Start here if you're new
what it is
Ensign runs nursing homes, senior living sites, therapy services, home health, hospice, and urgent care.
how it gets paid
Fiscal 2025 revenue was about $5.1B. The skilled-services segment (skilled nursing, post-acute, and related services) was the core at roughly $4.8B, or about 96% of sales.
why it's growing
Fiscal 2025 revenue rose about 19% vs. prior year to roughly $5.1B. Adjusted diluted EPS for the full year was about $6.57, also up close to 20% versus fiscal 2024.
what just happened
Q4 2025 revenue was about $1.36B (up roughly 20% vs. prior year). Adjusted EPS beat the consensus estimate.
At a glance
A balance sheet — strong enough to weather a downturn
80/100 earnings predictability — you can trust these numbers
~35x trailing p/e — you're paying up for this one
0.1% dividend yield — cash in your pocket every quarter
8.1% return on capital — nothing to write home about
xvary composite: 73/100 — average
What they do
Ensign runs nursing homes, senior living sites, therapy services, home health, hospice, and urgent care.
Healthcare is local. Ensign already serves patients through 370+ skilled nursing and senior living operations as of late 2025. If a hospital needs a bed today, it calls the operator with buildings, therapists, and more than 55,000 employees already in place, which means your smaller rival is late before it starts.
How they make money
~$5.1B
fiscal 2025 revenue · consolidated revenue grew about +19% vs. prior year
Skilled services (SNF, post-acute, related)
~$4.8B
Standard Bearer & other
~$0.22B
The products that matter
operates post-acute care facilities
Skilled Nursing Facilities
~$4.8B · ~96% of revenue
it's the center of the company, generating most of the roughly $5.1B consolidated total. if occupancy and reimbursement hold, this is where your earnings power comes from.
~96% of revenue
delivers therapy and rehab
Therapy & Rehabilitation
embedded in skilled footprint · ~19% consolidated rev. growth
therapy and rehab are layered into the same operations that drive skilled-services revenue. fiscal 2025 consolidated revenue growth was high-teens percent — the lift shows up in the core segment, not as a separate billion-dollar line in public reporting.
fastest growth
provides at-home care services
Home Health & Hospice
part of skilled-services mix
home health and hospice sit inside the skilled-services reporting line in filings — meaningful clinically, but not broken out as a standalone multi-hundred-million public segment.
small today
Key numbers
~$5.1B
fiscal 2025 revenue
That is the current size of the machine. Plain English: this is already a scaled operator, not a tiny turnaround story.
~35x
trailing p/e
P/E → how many years of current earnings you are paying for → so what: you are paying a growth-stock price for a regulated care operator.
~9%
operating margin (TTM)
Operating margin → profit after running the business → so what: there is a cushion, but it is not huge in a labor-heavy industry.
15%
debt share
Long-term debt as a share of capital → how much of the business is funded with borrowing → so what: leverage exists, but it is not the whole story.
Financial health
A
strength
- balance sheet grade A — very strong financial position
- risk rank 3 — safer than 50% of stocks
- price stability 85 / 100
- long-term debt $2.1B (15% of capital)
A — among the top-rated companies for balance sheet quality.
Total return vs. market
Return history isn't available for ENSG right now.
source: institutional data · return history unavailable
What just happened
beat estimates
Q4 2025 revenue was about $1.36B (up roughly 20% vs. prior year). Adjusted EPS cleared the consensus bar.
Per the company's fiscal Q4 2025 release, revenue was about $1.36 billion with roughly 20% vs. prior year growth. Adjusted diluted EPS was about $1.82 versus a consensus near $1.77. GAAP diluted EPS was about $1.61. Full-year fiscal 2025 adjusted EPS was about $6.57 on roughly $5.06 billion of revenue.
~$1.36B
Q4 revenue
~$1.82
Q4 adj. EPS
~+20%
Q4 rev. vs. prior year
the number that mattered
The ~20% quarterly revenue growth plus an adjusted EPS beat is what the market reacted to. Plain English: the roll-up is still comping well — but you still need to ask how much came from acquisitions versus same-facility operating leverage.
source: Ensign Group fiscal Q4 & FY 2025 results (investor relations / SEC)
Get this snapshot in your inbox
This page, delivered free — plus weekly updates when the numbers change. plain english, no spam.
weekly updates
earnings alerts
plain english
no spam
What could go wrong
the #1 risk here is government reimbursement pressure on skilled nursing economics. when most of your revenue flows through public payors, rate changes are not background noise — they are the business model.
med
reimbursement rate pressure
the company says most payment comes through programs like Medicare. if reimbursement tightens, ENSG cannot simply raise prices the way a consumer brand can.
with most of the roughly $5.1B revenue base tied to skilled and post-acute services, even modest rate pressure hits the core engine.
med
acquisition pricing gets harder
the bull case depends on buying underperforming facilities at prices that still leave room for operational improvement. management already operates in a more competitive acquisition market than it did when the strategy was less crowded.
at a mid-30s trailing P/E, the stock assumes the roll-up machine keeps finding attractive deals. if that pipeline slows, the multiple is the first thing investors question.
med
execution slip after a premium setup
Q4 2025 actually printed an adjusted EPS beat versus consensus, but the multiple is still rich if growth ever slows. premium stocks do not need disasters to reset — they just need the next quarter to feel ordinary.
the issue is not balance-sheet survival. it's valuation compression on a business already priced for smooth growth.
the combined risk picture is simple: the vast majority of revenue sits in reimbursement-sensitive skilled and post-acute services, while a mid-30s trailing multiple leaves you exposed if either rates or acquisition returns disappoint.
source: institutional data · regulatory filings · risk analysis
Pay attention to
guidance
2026 EPS guidance still sits at $7.41–$7.61
after Q4 results, this range still matters. if management starts trimming it, the premium multiple loses cover fast.
occupancy
same-facility occupancy reached 83.8%
Q4 2025 materials cited a same-facility occupancy record at 83.8% (with transitioning-facility occupancy around 84.9%). management says mature facilities can reach the high to mid-90s — that gap is operational upside if the story holds.
institutional flow
96.12% institutional ownership leaves little weak money
381 institutional buyers added shares in the last 12 months. when ownership is this concentrated, incremental flows can still move the stock.
valuation risk
~35x earnings versus 8.1% return on capital
that spread is the tension in one line. either returns improve as acquisitions mature, or the stock eventually has to meet the business where it is.
Analyst rankings
earnings predictability
80 / 100
management has usually kept results reasonably consistent. in human-speak, analysts think this is a company that misses less often than the average roll-up story.
price target context
$201
a recent analyst target moved up to $201, but the stock trades around $213. that tells you the shares have already run ahead of at least some published targets.
source: institutional data
Institutional activity
institutional ownership data for ENSG is being compiled.
source: institutional data
Price targets
3-5 year target range
n/a
n/a
$213
current price
n/a
target midpoint · n/a from current
Want the deeper analysis?
The full deep dive: dcf model, scenario analysis, competitive moat breakdown, and quarterly tracking — everything on this page, taken further.
see plans from $5/moThe deep dive