The Ensign Group (ENSG) Q3 2024 earnings summary

Executive summary

• Achieved record quarterly results with Q3 2024 revenue up 15% to $1.08 billion, driven by strong clinical and financial performance, higher occupancy, and integration of 53 new operations since 2023.

• Net income attributable to shareholders rose 22.8% to $78.4 million, with GAAP diluted EPS up 20.7% to $1.34 and adjusted EPS up 15.8% to $1.39.

• Same-store occupancy reached a record 81.7%, a 2.8% year-over-year increase, with skilled mix days at 31.6%.

• Operates 323 facilities across 14 states, focusing on skilled nursing, senior living, and ancillary healthcare services, supported by a decentralized, entrepreneurial culture.

• Expansion included 24 new skilled nursing operations and two campus operations, adding 2,565 beds and 202 senior living units, with entry into new states.

Financial highlights

• Service revenue for Q3 2024 was $1.08 billion, up from $935.3 million in Q3 2023; nine-month revenue reached $3.13 billion, up 13.8%.

• Adjusted net income for Q3 2024 was $81.1 million, up 17.7% year-over-year; adjusted EBITDA was $123.9 million, up from $107.1 million.

• Cash and cash equivalents at quarter-end were $532.1 million, with $572.1 million available under the line of credit.

• Lease-adjusted net debt to EBITDA ratio reached a record low of 1.88x; debt-to-equity ratio remained conservative.

• Quarterly cash dividend of $0.06 per share paid, marking 21 consecutive years of dividend increases.

Outlook and guidance

• Raised 2024 annual earnings guidance to $5.46–$5.52 per diluted share and revenue guidance to $4.25–$4.26 billion.

• Midpoint of adjusted EPS guidance is 15% above 2023 and 33% above 2022.

• 2024 guidance based on 58.5 million diluted shares, 25% tax rate, and includes closed and expected acquisitions.

• Management expects continued growth through acquisitions, organic occupancy gains, and a $135 million capital budget for renovations.