Investor Presentation November 6, 2025 Leading senior living operator in the United States Forward-Looking Statements – Safe Harbor Certain statements in this Investor Presentation may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are subject to various risks and uncertainties and include all statements that are not historical statements of fact and those regarding our intent, belief, or expectations. Forwar ...

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Company Overview - The Ensign Group, Inc's independent subsidiaries have provided post-acute care since 1999[6] - The company operates 348 facilities across 17 states[18] - The company has 39,000+ beds/units across the care continuum[18] - The company has 52,000+ employees[18] Financial Performance and Growth - The company's 2025 revenue guidance is $5 billion[18] - The company's 2025 EPS guidance is $6.40[18] - The company's skilled nursing operations have been operated less than three full years is 29.9%[59] - The company's same store SNF occupancy is 82.1%[18, 71] - The company's same store skilled mix days is 32.4%[18, 74] - The company's net cash provided by operating activities for the six months ended June 30, 2025, was $228 million[123] - The company's consolidated adjusted net income for Q2 2025 was $93.3 million, an increase of 22.1% compared to Q2 2024[126] - The company's revenue for the six months ended June 30, 2025, was $2.4008 billion, an increase of 17.3% compared to 2024[130] - The company's consolidated adjusted net income for the six months ended June 30, 2025, was $182.3 million, an increase of 20.1% compared to 2024[130] Real Estate Portfolio (Standard Bearer REIT) - Standard Bearer REIT has 140 properties[98] - Standard Bearer REIT's real estate fair value is $1.6 billion[98] - Standard Bearer REIT has 14,272 operating beds/units[98] - Standard Bearer REIT's weighted average lease tenor is 14.6 years[98] - 84.6% of Standard Bearer REIT is Ensign Operated[98]

Financial Data and Key Metrics Changes - The company achieved a GAAP diluted earnings per share of $1.37, an increase of 15.1% year-over-year, and adjusted diluted earnings per share of $1.52, an increase of 16.9% [25] - Consolidated GAAP revenue and adjusted revenues were both $1,200,000,000, reflecting a 16.1% increase [25] - GAAP net income was $80,300,000, up 16.6%, while adjusted net income reached $89,000,000, an increase of 18% [25][26] - The company raised its annual 2025 earnings guidance to between $6.22 and $6.38 per diluted share, up from $6.16 to $6.34 per diluted share, representing a 14.5% increase over 2024 results [9][29] Business Line Data and Key Metrics Changes - Same store occupancy increased to 82.6%, while transitioning occupancy rose to 83.5%, both showing significant improvement over the prior year [8] - Skilled census increased by 7.6% for same store operations and 9.9% for transitioning operations compared to the prior year [8] - Managed care census grew by 8.9% for same store and 15.6% for transitioning operations over the prior year [8] Market Data and Key Metrics Changes - The company added 47 new operations since January 2024, including 19 new operations in the latest quarter, expanding its footprint across multiple states [12][14] - The addition of 1,906 new skilled nursing beds and 200 senior living units across eight states demonstrates the company's growth strategy [13] Company Strategy and Development Direction - The company is focused on organic growth potential in its existing portfolio while continuing to pursue acquisition opportunities [10][17] - There is a commitment to maintaining a disciplined acquisition strategy, ensuring that growth aligns with leadership capabilities and market conditions [17][18] - The company aims to deepen its presence in established markets while exploring new opportunities in regions like the Southeast [16][69] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to achieve sustainable growth despite external challenges, emphasizing strong operational fundamentals [7][11] - The company is actively involved in advocacy regarding potential changes in Medicaid funding, ensuring that its interests are represented [38][40] - Management noted that the operating environment remains favorable, with opportunities for both leasing and acquiring post-acute care assets [17][18] Other Important Information - The company reported cash and cash equivalents of $282,700,000 and cash flow from operations of $72,200,000 [26] - A quarterly cash dividend of $6.25 per common share was declared, continuing a history of annual dividend increases for 22 consecutive years [28] Q&A Session Summary Question: Can you provide an overview of the appetite for value-based and outcome-based contracts? - Management highlighted a long history of engagement with managed care, emphasizing local partnerships that drive clinical success and financial returns [33][34] Question: What are the latest thoughts on potential Medicaid cuts? - Management is actively involved in advocacy efforts to educate Congress on the implications of potential changes to Medicaid funding, noting a focus on the expansion population [38][40] Question: How sustainable is the current pace of investment? - The company noted a strong deal flow and a disciplined approach to acquisitions, with a focus on real estate investments [48][49] Question: Are there still staffing constraints affecting admissions? - Management indicated that while the sector has not fully recovered from staffing shortages, the company has successfully filled positions to maintain occupancy levels [54][56] Question: What is the anticipated Medicaid rate update across the portfolio? - Management stated that discussions with states regarding Medicaid funding are ongoing, but there has been no proactive engagement due to the fluid nature of federal discussions [71][73]

Company Overview - The Ensign Group, Inc. (ENSG) has been providing post-acute care since 1999 through its independent subsidiaries [6] - The company operates 343 facilities with over 38,000 beds/units across the care continuum and employs more than 50,500 individuals [18] - The company has experienced a 15% annual revenue growth rate and a 16% annual EBITDAR growth rate since 2014 [18] Financial Performance and Guidance - The company's 2025 revenue guidance is $4.91 billion [18] - The company's 2025 EPS guidance is $6.30 [18] - Q1 2025 revenue reached $1.173 billion, a 16.1% increase compared to Q1 2024 [113] - Same facility skilled nursing facility revenue increased by 5.6% in Q1 2025 compared to Q1 2024 [113] - Consolidated adjusted net income increased by 18.0% in Q1 2025 compared to Q1 2024, reaching $89 million [113] Portfolio and Acquisitions - The company operates in 17 states [19, 35] - The company has 143 owned properties [19] - The company's occupancy rate is 82.6% [19] - The company's skilled mix days is 33.1% [19] - The company completed 73 acquisitions since 2023 [22] - The company completed 16 acquisitions from January 1, 2025, to April 1, 2025 [21] Standard Bearer REIT - Standard Bearer REIT has 137 properties with a real estate fair value of $1.5 billion [85] - Standard Bearer REIT operates in 16 states with 13,920 operating beds/units [85] - Standard Bearer REIT has a weighted average lease tenor of 14.3 years [85, 91] - 98% of Standard Bearer REIT's leases expire after 2031 [92] - Standard Bearer REIT's total rental revenue for Q1 2025 was $28.401 million, including $4.497 million from third-party tenants and $23.904 million from Ensign's independent subsidiaries [146]