Ensign (ENSG)
Market Price (9/6/2026): $170.7 | Market Cap: $9.9 BilSector: Health Care | Industry: Health Care Facilities
Ensign (ENSG)
Market Price (9/6/2026): $170.7Market Cap: $9.9 BilSector: Health CareIndustry: Health Care Facilities
Investment Highlights Why It Matters Detailed financial logic regarding cash flow yields vs trend-riding momentum.
Attractive cash flow generationCFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 11% Low stock price volatilityVol 12M is 28% Megatrend and thematic driversMegatrends include Aging Population & Chronic Disease. Themes include Geriatric Care. | Weak multi-year price returns2Y Excs Rtn is -23%, 3Y Excs Rtn is -2.2% | Key risksENSG key risks include [1] its heavy reliance on government reimbursement, Show more. |
| Attractive cash flow generationCFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 11% |
| Low stock price volatilityVol 12M is 28% |
| Megatrend and thematic driversMegatrends include Aging Population & Chronic Disease. Themes include Geriatric Care. |
| Weak multi-year price returns2Y Excs Rtn is -23%, 3Y Excs Rtn is -2.2% |
| Key risksENSG key risks include [1] its heavy reliance on government reimbursement, Show more. |
Qualitative Assessment
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Ensign (ENSG) stock has remained largely at the same level since 5/31/2026 because of the following key factors:
1. Strong Fiscal Q2 2026 Performance and Upgraded Full-Year Guidance. The Ensign Group reported adjusted earnings per share of $1.92 for fiscal Q2 2026 (ended June 30, 2026), surpassing analyst consensus estimates of $1.80 by $0.12. Consolidated revenue for the quarter increased by 17.3% year-over-year to $1.44 billion. Following these results, the company raised its 2026 annual adjusted EPS guidance to a range of $7.75-$7.85 and its annual revenue guidance to $5.87 billion-$5.92 billion, with the midpoint of the EPS guidance representing an 18.7% increase over 2025.
2. Strategic Acquisitions Driving Growth. Ensign continued its expansion strategy by completing 25 operational acquisitions in the first half of fiscal 2026, adding 3,109 beds and units, and investing approximately $412 million in these acquisitions. Notably, effective May 1, 2026, the company acquired the real estate and operations for 17 skilled nursing and senior living facilities in Texas and two senior living properties in Wisconsin.
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Ensign (ENSG) stock has remained largely at the same level since 5/31/2026 because of the following key factors:
1. Strong Fiscal Q2 2026 Performance and Upgraded Full-Year Guidance. The Ensign Group reported adjusted earnings per share of $1.92 for fiscal Q2 2026 (ended June 30, 2026), surpassing analyst consensus estimates of $1.80 by $0.12. Consolidated revenue for the quarter increased by 17.3% year-over-year to $1.44 billion. Following these results, the company raised its 2026 annual adjusted EPS guidance to a range of $7.75-$7.85 and its annual revenue guidance to $5.87 billion-$5.92 billion, with the midpoint of the EPS guidance representing an 18.7% increase over 2025.
2. Strategic Acquisitions Driving Growth. Ensign continued its expansion strategy by completing 25 operational acquisitions in the first half of fiscal 2026, adding 3,109 beds and units, and investing approximately $412 million in these acquisitions. Notably, effective May 1, 2026, the company acquired the real estate and operations for 17 skilled nursing and senior living facilities in Texas and two senior living properties in Wisconsin.
3. Improved Operational Metrics. The company demonstrated robust operational improvements in fiscal Q2 2026. Same-facility occupancy increased by 2.7% year-over-year to 84.1%, while transitioning-facility occupancy rose by 2.3% year-over-year to 84.7%. Additionally, skilled-mix revenues for same-facility and transitioning-facility operations saw increases of 10.1% and 14.0%, respectively.
4. Enhanced Financial Flexibility. On August 20, 2026, Ensign Group increased its credit facility to $800 million and extended its maturity, providing substantial liquidity and financial flexibility to support ongoing growth initiatives and future acquisitions.
5. Favorable Analyst Sentiment. Despite a temporary dip in early June due to an investigative report, the overall analyst sentiment remained positive. Analysts maintained a "Moderate Buy" consensus rating for ENSG, with an average 12-month price target ranging from $216.25 to $220.00, suggesting a significant upside potential for the stock.
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Stock Movement Drivers
Fundamental Drivers
The 1.9% change in ENSG stock from 5/31/2026 to 9/5/2026 was primarily driven by a 4.0% change in the company's Total Revenues ($ Mil).| (LTM values as of) | 5312026 | 9052026 | Change |
|---|---|---|---|
| Stock Price ($) | 167.58 | 170.79 | 1.9% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 5,274 | 5,487 | 4.0% |
| Net Income Margin (%) | 6.9% | 6.9% | 0.2% |
| P/E Multiple | 26.6 | 26.1 | -1.9% |
| Shares Outstanding (Mil) | 58 | 58 | -0.3% |
| Cumulative Contribution | 1.9% |
Market Drivers
5/31/2026 to 9/5/2026| Return | Correlation | |
|---|---|---|
| ENSG | 1.9% | |
| Market (SPY) | 1.8% | -24.4% |
| Sector (XLV) | 14.7% | 29.6% |
Fundamental Drivers
The -20.2% change in ENSG stock from 2/28/2026 to 9/5/2026 was primarily driven by a -27.0% change in the company's P/E Multiple.| (LTM values as of) | 2282026 | 9052026 | Change |
|---|---|---|---|
| Stock Price ($) | 214.01 | 170.79 | -20.2% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 5,058 | 5,487 | 8.5% |
| Net Income Margin (%) | 6.8% | 6.9% | 1.5% |
| P/E Multiple | 35.8 | 26.1 | -27.0% |
| Shares Outstanding (Mil) | 58 | 58 | -0.6% |
| Cumulative Contribution | -20.2% |
Market Drivers
2/28/2026 to 9/5/2026| Return | Correlation | |
|---|---|---|
| ENSG | -20.2% | |
| Market (SPY) | 12.6% | -3.5% |
| Sector (XLV) | 7.5% | 36.6% |
Fundamental Drivers
The -0.4% change in ENSG stock from 8/31/2025 to 9/5/2026 was primarily driven by a -13.9% change in the company's P/E Multiple.| (LTM values as of) | 8312025 | 9052026 | Change |
|---|---|---|---|
| Stock Price ($) | 171.53 | 170.79 | -0.4% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 4,615 | 5,487 | 18.9% |
| Net Income Margin (%) | 7.0% | 6.9% | -1.3% |
| P/E Multiple | 30.4 | 26.1 | -13.9% |
| Shares Outstanding (Mil) | 57 | 58 | -1.4% |
| Cumulative Contribution | -0.4% |
Market Drivers
8/31/2025 to 9/5/2026| Return | Correlation | |
|---|---|---|
| ENSG | -0.4% | |
| Market (SPY) | 20.4% | -0.8% |
| Sector (XLV) | 26.4% | 28.0% |
Fundamental Drivers
The 71.3% change in ENSG stock from 8/31/2023 to 9/5/2026 was primarily driven by a 62.0% change in the company's Total Revenues ($ Mil).| (LTM values as of) | 8312023 | 9052026 | Change |
|---|---|---|---|
| Stock Price ($) | 99.68 | 170.79 | 71.3% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 3,388 | 5,487 | 62.0% |
| Net Income Margin (%) | 7.1% | 6.9% | -2.8% |
| P/E Multiple | 23.1 | 26.1 | 13.4% |
| Shares Outstanding (Mil) | 56 | 58 | -4.0% |
| Cumulative Contribution | 71.3% |
Market Drivers
8/31/2023 to 9/5/2026| Return | Correlation | |
|---|---|---|
| ENSG | 71.3% | |
| Market (SPY) | 77.1% | 23.5% |
| Sector (XLV) | 34.7% | 37.5% |
Price Returns Compared
| 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | Total [1] | |
|---|---|---|---|---|---|---|---|
| Returns | |||||||
| ENSG Return | 15% | 13% | 19% | 19% | 31% | -1% | 139% |
| Peers Return | 4% | -47% | 16% | 5% | 68% | 15% | 28% |
| S&P 500 Return | 27% | -19% | 24% | 23% | 16% | 13% | 106% |
Monthly Win Rates [3] | |||||||
| ENSG Win Rate | 50% | 58% | 67% | 58% | 67% | 22% | |
| Peers Win Rate | 50% | 33% | 58% | 45% | 50% | 60% | |
| S&P 500 Win Rate | 75% | 42% | 67% | 75% | 67% | 56% | |
Max Drawdowns [4] | |||||||
| ENSG Max Drawdown | -28% | -25% | -14% | -15% | -19% | -32% | |
| Peers Max Drawdown | -42% | -67% | -39% | -46% | -32% | -39% | |
| S&P 500 Max Drawdown | -5% | -25% | -10% | -8% | -19% | -9% | |
[1] Cumulative total returns since the beginning of 2021
[2] Peers: NTRA, GH, OPCH, PGNY, TDOC.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2026 data is for the year up to 9/4/2026 (YTD)
How Low Can It Go
| Event | ENSG | S&P 500 |
|---|---|---|
| 2022 Inflation Shock & Fed Tightening | ||
| % Loss | -16.8% | -24.5% |
| % Gain to Breakeven | 20.2% | 32.4% |
| Time to Breakeven | 25 days | 427 days |
| 2020 COVID-19 Crash | ||
| % Loss | -52.2% | -33.7% |
| % Gain to Breakeven | 109.1% | 50.9% |
| Time to Breakeven | 143 days | 140 days |
| 2016-2017 Trump Reflation Bond Selloff | ||
| % Loss | -16.3% | -3.7% |
| % Gain to Breakeven | 19.5% | 3.9% |
| Time to Breakeven | 123 days | 6 days |
| 2015-2016 China Devaluation / Global Growth Scare | ||
| % Loss | -24.5% | -12.2% |
| % Gain to Breakeven | 32.5% | 13.9% |
| Time to Breakeven | 650 days | 62 days |
| 2011 US Debt Ceiling Crisis & European Contagion | ||
| % Loss | -29.6% | -17.9% |
| % Gain to Breakeven | 42.0% | 21.8% |
| Time to Breakeven | 199 days | 123 days |
| 2010 Eurozone Sovereign Debt Crisis / Flash Crash | ||
| % Loss | -12.1% | -15.4% |
| % Gain to Breakeven | 13.8% | 18.2% |
| Time to Breakeven | 8 days | 125 days |
In The Past
Ensign's stock fell -5.6% during the 2025 US Tariff Shock. Such a loss loss requires a 5.9% gain to breakeven.
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| Event | ENSG | S&P 500 |
|---|---|---|
| 2020 COVID-19 Crash | ||
| % Loss | -52.2% | -33.7% |
| % Gain to Breakeven | 109.1% | 50.9% |
| Time to Breakeven | 143 days | 140 days |
| 2015-2016 China Devaluation / Global Growth Scare | ||
| % Loss | -24.5% | -12.2% |
| % Gain to Breakeven | 32.5% | 13.9% |
| Time to Breakeven | 650 days | 62 days |
| 2011 US Debt Ceiling Crisis & European Contagion | ||
| % Loss | -29.6% | -17.9% |
| % Gain to Breakeven | 42.0% | 21.8% |
| Time to Breakeven | 199 days | 123 days |
| 2008-2009 Global Financial Crisis | ||
| % Loss | -49.1% | -53.4% |
| % Gain to Breakeven | 96.3% | 114.4% |
| Time to Breakeven | 154 days | 1085 days |
In The Past
Ensign's stock fell -5.6% during the 2025 US Tariff Shock. Such a loss loss requires a 5.9% gain to breakeven.
Preserve Wealth
Limiting losses and compounding gains is essential to preserving wealth.
Asset Allocation
Actively managed asset allocation strategies protect wealth. Learn more.
About Ensign (ENSG)
The Ensign Group, Inc. (ENSG) is a healthcare services company specializing in the post-acute care continuum and senior living. The company operates a significant network of healthcare facilities, including skilled nursing centers and senior living communities, primarily across various states in the Western and Midwestern U.S. Ensign's business is structured into two main segments: Skilled Services and Real Estate.
Ensign's core services under its Skilled Services segment include short and long-term skilled nursing care, which addresses the needs of patients with chronic conditions, prolonged illnesses, and the elderly. This encompasses comprehensive rehabilitative therapies such as physical, occupational, and speech therapy, alongside standard services like room and board, special nutritional programs, and social activities. The primary customers are individuals requiring recovery from acute events, long-term care, or supportive senior living environments.
Beyond direct facility-based care, Ensign also offers a range of ancillary services such as mobile diagnostics (including digital x-ray, ultrasound, and electrocardiograms), laboratory services, and patient transportation. These services cater to individuals both within its facilities and in their homes or other long-term care settings. Additionally, the company's Real Estate segment manages and leases properties, which supports its healthcare operations.
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Here are 1-2 brief analogies for Ensign (ENSG):
- It's like a Marriott or Hilton chain, but instead of hotels, they operate skilled nursing homes and senior living facilities.
- Think of it as an HCA Healthcare (a large hospital operator) that specializes in skilled nursing, rehabilitation, and senior living facilities.
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- Skilled Nursing Care: Provides short and long-term nursing care for patients with chronic conditions, prolonged illness, and the elderly.
- Rehabilitative Therapies: Offers physical, occupational, and speech therapies and other rehabilitative healthcare services.
- Senior Living Management: Manages senior living facilities, providing room and board, nutritional programs, and social and recreational services.
- Mobile Diagnostic & Ancillary Services: Delivers digital x-ray, ultrasound, electrocardiogram, laboratory, and patient transportation services.
- Real Estate Leasing: Engages in leasing real estate properties, primarily healthcare facilities.
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Ensign (symbol: ENSG) sells primarily to individuals. The company serves the following categories of customers:
- Elderly individuals and patients with chronic conditions or prolonged illnesses: These customers utilize Ensign's short and long-term nursing care services, skilled nursing, and other related support services provided within its healthcare facilities.
- Patients requiring rehabilitative care: This category includes individuals recovering from illness, injury, or surgery who need physical, occupational, or speech therapies to regain function and independence.
- Senior living residents: Individuals who reside in Ensign's senior living communities, benefiting from a range of services including room and board, social programs, and assistance with daily living.
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Barry Port, Chief Executive Officer and Chairman of the Board
Barry Port has served as Chief Executive Officer and a Board Member since May 2019 and was appointed Chairman of the Board in September 2025. Prior to his CEO role, he was Chief Operating Officer of Ensign Services, Inc. from 2012 to 2019. From 2006 to 2011, he served as President of Keystone Care, Inc., overseeing facilities in Texas. His healthcare leadership career began with operational roles directing skilled nursing campuses in Arizona and Texas.
Suzanne D. Snapper, Chief Financial Officer, Executive Vice President and Director
Suzanne D. Snapper has served as Chief Financial Officer since August 2009, having joined Ensign in April 2007. She played a pivotal role as CFO in the successful spin-offs of Care Trust REIT in 2014 and The Pennant Group in 2019, and contributed significantly to the formation of the Standard Bearer REIT in 2022. Before joining Ensign, Ms. Snapper spent ten years as a senior manager at KPMG LLP, where she provided audit services for public companies.
Spencer Burton, President & Chief Operating Officer
Spencer Burton was appointed President and Chief Operations Officer on May 30, 2019. He has nearly 20 years of experience in post-acute care and previously served as President of Pennant Healthcare, Inc., a Northwest-based portfolio company of Ensign Services. Mr. Burton also held leadership roles as Executive Director at affiliated operations in California, Texas, and Washington.
Chad A. Keetch, Chief Investment Officer, Executive Vice President & Secretary
Chad A. Keetch assumed the roles of Chief Investment Officer, Executive Vice President, and Secretary on May 30, 2019. He oversees business development, strategic growth, capital markets activities, new business ventures, and the management of the company's real estate portfolio. Mr. Keetch was instrumental in the spin-off of Care Trust REIT, Inc. in 2014 and The Pennant Group, Inc. in 2019. Prior to joining Ensign, he was a transactional attorney at Stoel Rives LLP (2008-2010) and Kirkland & Ellis LLP (2005-2008), where his practice focused on private equity, mergers and acquisitions, leveraged buyouts, and capital markets transactions.
Beverly B. Wittekind, Vice President and General Counsel
Beverly B. Wittekind serves as Vice President and General Counsel for The Ensign Group, Inc. She also holds the title of Chief Legal Officer for Ensign Services, Inc., where she provides strategic counsel in areas such as risk management, litigation, regulatory compliance, employment law, and dispute resolution. Ms. Wittekind joined Ensign in November 2009.
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The Ensign Group, Inc. (ENSG) faces several key risks inherent in the post-acute care continuum and skilled nursing facility industry.
- Reimbursement Rate Fluctuations and Government Regulation: Changes in government reimbursement policies, particularly for Medicare and Medicaid, represent a primary risk to Ensign Group's revenue streams and financial viability. These changes can include reductions in rates, shifts in state budgets, and the expiration of specific funding programs, such as a California program slated to end after 2026. The company's financial performance is closely linked to these policies, and reductions in reimbursement or delays in payments can materially and adversely affect its operations. Compliance with evolving regulations, including models like the Patient-Driven Payment Model (PDPM), also poses a significant risk.
- Labor Shortages and Rising Costs: The healthcare industry, especially the skilled nursing sector, faces persistent labor shortages, wage inflation, and demanding workloads. This workforce crisis, exacerbated by factors like burnout and low wages, contributes to increased operating costs for Ensign Group and can compromise the quality of resident care. The difficulty in recruiting and retaining qualified staff can lead to higher rates of infections, falls, and hospital readmissions, further impacting the business.
- Integration of Acquisitions and Competitive Landscape: Ensign Group's growth strategy heavily relies on acquiring and integrating new healthcare facilities. Successfully integrating these newly acquired operations, particularly large portfolios across multiple states, presents a significant challenge. Delays or inefficiencies in this integration process can hinder the realization of expected returns and impact operational performance. Furthermore, the company faces intense competition from other healthcare entities in acquiring, developing, and operating facilities, which can drive up acquisition costs and affect market share.
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The accelerating shift towards comprehensive home-based care models, enabled by advancements in telehealth and remote patient monitoring technologies, poses a clear emerging threat. This trend allows for more complex post-acute and rehabilitative care, traditionally provided in skilled nursing facilities or senior living centers, to be delivered effectively and safely in patients' homes. As patient preference and technological capabilities drive this evolution in healthcare delivery, the demand for Ensign's facility-based services could diminish.
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Ensign (symbol: ENSG) operates within several significant addressable markets within the U.S. healthcare services sector. These markets include skilled nursing facilities, the broader post-acute care continuum, senior living, and mobile diagnostics services. All market sizes are for the U.S. region.
Skilled Nursing Facilities Market
The U.S. skilled nursing facility market was valued at approximately USD 254.95 billion in 2025 and is projected to reach around USD 388.42 billion by 2035, growing at a compound annual growth rate (CAGR) of 4.3% from 2026 to 2035. Other estimates place the market size at USD 199.72 billion in 2024, with projections to reach USD 290.02 billion by 2033 at a CAGR of 4.39% from 2025 to 2033. Another source indicated a value of USD 202.4 billion in 2025, anticipated to grow to USD 279.9 billion by 2035. A more conservative estimate for the skilled nursing facility segment of the total U.S. post-acute care market in 2025 was approximately USD 130 billion.
Post-Acute Care Market
The U.S. post-acute care (PAC) market, which encompasses skilled nursing, home care, long-term acute care, and inpatient rehabilitation, demonstrates a substantial addressable market. This market was valued at approximately USD 507.12 billion in 2025 and is predicted to increase to around USD 822.98 billion by 2035, exhibiting a CAGR of 4.96% from 2026 to 2035. Other estimates for the U.S. post-acute care market size in 2025 include USD 490.6 billion, with a projection to reach USD 898.5 billion by 2035 at a CAGR of 6.4% from 2026 to 2035. Another report valued the market at USD 461.38 billion in 2025, expecting it to reach approximately USD 766.71 billion by 2035, growing at a CAGR of 5.21% from 2026 to 2035.
Senior Living Market
The U.S. senior living market size was valued at USD 943.90 billion in 2025 and is expected to reach USD 1.33 trillion by 2033, growing at a CAGR of 4.47% from 2026 to 2033. Another report estimated the market size at USD 923.75 billion in 2023, with a projection to reach approximately USD 1,391.23 billion by 2033, demonstrating a CAGR of 4.18% during the forecast period from 2024 to 2033.
Mobile Diagnostics Services Market
The U.S. mobile imaging services market, which includes digital x-ray, ultrasound, and EKG services as provided by Ensign, was valued at USD 5.3 billion in 2022. More specifically for mobile MRI services, the U.S. market size was estimated at USD 3.99 billion in 2025 and is projected to reach around USD 5.67 billion by 2035, with a CAGR of 3.58% from 2026 to 2035. Another report indicated the U.S. mobile MRI services market size was estimated at USD 3.67 billion in 2024.
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- Strategic Acquisitions and Portfolio Expansion: Ensign Group consistently expands its portfolio by acquiring skilled nursing and post-acute care facilities. The company often targets facilities with turnaround potential or long-term value, integrating them into its decentralized operating model. For instance, the company acquired 45 new operations in 2025 and added 52 new operations since the beginning of 2024, expanding its footprint across various states. This acquisition-driven growth is a core part of its strategy, with management's 2026 guidance assuming continued acquisition activity.
- Organic Growth through Enhanced Occupancy and Patient Mix: The company focuses on improving occupancy rates and attracting a higher-acuity patient mix (Medicare and managed care). Ensign has demonstrated strong organic growth, with same-facilities occupancy improving and transitioning-facilities occupancy increasing year-over-year. This improvement in occupancy, coupled with an increased number of skilled patient days and higher Medicare and managed care revenues, significantly contributes to revenue growth. Management believes significant organic growth potential remains, as many facilities have yet to reach peak occupancy levels.
- Expansion and Optimization of Service Offerings: Ensign Group's revenue expansion is driven by increasing service offerings in skilled nursing, rehabilitation, and senior living. The growing elderly population in the U.S. continues to fuel demand for these services, supporting Ensign's long-term outlook. The company's ability to offer advanced healthcare services, particularly rehabilitation, is anticipated to contribute significantly to the revenue growth of its Skilled Services segment.
- Strategic Real Estate Investments via Standard Bearer Healthcare REIT: Through its captive real estate investment trust (REIT), Standard Bearer Healthcare REIT, Inc., Ensign acquires and owns underlying real estate assets. This strategy provides both operational and real estate investment returns, with Standard Bearer capturing real estate value and contributing to financial stability through consistent rental income. The Standard Bearer segment saw a 33.9% increase in funds from operations in Q4 2025.
- Favorable Pricing and Reimbursement Trends: Ensign has benefited from price increases, as evidenced by its revenue growth outpacing the growth in units sold over the past two years. The company has also shown substantial year-over-year growth in same-store Medicare revenue and managed care revenue, indicating improved reimbursement rates for its skilled services. The ability of local partners to build clinical capabilities helps attract a higher-quality patient population with better reimbursement prospects.
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Share Repurchases
- The Ensign Group repurchased shares worth $20 million in 2025.
- As of September 30, 2024, the company did not make any purchases under its stock repurchase program.
Share Issuance
- Ensign's shares outstanding for the quarter ending December 31, 2025, were 0.059 billion, representing a 1.09% increase year-over-year.
- Shares outstanding increased by 1.09% in 2025 from 2024, and by 1.6% in 2024 from 2023.
Outbound Investments
- In 2025, The Ensign Group completed 51 acquisitions, including 12 real estate assets.
- Effective December 1, 2025, the company acquired the operations of four skilled nursing facilities in Colorado, Kansas, and Arizona.
- The Ensign Group acquired operations of Agave Grove Post Acute and four other skilled nursing facilities, as well as real estate in Texas and Wisconsin, effective February 1, 2026.
Capital Expenditures
- Accrued capital expenditures were $7.3 million for the nine months ended September 30, 2024, and $4.1 million for the same period in 2023.
- Capital investments are primarily focused on upgrading facilities, adding beds, and developing new healthcare infrastructure.
- A strategic focus for capital expenditures includes acquiring newer assets and improving existing physical plants to enhance care quality and census rates.
Peer Outperformance in Health Care Facilities
| Industry | Names | 1Y med | 3Y med | 5Y med | Top 3 by 5Y |
|---|---|---|---|---|---|
| Health Care Distributors | 7 | 14.0% | 94.3% | 127.8% | CAH 414% · MCK 351% · COR 179% |
| Managed Health Care | 8 | 32.5% | 0.9% | 3.3% | OSCR 77% · HQY 48% · ELV 16% |
| Health Care Services | 20 | 19.7% | 53.1% | -1.5% | HIMS 238% · RDNT 134% · DGX 68% |
| Health Care Facilities ← | 24 | -1.0% | 7.5% | -19.0% | THC 249% · NHC 244% · ENSG 108% |
| Health Care Equipment | 50 | -4.5% | -4.9% | -24.0% | POCI 10775% · UFPT 318% · GKOS 200% |
| Health Care Supplies | 12 | 27.9% | -14.2% | -35.5% | LNTH 272% · HAE 59% · MMSI 23% |
| Pharmaceuticals | 63 | -1.5% | 1.9% | -36.4% | LQDA 2406% · INDV 1148% · ETON 1022% |
| Life Sciences Tools & Services | 109 | 1.6% | -27.8% | -73.9% | SNWV 1688% · MEDP 203% · AXGN 178% |
| Biotechnology | 363 | 5.6% | -26.4% | -76.8% | BRTX 73900% · DNTH 1558% · CELZ 1486% |
| Health Care Technology | 20 | -24.5% | -57.0% | -78.6% | SPOK 68% · HSTM -2% · VEEV -13% |
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Peer Comparisons
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Financials
| Median | |
|---|---|
| Name | |
| Mkt Price | 93.67 |
| Mkt Cap | 6.8 |
| Rev LTM | 2,598 |
| Op Inc LTM | -17 |
| FCF LTM | 148 |
| FCF 3Y Avg | 167 |
| CFO LTM | 245 |
| CFO 3Y Avg | 240 |
Growth & Margins
| Median | |
|---|---|
| Name | |
| Rev Chg LTM | 12.4% |
| Rev Chg 3Y Avg | 14.4% |
| Rev Chg Q | 11.3% |
| QoQ Delta Rev Chg LTM | 2.7% |
| Op Inc Chg LTM | 9.8% |
| Op Inc Chg 3Y Avg | 14.1% |
| Op Mgn LTM | 0.0% |
| Op Mgn 3Y Avg | -0.4% |
| QoQ Delta Op Mgn LTM | 0.7% |
| CFO/Rev LTM | 9.5% |
| CFO/Rev 3Y Avg | 7.6% |
| FCF/Rev LTM | 4.5% |
| FCF/Rev 3Y Avg | 4.6% |
Valuation
| Median | |
|---|---|
| Name | |
| Mkt Cap | 6.8 |
| P/S | 1.7 |
| P/Op Inc | 1.6 |
| P/EBIT | 2.0 |
| P/E | 5.6 |
| P/CFO | 10.4 |
| Total Yield | 1.7% |
| Dividend Yield | 0.0% |
| FCF Yield 3Y Avg | 4.3% |
| D/E | 0.2 |
| Net D/E | 0.1 |
Segment Financials
Revenue by Segment| $ Mil | 2025 | 2024 | 2023 | 2022 | 2021 |
|---|---|---|---|---|---|
| Skilled Services | 4,838 | 4,077 | 3,579 | 2,906 | 2,523 |
| All other revenue | 233 | 193 | 156 | 123 | 103 |
| Standard Bearer | 127 | 95 | 82 | 73 | 58 |
| Elimination of intercompany revenue | -140 | -104 | -88 | -76 | -57 |
| Total | 5,058 | 4,260 | 3,729 | 3,025 | 2,627 |
| $ Mil | 2019 | 2018 | 2017 | 2016 | 2015 |
|---|---|---|---|---|---|
| Skilled Services | 244 | 191 | 140 | 118 | |
| All other revenue | -114 | -104 | -95 | -55 | -69 |
| Assisted and Independent Living Services | 15 | 17 | 12 | ||
| Home Health and Hospice Services | 26 | 20 | 17 | 14 | |
| TSA Services | 148 | ||||
| Total | 129 | 128 | 81 | 92 | 93 |
Price Behavior
| Market Price | $170.79 | |
| Market Cap ($ Bil) | 9.9 | |
| First Trading Date | 11/09/2007 | |
| Distance from 52W High | -20.8% | |
| 50 Days | 200 Days | |
| DMA Price | $174.34 | $182.25 |
| DMA Trend | indeterminate | up |
| Distance from DMA | -2.0% | -6.3% |
| 3M | 1YR | |
| Volatility | 26.0% | 27.9% |
| Downside Capture | -64.39 | -11.40 |
| Upside Capture | -49.63 | -10.90 |
| Correlation (SPY) | -24.2% | -1.0% |
| 1M | 2M | 3M | 6M | 1Y | 3Y | |
|---|---|---|---|---|---|---|
| Beta | -0.26 | -0.33 | -0.57 | -0.06 | -0.02 | 0.39 |
| Up Beta | -0.69 | -1.70 | -1.07 | -0.04 | 0.17 | 0.43 |
| Down Beta | 1.96 | 0.99 | 0.18 | 0.40 | 0.07 | 0.35 |
| Up Capture | -45% | 7% | -51% | -31% | -6% | 17% |
| Bmk +ve Days | 10 | 21 | 32 | 68 | 138 | 427 |
| Stock +ve Days | 8 | 16 | 28 | 51 | 113 | 379 |
| Down Capture | 10% | -37% | -94% | 2% | -19% | 57% |
| Bmk -ve Days | 11 | 21 | 32 | 59 | 113 | 324 |
| Stock -ve Days | 12 | 25 | 35 | 75 | 137 | 370 |
[1] Upside and downside betas calculated using positive and negative benchmark daily returns respectively
Based On 1-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with ENSG | |
|---|---|---|---|---|
| ENSG | -1.1% | 27.9% | -0.06 | - |
| Sector ETF (XLV) | 26.5% | 16.0% | 1.28 | 27.9% |
| Equity (SPY) | 19.7% | 12.8% | 1.13 | -0.9% |
| Gold (GLD) | 24.6% | 29.2% | 0.75 | -2.1% |
| Commodities (DBC) | 43.8% | 20.3% | 1.67 | -20.0% |
| Real Estate (VNQ) | 9.1% | 13.6% | 0.39 | 27.8% |
| Bitcoin (BTCUSD) | -28.1% | 43.8% | -0.63 | -20.3% |
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Based On 5-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with ENSG | |
|---|---|---|---|---|
| ENSG | 16.0% | 26.8% | 0.55 | - |
| Sector ETF (XLV) | 6.6% | 15.1% | 0.25 | 40.0% |
| Equity (SPY) | 12.8% | 17.2% | 0.57 | 33.9% |
| Gold (GLD) | 19.1% | 18.8% | 0.82 | 4.8% |
| Commodities (DBC) | 10.7% | 19.5% | 0.43 | 2.2% |
| Real Estate (VNQ) | 1.7% | 18.9% | -0.01 | 42.3% |
| Bitcoin (BTCUSD) | 10.2% | 52.6% | 0.38 | 6.5% |
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Based On 10-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with ENSG | |
|---|---|---|---|---|
| ENSG | 26.2% | 35.9% | 0.75 | - |
| Sector ETF (XLV) | 10.8% | 16.7% | 0.53 | 46.4% |
| Equity (SPY) | 15.3% | 17.9% | 0.72 | 46.4% |
| Gold (GLD) | 12.4% | 16.3% | 0.62 | 3.9% |
| Commodities (DBC) | 7.9% | 18.1% | 0.35 | 14.4% |
| Real Estate (VNQ) | 4.8% | 20.7% | 0.19 | 45.9% |
| Bitcoin (BTCUSD) | 63.7% | 66.2% | 1.03 | 12.9% |
Smart multi-asset allocation framework can stack odds in your favor. Learn How
Returns Analyses
Earnings Returns History
Updated 8/27/2026| Forward Returns | |||
|---|---|---|---|
| Earnings Date | 1D Returns | 5D Returns | 21D Returns |
| 7/27/2026 | 2.9% | 3.0% | 3.7% |
| 4/30/2026 | -1.6% | -6.6% | -11.6% |
| 2/4/2026 | 13.8% | 22.4% | 19.7% |
| 11/3/2025 | 0.1% | -1.3% | -3.2% |
| 7/24/2025 | 8.9% | 8.9% | 25.2% |
| 4/29/2025 | 0.7% | 4.2% | 14.4% |
| 2/5/2025 | -8.7% | -15.3% | -12.4% |
| 10/24/2024 | 2.7% | 4.1% | -1.7% |
| ... | |||
| SUMMARY STATS | |||
| # Positive | 15 | 15 | 16 |
| # Negative | 10 | 10 | 9 |
| Median Positive | 4.9% | 4.9% | 10.7% |
| Median Negative | -2.5% | -4.3% | -7.7% |
| Max Positive | 15.0% | 22.4% | 26.4% |
| Max Negative | -8.7% | -15.3% | -12.4% |
| Forward Returns | |||
|---|---|---|---|
| Earnings Date | 1D Returns | 5D Returns | 21D Returns |
| 7/27/2026 | 2.9% | 3.0% | 3.7% |
| 4/30/2026 | -1.6% | -6.6% | -11.6% |
| 2/4/2026 | 13.8% | 22.4% | 19.7% |
| 11/3/2025 | 0.1% | -1.3% | -3.2% |
| 7/24/2025 | 8.9% | 8.9% | 25.2% |
| 4/29/2025 | 0.7% | 4.2% | 14.4% |
| 2/5/2025 | -8.7% | -15.3% | -12.4% |
| 10/24/2024 | 2.7% | 4.1% | -1.7% |
| 7/25/2024 | 4.9% | 2.5% | 8.7% |
| 5/1/2024 | -2.4% | -2.8% | 1.5% |
| 2/1/2024 | 4.7% | 2.3% | 9.2% |
| 10/25/2023 | 0.3% | 1.5% | 15.3% |
| 7/27/2023 | 2.9% | 9.0% | 8.6% |
| 4/26/2023 | -3.6% | -6.0% | -10.8% |
| 2/2/2023 | -1.7% | -5.3% | -3.9% |
| 10/26/2022 | -4.0% | 0.6% | 4.5% |
| 8/1/2022 | 6.5% | 4.9% | 3.4% |
| 4/28/2022 | -2.0% | -5.1% | 0.5% |
| 2/9/2022 | 5.3% | 7.9% | 13.1% |
| 10/27/2021 | 10.0% | 13.1% | 12.3% |
| 7/28/2021 | -3.6% | -3.5% | -7.7% |
| 4/29/2021 | -1.0% | -1.6% | -4.0% |
| 2/3/2021 | -2.7% | -2.9% | -9.1% |
| 10/28/2020 | 5.5% | 10.6% | 26.4% |
| 8/5/2020 | 15.0% | 15.7% | 17.7% |
| SUMMARY STATS | |||
| # Positive | 15 | 15 | 16 |
| # Negative | 10 | 10 | 9 |
| Median Positive | 4.9% | 4.9% | 10.7% |
| Median Negative | -2.5% | -4.3% | -7.7% |
| Max Positive | 15.0% | 22.4% | 26.4% |
| Max Negative | -8.7% | -15.3% | -12.4% |
SEC Filings
Expand for More| Report Date | Filing Date | Filing |
|---|---|---|
| 06/30/2026 | 07/27/2026 | 10-Q |
| 03/31/2026 | 04/30/2026 | 10-Q |
| 12/31/2025 | 02/04/2026 | 10-K |
| 09/30/2025 | 11/03/2025 | 10-Q |
| 06/30/2025 | 07/24/2025 | 10-Q |
| 03/31/2025 | 04/29/2025 | 10-Q |
| 12/31/2024 | 02/05/2025 | 10-K |
| 09/30/2024 | 10/24/2024 | 10-Q |
| 06/30/2024 | 07/25/2024 | 10-Q |
| 03/31/2024 | 05/01/2024 | 10-Q |
| 12/31/2023 | 02/01/2024 | 10-K |
| 09/30/2023 | 10/25/2023 | 10-Q |
| 06/30/2023 | 07/27/2023 | 10-Q |
| 03/31/2023 | 04/26/2023 | 10-Q |
| 12/31/2022 | 02/02/2023 | 10-K |
| 09/30/2022 | 10/26/2022 | 10-Q |
| Report Date | Filing Date | Filing |
|---|---|---|
| 06/30/2026 | 07/27/2026 | 10-Q |
| 03/31/2026 | 04/30/2026 | 10-Q |
| 12/31/2025 | 02/04/2026 | 10-K |
| 09/30/2025 | 11/03/2025 | 10-Q |
| 06/30/2025 | 07/24/2025 | 10-Q |
| 03/31/2025 | 04/29/2025 | 10-Q |
| 12/31/2024 | 02/05/2025 | 10-K |
| 09/30/2024 | 10/24/2024 | 10-Q |
| 06/30/2024 | 07/25/2024 | 10-Q |
| 03/31/2024 | 05/01/2024 | 10-Q |
| 12/31/2023 | 02/01/2024 | 10-K |
| 09/30/2023 | 10/25/2023 | 10-Q |
| 06/30/2023 | 07/27/2023 | 10-Q |
| 03/31/2023 | 04/26/2023 | 10-Q |
| 12/31/2022 | 02/02/2023 | 10-K |
| 09/30/2022 | 10/26/2022 | 10-Q |
| 06/30/2022 | 08/01/2022 | 10-Q |
| 03/31/2022 | 04/28/2022 | 10-Q |
| 12/31/2021 | 02/09/2022 | 10-K |
| 09/30/2021 | 10/27/2021 | 10-Q |
| 06/30/2021 | 07/28/2021 | 10-Q |
| 03/31/2021 | 04/29/2021 | 10-Q |
| 12/31/2020 | 02/03/2021 | 10-K |
| 09/30/2020 | 10/28/2020 | 10-Q |
| 06/30/2020 | 08/05/2020 | 10-Q |
| 03/31/2020 | 05/11/2020 | 10-Q |
| 12/31/2019 | 02/05/2020 | 10-K |
| 09/30/2019 | 10/30/2019 | 10-Q |
Recent Forward Guidance
Updated 7/28/2026Latest: Q2 2026 Earnings Reported 7/27/2026
| Forward Guidance | Guidance Change | |||||||
|---|---|---|---|---|---|---|---|---|
| Metric | Source | Low | Mid | High | % Chg | % Delta | Change | Prior |
| 2026 Revenue | Reported | 5.87 Bil | 5.89 Bil | 5.92 Bil | 1.0% | Raised | Guidance: 5.83 Bil for 2026 | |
| 2026 EPS | Reported | 7.75 | 7.8 | 7.85 | 3.3% | Raised | Guidance: 7.55 for 2026 | |
Prior: Q1 2026 Earnings Reported 4/30/2026
| Forward Guidance | Guidance Change | |||||||
|---|---|---|---|---|---|---|---|---|
| Metric | Source | Low | Mid | High | % Chg | % Delta | Change | Prior |
| 2026 Revenue | Reported | 5.81 Bil | 5.83 Bil | 5.86 Bil | Raised | Guidance: 5.80 Bil for 2026 | ||
| 2026 Earnings Per Share | Reported | 7.48 | 7.55 | 7.62 | Raised | Guidance: 7.51 for 2026 | ||
Q4 2025 Earnings Reported 2/4/2026
| Forward Guidance | Guidance Change | |||||||
|---|---|---|---|---|---|---|---|---|
| Metric | Source | Low | Mid | High | % Chg | % Delta | Change | Prior |
| 2026 Revenue | Reported | 5.77 Bil | 5.80 Bil | 5.84 Bil | 14.7% | Higher New | Guidance: 5.06 Bil for 2025 | |
| 2026 EPS | Reported | 7.41 | 7.51 | 7.61 | 15.4% | Higher New | Guidance: 6.51 for 2025 | |
Q3 2025 Earnings Reported 11/3/2025
| Forward Guidance | Guidance Change | |||||||
|---|---|---|---|---|---|---|---|---|
| Metric | Source | Low | Mid | High | % Chg | % Delta | Change | Prior |
| 2025 Annual Revenue | Reported | 5.05 Bil | 5.06 Bil | 5.07 Bil | 1.1% | Raised | Guidance: 5.00 Bil for 2025 | |
| 2025 Annual Earnings Per Share | Reported | 6.48 | 6.51 | 6.54 | 1.7% | Raised | Guidance: 6.4 for 2025 | |
Insider Activity
Updated 8/13/2026| # | Owner | Title | Holding | Action | Filing Date | Price | Shares | Transacted Value | Value of Held Shares | Form |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Blouin, Ann Scott | Direct | Sell | 7292026 | 183.54 | 375 | 68,829 | 4,345,771 | Form | |
| 2 | Agwunobi, John O | Direct | Sell | 7222026 | 171.06 | 392 | 67,056 | 1,625,609 | Form | |
| 3 | Parkinson, Mark Vincent | Direct | Sell | 7172026 | 168.12 | 100 | 16,812 | 655,668 | Form | |
| 4 | Smith, Barry M | Direct | Sell | 6042026 | 164.28 | 700 | 114,996 | 3,507,707 | Form | |
| 5 | Smith, Barry M | Direct | Sell | 5062026 | 182.21 | 700 | 127,547 | 4,018,095 | Form |
| # | Owner | Title | Holding | Action | Filing Date | Price | Shares | Transacted Value | Value of Held Shares | Form |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Blouin, Ann Scott | Direct | Sell | 7292026 | 183.54 | 375 | 68,829 | 4,345,771 | Form | |
| 2 | Agwunobi, John O | Direct | Sell | 7222026 | 171.06 | 392 | 67,056 | 1,625,609 | Form | |
| 3 | Parkinson, Mark Vincent | Direct | Sell | 7172026 | 168.12 | 100 | 16,812 | 655,668 | Form | |
| 4 | Smith, Barry M | Direct | Sell | 6042026 | 164.28 | 700 | 114,996 | 3,507,707 | Form | |
| 5 | Smith, Barry M | Direct | Sell | 5062026 | 182.21 | 700 | 127,547 | 4,018,095 | Form | |
| 6 | Agwunobi, John O | Direct | Sell | 4222026 | 199.97 | 392 | 78,388 | 1,858,751 | Form | |
| 7 | Parkinson, Mark Vincent | Direct | Sell | 4172026 | 196.60 | 100 | 19,660 | 668,440 | Form | |
| 8 | Smith, Barry M | Direct | Sell | 4062026 | 196.65 | 700 | 137,655 | 4,356,191 | Form | |
| 9 | Smith, Barry M | Direct | Sell | 3022026 | 213.02 | 700 | 149,114 | 4,867,933 | Form | |
| 10 | Shaw, Daren | Direct | Sell | 2192026 | 213.43 | 1,000 | 213,430 | 5,063,840 | Form | |
| 11 | Parkinson, Mark Vincent | Direct | Sell | 2092026 | 198.00 | 100 | 19,800 | 574,200 | Form | |
| 12 | Blouin, Ann Scott | Direct | Sell | 2092026 | 198.00 | 375 | 74,250 | 4,524,696 | Form | |
| 13 | Snapper, Suzanne D | CFO | Direct | Sell | 2092026 | 196.11 | 4,573 | 896,823 | 53,516,991 | Form |
| 14 | Snapper, Suzanne D | CFO | Direct | Sell | 2092026 | 194.48 | 8,258 | 1,606,056 | 53,962,144 | Form |
| 15 | Smith, Barry M | Direct | Sell | 2042026 | 171.54 | 700 | 120,078 | 4,040,110 | Form | |
| 16 | Agwunobi, John O | Direct | Sell | 1222026 | 178.31 | 146 | 26,033 | 1,620,330 | Form | |
| 17 | Agwunobi, John O | Direct | Sell | 1222026 | 179.82 | 246 | 44,236 | 1,660,305 | Form | |
| 18 | Smith, Barry M | Direct | Sell | 1062026 | 173.59 | 700 | 121,513 | 4,105,751 | Form | |
| 19 | Wittekind, Beverly B | VP and Chief Legal Officer | Direct | Sell | 12232025 | 180.00 | 2,000 | 360,000 | 5,900,220 | Form |
| 20 | Wittekind, Beverly B | VP and Chief Legal Officer | Direct | Sell | 12162025 | 175.48 | 8,400 | 1,474,000 | 5,751,933 | Form |
| 21 | Smith, Barry M | Direct | Sell | 12032025 | 184.27 | 700 | 128,989 | 4,487,343 | Form | |
| 22 | Burton, Spencer | President and COO | Direct | Sell | 11242025 | 180.00 | 3,690 | 664,200 | 9,209,700 | Form |
| 23 | Burton, Spencer | President and COO | Direct | Sell | 11192025 | 180.00 | 2,209 | 397,620 | 9,209,700 | Form |
| 24 | Shaw, Daren | Direct | Sell | 11192025 | 178.57 | 1,000 | 178,570 | 4,308,180 | Form | |
| 25 | Burton, Spencer | President and COO | Direct | Sell | 11192025 | 177.30 | 5,899 | 1,045,893 | 9,071,554 | Form |
| 26 | Port, Barry | Chief Executive Officer | Direct | Sell | 11132025 | 180.71 | 28,315 | 5,116,700 | 10,206,474 | Form |
| 27 | Uychiat, Pison Marivic | Direct | Sell | 11072025 | 182.08 | 73 | 13,292 | 2,638,339 | Form | |
| 28 | Agwunobi, John O | Direct | Sell | 11072025 | 188.87 | 246 | 46,462 | 1,677,005 | Form | |
| 29 | Smith, Barry M | Direct | Sell | 11052025 | 180.64 | 700 | 126,448 | 4,525,393 | Form | |
| 30 | Smith, Barry M | Direct | Sell | 10032025 | 172.00 | 700 | 120,400 | 4,326,144 | Form | |
| 31 | Smith, Barry M | Direct | Sell | 9042025 | 172.06 | 700 | 120,442 | 4,654,567 | Form | |
| 32 | Shaw, Daren | Direct | Sell | 8192025 | 166.17 | 1,000 | 166,170 | 4,075,485 | Form | |
| 33 | Port, Barry | Chief Executive Officer | Direct | Sell | 8122025 | 160.00 | 2,399 | 383,840 | 9,124,800 | Form |
| 34 | Smith, Barry M | Direct | Sell | 8042025 | 150.00 | 700 | 105,000 | 4,162,800 | Form | |
| 35 | Blouin, Ann Scott | Direct | Sell | 8042025 | 149.23 | 425 | 63,423 | 3,287,089 | Form |
Investor Activity (13F)
Updated Sep 6, 2026Active managers (13F portfolio over $250M, at least 3 holdings) with a position over $5M that is either over 10% of their portfolio or held in a concentrated book of 50 or fewer total positions. Index/ETF, sovereign, bank, community-bank and charitable/donor-advised filers are excluded.
| Active Manager |
|---|
External Quote Links
| Y Finance | Barrons |
| TradingView | Morningstar |
| SeekingAlpha | ValueLine |
| Motley Fool | Robinhood |
| CNBC | Etrade |
| MarketWatch | Unusual Whales |
| YCharts | Perplexity Finance |
| FinViz |
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