % | 5.3% | 5.4% | 7.1% | 7.4% | 7.4% | 5.6% | 7.0% | 6.8% |
| Free cash flow | 159.4 m | 120.7 m | unavailable | unavailable | unavailable | unavailable | unavailable | unavailable |
Reported results vs expectations
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Balance sheet & financial health
Fiscal year 2025 · 31 Dec 2025
- Cash
- 503.9 m USD
- Financial debt
- 141.8 m USD
- Net debt
- -362.1 m USD
- Equity
- 2.2 bn USD
- Total assets
- 5.5 bn USD
- Debt / equity
- 0.06x
- Current ratio
- 1.42x
- ROE
- 16.9%
- ROA
- 6.8%
- FCF margin
- unavailable
Financial statements (source on every figure)
Revenue and net income (USD)
Margins
Income statement · USD
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Revenue | 2.4 bn | 2.6 bn | 3.0 bn | 3.7 bn | 4.3 bn | 5.1 bn | SEC (XBRL)· 04 Feb 2026verified |
| Cost of revenue | 1.9 bn | 2.0 bn | 2.4 bn | 2.9 bn | 3.4 bn | 4.0 bn | SEC (XBRL)· 04 Feb 2026verified |
| Gross profit | 537.4 m ≈ | 607.6 m ≈ | 671.0 m ≈ | 788.1 m ≈ | 883.6 m ≈ | 1.0 bn ≈ | SEC (XBRL)· 04 Feb 2026derived |
| Operating income | 223.2 m | 260.5 m | 296.8 m | 255.4 m | 358.3 m | 425.3 m | SEC (XBRL)· 04 Feb 2026verified |
| Depreciation & amortisation | 54.6 m | 56.0 m | 62.4 m | 72.4 m | 84.1 m | 104.3 m | SEC (XBRL)· 04 Feb 2026verified |
| EBITDA | 277.7 m ≈ | 316.5 m ≈ | 359.2 m ≈ | 327.8 m ≈ | 442.4 m ≈ | 529.6 m ≈ | SEC (XBRL)· 04 Feb 2026derived |
| Interest expense | 9.4 m | 6.8 m | 8.9 m | 8.1 m | 8.3 m | 8.0 m | SEC (XBRL)· 04 Feb 2026verified |
| Pre-tax income | 217.6 m | 258.0 m | 289.1 m | 272.8 m | 386.1 m | 455.6 m | SEC (XBRL)· 04 Feb 2026verified |
| Income tax | 46.2 m | 60.3 m | 64.4 m | 62.9 m | 87.6 m | 111.4 m | SEC (XBRL)· 04 Feb 2026verified |
| Net income | 170.5 m | 194.7 m | 224.7 m | 209.4 m | 298.0 m | 344.0 m | SEC (XBRL)· 04 Feb 2026verified |
| Diluted EPS | 3.06 | 3.42 | 3.95 | 3.65 | 5.12 | 5.84 | SEC (XBRL)· 04 Feb 2026verified |
| Weighted average diluted shares | 55.8 m | 56.9 m | 56.9 m | 57.3 m | 58.2 m | 58.9 m | SEC (XBRL)· 04 Feb 2026verified |
| Dividend per share | 0.20 | 0.21 | 0.22 | 0.23 | 0.24 | 0.25 | SEC (XBRL)· 04 Feb 2026verified |
≈ computed by olivLaw from the reported lines of the same year: Revenue − Cost of revenue; Operating income + Depreciation & amortisation.
Balance sheet · USD
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Cash | 236.6 m | 262.2 m | 316.3 m | 509.6 m | 464.6 m | 503.9 m | SEC (XBRL)· 04 Feb 2026verified |
| Receivables | 305.1 m | 328.7 m | 408.4 m | 485.0 m | 569.9 m | 637.0 m | SEC (XBRL)· 04 Feb 2026verified |
| Current assets | 583.0 m | 639.7 m | 781.1 m | 1.0 bn | 1.2 bn | 1.3 bn | SEC (XBRL)· 04 Feb 2026verified |
| Property, plant & equipment, net | 778.2 m | 888.4 m | 992.0 m | 1.1 bn | 1.3 bn | 1.7 bn | SEC (XBRL)· 04 Feb 2026verified |
| Goodwill | 54.5 m | 60.5 m | 76.9 m | 76.9 m | 98.0 m | 98.0 m | SEC (XBRL)· 04 Feb 2026verified |
| Intangibles (excl. goodwill) | 2.9 m | 2.7 m | 6.4 m | 6.5 m | 7.3 m | 6.4 m | SEC (XBRL)· 04 Feb 2026verified |
| Total assets | 2.5 bn | 2.9 bn | 3.5 bn | 4.2 bn | 4.7 bn | 5.5 bn | SEC (XBRL)· 04 Feb 2026verified |
| Accounts payable | 50.9 m | 58.1 m | 77.1 m | 92.8 m | 98.9 m | 97.3 m | SEC (XBRL)· 04 Feb 2026verified |
| Short-term debt | 3.0 m | 3.8 m | 3.9 m | 4.0 m | 4.1 m | 4.2 m | SEC (XBRL)· 04 Feb 2026verified |
| Long-term debt | 117.6 m | 152.9 m | 149.3 m | 145.5 m | 141.6 m | 137.5 m | SEC (XBRL)· 04 Feb 2026verified |
| Current liabilities | 562.4 m | 523.1 m | 582.1 m | 734.7 m | 743.4 m | 894.3 m | SEC (XBRL)· 04 Feb 2026verified |
| Total liabilities | 1.7 bn | 1.8 bn | 2.2 bn | 2.7 bn | 2.8 bn | 3.2 bn | SEC (XBRL)· 04 Feb 2026verified |
| Equity | 818.2 m | 1.0 bn | 1.2 bn | 1.5 bn | 1.8 bn | 2.2 bn | SEC (XBRL)· 04 Feb 2026verified |
Cash flow · USD
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Operating cash flow | 373.4 m | 275.7 m | 272.5 m | 376.7 m | 347.2 m | 564.3 m | SEC (XBRL)· 04 Feb 2026verified |
| Investing cash flow | -58.7 m | -173.9 m | -186.2 m | -182.7 m | -390.1 m | -513.2 m | SEC (XBRL)· 04 Feb 2026verified |
| Financing cash flow | -137.3 m | -76.1 m | -32.3 m | -612.0 k | -2.2 m | -11.8 m | SEC (XBRL)· 04 Feb 2026verified |
| Dividends paid | 10.8 m | 11.5 m | 12.2 m | 12.9 m | 13.7 m | 14.4 m | SEC (XBRL)· 04 Feb 2026verified |
| Share repurchases | 25.0 m | 10.1 m | 29.9 m | 0 | 0 | 20.0 m | SEC (XBRL)· 04 Feb 2026verified |
Computed indicators
Growth
Profitability
Returns
Balance sheet
Liquidity
Cash
Efficiency
Market and valuation
1 indicators that do not apply to the sector.
Valuation
olivLaw classification
Score: 63 / 100
A scoring methodology on indicators and valuation, not investment advice.
Closing price
04 Nov 2026Source: olivLaw, closing series
Market cap: 11.0 bn USD
Key indicators
Coverage and freshness
Score by group
- Valuation4
- Returns8
- Quality93
- Balance sheet87
- Growth96
Estimated value range
The combined range = the median of the valid methods' low, central and high values; it is not a probability interval and does not cover every result. Envelope of all methods: 140.26 – 174.22 USD.
Methods computed but outside the aggregate range: Dividend discount (DDM) (a small share of earnings is paid as dividends (capital returns through buybacks): the dividend model does not describe the value and stays outside the aggregate).
Valuation assumptions are editorial choices, not measured; beta is not measured.
Method ranges (USD per share)
— — Mid · ▏ Price
Valuation methods
- DCF (discounted cash flow)unavailable · the input exists, but its latest figure is far older than the latest reported period: not used
- Peers: EV/EBITDAunavailable · not enough peers
- Peers: P/E140.26 – 174.22 (Mid 160.55)3 companies used · median multiple 23.9x · quartiles 20.9x – 25.9xHCSG, NHC, PACS
- Dividend discount (DDM)outside the aggregate3.32 – 4.46 (Mid 3.81)a small share of earnings is paid as dividends (capital returns through buybacks): the dividend model does not describe the value and stays outside the aggregate
Classification (SIC) comparables group by industry code, not by economic activity; the direct group is an editorial selection by activity. Members' multiples are on their own trailing twelve months, at their own latest close.
Assumptions (illustrative, editorial)
- Risk-free rate
- 4.3%
- Equity risk premium
- 5.0%
- Beta (default)
- 1.00
- Cost of equity
- 9.3%
- Terminal growth
- 2.5%
Factor scorecard
Neutral profile · Score 63/100
| Factor | Value | Score | Weight used |
|---|---|---|---|
| ROIC · Quality | 18.0% | 100 (on a fixed band) | 13% |
| Net margin · Quality | 7.0% | 80 (vs peers) | 8% |
| FCF conversion · Quality | unavailable | unavailable | — |
| Revenue CAGR 3Y · Growth | 18.7% | 100 (on a fixed band) | 10% |
| EPS CAGR 3Y · Growth | 13.9% | 93 (on a fixed band) | 10% |
| Net debt / EBITDA · Balance sheet | -0.2x | 100 (on a fixed band) | 13% |
| Interest coverage · Balance sheet | 62.8x | 100 (on a fixed band) | 8% |
| Current ratio · Balance sheet | 1.2x | 33 (on a fixed band) | 5% |
| P/E (TTM) · Valuation | 28.0x | 9 (on a fixed band) | 13% |
| EV/EBITDA · Valuation | 17.2x | 0 (on a fixed band) | 13% |
| FCF yield · Valuation | unavailable | unavailable | — |
| Shareholder yield (distributions) · Returns | 0.6% | 8 (on a fixed band) | 8% |
| Payout ratio (FCF) · Returns | unavailable | unavailable | — |
Factors without a value were dropped; the remaining weights were renormalised.
Score groups
- Balance sheet87/100 · 3/3 factors with a value
- Growth96/100 · 2/2 factors with a value
- Quality93/100 · 2/3 factors with a value
- Returns· partial8/100 · 1/2 factors with a value
- Valuation4/100 · 2/3 factors with a value
A «partial» group is computed from under half of its weight or from one factor: it is not a full assessment of the group.
Memo
ENSIGN GROUP, INC (ENSG). Latest full fiscal year: 2025; data up to 2026-09-30.
Figures computed from the financial statements: revenue 5.1 bn USD in 2025; YoY growth 18.7%; net margin 7.0%; ROE 17.1%; net debt/EBITDA -0.2x.
The estimated value range is 140.26–174.22 USD per share (median of 1 methods, agreement: single method); assumptions are illustrative. Against the central value of 160.55 USD, the price of 188.31 USD leaves a potential of -14.7% (value / price − 1) and a margin of safety of -17.3% (1 − price / value). The range is the median of the methods' low, central and high values, not a probability interval.
olivLaw score 63/100, methodological classification: neutral profile (score, margin of safety and method agreement together; not a judgement of the right price). Groups assessed only in part: returns. Not investment advice.
Text generated deterministically from the figures shown; no language model. Not investment advice.
What supports the thesis
- ROIC: 18.0%
- Net margin: 7.0%
- Revenue CAGR 3Y: 18.7%
- EPS CAGR 3Y: 13.9%
- Net debt / EBITDA: -0.2x
- Interest coverage: 62.8x
What contradicts it
- P/E (TTM): 28.0x
- EV/EBITDA: 17.2x
- Shareholder yield (distributions): 0.6%
- The price is above the estimated value range
Not assessed (insufficient data or a ratio without meaning): FCF conversion, FCF yield, Payout ratio (FCF).
Versus the vertical median
Health services (SIC 805x) · same industry group (3-digit SIC) · compared with 5 companies
Multiples and returns vs the median
Price rebased to 100 (monthly, 5 years)
Companies in the vertical
| Market cap | P/E | ROE | Net margin | Revenue YoY | 1A / 3A | |
|---|---|---|---|---|---|---|
| ENSGEnsign Group, Inc | 11.0 bn | 28.0 | 17.1% | 7.0% | +18.7% | +2% / +85% |
| PACSPACS Group, Inc. | 8.0 bn | 28.0 | 26.6% | 4.9% | +29.3% | +50% / unavailable |
| NHCNational Healthcare Corp | 3.3 bn | 23.9 | 13.1% | 9.0% | +16.1% | +56% / +177% |
| BKDBrookdale Senior Living Inc. | 2.7 bn | — | -362.1% | -4.5% | +2.2% | +1% / +111% |
| HCSGHealthcare Services Group, Inc. | 1.8 bn | 17.9 | 20.4% | 5.6% | +7.1% | +41% / +173% |
| SNDASonida Senior Living, Inc. | 1.8 bn | — | -26.7% | -23.3% | +25.2% | +14% / +282% |
1- and 3-year price returns: for ENSG from daily closes (the same as the performance table), for the other companies from month-end closes.
olivLaw engine forecast
The world engine ran after the company's latest material disclosure. Probabilities are of TOUCHING a level within the horizon (not closing there) and sit next to the random walk (p_rw), the no-information benchmark.
The engine has no published run for this company yet.
Valuation scenarios (editable assumptions)
Illustrative scenarios
Illustrative: not forecasts and without probabilities. Each case is one coherent set of assumptions, computed on today's figures.
Estimated price (USD)
| Estimated price | Bear | Base | Bull |
|---|---|---|---|
| 1 years | 125.30 Total return -33% · Per year -33% | 220.52 Total return 17% · Per year 17% | 330.77 Total return 76% · Per year 76% |
| 3 years | 148.63 Total return -21% · Per year -7% | 291.63 Total return 55% · Per year 16% | 476.32 Total return 154% · Per year 36% |
| 5 years | 176.30 Total return -6% · Per year -1% | 385.68 Total return 106% · Per year 16% | 685.89 Total return 266% · Per year 30% |
- Exit P/E± 72.91
- Net margin± 51.04
- Annual revenue growth± 38.06
- Annual dilution± 4.29
AI analysis
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
Possibly outdated: the newest document it read is from 27 Jul 2026; since then the company filed 8-K (27 Oct 2026 · results), 10-Q (27 Oct 2026).
In brief
The Ensign Group is a post-acute care company that operates through independent subsidiaries in 17 states, focused on skilled nursing and senior living services. It matters now because it is in a growth phase through acquisitions, with second quarter 2026 consolidated revenue of $1.44 billion and raised annual guidance.
SWOT
Strengths
- Local management model with autonomy for subsidiaries and sharing of operating data between leaders, which supports care quality 1.
- Leadership stability and clinical results reported as above the average of its operating states 3.
- Owned real estate through Standard Bearer, providing rental income and a platform for future acquisitions 1.
Weaknesses
- Heavy dependence on Medicare and Medicaid makes revenue sensitive to reimbursement changes 1.
- Recent acquisitions include operations with low occupancy and clinical and operational hurdles that need time to integrate 3.
- The company is a holding company with no direct operating assets, so revenue depends on its independent subsidiaries 1.
Opportunities
- A fragmented sector leaves room for acquisitions and consolidation, including large portfolios and sales by non-profit owners 13.
- Expansion in Texas, its largest market, could strengthen its local position and operating efficiency 2.
- A rising mix of high-acuity patients could improve revenue per bed if the early-2026 trend continues 3.
Threats
- Regulatory changes and reimbursement cuts in public programmes could weigh on revenue and profitability 1.
- Government investigations and sanctions over billing practices could lead to fines and repayment obligations 1.
- A shortage of qualified staff could raise costs and lead to fines if minimum staffing levels are not met 1.
Risks
- Changes to Medicare and Medicaid reimbursementhigh
Rate reductions, or payments rising more slowly than costs, could materially reduce revenue and operating margins 1.
- Government reviews and sanctionshigh
Audits, investigations and billing reviews could lead to refunds, fines or loss of licences 1.
- Acquisition strategymedium
If acquired facilities cannot be integrated on time or are bought at unattractive prices, growth could slow or create unexpected costs 13.
- Labour costsmedium
A shortage of nurses and skilled staff could raise wage costs and affect compliance with staffing rules 1.
- Geographic concentrationlow
Concentration of operations in a limited number of states could expose the company to regional economic downturns, regulatory shifts or natural events 1.
Investment thesis
What would need to be true (bull case)
- Rising quarterly revenue, occupancy and skilled mix in 2026, together with raised guidance, could point to solid operational execution 3.
- If the reported clinical results and staff stability hold, the company could continue to attract patients and referral partners 3.
- The Standard Bearer property portfolio could support funding of future acquisitions, given its estimated fair value 12.
What would break the thesis
- Dependence on government programmes and possible reimbursement cuts could quickly erase operating gains 1.
- Acquisitions of low-occupancy facilities with clinical problems could take more time and capital than expected, which could slow margin improvement 3.
- Regulatory and audit risks could lead to sanctions affecting financial results and reputation 1.
What to watch
- Pace and cost of new acquisitions, especially in TexasQ3 2026
- Trend in Same Facility occupancy and skilled services mixQ3 2026
- Changes to Medicare and Medicaid rules and rates2027
- Delivery against raised annual guidance and the share repurchase programmenext 10-K
Products, market & competition
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
Possibly outdated: the newest document it read is from 27 Jul 2026; since then the company filed 8-K (27 Oct 2026 · results), 10-Q (27 Oct 2026).
The business
The Ensign Group, Inc. is a holding company whose independent subsidiaries provide skilled nursing, senior living and rehabilitative services, along with ancillary businesses including mobile diagnostics and medical transportation, in 17 states 1. As of 31 December 2025 it offered services through 373 skilled nursing and senior living facilities 1. It also acquires and owns healthcare real estate through its captive REIT Standard Bearer, formed in January 2022 1.
The operating model relies on local empowerment: each subsidiary is led locally, and leaders share real-time operating data and best practices with peers 1. Growth has come from acquisitions, organic improvement and operating efficiencies, with 145 facilities acquired from 2021 through 2025 1.
In the quarter ended 30 June 2026, Same Facility and Transitioning Facility occupancy was 84.1% and 84.7%, respectively 3. In the first half of 2026, Standard Bearer added real estate assets of $374.6 million linked to 18 stand-alone skilled nursing operations, three senior living operations and two campus operations 2.
Segments
Skilled Services
This segment covers operation of skilled nursing facilities and rehabilitation therapy. At 31 December 2025 it ran 357 operations with 37,911 operational beds 1. Revenue comes from Medicaid, Medicare, managed care, commercial insurance and private pay, and in 2025 Medicaid accounted for about 46.6% of skilled services revenue 1.
Market context
The US skilled nursing market is large and highly fragmented, with numerous local and regional providers, which the company says creates acquisition and consolidation opportunities 1. Demand is supported by an aging population and a shift of patient care toward lower-cost settings 1.
Company revenue depends heavily on government programs: Medicare and Medicaid together made up a significant share of skilled services revenue in 2025 1. Changes in regulation and reimbursement could quickly alter margins across the sector 1.
Trends
- Ageing population and lower-cost care settingstailwind
A growing senior population and a shift of treatment to skilled nursing facilities, which cost less than hospitals, could support long-term demand 1.
- Consolidation through acquisitionstailwind
Sector fragmentation offers acquisition opportunities, and rising reporting costs imposed by hospitals and insurers could push smaller providers to sell 1.
- Regulatory pressure and reimbursement cutsheadwind
Changes to Medicare and Medicaid, including rate reductions, could weigh on revenue if rates rise more slowly than costs 1.
- Shortage of skilled staffmixed
Competition for nurses and skilled personnel could raise labour costs, although the company presents local leadership stability as an advantage 13.
Competitive position
The sources do not name specific direct competitors. The sector is described as fragmented, with numerous local and regional providers 1. The company benchmarks itself against state and national averages on quality and staffing measures 3.
The company's stated edge lies in clinical results and leadership stability measured against peers in its operating states 3. It also notes that acquiring underperforming assets with low occupancy requires integration effort, and competition for assets in acquisitions is ongoing 3.
- Local and regional skilled nursing providers
The sources describe the market as fragmented across local and regional operators without naming them 1.
- Senior living operators
The company also operates in senior living, where it faces private operators in local markets 1.
- Other healthcare real estate investors
Standard Bearer competes for properties with other investors seeking healthcare assets, per the acquisition context in the sources 2.
- Mobile diagnostic and transport providers
Its ancillary businesses such as mobile diagnostics and transport compete with local providers in these niches 1.
Links, dependencies and risks
Who the company is tied to, from its own SEC filings (customers, suppliers, production, partners, competitors, countries, regulation), from the 5 %+ holders' statements (13D/13G) and from what other companies say about it. Click a node for its evidence; on a listed company the graph moves to it.
Loading the links…
News & filings
In the press
- How Much US Navy Carrier Pilots Earn, From Ensign To CommanderSimple Flying · 09 Oct 2026 · EN
- Short Seller Reports Drag Ensign Group (ENSG) DownYahoo Finance — News · 21 Sept 2026 · EN
The latest news item in our archive is from 09 Oct 2026; the newest SEC filing is from 27 Oct 2026. The press archive comes from the RSS feeds we follow and does not necessarily cover the latest event — the filings alongside do.
SEC filings
- Current report27 Oct 2026Results of operations · Financial statements and exhibits
- Quarterly report27 Oct 2026
- Current report25 Aug 2026Amendments to articles or bylaws · Financial statements and exhibits
- Current report20 Aug 2026Material agreement · Creation of a direct financial obligation · Regulation FD disclosure · Financial statements and exhibits
- Current report27 Jul 2026Results of operations · Financial statements and exhibits
- Quarterly report27 Jul 2026
- Current report15 Jun 2026Other events · Financial statements and exhibits
- Current report10 Jun 2026Other events
- Current report18 May 2026Shareholder vote
- Current report30 Apr 2026Results of operations · Financial statements and exhibits
Sources
- [1] Form 10-K, fiscal year ended 2025-12-31 · SEC / The Ensign Group, Inc. · 04 Feb 2026
- [2] Form 10-Q, quarter ended 2026-06-30 · SEC / The Ensign Group, Inc. · 27 Jul 2026
- [3] Form 8-K, results release (exhibit 99.1) · SEC / The Ensign Group, Inc. · 27 Jul 2026
Figures computed by olivLaw from SEC filings and closing prices; the qualitative analysis is AI-generated from cited sources. Not investment advice.