Ensign Beats Wall Street Estimates, Posts Strong 3Q26 Earnings

The Ensign Group, Inc. (Nasdaq: ENSG) announced operating results for the third quarter of 2026, reporting GAAP diluted earnings per share of $1.76 and adjusted earnings per share of $2.03. The company called the results “outstanding” on both a financial and clinical basis and raised its yearly earnings estimates as well.

Wall Street reacted favorably, with after-hours trade showing Ensign stock up more than $10, or 6 percent, at around $180 per share. The adjusted earnings of $2.03 per share bested Street expectations for $1.97 a share.

"We are thrilled to report another outstanding quarter. Our teams continue to demonstrate their unwavering commitment to dignifying post-acute care through moments of truth. Our core values, which our teams refer to using the acronym CAPLICO, create a shared culture that empowers nearly 60,000 partners to lead with compassion, accountability, ownership, and a relentless commitment to excellence,” said Barry Port, CEO of The Ensign Group. 

"Our clinical leaders also continue to drive outstanding outcomes, which is particularly impressive given our growth over the past several years. According to the most recently published CMS data, our Same Facilities achieved annual survey results that were 15 percent better at the state level and 28 percent better at the county level,” he said.

Port added that this is especially notable given that many of these facilities were 1- and 2-Star buildings at acquisition.

“Additionally, our Same Facilities outperformed in 5-Star Quality Measure results by 21 percent at the state level. These results reinforce our position as the provider of choice in our markets and demonstrate our ability to create long-term value through sustained clinical excellence,” he said.

Clinical Highlights:

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• - Over 80 percent of Ensign’s skilled nursing operations earned a CMS Quality Measure rating of 4 or 5 stars.

• - Short-stay residents achieved functional improvement rates 30 percent better than industry peers in Ensign’s operating states.

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  - Long-stay residents had antipsychotic medication rates 28 percent better than industry peers in Ensign operating states.

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• - Administrator turnover for Same Facilities was 45 percent lower than industry peers in Ensign operating states.

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• - Some 12 percent of all Ensign’s eligible operations, comprised of 40 buildings in 8 different states, earned CMS High Performing designations under its new Risk-Based Survey program, placing them among a select group of facilities recognized by CMS for consistently strong performance.

Financial Highlights:

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• - GAAP diluted earnings per share for the quarter was $1.76, an increase of 23.9 percent over the prior year quarter, and adjusted diluted earnings per share for the quarter was $2.03, an increase of 23.8 percent over the prior year quarter.

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• - GAAP net income was $104.3 million for the quarter, an increase of 24.4 percent over the prior year quarter, and adjusted net income was $120.5 million for the quarter, an increase of 24.9 percent over the prior year quarter.

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• - Same Facilities and Transitioning Facilities occupancy for the quarter were 84.1 percent and 86.1 percent, an increase of 1.6 percent and 3.9 percent, respectively, over the prior year quarter.

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• - Same Facilities and Transitioning Facilities skilled mix revenue for the quarter increased by 10.7 percent and 10.5 percent, respectively, over the prior year quarter and skilled days for the quarter increased by 7.2 percent and 7.9 percent, respectively, over the prior year quarter.

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• - Consolidated revenue for the quarter was $1.48 billion, an increase of 14.5 percent over the prior year quarter.

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Port said, “due to the strength of the third quarter and our confidence in the fourth quarter, we are increasing our annual 2026 earnings guidance to $7.94 to $8.02 per diluted share, up from our original guidance of $7.75 to $7.85. We are also raising the lower end of our annual revenue guidance to $5.89 billion, while maintaining the upper end at $5.92 billion. The midpoint of our earnings guidance represents a 21.5 percent increase over 2025 and 45.5 percent growth over 2024."

Acquisitions

Speaking to the company’s acquisition growth, Chad Keetch, Ensign’s chief investment officer and executive vice president said, “We continue to acquire new operations with significant long-term upside and expect to maintain a healthy pace of growth as we expand our mission driven approach to transform and dignify post-acute care. During the quarter and since, we accelerated our growth by adding 22 new operations, including three real estate assets and 19 leased operations. We also acquired five real estate properties that were under lease arrangements that we are operating.”

He added that since 2024, “we have successfully sourced, underwritten, closed, and transitioned 122 new operations across several markets, many of which are already performing at or above expectations, both clinically and financially. We continue to see opportunities that include everything from larger portfolios, landlords looking to replace current tenants, non-profits looking to divest of their post-acute assets and a steady flow of traditional one offs. We have several new additions lining up for next year as our local leadership and their partners at the Service Center work together to source, underwrite and carefully select the right opportunities.”

The recent acquisitions include the following leased operations:

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• - Delta Post Acute and Rehabilitation, an 80-bed skilled nursing facility located in Delta, Colo.;

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• - La Villa Grande Care Center, a 96-bed skilled nursing facility located in Grand Junction, Colo.;

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• - Milestone Health and Rehabilitation, a 190-bed skilled nursing facility located in Littleton, Colo.;

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• - Monument Ridge Health and Rehabilitation, an 88-bed skilled nursing facility located in Grand Junction, Colo.;

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• - Pendant Health and Rehabilitation, a 130-bed skilled nursing facility located in Lakewood, Colo.;

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• - Skyline Ridge Health and Rehabilitation, a healthcare campus with 85 skilled nursing beds and 47 independent living units located in Canon City, Colo.;

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• - Spring Village Care Center, a 91-bed skilled nursing facility located in Colorado Springs, Colo.;

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• - Burien Nursing and Rehabilitation, a 140-bed skilled nursing facility located in Burien, Wash.;

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• - Issaquah Nursing and Rehabilitation, a 140-bed skilled nursing facility located in Issaquah, Wash.;

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• - Park Ridge Nursing and Rehabilitation, a 115-bed skilled nursing facility located in Shoreline, Wash.;

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• - Park West Nursing and Rehabilitation, a 137-bed skilled nursing facility located in Seattle, Wash.;

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• - Bay Park Post-Acute and Rehabilitation, a 101-bed skilled nursing facility located in Sarasota, Fla.;

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• - Carrabelle Post-Acute and Rehabilitation, a 90-bed skilled nursing facility located in Carrabelle, Fla.;

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• - Cedar Hill Post-Acute and Rehabilitation, a 120-bed skilled nursing facility located in Jacksonville, Fla.;

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• - Davenport Post-Acute and Rehabilitation, a healthcare campus with 60 skilled nursing beds and 66 independent living units located in Davenport, Fla.;

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• - Greenville Post-Acute and Rehabilitation, a 58-bed skilled nursing facility located in Greenville, Fla.;

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• - Lake Haven Post-Acute and Rehabilitation, a 104-bed skilled nursing facility located in Dunedin, Fla.;

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• - Monticello Post-Acute and Rehabilitation, a 60-bed skilled nursing facility located in Monticello, Fla.; and

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• - Shores Post-Acute and Rehabilitation, a 120-bed skilled nursing facility located in Port Saint Joe, Fla.

Standard Bearer announced the following real estate acquisitions, which are operated by an Ensign-affiliate: 

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• - Las Ventanas de Socorro, a 126-bed skilled nursing facility located in Socorro, Texas; 

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• - Los Arcos del Norte Care Center, a 124-bed skilled nursing facility located in El Paso, Texas; and

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• - Englewood Heights Nursing and Rehabilitation, a 118-bed skilled nursing facility located in Pensacola, Fla.

Additionally, Standard Bearer announced it acquired the real estate assets of five facilities that were previously operated under third-party triple net leases. These facilities total 755 skilled nursing beds and are now subject to long-term leases with subsidiaries of Standard Bearer.

Ensign said its growing portfolio consists of 418 healthcare operations, 34 of which also include senior living operations, across 18 states. Ensign now owns 189 real estate assets, 150 of which are operated by an Ensign affiliate.

Ensign continues to provide additional disclosure on Standard Bearer, which is comprised of 183 owned properties. Of these assets, 146 are leased to Ensign-affiliated operators and 38 are leased to third-party operators. Keetch noted that each of these properties are subject to triple-net, long-term leases and generated rental revenue of $47.7 million for the quarter, of which $42.1 million was derived from Ensign affiliated operations. For the quarter, Ensign reported $27.3 million in FFO.

The company also said it paid a quarterly cash dividend of $0.065 per share of Ensign common stock.

Comments? Contact Patrick Connole at pconnole@parkplacelive.com.