The Ensign Group, Inc. ENSG

Health CareHealthcare Providers & ServicesUnited States of America

Last close 179.06 USD on Nov 2, 2026, +2.9% year to date

Quant rating

Quant rating A Rank 36 of 565 in Health Care

Growth B 129 of 565
Valuation A 63 of 565
Quality A 25 of 565
Revisions B 92 of 565
Momentum C 247 of 565

Wall Street consensus Buy (1.83)Average target 223.46 USD +24.8%

Historical valuation

Multiples use consensus estimates for the next twelve months. The dashed line is the 5-year average.

Key data

Market cap: 10.4B
Enterprise value: 10.3B
52-week range: 142.01 – 216.85
3-year range: 98.83 – 216.85
Dividend yield: 0.14%
Beta (5 years): 0.65
Shares outstanding: 58.3M
Next earnings: Feb 2, 2027

About the company

The Ensign Group, Inc.'s independent operating subsidiaries provide a broad spectrum of skilled nursing and senior living services, physical, occupational and speech therapies and other rehabilitative and healthcare services at approximately 418 healthcare facilities in Alabama, Alaska, Arizona, California, Colorado, Florida, Idaho, Iowa, Kansas, Nebraska, Nevada, Oregon, South Carolina, Tennessee, Texas, Utah, Washington and Wisconsin. The Company's healthcare facilities include over 50 senior living operations across 18 states. The Company's segments include skilled services and Standard Bearer. The skilled services segment includes the operation of skilled nursing facilities and rehabilitation therapy services. The Standard Bearer segment consists of selected real estate properties owned by Standard Bearer and leased to skilled nursing and senior living operators. The Company's subsidiaries, including Standard Bearer, own approximately 189 real estate assets.

Growth and profitability fiscal year ends December 31

Growth and profitability by fiscal year
	2025	2024	2023	2022	2021	5Y avg
Revenue (mil)	5,058	4,260	3,729	3,025	2,627	–
Revenue growth	18.7%	14.2%	23.3%	15.1%	9.4%	16.1%
EPS (basic, normalized)	6.57	5.50	4.77	4.14	3.64	–
EPS growth	19.5%	15.3%	15.2%	13.7%	–	–
Gross margin	21.1%	21.4%	21.7%	22.7%	23.7%	22.1%
Net margin	6.8%	7.0%	5.6%	7.4%	7.4%	6.8%
ROE	16.9%	17.9%	15.3%	19.8%	21.2%	18.2%

Balance sheet, last quarter
Cash & short-term investments (mil)	392
Current ratio	1.20x
Long-term debt (mil)	195
Net debt (mil)	−189
Total equity (mil)	2,559
Net debt / equity	−0.07x
Net debt / EBITDA	−0.31x

Estimates and valuation

Consensus estimates and implied multiples
	Sales (mil)			EBITDA (mil)			EPS
Fiscal year	Mean est.	Growth	EV/Sales	Mean est.	Growth	EV/EBITDA	Mean est.	Growth	P/E
2025 actual	5,058	+18.7%	2.0x	602	+24.6%	17.0x	6.57	+19.5%	27.3x
2026	5,906	+16.8%	1.7x	743	+23.3%	13.8x	7.93	+20.7%	22.6x
2027	6,626	+12.2%	1.5x	824	+10.9%	12.5x	8.70	+9.7%	20.6x
2028	7,236	+9.2%	1.4x	896	+8.8%	11.5x	9.57	+10.0%	18.7x

Estimate revisions

Change in consensus estimates over 1, 3 and 6 months
	Sales				EPS
Fiscal year	Estimate (mil)	1M	3M	6M	Estimate	1M	3M	6M
2026	5,906	0.0%	0.0%	+1.1%	7.93	+1.8%	+1.8%	+4.9%
2027	6,626	+1.9%	+1.9%	+3.0%	8.70	+1.8%	+1.8%	+4.5%
2028	7,236	+2.1%	+2.0%	+2.8%	9.57	+2.1%	+2.3%	+4.9%

Earnings surprises EPS beat in 4 of the last 4 quarters

Reported results versus consensus, last 10 fiscal quarters
Quarter ended	Mar 2024	Jun 2024	Sep 2024	Dec 2024	Mar 2025	Jun 2025	Sep 2025	Dec 2025	Mar 2026	Jun 2026
Sales reported (mil)	1,010	1,036	1,082	1,132	1,173	1,228	1,296	1,361	1,389	1,440
Sales mean (mil)	1,004	1,021	1,070	1,129	1,172	1,220	1,280	1,358	1,396	1,441
Surprise	+0.6%	+1.5%	+1.1%	+0.3%	+0.1%	+0.7%	+1.3%	+0.2%	−0.5%	−0.1%
EPS reported	1.30	1.32	1.39	1.49	1.52	1.59	1.64	1.82	1.85	1.92
EPS mean	1.28	1.30	1.38	1.48	1.49	1.55	1.61	1.77	1.82	1.84
Surprise	+1.2%	+1.3%	+0.9%	+0.7%	+2.0%	+2.5%	+2.1%	+3.0%	+1.8%	+4.2%

Peer comparison Healthcare Providers & Services

Peers in the same industry group, by market capitalization
Company	Market cap	Net debt/EBITDA	Net margin	P/B	FY1 P/E	FY2 P/E	FY1 EV/EBITDA	FY2 EV/EBITDA
ENSG The Ensign Group, Inc.	10.4B	−0.31x	6.8%	4.08x	22.6x	20.6x	13.8x	12.5x
UNH UnitedHealth Group Incorporated	359.4B	–	2.7%	3.45x	19.4x	17.1x	13.1x	11.9x
CVS CVS Health Corporation	113.2B	2.50x	0.4%	1.42x	11.0x	10.4x	8.3x	7.9x
HCA HCA Healthcare, Inc.	97.7B	3.41x	9.0%	−12.21x	15.6x	14.9x	9.5x	9.4x
ELV Elevance Health Inc	89.4B	–	2.8%	2.00x	14.2x	13.7x	10.0x	10.3x
CI The Cigna Group	78.0B	2.49x	2.2%	1.83x	9.7x	8.8x	7.7x	7.2x
Mean		2.02x	4.0%	0.09x	15.4x	14.2x	10.4x	9.9x
Median		2.50x	2.8%	1.91x	14.9x	14.3x	9.7x	9.8x

Technical analysis

1M+4.2%
3M+0.5%
1Y−0.4%
3Y+82.1%

Financial statements in millions of USD

Income statement in millions of USD, fiscal years

Income statement, The Ensign Group, Inc., fiscal years, most recent first
	2025	2024	2023	2022	2021	2020
Total revenue	5,058	4,260	3,729	3,025	2,627	2,403
Cost of revenue	3,992	3,351	2,921	2,337	2,006	1,852
Gross profit	1,066	910	809	688	622	550
Selling, general & administrative expenses	536	465	481	329	305	272
Research & development	–	–	–	–	–	–
Depreciation/amortization	104	84.1	72.4	62.4	56.0	54.6
Interest expense (income), operating	–	–	–	–	–	–
Unusual expense (income)	–	1.8	–	–	–	0
Other operating expenses	0	0	0	0	0	0
Operating income	425	358	255	297	260	223
Net interest income (expense)	16.5	20.5	−8.1	−8.9	−6.8	−5.5
Gain (loss) on sale of assets	–	–	–	–	–	–
Other non-operating income (expense)	13.8	7.3	25.5	1.2	4.4	0
Net income before taxes	456	386	273	289	258	218
Provision for taxes	111	87.6	62.9	64.4	60.3	46.2
Minority interest	−0.3	−0.5	−0.5	0	−3.1	−0.9
Equity in affiliates	–	–	–	–	–	–
U.S. GAAP adjustment	–	–	–	–	–	–
Net income before extraordinary items	344	298	209	225	195	170
Extraordinary items	–	–	–	–	0	0
Net income	344	298	209	225	195	170
EBIT, normalized	437	363	317	298	265	224
EBITDA, normalized	542	447	389	361	321	279
Basic EPS, normalized	6.57	5.50	4.77	4.14	3.64	–

Balance sheet in millions of USD, fiscal years

Balance sheet, The Ensign Group, Inc., fiscal years, most recent first
	2025	2024	2023	2022	2021	2020
Assets
Cash & short-term investments	572	527	527	332	276	250
Receivables	637	570	485	408	329	305
Total inventory	–	–	–	–	–	–
Prepaid expenses	62.9	60.9	35.0	41.0	35.0	27.9
Other current assets	0	0	0	0	0	0
Total current assets	1,272	1,158	1,047	781	640	583
Property, plant & equipment	3,795	3,152	2,847	2,443	2,027	1,804
Goodwill	98.0	98.0	76.9	76.9	60.5	54.5
Intangibles	6.4	7.3	6.5	6.4	6.4	6.6
Long-term investments	167	141	92.7	67.7	36.6	32.1
Note receivable	–	–	–	–	–	–
Other long-term assets	125	113	107	76.9	80.2	65.7
Total assets	5,463	4,669	4,178	3,452	2,851	2,546
Liabilities
Accounts payable	97.3	98.9	92.8	77.1	58.1	50.9
Payable/accrued	–	–	–	–	–	–
Accrued expenses	788	618	624	488	449	393
Short-term debt	0	0	0	0	0	0
Current portion of long-term debt	4.2	4.1	4.0	3.9	3.8	3.0
Other current liabilities	4.6	22.4	14.2	12.9	12.4	115
Total current liabilities	894	743	735	582	523	562
Long-term debt	138	142	145	149	153	113
Minority interest	3.1	3.3	5.5	1.5	0.9	0.1
Other liabilities	2,196	1,944	1,800	1,472	1,153	1,052
Total liabilities	3,231	2,832	2,686	2,205	1,830	1,728
Shareholders' equity
Preferred stock	–	–	–	–	–	–
Common stock	0.1	0.1	0.1	0.1	0.1	0.1
Additional paid-in capital	615	528	466	416	370	338
Retained earnings (accumulated deficit)	1,756	1,427	1,143	946	734	551
Treasury stock	−139	−118	−117	−115	−83.0	−71.2
Other equity	0	0	0	0	0	0
Total equity	2,232	1,837	1,492	1,247	1,021	818
Total liabilities & shareholders' equity	5,463	4,669	4,178	3,452	2,851	2,546

Cash flow statement in millions of USD, fiscal years

Cash flow statement, The Ensign Group, Inc., fiscal years, most recent first
	2025	2024	2023	2022	2021	2020
Operating activities
Net income	344	298	210	225	198	171
Depreciation, depletion & amortization	104	84.1	72.4	62.4	56.0	54.6
Deferred taxes	−16.9	0.6	−27.5	−6.5	−0.7	−27.8
Non-cash items	36.3	24.3	67.9	21.3	11.7	26.2
Changes in working capital	96.3	−60.3	54.0	−29.3	11.0	149
Cash from operations	564	347	377	273	276	373
Investing activities
Capital expenditures	−194	−158	−174	−172	−168	−75.3
Other investing cash flows	−320	−232	−8.7	−13.9	−6.1	16.7
Cash from investing	−513	−390	−183	−186	−174	−58.7
Financing activities
Financing cash flow items	−2.4	−6.8	−2.2	−5.9	−106	98.4
Cash dividends paid	−14.4	−13.7	−12.9	−12.2	−11.5	−10.8
Issuance (retirement) of debt, net	–	–	–	–	–	–
Other financing cash flows	5.0	18.3	14.5	−14.2	41.2	−225
Cash from financing	−11.8	−2.2	−0.6	−32.3	−76.1	−137
Foreign exchange effects	–	–	–	–	–	–
Net change in cash	39.3	−45.0	193	54.1	25.6	177
Free cash flow	371	189	203	100	108	298

Disclaimer

The financial data presented in this report is delayed and obtained from sources QDD Research believes to be reliable, including stock exchanges, SEDAR, and EDGAR. However, no representation or warranty is made as to the accuracy, completeness, or timeliness of the information. QDD Research accepts no liability for any errors, omissions, or financial losses arising from the use of this data.

This report is generated using a fully systematic and quantitative approach. All factor scores and the overall quant rating (ranging from D to A+) are derived from algorithmic models and are based solely on objective financial metrics. These scores are intended for informational purposes only and should not be interpreted as investment advice or a recommendation to buy, sell, or hold any securities.

QDD Research is not a registered investment advisor or broker-dealer and does not provide personalized financial advice. The content is not tailored to the specific investment goals, financial situation, or risk profile of any individual investor. We strongly encourage readers to consult with a licensed broker or investment advisor before making any investment decisions based on the information contained in this report.

Live quote provided by TradingView. Report data updated Nov 2, 2026 after market close.