Business 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.
Business History
Generated: Jun 7, 2026 3:17pmPrice Overview
Last updated: Jun 7, 2026 3:14pm (5d ago)Price History (1 Year)
Revenue & Net Income Trend
| Period | Revenue | Net Income | Net Margin | YoY/QoQ |
|---|
Key Metrics
EPS (Diluted): 6.00
Total Equity: $2.23B
Shares: 58,873,000
Total Debt: $2.09B
Cash: $503.88M
EBITDA: $567.94M
Total Debt: $2.09B
Cash: $503.88M
Revenue: $5.06B
Revenue: $5.06B
Revenue: $5.06B
Total Equity: $2.23B
Tax Rate: 24.4%
Equity: $2.23B
Total Debt: $2.09B
Cash: $503.88M
Current Liabilities: $894.35M
Long-Term Debt: $2.09B
Total Debt: $2.09B
Total Equity: $2.23B
Shares: 58,873,000
Shares: 58,873,000
CapEx: -$193.56M
Shares: 58,873,000
Stock Price: $170.30
Net Income: $343.97M
Industry Benchmarks
Deep Analysis
Pre-flight intelligence scans the company first, then routes to the right analytical methods.
Income Statement (Annual)
Last updated: Jun 7, 2026 3:21pm (5d ago)| Metric | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|
| Revenue | $2.6B | $3.0B | $3.7B | $4.3B | $5.1B |
| Cost of Revenue | $2.2B | $2.5B | $3.1B | $3.6B | $4.3B |
| Gross Profit | $468.2M | $518.0M | $590.8M | $667.6M | $799.5M |
| Operating Expenses | $207.7M | $221.2M | $335.4M | $309.3M | $374.1M |
| Operating Income | $260.5M | $296.8M | $255.4M | $358.3M | $425.3M |
| Net Income | $194.7M | $224.7M | $209.4M | $298.0M | $344.0M |
| EBITDA | $320.8M | $360.4M | $353.2M | $478.5M | $567.9M |
| EPS | $3.57 | $4.09 | $3.76 | $5.26 | $6.00 |
| EPS (Diluted) | — | — | — | — | — |
Balance Sheet (Annual)
Last updated: Jun 7, 2026 3:14pm (5d ago)| Metric | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|
| Cash & Equivalents | $262.2M | $316.3M | $509.6M | $464.6M | $503.9M |
| Total Current Assets | $639.7M | $781.1M | $1.0B | $1.2B | $1.3B |
| Total Assets | $2.9B | $3.5B | $4.2B | $4.7B | $5.5B |
| Current Liabilities | $523.1M | $582.1M | $734.7M | $743.4M | $894.3M |
| Long-Term Debt | $152.9M | $149.3M | $145.5M | $141.6M | $2.1B |
| Total Liabilities | $1.8B | $2.2B | $2.7B | $2.8B | $3.2B |
| Total Equity | $1.0B | $1.2B | $1.5B | $1.8B | $2.2B |
| Retained Earnings | $734.0M | $946.3M | $1.1B | $1.4B | $1.8B |
Cash Flow (Annual)
Last updated: Jun 7, 2026 3:21pm (5d ago)| Metric | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|
| Operating Cash Flow | $275.7M | $272.5M | $376.7M | $347.2M | $564.3M |
| Capital Expenditure | -$69.6M | -$87.5M | -$106.2M | -$158.2M | -$193.6M |
| Free Cash Flow | $206.1M | $185.0M | $270.5M | $188.9M | $370.7M |
| Acquisitions (net) | -$8.0M | -$16.4M | $0 | $0 | $0 |
| Debt Repayment | — | — | — | — | — |
| Dividends Paid | — | — | — | — | — |
| Stock Buybacks | -$11.8M | -$31.6M | -$1.9M | -$1.2M | -$21.4M |
| Net Change in Cash | $25.6M | $54.1M | $193.4M | -$45.0M | $39.3M |
Analyst Estimates (Annual)
Last updated: Jun 7, 2026 3:14pm (5d ago)| Metric | 2025 | 2026 | 2027 | 2028 |
|---|---|---|---|---|
| Revenue |
$5.1B $5.1B – $5.1B
|
$5.8B $5.8B – $5.9B
|
$6.4B $6.4B – $6.5B
|
$7.0B $7.0B – $7.0B
|
| EBITDA |
$567.7M $566.6M – $570.4M
|
$654.8M $653.7M – $657.9M
|
$721.1M $712.1M – $730.2M
|
$789.3M $789.3M – $789.3M
|
| Net Income |
$383.9M $382.7M – $385.1M
|
$446.0M $444.4M – $447.7M
|
$490.1M $476.2M – $504.0M
|
$528.4M $488.4M – $567.2M
|
| EPS | — | — | — | — |
Growth Trends (YoY %)
Last updated: Jun 7, 2026 3:21pm (5d ago)| Metric | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|
| Revenue Growth | +15.1% | +23.3% | +14.2% | +18.7% |
| Gross Profit Growth | +10.6% | +14.0% | +13.0% | +19.8% |
| Operating Income Growth | +14.0% | -14.0% | +40.3% | +18.7% |
| Net Income Growth | +15.4% | -6.8% | +42.3% | +15.4% |
| EBITDA Growth | +12.3% | -2.0% | +35.5% | +18.7% |
Insider Trading (Recent)
Last updated: Jun 7, 2026 3:18pm (5d ago)All SEC Form 4 codes
- P Purchase
- Open-market or private purchase of shares.
- S Sale
- Open-market or private sale of shares.
- A Award / grant
- Grant or award of securities (RSUs, options, etc.) under Rule 16b-3.
- D Return to issuer
- Securities disposed back to the company under Rule 16b-3.
- F In-kind (tax)
- Shares withheld or delivered to pay the option-exercise price or tax — not an open-market sale.
- I Discretionary
- Discretionary transaction under an employee plan — Rule 16b-3(f).
- M Option exercise
- Exercise or conversion of a derivative (option/RSU) into shares — exempt.
- C Conversion
- Conversion of a derivative security into the underlying shares.
- E Short expiration
- Expiration of a short derivative position.
- H Long expiration
- Expiration or cancellation of a long derivative position with value received.
- O OTM exercise
- Exercise of an out-of-the-money derivative.
- X ITM exercise
- Exercise of an in-the-money or at-the-money derivative.
- G Gift
- Bona fide gift of securities.
- L Small acquisition
- Small acquisition under Rule 16a-6.
- W Inheritance
- Acquisition or disposition by will or the laws of descent.
- Z Voting trust
- Deposit into or withdrawal from a voting trust.
- J Other
- Other acquisition or disposition (explained in a Form 4 footnote).
- K Equity swap
- Transaction in an equity swap or similar instrument.
- U Tender / buyout
- Disposition via tender of shares in a change-of-control transaction.
Compensation-plan codes (A, D, F, M) are routine and rarely directional. Open-market P (buy) and S (sale) carry the most signal.
| Date | Insider | Type | Shares | Price | Value |
|---|---|---|---|---|---|
| 2026-06-02 | SMITH BARRY M | S-Sale | 700.00 | $164.28 | $114,996 |
| 2026-05-26 | Burton Spencer | F-InKind | 281.00 | $172.42 | $48,450 |
| 2026-05-27 | Burton Spencer | F-InKind | 264.00 | $171.97 | $45,400 |
| 2026-05-26 | Keetch Chad | F-InKind | 326.00 | $172.42 | $56,209 |
| 2026-05-27 | Keetch Chad | F-InKind | 306.00 | $171.97 | $52,623 |
| 2026-05-26 | Port Barry | F-InKind | 509.00 | $172.42 | $87,762 |
| 2026-05-27 | Port Barry | F-InKind | 509.00 | $171.97 | $87,533 |
| 2026-05-26 | Snapper Suzanne D. | F-InKind | 458.00 | $172.42 | $78,968 |
| 2026-05-27 | Snapper Suzanne D. | F-InKind | 458.00 | $171.97 | $78,762 |
| 2026-05-26 | Wittekind Beverly B. | F-InKind | 123.00 | $172.42 | $21,208 |
| 2026-05-27 | Wittekind Beverly B. | F-InKind | 102.00 | $171.97 | $17,541 |
| 2026-05-15 | Wittekind Beverly B. | F-InKind | 102.00 | $177.67 | $18,122 |
| 2026-05-18 | Wittekind Beverly B. | F-InKind | 102.00 | $176.66 | $18,019 |
| 2026-05-18 | Wittekind Beverly B. | F-InKind | 102.00 | $176.66 | $18,019 |
| 2026-05-18 | Uychiat Pison Marivic | F-InKind | 82.00 | $176.66 | $14,486 |
| 2026-05-18 | Snapper Suzanne D. | F-InKind | 489.00 | $176.66 | $86,387 |
| 2026-05-18 | Port Barry | F-InKind | 550.00 | $176.66 | $97,163 |
| 2026-05-18 | Keetch Chad | F-InKind | 387.00 | $176.66 | $68,367 |
| 2026-05-18 | Burton Spencer | F-InKind | 351.00 | $176.66 | $62,008 |
| 2026-05-04 | SMITH BARRY M | S-Sale | 700.00 | $182.21 | $127,547 |
Dividend History (Last 20)
Last updated: Jun 7, 2026 3:14pm (5d ago)| Date | Dividend | Declaration | Record | Payment |
|---|---|---|---|---|
| 2026-03-31 | $0.07 | 2026-03-20 | 2026-03-31 | 2026-04-30 |
| 2025-12-31 | $0.07 | 2025-12-19 | 2025-12-31 | 2026-01-31 |
| 2025-09-30 | $0.06 | 2025-09-19 | 2025-09-30 | 2025-10-31 |
| 2025-06-30 | $0.06 | 2025-06-19 | 2025-06-30 | 2025-07-31 |
| 2025-03-31 | $0.06 | 2025-03-20 | 2025-03-31 | 2025-04-30 |
| 2024-12-31 | $0.06 | 2024-12-13 | 2024-12-31 | 2025-01-31 |
| 2024-09-30 | $0.06 | 2024-09-13 | 2024-09-30 | 2024-10-31 |
| 2024-06-28 | $0.06 | 2024-06-14 | 2024-06-30 | 2024-07-31 |
| 2024-03-27 | $0.06 | 2024-03-22 | 2024-03-31 | 2024-04-30 |
| 2023-12-28 | $0.06 | 2023-12-15 | 2023-12-31 | 2024-01-31 |
| 2023-09-28 | $0.06 | 2023-09-15 | 2023-09-30 | 2023-10-31 |
| 2023-06-29 | $0.06 | 2023-06-16 | 2023-06-30 | 2023-07-31 |
| 2023-03-30 | $0.06 | 2023-03-17 | 2023-03-31 | 2023-04-28 |
| 2022-12-29 | $0.06 | 2022-12-16 | 2022-12-31 | 2023-01-31 |
| 2022-09-29 | $0.06 | 2022-09-16 | 2022-09-30 | 2022-10-31 |
| 2022-06-29 | $0.06 | 2022-06-17 | 2022-06-30 | 2022-07-29 |
| 2022-03-30 | $0.06 | 2022-03-18 | 2022-03-31 | 2022-04-29 |
| 2021-12-30 | $0.06 | 2021-12-17 | 2021-12-31 | 2022-01-31 |
| 2021-09-29 | $0.05 | 2021-09-17 | 2021-09-30 | 2021-10-31 |
| 2021-06-29 | $0.05 | 2021-06-18 | 2021-06-30 | 2021-07-31 |
Narrative Economics
Advanced Analysis Forensic deep-dive · two lenses
I love the business and won't pay up for it. The quality lens at +73 is doing exactly what it should — telling me Ensign is a real compounder with clean cash conversion (OCF/NI 1.45x), disciplined dilution, and a flywheel that's nearly doubled revenue in four years. But the value lens at -52 is just as clear: $170 against a $147-153 fair value cluster means I'm funding the optimism, not buying it. The DCF stretch to $187 is the only method that makes today work, and it's the most assumption-heavy. No margin of safety, and skilled nursing is not the industry where I want to be the one paying full freight — labor and reimbursement can re-rate this fast.
Playbook: this is a watchlist name with a hard limit, not a starter today. I put a bid in the $138-142 zone for a 1.5-2% starter position — that's the ~$140 attractive-below mark and roughly 18% below spot, which finally gives me the cushion the EPV floor of $65 says I need. If it gets to $125 on a broader healthcare drawdown or an operational wobble that doesn't break the thesis, I scale to a full 4-5% position. On the upside, I do nothing chasing — if it runs to $200+ on continued execution, fine, I missed it, the next opportunity will come because reimbursement scares are a recurring feature of this industry. The one thing that would flip me to buying here at $170 is a step-change in the acquisition pipeline or a balance-sheet event that materially de-risks the net debt — neither is on the table. Patience trade.
Ensign has nearly doubled revenue from $2.63B (2021) to $5.06B (2025), a ~17.8% CAGR, while net income grew from $194.7M to $344.0M and FCF reached $370.7M. Gross margin has compressed modestly (17.8% → 15.8%) but operating margin has stabilized at 8.4% after a 2023 dip to 6.8%, suggesting the acquisition-led growth model is absorbing new facilities without permanent margin damage. Earnings quality is genuinely high: OCF/NI of 1.45x, accruals of -2.7% of assets, Beneish M of -2.58, and Altman Z of 3.57 all corroborate that reported earnings convert to cash.
Capital structure is the one area of constraint, not crisis: $572M liquid cash against $-1.52B net debt, but with $370M annual FCF and a self-funding profile, leverage is serviceable and consistent with a real-estate-heavy operator. Dilution discipline is solid — diluted share CAGR of 0.8%, SBC at only 1% of revenue — though buybacks recover just 43% of SBC, so per-share value is preserved but not actively enhanced via repurchases.
Management/insider behavior reads neutral-to-fine: the 34 'sales' over 12 months are dominated by F-coded tax-withholding events on vesting (not discretionary selling); only one true open-market S-sale ($115K by Smith) appears in the recent tape. No P buys, but no red-flag selling pattern either. This looks like a well-run, mature compounder in a structurally tough industry.
Verify before trusting this (6)
- Medicare/Medicaid reimbursement mix and exposure to rate changes — core to margin durability
- Acquisition pipeline and goodwill/intangibles trend — model depends on facility roll-ups
- Lease vs owned real estate split (Standard Bearer REIT spinoff structure) and true economic leverage
- Labor cost trends (nursing wage inflation) as driver of GM compression from 17.8% to 15.8%
- Debt maturity schedule and covenants given $1.5B+ net debt
- Same-store occupancy and skilled-mix trends underlying organic growth vs acquired growth
Price is $170.30 against a composite FV of $146.55 and signal-adjusted FV of $153.33 — both point to roughly 10% downside, not upside. The DCF stretch case at $187 gets you a small premium, but it's the most assumption-heavy of the methods and the EPV floor of $65 reminds you what the business is worth without continued acquisition-driven growth. Average those honestly and deserved value clusters in the $140-155 zone.
This is a high-quality compounder (quality score 73, clean earnings, OCF 45% above NI), and that justifiably lifts deserved value toward the upper end of the FV range — but it does not justify paying above it. The market already knows Ensign is well-run; the steady-compounder narrative is in the tape. To make today's price work you need the acquisition flywheel to keep producing at historical rates against worsening labor and reimbursement headwinds — a reasonable base case, but not a discounted one.
No margin of safety here. Fairly-to-modestly-rich is the honest read; I'd want a real pullback before this is interesting on valuation alone.
Verify before trusting this (4)
- Forward occupancy and skilled-mix trends in next 10-Q — the margin drivers behind DCF assumptions
- Acquisition pace and per-deal multiples — is the flywheel still finding cheap targets?
- Medicare/Medicaid rate updates and labor cost trajectory in the next earnings call
- Any one-time gains in recent OCF that would tighten the OCF/NI gap