ENSIGN GROUP, INC(ENSG)Stock Analysis
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Rank #438 of 2,879 stocksTOP 25%
Rankings refresh quarterly once 80% of peers have filed (~45 days after quarter-end). Next update: ~Aug 14, 2026.
Revenue Growth
Profitability
Balance Sheet
Earnings Quality
Free Cash Flow
Institutional Flow
Revenue Scale
Dilution Risk
ENSG Stock Analysis & AI Quality Score
AI stock analysis and institutional research for ENSIGN GROUP, INC (ENSG), a Healthcare sector company. 13F Pro's AI-powered ranking engine scores ENSG at 68.0/100 on a 32-signal composite quality model, placing it at rank #438 of 2,879 stocks — the top 25% of the AI-ranked universe. ENSG scores in the top quartile across revenue scale (78.2), revenue growth (76.5), balance sheet strength (76.3). Based on the latest XBRL financial filings (Q1 2026), ENSIGN GROUP, INC reports quarterly revenue of $1.4B, net income of $99.7M, an operating margin of 9.0%. Top institutional holders of ENSG by reported 13-F value include BlackRock,, BAILLIE GIFFORD & CO, VANGUARD PORTFOLIO MANAGEMENT, based on the most recent SEC filings. ENSG trades on the Nasdaq exchange and files with the SEC under CIK 1125376. 13F Pro's AI research platform runs 10 specialized AI analysts — value, growth, momentum, macro, and activist specialists — that debate ENSG daily and publish AI-generated analysis with cited SEC sources. The platform aggregates historical XBRL financial facts, 10-Q and 10-K filings, insider Form 4 transactions, and institutional 13-F holdings for ENSIGN GROUP, INC directly from SEC EDGAR. ENSIGN GROUP, INC's 13F Pro composite quality score has ranged between 8 and 80 since 2021, currently 68.0 — a stable long-term trajectory across 56 quarterly and live scoring snapshots.
What's Driving ENSG's Business? Latest 10-Q Breakdown
AI-extracted from ENSIGN GROUP, INC's 10-Q filed 2026-04-30 — Q1 2026 (three months ended March 31, 2026). Every figure is machine-verified against the filing text on SEC EDGAR.
Q1 revenue surged 18.4% to $1.39B driven by 2.6% occupancy gains and 34 new facility additions; diluted EPS grew 21.9% to $1.67.
Biggest Revenue Drivers
Total revenue: $1,389.2M+18.4% YoY
Strong occupancy growth across Same Facilities (+2.3%) and Transitioning Facilities (+3.8%); 34 new operations added with $128.0M contribution from Recently Acquired Facilities.
Growth from 19 real estate purchases and annual rent increases; FFO increased 26.6% to $21.6M.
Senior living and ancillary services growth; includes $30.6M senior living and $28.5M other ancillary services.
Largest Expense Items
Increased by acquisition activities and higher acuity patient mix; decreased as percentage of revenue by 0.3% to 79.1%.
Additional headcount for acquisitions, wage increases, and system implementation costs; remained flat at 5.3% of revenue.
Increased from newly acquired operations with greater real estate mix and capital investments; remained flat at 2.1% of revenue.
Margins: Operating income margin improved to 9.0% from 8.6% YoY despite acquisition-related costs. Adjusted EBITDA increased to $171.2M (+24.6% YoY), demonstrating underlying operational strength as cost of services declined 30 basis points as a percentage of revenue due to operational leverage and higher acuity patient mix.
Watch Items from the Filing
- Medicare and Medicaid represent 69.1% of service revenue; any reductions in reimbursement rates, sequestration, or policy changes under current administration could materially harm revenue and profitability.
- 25 of 378 facilities represent Recently Acquired Facilities with lower-than-mature occupancy (80.5% vs 84.0% consolidated); integration risk and potential for write-downs if underperformance continues.
- Company signed definitive agreements for 19 additional operations ($342.4M real estate purchase) pending customary closing conditions; significant capital deployment and integration execution risk in rapid growth.
- 22 of independent subsidiaries have multi-claim Reviews scheduled or in process as of March 31, 2026; increased regulatory scrutiny could result in claim denials, refund obligations, or payment reductions.
- California OHCA pursuing Cost and Market Impact Review of proposed transaction with invasive subpoena; company filed constitutional challenge; regulatory delays could prevent closings and revenue realization.
AI-extracted and verified against SEC EDGAR filing text. Not investment advice.
Revenue
Q1 2026
$1.4B
Net Income
Q1 2026
$99.7M
Free Cash Flow
Q1 2026
$100.2M
Operating Margin
Q1 2026
9.0%
D/E Ratio
Q1 2026
0.06
Revenue & Net Income
Earnings Per Share
Key Financials Over Time
Export Financial Table · Pro+Revenue
+18.7% YoYNet Income
+15.4% YoYOperating Income
+18.7% YoYEPS (Diluted)
+14.1% YoYTotal Assets
+17.0% YoYTotal Debt
-2.6% YoYOp. Cash Flow
+62.5% YoY| Metric | FY 2025 | FY 2024 | FY 2023 | FY 2022 | FY 2020 | FY 2019 |
|---|---|---|---|---|---|---|
| Revenue | $5.06B +18.7% | $4.26B +14.2% | $3.73B +23.3% | $3.03B +25.9% | $2.40B +18.0% | $2.04B |
| Net Income | $344.0M +15.4% | $298.0M +42.3% | $209.4M -6.8% | $224.7M +31.8% | $170.5M +54.2% | $110.5M |
| Operating Income | $425.3M +18.7% | $358.3M +40.3% | $255.4M -14.0% | $296.8M +33.0% | $223.2M +72.7% | $129.2M |
| EPS (Diluted) | $5.84 +14.1% | $5.12 +40.3% | $3.65 -7.6% | $3.95 +29.1% | $3.06 +55.3% | $1.97 |
| Total Assets | $5.46B +17.0% | $4.67B +11.8% | $4.18B +21.0% | $3.45B +35.6% | $2.55B +7.8% | $2.36B |
| Total Debt | $148.6M -2.6% | $152.5M -2.4% | $156.3M -2.4% | $160.2M +32.8% | $120.6M -63.8% | $333.1M |
| Operating Cash Flow | $564.3M +62.5% | $347.2M -7.8% | $376.7M +38.2% | $272.5M -27.0% | $373.4M +94.2% | $192.2M |
AI Insight: ENSG Financial Trends
ENSG delivers consistent revenue and earnings growth, with Q1 2026 net income hitting $100M — up 25% from Q2 2024 — while debt remains negligible.
• Revenue grew steadily from $1,025M in Q2 2024 to $1,389M in Q1 2026, a 35% increase over six quarters.
• Operating income expanded from $86M in Q2 2024 to $125M in Q1 2026, with Q4 2025 and Q1 2026 marking new highs.
• Total debt declined from $153M in Q4 2024 to $141M in Q1 2026 as equity surged from $1,657M to $2,366M, compressing leverage significantly.
• Operating cash flow strengthened to $183M in Q4 2025, though Q1 2026 pulled back to $100M, consistent with typical seasonal patterns.
⚠ Operating margin dipped in Q3 2025 to 7.4% from 8.5% in Q2 2025, before recovering in Q4 2025 — worth monitoring for persistence.
⚠ Operating CF of $100M in Q1 2026 is the weakest in three quarters; confirm this reflects seasonality, not a structural cash conversion issue.
AI Insight: ENSG Ratio Trends
ENSG's Q4 2025–Q1 2026 margin recovery and near-zero leverage signal durable operational resilience after a Q3 2025 dip.
• Operating margin rebounded sharply to 9.1% in Q4 2025 and held at 9.0% in Q1 2026 after troughing at 7.4% in Q3 2025.
• ROA improved to 7.1% in Q1 2026, the highest level in the dataset, up from 6.4% in Q2 2024.
• D/E ratio declined steadily from 0.09 in Q2 2024 to 0.06 in Q1 2026, reflecting a progressively cleaner balance sheet.
⚠ ROIC contracted from 20.8% in Q4 2025 to 19.9% in Q1 2026 — still solid but reversing a strong sequential peak.
⚠ Q3 2025 operating margin collapsed 170bp quarter-over-quarter to 7.4%; recurrence of such volatility warrants monitoring.
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Available Research
13F Pro tracks comprehensive data for ENSIGN GROUP, INC including:
Top Institutional Holders of ENSG
BlackRock, Inc.
$1.5B7,364,534 shBAILLIE GIFFORD & CO
$972.5M4,826,172 shVANGUARD PORTFOLIO MANAGEMENT LLC
$628.7M3,120,298 shVANGUARD CAPITAL MANAGEMENT LLC
$522.5M2,592,905 shFMR LLC
$462.7M2,296,465 shSTATE STREET CORP
$415.8M2,062,850 shWASATCH ADVISORS LP
$414.7M2,057,995 shGEODE CAPITAL MANAGEMENT, LLC
$340.0M1,687,292 shCapital Research Global Investors
$282.5M1,402,108 shDIMENSIONAL FUND ADVISORS LP
$193.6M960,573 sh
| Fund | Value | Shares |
|---|---|---|
| BlackRock, Inc. | $1.5B | 7,364,534 |
| BAILLIE GIFFORD & CO | $972.5M | 4,826,172 |
| VANGUARD PORTFOLIO MANAGEMENT LLC | $628.7M | 3,120,298 |
| VANGUARD CAPITAL MANAGEMENT LLC | $522.5M | 2,592,905 |
| FMR LLC | $462.7M | 2,296,465 |
| STATE STREET CORP | $415.8M | 2,062,850 |
| WASATCH ADVISORS LP | $414.7M | 2,057,995 |
| GEODE CAPITAL MANAGEMENT, LLC | $340.0M | 1,687,292 |
| Capital Research Global Investors | $282.5M | 1,402,108 |
| DIMENSIONAL FUND ADVISORS LP | $193.6M | 960,573 |
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Is ENSG a good stock to buy?
13F Pro's AI-powered analysis of ENSIGN GROUP, INC (ENSG) draws on SEC EDGAR-sourced fundamentals, institutional 13F holdings, and insider Form 4 transactions in the Healthcare sector (listed on Nasdaq). The 32-signal AI Quality Score, current rank, and full bull/bear verdict for ENSG are available on the ENSG stock profile dashboard — with the same data, AI insights, ratios, and institutional activity refreshed after every 10-K, 10-Q, 13F, and Form 4 filing.
Which hedge funds own ENSG?
Institutional investors are required to disclose their holdings quarterly via SEC Form 13F. 13F Pro aggregates these filings to show which hedge funds, mutual funds, and asset managers are buying or selling ENSG. Combined with insider transaction data from Form 4 filings and AI-powered analysis from 10 specialized research agents, 13F Pro provides a comprehensive view of ENSIGN GROUP, INC's investment landscape.