Core Viewpoint - The Ensign Group (ENSG) demonstrates a strong capability in identifying and acquiring distressed assets, leveraging a decentralized leadership model to improve clinical and financial performance, and ultimately capitalizing on growth opportunities [1] Group 1 - The company has a consistent track record of acquiring distressed assets, which positions it well for future growth [1] - The decentralized leadership model employed by the company enhances both clinical and financial performance, allowing for more effective management and operational efficiency [1] - The focus on capitalizing on growth opportunities indicates a proactive approach to investment and asset management [1]

Core Insights - The Ensign Group, Inc. (ENSG) reported a fourth-quarter 2025 adjusted EPS of $1.82, exceeding the Zacks Consensus Estimate by 4%, with a year-over-year improvement of 19.5% [1][8] - Operating revenues increased by 20.2% year over year to $1.36 billion, although this figure fell short of the consensus estimate by 0.5% [1][8] - The strong earnings performance was driven by improved occupancy rates, higher patient days, and enhanced skilled service performance, despite being partially offset by increased expenses [1] Financial Performance - Adjusted net income for the quarter was $107.8 million, reflecting a 23.2% year-over-year increase [2] - Same-facilities occupancy rose by 240 basis points to 83.8%, while transitioning-facilities occupancy increased by 290 basis points year over year to 84.9% [2] - Total expenses grew by 19.9% year over year to $1.24 billion, primarily due to higher costs of services, rent, and general & administrative expenses, but were lower than the estimated $1.25 billion [2] Segment Performance - Skilled Services segment revenues reached $1.3 billion in Q4, a 20.2% year-over-year growth, although it missed estimates by 1.5% [3] - Segment income for Skilled Services increased to $169.3 million from $141 million a year ago [3] - Rental revenues surged by 37.2% year over year to $34.5 million, supported by buyouts, with segment income rising 38.3% year over year to $10.3 million [4] Financial Position - As of December 31, 2025, cash and cash equivalents stood at $503.9 million, up from $464.6 million at the end of 2024 [5] - Total assets increased to $5.5 billion from $4.7 billion at the end of 2024 [5] - Long-term debt, excluding current maturities, decreased to $137.5 million from $141.6 million as of December 31, 2024 [6] 2026 Outlook - Revenues for 2026 are projected to be between $5.77 billion and $5.84 billion, an increase from the 2025 level of $5.06 billion, which grew 18.7% year over year [7] - Adjusted EPS is expected to be in the range of $7.41 to $7.61 for 2026, higher than the 2025 level of $6.57, which grew 19.5% year over year [7] - The estimated weighted average common shares outstanding is around 60 million, with a tax rate expected at 25% [7]

Core Insights - The Ensign Group reported record financial results for fiscal 2025, with a GAAP diluted EPS of $5.84, an increase of 14.1%, and consolidated revenue of $5.1 billion, up 18.7% [6][15][17] - The company highlighted strong operational metrics, including same-store occupancy rates reaching all-time highs of 83.8% and transitioning occupancy at 84.9% [1][4] - Ensign's management emphasized the importance of clinical performance linked to staff retention, with a notable 33% reduction in director of nursing turnover over recent years [2][3] Financial Performance - For Q4, Ensign reported a GAAP diluted EPS of $1.61, up 18.4%, and consolidated revenue of $1.4 billion, an increase of 20.2% [17] - The company ended fiscal 2025 with $504 million in cash and a lease-adjusted net debt/EBITDA ratio of 1.77x, indicating strong financial health [6][17] - Fiscal 2026 guidance includes diluted EPS of $7.41 to $7.61 and revenue projections of $5.77 billion to $5.84 billion [19] Operational Highlights - The company added 17 new operations during the quarter, increasing its skilled nursing bed capacity by 1,371 across seven states [5][8] - Skilled days increased by 8.5% for same-store operations and 10% for transitioning operations compared to the prior year [9] - Ensign's same-store operations outperformed peers in quality measures, achieving a 24% advantage at the state level and a 33% advantage at the county level [3] Growth Strategy - Ensign's active acquisition pipeline is described as healthy but increasingly competitive, with over $1 billion available for future investments [5][6] - The company is focusing on organic growth potential, with occupancy levels still below those of mature operations, indicating room for expansion [7] - Management is pursuing strategic capital projects, including new construction and facility upgrades, to enhance service capacity [10][16] Clinical and Staffing Improvements - The company reported improvements in clinical outcomes, with same-store operations achieving five-star quality measure results that were 22% better nationally [3] - Staffing agency usage has decreased, and stable wage growth has contributed to improved staff retention, supporting care quality [2][20] - Specific facilities, such as South Bay Post Acute and Shoreline Health, demonstrated significant operational improvements and revenue growth through specialized care programs [13][14]

分组1 - Ensign Group (ENSG) reported quarterly earnings of $1.82 per share, exceeding the Zacks Consensus Estimate of $1.75 per share, and up from $1.49 per share a year ago [1] - The earnings surprise for this quarter was +4.00%, and the company has surpassed consensus EPS estimates in all four of the last quarters [2] - The company posted revenues of $1.36 billion for the quarter, which was below the Zacks Consensus Estimate by 0.53%, but an increase from $1.13 billion year-over-year [3] 分组2 - Ensign Group shares have declined approximately 0.3% since the beginning of the year, while the S&P 500 has gained 1.1% [4] - The current consensus EPS estimate for the upcoming quarter is $1.73 on revenues of $1.35 billion, and for the current fiscal year, it is $7.09 on revenues of $5.64 billion [8] - The Medical - Nursing Homes industry, to which Ensign Group belongs, is currently ranked in the top 12% of over 250 Zacks industries, indicating a favorable outlook compared to the bottom 50% [9]

Financial Performance - GAAP diluted earnings per share for the year was $5.84, an increase of 14.1% over the prior year, and for the quarter was $1.61, an increase of 18.4% over the prior year quarter [2]. - Adjusted diluted earnings per share for the year was $6.57, an increase of 19.5% over the prior year, and for the quarter was $1.82, an increase of 22.1% over the prior year quarter [2]. - Consolidated revenue for the year was $5.06 billion, an increase of 18.7% over the prior year, and for the quarter was $1.36 billion, an increase of 20.2% over the prior year quarter [2]. - Total skilled services revenue was $4.84 billion for the year, an increase of 18.7% over the prior year, and $1.30 billion for the quarter, an increase of 20.2% over the prior year quarter [2]. - Total revenue for the year ended December 31, 2025, was $5,057,841, an increase of 18.7% from $4,260,485 in 2024 [19]. - Service revenue for the three months ended December 31, 2025, reached $1,353,885, up 20.2% from $1,126,374 in the same period of 2024 [19]. - Net income attributable to The Ensign Group, Inc. for the year ended December 31, 2025, was $343,971, representing a 15.4% increase from $297,973 in 2024 [24]. - Operating cash flow for the year ended December 31, 2025, was $564,270, compared to $347,186 in 2024, indicating a significant increase of 62.5% [22]. - Total expenses for the year ended December 31, 2025, were $4,632,535, an increase of 18.7% from $3,902,181 in 2024 [19]. - Non-GAAP net income for the year ended December 31, 2025, was $386,602, an increase of 20.6% from $320,497 in 2024 [24]. - Adjusted EBITDA for the year ended December 31, 2025, reached $602,350, up 22.8% from $490,392 in 2024 [31]. - Adjusted EBT for the year ended December 31, 2025, was $515,860, a 20.5% increase from $427,976 in 2024 [33]. - Segment income for skilled services was $616,397 for the year ended December 31, 2025, compared to $518,463 in 2024, indicating a 18.9% increase [54]. Acquisitions and Operations - The company acquired 17 new operations during the quarter, bringing the total acquisitions in 2025 to 51 [6]. - Ensign's portfolio consists of 378 healthcare operations across 17 states, with 160 real estate assets owned [8]. - The number of facilities increased to 326 in Q4 2025, a growth of 14.0% compared to 286 in Q4 2024 [37]. - The number of facilities at period end rose to 326, representing a 14.0% increase from 286 in 2024 [40]. - The company maintained 48 transitioning facilities with stable revenue performance [40]. Occupancy and Patient Metrics - Same Facilities and Transitioning Facilities occupancy for the year were 82.9% and 84.2%, respectively, and for the quarter were 83.8% and 84.9%, respectively, showing increases over the prior year [2]. - Actual patient days for Q4 2025 totaled 2,869,685, reflecting a 16.2% increase from 2,469,517 in Q4 2024 [37]. - Occupancy percentage for operational beds improved to 83.2% in Q4 2025, up from 80.9% in Q4 2024 [37]. - Actual patient days reached 10,795,373, an increase of 14.5% compared to 9,431,825 in 2024 [40]. - Occupancy percentage for operational beds improved to 82.2%, up 2.1% from 80.5% in 2024 [40]. Revenue Sources - Medicaid revenue for the year ended December 31, 2025, was $2,002,007, representing 39.8% of total revenue, slightly up from 39.7% in 2024 [51]. - Medicare revenue increased to $1,194,554, accounting for 23.7% of total revenue, down from 24.9% in 2024 [51]. - Managed care revenue for the year ended December 31, 2025, was $944,316, representing 18.8% of total revenue, up from 18.6% in 2024 [51]. - Total Medicaid and Medicare revenue combined was $3,497,683, making up 69.5% of total service revenue, down from 70.9% in 2024 [51]. Stock and Dividends - The company reported a strong liquidity position with approximately $503.9 million of cash on hand and $591.6 million of available capacity under its line-of-credit [6]. - The company plans to continue its dividend payments, having increased the dividend for the 23rd consecutive year [10]. - The company incurred $12,924 in stock-based compensation expense for the three months ended December 31, 2025, compared to $9,820 in the same period of 2024 [24]. - Stock-based compensation expense for Q4 2025 was $12,924, compared to $9,820 in Q4 2024, indicating a 31.5% increase [33]. Revenue Rates and Mix - The average daily revenue rate for Medicare increased to $817.48 from $784.12 in 2024 [44]. - The percentage of skilled nursing revenue from Medicare rose to 21.4% from 20.3% in 2024 [46]. - Skilled nursing revenue mix showed an increase in Medicare from 20.7% in 2024 to 21.4% in 2025 for same facilities [47]. - The percentage of skilled nursing days covered by Medicaid was 57.8% in 2025, slightly down from 58.4% in 2024 [47]. - Recently acquired facilities generated skilled services revenue of $653,063, a significant increase from $163,826 in 2024 [40]. - Same facility skilled services revenue grew by 6.5% to $3,424,421 from $3,214,896 in 2024 [40]. - Recently acquired facilities generated $221,949 in skilled services revenue in Q4 2025, a significant increase from $74,449 in Q4 2024 [38]. - The skilled mix by nursing revenue for Q4 2025 was 49.2%, up from 47.8% in Q4 2024, showing a 2.9% improvement [37]. - The skilled mix by nursing days improved to 30.7%, up from 29.9% in 2024 [40].

Core Insights - The Ensign Group, Inc. reported record operating results for the fiscal year and fourth quarter of 2025, with GAAP diluted earnings per share of $5.84 and adjusted earnings per share of $6.57 for the year, reflecting increases of 14.1% and 19.5% respectively compared to the previous year [1][6]. Operating Results - The company achieved a record year and quarter in key performance areas, attributing success to the dedication of its healthcare professionals [3]. - Ensign-affiliated facilities outperformed peers in clinical excellence, with a 24% advantage at the state level and 33% at the county level in annual survey results [4]. - Occupancy rates for same-store and transitioning facilities reached all-time highs of 83.8% and 84.9% respectively during the quarter [5]. Financial Performance - GAAP net income for the year was $344.0 million, a 15.4% increase year-over-year, while adjusted net income was $386.6 million, up 20.6% [6]. - Total skilled services revenue was $4.84 billion for the year, marking an 18.7% increase, with quarterly revenue of $1.30 billion, a 20.2% increase [6]. - The company reported a strong liquidity position with approximately $503.9 million in cash and $591.6 million available under its line of credit [8]. Growth and Acquisitions - Ensign added 17 new operations during the quarter, bringing the total acquisitions in 2025 to 51, indicating ongoing growth opportunities in various healthcare markets [8][9]. - The company plans to continue its strategy of acquiring both performing and underperforming operations across multiple states [11]. - Ensign's portfolio now includes 378 healthcare operations across 17 states, with a focus on both leasing and acquiring real estate [11]. Future Guidance - The company issued annual earnings guidance for 2026 of $7.41 to $7.61 per diluted share, representing a 14.3% increase over 2025 results [7]. - Management remains optimistic about organic growth potential, indicating that current occupancy levels allow for sustained earnings and revenue growth even without new acquisitions [7].

Operations and Facilities - As of December 31, 2025, the company operated 357 skilled nursing facilities with a total of 37,911 operational beds, generating approximately 46.6% of skilled services revenue from Medicaid and 24.7% from Medicare[26] - The company operates 373 facilities with a total of 37,911 skilled nursing beds and 3,402 senior living units as of December 31, 2025[81] - From January 1, 2021, to December 31, 2025, the company acquired 145 facilities, adding 14,739 operational skilled nursing beds and 1,148 senior living units[33] - In 2025, the company expanded operations by adding 40 skilled nursing operations and 5 senior living operations, contributing 4,175 skilled nursing beds and 313 senior living units[35] Revenue Sources - The company generated rental revenues of $126.9 million in 2025, with $107.6 million derived from independent subsidiaries, which were eliminated in consolidation[27] - Revenue is primarily derived from Medicaid, Medicare, managed care, and private pay patients, with Medicaid being the largest funding source for skilled nursing facilities[45][46] - Medicare currently accounts for approximately 24.7% of the company's skilled nursing services revenue year-to-date, making it the second-largest revenue payer[135] Quality of Care - The average score on the Overall Star Rating for all facilities is 6.8% better than the national average, with an average quality measure rating 18.2% better than the national average[41] - The company has a strong history of improving the quality of care in acquired facilities, with consistent improvements in star ratings post-acquisition[38] - The company aims to attract high acuity patients, which generally result in higher reimbursement rates, by maintaining a reputation for quality care[90] Workforce and Talent Development - The company emphasizes ongoing education and training for its staff, which is believed to enhance the quality of care provided[78] - The company has a rigorous "CEO-in-Training Program" with 70 to 80 prospective administrators progressing through training at any given time[88] - In 2025, approximately 89% of employees contributed to Elevate Charities Emergency Fund, demonstrating strong employee engagement[104] Market Trends and Demographics - The aging population in the U.S. is projected to increase from 17% to 21% by 2030, creating a growing demand for skilled nursing and senior living services[42] - The competitive landscape is characterized by numerous local and regional providers, with the company focusing on establishing a strong community reputation to attract patients[70][72] Financial Performance and Strategy - The company has a disciplined acquisition strategy focused on selectively acquiring operations within target markets, contributing to its growth[80] - The aggregate EBITDAR as a percentage of revenue for facilities acquired from 2002 through 2025 improved from 13.2% during the first three months of operations to 18.8% during the 45th quarter of operation[95] - The company plans to continue growth through talent development, increasing the mix of higher acuity patients, and acquiring additional operations in existing and new markets[33] Regulatory Environment - The company is sensitive to changes in state-based revenue programs, particularly Medicaid, which may face variability due to budget shortfalls and legislative changes[49] - The OBBB establishes a limit of $1.0 million for home equity that can be exempted from calculating an individual's eligibility for Medicaid in seeking long-term care starting January 1, 2028[118] - The OBBB reduces Medicaid retroactive eligibility from 90 days to 30 days for most enrollees, with a 60-day limit for long-term care residents[116] Medicare and Reimbursement Changes - For fiscal year 2026, CMS has finalized a 3.2% increase to SNF PPS payment rates, based on a final SNF market basket of 3.3% and adjustments[123] - The Patient-Driven Payment Model (PDPM) classifies residents based on clinical condition and care needs, incorporating five case-mix adjusted payment components[136] - The SNF Quality Reporting Program (SNF QRP) imposes a 2.0% payment rate reduction for facilities that fail to submit required quality data[138] Compliance and Legal Issues - Financial arrangements between healthcare providers are regulated under federal and state laws, including anti-kickback and Stark laws[205] - Violations of the Social Security Act can lead to criminal penalties exceeding $0.1 million and civil monetary penalties of more than $0.1 million per violation[207] - The Stark Law prohibits physicians from referring Medicare or Medicaid patients for designated health services to entities with which they have a financial relationship unless exceptions are met[208]

Group 1 - The Ensign Group, Inc. has acquired the real estate and operations of "Sunset Valley Rehabilitation and Healthcare Center," an 80-bed skilled nursing facility in Littlefield, Texas, effective February 1, 2026 [1][2] - The acquisition was made through Standard Bearer Healthcare REIT, Inc., Ensign's captive real estate company, with operations leased to an Ensign-affiliated tenant [1][3] - In addition, Ensign acquired the operations of "Agave Grove Post Acute," a 225-bed skilled nursing facility in Glendale, Arizona, also effective February 1, 2026 [4][5] Group 2 - These acquisitions expand Ensign's portfolio to 378 healthcare operations, including 47 senior living operations across 17 states [5] - Ensign subsidiaries, including Standard Bearer, own a total of 160 real estate assets [5] - The company is actively seeking further opportunities to acquire real estate and lease both well-performing and struggling skilled nursing and senior living facilities throughout the United States [5]

Core Insights - The Ensign Group, Inc. has acquired the operations of "Agave Grove Post Acute", a 225-bed skilled nursing facility in Glendale, Arizona, effective February 1, 2026 [1] - This acquisition is part of Ensign's strategy to expand its portfolio in Arizona, particularly in the Phoenix area [2] - Ensign's portfolio now includes 378 healthcare operations across 17 states, with 47 of those being senior living operations [4] Company Expansion - The acquisition of Agave Grove Post Acute aligns with Ensign's ongoing growth strategy in Arizona, following previous expansions in the state [2] - Ensign is actively seeking additional opportunities to acquire both well-performing and struggling skilled nursing and senior living facilities across the United States [4] Real Estate Operations - The real estate associated with the newly acquired facility was purchased by subsidiaries of Standard Bearer Healthcare REIT, Inc., which is Ensign's captive real estate company [3] - Ensign subsidiaries currently own 160 real estate assets, further solidifying their presence in the healthcare real estate market [4] Service Offerings - Ensign's independent operating subsidiaries provide a wide range of services, including skilled nursing, senior living, and various rehabilitative therapies across 378 healthcare facilities [5]

Core Insights - The Ensign Group, Inc. has acquired the real estate and operations of "Timber Ridge Health and Rehabilitation," a 48-bed skilled nursing facility in Stevens Point, Wisconsin, effective February 1, 2026 [1][3] - The acquisition is part of Ensign's strategy to expand its presence in the Wisconsin market, following previous acquisitions in 2024 and 2025 [2] - In addition to the Timber Ridge acquisition, Ensign also acquired the operations of "Agave Grove Post Acute," a 225-bed skilled nursing facility in Glendale, Arizona, on the same day [4] Company Expansion - Following these acquisitions, Ensign's portfolio now includes 378 healthcare operations across 17 states, comprising 47 senior living operations [5] - Ensign subsidiaries, including Standard Bearer Healthcare REIT, Inc., own a total of 160 real estate assets [5] - The company is actively seeking further acquisition opportunities in skilled nursing, senior living, and other healthcare-related businesses throughout the United States [5] Community Engagement - The President of Gateway Healthcare LLC emphasized the strong team and reputation of the Timber Ridge facility within the community, indicating a commitment to maintaining high service standards [3]