At a glance
The Ensign Group Inc is worth $10.74B, about 32 times its fiscal 2025 earnings. Revenue grew 18.7% to $5.06B in fiscal 2025, with 6.8% kept as profit; over 5 years it has grown 16.1% a year. It pays a 0.15% dividend yield, raised every year for at least 9 years, and returned $124.7M to shareholders in dividends and buybacks over FY2021–FY2025. The stock returned −0.7% over the past year with dividends reinvested and +19.6% a year over five years, against +11.5% and +11.7% for the S&P 500. At its worst it fell 52.2% in the 2020 crash (S&P 500: 33.7%) and 24.6% in the 2022 bear market (S&P 500: 24.5%), and was back at its earlier high 5 months after the low.
The business in plain English
Ensign Group, founded in 1999, is a holding company whose independent subsidiaries run skilled nursing facilities in 17 states. These nursing homes provide doctor-prescribed medical care and rehabilitation. Many patients are recovering from strokes, heart and lung conditions or joint replacements; others stay long term. As of December 31, 2025, Ensign ran 357 skilled nursing operations with 37,911 beds. It also runs senior living communities and services such as mobile X-rays and patient transportation.
Skilled nursing produced about 95.6% of Ensign's $5.06 billion in revenue in 2025. Government programs pay most of the bills. Medicaid, the state-federal program for people with low incomes, provided about 46.6% of skilled services revenue. Medicare, the federal program mainly for older Americans, provided about 24.7%. Managed care plans, insurers and patients paying privately cover the rest.
Ensign's other reported segment is Standard Bearer, a real estate investment trust (REIT), which is a tax-advantaged property owner. Formed in January 2022, it owns 152 properties and rents them out under triple-net leases, where the tenant pays taxes, insurance and upkeep. Most tenants are Ensign's own operations. Of $126.9 million in 2025 rent, $107.6 million came from them and cancels out in reported totals. Senior living, ancillary services and other real estate make up about 4.6% of revenue. Growth comes mainly from acquisitions: 145 facilities from 2021 through 2025.
Price history
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ENSG -0.7% over the year to Oct 28, 2026, total return with dividends reinvested.
Latest results
- In Q3 FY2026 (ended Sep 30, 2026), revenue was $1.48B, up 14.5% from a year earlier, and net income was $104.3M (+24.4%).
- For fiscal 2025, revenue was $5.06B (+18.7% year over year; +16.1% a year from FY2020 to FY2025) with a 6.8% net margin.
Financial health check
| Revenue growth a year (FY2020–FY2025) | +16.1% good |
|---|---|
| Operating margin | 8.4% watch |
| Return on equity (FY2025) | 15.4% good |
| Return on assets (FY2025) | 6.3% watch |
| Net cash (cash minus debt) | $193.0M good |
| Fiscal year | Revenue | Net income | Free cash flow |
|---|---|---|---|
| FY2020 | $2.40B | $170.5M | — |
| FY2021 | $2.63B | $194.7M | — |
| FY2022 | $3.03B | $224.7M | — |
| FY2023 | $3.73B | $209.4M | — |
| FY2024 | $4.26B | $298.0M | — |
| FY2025 | $5.06B | $344.0M | — |
Valuation snapshot
| Market value | $10.74B |
|---|---|
| P/E ratio | 31.5 |
| Dividend yield | 0.15% |
Rank among 1514 US companies
Market value at each year end
The Ensign Group’s market value went from $1.13B at the end of 2016 to $10.74B on Oct 28, 2026, about 9.5 times as much; since the end of 2025 it is up 6%.
Show as a table
| Year end | Market value | Change |
|---|---|---|
| Oct 28, 2026 | $10.74B | +6.4% |
| 2025 | $10.09B | +32.6% |
| 2024 | $7.61B | +20.2% |
| 2023 | $6.33B | +20.7% |
| 2022 | $5.25B | +13.2% |
| 2021 | $4.64B | +17.3% |
| 2020 | $3.96B | +63.4% |
| 2019 | $2.42B | +19.3% |
| 2018 | $2.03B | +78.7% |
| 2017 | $1.14B | +0.9% |
| 2016 | $1.13B |
Price behavior
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | |
|---|---|---|---|---|---|
| ENSG price data to Oct 28, 2026 | +5.8% | -0.7% | +23.9% | +19.6% | +26.5% |
Show as a table
| Year | Price data |
|---|---|
| 2026 (to date) | +5.8% |
| 2025 | +31.3% |
| 2024 | +18.6% |
| 2023 | +19.0% |
| 2022 | +13.0% |
| 2021 | +15.4% |
| 2020 | +61.4% |
| 2019 | +17.4% |
| 2018 | +75.8% |
| 2017 | +0.8% |
| 2016 | -1.1% |
| 2015 | +3.0% |
| 2014 | +75.0% |
| 2013 | +64.3% |
| 2012 | +11.8% |
| 2011 | -0.6% |
| 2010 | +63.6% |
| 2009 | -7.0% |
| 2008 | +17.8% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Before this security existed |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Lost 38.1% over that stretch · deepest drop along the way 52.2%, back to its old high 4.7 months after the low |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Lost 1.8% over that stretch · deepest drop along the way 24.6%, back to its old high 4.7 months after the low |
Insider activity
Form 4 filings from 2025-10-29 to 2026-10-29 (25 read): 0 open-market purchases and 6 sales ($286K), 6 of them under pre-arranged 10b5-1 trading plans.
| Date | Insider | Type | Value |
|---|---|---|---|
| Jun 2, 2026 | Barry M Smith Director | sell (plan) | $115K |
| Jul 20, 2026 | John O Agwunobi Director | sell (plan) | $67K |
| Jul 27, 2026 | Ann Scott Blouin Director | sell (plan) | $37K |
| Jul 27, 2026 | Ann Scott Blouin Director | sell (plan) | $32K |
| Oct 16, 2026 | Mark Vincent Parkinson Director | sell (plan) | $18K |
Who owns it
Large shareholders (13G filings)
| BlackRock, Inc. | 9.1% | Jun 30, 2026 |
| BAILLIE GIFFORD & CO | 7.9% | Dec 31, 2025 |
| Vanguard Capital Management | 5.21% | Mar 31, 2026 |
| Vanguard Portfolio Management | 4.91% | Jun 30, 2026 |
| Wasatch Advisors LP | 4.9% | Dec 31, 2025 |
ETFs with the most weight in ENSG
| RISN Inspire Tactical Balanced ETF | 2.94% |
| OSCV Opus Small Cap Value ETF | 2.73% |
| XHS SPDR S&P Health Care Services ETF | 1.94% |
| JSMD Janus Henderson Small/Mid Cap Growth Alpha ETF | 1.82% |
| SMMV iShares MSCI USA Small-Cap Min Vol Factor ETF | 1.41% |
| IHF iShares U.S. Healthcare Providers ETF | 1.11% |
| SMDV ProShares Russell 2000 Dividend Growers ETF | 1.11% |
| JPSV JPMorgan Active Small Cap Value ETF | 1.05% |
What could go wrong
- Dependence on Medicaid and Medicare rates. Medicaid and Medicare paid about 46.6% and 24.7% of skilled services revenue in 2025. Rate cuts, state spending requirements or political changes at HHS, the federal health department, could hurt revenue and profits.
- Growth depends on buying and fixing facilities. Ensign bought 145 facilities from 2021 through 2025 and relies on improving them. Paying too much, integration problems or liabilities inherited from sellers could slow growth or hurt results.
- Most facilities are leased, not owned. As of December 31, 2025, Ensign leased 253 of its 373 facilities. Missing rent or debt payments, or breaking loan terms, could trigger defaults across several agreements and cost it facilities.
- Audits, inspections and refund demands. Regulators audit billing and inspect care. Problems can lead to refunds, fines, lost licenses or criminal charges. Changes to the federal Special Focus Facility program, which targets poorly performing homes, raise the risk of sanctions.
- Nurse shortages and higher labor costs. Competition for nurses and other skilled staff could push up wages. Facilities that miss state minimum staffing requirements can be fined, and staffing levels may also affect reimbursement.
- Lawsuits and self-insured losses. Claims over patient care can bring large settlements or damage awards. Self-insurance programs could produce unexpected losses, and changes to arbitration agreements with residents could increase claims.
Recent events
- Quarterly results released
- Bylaws or fiscal year changed
- Major agreement signed; New debt or financial obligation; Investor presentation or announcement
- Quarterly results released
- Other company announcement
- Shareholder vote results
- Quarterly results released
- Quarterly results released
- Quarterly results released
For income and retirement investors
Ensign pays a dividend, but it is small. The yield was 0.15% as of October 28, 2026. The 2025 dividend of about $0.25 a share used just 4.2% of earnings. Ensign has raised it for at least 9 straight years, but only by about 4.5% a year from 2020 to 2025. It keeps most of its profit to pay for acquisitions and real estate. Buybacks totaled $60 million from 2021 through 2025, yet the share count rose 5.9% between February 2022 and October 2026. For income investors, the dividend is a token amount.
The shares have fallen hard in sell-offs. In the 2020 COVID crash they dropped 52.2% from February 19 to March 16, 2020, then took about 4.7 months to recover. In 2022 they fell 24.6% between April and June and recovered by November. Even so, they lost just 1.8% from the market's January peak to its October low. A single stock carries more risk than a diversified fund.
Questions investors ask
How does Ensign Group make money?
Mostly by running skilled nursing facilities. In 2025, about 95.6% of its $5.06 billion in revenue came from these nursing homes. They care for patients recovering from strokes, joint replacements and other conditions, as well as long-stay elderly residents. Medicaid paid about 46.6% of skilled services revenue and Medicare about 24.7%. The rest of Ensign's revenue comes from senior living, ancillary services such as mobile X-rays, and rent from properties leased to outside operators.
Does Ensign Group raise its dividend every year?
Yes, so far. Ensign's dividend per share rose every year from 2016 to 2025. That is at least 9 straight annual increases, and the true streak may be longer. The raises are small: the dividend went from $0.2025 a share in 2020 to $0.2525 in 2025, about 4.5% a year. It used just 4.2% of 2025 earnings, and the yield was 0.15% as of October 28, 2026. The 10-K warns the company may not be able to maintain dividends.
Is Ensign Group a REIT?
No. Ensign is a holding company that runs nursing homes, but it owns a REIT called Standard Bearer. A real estate investment trust owns property and generally avoids federal corporate income tax if it follows strict rules. Standard Bearer was formed in January 2022. It holds 152 of Ensign's 158 owned properties and leases them to Ensign's operations and outside operators. If Standard Bearer lost REIT status, it would be taxed as a regular corporation and could face a large tax bill.
How much debt does Ensign Group have?
Relatively little compared with its cash. As of September 30, 2026, Ensign reported about $199 million of total debt and $392 million of cash and investments, or net cash of about $193 million. Leases are a separate commitment: as of December 31, 2025, it leased 253 of its 373 facilities. Its 10-K warns that missing rent or debt payments could trigger defaults across agreements. An August 20, 2026 filing also reported a new debt or financial obligation.
How has Ensign Group stock performed?
Strongly over long periods, though the shares slipped 0.7% in the year to October 28, 2026. As of that date, the share price had gained about 26.5% a year over 10 years and 19.6% a year over 5 years, including a 31.3% rise in calendar 2025. The ride has been bumpy. The deepest drop in the year to that date was 31.8%, and the worst in 19 years of price history was 58.4%. The shares traded at 31.5 times 2025 earnings per share.