The Ensign Group Reports Third Quarter 2026 Results; Raises 2026 Annual Earnings Guidance

The higher earnings outlook follows growth in occupancy and Medicare revenue, alongside acquisitions that expanded operations into Florida.

Rhea-AI Summary

The Ensign Group (ENSG) raised its 2026 earnings guidance after reporting third-quarter adjusted diluted earnings per share of $2.03. Adjusted EPS rose 23.8% year over year; GAAP diluted EPS increased 23.9% to $1.76. Revenue grew 14.5% to $1.48 billion, and GAAP net income rose 24.4% to $104.3 million.

The company now expects annual earnings of $7.94–$8.02 per diluted share, excluding specified costs, versus $7.75–$7.85 previously. Revenue guidance is $5.89–$5.92 billion, with the lower end raised. Same Facilities and Transitioning Facilities occupancy reached 84.1% and 86.1%, respectively. During the quarter and since, Ensign added 22 operations, including its entry into Florida, and bought five properties it already operated under leases. Cash on hand was approximately $337.6 million, with $731.6 million available under its credit line. Standard Bearer quarterly rental revenue rose 46.3% to $47.7 million.

26 points · 1 major

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0 major · 1 point

Hollow bars mark forward-looking points. How the balance works

Positive

• Major point. Forward-looking: it has not happened yet and may not happen.Annual earnings guidance raised to $7.94–$8.02 per diluted share, excluding specified costs, from $7.75–$7.85.
• Moderate pointQuarterly consolidated revenue increased 14.5% year over year to $1.48 billion.
• Moderate pointQuarterly GAAP diluted EPS rose 23.9% year over year to $1.76.
• Moderate pointQuarterly adjusted diluted EPS rose 23.8% year over year to $2.03.
• Moderate pointQuarterly GAAP net income increased 24.4% year over year to $104.3 million.
• Moderate pointQuarterly adjusted net income increased 24.9% year over year to $120.5 million.
• Moderate pointAcquisitions added 22 operations during the quarter and since: three real estate assets and 19 leased operations.

19 minor points

• Minor point. Forward-looking: it has not happened yet and may not happen.Annual revenue guidance lower end raised to $5.89 billion; upper end maintained at $5.92 billion.
• Minor pointSame Facilities occupancy reached 84.1%, up 1.6% over the prior-year quarter.
• Minor pointTransitioning Facilities occupancy reached 86.1%, up 3.9% over the prior-year quarter.
• Minor pointSame Facilities skilled mix revenue grew 10.7% and skilled days 7.2% year over year.
• Minor pointTransitioning Facilities skilled mix revenue grew 10.5% and skilled days 7.9% year over year.
• Minor pointSame Facilities Medicare revenue grew 11.1% and Medicare days 7.6% year over year.
• Minor pointTransitioning Facilities Medicare revenue grew 7.8% and Medicare days 6.3% year over year.
• Minor pointSame Facilities managed care revenue grew 9.1% and managed care days 3.1% year over year.
• Minor pointTransitioning Facilities managed care revenue grew 7.2% and managed care days 3.8% year over year.
• Minor pointStandard Bearer quarterly rental revenue increased 46.3% year over year to $47.7 million.
• Minor pointStandard Bearer quarterly funds from operations increased 41.3% year over year to $27.3 million.
• Minor pointFlorida entry expanded Ensign's operating presence into a new state.
• Minor pointReal estate purchases added five previously leased facilities, totaling 755 skilled nursing beds.
• Minor pointSame Facilities CMS Quality Measure ratings were 21% better than industry peers in operating states.
• Minor pointSame Facilities CMS survey inspection results were 15% better than industry peers in operating states.
• Minor pointShort-stay residents' functional improvement rates were 30% better than industry peers in operating states.
• Minor pointLong-stay residents' antipsychotic medication rates were 28% better than industry peers in operating states.
• Minor pointSame Facilities administrator turnover was 45% lower than industry peers in operating states.
• Minor point. Forward-looking: it has not happened yet and may not happen.The company plans to continue paying dividends.

Negative

• Minor point. Forward-looking: it has not happened yet and may not happen.Annual guidance assumes acquisitions expected to close through the fourth quarter of 2026.

News Explained

Standard Bearer acquired the real estate of five facilities previously leased from third parties, and the facilities are now under long-term leases with Standard Bearer subsidiaries, keeping the operating sites leased within Ensign’s property structure.

Key Figures

GAAP diluted EPS: $1.76 Adjusted diluted EPS: $2.03 GAAP net income: $104.3 million +4 more

GAAP diluted EPS

$1.76

Q3 2026; up 23.9% year over year

Adjusted diluted EPS

$2.03

Q3 2026; up 23.8% year over year

GAAP net income

$104.3 million

Q3 2026; up 24.4% year over year

Adjusted net income

$120.5 million

Q3 2026; up 24.9% year over year

Consolidated revenue

$1.48 billion

Q3 2026; up 14.5% year over year

2026 diluted EPS guidance

$7.94 to $8.02

Raised from original guidance of $7.75 to $7.85

2026 revenue guidance

$5.89 billion to $5.92 billion

Lower end raised; upper end maintained

Previous Earnings Reports

4 past events · Latest: Jul 27

Same Type 4 events

1. Jul 27

   Earnings results

   24h Move

   +2.9%

   Reported Q2 diluted EPS growth and raised 2026 earnings and revenue guidance.

2. Apr 30

   Earnings results

   24h Move

   -1.6%

   Reported Q1 results and raised annual EPS and revenue guidance.

3. Feb 04

   Earnings results

   24h Move

   +13.8%

   Issued 2026 EPS and revenue guidance with fiscal-year and fourth-quarter results.

4. Nov 03

   Earnings results

   24h Move

   +0.1%

   Reported Q3 2025 results and raised annual earnings and revenue guidance.

24h Move is the share-price change in the day after each event; other market factors may also have contributed.

Key Terms

gaap, ffo, non-gaap financial measures, triple-net

4 terms

gaap financial

"reporting GAAP diluted earnings per share of $1.76"

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.

View in glossary

ffo financial

"FFO was $27.3 million for the quarter"

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.

non-gaap financial measures financial

"A discussion of the Company's use of non-GAAP financial measures"

Non-GAAP financial measures are numbers companies use to show their financial performance that exclude certain expenses or income. They help investors see how the company might perform without one-time costs or other unusual items, giving a different perspective from official reports. However, since they can be adjusted, they don’t always tell the full story and should be looked at alongside standard financial figures.

triple-net financial

"subject to triple-net, long-term leases"

triple-net (often shown as NNN) is a type of commercial lease where the tenant pays base rent plus the property’s taxes, insurance and most operating or maintenance costs, leaving the landlord mainly responsible for ownership and financing. For investors it matters because it produces steadier, more predictable cash flow and lower day-to-day expense risk for the owner—like receiving rent from a tenant who also pays for upkeep—affecting yield, valuation and risk profile.

AI-generated analysis. How Rhea-AI works. Not financial advice.

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Conference Call and Webcast scheduled for tomorrow, October 28, 2026 at 10:00 am PT

SAN JUAN CAPISTRANO, Calif., Oct. 27, 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 third quarter ended September 30, 2026, reporting GAAP diluted earnings per share of $1.76 and adjusted earnings per share⁽²⁾ of $2.03.

"We are thrilled to report another outstanding quarter. Our teams continue to demonstrate their unwavering commitment to dignifying post-acute care through moments of truth. Our core values, which our teams refer to using the acronym CAPLICO, create a shared culture that empowers nearly 60,000 partners to lead with compassion, accountability, ownership, and a relentless commitment to excellence. We believe culture is not separate from performance, it is the foundation that makes sustainable clinical, operational and financial performance possible,” said Barry Port, Chief Executive Officer of The Ensign Group. 

"Our clinical leaders also continue to drive outstanding outcomes, which is particularly impressive given our growth over the past several years. According to the most recently published CMS data, our Same Facilities achieved annual survey results that were 15% better at the state level and 28% better at the county level. This is especially notable given that many of these facilities were 1- and 2-star buildings at acquisition. Additionally, our Same Facilities outperformed in 5-Star Quality Measure results by 21% at the state level. These results reinforce our position as the provider of choice in our markets and demonstrate our ability to create long-term value through sustained clinical excellence,” Port said.

Clinical Highlights⁽¹⁾:

• Same Facilities achieved Centers for Medicare & Medicaid Services (CMS) Quality Measure ratings that were 21% better than industry peers in our operating states, demonstrating superior clinical outcomes.
• Same Facilities achieved CMS Cycle 1 survey inspection results that were 15% better than industry peers in our operating states, validating clinical excellence through regulatory oversight.
• Over 80% of our skilled nursing operations earned a CMS Quality Measure rating of 4 or 5 stars, demonstrating our continued commitment to delivering high-quality clinical care.
• Short-stay residents achieved functional improvement rates 30% better than industry peers in our operating states, reflecting our focus on rehabilitation and helping patients regain independence.
• Long-stay residents had antipsychotic medication rates 28% better than industry peers in our operating states, reflecting our focus on appropriate medication management and resident-centered care.
• Administrator turnover for Same Facilities was 45% lower than our industry peers in our operating states, supporting leadership continuity and operational stability.
• 12% of all our eligible operations, comprised of 40 buildings in 8 different states, earned CMS High Performing designations under its new risk-based survey program, placing them among a select group of facilities recognized by CMS for consistently strong performance.
• 43 Ensign-affiliated operations were recognized on Newsweek’s America’s Best Nursing Homes 2027 list.
  
  

Financial Highlights:

• GAAP diluted earnings per share for the quarter was $1.76, an increase of 23.9% over the prior year quarter, and adjusted diluted earnings per share⁽²⁾ for the quarter was $2.03, an increase of 23.8% over the prior year quarter.
• GAAP net income was $104.3 million for the quarter, an increase of 24.4% over the prior year quarter, and adjusted net income⁽²⁾ was $120.5 million for the quarter, an increase of 24.9% over the prior year quarter.
• Same Facilities and Transitioning Facilities occupancy for the quarter were 84.1% and 86.1%, an increase of 1.6% and 3.9%, respectively, over the prior year quarter.
• Same Facilities and Transitioning Facilities skilled mix revenue for the quarter increased by 10.7% and 10.5%, respectively, over the prior year quarter and skilled days for the quarter increased by 7.2% and 7.9%, respectively, over the prior year quarter.
• Same Facilities and Transitioning Facilities Medicare revenue for the quarter improved by 11.1% and 7.8%, respectively, from the prior year quarter and Medicare days for the quarter improved by 7.6% and 6.3%, respectively, from the prior year quarter. 
• Same Facilities and Transitioning Facilities managed care revenue for the quarter improved by 9.1% and 7.2%, respectively, from the prior year quarter and managed care days for the quarter improved by 3.1% and 3.8%, respectively, from the prior year quarter. 
• Consolidated revenue for the quarter was $1.48 billion, an increase of 14.5% over the prior year quarter.
• Standard Bearer⁽³⁾ revenue was $47.7 million for the quarter, an increase of 46.3% over the prior year quarter. FFO was $27.3 million for the quarter, an increase of 41.3% over the prior year quarter.
  1. The data source for clinical results is from CMS Care Compare Five-Star Quality Rating System, September 2026. Cycle 1 survey inspection results are based on the latest CMS-reported regulatory inspection cycle which reflects results as of Q1 2026. State-wide averages represent the average reported performance of facilities within the states in which we operate. National averages represent the average performance of all facilities included in the CMS Care Compare database nationwide.
  2. See "Reconciliation of GAAP to Non-GAAP Financial Information".
  3. Our Skilled Services and Standard Bearer Segments are defined and outlined in Note 7 on Form 10-Q.
     
     

Clinical and Operating Results

“We continue to see strong demand across our portfolio and experienced growth in occupancy and skilled mix during the quarter. In particular, we saw year-over-year growth across all skilled payor categories during the quarter, with growth in Medicare being particularly strong. On the census front, our Same Facilities and Transitioning occupancy for the third quarter was 84.1% and 86.1%, respectively. In addition to growing census, our Same Facilities and Transitioning Facilities skilled mix revenue increased by 10.7% and 10.5%, respectively, over the prior year quarter. Medicare revenue increased for both our Same Facilities and Transitioning Facilities by 11.1% and 7.8%, respectively. Also, managed care revenue increased by 9.1% and 7.2%, respectively, for Same Facilities and Transitioning Facilities over the prior year quarter, with total skilled days up 7.2% and 7.9%, respectively, from the prior year quarter,” Port said.

He added, “These improvements in occupancy and skilled mix clearly demonstrate that patients, families, hospital systems, physicians, and managed care organizations continue to choose Ensign affiliated operations because of the outcomes our teams achieve and the distinctive culture and experience our local teams create every day. This cannot and will not happen, especially consistently and over a long period of time, without consistently achieving these industry-leading high-quality clinical outcomes. Occupancy and skilled mix are more than financial metrics; they are one of the clearest external validations that an operation consistently delivers the outcomes and experience that stakeholders value."

“Due to the strength of the third quarter and our confidence in the fourth quarter, we are increasing our annual 2026 earnings guidance to $7.94 to $8.02 per diluted share, up from our original guidance of $7.75 to $7.85. We are also raising the lower end of our annual revenue guidance to $5.89 billion, while maintaining the upper end at $5.92 billion. The midpoint of our earnings guidance represents a 21.5% increase over 2025 and 45.5% growth over 2024," Mr. Port said.

Speaking to the Company’s acquisition growth, Chad Keetch, Ensign’s Chief Investment Officer and Executive Vice President said, “We continue to acquire new operations with significant long-term upside and expect to maintain a healthy pace of growth as we expand our mission driven approach to transform and dignify post-acute care. During the quarter and since, we accelerated our growth by adding 22 new operations, including three real estate assets and 19 leased operations. We also acquired five real estate properties that were under lease arrangements that we are operating. Since 2024, we have successfully sourced, underwritten, closed, and transitioned 122 new operations across several markets, many of which are already performing at or above expectations, both clinically and financially. 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 offs. We have several new additions lining up for next year as our local leadership and their 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 $337.6 million of cash on hand and $731.6 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 59.5 million and a 25.0% tax rate. In addition, the guidance assumes, among other things, normalized insurance costs, acquisitions expected to close through the fourth 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 Quarterly Report on Form 10-Q for the quarter ended September 30, 2026, 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 complete these acquisitions and to expand our presence in several key markets, including our entrance into Florida. Florida represents a natural continuation of our strategic expansion into the Southeast, which began with our entry into Tennessee, South Carolina and Alabama. Our approach has been deliberate: enter new markets, develop strong local leadership and clusters, and build the infrastructure necessary to support disciplined growth over time," Mr. Keetch said.

The recent acquisitions include the following leased operations:

• Delta Post Acute and Rehabilitation, an 80-bed skilled nursing facility located in Delta, CO;
• La Villa Grande Care Center, a 96-bed skilled nursing facility located in Grand Junction, CO;
• Milestone Health and Rehabilitation, a 190-bed skilled nursing facility located in Littleton, CO;
• Monument Ridge Health and Rehabilitation, an 88-bed skilled nursing facility located in Grand Junction, CO;
• Pendant Health and Rehabilitation, a 130-bed skilled nursing facility located in Lakewood, CO;
• Skyline Ridge Health and Rehabilitation, a healthcare campus with 85 skilled nursing beds and 47 independent living units located in Canon City, CO;
• Spring Village Care Center, a 91-bed skilled nursing facility located in Colorado Springs, CO;
• Burien Nursing and Rehabilitation, a 140-bed skilled nursing facility located in Burien, WA;
• Issaquah Nursing and Rehabilitation, a 140-bed skilled nursing facility located in Issaquah, WA;
• Park Ridge Nursing and Rehabilitation, a 115-bed skilled nursing facility located in Shoreline, WA;
• Park West Nursing and Rehabilitation, a 137-bed skilled nursing facility located in Seattle, WA;
• Bay Park Post-Acute and Rehabilitation, a 101-bed skilled nursing facility located in Sarasota, FL;
• Carrabelle Post-Acute and Rehabilitation, a 90-bed skilled nursing facility located in Carrabelle, FL;
• Cedar Hill Post-Acute and Rehabilitation, a 120-bed skilled nursing facility located in Jacksonville, FL;
• Davenport Post-Acute and Rehabilitation, a healthcare campus with 60 skilled nursing beds and 66 independent living units located in Davenport, FL;
• Greenville Post-Acute and Rehabilitation, a 58-bed skilled nursing facility located in Greenville, FL;
• Lake Haven Post-Acute and Rehabilitation, a 104-bed skilled nursing facility located in Dunedin, FL;
• Monticello Post-Acute and Rehabilitation, a 60-bed skilled nursing facility located in Monticello, FL; and
• Shores Post-Acute and Rehabilitation, a 120-bed skilled nursing facility located in Port Saint Joe, FL.

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

• Las Ventanas de Socorro, a 126-bed skilled nursing facility located in Socorro, Texas; 
• Los Arcos del Norte Care Center, a 124-bed skilled nursing facility located in El Paso, Texas; and
•  Englewood Heights Nursing and Rehabilitation, a 118-bed skilled nursing facility located in Pensacola, Florida.
  
  

Additionally, Standard Bearer announced it acquired the real estate assets of five facilities that were previously operated under third-party triple net leases. These facilities total 755 skilled nursing beds and are now subject to long-term leases with subsidiaries of Standard Bearer.

Ensign's growing portfolio consists of 418 healthcare operations, 34 of which also include senior living operations, across 18 states. Ensign now owns 189 real estate assets, 150 of 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 183 owned properties. Of these assets, 146 are leased to Ensign-affiliated operators and 38 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 $47.7 million for the quarter, of which $42.1 million was derived from Ensign affiliated operations. For the quarter, Ensign reported $27.3 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.

Conference Call

A live webcast will be held on Wednesday, October 28, 2026, at 10:00 a.m. Pacific time (1:00 p.m. Eastern time) to discuss Ensign’s third quarter of 2026 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, November 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 418 healthcare facilities in Alabama, Alaska, Arizona, California, Colorado, Florida, 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 also 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.
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF INCOME
	Three Months Ended September 30,								Nine Months Ended September 30,
		2026				2025				2026				2025
	(In thousands, except per share data)
REVENUE
Service revenue	$	1,476,835			$	1,289,779			$	4,291,635			$	3,678,233
Rental revenue		7,167				6,626				22,044				18,982
TOTAL REVENUE	$	1,484,002			$	1,296,405			$	4,313,679			$	3,697,215
Expense:
Cost of services		1,166,802				1,044,659				3,396,865				2,944,288
Rent—cost of services		66,970				61,528				198,888				175,799
General and administrative expense		79,595				67,367				239,727				199,029
Depreciation and amortization		32,646				26,633				92,853				76,606
TOTAL EXPENSES	$	1,346,013			$	1,200,187			$	3,928,333			$	3,395,722
Income from operations		137,989				96,218				385,346				301,493
Other income (expense):
Interest expense		(2,286	)			(1,971	)			(6,151	)			(6,033	)
Interest income		4,717				6,168				15,886				18,291
Other (expense) income		(222	)			6,185				7,363				11,787
OTHER INCOME, NET	$	2,209			$	10,382			$	17,098			$	24,045
Income before provision for income taxes		140,198				106,600				402,444				325,538
Provision for income taxes		35,814				22,689				98,470				76,808
NET INCOME	$	104,384			$	83,911			$	303,974			$	248,730
Less: net income attributable to noncontrolling interests		122				67				306				213
NET INCOME ATTRIBUTABLE TO THE ENSIGN GROUP, INC.	$	104,262			$	83,844			$	303,668			$	248,517
NET INCOME PER SHARE ATTRIBUTABLE TO THE ENSIGN GROUP INC.
Basic	$	1.80			$	1.46			$	5.25			$	4.34
Diluted	$	1.76			$	1.42			$	5.11			$	4.23
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING
Basic		57,824				57,382				57,851				57,214
Diluted		59,303				58,956				59,455				58,713

THE ENSIGN GROUP, INC.
UNAUDITED CONDENSED CONSOLIDATED BALANCE SHEETS
(In thousands)
	September 30, 2026			December 31, 2025
ASSETS
Current assets:
Cash and cash equivalents	$	337,592		$	503,881
Accounts receivable—less allowance for doubtful accounts of $7,910 and $7,805 at September 30, 2026 and December 31, 2025, respectively		664,773			636,985
Investments—current		54,102			68,506
Prepaid expenses and other current assets		98,416			62,932
Total current assets	$	1,154,883		$	1,272,304
Property and equipment, net		2,278,231			1,696,863
Right-of-use assets		2,117,457			2,097,862
Insurance subsidiary deposits and investments		219,988			166,841
Deferred tax assets		83,188			83,138
Restricted and other assets		40,459			41,600
Intangible assets, net		6,203			6,381
Goodwill		97,981			97,981
TOTAL ASSETS	$	5,998,390		$	5,462,970
LIABILITIES AND EQUITY
Current liabilities:
Accounts payable	$	125,374		$	97,327
Accrued wages and related liabilities		420,724			422,326
Lease liabilities—current		120,388			114,816
Accrued self-insurance liabilities—current		111,021			81,623
Other accrued liabilities		181,365			174,027
Current maturities of long-term debt		4,040			4,227
Total current liabilities	$	962,912		$	894,346
Long-term lease liabilities—less current portion		1,968,539			1,949,213
Accrued self-insurance liabilities—less current portion		201,675			164,792
Other long-term liabilities		107,189			82,266
Long-term debt—less current maturities		194,684			137,529
Total equity		2,563,391			2,234,824
TOTAL LIABILITIES AND EQUITY	$	5,998,390		$	5,462,970

THE ENSIGN GROUP, INC.
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)
The following table presents selected data from our condensed consolidated statements of cash flows for the periods presented:
	Nine Months Ended September 30,
		2026				2025
NET CASH PROVIDED BY (USED IN):
Operating activities	$	512,348			$	380,950
Investing activities		(690,937	)			(389,237	)
Financing activities		12,300				(12,643	)
Net decrease in cash and cash equivalents	$	(166,289	)		$	(20,930	)
Cash and cash equivalents beginning of period		503,881				464,598
Cash and cash equivalents at end of period	$	337,592			$	443,668

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 net income to Adjusted net income and diluted earnings per share to Adjusted earnings per share for the periods presented:
	Three Months Ended September 30,								Nine Months Ended September 30,
		2026				2025				2026				2025
Net income attributable to The Ensign Group, Inc.	$	104,262			$	83,844			$	303,668			$	248,517
Adjustments:
Stock-based compensation expense(1)		19,044				12,989				49,105				35,375
Cost of services - Litigation(2)		—				12,000				—				12,000
Cost of services - acquisition related costs(3)		213				528				1,013				1,663
Cost of services - (gain) loss on long-lived assets and business interruption recoveries, net		(564	)			(1,660	)			720				(2,660	)
General and administrative - costs incurred related to system implementations		1,721				701				6,920				1,472
Depreciation and amortization - patient base(4)		—				—				—				1,020
Interest expense - write off deferred financing fees(5)		159				—				159				—
Other income - gain on other investments (6)		—				(2,437	)			—				(2,437	)
Provision for income taxes on Non-GAAP adjustments(7)		(4,379	)			(9,491	)			(16,621	)			(16,184	)
Adjusted Net Income	$	120,456			$	96,474			$	344,964			$	278,766
Average number of diluted shares outstanding		59,303				58,956				59,455				58,713
Diluted Earnings Per Share	$	1.76			$	1.42			$	5.11			$	4.23
Adjusted Earnings Per Share	$	2.03			$	1.64			$	5.80			$	4.75
Footnotes:
(1)  Represents stock-based compensation expense incurred.
	Three Months Ended September 30,								Nine Months Ended September 30,
		2026				2025				2026				2025
Cost of services	$	12,814			$	8,687			$	32,707			$	23,720
General and administrative		6,230				4,302				16,398				11,655
Total Non-GAAP adjustment	$	19,044			$	12,989			$	49,105			$	35,375
(2) Represents specific proceedings and adjustments arising outside of the ordinary course of business.
(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 the Credit Facility.
(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 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 September 30,								Nine Months Ended September 30,
		2026				2025				2026				2025
Consolidated Statements of Income Data:
Net income	$	104,384			$	83,911			$	303,974			$	248,730
Less: Net income attributable to noncontrolling interests		122				67				306				213
Interest income		4,717				6,168				15,886				18,291
Add: Provision for income taxes		35,814				22,689				98,470				76,808
Depreciation and amortization		32,646				26,633				92,853				76,606
Interest expense		2,286				1,971				6,151				6,033
EBITDA	$	170,291			$	128,969			$	485,256			$	389,673
Adjustments to EBITDA:
Stock-based compensation expense		19,044				12,989				49,105				35,375
Costs incurred related to system implementations		1,721				701				6,920				1,472
Acquisition related costs(1)		213				528				1,013				1,663
(Gain) loss on long-lived assets and business interruption recoveries, net		(564	)			(1,660	)			720				(2,660	)
Litigation(2)		—				12,000				—				12,000
Gain on other investments(3)		—				(2,437	)			—				(2,437	)
ADJUSTED EBITDA	$	190,705			$	151,090			$	543,014			$	435,086
Rent—cost of services		66,970				61,528				198,888				175,799
ADJUSTED EBITDAR	$	257,675							$	741,902
(1) Represents costs incurred to acquire operations that are not capitalizable.
(2) Represents specific proceedings and adjustments arising outside of the ordinary course of business.
(3) 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.

The table below reconciles income before provision for income taxes to Adjusted EBT for the periods presented:
	Three Months Ended September 30,								Nine Months Ended September 30,
		2026				2025				2026				2025
Consolidated statements of income data:	(In thousands)
Income before provision for income taxes	$	140,198			$	106,600			$	402,444			$	325,538
Stock-based compensation expense		19,044				12,989				49,105				35,375
Costs incurred related to system implementations		1,721				701				6,920				1,472
Acquisition related costs(1)		213				528				1,013				1,663
(Gain) loss on long-lived assets and business interruption recoveries, net		(564	)			(1,660	)			720				(2,660	)
Litigation(2)		—				12,000				—				12,000
Gain on other investments(3)		—				(2,437	)			—				(2,437	)
Write off deferred financing fees(4)		159				—				159				—
Depreciation and amortization - patient base(5)		—				—				—				1,020
ADJUSTED EBT	$	160,771			$	128,721			$	460,361			$	371,971
(1) Represents costs incurred to acquire operations that are not capitalizable.
(2) Represents specific proceedings and adjustments arising outside of the ordinary course of business.
(3) 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.
(4) Represents the write off of deferred financing fees associated with the Credit Facility.
(5) Represents amortization expenses related to patient base intangible assets at newly acquired skilled nursing and senior living facilities.

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 September 30,
		2026				2025			Change				% Change
TOTAL FACILITY RESULTS:	(Dollars in thousands)
Skilled services revenue	$	1,421,971			$	1,239,096			$	182,875				14.8	%
Number of facilities at period end		350				315				35			11.1		%
Number of campuses at period end(1)		32				30				2			6.7		%
Actual patient days		3,136,313				2,772,062				364,251			13.1		%
Occupancy percentage — Operational beds		83.1	%			82.3	%			0.8	%		1.0		%
Skilled mix by nursing days		30.7	%			30.3	%			0.4	%		1.3		%
Skilled mix by nursing revenue		49.7	%			48.9	%			0.8	%		1.6		%

	Three Months Ended September 30,
		2026				2025			Change				% Change
SAME FACILITY RESULTS:(2)	(Dollars in thousands)
Skilled services revenue	$	997,182			$	944,666			$	52,516				5.6	%
Number of facilities at period end		234				234				—			—		%
Number of campuses at period end(1)		25				25				—			—		%
Actual patient days		2,192,074				2,144,063				48,011			2.2		%
Occupancy percentage — Operational beds		84.1	%			82.8	%			1.3	%		1.6		%
Skilled mix by nursing days		32.2	%			30.7	%			1.5	%		4.9		%
Skilled mix by nursing revenue		51.2	%			49.5	%			1.7	%		3.4		%

	Three Months Ended September 30,
		2026				2025			Change				% Change
TRANSITIONING FACILITY RESULTS:(3)	(Dollars in thousands)
Skilled services revenue	$	198,406			$	188,266			$	10,140				5.4	%
Number of facilities at period end		50				50				—			—		%
Number of campuses at period end(1)		4				4				—			—		%
Actual patient days		416,274				398,635				17,639			4.4		%
Occupancy percentage — Operational beds		86.1	%			82.9	%			3.2	%		3.9		%
Skilled mix by nursing days		29.3	%			28.3	%			1.0	%		3.5		%
Skilled mix by nursing revenue		49.3	%			47.8	%			1.5	%		3.1		%

	Three Months Ended September 30,
	2026				2025				Change				% Change
RECENTLY ACQUIRED FACILITY RESULTS:(4)	(Dollars in thousands)
Skilled services revenue	$	226,383			$	106,164				120,219				NM
Number of facilities at period end		66				31				35				NM
Number of campuses at period end(1)		3				1				2				NM
Actual patient days		527,965				229,364				298,601				NM
Occupancy percentage — Operational beds		77.4	%			76.9	%		NM					NM
Skilled mix by nursing days		25.9	%			29.4	%		NM					NM
Skilled mix by nursing revenue		43.2	%			45.6	%		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 acquired prior to January 1, 2023.
(3) Transitioning Facility results represent all facilities acquired from January 1, 2023 to December 31, 2024.
(4) Recently Acquired Facility results represent all facilities acquired on or subsequent to January 1, 2025.

	Nine Months Ended September 30,
		2026				2025			Change				% Change
TOTAL FACILITY RESULTS:	(Dollars in thousands)
Skilled services revenue	$	4,132,718			$	3,536,226			$	596,492				16.9	%
Number of facilities at period end		350				315				35			11.1		%
Number of campuses at period end(1)		32				30				2			6.7		%
Actual patient days		9,049,988				7,925,688				1,124,300			14.2		%
Occupancy percentage — Operational beds		83.3	%			81.8	%			1.5	%		1.8		%
Skilled mix by nursing days		31.2	%			30.8	%			0.4	%		1.3		%
Skilled mix by nursing revenue		50.1	%			49.4	%			0.7	%		1.4		%

	Nine Months Ended September 30,
		2026				2025			Change				% Change
SAME FACILITY RESULTS:(2)	(Dollars in thousands)
Skilled services revenue	$	2,964,727			$	2,788,004			$	176,723				6.3	%
Number of facilities at period end		234				234				—			—		%
Number of campuses at period end(1)		25				25				—			—		%
Actual patient days		6,501,802				6,314,247				187,555			3.0		%
Occupancy percentage — Operational beds		84.2	%			82.4	%			1.8	%		2.2		%
Skilled mix by nursing days		32.3	%			31.4	%			0.9	%		2.9		%
Skilled mix by nursing revenue		51.2	%			50.2	%			1.0	%		2.0		%

	Nine Months Ended September 30,
		2026				2025			Change				% Change
TRANSITIONING FACILITY RESULTS:(3)	(Dollars in thousands)
Skilled services revenue	$	591,263			$	553,169			$	38,094				6.9	%
Number of facilities at period end		50				50				—			—		%
Number of campuses at period end(1)		4				4				—			—		%
Actual patient days		1,224,006				1,176,804				47,202			4.0		%
Occupancy percentage — Operational beds		85.3	%			82.6	%			2.7	%		3.3		%
Skilled mix by nursing days		29.7	%			28.4	%			1.3	%		4.6		%
Skilled mix by nursing revenue		49.5	%			47.7	%			1.8	%		3.8		%

	Nine Months Ended September 30,
		2026				2025			Change				% Change
RECENTLY ACQUIRED FACILITY RESULTS:(4)	(Dollars in thousands)
Skilled services revenue	$	576,728			$	195,053			$	381,675				NM
Number of facilities at period end		66				31				35			NM
Number of campuses at period end(1)		3				1				2			NM
Actual patient days		1,324,180				434,637				889,543			NM
Occupancy percentage — Operational beds		77.9	%			73.5	%		NM				NM
Skilled mix by nursing days		27.4	%			28.6	%		NM				NM
Skilled mix by nursing revenue		45.4	%			43.0	%		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 acquired prior to January 1, 2023.
(3) Transitioning Facility results represent all facilities acquired from January 1, 2023 to December 31, 2024.
(4) Recently Acquired Facility results represent all facilities acquired on or subsequent to January 1, 2025.

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 September 30,
	Same Facility						Transitioning						Recently Acquired						Total
	2026			2025			2026			2025			2026			2025			2026			2025
SKILLED NURSING AVERAGE DAILY REVENUE RATES
Medicare	$	812.29		$	786.86		$	881.30		$	868.99		$	776.17		$	780.84		$	817.11		$	800.89
Managed care		608.68			575.23			653.34			632.45			608.80			636.13			613.50			585.56
Other skilled		633.17			646.45			704.35			664.14			642.24			678.64			640.87			650.94
Total skilled revenue		684.56			662.53			773.03			754.56			692.63			710.75			696.80			678.71
Medicaid		308.98			300.07			324.57			319.99			319.89			351.46			312.94			307.19
Private and other payors		312.06			297.40			351.51			353.62			311.03			366.81			317.34			312.58
Total skilled nursing revenue	$	430.17		$	411.09		$	458.80		$	446.75		$	415.17		$	459.02		$	431.41		$	420.16

	Nine Months Ended September 30,
	Same Facility						Transitioning						Recently Acquired						Total
	2026			2025			2026			2025			2026			2025			2026			2025
SKILLED NURSING AVERAGE DAILY REVENUE RATES
Medicare	$	812.21		$	780.70		$	884.35		$	854.98		$	789.09		$	730.79		$	820.37		$	791.47
Managed care		599.55			571.73			652.80			615.05			620.54			580.21			607.67			576.91
Other skilled		642.17			646.06			688.76			666.94			653.15			694.03			647.79			650.77
Total skilled revenue		682.95			658.94			773.08			744.66			706.21			669.83			697.45			671.14
Medicaid		310.64			299.81			327.20			317.97			318.92			353.87			314.13			305.55
Private and other payors		313.84			291.96			360.88			354.36			332.10			365.61			323.97			306.74
Total skilled nursing revenue	$	431.22		$	411.79		$	463.17		$	443.06		$	426.95		$	445.64		$	434.88		$	418.26
(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 September 30,
	Same Facility						Transitioning						Recently Acquired						Total
	2026			2025			2026			2025			2026			2025			2026			2025
PERCENTAGE OF SKILLED NURSING REVENUE
Medicare	21.1	%		20.3	%		27.6	%		27.5	%		22.7	%		22.7	%		22.3	%		21.6	%
Managed care	20.0			19.6			15.0			15.0			14.2			13.6			18.3			18.3
Other skilled	10.1			9.6			6.7			5.3			6.3			9.3			9.1			9.0
Skilled mix	51.2	%		49.5	%		49.3	%		47.8	%		43.2	%		45.6	%		49.7	%		48.9	%
Private and other payors	6.9			7.3			8.6			8.9			10.7			9.3			7.7			7.7
Medicaid	41.9			43.2			42.1			43.3			46.1			45.1			42.6			43.4
TOTAL SKILLED NURSING	100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%

	Three Months Ended September 30,
	Same Facility						Transitioning						Recently Acquired						Total
	2026			2025			2026			2025			2026			2025			2026			2025
PERCENTAGE OF SKILLED NURSING DAYS
Medicare	11.2	%		10.6	%		14.4	%		14.1	%		12.2	%		13.3	%		11.8	%		11.3	%
Managed care	14.1			14.0			10.5			10.6			9.7			9.8			12.9			13.2
Other skilled	6.9			6.1			4.4			3.6			4.0			6.3			6.0			5.8
Skilled mix	32.2	%		30.7	%		29.3	%		28.3	%		25.9	%		29.4	%		30.7	%		30.3	%
Private and other payors	9.5			10.1			11.1			11.3			14.3			11.7			10.6			10.3
Medicaid	58.3			59.2			59.6			60.4			59.8			58.9			58.7			59.4
TOTAL SKILLED NURSING	100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%

	Nine Months Ended September 30,
	Same Facility						Transitioning						Recently Acquired						Total
	2026			2025			2026			2025			2026			2025			2026			2025
PERCENTAGE OF SKILLED NURSING REVENUE
Medicare	21.3	%		20.9	%		28.1	%		28.1	%		24.3	%		20.6	%		22.7	%		22.0	%
Managed care	19.8			20.1			14.9			14.3			14.7			13.2			18.4			18.8
Other skilled	10.1			9.2			6.5			5.3			6.4			9.2			9.0			8.6
Skilled mix	51.2	%		50.2	%		49.5	%		47.7	%		45.4	%		43.0	%		50.1	%		49.4	%
Private and other payors	6.9			7.1			8.4			8.9			10.2			9.7			7.6			7.5
Medicaid	41.9			42.7			42.1			43.4			44.4			47.3			42.3			43.1
TOTAL SKILLED NURSING	100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%		100.0	%

	Nine Months Ended September 30,
	Same Facility						Transitioning						Recently Acquired						Total
	2026			2025			2026			2025			2026			2025			2026			2025
PERCENTAGE OF SKILLED NURSING DAYS
Medicare	11.3	%		11.0	%		14.7	%		14.6	%		13.1	%		12.6	%		12.0	%		11.6	%
Managed care	14.2			14.5			10.6			10.3			10.1			10.1			13.1			13.6
Other skilled	6.8			5.9			4.4			3.5			4.2			5.9			6.1			5.6
Skilled mix	32.3	%		31.4	%		29.7	%		28.4	%		27.4	%		28.6	%		31.2	%		30.8	%
Private and other payors	9.5			9.9			10.8			11.2			13.2			11.9			10.3			10.2
Medicaid	58.2			58.7			59.5			60.4			59.4			59.5			58.5			59.0
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 September 30,
		2026						2025
	Revenue			% of Revenue			Revenue			% of Revenue
Medicaid(1)	$	590,450		40.0	%		$	515,157		39.9	%
Medicare		342,866		23.2				303,281		23.5
Medicaid-skilled		78,474		5.3				78,450		6.1
Total Medicaid and Medicare	$	1,011,790		68.5	%		$	896,888		69.5	%
Managed care		276,484		18.7				237,978		18.5
Private and other(2)		188,561		12.8				154,913		12.0
SERVICE REVENUE	$	1,476,835		100.0	%		$	1,289,779		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.

	Nine Months Ended September 30,
		2026						2025
	Revenue			% of Revenue			Revenue			% of Revenue
Medicaid(1)	$	1,700,719		39.6	%		$	1,454,845		39.6	%
Medicare		1,018,345		23.7				882,149		24.0
Medicaid-skilled		234,376		5.5				223,208		6.0
Total Medicaid and Medicare	$	2,953,440		68.8	%		$	2,560,202		69.6	%
Managed care		802,683		18.7				694,690		18.9
Private and other(2)		535,512		12.5				423,341		11.5
SERVICE REVENUE	$	4,291,635		100.0	%		$	3,678,233		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 September 30,								Nine Months Ended September 30,
	2026				2025				2026				2025
Statements of Income Data:
Segment income(1)	$	185,198			$	153,126			$	538,836			$	447,061
Depreciation and amortization		15,279				14,155				46,034				41,118
EBITDA	$	200,477			$	167,281			$	584,870			$	488,179
Adjustments to EBITDA:
Stock-based compensation expense		12,299				8,327				31,335				22,774
Gain on business interruption recoveries		—				(2,733	)			—				(3,733	)
ADJUSTED EBITDA	$	212,776			$	172,875			$	616,205			$	507,220
(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.

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 September 30,						Nine Months Ended September 30,
	2026			2025			2026			2025
Rental revenue generated from third-party tenants	$	5,562		$	4,976		$	17,180		$	14,185
Rental revenue generated from Ensign's independent subsidiaries		42,142			27,634			110,759			78,294
TOTAL RENTAL REVENUE	$	47,704		$	32,610		$	127,939		$	92,479
Segment income(1)		13,751			9,622			36,630			27,331
Depreciation and amortization		13,565			9,709			37,024			27,450
FFO(2)	$	27,316		$	19,331		$	73,654		$	54,781
(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 and nine months ended September 30, 2026 is management fee of $2.9 million and $7.7 million, respectively, and interest of $14.9 million and $38.9 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 and nine months ended September 30, 2025 is management fee of $2.0 million and $5.5 million, respectively, and interest of $9.1 million and $25.2 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 on the 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.

Discussion of Non-GAAP Financial Measures

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) (gain) loss on long-lived assets and business interruption recoveries, (f) write off of deferred financing fees, (g) litigation arising outside of the ordinary course of business, (h) gain on other investments, and (i) amortization of patient base intangible assets. Adjusted net income consists of net income excluding (a) stock‑based compensation expense, (b) acquisition related costs, (c) costs incurred related to system implementations, (d) (gain) loss on long-lived assets and business interruption recoveries, (e) write off of deferred financing fees, (f) litigation arising outside of the ordinary course of business, (g) gain on other investments, (h) amortization of patient base intangible assets, and (i) the income tax effect of these adjustments. Adjusted earnings per share consists of adjusted net income divided by the weighted‑average diluted shares outstanding for the applicable period. 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) (gain) loss on long-lived assets and business interruption recoveries, (i) litigation arising outside of the ordinary course of business 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) (gain) loss on long-lived assets and business interruption recoveries (j) litigation arising outside of the ordinary course of business and (k) gain on other investments. 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 EBT, adjusted net income, adjusted earnings per share, EBITDA, adjusted EBITDA 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 EBT, adjusted net income, adjusted earnings per share, EBITDA, adjusted EBITDA, adjusted EBITDAR 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 these 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

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

What is Ensign Group's updated 2026 earnings and revenue guidance?

Ensign expects annual earnings of $7.94 to $8.02 per diluted share, excluding specified costs, and revenue of $5.89 billion to $5.92 billion. The previous earnings range was $7.75 to $7.85. The company raised the revenue range's lower end while maintaining its upper end.

What assumptions and exclusions underpin ENSG's 2026 earnings guidance?

The guidance assumes approximately 59.5 million diluted weighted average common shares, a 25.0% tax rate, normalized insurance costs, acquisitions expected to close through the fourth quarter of 2026, and management's current reimbursement-rate expectations. It excludes certain charges outside normal business, amortization of system implementation costs, acquisition-related costs and share-based compensation.

How did Ensign Group perform in the third quarter of 2026?

Ensign reported $1.48 billion in revenue, up 14.5% year over year, and GAAP diluted EPS of $1.76, up 23.9%. Adjusted diluted EPS was $2.03, an increase of 23.8%. GAAP net income increased 24.4% to $104.3 million.