The Ensign Group
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The Ensign Group (ENSG) investor relations material

The Ensign Group Q4 2025 earnings summary

Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.
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Q4 2025 earnings summary4 Feb, 2026

Executive summary

  • Achieved record annual and quarterly results in revenue, net income, and EPS, driven by strong operational performance, clinical excellence, and a patient-focused culture.

  • Outperformed industry peers in CMS survey results and quality measures, with significant improvements in staff retention and leadership stability.

  • Expanded to 378 facilities with over 42,000 beds/units and 56,000+ employees across 17 states, adding 51 new operations in 2025 and 17 in Q4.

  • Emphasizes a decentralized, entrepreneurial leadership model and cluster-based operational structure to drive superior clinical and financial outcomes.

  • Achieved a 16% annual revenue and EBITDAR growth rate since 2014, with a total shareholder return of 4,589% since IPO.

Financial highlights

  • FY25 GAAP diluted EPS: $5.84 (+14.1% YoY); adjusted EPS: $6.57 (+19.5% YoY); GAAP net income: $344M (+15.4% YoY); adjusted net income: $386.6M (+20.6% YoY).

  • FY25 consolidated revenue: $5.06B (+18.7% YoY); Q4 revenue: $1.36B (+20.2% YoY); adjusted net income Q4: $107.8M (+23.2% YoY).

  • Adjusted EBITDAR for 2025: $841.7M; adjusted EBITDA: $602.4M (up from $490.4M in 2024).

  • Cash and equivalents: $503.9M; cash flow from operations: $564.3M; available credit: $591.6M.

  • Increased dividend for 23rd consecutive year; $0.065 per share paid in Q4.

Outlook and guidance

  • FY26 earnings guidance: $7.41–$7.61 per diluted share; revenue guidance: $5.77B–$5.84B.

  • Midpoint of FY26 EPS guidance is 14.3% above FY25 and 36.5% above FY24.

  • Guidance assumes 60M diluted shares, 25% tax rate, normalized insurance costs, and excludes certain non-recurring charges.

  • Guidance includes expected Q1 2026 acquisitions and assumes continued progress in occupancy, skilled mix, and operational initiatives.

Detail organic growth strategy given 83% occupancy
Impact of payor mix shifts on revenue growth
Standard Bearer's role in long-term growth strategy
Justify paying premium for newer, performing assets
Detail organic growth potential at 83% occupancy
Impact of specialty programs on financial growth
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Frequently asked questions

The Ensign Group Inc is a provider of healthcare services, primarily focusing on skilled nursing, rehabilitative care, and assisted living services. The company operates a network of facilities across the United States, offering short-term and long-term care for elderly and post-acute patients. In addition to skilled nursing and senior living, Ensign provides home health, hospice care, and physical therapy services. The company is headquartered in San Juan Capistrano, California, and its shares are listed on the NASDAQ.

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