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The Ensign Group
(NASDAQ:ENSG)
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Rating:75Outperform
Price Target:
$207.00
▲(14.60% Upside)
Action:Reiterated
Date:10/29/26
The score is driven primarily by strong financial performance—especially growing revenue and robust free cash flow—supported by a positive earnings call with raised 2026 guidance. Technicals are constructive with price trending above major averages. The main constraints are a premium valuation and execution risk from integrating and turning around newly acquired underperforming facilities, alongside prior leverage volatility.
Positive Factors
Revenue and earnings growth
Strong revenue and earnings growth, reinforced by raised full-year guidance, indicates expanding demand and effective operating execution. If sustained, this growth can increase internal funding for acquisitions, technology and facility improvements while strengthening Ensign’s competitive position over the next several quarters.
Negative Factors
Margin compression
Recent gross and operating margin pressure suggests that revenue growth is not translating into earnings at the same rate as before. If costs or unfavorable mix remain elevated, profitability and cash available for reinvestment could be constrained despite continued top-line expansion.
Read all positive and negative factors
Positive Factors
Negative Factors
Revenue and earnings growth
Strong revenue and earnings growth, reinforced by raised full-year guidance, indicates expanding demand and effective operating execution. If sustained, this growth can increase internal funding for acquisitions, technology and facility improvements while strengthening Ensign’s competitive position over the next several quarters.
Read all positive factors
The Ensign Group Key Performance Indicators (KPIs)
Any
Income Before Taxes by Segment
Profitability by business unit before taxes, revealing which segments (for example skilled nursing, assisted living, home health, hospice, or management services) drive margins or generate losses. Highlights where management should allocate capital, which operations are most resilient to downturns, and where reimbursement or regulatory pressure could hit earnings.
Profitability by business unit before taxes, revealing which segments (for example skilled nursing, assisted living, home health, hospice, or management services) drive margins or generate losses. Highlights where management should allocate capital, which operations are most resilient to downturns, and where reimbursement or regulatory pressure could hit earnings.
Data provided by:
The Fly
The FlyThe Ensign Group (ENSG) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$10.74B
Dividend Yield0.14%
Average Volume (3M)351.04K
Price to Earnings (P/E)26.6
Beta (1Y)0.12
Revenue Growth17.49%
EPS Growth19.82%
CountryUS
Employees46,000
SectorHealthcare
Sector Strength45
IndustryMedical - Care Facilities
Share Statistics
EPS (TTM)6.91
Shares Outstanding58,282,433
10 Day Avg. Volume313,361
30 Day Avg. Volume351,043
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 Cap1.13
Enterprise Value/Revenue2.13
Enterprise Value/Gross Profit14.48
Enterprise Value/Ebitda18.30
Forecast
1Y Price Target
$226.67Price Target Upside25.49% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering4
EPS Forecast (FY)7.81
Revenue Forecast (FY)$5.90B
The Ensign Group Business Overview & Revenue Model
Company Description
The Ensign Group, Inc. operates as a healthcare provider, primarily concentrating on post-acute care services, alongside other supporting business ventures. The company's activities are organized into two main divisions: Skilled Services and Real ...
How the Company Makes Money
ENSG makes money primarily by delivering patient care services at its skilled nursing facilities and senior living operations and being reimbursed for those services. The core revenue stream is patient service revenue generated from skilled nursin...
The Ensign Group Earnings Call Summary
Earnings Call Date:Oct 27, 2026
(Q3-2026)
| % Change Since: |
Next Earnings Date:Feb 10, 2027
Earnings Call Sentiment Positive
The call was strongly positive, supported by double-digit revenue and earnings growth, higher 2026 guidance, broad-based occupancy and skilled-mix gains, above-market clinical outcomes, substantial acquisition activity, and significant balance-sheet capacity. Management also highlighted ongoing AI and technology investments and a large acquisition pipeline. The main challenges were concentrated in newly acquired turnaround operations, particularly in Florida and Texas, which have below-average occupancy, clinical, financial, and physical-plant issues and are expected to take a year or more to contribute. Overall, the highlights significantly outweighed the lowlights.Positive Updates
Strong Third-Quarter Financial Performance
GAAP diluted earnings per share was $1.76, an increase of 23.9%; adjusted diluted earnings per share was $2.03, an increase of 23.8%; consolidated GAAP and adjusted revenue were both $1.48 billion, an increase of 14.5%; GAAP net income was $104.3 million, an increase of 24.4%; and adjusted net income was $120.5 million, an increase of 24.9%.
Negative Updates
New Florida Operations Face Litigation and Turnaround Challenges
Management identified Florida’s litigation environment as a major red flag historically. The newly acquired Florida operations were described as almost all having below-average occupancy and substantial clinical and operational challenges, with problems across clinical performance, finances, and physical plant.
Read all updates
Q3-2026 Updates
Positive
Negative
Strong Third-Quarter Financial Performance
GAAP diluted earnings per share was $1.76, an increase of 23.9%; adjusted diluted earnings per share was $2.03, an increase of 23.8%; consolidated GAAP and adjusted revenue were both $1.48 billion, an increase of 14.5%; GAAP net income was $104.3 million, an increase of 24.4%; and adjusted net income was $120.5 million, an increase of 24.9%.
Read all positive updates
Company Guidance
The company increased annual 2026 earnings guidance to $7.94 to $8.02 per diluted share, up from previous guidance of $7.75 to $7.85, and raised the lower end of annual revenue guidance to $5.89 billion while maintaining the upper end at $5.92 billion; the midpoint of earnings guidance represents a 21.5% increase over 2025 and 45.1% growth over 2024. The guidance assumes diluted weighted average common shares outstanding of approximately 59.5 million, a tax rate of 25.0%, the inclusion of acquisitions closed and expected to close through the fourth quarter of 26, and management's expectations for reimbursement rates, with the primary exclusion coming from stock based compensation and amortization of system implementation cost.The Ensign Group Financial Statement Overview
Summary
Income Statement
78
Positive
Balance Sheet
69
Positive
Cash Flow
82
Very Positive
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 5.67B | 5.06B | 4.26B | 3.73B | 3.03B | 2.63B |
| Gross Profit | 835.92M | 799.45M | 667.59M | 590.76M | 517.99M | 468.21M |
| EBITDA | 661.21M | 567.94M | 478.52M | 353.24M | 360.38M | 320.84M |
| Net Income | 399.12M | 343.97M | 297.97M | 209.40M | 224.68M | 194.65M |
Balance Sheet | ||||||
| Total Assets | 6.00B | 5.46B | 4.67B | 4.18B | 3.45B | 2.85B |
| Cash, Cash Equivalents and Short-Term Investments | 391.69M | 572.39M | 526.85M | 526.86M | 331.71M | 275.96M |
| Total Debt | 2.29B | 4.15B | 1.97B | 1.87B | 1.57B | 1.27B |
| Total Liabilities | 3.43B | 3.23B | 2.83B | 2.68B | 2.20B | 1.83B |
| Stockholders Equity | 2.56B | 2.23B | 1.84B | 1.49B | 1.25B | 1.02B |
Cash Flow | ||||||
| Free Cash Flow | 509.91M | 370.71M | 188.95M | 270.49M | 184.97M | 206.13M |
| Operating Cash Flow | 695.67M | 564.27M | 347.19M | 376.67M | 272.51M | 275.68M |
| Investing Cash Flow | -814.88M | -513.18M | -390.05M | -182.70M | -186.18M | -173.91M |
| Financing Cash Flow | 13.13M | -11.81M | -2.16M | -612.00K | -32.26M | -76.14M |
The Ensign Group Technical Analysis
Positive
180.63
Price Trends
174.64
Positive
171.79
Positive
181.45
Positive
Market Momentum
0.87
Negative
60.29
Neutral
49.21
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 180.63 is above the 20-day moving average (MA) of 174.18, above the 50-day MA of 174.64, and below the 200-day MA of 181.45, indicating a bullish trend. The MACD of 0.87 indicates Negative momentum. The RSI at 60.29 is Neutral, neither overbought nor oversold. The STOCH value of 49.21 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive 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 |
|---|---|---|---|---|---|---|---|
85 Outperform | $3.32B | 23.45 | 12.94% | 1.24% | 7.19% | 32.91% | |
82 Outperform | $2.28B | 21.51 | 9.57% | ― | 15.88% | 25.01% | |
75 Outperform | $10.74B | 26.64 | 16.63% | 0.14% | 17.49% | 19.82% | |
68 Neutral | $7.77B | 28.86 | 27.15% | ― | 15.15% | 101.51% | |
62 Neutral | $1.47B | 44.85 | 9.51% | ― | 37.90% | 15.84% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
48 Neutral | $2.38B | -17.24 | 405.63% | ― | -4.42% | 44.67% |
* Healthcare Sector Average
ENSG
The Ensign Group
184.11
1.68
0.92%
ADUS
Addus Homecare
122.18
-0.57
-0.46%
BKD
Brookdale Senior Living
9.98
1.03
11.51%
NHC
National Healthcare
211.79
92.72
77.87%
PNTG
Pennant Group
42.16
17.13
68.44%
PACS
PACS Group Inc
49.06
36.62
294.37%
The Ensign Group Corporate Events
Business Operations and StrategyRegulatory Filings and Compliance
Ensign Group Updates Bylaws and Tightens Governance Rules
Neutral
Aug 25, 2026
On August 20, 2026, The Ensign Group’s board adopted amended and restated bylaws to align its governance framework with recent developments in Delaware law and to clarify the authority of the board and meeting chairs in managing stockholder ...
Business Operations and StrategyPrivate Placements and Financing
Ensign Group Expands Long-Term Credit Facility for Growth
Positive
Aug 20, 2026
On August 19, 2026, The Ensign Group, Inc. and Standard Bearer Healthcare REIT, Inc. entered into a Fourth Amended and Restated Credit Agreement that increased Ensign’s revolving credit facility by $200 million to $800 million and extended i...
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.