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

$186.48+2.37(0.01%)Market open

Market Cap

$10.54B

P/E

26.4x

P/S

1.9x

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: Cash & Earnings Quality (25/25); weakest: Profitability (18/25).

Profitability18/25

Growth24/25

Balance Sheet & Red Flags21/25

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 · 26.4x5y range 23.9x – 43.1x

Currently below its 20-quarter median.

P/S · 1.9x5y range 1.7x – 3.2x

Currently near its 20-quarter median.

P/B · 4.1x5y range 3.8x – 8.2x

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.

Price & Volume

Market Cap $10.54B

Metrics at a Glance

as of September 2026

Revenue & Profit

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

TTM Revenue: $5.64B
Q. Revenue: $1.48B
TTM EBITDA: $629.73M
TTM Op. Income: $509.16M
Q. Op. Income: $137.99M
TTM Net Income: $399.12M
Q. Net Income: $104.26M
EPS: $1.8
Shares Out.: $57.82M

$5.64B in TTM revenue grew 17.1% YoY, reaching $1.48B last quarter. TTM EBITDA of $629.73M and TTM operating income of $509.16M show growth is flowing through to the bottom line. TTM net income of $399.12M 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: 21.0%
EBITDA Margin: 11.6%
Op. Margin: 9.3%
Net Margin: 7.1%

Op. margin of 9.3% is up 1.9% YoY — cost efficiency is improving. Net margin at 7.1% and gross margin of 21.0% show how much of each revenue dollar survives to profit. Over the past year, operating margin is up 25% — an improving trend.

Price Ratios

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

P/E Ratio: 26.4x
P/S Ratio: 1.9x
P/B Ratio: 4.1x

At 26.4x P/E, the stock trades within typical market levels. P/S of 1.9x 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 12% — a weakening trend.

Assets & Liabilities

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

Total Assets: $6.00B
Cash: $337.59M
Long-Term Debt: $194.68M
Book Value: $2.56B
D/E Ratio: 0.1
Debt/EBITDA: 1.1

With $6.00B in assets and $194.68M in long-term debt, D/E is 0.1and book value is $2.56B — a conservative capital structure with a cushion to weather downturns. Over the past year, debt/equity is up 16% — a weakening trend.

Cash Flow

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

Op. Cash Flow: $240.24M
TTM Free Cash Flow: $509.91M
FCF Margin: 9.0%
FCF / Net Income: 1.3

TTM FCF of $509.91M on $240.24M in operating cash flow. The FCF / Net Income ratio of 1.3x means free cash flow covers net income — earnings are backed by cash. Across the last 8 quarters, free cash flow has risen for 7 consecutive quarters — an improving trend.