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ENSGThe Ensign Group, Inc.
$175.46$10.2B
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  4. Financial Ratios

The Ensign Group, Inc. (ENSG) Financial Ratios

Latest Ratios: P/E Ratio 30.0x · EV/EBITDA 26.2x · ROE 16.9%. (2005–2025 historical series)

Income StatementBalance SheetCash FlowRatios
AnnualQuarterly

ENSG Valuation Multiples

Price-based multiples — how expensive the stock is relative to earnings, sales, book value, and cash flow

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Market Cap$10.2B$10.3B$7.7B$6.4B$5.4B$4.8B$4.1B$2.5B$2.0B$1.1B$1.1B
Enterprise Value$13.9B$13.9B$9.2B$7.8B$6.6B$5.8B$4.9B$3.8B$2.2B$1.4B$1.3B
P/E Ratio →30.0429.8325.9530.7423.9524.5523.8323.0321.3426.9621.64
P/S Ratio2.022.031.821.721.781.821.691.251.120.690.65
P/B Ratio4.624.594.204.304.314.684.973.873.282.192.35
P/FCF27.5927.6640.9523.7829.0923.1912.5921.0512.7069.47132.23
P/OCF18.1218.1822.2917.0819.7417.3410.9013.219.3815.0314.65

P/E links to full P/E history page with 30-year chart

ENSG EV Ratios

Enterprise-value multiples — capital-structure-neutral measures of total business value

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
EV / Revenue—2.752.172.092.192.202.061.881.250.860.79
EV / EBITDA26.2026.2620.9023.7818.4818.2717.8121.2416.8415.6010.03
EV / EBIT32.6330.0023.4527.7522.2721.8321.7929.0325.1430.5214.08
EV / FCF—37.5148.9428.8135.8928.0515.3131.7214.0786.62159.81

ENSG Profitability

Margins and return-on-capital ratios measuring operating efficiency

Margins

Full margin charts and quarterly trend are on the Earnings History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Gross Margin15.8%15.8%15.7%15.8%17.1%17.8%17.0%14.3%12.5%10.8%11.4%
Operating Margin8.4%8.4%8.4%6.8%9.8%9.9%9.3%6.3%4.8%2.7%5.6%
Net Profit Margin6.8%6.8%7.0%5.6%7.4%7.4%7.1%5.4%5.3%2.5%3.0%

Return on Capital

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
ROE16.9%16.9%17.9%15.3%19.8%21.2%23.1%17.6%16.8%8.4%11.3%
ROA6.8%6.8%6.7%5.5%7.1%7.2%6.9%6.2%8.1%3.8%5.7%
ROIC6.9%6.9%8.7%7.1%9.8%10.5%9.2%7.0%8.0%4.4%11.8%
ROCE10.0%10.0%9.7%8.1%11.4%12.1%11.2%8.8%9.5%5.2%13.5%

ENSG Leverage & Debt

Solvency and debt-coverage ratios — lower is generally safer

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Debt / Equity1.861.861.071.251.261.241.362.050.400.630.62
Debt / EBITDA7.857.854.465.714.384.004.017.471.873.572.17
Net Debt / Equity—1.630.820.911.010.981.071.960.350.540.49
Net Debt / EBITDA6.896.893.414.153.503.173.167.141.633.091.73
Debt / FCF—9.857.995.036.804.872.7210.671.3717.1427.59
Interest Coverage58.0458.0447.6034.7333.3738.6724.248.425.733.2913.03

ENSG Liquidity & Efficiency

Short-term solvency ratios and asset-utilisation metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Current Ratio1.421.421.561.421.341.221.041.201.291.631.58
Quick Ratio1.421.421.561.421.341.221.041.201.291.631.58
Cash Ratio0.640.640.710.720.570.530.440.220.150.250.33
Asset Turnover—0.930.910.890.880.920.940.861.481.451.65
Inventory Turnover———————————
Days Sales Outstanding—45.9748.8247.4749.2745.6746.3455.3852.4060.5353.91

ENSG Shareholder Yields

Earnings, FCF, buyback, and dividend yields — total returns to shareholders

Dividends

Full dividend history and growth charts are on the Dividend History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Dividend Yield0.1%0.1%0.2%0.2%0.2%0.2%0.3%0.4%0.5%0.8%0.8%
Payout Ratio4.2%4.2%4.6%6.2%5.4%5.9%6.4%9.2%10.2%21.5%16.3%

Total Shareholder Return Metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Earnings Yield3.3%3.4%3.9%3.3%4.2%4.1%4.2%4.3%4.7%3.7%4.6%
FCF Yield3.6%3.6%2.4%4.2%3.4%4.3%7.9%4.8%7.9%1.4%0.8%
Buyback Yield0.2%0.2%0.0%0.0%0.6%0.2%0.6%0.3%0.1%0.7%2.8%
Total Shareholder Yield0.3%0.3%0.2%0.2%0.8%0.5%0.9%0.7%0.6%1.5%3.5%
Shares Outstanding—$59M$58M$57M$57M$57M$56M$56M$54M$53M$52M

Key Metrics

Growth RegimeAccelerating
ProfitabilityModerate
Balance SheetFortress
Cash FlowRobust
Top Statement Risk

Reimbursement and labor cost pressure

Verified Source

Metrics are mathematically derived from official filings.

SEC 10-K (2026Q2)

Margin Resilience Amid Cost Pressures

Operating margin held at 8.5% in Q2 2026 despite revenue growth of 17.3%, per reported financials, indicating that top-line expansion is not yet translating into bottom-line gains.

Gross margin recovered to 16.6% in Q2 2026 from the anomalous 8.7% in Q4 2025, but the volatility suggests cost or revenue recognition timing issues. The stability of operating margin around 8.5% over the past year, despite accelerating revenue, implies that labor and supply cost inflation is absorbing the benefits of scale. Investors should monitor whether the raised guidance for the back half of the year materializes into margin expansion, as the current trajectory suggests limited operating leverage.

Capital Efficiency Stalls at Low Levels

ROIC has remained flat at approximately 2.1% over the last ten quarters, per reported data, suggesting that aggressive acquisition-driven asset growth is not yet generating incremental returns on invested capital.

Despite a 29.5% year-over-year increase in total assets, ROIC has not improved, indicating that new facilities are being integrated without immediate margin uplift. The low ROIC relative to peers like NHC (9.9%) may reflect the heavy real estate base and the early-stage turnaround of acquired assets. As Ensign continues its buy-and-build strategy, the market will likely reward only if ROIC begins to trend upward as these assets mature.

Working Capital Efficiency Stable but DSO High

DSO has improved modestly to 42 days in Q2 2026 from 47 days in Q4 2024, per financial statements, while DPO remains low at 9 days, indicating limited supplier leverage.

The cash conversion cycle is not calculable due to missing DIO data, but the combination of a 42-day DSO and a 9-day DPO suggests that Ensign is financing its operations largely through its own cash flow rather than supplier credit. The improvement in DSO is a positive sign for collections from government payers, but the low DPO may indicate a lack of negotiating power with suppliers. Asset turnover has remained constant at 0.25, reflecting the capital-intensive nature of the real estate holdings.

Leverage Normalizes After Temporary Spike

Debt-to-equity fell to 0.92 in Q2 2026 from a temporary spike of 1.86 in Q4 2025, per balance sheet data, while interest coverage remains strong at 70.15.

The spike in leverage in Q4 2025 appears to be a temporary financing event, likely related to acquisition activity, as it normalized within two quarters. Interest coverage of 70.15 is exceptionally high, indicating that debt service is not a concern. However, the D/EBITDA ratio of 14.62 in Q2 2026, though down from 27.42 in Q4 2025, is elevated relative to peers, suggesting that EBITDA is low relative to the debt load, which may be a function of the real estate-heavy model.

Liquidity Buffer Thins but Remains Adequate

Current ratio dipped to 1.21 in Q2 2026 from 1.56 in Q1 2026, per reported figures, as cash fell to $262.3M, but the buffer still covers short-term obligations.

The decline in the current ratio is driven by a reduction in cash, likely used for acquisitions or debt repayment, but the ratio remains above 1.0, indicating that current assets cover current liabilities. The quick ratio is identical to the current ratio, suggesting that inventory is not a significant component of current assets, which is typical for a service-based healthcare provider. Under a severe stress scenario, such as a sudden drop in occupancy or a reimbursement cut, the liquidity position could tighten, but the fortress balance sheet with low leverage provides a cushion.

EV/EBITDA Misleads on Real Estate Value

EV/EBITDA of 26.50, per current valuation multiples, is commonly misapplied to Ensign because it fails to capture the embedded value of the Standard Bearer real estate portfolio.

Analysts often compare Ensign's EV/EBITDA to pure-play operators like NHC, but this ignores the fact that a significant portion of Ensign's asset base is real estate, which should be valued on a cap rate basis or through a sum-of-the-parts analysis. The low debt/equity ratio and the potential for future spin-offs or sale-leaseback transactions suggest that the market may be undervaluing the real estate holdings. A more appropriate metric would be to separate the Skilled Services and Real Estate segments and apply a REIT-like multiple to the latter, or to use P/B as a cross-check given the tangible asset base.

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Includes 30+ ratios · 21 years · Updated daily

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ENSG — Frequently Asked Questions

Quick answers to the most common questions about buying ENSG stock.

What is The Ensign Group, Inc.'s P/E ratio?

The Ensign Group, Inc.'s current P/E ratio is 30.0x. The historical average is 18.9x. This places it at the 95th percentile of its historical range.

What is The Ensign Group, Inc.'s EV/EBITDA?

The Ensign Group, Inc.'s current EV/EBITDA is 26.2x. This enterprise value multiple compares the company's total value (equity + debt - cash) to its EBITDA. The historical average is 12.6x.

What is The Ensign Group, Inc.'s ROE?

The Ensign Group, Inc.'s return on equity (ROE) is 16.9%. The historical average is 20.3%.

Is ENSG stock overvalued?

Based on historical data, The Ensign Group, Inc. is trading at a P/E of 30.0x. This is at the 95th percentile of its historical P/E range. Compare with industry peers and growth rates for a complete picture.

What is The Ensign Group, Inc.'s dividend yield?

The Ensign Group, Inc.'s current dividend yield is 0.14% with a payout ratio of 4.2%.

What are The Ensign Group, Inc.'s profit margins?

The Ensign Group, Inc. has 15.8% gross margin and 8.4% operating margin.

How much debt does The Ensign Group, Inc. have?

The Ensign Group, Inc.'s Debt/EBITDA ratio is 7.8x, indicating high leverage. A ratio above 4x may signal elevated financial risk.