The Ensign Group, Inc. (ENSG) 10-Year Financial Performance & Capital Metrics

ENSG • • Industrial / General

HealthcareHealthcare FacilitiesSenior Living & Long-Term CareSkilled Nursing Facilities

AboutThe Ensign Group, Inc. provides health care services in the post-acute care continuum and other ancillary businesses. The company operates in two segments, Skilled Services and Real Estate. The company offers skilled services, which include short and long-term nursing care services for patients with chronic conditions, prolonged illness, and the elderly; and physical, occupational, and speech therapies and other rehabilitative and healthcare services. It also provides standard services, such as room and board, special nutritional programs, social, recreational, entertainment, and other services. In addition, the company offers senior living, as well as mobile diagnostics services; leases real estate properties; and provides other ancillary services consisting of digital x-ray, ultrasound, electrocardiogram, laboratory, sub-acute, and patient transportation services to people in their homes or at long-term care facilities. As of April 4, 2022, it operated 252 healthcare facilities in Arizona, California, Colorado, Idaho, Iowa, Kansas, Nebraska, Nevada, South Carolina, Texas, Utah, Washington, and Wisconsin. The company was incorporated in 1999 and is based in San Juan Capistrano, California.Show more

Revenue $4.26B +14.2%
EBITDA $442M +35.0%
Net Income $298M +42.3%
EPS (Diluted) 5.12 +40.3%
Gross Margin 15.67% -1.1%
EBITDA Margin 10.38% +18.2%
Operating Margin 8.41% +22.8%
Net Margin 6.99% +24.6%
ROE 17.85% +17.1%
ROIC 8.66% +21.2%
Debt/Equity 1.07 -14.2%
Interest Coverage 43.24 +36.9%

Technical Analysis

Key Insights

Based on financial data analysis

✓Strengths

✓Strong 5Y profit CAGR of 21.9%
✓Strong Piotroski F-Score: 7/9
✓11 consecutive years of dividend growth
✓Strong 5Y sales CAGR of 15.9%
✓Good 3Y average ROE of 17.6%

✗Weaknesses

No significant weaknesses identified

Price & Volume

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Growth Metrics

Revenue CAGR

10Y15.28%

5Y15.91%

3Y17.48%

TTM17.54%

Profit (Net Income) CAGR

10Y23.55%

5Y21.94%

3Y15.25%

TTM36.76%

EPS CAGR

10Y20.7%

5Y21.05%

3Y14.4%

TTM35.35%

ROCE

10Y Avg10.95%

5Y Avg10.49%

3Y Avg9.75%

Latest9.72%

Peer Comparison

Skilled Nursing Facilities

Name	Market Cap	Current Price	P/E Ratio	Revenue Growth 1Y	Net Margin	ROE	FCF Yield	Debt/Equity
ENSGThe Ensign Group, Inc.	10.63B	183.54	35.85	14.24%	6.8%	15.46%	1.78%	1.07
NHCNational HealthCare Corporation	2.16B	139.01	21.29	13.7%	6.75%	9.57%	3.7%	0.22

Profit & Loss

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Sales/Revenue+	1.34B	1.65B	1.6B	1.75B	2.04B	2.4B	2.63B	3.03B	3.73B	4.26B
Revenue Growth %	0.31%	0.23%	-0.03%	0.1%	0.16%	0.18%	0.09%	0.15%	0.23%	0.14%
Cost of Goods Sold+	1.16B	1.47B	1.43B	1.54B	1.75B	2B	2.16B	2.51B	3.14B	3.59B
COGS % of Revenue	0.86%	0.89%	0.89%	0.88%	0.86%	0.83%	0.82%	0.83%	0.84%	0.84%
Gross Profit+	185.36M	188.47M	172.9M	218.68M	291.11M	407.47M	468.21M	517.99M	590.76M	667.59M
Gross Margin %	0.14%	0.11%	0.11%	0.12%	0.14%	0.17%	0.18%	0.17%	0.16%	0.16%
Gross Profit Growth %	0.19%	0.02%	-0.08%	0.26%	0.33%	0.4%	0.15%	0.11%	0.14%	0.13%
Operating Expenses+	92.27M	96.62M	129.71M	133.76M	161.93M	184.31M	207.75M	221.16M	335.39M	309.28M
OpEx % of Revenue	0.07%	0.06%	0.08%	0.08%	0.08%	0.08%	0.08%	0.07%	0.09%	0.07%
Selling, General & Admin	64.16M	69.17M	74.12M	90.56M	110.87M	129.74M	151.76M	158.81M	263M	225.14M
SG&A % of Revenue	0.05%	0.04%	0.05%	0.05%	0.05%	0.05%	0.06%	0.05%	0.07%	0.05%
Research & Development	0	0	0	0	0	0	0	0	0	0
R&D % of Revenue	-	-	-	-	-	-	-	-	-	-
Other Operating Expenses	28.11M	27.46M	55.59M	43.2M	51.05M	54.57M	55.98M	62.35M	72.39M	84.14M
Operating Income+	93.08M	91.85M	43.19M	84.91M	129.18M	223.16M	260.46M	296.82M	255.37M	358.3M
Operating Margin %	0.07%	0.06%	0.03%	0.05%	0.06%	0.09%	0.1%	0.1%	0.07%	0.08%
Operating Income Growth %	0.28%	-0.01%	-0.53%	0.97%	0.52%	0.73%	0.17%	0.14%	-0.14%	0.4%
EBITDA+	121.19M	130.53M	87.66M	129.78M	180.23M	277.73M	316.45M	359.18M	327.75M	442.44M
EBITDA Margin %	0.09%	0.08%	0.05%	0.07%	0.09%	0.12%	0.12%	0.12%	0.09%	0.1%
EBITDA Growth %	0.22%	0.08%	-0.33%	0.48%	0.39%	0.54%	0.14%	0.14%	-0.09%	0.35%
D&A (Non-Cash Add-back)	28.11M	38.68M	44.47M	44.86M	51.05M	54.57M	55.98M	62.35M	72.39M	84.14M
EBIT	93.93M	92.95M	44.8M	86.93M	131.83M	226.97M	264.85M	298.02M	280.85M	394.38M
Net Interest Income+	-1.98M	-6.03M	-12.01M	-13.17M	-13.01M	-5.55M	-2.46M	-3.9M	11.13M	20.46M
Interest Income	845K	1.11M	1.61M	2.02M	2.65M	3.81M	4.39M	5.04M	19.22M	28.75M
Interest Expense	2.83M	7.14M	13.62M	15.18M	15.66M	9.36M	6.85M	8.93M	8.09M	8.29M
Other Income/Expense	-1.98M	-6.03M	-12.01M	-13.17M	-13.01M	-5.55M	-2.46M	-7.74M	17.39M	27.79M
Pretax Income+	91.1M	85.82M	31.18M	71.75M	116.17M	217.61M	258M	289.09M	272.76M	386.09M
Pretax Margin %	0.07%	0.05%	0.02%	0.04%	0.06%	0.09%	0.1%	0.1%	0.07%	0.09%
Income Tax+	35.18M	32.98M	14.21M	12.69M	23.95M	46.24M	60.28M	64.44M	62.91M	87.64M
Effective Tax Rate %	0.61%	0.58%	1.3%	1.29%	0.95%	0.78%	0.75%	0.78%	0.77%	0.77%
Net Income+	55.43M	49.99M	40.48M	92.36M	110.53M	170.48M	194.65M	224.68M	209.4M	297.97M
Net Margin %	0.04%	0.03%	0.03%	0.05%	0.05%	0.07%	0.07%	0.07%	0.06%	0.07%
Net Income Growth %	0.54%	-0.1%	-0.19%	1.28%	0.2%	0.54%	0.14%	0.15%	-0.07%	0.42%
Net Income (Continuing)	55.92M	52.84M	16.97M	59.06M	92.21M	171.36M	197.72M	224.65M	209.85M	298.46M
Discontinued Operations	0	0	23.7M	32.87M	18.84M	0	0	0	0	0
Minority Interest	-339K	4.05M	7.66M	11.4M	1.95M	150K	946K	1.47M	5.45M	3.32M
EPS (Diluted)+	1.06	0.96	0.77	1.70	1.97	3.06	3.42	3.95	3.65	5.12
EPS Growth %	0.36%	-0.09%	-0.2%	1.21%	0.16%	0.55%	0.12%	0.15%	-0.08%	0.4%
EPS (Basic)	1.10	0.99	0.79	1.78	2.07	3.19	3.57	4.09	3.76	5.26
Diluted Shares Outstanding	52.21M	52.13M	52.83M	54.4M	55.98M	55.79M	56.92M	56.87M	57.32M	58.24M
Basic Shares Outstanding	50.32M	50.55M	50.93M	52.02M	53.45M	53.43M	54.49M	54.89M	55.71M	56.66M
Dividend Payout Ratio	0.14%	0.16%	0.22%	0.1%	0.09%	0.06%	0.06%	0.05%	0.06%	0.05%

Balance Sheet

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Total Current Assets+	294.97M	333.86M	368.08M	348.07M	411.08M	582.96M	639.71M	781.13M	1.05B	1.16B
Cash & Short-Term Investments	43.57M	69.26M	55.43M	39.77M	76.93M	250.01M	275.96M	331.71M	526.86M	526.85M
Cash Only	41.57M	57.71M	42.34M	31.08M	59.17M	236.56M	262.2M	316.27M	509.63M	464.6M
Short-Term Investments	2M	11.55M	13.09M	8.68M	17.75M	13.45M	13.76M	15.44M	17.23M	62.26M
Accounts Receivable	209.03M	244.43M	265.07M	251.91M	308.99M	305.06M	328.73M	408.43M	485.04M	569.9M
Days Sales Outstanding	56.86	53.91	60.53	52.4	55.38	46.34	45.67	49.27	47.47	48.82
Inventory	0	0	0	0	0	0	0	0	0	0
Days Inventory Outstanding	-	-	-	-	-	-	-	-	-	-
Other Current Assets	0	0	0	30.64M	0	0	29.56M	36.34M	35.04M	60.88M
Total Non-Current Assets+	452.79M	667.16M	734.36M	833.89M	1.95B	1.96B	2.21B	2.67B	3.13B	3.51B
Property, Plant & Equipment	299.63M	484.5M	537.08M	618.87M	1.81B	1.8B	2.03B	2.44B	2.85B	3.15B
Fixed Asset Turnover	4.48x	3.42x	2.98x	2.84x	1.12x	1.33x	1.30x	1.24x	1.31x	1.35x
Goodwill	40.89M	67.1M	81.06M	80.48M	54.47M	54.47M	60.47M	76.87M	76.87M	97.98M
Intangible Assets	64.08M	54.66M	58.05M	58.6M	6.45M	6.62M	6.38M	6.44M	6.53M	7.29M
Long-Term Investments	0	0	0	0	0	0	0	0	0	0
Other Non-Current Assets	42.74M	37.83M	45.41M	130.75M	70.83M	65.36M	83.61M	104.94M	132.89M	187.75M
Total Assets+	747.76M	1B	1.1B	1.18B	2.36B	2.55B	2.85B	3.45B	4.18B	4.67B
Asset Turnover	1.79x	1.65x	1.45x	1.48x	0.86x	0.94x	0.92x	0.88x	0.89x	0.91x
Asset Growth %	0.51%	0.34%	0.1%	0.07%	1%	0.08%	0.12%	0.21%	0.21%	0.12%
Total Current Liabilities+	179.87M	211.93M	225.82M	269.23M	343.17M	562.4M	523.07M	582.07M	734.75M	743.43M
Accounts Payable	36.03M	38.99M	39.04M	39.85M	44.97M	50.9M	58.12M	77.09M	92.81M	98.95M
Days Payables Outstanding	11.37	9.71	10	9.47	9.4	9.31	9.82	11.22	10.79	10.05
Short-Term Debt	620K	8.13M	9.94M	10.11M	2.7M	2.96M	3.76M	3.88M	3.95M	4.09M
Deferred Revenue (Current)	1000K	1000K	1000K	1000K	1000K	1000K	1000K	1000K	1000K	1000K
Other Current Liabilities	0	1.97M	0	30.25M	0	102.02M	0	0	0	0
Current Ratio	1.64x	1.58x	1.63x	1.29x	1.20x	1.04x	1.22x	1.34x	1.42x	1.56x
Quick Ratio	1.64x	1.58x	1.63x	1.29x	1.20x	1.04x	1.22x	1.34x	1.42x	1.56x
Cash Conversion Cycle	-	-	-	-	-	-	-	-	-	-
Total Non-Current Liabilities+	140.91M	328.6M	376.55M	310.39M	1.36B	1.16B	1.31B	1.62B	1.95B	2.09B
Long-Term Debt	99.05M	275.49M	302.99M	233.13M	325.22M	112.54M	152.88M	149.27M	145.5M	141.59M
Capital Lease Obligations	0	0	0	0	973.98M	950.32M	1.06B	1.36B	1.64B	1.74B
Deferred Tax Liabilities	0	0	0	0	0	0	0	0	0	0
Other Non-Current Liabilities	41.86M	53.12M	61.49M	65.84M	63.39M	102.09M	96.44M	116.77M	160.65M	208.59M
Total Liabilities	320.77M	540.53M	602.37M	579.62M	1.71B	1.73B	1.83B	2.2B	2.68B	2.83B
Total Debt+	99.67M	283.62M	312.93M	243.24M	1.35B	1.11B	1.27B	1.57B	1.87B	1.97B
Net Debt	58.1M	225.91M	270.59M	212.16M	1.29B	877.45M	1B	1.26B	1.36B	1.51B
Debt / Equity	0.23x	0.62x	0.63x	0.40x	2.05x	1.36x	1.24x	1.26x	1.25x	1.07x
Debt / EBITDA	0.82x	2.17x	3.57x	1.87x	7.47x	4.01x	4.00x	4.38x	5.71x	4.46x
Net Debt / EBITDA	0.48x	1.73x	3.09x	1.63x	7.14x	3.16x	3.17x	3.50x	4.15x	3.41x
Interest Coverage	32.91x	12.87x	3.17x	5.59x	8.25x	23.84x	38.03x	33.24x	31.58x	43.24x
Total Equity+	426.99M	460.5M	500.06M	602.34M	656.14M	818.23M	1.02B	1.25B	1.5B	1.84B
Equity Growth %	0.66%	0.08%	0.09%	0.2%	0.09%	0.25%	0.25%	0.22%	0.2%	0.23%
Book Value per Share	8.18	8.83	9.47	11.07	11.72	14.67	17.95	21.96	26.12	31.60
Total Shareholders' Equity	427.32M	456.45M	492.4M	590.93M	654.2M	818.08M	1.02B	1.25B	1.49B	1.84B
Common Stock	51K	52K	53K	55K	56K	58K	58K	59K	60K	61K
Retained Earnings	193.42M	235.02M	264.69M	344.9M	391.52M	551.05M	733.99M	946.34M	1.14B	1.43B
Treasury Stock	-1.22M	-31.12M	-38.41M	-38.41M	-45.3M	-71.21M	-83.04M	-114.63M	-116.56M	-117.76M
Accumulated OCI	0	0	0	0	0	0	0	0	0	0
Minority Interest	-339K	4.05M	7.66M	11.4M	1.95M	150K	946K	1.47M	5.45M	3.32M

Cash Flow

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Cash from Operations+	33.37M	73.89M	72.95M	210.3M	192.22M	373.35M	275.68M	272.51M	376.67M	347.19M
Operating CF Margin %	0.02%	0.04%	0.05%	0.12%	0.09%	0.16%	0.1%	0.09%	0.1%	0.08%
Operating CF Growth %	-0.61%	1.21%	-0.01%	1.88%	-0.09%	0.94%	-0.26%	-0.01%	0.38%	-0.08%
Net Income	55.92M	52.84M	40.83M	92.53M	111.69M	171.36M	197.72M	224.65M	209.85M	298.46M
Depreciation & Amortization	28.11M	38.68M	44.47M	47.34M	51.05M	54.57M	55.98M	62.35M	72.39M	84.14M
Stock-Based Compensation	6.68M	9.1M	9.7M	10.34M	11.32M	14.52M	18.68M	22.72M	30.77M	36.23M
Deferred Taxes	1.25M	-2.21M	10.33M	1.09M	3.49M	-27.81M	-24.88M	-6.5M	-27.48M	635K
Other Non-Cash Items	16.92M	7.72M	32.51M	25.04M	10.72M	11.65M	28.14M	6.23M	53.25M	2.89M
Working Capital Changes	-75.5M	-32.25M	-64.88M	33.96M	3.95M	149.05M	33K	-36.94M	37.89M	-75.16M
Change in Receivables	-100.32M	-63.62M	-52.3M	-13.1M	-60.42M	2.17M	-30.77M	-82.43M	-79.82M	-84.4M
Change in Inventory	33.51M	30.3M	-9.8M	44.01M	55.62M	0	0	0	0	0
Change in Payables	1.78M	577K	3.33M	3.08M	4.46M	6.63M	7.12M	17.87M	15.92M	2.83M
Cash from Investing+	-168.54M	-210.64M	-106.59M	-151.21M	-247.01M	-58.67M	-173.91M	-186.18M	-182.7M	-390.05M
Capital Expenditures	-60.02M	-65.7M	-54.08M	-135.62M	-71.54M	-50.33M	-69.55M	-87.55M	-106.18M	-158.24M
CapEx % of Revenue	0.04%	0.04%	0.03%	0.08%	0.04%	0.02%	0.03%	0.03%	0.03%	0.04%
Acquisitions	-	-	-	-	-	-	-	-	-	-
Investments	-	-	-	-	-	-	-	-	-	-
Other Investing	282K	-121.36M	23.41M	-526K	-165.54M	-58.67M	-91.6M	-74.62M	-64.55M	-153.06M
Cash from Financing+	126.33M	152.88M	18.27M	-70.34M	82.88M	-137.3M	-76.14M	-32.26M	-612K	-2.16M
Debt Issued (Net)	-	-	-	-	-	-	-	-	-	-
Equity Issued (Net)	-	-	-	-	-	-	-	-	-	-
Dividends Paid	-7.49M	-8.17M	-8.72M	-9.42M	-10.19M	-10.83M	-11.55M	-12.17M	-12.89M	-13.67M
Share Repurchases	-	-	-	-	-	-	-	-	-	-
Other Financing	2.16M	6.57M	2.42M	9.01M	16.62M	111.99M	-94.92M	2.51M	18.09M	16.67M
Net Change in Cash	-	-	-	-	-	-	-	-	-	-
Free Cash Flow+	-26.65M	8.19M	15.79M	155.35M	120.68M	323.02M	206.13M	184.97M	270.49M	188.95M
FCF Margin %	-0.02%	0%	0.01%	0.09%	0.06%	0.13%	0.08%	0.06%	0.07%	0.04%
FCF Growth %	-1.85%	1.31%	0.93%	8.84%	-0.22%	1.68%	-0.36%	-0.1%	0.46%	-0.3%
FCF per Share	-0.51	0.16	0.30	2.86	2.16	5.79	3.62	3.25	4.72	3.24
FCF Conversion (FCF/Net Income)	0.60x	1.48x	1.80x	2.28x	1.74x	2.19x	1.42x	1.21x	1.80x	1.17x
Interest Paid	2.77M	6.43M	13.28M	15.99M	0	9.92M	5.69M	7.6M	7.03M	7.06M
Taxes Paid	35.49M	23.16M	38.38M	19.65M	0	74.36M	65.55M	70.06M	89.73M	96.34M

Key Ratios

Metric	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Return on Equity (ROE)	16.19%	11.27%	8.43%	16.76%	17.57%	23.13%	21.16%	19.79%	15.25%	17.85%
Return on Invested Capital (ROIC)	18.35%	11.76%	4.45%	8.04%	7.02%	9.2%	10.5%	9.83%	7.14%	8.66%
Gross Margin	13.81%	11.39%	10.82%	12.46%	14.29%	16.96%	17.82%	17.12%	15.84%	15.67%
Net Margin	4.13%	3.02%	2.53%	5.26%	5.43%	7.1%	7.41%	7.43%	5.61%	6.99%
Debt / Equity	0.23x	0.62x	0.63x	0.40x	2.05x	1.36x	1.24x	1.26x	1.25x	1.07x
Interest Coverage	32.91x	12.87x	3.17x	5.59x	8.25x	23.84x	38.03x	33.24x	31.58x	43.24x
FCF Conversion	0.60x	1.48x	1.80x	2.28x	1.74x	2.19x	1.42x	1.21x	1.80x	1.17x
Revenue Growth	30.6%	23.33%	-3.42%	9.78%	16.07%	17.98%	9.36%	15.15%	23.27%	14.24%

Revenue by Segment

	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Service	-	-	-	-	-	2.39B	2.61B	-	3.71B	4.24B
Service Growth	-	-	-	-	-	-	9.38%	-	-	14.28%
Rental	-	-	-	-	-	15.16M	15.98M	-	21.28M	95.09M
Rental Growth	-	-	-	-	-	-	5.46%	-	-	346.75%
Skilled Services	-	-	-	-	-	-	-	2.91B	-	-
Skilled Services Growth	-	-	-	-	-	-	-	-	-	-
Transitional and Skilled Services	-	-	-	1.68B	1.93B	-	-	-	-	-
Transitional and Skilled Services Growth	-	-	-	-	15.22%	-	-	-	-	-
Home Health and Hospice	-	-	-	169.04M	-	-	-	-	-	-
Home Health and Hospice Growth	-	-	-	-	-	-	-	-	-	-
Assisted and Independent Living Services	-	-	-	151.8M	-	-	-	-	-	-
Assisted and Independent Living Services Growth	-	-	-	-	-	-	-	-	-	-
All Other	-	-	-	40.81M	-	-	-	-	-	-
All Other Growth	-	-	-	-	-	-	-	-	-	-
Intersegment Eliminations	-3.33M	-5.11M	-6.06M	-7.29M	-	-	-	-	-	-
Intersegment Eliminations Growth	-	-53.64%	-18.48%	-20.42%	-	-	-	-	-	-

Revenue by Geography

	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
All Other	74.79M	-	53.15M	40.81M	-	-	-	-	-	-
All Other Growth	-	-	-	-23.21%	-	-	-	-	-	-

Frequently Asked Questions

Valuation & Price

The Ensign Group, Inc. (ENSG) has a price-to-earnings (P/E) ratio of 35.8x. This suggests investors expect higher future growth.

Growth & Financials

The Ensign Group, Inc. (ENSG) reported $4.83B in revenue for fiscal year 2024. This represents a 537% increase from $758.3M in 2011.

The Ensign Group, Inc. (ENSG) grew revenue by 14.2% over the past year. This is steady growth.

Yes, The Ensign Group, Inc. (ENSG) is profitable, generating $328.2M in net income for fiscal year 2024 (7.0% net margin).

Dividend & Returns

Yes, The Ensign Group, Inc. (ENSG) pays a dividend with a yield of 0.13%. This makes it attractive for income-focused investors.

The Ensign Group, Inc. (ENSG) has a return on equity (ROE) of 17.9%. This is reasonable for most industries.

The Ensign Group, Inc. (ENSG) generated $289.5M in free cash flow for fiscal year 2024. Positive FCF indicates the company can fund dividends, buybacks, or reinvestment.

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