Revenue growth remains strong at 18.4% as of 2026Q1, though gross margins have shown significant volatility, fluctuating between 8.7% and 21.1% over the last five quarters.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 |
|---|
| Sales/Revenue | 5.27B | 5.06B | 4.26B | 3.73B | 3.03B | 2.63B | 2.4B | 2.04B | 1.75B | 1.6B | 1.65B | 1.34B | 1.03B | 904.56M | 823.15M | 758.28M | 649.53M | 542M | 469.37M | 411.32M | 358.57M | 300.85M |
| Revenue Growth % | 19.23% | 18.72% | 14.24% | 23.27% | 15.15% | 9.36% | 17.98% | 16.07% | 9.78% | -3.42% | 23.33% | 30.6% | 13.58% | 9.89% | 8.56% | 16.74% | 19.84% | 15.47% | 14.11% | 14.71% | 19.19% | - |
| Cost of Goods Sold | 4.47B | 4.36B | 3.59B | 3.14B | 2.51B | 2.16B | 2B | 1.75B | 1.54B | 1.43B | 1.47B | 1.16B | 871.16M | 739.6M | 669.71M | 614.53M | 531.15M | 449.02M | 391.67M | 351.69M | 301.25M | 255.5M |
| COGS % of Revenue | - | 86.26% | 84.33% | 84.16% | 82.88% | 82.18% | 83.04% | 85.71% | 87.54% | 89.18% | 88.61% | 86.19% | 84.79% | 81.76% | 81.36% | 81.04% | 81.77% | 82.84% | 83.45% | 85.5% | 84.01% | 84.92% |
| Gross Profit | 800.38M | 695.13M | 667.59M | 590.76M | 517.99M | 468.21M | 407.47M | 291.11M | 218.68M | 172.9M | 188.47M | 185.36M | 156.25M | 164.95M | 153.45M | 143.75M | 118.39M | 92.98M | 77.7M | 59.63M | 57.32M | 45.35M |
| Gross Margin % | 15.18% | 13.74% | 15.67% | 15.84% | 17.12% | 17.82% | 16.96% | 14.29% | 12.46% | 10.82% | 11.39% | 13.81% | 15.21% | 18.24% | 18.64% | 18.96% | 18.23% | 17.16% | 16.55% | 14.5% | 15.99% | 15.07% |
| Gross Profit Growth % | - | 4.13% | 13% | 14.05% | 10.63% | 14.91% | 39.97% | 33.12% | 26.48% | -8.26% | 1.68% | 18.63% | -5.28% | 7.5% | 6.75% | 21.42% | 27.32% | 19.67% | 30.3% | 4.02% | 26.39% | - |
| Operating Expenses | 257.29M | 261.33M | 309.28M | 335.39M | 221.16M | 207.75M | 184.31M | 161.93M | 133.76M | 129.71M | 96.62M | 92.27M | 83.33M | 107.01M | 75.18M | 53.05M | 42.73M | 34.04M | 29.04M | 22.91M | 18.43M | 13.37M |
| OpEx % of Revenue | - | 5.17% | 7.26% | 8.99% | 7.31% | 7.91% | 7.67% | 7.95% | 7.62% | 8.12% | 5.84% | 6.88% | 8.11% | 11.83% | 9.13% | 7% | 6.58% | 6.28% | 6.19% | 5.57% | 5.14% | 4.44% |
| Selling, General & Admin | 281.48M | 261.33M | 225.14M | 263M | 158.81M | 151.76M | 129.74M | 110.87M | 90.56M | 74.12M | 69.17M | 64.16M | 56.9M | 40.1M | 31.82M | 29.77M | 26.1M | 20.77M | 20.02M | 15.95M | 14.21M | 10.91M |
| SG&A % of Revenue | - | 5.17% | 5.28% | 7.05% | 5.25% | 5.78% | 5.4% | 5.44% | 5.16% | 4.64% | 4.18% | 4.78% | 5.54% | 4.43% | 3.87% | 3.93% | 4.02% | 3.83% | 4.26% | 3.88% | 3.96% | 3.63% |
| Research & Development | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| R&D % of Revenue | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Operating Expenses | 1000K | 0 | 84.14M | 72.39M | 62.35M | 55.98M | 54.57M | 51.05M | 43.2M | 55.59M | 27.46M | 28.11M | 26.43M | 66.91M | 43.36M | 23.29M | 16.63M | 13.28M | 9.03M | 6.97M | 4.22M | 2.46M |
| Operating Income | 448.79M | 433.8M | 358.3M | 255.37M | 296.82M | 260.46M | 223.16M | 129.18M | 84.91M | 43.19M | 91.85M | 93.08M | 72.92M | 57.94M | 78.27M | 90.7M | 75.65M | 58.94M | 48.66M | 36.72M | 38.89M | 31.99M |
| Operating Margin % | 8.51% | 8.58% | 8.41% | 6.85% | 9.81% | 9.91% | 9.29% | 6.34% | 4.84% | 2.7% | 5.55% | 6.94% | 7.1% | 6.41% | 9.51% | 11.96% | 11.65% | 10.87% | 10.37% | 8.93% | 10.85% | 10.63% |
| Operating Income Growth % | - | 21.07% | 40.31% | -13.97% | 13.96% | 16.72% | 72.75% | 52.13% | 96.62% | -52.98% | -1.33% | 27.64% | 25.86% | -25.97% | -13.7% | 19.88% | 28.36% | 21.13% | 32.51% | -5.59% | 21.59% | - |
| EBITDA | 557.73M | 538.12M | 442.44M | 327.75M | 359.18M | 316.45M | 277.73M | 180.23M | 129.78M | 87.66M | 130.53M | 121.19M | 99.35M | 91.88M | 106.74M | 114.7M | 92.29M | 72.21M | 57.79M | 43.7M | 43.11M | 34.44M |
| EBITDA Margin % | 10.57% | 10.64% | 10.38% | 8.79% | 11.87% | 12.04% | 11.56% | 8.85% | 7.4% | 5.48% | 7.89% | 9.03% | 9.67% | 10.16% | 12.97% | 15.13% | 14.21% | 13.32% | 12.31% | 10.62% | 12.02% | 11.45% |
| EBITDA Growth % | 19.65% | 21.63% | 34.99% | -8.75% | 13.5% | 13.94% | 54.09% | 38.88% | 48.05% | -32.84% | 7.7% | 21.98% | 8.13% | -13.92% | -6.94% | 24.29% | 27.8% | 24.96% | 32.26% | 1.35% | 25.17% | - |
| D&A (Non-Cash Add-back) | 108.94M | 104.33M | 84.14M | 72.39M | 62.35M | 55.98M | 54.57M | 51.05M | 44.86M | 44.47M | 38.68M | 28.11M | 26.43M | 33.94M | 28.46M | 24M | 16.63M | 13.28M | 9.14M | 6.98M | 4.22M | 2.46M |
| EBIT | 354.99M | 433.8M | 394.38M | 280.85M | 298.02M | 264.85M | 226.97M | 131.83M | 86.93M | 44.8M | 92.95M | 93.93M | 73.52M | 58.45M | 78.53M | 90.94M | 75.9M | 59.22M | 50.03M | 36.72M | 38.89M | 31.99M |
| Net Interest Income | 11.68M | 16.52M | 20.46M | 11.13M | -3.9M | -2.46M | -5.55M | -13.01M | -13.17M | -12.01M | -6.03M | -1.98M | -12.38M | -12.28M | -11.97M | -13.53M | -8.88M | -5.41M | -3.41M | 0 | 0 | 0 |
| Interest Income | 24.16M | 24.51M | 28.75M | 19.22M | 5.04M | 4.39M | 3.81M | 2.65M | 2.02M | 1.61M | 1.11M | 845K | 594K | 506K | 255K | 249K | 248K | 279K | 1.37M | 0 | 0 | 0 |
| Interest Expense | 4.02M | 7.99M | 8.29M | 8.09M | 8.93M | 6.85M | 9.36M | 15.66M | 15.18M | 13.62M | 7.14M | 2.83M | 12.98M | 12.79M | 12.23M | 13.78M | 9.12M | 5.69M | 4.78M | 0 | 0 | 0 |
| Other Income/Expense | 28.83M | 21.83M | 27.79M | 17.39M | -7.74M | -2.46M | -5.55M | -13.01M | -13.17M | -12.01M | -6.03M | -1.98M | -12.38M | -12.28M | -11.97M | -13.53M | -8.88M | -5.41M | -3.41M | -3.29M | -2.22M | -1.54M |
| Pretax Income | 477.61M | 455.62M | 386.09M | 272.76M | 289.09M | 258M | 217.61M | 116.17M | 71.75M | 31.18M | 85.82M | 91.1M | 60.54M | 45.66M | 66.3M | 77.17M | 66.78M | 53.53M | 45.24M | 33.43M | 36.67M | 30.44M |
| Pretax Margin % | 9.06% | 9.01% | 9.06% | 7.31% | 9.56% | 9.82% | 9.06% | 5.7% | 4.09% | 1.95% | 5.19% | 6.79% | 5.89% | 5.05% | 8.05% | 10.18% | 10.28% | 9.88% | 9.64% | 8.13% | 10.23% | 10.12% |
| Income Tax | 113.95M | 111.36M | 87.64M | 62.91M | 64.44M | 60.28M | 46.24M | 23.95M | 12.69M | 14.21M | 32.98M | 35.18M | 26.8M | 20M | 25.13M | 29.49M | 26.25M | 21.04M | 17.74M | 12.9M | 14.13M | 12.05M |
| Effective Tax Rate % | 23.86% | 24.44% | 22.7% | 23.06% | 22.29% | 23.36% | 21.25% | 20.62% | 17.68% | 45.56% | 38.42% | 38.62% | 44.27% | 43.81% | 37.91% | 38.22% | 39.31% | 39.31% | 39.2% | 38.6% | 38.52% | 39.6% |
| Net Income | 363.36M | 343.97M | 297.97M | 209.4M | 224.68M | 194.65M | 170.48M | 110.53M | 92.36M | 40.48M | 49.99M | 55.43M | 35.95M | 24.04M | 40.59M | 47.67M | 40.53M | 32.49M | 27.51M | 20.53M | 22.55M | 18.39M |
| Net Margin % | 6.89% | 6.8% | 6.99% | 5.61% | 7.43% | 7.41% | 7.1% | 5.43% | 5.26% | 2.53% | 3.02% | 4.13% | 3.5% | 2.66% | 4.93% | 6.29% | 6.24% | 5.99% | 5.86% | 4.99% | 6.29% | 6.11% |
| Net Income Growth % | 17.44% | 15.44% | 42.3% | -6.8% | 15.43% | 14.18% | 54.23% | 19.67% | 128.2% | -19.03% | -9.82% | 54.19% | 49.54% | -40.77% | -14.86% | 17.64% | 24.75% | 18.09% | 34.01% | -8.97% | 22.63% | - |
| Net Income (Continuing) | 363.58M | 344.26M | 298.46M | 209.85M | 224.65M | 197.72M | 171.36M | 92.21M | 59.06M | 16.97M | 52.84M | 55.92M | 33.74M | 25.66M | 41.16M | 47.67M | 40.53M | 32.49M | 27.51M | 20.53M | 22.55M | 18.39M |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 18.84M | 32.87M | 23.7M | 0 | 0 | 0 | 0 | 1.36M | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | 3.45M | 3.1M | 3.32M | 5.45M | 1.47M | 946K | 150K | 1.95M | 11.4M | 7.66M | 4.05M | -339K | -1.05M | 1.16M | 1.41M | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| EPS (Diluted) | 6.10 | 5.84 | 5.12 | 3.65 | 3.95 | 3.42 | 3.06 | 1.97 | 1.70 | 0.77 | 0.96 | 1.06 | 0.78 | 0.54 | 0.93 | 1.11 | 0.96 | 0.78 | 0.67 | 0.59 | 0.67 | 0.53 |
| EPS Growth % | 16.07% | 14.06% | 40.27% | -7.59% | 15.5% | 11.76% | 55.33% | 15.88% | 120.78% | -19.79% | -9.43% | 35.9% | 44.44% | -41.94% | -16.22% | 15.63% | 23.08% | 16.42% | 13.56% | -11.94% | 26.42% | - |
| EPS (Basic) | - | 6.00 | 5.26 | 3.76 | 4.09 | 3.57 | 3.19 | 2.07 | 1.78 | 0.79 | 0.99 | 1.10 | 0.80 | 0.55 | 0.95 | 1.14 | 0.98 | 0.79 | 0.67 | 0.70 | 0.83 | 0.68 |
| Diluted Shares Outstanding | 59.57M | 58.87M | 58.24M | 57.32M | 56.87M | 56.92M | 55.79M | 55.98M | 54.4M | 52.83M | 52.13M | 52.21M | 46.19M | 44.73M | 43.88M | 43.17M | 42.32M | 41.85M | 41.43M | 34.94M | 33.65M | 35.01M |
| Basic Shares Outstanding | 57.77M | 57.31M | 56.66M | 55.71M | 54.89M | 54.49M | 53.43M | 53.45M | 52.02M | 50.93M | 50.55M | 50.32M | 44.68M | 43.8M | 42.86M | 41.93M | 41.49M | 41.21M | 41.04M | 28.99M | 26.73M | 26.94M |
| Dividend Payout Ratio | - | 4.19% | 4.59% | 6.16% | 5.42% | 5.93% | 6.35% | 9.22% | 10.2% | 21.54% | 16.35% | 13.52% | 17.52% | 17.96% | 16.27% | 9.73% | 10.24% | 11.41% | 11.94% | 12.82% | 8.76% | 6.82% |
Regulatory reimbursement and staffing
As reported in recent financial filings, Ensign Group has maintained a robust growth trajectory, with revenue expanding by 18.4% in 2026Q1, reflecting the successful integration of acquired facilities into its decentralized cluster model while sustaining double-digit top-line growth across the previous ten-quarter period.
The company's ability to consistently scale revenue suggests that its acquisition-led growth strategy remains effective in capturing market share. Investors should monitor whether this growth is primarily driven by volume increases in skilled nursing occupancy or if pricing adjustments are contributing to the sustained upward trend.
Based on the provided income statement data, gross margins have exhibited significant fluctuations, ranging from a low of 8.7% in 2025Q4 to a peak of 21.1% in 2026Q1, indicating potential sensitivity to seasonal labor costs and the timing of government reimbursement adjustments.
The sharp variance in gross profitability suggests that the company's cost structure is highly susceptible to external pressures, particularly in nursing labor markets. This volatility implies that while the company can grow revenue, maintaining consistent profitability remains a challenge in the current regulatory environment.
According to historical income statements, Ensign has demonstrated improved operating leverage, with operating income rising to $124.9M in 2026Q1, as the company successfully managed SG&A expenses relative to the broader expansion of its facility footprint and total revenue base over the last two years.
The ability to scale operating income faster than revenue in recent quarters suggests that the decentralized cluster model is achieving administrative efficiencies. This trend appears to indicate that the company is successfully leveraging its regional management infrastructure to absorb the overhead costs associated with new facility acquisitions.
As evidenced by the 2026Q1 results, net income reached $99.7M, reflecting a net margin of 7.2%, which appears to be supported by disciplined expense management despite the ongoing increase in stock-based compensation, which reached $13.9M in the most recent quarter.
While the growth in net income is encouraging, the rising trend in stock-based compensation warrants further investigation to ensure it does not dilute long-term shareholder value. The current earnings profile appears stable, though investors should remain cautious regarding the impact of non-operating items on bottom-line performance.
Despite strong top-line performance, the company's reliance on government-funded reimbursement models, as highlighted in recent filings, creates a structural risk where potential federal staffing mandates could significantly compress operating margins if reimbursement rates fail to keep pace with mandatory labor cost increases.
Short-term margin expansion may be masking underlying vulnerabilities related to the company's high fixed-cost base. If the current labor market remains tight, the company may struggle to maintain its current profitability levels without significant support from future CMS reimbursement adjustments.
Quick answers to the most common questions about buying ENSG stock.
For fiscal year 2025, The Ensign Group, Inc. (ENSG) reported total revenue of $5.06B. This represents a 1581.2% increase compared to $300.9M in 2005.
The Ensign Group, Inc. (ENSG) is profitable, generating $344.0M in net income for the fiscal year ending 2025 with a net profit margin of 6.8%.
The Ensign Group, Inc. (ENSG) reported an operating income of $433.8M, resulting in an operating profit margin of 8.6%. This margin reflects the operational efficiency of the business before interest and taxes.
The Ensign Group, Inc. (ENSG) generated $695.1M in gross profit for the year, representing a gross profit margin of 13.7%. This demonstrates the company's core pricing power and production efficiency.