Medical - Care Facilities
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ENSG vs ADUS vs NHC vs HCSG
Revenue, margins, valuation, and 5-year total return — side by side.
Medical - Care Facilities
Medical - Care Facilities
Medical - Care Facilities
ENSG vs ADUS vs NHC vs HCSG — Key Financials
Market cap, revenue, margins, and valuation side-by-side.
| Company Snapshot | ||||
|---|---|---|---|---|
| Industry | Medical - Care Facilities | Medical - Care Facilities | Medical - Care Facilities | Medical - Care Facilities |
| Market Cap | $10.18B | $1.81B | $2.66B | $1.60B |
| Revenue (TTM) | $5.27B | $1.45B | $1.50B | $1.84B |
| Net Income (TTM) | $363M | $100M | $101M | $59M |
| Gross Margin | 15.2% | 32.5% | 38.5% | 13.3% |
| Operating Margin | 8.5% | 9.8% | 8.1% | 3.0% |
| Forward P/E | 23.2x | 14.1x | 21.5x | 20.8x |
| Total Debt | $4.15B | $209M | $87M | $25M |
| Cash & Equiv. | $504M | $82M | — | $161M |
ENSG vs ADUS vs NHC vs HCSG — Long-Term Stock Performance
Price return indexed to 100 at period start. Dividends excluded.
| Stock | May 20 | May 26 | Return |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | 100 | 398.7 | +298.7% |
| Addus HomeCare Corp… (ADUS) | 100 | 98.3 | -1.7% |
| National HealthCare… (NHC) | 100 | 255.6 | +155.6% |
| Healthcare Services… (HCSG) | 100 | 93.3 | -6.7% |
Price return only. Dividends and distributions are not included.
Quick Verdict: ENSG vs ADUS vs NHC vs HCSG
Each card shows where this stock fits in a portfolio — not just who wins on paper.
ENSG has the current edge in this matchup, primarily because of its strength in income & stability and long-term compounding.
- Dividend streak 12 yrs, beta 0.42, yield 0.1%
- 7.5% 10Y total return vs NHC's 198.2%
- Beta 0.42, yield 0.1%, current ratio 1.42x
- 6.9% margin vs HCSG's 3.2%
ADUS is the #2 pick in this set and the best alternative if growth exposure and sleep-well-at-night is your priority.
- Rev growth 23.2%, EPS growth 23.2%, 3Y rev CAGR 14.4%
- Lower volatility, beta 0.58, Low D/E 19.2%, current ratio 1.80x
- PEG 0.70 vs ENSG's 1.68
- 23.2% revenue growth vs HCSG's 7.1%
NHC is the clearest fit if your priority is dividends and momentum.
- 1.4% yield, 12-year raise streak, vs ENSG's 0.1%, (2 stocks pay no dividend)
- +81.9% vs ADUS's -13.4%
HCSG is the clearest fit if your priority is efficiency.
- 7.3% ROA vs NHC's 6.4%, ROIC 9.0% vs 8.4%
See the full category breakdown
| Category | Winner | Why |
|---|---|---|
| Growth | 23.2% revenue growth vs HCSG's 7.1% | |
| Value | Lower P/E (14.1x vs 21.5x), PEG 0.70 vs 0.93 | |
| Quality / Margins | 6.9% margin vs HCSG's 3.2% | |
| Stability / Safety | Beta 0.42 vs HCSG's 1.12 | |
| Dividends | 1.4% yield, 12-year raise streak, vs ENSG's 0.1%, (2 stocks pay no dividend) | |
| Momentum (1Y) | +81.9% vs ADUS's -13.4% | |
| Efficiency (ROA) | 7.3% ROA vs NHC's 6.4%, ROIC 9.0% vs 8.4% |
ENSG vs ADUS vs NHC vs HCSG — Revenue Breakdown by Segment
How each company's revenue is distributed across its business units
ENSG vs ADUS vs NHC vs HCSG — Financial Metrics
Side-by-side numbers across 4 stocks — who leads on profitability, valuation, growth, and risk.
Who Leads Where
ADUS leads in 1 of 6 categories
HCSG leads 1 • NHC leads 1 • ENSG leads 0 • 3 tied
Explore the data ↓Income & Cash Flow (Last 12 Months)
Evenly matched — ENSG and NHC each lead in 2 of 6 comparable metrics.
Income & Cash Flow (Last 12 Months)
ENSG is the larger business by revenue, generating $5.3B annually — 3.6x ADUS's $1.4B. Profitability is closely matched — net margins range from 6.9% (ENSG) to 3.2% (HCSG). On growth, ENSG holds the edge at +18.4% YoY revenue growth, suggesting stronger near-term business momentum.
| Metric | ||||
|---|---|---|---|---|
| RevenueTrailing 12 months | $5.3B | $1.4B | $1.5B | $1.8B |
| EBITDAEarnings before interest/tax | $558M | $159M | $166M | $72M |
| Net IncomeAfter-tax profit | $363M | $100M | $101M | $59M |
| Free Cash FlowCash after capex | $406M | $137M | $147M | $139M |
| Gross MarginGross profit ÷ Revenue | +15.2% | +32.5% | +38.5% | +13.3% |
| Operating MarginEBIT ÷ Revenue | +8.5% | +9.8% | +8.1% | +3.0% |
| Net MarginNet income ÷ Revenue | +6.9% | +6.9% | +6.7% | +3.2% |
| FCF MarginFCF ÷ Revenue | +7.7% | +9.5% | +9.8% | +7.6% |
| Rev. Growth (YoY)Latest quarter vs prior year | +18.4% | +7.7% | +12.5% | +6.6% |
| EPS Growth (YoY)Latest quarter vs prior year | +21.9% | +17.2% | -8.4% | +175.0% |
Valuation Metrics
ADUS leads this category, winning 5 of 7 comparable metrics.
Valuation Metrics
At 18.7x trailing earnings, ADUS trades at a 37% valuation discount to ENSG's 29.8x P/E. Adjusting for growth (PEG ratio), ADUS offers better value at 0.93x vs ENSG's 2.16x — a lower PEG means you pay less per unit of expected earnings growth.
| Metric | ||||
|---|---|---|---|---|
| Market CapShares × price | $10.2B | $1.8B | $2.7B | $1.6B |
| Enterprise ValueMkt cap + debt − cash | $13.8B | $1.9B | $2.7B | $1.5B |
| Trailing P/EPrice ÷ TTM EPS | 29.85x | 18.67x | 22.35x | 27.54x |
| Forward P/EPrice ÷ next-FY EPS est. | 23.19x | 14.12x | 21.51x | 20.83x |
| PEG RatioP/E ÷ EPS growth rate | 2.16x | 0.93x | 0.97x | — |
| EV / EBITDAEnterprise value multiple | 25.71x | 12.52x | 15.85x | 22.38x |
| Price / SalesMarket cap ÷ Revenue | 2.01x | 1.28x | 1.81x | 0.87x |
| Price / BookPrice ÷ Book value/share | 4.59x | 1.65x | 2.50x | 3.19x |
| Price / FCFMarket cap ÷ FCF | 27.46x | 17.48x | 17.89x | 11.49x |
Profitability & Efficiency
HCSG leads this category, winning 6 of 9 comparable metrics.
Profitability & Efficiency
ENSG delivers a 16.6% return on equity — every $100 of shareholder capital generates $17 in annual profit, vs $9 for ADUS. HCSG carries lower financial leverage with a 0.05x debt-to-equity ratio, signaling a more conservative balance sheet compared to ENSG's 1.86x. On the Piotroski fundamental quality scale (0–9), ADUS scores 7/9 vs NHC's 2/9, reflecting strong financial health.
| Metric | ||||
|---|---|---|---|---|
| ROE (TTM)Return on equity | +16.6% | +9.3% | +9.6% | +11.8% |
| ROA (TTM)Return on assets | +6.8% | +7.0% | +6.4% | +7.3% |
| ROICReturn on invested capital | +7.0% | +8.8% | +8.4% | +9.0% |
| ROCEReturn on capital employed | +10.2% | +10.9% | — | +7.7% |
| Piotroski ScoreFundamental quality 0–9 | 5 | 7 | 2 | 7 |
| Debt / EquityFinancial leverage | 1.86x | 0.19x | 0.08x | 0.05x |
| Net DebtTotal debt minus cash | $3.7B | $127M | $87M | -$136M |
| Cash & Equiv.Liquid assets | $504M | $82M | — | $161M |
| Total DebtShort + long-term debt | $4.2B | $209M | $87M | $25M |
| Interest CoverageEBIT ÷ Interest expense | 88.33x | 14.45x | 24.41x | 33.02x |
Total Returns (Dividends Reinvested)
NHC leads this category, winning 5 of 6 comparable metrics.
Total Returns (Dividends Reinvested)
A $10,000 investment in NHC five years ago would be worth $26,213 today (with dividends reinvested), compared to $7,888 for HCSG. Over the past 12 months, NHC leads with a +81.9% total return vs ADUS's -13.4%. The 3-year compound annual growth rate (CAGR) favors NHC at 46.5% vs ADUS's 5.2% — a key indicator of consistent wealth creation.
| Metric | ||||
|---|---|---|---|---|
| YTD ReturnYear-to-date | +0.3% | -8.7% | +31.9% | +28.6% |
| 1-Year ReturnPast 12 months | +27.5% | -13.4% | +81.9% | +55.8% |
| 3-Year ReturnCumulative with dividends | +88.9% | +16.3% | +214.6% | +48.6% |
| 5-Year ReturnCumulative with dividends | +103.2% | +0.0% | +162.1% | -21.1% |
| 10-Year ReturnCumulative with dividends | +752.0% | +399.9% | +198.2% | -26.8% |
| CAGR (3Y)Annualised 3-year return | +23.6% | +5.2% | +46.5% | +14.1% |
Risk & Volatility
Evenly matched — ENSG and NHC each lead in 1 of 2 comparable metrics.
Risk & Volatility
ENSG is the less volatile stock with a 0.42 beta — it tends to amplify market swings less than HCSG's 1.12 beta. A beta below 1.0 means the stock typically moves less than the S&P 500. NHC currently trades 93.1% from its 52-week high vs ADUS's 78.2% drawdown — a narrower gap to the peak suggests stronger recent price momentum.
| Metric | ||||
|---|---|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.42x | 0.58x | 0.60x | 1.12x |
| 52-Week HighHighest price in past year | $218.00 | $124.44 | $184.08 | $24.39 |
| 52-Week LowLowest price in past year | $133.81 | $90.89 | $93.54 | $12.66 |
| % of 52W HighCurrent price vs 52-week peak | +80.0% | +78.2% | +93.1% | +91.5% |
| RSI (14)Momentum oscillator 0–100 | 23.3 | 49.3 | 51.2 | 61.8 |
| Avg Volume (50D)Average daily shares traded | 358K | 236K | 117K | 676K |
Analyst Outlook
Evenly matched — NHC and HCSG each lead in 1 of 2 comparable metrics.
Analyst Outlook
Analyst consensus: ENSG as "Buy", ADUS as "Buy", HCSG as "Hold". Consensus price targets imply 32.3% upside for ADUS (target: $129) vs 9.8% for HCSG (target: $25). For income investors, NHC offers the higher dividend yield at 1.44% vs ENSG's 0.14%.
| Metric | ||||
|---|---|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Buy | Buy | — | Hold |
| Price TargetConsensus 12-month target | $222.33 | $128.67 | — | $24.50 |
| # AnalystsCovering analysts | 13 | 15 | — | 15 |
| Dividend YieldAnnual dividend ÷ price | +0.1% | — | +1.4% | — |
| Dividend StreakConsecutive years of raises | 12 | 2 | 12 | 20 |
| Dividend / ShareAnnual DPS | $0.24 | — | $2.47 | — |
| Buyback YieldShare repurchases ÷ mkt cap | +0.2% | 0.0% | +0.6% | +3.9% |
ADUS leads in 1 of 6 categories (Valuation Metrics). HCSG leads in 1 (Profitability & Efficiency). 3 tied.
ENSG vs ADUS vs NHC vs HCSG: Key Questions Answered
10 questions · data-driven answers · updated daily
01Is ENSG or ADUS or NHC or HCSG a better buy right now?
For growth investors, Addus HomeCare Corporation (ADUS) is the stronger pick with 23.
2% revenue growth year-over-year, versus 7. 1% for Healthcare Services Group, Inc. (HCSG). Addus HomeCare Corporation (ADUS) offers the better valuation at 18. 7x trailing P/E (14. 1x forward), making it the more compelling value choice. Analysts rate The Ensign Group, Inc. (ENSG) a "Buy" — based on 13 analyst ratings — the highest consensus in this comparison. The "better buy" depends entirely on your goals: growth investors should weight revenue trajectory, value investors should weight P/E and PEG, and income investors should weight dividend yield and streak.
02Which has the better valuation — ENSG or ADUS or NHC or HCSG?
On trailing P/E, Addus HomeCare Corporation (ADUS) is the cheapest at 18.
7x versus The Ensign Group, Inc. at 29. 8x. On forward P/E, Addus HomeCare Corporation is actually cheaper at 14. 1x. The PEG ratio (P/E divided by earnings growth rate) is the most growth-adjusted single valuation metric: Addus HomeCare Corporation wins at 0. 70x versus The Ensign Group, Inc. 's 1. 68x — a PEG below 1. 0 traditionally signals the market is underpricing earnings growth.
03Which is the better long-term investment — ENSG or ADUS or NHC or HCSG?
Over the past 5 years, National HealthCare Corporation (NHC) delivered a total return of +162.
1%, compared to -21. 1% for Healthcare Services Group, Inc. (HCSG). Over 10 years, the gap is even starker: ENSG returned +752. 0% versus HCSG's -26. 8%. Past returns do not guarantee future results, and the stock with the higher historical return may already have its best growth priced in.
04Which is safer — ENSG or ADUS or NHC or HCSG?
By beta (market sensitivity over 5 years), The Ensign Group, Inc.
(ENSG) is the lower-risk stock at 0. 42β versus Healthcare Services Group, Inc. 's 1. 12β — meaning HCSG is approximately 166% more volatile than ENSG relative to the S&P 500. On balance sheet safety, Healthcare Services Group, Inc. (HCSG) carries a lower debt/equity ratio of 5% versus 186% for The Ensign Group, Inc. — giving it more financial flexibility in a downturn.
05Which is growing faster — ENSG or ADUS or NHC or HCSG?
By revenue growth (latest reported year), Addus HomeCare Corporation (ADUS) is pulling ahead at 23.
2% versus 7. 1% for Healthcare Services Group, Inc. (HCSG). On earnings-per-share growth, the picture is similar: Healthcare Services Group, Inc. grew EPS 52. 8% year-over-year, compared to 14. 1% for The Ensign Group, Inc.. Over a 3-year CAGR, ENSG leads at 18. 7% annualised revenue growth. Higher growth typically commands a higher valuation multiple — check whether the premium P/E or P/S is justified by the growth rate using the PEG ratio.
06Which has better profit margins — ENSG or ADUS or NHC or HCSG?
National HealthCare Corporation (NHC) is the more profitable company, earning 8.
2% net margin versus 3. 2% for Healthcare Services Group, Inc. — meaning it keeps 8. 2% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: ADUS leads at 9. 7% versus 2. 6% for HCSG. At the gross margin level — before operating expenses — NHC leads at 37. 3%, reflecting greater pricing power or product mix advantage. Stronger margins indicate durable pricing power, lower cost of revenue, or higher mix of software/services. They are one of the clearest signs of business quality.
07Is ENSG or ADUS or NHC or HCSG more undervalued right now?
The PEG ratio (forward P/E divided by expected earnings growth rate) is the most precise measure of undervaluation relative to growth potential.
By this metric, Addus HomeCare Corporation (ADUS) is the more undervalued stock at a PEG of 0. 70x versus The Ensign Group, Inc. 's 1. 68x. A PEG below 1. 0 is traditionally considered the threshold for growth-adjusted undervaluation. On forward earnings alone, Addus HomeCare Corporation (ADUS) trades at 14. 1x forward P/E versus 23. 2x for The Ensign Group, Inc. — 9. 1x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for ADUS: 32. 3% to $128. 67.
08Which pays a better dividend — ENSG or ADUS or NHC or HCSG?
In this comparison, NHC (1.
4% yield), ENSG (0. 1% yield) pay a dividend. ADUS, HCSG do not pay a meaningful dividend and should not be held primarily for income.
09Is ENSG or ADUS or NHC or HCSG better for a retirement portfolio?
For long-horizon retirement investors, The Ensign Group, Inc.
(ENSG) is the stronger choice — it scores higher on the combination of lower volatility, dividend reliability, and long-term compounding (low volatility (β 0. 42), +752. 0% 10Y return). Both have compounded well over 10 years (ENSG: +752. 0%, HCSG: -26. 8%), confirming both are viable long-term holds — but the lower-volatility option typically results in less emotional selling during corrections. Retirement portfolios generally favour predictability over maximum returns. Consult a financial advisor before making allocation decisions.
10What are the main differences between ENSG and ADUS and NHC and HCSG?
Both stocks operate in the Healthcare sector, making this a peer-level intra-sector comparison — the same macro tailwinds and headwinds will affect both.
In terms of investment character: ENSG is a mid-cap high-growth stock; ADUS is a small-cap high-growth stock; NHC is a small-cap quality compounder stock; HCSG is a small-cap quality compounder stock. NHC pays a dividend while ENSG, ADUS, HCSG do not, making them suitable for different income and tax situations. These fundamental differences mean investors should not choose between them on a single metric — the "better stock" depends entirely on which of these characteristics aligns with your investment strategy.
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