The Ensign Group (ENSG) Q1 2025 earnings summary

Executive summary

• Achieved record-setting Q1 2025 results with consolidated revenue up 16.1% to $1.17B, GAAP net income up 16.6% to $80.3M, and diluted EPS up 15.1% to $1.37, driven by higher occupancy, skilled mix, and acquisitions.

• Adjusted net income rose 18% to $89.0M and adjusted diluted EPS increased 16.9% to $1.52.

• Added 19 new operations in Q1 and 47 since January 2024, expanding into Alabama, Oregon, Alaska, and increasing market density in Tennessee.

• Completed a $20M stock repurchase program and paid a quarterly dividend of $0.0625 per share, marking 22 consecutive years of dividend increases.

• Operates 343 healthcare facilities across 17 states, with over 50,500 employees and 38,000+ beds/units.

Financial highlights

• Q1 2025 service revenue was $1.17B, up 16.2% year-over-year; rental revenue from third parties was $6.0M.

• Adjusted EBITDA reached $137.4M, up from $115.7M in Q1 2024; adjusted EBITDAR was $194.5M.

• Cash and cash equivalents stood at $282.7M at quarter-end; cash flow from operations was $72.2M.

• Net debt to adjusted EBITDA ratio was 2.13x; over $1B in liquidity available, including $572.1M under the credit facility.

• Over $190M invested in strategic growth during the quarter, with $194.2M deployed for acquisitions.

Outlook and guidance

• 2025 annual earnings guidance raised to $6.22–$6.38 per diluted share, a 14.5% increase over 2024.

• 2025 revenue guidance increased to $4.89B–$4.94B, reflecting Q1 growth and anticipated acquisitions.

• Guidance based on 59.5M diluted shares, 25% tax rate, and expected acquisitions through Q2 2025.