Upside case
Bull case
$315+78.8%
ENSG would need investors to value it at roughly 42x earnings — about 18x more generous than today's 23x forward P/E. That requires meaningful multiple expansion on top of continued earnings growth.
Analysis OverviewBuyUpdated May 1, 2026
The Ensign Group, Inc. (ENSG) Stock Analysis
Wall Street verdict, consensus price target, and analyst rating breakdown — everything needed to frame the risk/reward at today's price.
Analyst consensus
Buy
Covering
13
analysts
9 bullish · 2 bearish · 13 covering ENSG
Strong Buy
0
Buy
9
Hold
2
Sell
2
Strong Sell
0
Consensus Target
$222
+26.4% vs today
Scenario Range
$71 – $315
Model bear to bull value window
Coverage
13
Published analyst ratings
Valuation Context
23.4x
Forward P/E · Market cap $10.3B
ENSG price targets
Three scenarios for where ENSG stock could go
Current
~$176
Confidence
77 / 100
Updated
May 1, 2026
Where we are now
Current · $176
Bear
$71
Base
$253
Bull
$315
Market caseClosest to today
Base case
$253+43.6%
At 34x on FY1 earnings, the base case reflects a reasonable but not stretched valuation. It prices in continued growth without assuming an exceptional setup.
Stress case
Bear case
$71-59.8%
If investor confidence fades or macro conditions deteriorate, a 14x multiple contraction could push ENSG down roughly 60% from where it trades now.
Not financial advice. Model confidence reflects internal scenario assumptions, not a guarantee of returns. Past performance does not predict future results.
The Ensign Group, Inc.
ENSG · NASDAQHealthcareMedical - Care FacilitiesDecember year-end
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.
Market Cap
$10.3B
Revenue TTM
$5.3B
Net Income TTM
$363M
Net Margin
6.9%
ENSG Revenue and Earnings Performance
Quarterly beat-or-miss track record against analyst estimates, plus forward revenue and EPS outlook for the next two fiscal years.
EPS Beat Rate
100%Exceptional
12 quarters tracked
Revenue Beat Rate
67%Exceptional
vs consensus estimates
Avg EPS Surprise
+1.9%
above Street consensus
Beat / Miss Record
BeatMissLeft = EPS · Right = Revenue
Q3 2025
Q4 2025
Q1 2026
Q2 2026
Last 4 Quarters
EPS beats: 4 of 4Q3 2025
EPS
$1.59/$1.55
Revenue
$1.2B/$1.2B
Q4 2025
EPS
$1.64/$1.59
Revenue
$1.3B/$1.4B
Q1 2026
EPS
$1.82/$1.75
Revenue
$1.4B/$1.4B
Q2 2026
EPS
$1.85/$1.79
Revenue
$1.4B/$1.4B
| Quarter | EPS (Actual / Est) | EPS Surprise | Revenue (Actual / Est) | Rev Surprise |
|---|---|---|---|---|
| Q3 2025 | $1.59/$1.55 | +2.6% | $1.2B/$1.2B | +0.7% |
| Q4 2025 | $1.64/$1.59 | +3.1% | $1.3B/$1.4B | -5.2% |
| Q1 2026 | $1.82/$1.75 | +4.0% | $1.4B/$1.4B | -0.5% |
| Q2 2026 | $1.85/$1.79 | +3.4% | $1.4B/$1.4B | -0.5% |
FY1–FY2 Estimates
Revenue Outlook
FY1
$6.2B
+17.0% YoY
FY2
$7.2B
+16.9% YoY
EPS Outlook
FY1
$7.27
+19.2% YoY
FY2
$8.38
+15.3% YoY
Trailing FCF (TTM)$406M
FCF Margin: 7.7%
Next Earnings
—
Expected EPS
—
Expected Revenue
—
ENSG beat EPS estimates in 4 of 4 tracked quarters. A perfect track record raises the bar for the upcoming report.
ENSG Revenue Breakdown by Segment
Product and geographic revenue mix from the latest annual disclosure, with year-over-year growth by segment.
Latest disclosure
FY 2025
Total disclosed revenue $5.0B
Product Mix
Latest annual revenue by segment or product family
Skilled Services Segment
97.4%
YoY unavailable
Tap, hover, or focus a slice to inspect segment detail.
Geographic Mix
Latest annual revenue by reported region
Segment breakdown not available for this company.
Skilled Services Segment is the largest disclosed segment at 97.4% of FY 2025 revenue, with no year-over-year comparison yet.
ENSG Valuation Snapshot
Current multiples compared to the S&P 500, the company's sector, and its own five-year average.
Relative Value Signal
Significantly Overvalued
Fair value est. $116 — implies -36.9% from today's price.
Premium to Fair Value
36.9%
above fair value
Deep DiscountFair ValueVery Expensive
vs S&P 500 Trailing P/E
ENSG
30.1x
vs
S&P 500
25.2x
+19% premium
vs Healthcare Trailing P/E
ENSG
30.1x
vs
Healthcare
22.2x
+36% premium
vs ENSG 5Y Avg P/E
Today
30.1x
vs
5Y Average
27.0x
+12% premium
Forward PE
23.4x
S&P 500
19.1x
+23%
Healthcare
19.0x
+23%
5Y Avg
—
—
Trailing PE
30.1x
S&P 500
25.2x
+19%
Healthcare
22.2x
+36%
5Y Avg
27.0x
+12%
PEG Ratio
2.18x
S&P 500
1.74x
+25%
Healthcare
1.52x
+44%
5Y Avg
—
—
EV/EBITDA
25.9x
S&P 500
15.2x
+70%
Healthcare
14.1x
+84%
5Y Avg
21.5x
+21%
Price/FCF
27.7x
S&P 500
21.3x
+30%
Healthcare
18.6x
+49%
5Y Avg
28.9x
-4%
Price/Sales
2.0x
S&P 500
3.1x
-35%
Healthcare
2.8x
-28%
5Y Avg
1.8x
+11%
Dividend Yield
0.14%
S&P 500
1.87%
-93%
Healthcare
1.40%
-90%
5Y Avg
0.20%
-29%
| Metric | ENSG | S&P 500 | Healthcare | 5Y Avg ENSG |
|---|---|---|---|---|
| Forward PE | 23.4x | 19.1x+23% | 19.0x+23% | — |
| Trailing PE | 30.1x | 25.2x+19% | 22.2x+36% | 27.0x+12% |
| PEG Ratio | 2.18x | 1.74x+25% | 1.52x+44% | — |
| EV/EBITDA | 25.9x | 15.2x+70% | 14.1x+84% | 21.5x+21% |
| Price/FCF | 27.7x | 21.3x+30% | 18.6x+49% | 28.9x |
| Price/Sales | 2.0x | 3.1x-35% | 2.8x-28% | 1.8x+11% |
| Dividend Yield | 0.14% | 1.87% | 1.40% | 0.20% |
ENSG trades above S&P 500 benchmarks on 5 of 6 measured multiples — commands a broad premium across most valuation dimensions.
Forward P/E and PEG reflect analyst consensus estimates. Historical averages use trailing ratios where forward data is unavailable.S&P 500 and sector benchmarks both use trailing median P/E — similar readings indicate the broader index and sector are priced alike.
Open valuation toolENSG Financial Health
Verdict
Strong
Key financial metrics for ENSG are shown below.
Cash Engine
Revenue, margins, and cash generation
Revenue (TTM)
Trailing-twelve-month sales base
$5.3B
Revenue Growth
TTM vs prior year
+19.2%
Gross Margin
Gross profit as a share of revenue
15.2%
Operating Margin
Operating income divided by revenue
8.5%
Net Margin
Net income divided by revenue
6.9%
EPS (TTM)
Diluted earnings per share, trailing twelve months
$6.10
Free Cash Flow (TTM)
Cash generation after capex
$406M
FCF Margin
FCF as share of revenue — the primary cash quality signal
7.7%
Capital Quality
ROIC, leverage, and debt serviceability
ROIC
Return on invested capital — primary competitive quality signal
7.0%
ROA
Return on assets, trailing twelve months
6.8%
Cash & Equivalents
Liquid assets on the balance sheet
$504M
Net Debt
Total debt minus cash
$3.7B
Debt Serviceability
Net debt as a multiple of annual free cash flow
9.0× FCF
~9.0 years to full repayment at current FCF run-rate
ROE
Return on equity, trailing twelve months
16.6%
Shareholder Returns
How capital is returned to owners
Total shareholder yield
0.3%
Dividend
0.1%
Buyback
0.2%
Share Repurchases
Trailing buyback outflow — dollar magnitude of capital returned
$21M
Dividend / Share
Annualized trailing dividend per share
$0.24
Payout Ratio
Share of earnings distributed as dividends
4.2%
Shares Outstanding
Declining as buybacks retire shares
58M
All figures from the trailing twelve months. ROIC uses invested capital (equity + net debt).
Open full ratios pageENSG Stock Risk Factors
Key factors that could pressure the stock price, compress the multiple, or weigh on future results.
AI analysis · updated April 29, 2026
High Risk
Regulatory Changes
Potential shifts in government reimbursement policies, particularly from Medicare and Medicaid, pose a significant risk to Ensign Group's revenue and profitability. Changes in these structures could lead to substantial financial impacts.
High Risk
Labor Shortages
The healthcare sector, including post-acute care, is facing significant challenges with nursing labor shortages. Wage inflation that exceeds reimbursement increases can compress Ensign Group's margins, potentially affecting profitability.
Medium
Competitive Pressures
Intense competition within the healthcare industry can adversely affect occupancy rates and profitability for Ensign Group. This competitive landscape may lead to reduced market share and lower revenue.
Medium
Access to Capital
Disruptions in access to capital could hinder Ensign Group's ability to fund operations and expansion initiatives. Limited capital availability may restrict growth opportunities and operational flexibility.
Medium
Valuation Concerns
Analyses indicate that Ensign Group's price-to-earnings (P/E) ratio is higher than market and sector averages, suggesting a potentially rich valuation. A discounted cash flow (DCF) model also indicates the stock may be overvalued based on projected future cash flows.
Lower
Interest Rate Fluctuations
General market risks, such as fluctuations in interest rates, can impact bond prices and overall investment value. While not specific to Ensign Group, these changes can affect investor sentiment and financial performance.
These are risk mechanisms, not predictions. The key question is which would force a cut to earnings estimates or a lower multiple than the market currently prices in.
Why ENSG Stock Could Outperform
Structural drivers behind the upside case and why the stock could outperform over the next 12 months.
AI analysis · updated April 29, 2026
Strong Earnings Growth and Guidance
Ensign Group has demonstrated consistent revenue growth, with projections for FY2026 EPS between $7.41–$7.61. The company has a history of beating EPS estimates, with the last reported quarter showing a 4.00% surprise.
Acquisition-Driven Expansion
The company's decentralized operational model empowers local leadership to acquire and revitalize underperforming facilities, driving consistent double-digit revenue growth. This strategy has led to a significant total shareholder return over the past few years.
High-Acuity Care Model
Investors believe Ensign's specialized post-acute care model can continue to grow profitably, even amidst complex reimbursement and labor pressures.
Analyst Optimism
Multiple research sources show a constructive view of Ensign's growth profile, with a consensus rating of 'Buy' or 'Moderate Buy' from analysts. Recent analyst updates have highlighted upward revisions to earnings estimates and favorable rankings.
Financial Health
Ensign Group has an excellent balance sheet with an acceptable track record. Its dividend has been increasing for 18 years, and the payout ratio is considered healthy and sustainable.
A real bull case compounds — each driver matters most when it strengthens margins, supports capital returns, and keeps the company above the market's minimum growth bar simultaneously.
ENSG Stock Price Performance
52-week range context and price returns across multiple time horizons. Dividend contribution is shown separately in the Capital Return section.
Current Price
$175.93
52W Range Position
52%
52-Week Range
Current price plotted between the 52-week low and high.
52-Week Low
$129.91
+35.4% from the low
52-Week High
$218.00
-19.3% from the high
1 Month
-11.14%
3 Month
-11.06%
YTD
+1.2%
1 Year
+31.7%
3Y CAGR
+23.8%
5Y CAGR
+15.6%
10Y CAGR
+24.0%
Range context matters because valuation compression and earnings misses rarely hit from the same starting point. A stock already far below its high can still fall, but it is no longer carrying the same embedded optimism as one pressing a fresh peak.
ENSG vs Peers
Valuation, growth, and margin comparison against the closest publicly traded peers for this company.
Peer Set
Accurate peer set
Forward PE
23.4x
vs 21.3x median
+10% above peer median
Revenue Growth
+17.0%
vs +14.5% median
+17% above peer median
Net Margin
6.9%
vs 3.1% median
+121% above peer median
| Company | Mkt Cap | Fwd PE | Rev Grw | Margin | Rating | Upside |
|---|---|---|---|---|---|---|
ENS ENSG The Ensign Group, Inc. | $10.3B | 23.4x | +17.0% | 6.9% | Buy | +26.4% |
NHC NHC National HealthCare Corporation | $2.6B | 21.3x | +25.3% | 6.7% | — | — |
PNT PNTG The Pennant Group, Inc. | $1.1B | 24.6x | +28.7% | 3.1% | Buy | +19.9% |
ADU ADUS Addus HomeCare Corporation | $1.8B | 14.0x | +14.5% | 6.9% | Buy | +33.1% |
CCR CCRN Cross Country Healthcare, Inc. | $326M | 103.4x | -16.0% | -9.0% | Hold | +4.9% |
SEM SEM Select Medical Holdings Corporation | $2.0B | 13.1x | +1.4% | 2.4% | Hold | +9.6% |
This peer comparison reflects companies with similar business models, product lines, or market positioning, supplemented by industry grouping when direct matches are limited.
ENSG Dividend and Capital Return
ENSG returns 0.3% annually — 0.14% through dividends and 0.2% through buybacks.
Dividend SustainableFCF Well Covered
Total Shareholder Yield
0.3%
Dividend + buyback return per year
Buyback Yield
0.2%
Dividend Yield
0.14%
Payout Ratio
4.2%
How ENSG Splits Its Return
Div 0.14%
Buyback 0.2%
Dividend 0.14%Buybacks 0.2%
Dividend Profile
Yield, cadence, and growth quality
Dividend / Share
Trailing annualized cash dividend
$0.24
Growth Streak
Consecutive years of dividend increases
18Y
3Y Div CAGR
4.3%
5Y Div CAGR
4.5%
Ex-Dividend Date
—
Payment Cadence
Quarterly
4 payments over the last 12 months
Buyback Engine
How much per-share support comes from repurchases
Repurchases (TTM)
Cash used for buybacks in the latest trailing period
$21M
Estimated Shares Retired
121.8K
Approx. Share Reduction
0.2%
Shares Outstanding
Current diluted share count from the screening snapshot
58M
| Year | Div / Share | YoY Grw | BB Yield | Total Yield |
|---|---|---|---|---|
| 2026 | $0.07 | — | — | — |
| 2025 | $0.25 | +4.1% | 0.2% | 0.3% |
| 2024 | $0.24 | +4.3% | 0.0% | 0.2% |
| 2023 | $0.23 | +4.5% | 0.0% | 0.2% |
| 2022 | $0.22 | +4.7% | 0.6% | 0.8% |
FAQ
7 questionsENSG Investor Questions
Common questions answered from live analyst data and company financials.
01Is The Ensign Group, Inc. (ENSG) stock a buy or sell in 2026?
The Ensign Group, Inc. (ENSG) is rated Buy by Wall Street analysts as of 2026. Of 13 analysts covering the stock, 9 rate it Buy or Strong Buy, 2 rate it Hold, and 2 rate it Sell or Strong Sell. The consensus 12-month price target is $222, implying +26.4% from the current price of $176. The bear case scenario is $71 and the bull case is $315.
02What is the ENSG stock price target for 2026?
The Wall Street consensus price target for ENSG is $222 based on 13 analyst estimates. The high-end target is $230 (+30.7% from today), and the low-end target is $215 (+22.2%). The base case model target is $253.
03Is The Ensign Group, Inc. (ENSG) stock overvalued in 2026?
ENSG trades at 23.4x times forward earnings. The stock trades at a notable premium to the broad market, which is typical for businesses with strong free cash flow and above-average growth expectations. Based on current multiples versus the peer group, the relative model signals significantly overvalued. Whether the stock is over or undervalued ultimately depends on whether consensus earnings estimates are achievable.
04What are the main risks for The Ensign Group, Inc. (ENSG) stock in 2026?
The primary risks for ENSG in 2026 are: (1) Regulatory Changes — Potential shifts in government reimbursement policies, particularly from Medicare and Medicaid, pose a significant risk to Ensign Group's revenue and profitability. (2) Labor Shortages — The healthcare sector, including post-acute care, is facing significant challenges with nursing labor shortages. (3) Competitive Pressures — Intense competition within the healthcare industry can adversely affect occupancy rates and profitability for Ensign Group. Each factor has the potential to pressure earnings or compress the stock's valuation multiple.
05What is The Ensign Group, Inc.'s revenue and earnings forecast?
Analyst consensus estimates ENSG will report consensus revenue of $6.2B (+17.0% year-over-year) and EPS of $7.27 (+19.2% year-over-year) for the upcoming fiscal year. The following year, analysts project $7.2B in revenue.
06When does The Ensign Group, Inc. (ENSG) report its next earnings?
A confirmed upcoming earnings date for ENSG is not yet available. Check the Earnings section above for the most recent quarterly report dates and forward estimates.
07How much free cash flow does The Ensign Group, Inc. generate?
The Ensign Group, Inc. (ENSG) generated $406M in free cash flow over the trailing twelve months — a free cash flow margin of 7.7%. ENSG returns capital to shareholders through dividends (0.1% yield) and share repurchases ($21M TTM).