ENSG
HealthcareThe Ensign Group, Inc. · Medical - Care Facilities · $10B
What is The Ensign Group, Inc.?
The Ensign Group operates a large network of post-acute care and senior living facilities across more than a dozen U.S. states. The company focuses on skilled nursing, rehabilitation, and ancillary healthcare services for elderly and chronically ill patients.
Ensign generates revenue through two primary segments: Skilled Services and Real Estate. The Skilled Services segment provides short- and long-term nursing care, physical therapy, occupational therapy, and speech therapy. The Real Estate segment leases healthcare properties to operators. Ancillary offerings — including mobile diagnostics, laboratory services, and patient transportation — round out the business model, allowing Ensign to serve patients across the post-acute care continuum.
Ensign was incorporated in 1999 and is headquartered in San Juan Capistrano, California.
- Skilled nursing and long-term care for elderly and chronically ill patients
- Physical, occupational, and speech rehabilitation therapy services
- Senior living community management and operations
- Healthcare real estate leasing to third-party operators
- Mobile diagnostics and ancillary clinical services
Is ENSG a Good Stock to Buy?
UQS Score rates ENSG as Below Average overall, reflecting meaningful headwinds across several key pillars.
Growth stands out as the clearest bright spot in Ensign's profile. The company has expanded its facility count steadily and continues to pursue an acquisition-driven growth strategy within the fragmented post-acute care market. Valuation is rated Neutral, suggesting the stock is neither deeply discounted nor significantly stretched relative to its fundamentals.
Quality, Moat, and Risk are all rated Weak — pointing to thin competitive differentiation, operational vulnerabilities common in skilled nursing, and profitability characteristics that lag stronger healthcare peers.
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Past performance does not guarantee future results. UQS Score is based on fundamental data and is not a buy/sell recommendation.
Does ENSG pay dividends?
Yes — The Ensign Group, Inc. pays a dividend.
Ensign pays a regular dividend, which is relatively uncommon among growth-oriented healthcare operators of its size. The dividend reflects the company's intent to return some capital to shareholders even as it pursues facility acquisitions. Income-focused investors may find the dividend noteworthy, though the payout should be evaluated alongside the company's broader capital allocation priorities.
When does ENSG report earnings?
The Ensign Group reports earnings on a quarterly cadence, consistent with standard practice for U.S.-listed equities.
Ensign's recent quarters have reflected continued facility growth, though margin pressures common across the skilled nursing sector — including labor costs and reimbursement rate dynamics — remain ongoing considerations. Revenue trends have generally tracked the company's acquisition pace.
For the most recent quarter's results and guidance, visit The Ensign Group's investor relations page directly.
ENSG Price History
+132.8% over 5Y
Monthly close, adjusted for stock splits and dividend reinvestment.
What if I invested in The Ensign Group, Inc.?
Based on The Ensign Group, Inc.'s historical closing prices, adjusted for stock splits and dividend reinvestment. Past performance does not guarantee future results. This is for informational purposes only and is not financial advice.
ENSG Long-term Outlook
Ensign's Growth pillar rating of Good suggests the company's expansion trajectory remains intact, driven by its disciplined acquisition model in a fragmented market. However, the Weak Risk rating signals that execution risk, reimbursement uncertainty, and labor cost pressures could weigh on the pace of earnings improvement. The Neutral Valuation rating indicates the market has largely priced in current expectations, leaving limited margin of safety if growth disappoints.
Growth drivers
- Continued acquisition of underperforming skilled nursing facilities at scale
- Demographic tailwinds from an aging U.S. population increasing demand for post-acute care
- Expansion of ancillary and mobile diagnostic service lines
Key risks
- Government reimbursement rate changes affecting Medicare and Medicaid revenue
- Elevated labor costs and staffing shortages across the skilled nursing industry
- Integration risk from a high-volume acquisition strategy
ENSG vs Peers
Ensign operates in a competitive post-acute and broader healthcare services landscape alongside several larger and more diversified peers.
UHS operates acute care hospitals and behavioral health facilities, giving it a broader and more diversified hospital-based revenue mix than Ensign's post-acute focus.
Solventum focuses on medical technology and healthcare solutions rather than facility-based care, representing a fundamentally different business model within the broader healthcare sector.
Encompass Health specializes in inpatient rehabilitation hospitals, making it a closer post-acute peer to Ensign but with a distinct focus on higher-acuity rehabilitation rather than skilled nursing.
Frequently Asked Questions
What does The Ensign Group do?
The Ensign Group operates skilled nursing facilities, senior living communities, and ancillary healthcare service businesses across more than a dozen U.S. states. The company provides nursing care, rehabilitation therapies, and mobile diagnostic services, and also leases healthcare real estate through its Real Estate segment.
Does ENSG pay dividends?
Yes, The Ensign Group pays a regular dividend. This is relatively uncommon among healthcare operators that are also actively acquiring facilities. Investors should review the current dividend rate and payout history on the company's investor relations page for the most up-to-date information.
When does ENSG report earnings?
Ensign reports financial results on a quarterly basis, in line with standard U.S. public company practice. For the exact timing of upcoming earnings releases, check The Ensign Group's investor relations page or a financial calendar service.
Is ENSG a good stock to buy?
UQS Score rates ENSG as Below Average overall. Growth is the strongest pillar, reflecting the company's active acquisition strategy, but Quality, Moat, and Risk are all rated Weak. Investors should weigh the growth trajectory against meaningful operational and reimbursement risks before making a decision.
Is ENSG overvalued?
UQS Score rates ENSG's Valuation pillar as Neutral, suggesting the stock is neither clearly cheap nor obviously expensive relative to its fundamentals. A Neutral rating means the market appears to have largely priced in current expectations. The full valuation breakdown is available to Pro members.
How does ENSG compare to its competitors?
Compared to peers like Encompass Health, Universal Health Services, and Solventum, Ensign is more narrowly focused on skilled nursing and post-acute care. Its acquisition-driven growth model differentiates it operationally, though its Quality and Moat scores suggest it has not yet built the durable competitive advantages seen in some larger healthcare peers.
What is ENSG's market cap bracket?
The Ensign Group is classified as a large-cap company. This places it among the more substantial operators in the post-acute care space, though it remains smaller than the largest diversified hospital systems and healthcare conglomerates.
Who founded The Ensign Group?
The Ensign Group was incorporated in 1999. Founding and leadership history is publicly available through the company's official filings and investor relations materials for those seeking detailed background on the organization's origins.
Is ENSG a long-term quality investment?
As a long-term quality indicator, ENSG's UQS Score of Below Average reflects current weaknesses in Quality, Moat, and Risk that investors should consider carefully. The Good Growth rating shows expansion potential, but durable long-term quality typically requires stronger competitive positioning and more consistent profitability characteristics.
What is the main competitive advantage of The Ensign Group?
Ensign's primary competitive approach centers on acquiring and turning around underperforming skilled nursing facilities in a highly fragmented market. This operational playbook, combined with a decentralized management structure, has supported consistent facility growth — though the UQS Moat pillar rates this advantage as Weak relative to broader sector peers.
What sector does ENSG belong to?
ENSG operates in the Healthcare sector, specifically within the post-acute care and skilled nursing sub-industry. This segment is heavily influenced by government reimbursement programs, demographic trends, and labor market conditions — all of which shape the company's financial profile.
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Pro Analysis
ENSG — Score History
| Date | UQS | Quality | Moat | Growth | Risk | Value | Change |
|---|---|---|---|---|---|---|---|
| May 22, 2026 | 49.1 | 40.9 | 37.0 | 72.5 | 43.4 | 57.4 | +3.2 |
| May 10, 2026 | 45.9 | 9.3 | 37.0 | 72.5 | 60.0 | 72.0 | +0.1 |
| May 8, 2026 | 45.8 | 9.3 | 37.0 | 72.4 | 60.0 | 71.5 | -0.3 |
| May 7, 2026 | 46.1 | 39.2 | 37.0 | 72.4 | 28.2 | 55.3 | +0.5 |
| May 4, 2026 | 45.6 | 38.4 | 37.0 | 72.4 | 28.2 | 53.9 | +0.3 |
| May 3, 2026 | 45.3 | 38.4 | 37.0 | 71.1 | 28.2 | 53.5 | +0.1 |
| May 2, 2026 | 45.2 | 38.4 | 37.0 | 71.1 | 28.2 | 52.5 | +0.1 |
| Apr 26, 2026 | 45.1 | 38.4 | 37.0 | 70.8 | 28.2 | 52.5 | +0.3 |
| Apr 25, 2026 | 44.8 | 38.4 | 37.0 | 70.8 | 28.2 | 50.7 | -0.1 |
| Apr 23, 2026 | 44.9 | 38.5 | 37.0 | 70.8 | 28.2 | 50.7 | +0.1 |
ENSG — Pillar Breakdown
Quality
— 40.9/100 (25%)The Ensign Group, Inc. has average quality metrics, with room for improvement in margins or capital efficiency.
How effectively capital is deployed to generate returns.
Profitability relative to shareholders' equity.
Ability to convert revenue into operating profit.
Bottom-line profit as a share of revenue.
Asset productivity — how much gross profit each dollar of assets generates.
Free cash flow relative to market value.
Growth
— 72.5/100 (20%)The Ensign Group, Inc. demonstrates healthy growth trends across revenue and earnings.
Revenue trajectory over the last twelve months.
Compound annual revenue growth rate over 3 years.
Year-over-year earnings per share growth.
Analyst consensus for future revenue growth.
Analyst consensus for future earnings growth.
Risk
— 43.4/100 (15%)The Ensign Group, Inc. has some risk factors including moderate leverage or solvency concerns.
Debt levels relative to earnings capacity.
Total debt relative to shareholder equity.
Short-term liquidity — ability to pay near-term obligations.
Earnings capacity relative to interest payments.
Valuation
— 56.8/100 (15%)The Ensign Group, Inc. trades at a reasonable valuation with decent earnings yield and FCF multiples.
Inverse of forward P/E — higher yield means cheaper stock.
How many years of FCF the market cap represents.
P/E relative to earnings growth — lower is more attractive.
Enterprise value multiple relative to sector median.
Moat
— 37/100 (25%)The Ensign Group, Inc. possesses some competitive advantages but faces meaningful competition. The Moat pillar evaluates competitive advantages across five dimensions: Switching Costs, Network Effects, Cost Advantage, Intangible Assets, and Scale & Ecosystem. Sign in to customize moat ratings for ENSG.
Score Composition
Financial Data
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How is the ENSG UQS Score Calculated?
The UQS (Unified Quality Score) for The Ensign Group, Inc. is calculated using a proprietary 6-pillar framework with 29 financial metrics. Each pillar evaluates a different dimension on a 0–100 scale, then combines into a single weighted score. Scoring thresholds are calibrated per sector. Momentum is an optional Pro toggle — without it, you get the 5-pillar / 25-metric core shown below.
Quality (25%) measures profitability and capital efficiency — ROIC, ROE, margins, GP/Assets, and FCF Yield.
Moat (25%) assesses The Ensign Group, Inc.'s competitive advantages across switching costs, network effects, cost advantages, intangible assets, and ecosystem scale.
Growth (20%) tracks revenue trajectory and earnings momentum, combining historical results with analyst forward estimates.
Risk (15%) is inversely scored — lower leverage and strong balance sheet health result in higher scores.
Valuation (15%) measures whether The Ensign Group, Inc. is fairly priced using earnings yield, price-to-FCF, PEG ratio, and EV/EBITDA relative to sector peers.
Six investor-inspired presets are available, each with different pillar weights: Balanced, Buffett, Munger, Lynch, Cathie Wood, and Graham. The public score shown here uses the Balanced preset. Learn more in our FAQ.