The Ensign Group (ENSG) Stock Fundamentals, Analysis & Risk Signals

Health score, price, valuation, risk signals, and key metrics at a glance.

The Ensign Group

NasdaqGS•Healthcare•Medical Care Facilities

$170.79-1.30(-0.01%)Pre-market

Market Cap

$10.08B

P/E

26.6x

P/S

1.8x

P/B

4.1x

The Ensign Group, Inc. provides skilled nursing, senior living, and rehabilitative services. It operates through two segments: Skilled Services and Standard Bearer. The Skilled Services segment provides short and long-term nursing care services for patients with chronic conditions, prolonged illness, and the elderly; specialty care, such as on-site dialysis, ventilator care, cardiac, and pulmonary management; and standard services, such as room and board, special nutritional programs, social services, recreational activities, entertainment, and other services. The Standard Bearer segment leases post-acute care properties to healthcare operators. In addition, the company operates senior living units; and provides ancillary services consisting of digital x-ray, ultrasound, electrocardiograms, sub-acute services, dialysis, respiratory, and long-term care pharmacy and patient transportation to people in their homes or at long-term care facilities, as well as mobile diagnostics. The company operates healthcare facilities in Alabama, Alaska, Arizona, Colorado, Idaho, Iowa, Kansas, Oregon, Nebraska, Nevada, South Carolina, Tennessee, Texas, Utah, Washington, and Wisconsin. The company was incorporated in 1999 and is based in San Juan Capistrano, California.

How this company scores

ExcellentMetricSide Score: 88/100

Strongest: Balance Sheet & Red Flags (25/25); weakest: Profitability (15/25).

Profitability15/25

Growth23/25

Balance Sheet & Red Flags25/25

Cash & Earnings Quality25/25

Strengths

Growing revenueRising free cash flowHigh ROERising earnings

Valuation vs. 5-year range

Today's multiple positioned against its own trailing range — a visual premium/discount check.

P/E · 26.6x5y range 20.3x – 34.0x

Currently near its 20-quarter median.

P/S · 1.8x5y range 1.5x – 2.2x

Currently near its 20-quarter median.

P/B · 4.1x5y range 3.6x – 4.9x

Watch items

Data-driven signals worth keeping an eye on across the last 8 quarters

Some Concerns

Earnings Quality

Watch

FCF/Net Income has dropped below 0.7x in 3 quarters — monitor for earnings quality deterioration.

Share Dilution

Watch

Shares outstanding rose 2.1% — mild dilution. Compare to earnings growth to assess the net per-share impact.

Price & Volume

Market Cap $10.08B

Metrics at a Glance

as of June 2026

Revenue & Profit

Revenue, EBITDA, operating income, net income, EPS, and shares

TTM Revenue: $5.45B
Q. Revenue: $1.43B
TTM EBITDA: $581.95M
TTM Op. Income: $467.39M
Q. Op. Income: $122.50M
TTM Net Income: $378.70M
Q. Net Income: $99.74M
EPS: $1.72
Shares Out.: $57.96M

$5.45B in TTM revenue grew 18.3% YoY, reaching $1.43B last quarter. TTM EBITDA of $581.95M and TTM operating income of $467.39M show growth is flowing through to the bottom line. TTM net income of $378.70M means revenue is converting into profit. Across the last 8 quarters, TTM revenue has risen for 7 consecutive quarters — an improving trend.

Margins

Gross, EBITDA, operating, and net margin trends

Gross Margin: 20.8%
EBITDA Margin: 10.7%
Op. Margin: 8.6%
Net Margin: 7.0%

Op. margin of 8.6% is up 0.0% YoY — cost efficiency is improving. Net margin at 7.0% and gross margin of 20.8% show how much of each revenue dollar survives to profit. Across the last 8 quarters, operating margin has fallen for 2 consecutive quarters — a weakening trend.

Price Ratios

P/E, P/S, P/B, EV/EBITDA, FCF yield, and earnings yield

P/E Ratio: 26.6x
P/S Ratio: 1.8x
P/B Ratio: 4.1x

At 26.6x P/E, the stock trades within typical market levels. P/S of 1.8x and P/B of 4.1x provide additional context. Use the growth and margin sections to judge whether the multiple is justified. Over the past year, P/E is down 3% — an improving trend.

Assets & Liabilities

Total assets, cash, debt, book value, and leverage

Total Assets: $5.75B
Cash: $262.30M
Long-Term Debt: $135.56M
Book Value: $2.44B
D/E Ratio: 0.1
Debt/EBITDA: 0.9

With $5.75B in assets and $135.56M in long-term debt, D/E is 0.1and book value is $2.44B — a conservative capital structure with a cushion to weather downturns. Across the last 8 quarters, debt/equity has fallen for 7 consecutive quarters — an improving trend.

Cash Flow

Operating cash flow, free cash flow, FCF margin, and earnings quality

Op. Cash Flow: $171.95M
TTM Free Cash Flow: $419.09M
FCF Margin: 7.7%
FCF / Net Income: 1.1

TTM FCF of $419.09M on $171.95M in operating cash flow. The FCF / Net Income ratio of 1.1x means free cash flow covers net income — earnings are backed by cash. Across the last 8 quarters, free cash flow has risen for 6 consecutive quarters — an improving trend.