Comprehensive Stock Comparison
Compare The Ensign Group, Inc. (ENSG) vs Fresenius Medical Care AG & Co. KGaA (FMS) Stock
Analyze side-by-side fundamentals, valuation, growth, and profitability to decide which stock is the better buy.
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Quick Verdict
| Category | Winner | Why |
|---|---|---|
| Growth |  ENSG | 18.7% revenue growth vs FMS's 1.5% |
| Value |  FMS | Lower P/E (9.7x vs 28.2x), PEG 1.90 vs 2.04 |
| Quality / Margins | ENSG | 6.8% net margin vs FMS's 5.0% |
| Stability / Safety | FMS | Beta 0.40 vs ENSG's 0.43, lower leverage |
| Dividends | ENSG | 0.1% yield; 12-year raise streak; FMS pays no meaningful dividend |
| Momentum (1Y) | ENSG | +61.4% vs FMS's +0.5% |
| Efficiency (ROA) | ENSG | 6.3% ROA vs FMS's 3.2%, ROIC 8.9% vs 5.6% |
Who Each Stock Is For
Income & stability
ENSGDividend streak 12 yrs, beta 0.43, yield 0.1%
Growth exposure
ENSGRev growth 18.7%, EPS growth 14.1%, 3Y rev CAGR 18.7%
Long-term compounding (10Y)
ENSG9.5% 10Y total return vs FMS's -29.0%
Sleep-well-at-night portfolio
FMSLower volatility, beta 0.40, Low D/E 75.6%, current ratio 1.26x
Valuation efficiency (growth/$)
FMSPEG 1.90 vs ENSG's 2.04
Defensive / Recession hedge
FMSBeta 0.40, current ratio 1.26x
Business Model
What each company does and how it makes money
The Ensign Group operates a network of skilled nursing facilities and senior living communities across multiple states. It generates revenue primarily from patient care reimbursements—mainly Medicare and Medicaid—along with private pay services and ancillary offerings like therapy and diagnostics. The company's competitive advantage lies in its decentralized operational model that empowers local leaders and its disciplined acquisition strategy for underperforming facilities.
Fresenius Medical Care is a global leader in dialysis care and products for patients with chronic kidney failure. It generates revenue through two main segments: dialysis services (about 75% of revenue) from its network of outpatient clinics and hospital contracts, and dialysis products (about 25%) including machines, dialyzers, and related supplies. The company's key advantage is its vertically integrated model—combining clinics, products, and services—which creates patient stickiness and economies of scale in the capital-intensive dialysis industry.
Revenue Breakdown by Segment
How each company's revenue is distributed across its business units
Financial Metrics Comparison
Side-by-side fundamentals across 2 stocks. BestLagging
Financial Scorecard
ENSG 3FMS 2FMS4/6 metricsFMS6/6 metricsENSG8/9 metricsENSG6/6 metricsENSG1/1 metricsENSG leads in 3 of 6 categories (Profitability & Efficiency, Total Returns). FMS leads in 2 (Financial Metrics, Valuation Metrics). 1 tied.
Financial Metrics (TTM)
FMS is the larger business by revenue, generating $19.6B annually — 4.1x ENSG's $4.8B. Profitability is closely matched — net margins range from 6.8% (ENSG) to 5.0% (FMS). On growth, ENSG holds the edge at +19.8% YoY revenue growth, suggesting stronger near-term business momentum.
| Metric | ENSGThe Ensign Group,… | FMSFresenius Medical… |
|---|---|---|
| RevenueTrailing 12 months | $4.8B | $19.6B |
| EBITDAEarnings before interest/tax | $501M | $3.3B |
| Net IncomeAfter-tax profit | $328M | $978M |
| Free Cash FlowCash after capex | $290M | $1.2B |
| Gross MarginGross profit ÷ Revenue | +15.7% | +25.6% |
| Operating MarginEBIT ÷ Revenue | +8.3% | +9.3% |
| Net MarginNet income ÷ Revenue | +6.8% | +5.0% |
| FCF MarginFCF ÷ Revenue | +6.0% | +6.0% |
| Rev. Growth (YoY)Latest quarter vs prior year | +19.8% | -0.3% |
| EPS Growth (YoY)Latest quarter vs prior year | +6.0% | +8.5% |
Valuation Metrics
At 11.8x trailing earnings, FMS trades at a 67% valuation discount to ENSG's 36.3x P/E. Adjusting for growth (PEG ratio), FMS offers better value at 2.32x vs ENSG's 2.63x — a lower PEG means you pay less per unit of expected earnings growth.
| Metric | ENSGThe Ensign Group,… | FMSFresenius Medical… |
|---|---|---|
| Market CapShares × price | $12.3B | $13.4B |
| Enterprise ValueMkt cap + debt − cash | $13.8B | $24.0B |
| Trailing P/EPrice ÷ TTM EPS | 36.31x | 11.82x |
| Forward P/EPrice ÷ next-FY EPS est. | 28.21x | 9.71x |
| PEG RatioP/E ÷ EPS growth rate | 2.63x | 2.32x |
| EV / EBITDAEnterprise value multiple | 26.13x | 6.33x |
| Price / SalesMarket cap ÷ Revenue | 2.43x | 0.59x |
| Price / BookPrice ÷ Book value/share | 5.59x | 0.81x |
| Price / FCFMarket cap ÷ FCF | 33.12x | — |
Profitability & Efficiency
ENSG delivers a 15.5% return on equity — every $100 of shareholder capital generates $15 in annual profit, vs $7 for FMS. FMS carries lower financial leverage with a 0.76x debt-to-equity ratio, signaling a more conservative balance sheet compared to ENSG's 0.93x. On the Piotroski fundamental quality scale (0–9), ENSG scores 7/9 vs FMS's 5/9, reflecting strong financial health.
| Metric | ENSGThe Ensign Group,… | FMSFresenius Medical… |
|---|---|---|
| ROE (TTM)Return on equity | +15.5% | +6.8% |
| ROA (TTM)Return on assets | +6.3% | +3.2% |
| ROICReturn on invested capital | +8.9% | +5.6% |
| ROCEReturn on capital employed | +10.0% | +6.9% |
| Piotroski ScoreFundamental quality 0–9 | 7 | 5 |
| Debt / EquityFinancial leverage | 0.93x | 0.76x |
| Net DebtTotal debt minus cash | $1.6B | $9.2B |
| Cash & Equiv.Liquid assets | $504M | $1.6B |
| Total DebtShort + long-term debt | $2.1B | $10.8B |
| Interest CoverageEBIT ÷ Interest expense | 53.02x | 6.84x |
Total Returns (with DRIP)
A $10,000 investment in ENSG five years ago would be worth $26,368 today (with dividends reinvested), compared to $7,700 for FMS. Over the past 12 months, ENSG leads with a +61.4% total return vs FMS's +0.5%. The 3-year compound annual growth rate (CAGR) favors ENSG at 33.1% vs FMS's 8.1% — a key indicator of consistent wealth creation.
| Metric | ENSGThe Ensign Group,… | FMSFresenius Medical… |
|---|---|---|
| YTD ReturnYear-to-date | +21.9% | -2.0% |
| 1-Year ReturnPast 12 months | +61.4% | +0.5% |
| 3-Year ReturnCumulative with dividends | +135.7% | +26.5% |
| 5-Year ReturnCumulative with dividends | +163.7% | -23.0% |
| 10-Year ReturnCumulative with dividends | +952.4% | -29.0% |
| CAGR (3Y)Annualised 3-year return | +33.1% | +8.1% |
Risk & Volatility
FMS is the less volatile stock with a 0.40 beta — it tends to amplify market swings less than ENSG's 0.43 beta. A beta below 1.0 means the stock typically moves less than the S&P 500. ENSG currently trades 97.3% from its 52-week high vs FMS's 75.6% drawdown — a narrower gap to the peak suggests stronger recent price momentum.
| Metric | ENSGThe Ensign Group,… | FMSFresenius Medical… |
|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.43x | 0.40x |
| 52-Week HighHighest price in past year | $218.00 | $30.46 |
| 52-Week LowLowest price in past year | $118.73 | $20.95 |
| % of 52W HighCurrent price vs 52-week peak | +97.3% | +75.6% |
| RSI (14)Momentum oscillator 0–100 | 65.6 | 48.5 |
| Avg Volume (50D)Average daily shares traded | 369K | 638K |
Analyst Outlook
Wall Street rates ENSG as "Buy" and FMS as "Hold". Consensus price targets imply 21.6% upside for FMS (target: $28) vs 4.8% for ENSG (target: $222). ENSG is the only dividend payer here at 0.12% yield — a key consideration for income-focused portfolios.
| Metric | ENSGThe Ensign Group,… | FMSFresenius Medical… |
|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Buy | Hold |
| Price TargetConsensus 12-month target | $222.33 | $28.00 |
| # AnalystsCovering analysts | 13 | 18 |
| Dividend YieldAnnual dividend ÷ price | +0.1% | — |
| Dividend StreakConsecutive years of raises | 12 | 3 |
| Dividend / ShareAnnual DPS | $0.24 | — |
| Buyback YieldShare repurchases ÷ mkt cap | +0.0% | 0.0% |
Historical Charts
Charts are rendered on first load. Hover for details.
Chart 1Total Return — 5 Years (Rebased to 100)
| Stock | Mar 20 | Mar 26 | Change |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | 100 | 480.26 | +380.3% |
| Fresenius Medical C… (FMS) | 100 | 60.21 | -39.8% |
The Ensign Group, I… (ENSG) returned +164% over 5 years vs Fresenius Medical C… (FMS)'s -23%. A $10,000 investment in ENSG 5 years ago would be worth $26,368 today (including dividends reinvested).
Chart 2Revenue Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | $1.7B | $5.1B | +205.6% |
| Fresenius Medical C… (FMS) | $17.0B | $19.6B | +15.3% |
The Ensign Group, Inc.'s revenue grew from $1.7B (2016) to $5.1B (2025) — a 13.2% CAGR. Fresenius Medical Care AG & Co. KGaA's revenue grew from $17.0B (2016) to $19.6B (2025) — a 1.6% CAGR.
Chart 3Net Margin Trend — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | 3.0% | 6.8% | +125.1% |
| Fresenius Medical C… (FMS) | 6.9% | 5.0% | -28.2% |
The Ensign Group, Inc.'s net margin went from 3% (2016) to 7% (2025). Fresenius Medical Care AG & Co. KGaA's net margin went from 7% (2016) to 5% (2025).
Chart 4P/E Ratio History — 9 Years
| Stock | 2017 | 2025 | Change |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | 27 | 29.8 | +10.4% |
| Fresenius Medical C… (FMS) | 25.3 | 14.2 | -43.9% |
The Ensign Group, Inc. has traded in a 21x–31x P/E range over 9 years; current trailing P/E is ~36x. Fresenius Medical Care AG & Co. KGaA has traded in a 10x–39x P/E range over 9 years; current trailing P/E is ~12x.
Chart 5EPS Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | 0.96 | 5.84 | +508.3% |
| Fresenius Medical C… (FMS) | 1.87 | 1.68 | -10.2% |
The Ensign Group, Inc.'s EPS grew from $0.96 (2016) to $5.84 (2025) — a 22% CAGR. Fresenius Medical Care AG & Co. KGaA's EPS grew from $1.87 (2016) to $1.68 (2025) — a -1% CAGR.
Chart 6Free Cash Flow — 5 Years
The Ensign Group, Inc. generated $371M FCF in 2025 (+80% vs 2021). Fresenius Medical Care AG & Co. KGaA generated $0M FCF in 2025 (-100% vs 2021).
ENSG vs FMS: Frequently Asked Questions
9 questions · data-driven answers · updated daily
01Is ENSG or FMS a better buy right now?
Fresenius Medical Care AG & Co. KGaA (FMS) offers the better valuation at 11.8x trailing P/E (9.7x 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 FMS?
On trailing P/E, Fresenius Medical Care AG & Co. KGaA (FMS) is the cheapest at 11.8x versus The Ensign Group, Inc. at 36.3x. On forward P/E, Fresenius Medical Care AG & Co. KGaA is actually cheaper at 9.7x. The PEG ratio (P/E divided by earnings growth rate) is the most growth-adjusted single valuation metric: Fresenius Medical Care AG & Co. KGaA wins at 1.90x versus The Ensign Group, Inc.'s 2.04x — a reasonable growth-adjusted valuation.
03Which is the better long-term investment — ENSG or FMS?
Over the past 5 years, The Ensign Group, Inc. (ENSG) delivered a total return of +163.7%, compared to -23.0% for Fresenius Medical Care AG & Co. KGaA (FMS). A $10,000 investment in ENSG five years ago would be worth approximately $26K today (assuming dividends reinvested). Over 10 years, the gap is even starker: ENSG returned +952.4% versus FMS's -29.0%. 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 FMS?
By beta (market sensitivity over 5 years), Fresenius Medical Care AG & Co. KGaA (FMS) is the lower-risk stock at 0.40β versus The Ensign Group, Inc.'s 0.43β — meaning ENSG is approximately 6% more volatile than FMS relative to the S&P 500. On balance sheet safety, Fresenius Medical Care AG & Co. KGaA (FMS) carries a lower debt/equity ratio of 76% versus 93% for The Ensign Group, Inc. — giving it more financial flexibility in a downturn.
05Which has better profit margins — ENSG or FMS?
The Ensign Group, Inc. (ENSG) is the more profitable company, earning 6.8% net margin versus 5.0% for Fresenius Medical Care AG & Co. KGaA — meaning it keeps 6.8% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: FMS leads at 9.3% versus 8.4% for ENSG. At the gross margin level — before operating expenses — FMS leads at 25.6%, 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.
06Is ENSG or FMS 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, Fresenius Medical Care AG & Co. KGaA (FMS) is the more undervalued stock at a PEG of 1.90x versus The Ensign Group, Inc.'s 2.04x. Both stocks trade at elevated growth-adjusted valuations, so expected growth needs to materialise. On forward earnings alone, Fresenius Medical Care AG & Co. KGaA (FMS) trades at 9.7x forward P/E versus 28.2x for The Ensign Group, Inc. — 18.5x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for FMS: 21.6% to $28.00.
07Which pays a better dividend — ENSG or FMS?
In this comparison, ENSG (0.1% yield) pays a dividend. FMS does not pay a meaningful dividend and should not be held primarily for income.
08Is ENSG or FMS 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 0.43), +952.4% 10Y return). Both have compounded well over 10 years (ENSG: +952.4%, FMS: -29.0%), 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.
09What are the main differences between ENSG and FMS?
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 quality compounder stock; FMS is a mid-cap deep-value stock. 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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