The Ensign Group Reports Fiscal Year and Fourth Quarter 2025 Results; Issues 2026 Annual Earnings and Revenue Guidance

Rhea-AI Summary

The Ensign Group (Nasdaq: ENSG) reported fiscal 2025 GAAP diluted EPS of $5.84 and adjusted EPS of $6.57, with GAAP net income of $344.0M and consolidated revenue of $5.06B. Q4 2025 GAAP diluted EPS was $1.61 and consolidated revenue was $1.36B.

Management issued 2026 guidance of $7.41–$7.61 EPS and revenue of $5.77B–$5.84B, noted cash of $503.9M, and highlighted 51 acquisitions completed in 2025 (including 12 real estate assets).

Positive

• GAAP diluted EPS +14.1% year-over-year in 2025
• Adjusted diluted EPS +19.5% year-over-year in 2025
• Consolidated revenue +18.7% to $5.06 billion in 2025
• FFO +28.3% to $75.2 million for 2025
• 2026 guidance midpoint implies +14.3% EPS growth versus 2025
• Strong liquidity with $503.9 million cash on hand

Negative

• 2026 guidance assumes acquisitions closing through Q1 2026
• Guidance excludes certain charges and acquisition-related costs
• Standard Bearer rental revenue concentration: $29.3M from Ensign affiliates

News Market Reaction – ENSG

-0.24% 2.0x vol

21 alerts

-0.24% News Effect

+8.0% Peak in 4 hr 47 min

-$28M Valuation Impact

$11.49B Market Cap

2.0x Rel. Volume

On the day this news was published, ENSG declined 0.24%, reflecting a mild negative market reaction. Argus tracked a peak move of +8.0% during that session. Our momentum scanner triggered 21 alerts that day, indicating elevated trading interest and price volatility. This price movement removed approximately $28M from the company's valuation, bringing the market cap to $11.49B at that time. Trading volume was above average at 2.0x the daily average, suggesting increased trading activity.

Data tracked by StockTitan Argus on the day of publication.

Key Figures

FY 2025 GAAP EPS: $5.84 FY 2025 adjusted EPS: $6.57 Q4 2025 GAAP EPS: $1.61 +5 more

8 metrics

FY 2025 GAAP EPS $5.84 Year ended December 31, 2025

FY 2025 adjusted EPS $6.57 Year ended December 31, 2025

Q4 2025 GAAP EPS $1.61 Quarter ended December 31, 2025

Q4 2025 adjusted EPS $1.82 Quarter ended December 31, 2025

FY 2025 GAAP net income $344.0M Year ended December 31, 2025

FY 2025 revenue $5.06B Consolidated revenue, year ended December 31, 2025

2026 EPS guidance $7.41–$7.61 Management’s annual 2026 diluted EPS guidance range

2026 revenue guidance $5.77B–$5.84B Management’s annual 2026 revenue guidance range

Market Reality Check

Price: $210.64 Vol: Volume 315,086 is roughly...

normal vol

$210.64 Last Close

Volume Volume 315,086 is roughly in line with the 329,946 20-day average (rel. volume 0.95). normal

Technical Price $173.60 is trading above the $163.62 200-day MA and 10.51% below the 52-week high.

Peers on Argus

ENSG was up 0.6% while peers were mixed: DVA +5.26%, UHS +1.55%, EHC +0.64%, CHE...

ENSG was up 0.6% while peers were mixed: DVA +5.26%, UHS +1.55%, EHC +0.64%, CHE -0.12%, OPCH -1.28%, pointing to a company-specific reaction to earnings rather than a broad sector move.

Previous Earnings Reports

5 past events · Latest: Nov 03 (Positive)

Same Type Pattern 5 events

Date	Event	Sentiment	Move	Catalyst
Nov 03	Q3 2025 earnings	Positive	+2.1%	Strong Q3 EPS and revenue with raised 2025 guidance.
Oct 20	Earnings call notice	Neutral	+1.9%	Scheduled webcast to discuss upcoming Q3 2025 results.
Jul 24	Q2 2025 earnings	Positive	+8.9%	Strong Q2 EPS, higher occupancy and raised 2025 outlook.
Jul 21	Earnings call notice	Neutral	-0.7%	Announcement of timing for Q2 2025 earnings release and call.
Apr 29	Q1 2025 earnings	Positive	+0.7%	Record Q1 EPS, occupancy gains and raised 2025 guidance.

Pattern Detected

Earnings-related news has typically led to positive price reactions, especially when results are strong and guidance is raised.

Recent Company History

Across the last four earnings-related updates from Apr 29, 2025 through Nov 3, 2025, Ensign repeatedly reported double-digit EPS growth and raised full-year guidance while expanding its facility base. These announcements generally coincided with positive share moves, particularly after strong quarters like Q2 2025. Today’s full-year 2025 results and new 2026 guidance continue this pattern of growth, higher occupancy, and portfolio expansion, reinforcing the trajectory shown in prior quarters.

Historical Comparison

+2.6% avg move · Recent earnings and earnings-call headlines for ENSG have typically produced modest positive moves a...

earnings

+2.6%

Average Historical Move earnings

Recent earnings and earnings-call headlines for ENSG have typically produced modest positive moves around 2.57%, especially when accompanied by raised guidance and occupancy gains.

Through 2025, ENSG has reported sequentially strong quarterly results with rising EPS, improving occupancy and multiple guidance raises, culminating in full-year 2025 numbers and a new 2026 earnings and revenue outlook.

Market Pulse Summary

This announcement detailed strong 2025 performance with GAAP EPS of $5.84, adjusted EPS of $6.57, an...

Analysis

This announcement detailed strong 2025 performance with GAAP EPS of $5.84, adjusted EPS of $6.57, and consolidated revenue of $5.06B, alongside higher 2026 earnings and revenue guidance. Occupancy and skilled mix continued to improve while the portfolio expanded to 378 operations. Investors may track future quarters for execution on acquisition integration, reimbursement dynamics, and whether guidance remains supported by occupancy and margin trends.

Key Terms

gaap, adjusted earnings per share, non-gaap, ffo, +4 more

8 terms

gaap financial

"reporting GAAP diluted earnings per share of $5.84 and adjusted earnings..."

GAAP, or Generally Accepted Accounting Principles, are a set of standardized rules and guidelines that companies follow when preparing their financial statements. They ensure consistency, transparency, and comparability across different companies, making it easier for investors to understand and compare financial information accurately. This helps investors make informed decisions based on trustworthy and uniform financial reports.

adjusted earnings per share financial

"and adjusted earnings per share(1) of $6.57, both for the year ended..."

Adjusted Earnings Per Share shows how much profit a company makes for each share of stock, but it removes unusual or one-time items like big expenses or gains. This helps investors see the company's true ongoing performance, making it easier to compare how well different companies are doing over time.

non-gaap financial

"See "Reconciliation of GAAP to Non-GAAP Financial Information"."

Non-GAAP refers to financial measures that companies use to show their earnings or performance without including certain expenses or income that are often added back to give a different picture. It matters because it can make a company's results look better or more favorable, but it may also hide important costs, so investors need to look at both GAAP (official rules) and non-GAAP numbers to get a full understanding.

ffo financial

"FFO was $75.2 million for the year, an increase of 28.3% over..."

Funds from operations (FFO) is a performance metric used mainly for real estate companies that measures the cash generated by their core rental and property-management activities, while removing accounting items such as building depreciation and one-time gains or losses from property sales. Investors rely on FFO to assess a real estate firm's ability to pay and sustain dividends and fund growth—similar to checking how much actual rent a landlord collects each month rather than paper profits.

form 10-k regulatory

"on Form 10-K for the year ended December 31, 2025, which is expected..."

A Form 10-K is a comprehensive report that publicly traded companies are required to file annually with regulators. It provides a detailed overview of a company's financial health, operations, and risks, similar to a detailed health report. Investors use this information to assess the company's performance and make informed decisions about buying or selling its stock.

rule 10b5-1 regulatory

"These sales were executed under a Rule 10b5-1 trading plan adopted..."

Rule 10b5-1 is a regulation that allows company insiders to buy or sell their shares at predetermined times, even if they have access to non-public information. It acts like setting a schedule in advance for transactions, helping prevent accusations of unfair trading. This rule provides a way for insiders to plan trades transparently, giving investors confidence that these transactions are not based on hidden information.

form 4 regulatory

"filed an amended Form 4 to correct how a prior stock gift was..."

Form 4 is a official document that company insiders, such as executives or major shareholders, file with regulators whenever they buy or sell company shares. It provides transparency about how those with inside knowledge are trading, helping investors see if insiders are confident in the company's prospects or may be selling for personal reasons. This information can influence investor decisions by revealing insiders' perspectives on the company's value.

form 144 regulatory

"has filed a notice under Rule 144 to sell 700 shares of common..."

Form 144 is a document that investors must file with the government when they plan to sell a large number of shares of a company's stock. It helps ensure transparency so everyone knows how many shares are being sold and when, which can impact the stock's price.

AI-generated analysis. Not financial advice.

Conference Call and Webcast scheduled for tomorrow, February 5, 2026 at 10:00 am PT

SAN JUAN CAPISTRANO, Calif., Feb. 04, 2026 (GLOBE NEWSWIRE) -- The Ensign Group, Inc. (Nasdaq: ENSG), the parent company of the Ensign^(TM) group of companies, which provide post-acute healthcare services and invest in the long-term healthcare industry, primarily in skilled nursing and senior living facilities, announced operating results for the fiscal year and fourth quarter of 2025, reporting GAAP diluted earnings per share of $5.84 and adjusted earnings per share⁽¹⁾ of $6.57, both for the year ended December 31, 2025. Ensign also reported GAAP diluted earnings per share of $1.61 and adjusted earnings per share⁽¹⁾ of $1.82, both for the quarter ended December 31, 2025.

Highlights Include:

• GAAP diluted earnings per share for the year was $5.84 and for the quarter was $1.61, an increase of 14.1% and 18.4% over the prior year and prior year quarter, respectively.
   
• Adjusted diluted earnings per share⁽¹⁾ for the year was $6.57 and for the quarter was $1.82, an increase of 19.5% and 22.1% over the prior year and prior year quarter, respectively.
   
• GAAP net income was $344.0 million for the year and $95.5 million for the quarter, an increase of 15.4% and 19.8%, over the prior year and prior year quarter, respectively.
   
• Adjusted net income⁽¹⁾ was $386.6 million for the year and $107.8 million for the quarter, an increase of 20.6% and 23.2% over the prior year and prior year quarter, respectively.
   
• Same Facilities and Transitioning Facilities occupancy for the year were 82.9% and 84.2%, an increase of 2.5% and 4.2%, respectively, over the prior year and for the quarter were 83.8% and 84.9%, an increase of 2.9% and 3.5%, respectively, over the prior year quarter.
   
• Same Facilities and Transitioning Facilities skilled days for the year increased by 6.8% and 10.7%, respectively, over the prior year and for the quarter increased by 8.5% and 10.0%, respectively, over the prior year quarter.
   
• Same Facilities and Transitioning Facilities Medicare revenue for the year improved by 11.5% and 9.4%, respectively, over the prior year, and for the quarter improved by 15.7% and 11.3%, respectively, over the prior year quarter.
   
• Total skilled services⁽²⁾ revenue was $4.84 billion for the year and $1.30 billion for the quarter, an increase of 18.7% and 20.2% over the prior year and prior year quarter, respectively.
   
• Consolidated revenue for the year was $5.06 billion, an increase of 18.7% over the prior year. Consolidated revenue for the quarter was $1.36 billion, an increase of 20.2% over the prior year quarter.
   
• Standard Bearer⁽²⁾ revenue was $126.9 million for the year, an increase of 33.5% over the prior year, and $34.5 million for the quarter, an increase of 37.2% over the prior year quarter. FFO was $75.2 million for the year, an increase of 28.3% over the prior year, and $20.4 million for the quarter, an increase of 33.9% over the prior year quarter.
  

	(1)	See "Reconciliation of GAAP to Non-GAAP Financial Information".
	(2)	Our Skilled Services and Standard Bearer Segments are defined and outlined in Note 7 of Item 8. Financial Statements and Supplementary Data on Form 10-K.

Operating Results

“We are excited to report another record year and record quarter in several key areas. It’s difficult to convey in words how so many individuals work so hard and achieve such amazing outcomes through so many small moments of selfless service. None of the results are possible without the outstanding work being done by these amazing nurses, therapists, dieticians, food service professionals, activities coordinators and the many others whose unwavering commitment shapes the daily care experience for thousands of patients across our portfolio,” said Barry Port, Ensign’s Chief Executive Officer.

“There are several measurements that showcase our clinical excellence. For example, according to the most recently published CMS data, same-store Ensign-affiliated facilities outperformed their peers in their annual survey results by an impressive 24% at the state level and 33% at the county level. This exceptional performance is only possible by achieving sustained clinical performance over time. In that same CMS data set, Ensign-affiliated operations also maintained a 19% advantage in overall 4- and 5-star rated buildings when compared to their peers. This is particularly noteworthy given the majority of these communities were 1- and 2-star facilities at the time of acquisition,” Port said.

He also noted that, “Our clinical achievements are bearing fruit in several ways. On the census front, our same store and transitioning occupancy increased to 83.8% and 84.9% during the quarter, which are both all-time highs. On the skilled mix front, we saw an increase across all skilled payors. As each operation solidifies their reputation in their respective markets, they are not only seeing more patients, but they are also being entrusted to care for more medically complex patients, which includes a larger share of Medicare, managed care and other skilled patients.”

Speaking to the Company’s organic growth potential, Mr. Port added, “While we are thrilled with our current record same store occupancy, we are actually excited that it’s as low as it is. At 83%, we have enough organic growth potential left in our organization to sustain our consistent earnings and revenue growth, even if we stopped acquiring. Also, it is not uncommon to see some of our most mature operations consistently achieve and maintain occupancies in mid- to high 90’s. The organic potential in our portfolio continues to remain one of our most compelling opportunities to continue to drive results.”

“We are very humbled by what we were able to accomplish in 2025, and we are eager to continue to drive organic improvements and take advantage of the acquisition opportunities that we see on the horizon. We are issuing our annual 2026 earnings guidance of $7.41 to $7.61 per diluted share and annual revenue guidance of $5.77 billion to $5.84 billion. The midpoint of this 2026 earnings guidance represents an increase of 14.3% over our 2025 results and is 36.5% higher than our 2024 results. We look forward to 2026 with confidence that our partners will continue to manage and innovate while balancing the addition of newly acquired operations," Mr. Port said.

Speaking to the Company’s acquisition growth, Chad Keetch, Ensign’s Chief Investment Officer and Executive Vice President said, “During the quarter and since we accelerated our growth by adding 17 new operations, including 12 real estate assets, bringing the number of operations acquired during 2025 and since to 51. We continue to see opportunities that include everything from larger portfolios, landlords looking to replace current tenants, non-profits looking to divest of their post-acute assets and a steady flow of traditional one-sie two-sies. We have several new additions lining up for the first quarter of 2026 as our local leadership and their deal partners at the Service Center work together to source, underwrite and carefully select the right opportunities.”

Suzanne Snapper, Ensign’s Executive Vice President and Chief Financial Officer reported that the Company’s liquidity remains strong with approximately $503.9 million of cash on hand and $591.6 million of available capacity under its line-of-credit. Ms. Snapper also indicated that, “Management’s annual guidance is based on diluted weighted average common shares outstanding of approximately 60.0 million and a 25.0% tax rate. In addition, the guidance assumes, among other things, normalized insurance costs, acquisitions expected to close through the first quarter of 2026 and management’s current expectations regarding reimbursement rates. It also excludes certain charges that arise outside the normal course of business, amortization of system implementation costs, acquisition related costs and share-based compensation.”

A discussion of the Company's use of non-GAAP financial measures is set forth below. A reconciliation of net income to adjusted EBT, EBITDA, adjusted EBITDAR, adjusted EBITDA and FFO for Standard Bearer, as well as a reconciliation of GAAP earnings per share, net income to adjusted net income and adjusted net earnings per share appear in the financial data portion of this release. More complete information is contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2025, which is expected to be filed with the SEC today and can be viewed on the Company’s website at http://www.ensigngroup.net.

Growth and Real Estate Highlights

Mr. Keetch added additional commentary on the Company’s continued acquisition activity. “We were thrilled to continue our pace of acquisitions during the quarter and since. This growth is spread across several distinct healthcare markets, wherein each of our local clusters prepared and executed their specialized, building-by-building transition plans. Overall, our growth this quarter continues to demonstrate our ability to take on larger multi-facility portfolios as well as our traditional singles and doubles. We continue to learn from and perfect our transition process and believe that those lessons are showing through in the performance of our recently acquired acquisitions. As we’ve shown during the quarter and the last few years, our building-by-building approach to transitions works for single operations, small portfolios and larger portfolios, particularly when a larger deal spans several markets and geographies," Mr. Keetch said.

The recent acquisitions include the following leased operations:

• The Health Center of Eastview, a 90-bed skilled nursing facility in Birmingham, Alabama;
• The Rehabilitation Center at Sandalwood, a 103-bed skilled nursing facility in Wheat Ridge, Colorado;
• Edgewater Health and Rehabilitation, a 69-bed skilled nursing facility in Lakewood, Colorado;
• Santa Rosa Care Center, a 144-bed skilled nursing facility in Tucson, Arizona; and
• Agave Grove Post Acute, a 225-bed skilled nursing facility in Glendale, Arizona.
  
  

Standard Bearer also announced the following real estate acquisitions, which are operated by an Ensign-affiliate:

• Stonehenge of American Fork, a 90-bed skilled nursing facility located in American Fork, Utah;
• Stonehenge of Cedar City, a 50-bed skilled nursing facility located in Cedar City, Utah;
• Stonehenge of Ogden, a 52-bed skilled nursing facility located in Washington Terrace, Utah;
• Stonehenge of Orem, a 34-bed skilled nursing facility located in Orem, Utah;
• Stonehenge of Richfield, a 30-bed skilled nursing facility located in Richfield, Utah;
• Stonehenge of South Jordan, a 32-bed skilled nursing facility located in South Jordan, Utah;
• Stonehenge of Springville, a 50-bed skilled nursing facility located in Springville, Utah;
• Willow Point Rehabilitation and Nursing Center, a 45-bed skilled nursing facility in Kansas City, Kansas;
• The Chateau Waco, a 123-bed skilled nursing facility located in Waco, Texas;
• Sunset Valley Rehabilitation and Healthcare Center, an 80-bed skilled nursing facility located in Littlefield, Texas;
• Wylie Oaks Healthcare and Rehabilitation, a 106-bed skilled nursing facility located in Wylie, Texas; and
• Timber Ridge Health and Rehabilitation, a 48-bed skilled nursing facility located in Stevens Point, Wisconsin.
  
  

Ensign's growing portfolio consists of 378 healthcare operations, 31 of which also include senior living operations, across 17 states. Ensign now owns 160 real estate assets, 124 which are operated by an Ensign affiliate. Mr. Keetch noted that Ensign’s overall strategy will continue to include both leasing and acquiring the real estate, and that the Company is actively looking for performing and underperforming operations in several states.

The Company continues to provide additional disclosure on Standard Bearer, which is comprised of 154 owned properties. Of these assets, 120 are leased to an Ensign-affiliated operator and 35 are leased to third-party operators. Mr. Keetch noted that each of these properties are subject to triple-net, long-term leases and generated rental revenue of $34.5 million for the quarter, of which $29.3 million was derived from Ensign affiliated operations. For the quarter, Standard Bearer reported $20.4 million in FFO.

The Company also paid a quarterly cash dividend of $0.065 per share of Ensign common stock. Ms. Snapper noted that as the Company’s liquidity remains strong, it plans to continue its long history of paying dividends into the future, noting that in December of 2025 it increased the dividend for the 23rd consecutive year.

Conference Call

A live webcast will be held Thursday, February 5, 2026, at 10:00 a.m. Pacific time (1:00 p.m. Eastern time) to discuss Ensign’s fiscal year and fourth quarter of 2025 financial results. To listen to the webcast, or to view any financial or statistical information required by SEC Regulation G, please visit the Investors Relations section of Ensign’s website at http://investor.ensigngroup.net. The webcast will be recorded and will be available for replay via the website until 5:00 p.m. Pacific time on Friday, February 27, 2026.

About Ensign™

The Ensign Group, Inc.'s independent subsidiaries provide a broad spectrum of skilled nursing and senior living services, physical, occupational and speech therapies and other rehabilitative and healthcare services at 378 healthcare facilities in Alabama, Alaska, Arizona, California, Colorado, Idaho, Iowa, Kansas, Nebraska, Nevada, Oregon, South Carolina, Tennessee, Texas, Utah, Washington and Wisconsin. As part of its investment strategy, the Company will also acquire, lease and own healthcare real estate to service the post-acute care continuum through acquisition and investment opportunities in healthcare properties. Ensign’s new business venture operating subsidiaries also offer several other post-acute-related services, including mobile x-ray, emergency and non-emergency transportation services, long-term care pharmacy and other consulting services across several states. Each of these operations is operated by a separate, independent subsidiary that has its own management, employees and assets. References herein to the consolidated "Company" and "its" assets and activities, as well as the use of the terms "we," "us," "its" and similar verbiage, are not meant to imply that The Ensign Group, Inc. has direct operating assets, employees or revenue, or that any of the facilities, the Service Center, Standard Bearer or the captive insurance subsidiary are operated by the same entity. More information about Ensign is available at http://www.ensigngroup.net.

Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995:

This press release contains, and the related conference call and webcast will include forward-looking statements that are based on management’s current expectations, assumptions and beliefs about its business, financial performance, operating results, the industry in which it operates and other future events. Forward-looking statements can often be identified by words such as "anticipates," "expects," "intends," "plans," "predicts," "believes," "seeks," "estimates," "may," "will," "should," "would," "could," "potential," "continue," "ongoing," similar expressions, and variations or negatives of these words. These forward-looking statements include, but are not limited to, statements regarding growth prospects, future operating and financial performance, and acquisition activities. They are not guarantees of future results and are subject to risks, uncertainties and assumptions that could cause actual results to materially and adversely differ from those expressed in any forward-looking statement.

These risks and uncertainties relate to the Company’s business, its industry and its common stock and include: reduced prices and reimbursement rates for its services; its ability to acquire, develop, manage or improve operations, its ability to manage its increasing borrowing costs as it incurs additional indebtedness to fund the acquisition and development of operations; its ability to access capital on a cost-effective basis to continue to successfully implement its growth strategy; its operating margins and profitability could suffer if it is unable to grow and manage effectively its increasing number of operations; competition from other companies in the acquisition, development and operation of facilities; its ability to defend claims and lawsuits, including professional liability claims alleging that our services resulted in personal injury, and other regulatory-related claims; and the application of existing or proposed government regulations, or the adoption of new laws and regulations, that could limit its business operations, require it to incur significant expenditures or limit its ability to relocate its operations if necessary. Additionally, our business and operations continue to be impacted by the unprecedented nature of the changes in the regulations and environment, as such, we are unable to predict the full extent and duration of the financial impact of these changes on our business, financial condition and results of operations. Therefore, our actual results could differ materially and adversely from those expressed in any forward-looking statements as a result of various factors. Readers should not place undue reliance on any forward-looking statements and are encouraged to review the Company’s periodic filings with the Securities and Exchange Commission, including its Form 10-Q and 10-K, for a more complete discussion of the risks and other factors that could affect Ensign’s business, prospects and any forward-looking statements. Except as required by the federal securities laws, Ensign does not undertake any obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events, changing circumstances or any other reason after the date of this press release.

Contact Information
Investor/Media Relations, The Ensign Group, Inc., (949) 487-9500, ir@ensignservices.net.

SOURCE: The Ensign Group, Inc.

THE ENSIGN GROUP, INC. CONSOLIDATED STATEMENTS OF INCOME
	Three Months Ended December 31,								Year Ended December 31,
		2025				2024				2025				2024
	(In thousands, except per share data)
REVENUE
Service revenue	$	1,353,885			$	1,126,374			$	5,032,118			$	4,237,525
Rental revenue		6,741				5,878				25,723				22,960
TOTAL REVENUE	$	1,360,626			$	1,132,252			$	5,057,841			$	4,260,485
Expense:
Cost of services		1,074,788				897,269				4,019,076				3,376,884
Rent—cost of services		63,513				56,076				239,312				216,016
General and administrative expense		70,791				55,611				269,820				225,143
Depreciation and amortization		27,721				22,519				104,327				84,138
TOTAL EXPENSES	$	1,236,813			$	1,031,475			$	4,632,535			$	3,902,181
Income from operations		123,813				100,777				425,306				358,304
Other income (expense):
Interest expense		(1,955	)			(2,258	)			(7,988	)			(8,286	)
Interest income		6,221				7,598				24,512				28,749
Other income (expense)		2,005				(359	)			13,792				7,327
OTHER INCOME, NET	$	6,271			$	4,981			$	30,316			$	27,790
Income before provision for income taxes		130,084				105,758				455,622				386,094
Provision for income taxes		34,550				26,008				111,358				87,636
NET INCOME	$	95,534			$	79,750			$	344,264			$	298,458
Less: net income attributable to noncontrolling interests		80				63				293				485
NET INCOME ATTRIBUTABLE TO THE ENSIGN GROUP, INC.	$	95,454			$	79,687			$	343,971			$	297,973
NET INCOME PER SHARE ATTRIBUTABLE TO THE ENSIGN GROUP INC.
Basic	$	1.66			$	1.40			$	6.00			$	5.26
Diluted	$	1.61			$	1.36			$	5.84			$	5.12
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING
Basic		57,580				56,958				57,306				56,655
Diluted		59,291				58,580				58,873				58,240

THE ENSIGN GROUP, INC. CONSOLIDATED BALANCE SHEETS (In thousands)
	December 31,
		2025				2024
ASSETS
Current assets:
Cash and cash equivalents	$	503,881			$	464,598
Accounts receivable—less allowance for doubtful accounts of $7,805 and $8,435 at December 31, 2025 and 2024, respectively		636,985				569,897
Investments—current		68,506				62,255
Prepaid expenses and other current assets		62,932				60,882
Total current assets	$	1,272,304			$	1,157,632
Property and equipment, net		1,696,863				1,291,354
Right-of-use assets		2,097,862				1,861,071
Insurance subsidiary deposits and investments		166,841				141,246
Deferred tax assets		83,138				66,281
Restricted and other assets		41,600				46,499
Intangible assets, net		6,381				7,292
Goodwill		97,981				97,981
TOTAL ASSETS	$	5,462,970			$	4,669,356
LIABILITIES AND EQUITY
Current liabilities:
Accounts payable	$	97,327			$	98,947
Accrued wages and related liabilities		422,326				347,532
Lease liabilities—current		114,816				93,475
Accrued self-insurance liabilities—current		81,623				67,331
Other accrued liabilities		174,027				132,057
Current maturities of long-term debt		4,227				4,086
Total current liabilities	$	894,346			$	743,428
Long-term lease liabilities—less current portion		1,949,213				1,735,325
Accrued self-insurance liabilities—less current portion		164,792				144,421
Other long-term liabilities		82,266				64,169
Long-term debt—less current maturities		137,529				141,585
Total equity		2,234,824				1,840,428
TOTAL LIABILITIES AND EQUITY	$	5,462,970			$	4,669,356

THE ENSIGN GROUP, INC. CONSOLIDATED STATEMENTS OF CASH FLOWS (In thousands)
The following table presents selected data from our consolidated statements of cash flows for the periods presented:
	Year Ended December 31,
		2025				2024
NET CASH PROVIDED BY (USED IN):
Operating activities	$	564,270			$	347,186
Investing activities		(513,177	)			(390,052	)
Financing activities		(11,810	)			(2,162	)
Net increase (decrease) in cash and cash equivalents	$	39,283			$	(45,028	)
Cash and cash equivalents beginning of period		464,598				509,626
Cash and cash equivalents at end of period	$	503,881			$	464,598

THE ENSIGN GROUP, INC. UNAUDITED RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION (In thousands, except per share data)
RECONCILIATION OF GAAP TO NON-GAAP NET INCOME
The following table reconciles GAAP net income to Non-GAAP net income for the periods presented:
	Three Months Ended December 31,								Year Ended December 31,
		2025				2024				2025				2024
Net income attributable to The Ensign Group, Inc.	$	95,454			$	79,687			$	343,971			$	297,973
Non-GAAP adjustments
Stock-based compensation expense(1)		12,924				9,820				48,299				36,226
Litigation(2)		—				—				12,000				(1,425	)
Cost of services - (gain) loss on business interruption recoveries and long-lived assets, net		(625	)			—				(3,285	)			2,335
Cost of services - acquisition related costs(3)		548				501				2,211				1,019
General and administrative - costs incurred related to system implementations		958				431				2,430				2,953
Depreciation and amortization - patient base(4)		—				125				1,020				574
Interest expense - write off deferred financing fees (5)		—				200				—				200
Other income - gain on other investments (6)		—				—				(2,437	)			—
Provision for income taxes on Non-GAAP adjustments(7)		(1,423	)			(3,201	)			(17,607	)			(19,358	)
Non-GAAP Net Income	$	107,836			$	87,563			$	386,602			$	320,497
Average number of diluted shares outstanding		59,291				58,580				58,873				58,240
Diluted Earnings Per Share	$	1.61			$	1.36			$	5.84			$	5.12
Adjusted Diluted Earnings Per Share	$	1.82			$	1.49			$	6.57			$	5.50
Footnotes:
(1) Represents stock-based compensation expense incurred.
	Three Months Ended December 31,								Year Ended December 31,
		2025				2024				2025				2024
Cost of services	$	8,496			$	6,554			$	32,216			$	23,880
General and administrative		4,428				3,266				16,083				12,346
Total Non-GAAP adjustment	$	12,924			$	9,820			$	48,299			$	36,226
(2) Represents specific proceedings and adjustments arising outside of the ordinary course of business.
	Three Months Ended December 31,								Year Ended December 31,
		2025				2024				2025				2024
Cost of services	$	—			$	—			$	12,000			$	(1,634	)
General and administrative		—				—				—				209
Total Non-GAAP adjustment	$	—			$	—			$	12,000			$	(1,425	)
(3) Represents costs incurred to acquire operations that are not capitalizable.
(4) Represents amortization expenses related to patient base intangible assets at newly acquired skilled nursing and senior living facilities.
(5) Represents the write off of deferred financing fees associated with mortgage loans.
(6) Represents gains on the sale of investments that are not part of our core business operations. These investments have no observable market prices and are held at historical cost basis until sold or impaired.
(7) Represents an adjustment to the provision for income tax to our historical year to date effective tax rate of 25.0%.

THE ENSIGN GROUP, INC. UNAUDITED RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION (In thousands)
The table below reconciles net income to EBITDA, Adjusted EBITDA and Adjusted EBITDAR for the periods presented:
	Three Months Ended December 31,								Year Ended December 31,
		2025				2024				2025				2024
Consolidated Statements of Income Data:
Net income	$	95,534			$	79,750			$	344,264			$	298,458
Less: Net income attributable to noncontrolling interests		80				63				293				485
Interest income		6,221				7,598				24,512				28,749
Add: Provision for income taxes		34,550				26,008				111,358				87,636
Depreciation and amortization		27,721				22,519				104,327				84,138
Interest expense		1,955				2,258				7,988				8,286
EBITDA	$	153,459			$	122,874			$	543,132			$	449,284
Adjustments to EBITDA:
Stock-based compensation expense		12,924				9,820				48,299				36,226
Litigation(1)		—				—				12,000				(1,425	)
(Gain) loss on business interruption recoveries and long-lived assets, net		(625	)			—				(3,285	)			2,335
Gain on other investments(2)		—				—				(2,437	)			—
Acquisition related costs(3)		548				501				2,211				1,019
Costs incurred related to system implementations		958				431				2,430				2,953
ADJUSTED EBITDA	$	167,264			$	133,626			$	602,350			$	490,392
Rent—cost of services		63,513				56,076				239,312				216,016
ADJUSTED EBITDAR	$	230,777							$	841,662
(1) Represents specific proceedings and adjustments arising outside of the ordinary course of business.
(2) Represents gains on the sale of investments that are not part of our core business operations. These investments have no observable market prices and are held at historical cost basis until sold or impaired.
(3) Represents costs incurred to acquire operations that are not capitalizable.

The table below reconciles income before provision for income taxes to Adjusted EBT for the periods presented:
	Three Months Ended December 31,								Year Ended December 31,
		2025				2024				2025				2024
Consolidated statements of income data:	(In thousands)
Income before provision for income taxes	$	130,084			$	105,758			$	455,622			$	386,094
Stock-based compensation expense		12,924				9,820				48,299				36,226
Litigation(1)		—				—				12,000				(1,425	)
(Gain) loss on business interruption recoveries and long-lived assets, net		(625	)			—				(3,285	)			2,335
Gain on other investments(2)		—				—				(2,437	)			—
Acquisition related costs(3)		548				501				2,211				1,019
Costs incurred related to system implementations		958				431				2,430				2,953
Depreciation and amortization - patient base(4)		—				125				1,020				574
Interest expense - write off of deferred financing fees(5)		—				200				—				200
ADJUSTED EBT	$	143,889			$	116,835			$	515,860			$	427,976
(1) Represents specific proceedings and adjustments arising outside of the ordinary course of business.
(2) Represents gains on the sale of investments that are not part of our core business operations. These investments have no observable market prices and are held at historical cost basis until sold or impaired.
(3) Represents costs incurred to acquire operations that are not capitalizable.
(4) Represents amortization expenses related to patient base intangible assets at newly acquired skilled nursing and senior living facilities.
(5) Represents the write off of deferred financing fees associated with mortgage loans.

THE ENSIGN GROUP, INC. UNAUDITED SELECT PERFORMANCE INDICATORS
The following tables summarize our selected performance indicators for our skilled services segment along with other statistics, for each of the dates or periods presented:
	Three Months Ended December 31,
	2025					2024					Change					% Change
TOTAL FACILITY RESULTS:	(Dollars in thousands)
Skilled services revenue	$	1,301,583				$	1,082,825				$	218,758				20.2		%
Number of facilities at period end		326					286					40				14.0		%
Number of campuses at period end(1)		31					30					1				3.3		%
Actual patient days		2,869,685					2,469,517					400,168				16.2		%
Occupancy percentage — Operational beds		83.2		%			80.9		%			2.3		%		2.8		%
Skilled mix by nursing days		30.5		%			29.1		%			1.4		%		4.8		%
Skilled mix by nursing revenue		49.2		%			47.8		%			1.4		%		2.9		%

	Three Months Ended December 31,
	2025					2024					Change					% Change
SAME FACILITY RESULTS:(2)	(Dollars in thousands)
Skilled services revenue	$	884,663				$	823,797				$	60,866				7,4		%
Number of facilities at period end		210					210					—				—		%
Number of campuses at period end(1)		25					25					—				—		%
Actual patient days		1,938,015					1,865,624					72,391				3,9		%
Occupancy percentage — Operational beds		83,8		%			81,4		%			2,4		%		2,9		%
Skilled mix by nursing days		32,0		%			30,7		%			1,3		%		4,2		%
Skilled mix by nursing revenue		50,8		%			49,5		%			1,3		%		2,6		%

	Three Months Ended December 31,
	2025					2024					Change					% Change
TRANSITIONING FACILITY RESULTS:(3)	(Dollars in thousands)
Skilled services revenue	$	194,971				$	184,579				$	10,392				5.6		%
Number of facilities at period end		48					48					—				—		%
Number of campuses at period end(1)		2					2					—				—		%
Actual patient days		432,877					418,347					14,530				3.5		%
Occupancy percentage — Operational beds		84.9		%			82.0		%			2.9		%		3.5		%
Skilled mix by nursing days		29.2		%			27.5		%			1.7		%		6.2		%
Skilled mix by nursing revenue		50.5		%			47.8		%			2.7		%		5.6		%

	Three Months Ended December 31,
	2025					2024					Change				% Change
RECENTLY ACQUIRED FACILITY RESULTS:(4)	(Dollars in thousands)
Skilled services revenue	$	221,949				$	74,449				$	147,500			NM
Number of facilities at period end		68					28					40			NM
Number of campuses at period end(1)		4					3					1			NM
Actual patient days		498,793					185,546					313,247			NM
Occupancy percentage — Operational beds		79.4		%			74.6		%		NM				NM
Skilled mix by nursing days		25.8		%			16.8		%		NM				NM
Skilled mix by nursing revenue		41.8		%			27.8		%		NM				NM

	(1)	Campus represents a facility that offers both skilled nursing and senior living services. Revenue and expenses related to skilled nursing and senior living services have been allocated and recorded in the respective operating segment.
	(2)	Same Facility results represent all facilities purchased prior to January 1, 2022.
	(3)	Transitioning Facility results represent all facilities purchased from January 1, 2022 to December 31, 2023.
	(4)	Recently Acquired Facility (Acquisitions) results represent all facilities purchased on or subsequent to January 1, 2024.

	Year Ended December 31,
	2025					2024					Change					% Change
TOTAL FACILITY RESULTS:	(Dollars in thousands)
Skilled services revenue	$	4,837,809				$	4,076,825				$	760,984				18.7		%
Number of facilities at period end		326					286					40				14.0		%
Number of campuses at period end(1)		31					30					1				3.3		%
Actual patient days		10,795,373					9,431,825					1,363,548				14.5		%
Occupancy percentage — Operational beds		82.2		%			80.5		%			1.7		%		2.1		%
Skilled mix by nursing days		30.7		%			29.9		%			0.8		%		2.7		%
Skilled mix by nursing revenue		49.4		%			48.6		%			0.8		%		1.6		%

	Year Ended December 31,
	2025					2024					Change					% Change
SAME FACILITY RESULTS:(2)(5)	(Dollars in thousands)
Skilled services revenue	$	3,424,421				$	3,214,896				$	209,525				6.5		%
Number of facilities at period end		210					210					—				—		%
Number of campuses at period end(1)		25					25					—				—		%
Actual patient days		7,579,892					7,382,176					197,716				2.7		%
Occupancy percentage — Operational beds		82.9		%			80.9		%			2.0		%		2.5		%
Skilled mix by nursing days		32.3		%			31.1		%			1.2		%		3.9		%
Skilled mix by nursing revenue		51.2		%			49.5		%			1.7		%		3.4		%

	Year Ended December 31,
	2025					2024					Change					% Change
TRANSITIONING FACILITY RESULTS:(3)	(Dollars in thousands)
Skilled services revenue	$	760,325				$	697,529				$	62,796				9.0		%
Number of facilities at period end		48					48					—				—		%
Number of campuses at period end(1)		2					2					—				—		%
Actual patient days		1,703,570					1,639,695					63,875				3.9		%
Occupancy percentage — Operational beds		84.2		%			80.8		%			3.4		%		4.2		%
Skilled mix by nursing days		29.6		%			27.8		%			1.8		%		6.5		%
Skilled mix by nursing revenue		50.8		%			48.6		%			2.2		%		4.5		%

	Year Ended December 31,
	2025					2024					Change				% Change
RECENTLY ACQUIRED FACILITY RESULTS:(4)	(Dollars in thousands)
Skilled services revenue	$	653,063				$	163,826				$	489,237			NM
Number of facilities at period end		68					28					40			NM
Number of campuses at period end(1)		4					3					1			NM
Actual patient days		1,511,911					407,872					1,104,039			NM
Occupancy percentage — Operational beds		76.9		%			73.9		%		NM				NM
Skilled mix by nursing days		23.9		%			17.6		%		NM				NM
Skilled mix by nursing revenue		38.3		%			28.9		%		NM				NM

	(1)	Campus represents a facility that offers both skilled nursing and senior living services. Revenue and expenses related to skilled nursing and senior living services have been allocated and recorded in the respective operating segment.
	(2)	Same Facility results represent all facilities purchased prior to January 1, 2022.
	(3)	Transitioning Facility results represent all facilities purchased from January 1, 2022 to December 31, 2023.
	(4)	Recently Acquired Facility (Acquisitions) results represent all facilities purchased on or subsequent to January 1, 2024.
	(5)	Skilled services revenue and key performance metrics for a closed facility were not material and has been excluded from Same Facilities results during the year ended December 31, 2024. The facility was closed in 2024 as the program was transitioned from an intermediate care facility to a group home setting.

THE ENSIGN GROUP, INC. UNAUDITED SKILLED NURSING AVERAGE DAILY REVENUE RATES AND PERCENT OF SKILLED NURSING REVENUE AND DAYS BY PAYOR
The following tables reflect the change in skilled nursing average daily revenue rates, excluding services that are not covered by the daily rate(1):
	Three Months Ended December 31,
	Same Facility								Transitioning								Acquisitions								Total
		2025				2024				2025				2024				2025				2024				2025				2024
SKILLED NURSING AVERAGE DAILY REVENUE RATES
Medicare	$	817.48			$	784.12			$	900.01			$	847.42			$	786.91			$	658.57			$	827.19			$	791.34
Managed care		596.61				568.94				637.91				589.08				601.74				491.93				602.39				568.89
Other skilled		633.26				642.71				605.00				621.12				707.90				638.47				639.69				639.97
Total skilled revenue		681.67				656.89				754.94				720.11				699.38				591.98				694.85				664.26
Medicaid		312.99				301.00				304.79				301.10				335.65				307.61				315.76				301.56
Private and other payors		299.78				269.80				314.59				281.27				350.63				320.50				312.47				277.12
Total skilled nursing revenue	$	429.76			$	406.77			$	437.25			$	414.50			$	431.37			$	357.54			$	431.17			$	404.45

	Year Ended December 31,
	Same Facility								Transitioning								Acquisitions								Total
		2025				2024				2025				2024				2025				2024				2025				2024
SKILLED NURSING AVERAGE DAILY REVENUE RATES
Medicare	$	794.60			$	756.42			$	867.32			$	824.75			$	733.57			$	640.67			$	800.94			$	767.72
Managed care		580.98				555.22				612.73				569.70				563.86				475.65				583.47				555.37
Other skilled		647.55				627.88				602.64				560.62				702.70				657.94				647.69				620.42
Total skilled revenue		668.90				639.75				730.74				695.94				660.49				577.33				677.40				647.28
Medicaid		306.45				297.15				295.11				282.49				331.49				303.57				308.27				294.78
Private and other payors		296.84				277.27				313.66				285.73				346.37				301.84				308.27				280.24
Total skilled nursing revenue	$	422.67			$	401.49			$	425.65			$	397.59			$	412.24			$	351.38			$	421.69			$	398.66

(1) The rates are based on contractually agreed-upon amounts or rates, excluding the estimates of variable consideration under the revenue recognition standard, Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 606.

The following tables set forth our percentage of skilled nursing patient revenue and days for the periods presented:

	Three Months Ended December 31,
	Same Facility						Transitioning						Acquisitions						Total
	2025			2024			2025			2024			2025			2024			2025			2024
PERCENTAGE OF SKILLED NURSING REVENUE
Medicare	21.4	%		20.3	%		28.1	%		27.6	%		20.0	%		13.3	%		22.2	%		21.1	%
Managed care	19.9			20.0			15.5			14.7			14.3			8.7			18.2			18.4
Other skilled	9.5			9.2			6.9			5.5			7.5			5.8			8.8			8.3
Skilled mix	50.8	%		49.5	%		50.5	%		47.8	%		41.8	%		27.8	%		49.2	%		47.8	%
Private and other payors	7.1			7.1			6.1			6.5			10.4			14.8			7.5			7.5
Medicaid	42.1			43.4			43.4			45.7			47.8			57.4			43.3			44.7
TOTAL SKILLED NURSING	100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%

	Three Months Ended December 31,
	Same Facility						Transitioning						Acquisitions						Total
	2025			2024			2025			2024			2025			2024			2025			2024
PERCENTAGE OF SKILLED NURSING DAYS
Medicare	11.3	%		10.5	%		13.7	%		13.5	%		11.0	%		7.2	%		11.6	%		10.8	%
Managed care	14.3			14.3			10.6			10.4			10.2			6.3			13.0			13.0
Other skilled	6.4			5.9			4.9			3.6			4.6			3.3			5.9			5.3
Skilled mix	32.0	%		30.7	%		29.2	%		27.5	%		25.8	%		16.8	%		30.5	%		29.1	%
Private and other payors	10.2			10.7			8.6			9.6			12.7			16.5			10.4			11.0
Medicaid	57.8			58.6			62.2			62.9			61.5			66.7			59.1			59.9
TOTAL SKILLED NURSING	100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%

	Year Ended December 31,
	Same Facility						Transitioning						Acquisitions						Total
	2025			2024			2025			2024			2025			2024			2025			2024
PERCENTAGE OF SKILLED NURSING REVENUE
Medicare	21.4	%		20.7	%		28.3	%		28.8	%		18.1	%		13.6	%		22.0	%		21.9	%
Managed care	20.3			19.9			16.1			14.7			13.0			9.6			18.6			18.6
Other skilled	9.5			8.9			6.4			5.1			7.2			5.7			8.8			8.1
Skilled mix	51.2	%		49.5	%		50.8	%		48.6	%		38.3	%		28.9	%		49.4	%		48.6	%
Private and other payors	6.9			7.3			6.5			7.3			11.5			13.8			7.5			7.5
Medicaid	41.9			43.2			42.7			44.1			50.2			57.3			43.1			43.9
TOTAL SKILLED NURSING	100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%
	Year Ended December 31,
	Same Facility						Transitioning						Acquisitions						Total
	2025			2024			2025			2024			2025			2024			2025			2024
PERCENTAGE OF SKILLED NURSING DAYS
Medicare	11.4	%		11.0	%		13.9	%		13.9	%		10.1	%		7.5	%		11.6	%		11.4	%
Managed care	14.8			14.4			11.2			10.3			9.5			7.1			13.5			13.4
Other skilled	6.1			5.7			4.5			3.6			4.3			3.0			5.6			5.1
Skilled mix	32.3	%		31.1	%		29.6	%		27.8	%		23.9	%		17.6	%		30.7	%		29.9	%
Private and other payors	9.9			10.5			8.8			10.1			13.6			16.1			10.3			10.7
Medicaid	57.8			58.4			61.6			62.1			62.5			66.3			59.0			59.4
TOTAL SKILLED NURSING	100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%

THE ENSIGN GROUP, INC. UNAUDITED REVENUE BY PAYOR SOURCE
The following tables set forth our service revenue by payor source and as a percentage of total service revenue for the periods presented:
	Three Months Ended December 31,
	2025						2024
	Revenue			% of Revenue			Revenue			% of Revenue
Medicaid(1)	$	547,162		40.4	%		$	454,779		40.4	%
Medicare		312,405		23.1				267,180		23.7
Medicaid-skilled		77,914		5.8				69,720		6.2
Total Medicaid and Medicare	$	937,481		69.3	%		$	791,679		70.3	%
Managed care		249,626		18.4				207,989		18.5
Private and other(2)		166,778		12.3				126,706		11.2
SERVICE REVENUE	$	1,353,885		100.0	%		$	1,126,374		100.0	%

(1) Medicaid payor includes revenue for senior living operations.
(2) Private and other includes revenue for skilled services (private, Veteran Affairs and hospice payors), senior living and ancillary operations.

	Year Ended December 31,
	2025						2024
	Revenue			% of Revenue			Revenue			% of Revenue
Medicaid(1)	$	2,002,007		39.8	%		$	1,682,344		39.7	%
Medicare		1,194,554		23.7				1,055,226		24.9
Medicaid-skilled		301,122		6.0				266,738		6.3
Total Medicaid and Medicare	$	3,497,683		69.5	%		$	3,004,308		70.9	%
Managed care		944,316		18.8				789,643		18.6
Private and other(2)		590,119		11.7				443,574		10.5
SERVICE REVENUE	$	5,032,118		100.0	%		$	4,237,525		100.0	%

(1) Medicaid payor includes revenue for senior living operations.
(2) Private and other includes revenue for skilled services (private, Veteran Affairs and hospice payors), senior living and ancillary operations.

THE ENSIGN GROUP, INC. UNAUDITED RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL INFORMATION BY SEGMENT (In thousands)
Skilled Services
The table below reconciles net income to EBITDA and Adjusted EBITDA for the skilled services reportable segment for the periods presented:
	Three Months Ended December 31,							Year Ended December 31,
	2025				2024			2025				2024
Statements of Income Data:
Segment income(1)	$	169,336			$	140,980		$	616,397			$	518,463
Depreciation and amortization		14,703				12,207			55,821				45,195
EBITDA	$	184,039			$	153,187		$	672,218			$	563,658
Adjustments to EBITDA:
Stock-based compensation expense		8,123				6,302			30,897				22,992
Gain on business interruption recoveries		(625	)			—			(4,358	)			—
Litigation(2)		—				—			—				2,100
ADJUSTED EBITDA	$	191,537			$	159,489		$	698,757			$	588,750

(1) Segment income reflects profit from operations before provision for income taxes and impairment charges from operations. General and administrative expenses are not allocated to the skilled services segment for purposes of determining segment profit or loss. 
(2) Litigation relates to specific proceedings arising outside of the ordinary course of business.

Standard Bearer

The following table sets forth details of operating results for our revenue and earnings, and their respective components, by Standard Bearer for the periods presented:

	Three Months Ended December 31,						Year Ended December 31,
	2025			2024			2025			2024
Rental revenue generated from third-party tenants	$	5,185		$	4,388		$	19,370		$	16,976
Rental revenue generated from Ensign's independent subsidiaries		29,266			20,714			107,560			78,110
TOTAL RENTAL REVENUE	$	34,451		$	25,102		$	126,930		$	95,086
Segment income(1)		10,292			7,443			37,623			29,335
Depreciation and amortization		10,149			7,818			37,599			29,297
FFO(2)	$	20,441		$	15,261		$	75,222		$	58,632

(1) Segment income reflects profit from operations before provision for income taxes, excluding gain or loss from sale of real estate, insurance recoveries and impairment of long-lived assets. Included in Standard Bearer expenses for the three months and year ended December 31, 2025 is management fee of $2.1 million and $7.6 million, respectively, and interest of $9.9 million and $35.1 million, respectively, from intercompany agreements between Standard Bearer and the Company and its independent subsidiaries, including the Service Center. Included in Standard Bearer expenses for the three months and year ended December 31, 2024 is management fee of $1.5 million and $5.7 million, respectively, and interest of $5.5 million and $20.3 million, respectively, from intercompany agreements between Standard Bearer and the Company and its independent subsidiaries, including the Service Center.

(2) FFO, in accordance with the definition used by the National Association of Real Estate Investment Trusts, means net income attributable to common stockholders, computed in accordance with U.S. GAAP, excluding gains or losses from sale of real estate, insurance recoveries related to real estate and impairment of long-lived assets, while including depreciation and amortization related to real estate to earnings.

Discussion of Non-GAAP Financial Measures

EBITDA consists of net income before (a) interest income, (b) provision for income taxes, (c) depreciation and amortization and (d) interest expense. Adjusted EBITDA consists of net income before (a) interest income, (b) provision for income taxes, (c) depreciation and amortization, (d) interest expense, (e) stock-based compensation expense, (f) acquisition related costs, (g) costs incurred related to system implementations, (h) litigation arising outside of the ordinary course of business, (i) gain/loss on business interruption recoveries and long-lived assets, and (j) gain on other investments. Adjusted EBITDAR consists of net income before (a) interest income, (b) provision for income taxes, (c) depreciation and amortization, (d) interest expense, (e) rent-cost of services, (f) stock-based compensation expense, (g) acquisition related costs, (h) costs incurred related to system implementations, (i) litigation arising outside of the ordinary course of business, (j) gain/loss on business interruption recoveries and long-lived assets, and (k) gain on other investments. Adjusted EBT consists of net income before (a) provision for income taxes, (b) stock-based compensation expense, (c) acquisition related costs, (d) costs incurred related to system implementations, (e) litigation arising outside of the ordinary course of business, (f) gain/loss on business interruption recoveries and long-lived assets, (g) gain on other investments, (h) amortization of patient base intangible assets and (I) write off of deferred financing fees. Funds from Operations (FFO) for our Standard Bearer segment consists of segment income, excluding depreciation and amortization related to real estate, gains or losses from the sale of real estate, insurance recoveries related to real estate and impairment of long-lived assets. The Company believes that the presentation of adjusted net income, adjusted earnings per share, EBITDA, adjusted EBITDA, adjusted EBT and FFO provides important supplemental information to management and investors to evaluate the Company’s operating performance. Adjusted EBITDAR is a financial valuation measure that is not specified in GAAP. This measure is not displayed as a performance measure as it excludes rent expense, which is a normal and recurring operating expense. The Company believes disclosure of adjusted net income, adjusted net income per share, EBITDA, adjusted EBITDA, adjusted EBITDAR, adjusted EBT and FFO has substance because the excluded revenues and expenses are infrequent in nature and are variable in nature, or do not represent current revenues or cash expenditures. A material limitation associated with the use of these measures as compared to the GAAP measures of net income and diluted earnings per share is that they may not be comparable with the calculation of net income and diluted earnings per share for other companies in the Company's industry. These non-GAAP financial measures should not be relied upon to the exclusion of GAAP financial measures. For further information regarding why the Company believes that this non-GAAP measures provide useful information to investors, the specific manner in which management uses these measures, and some of the limitations associated with the use of these measures, please refer to the Company's periodic filings with the Securities and Exchange Commission, including its Annual Report on Form 10-K and Quarterly Report on Form 10-Q. The Company’s periodic filings are available on the SEC's website at www.sec.gov or under the "Financials" link of the Investor Relations section on Ensign’s website at http://www.ensigngroup.net.

FAQ

What were Ensign (ENSG) GAAP and adjusted EPS for fiscal 2025?

GAAP diluted EPS for 2025 was $5.84 and adjusted EPS was $6.57. According to the company, adjusted EPS rose 19.5% year-over-year, reflecting higher skilled services revenue and operational gains across the portfolio.

What revenue and EPS guidance did Ensign (ENSG) issue for 2026?

Ensign guided to $7.41–$7.61 EPS and $5.77B–$5.84B revenue for 2026. According to the company, the midpoint of EPS guidance implies a 14.3% increase over 2025 and assumes certain planned acquisitions through Q1 2026.

How did Ensign (ENSG) perform on occupancy and skilled services in Q4 2025?

Same facilities occupancy reached 83.8% and transitioning occupancy 84.9% in Q4 2025. According to the company, skilled days and Medicare revenue increased notably versus the prior year, supporting stronger skilled services revenue.

What cash and liquidity did Ensign (ENSG) report at year-end 2025?

Ensign reported approximately $503.9 million cash on hand and $591.6 million available on its credit facility. According to the company, management views liquidity as strong to support acquisitions and dividends.

How active was Ensign (ENSG) in acquisitions during 2025 and early 2026?

Ensign completed 51 acquisitions in 2025, including 12 real estate assets, and added 17 operations during the quarter. According to the company, additional deals are expected to close in early 2026 as local teams source and underwrite opportunities.