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Ensign Group Q4 Earnings Beat Estimates on Growing Occupancy
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Key Takeaways
Ensign Group posted Q4 adjusted EPS of $1.82, beating estimates as revenue grew 20.2% year over year.
Ensign Group benefited from higher patient days as same-facility occupancy rose 240 bps.
ENSG forecast 2026 revenue of $5.77-$5.84B and adjusted EPS of $7.41-$7.61, above 2025 levels.
The Ensign Group, Inc. (ENSG - Free Report) reported a fourth-quarter 2025 adjusted EPS of $1.82, which beat the Zacks Consensus Estimate by 4%. The bottom line improved 19.5% year over year.
Operating revenues advanced 20.2% year over year to $1.36 billion. The top line missed the consensus mark by 0.5%.
The strong earnings were supported by improved occupancy rates, higher patient days and higher skilled service performance. The positives were partly offset by higher expenses.
The Ensign Group, Inc. Price, Consensus and EPS Surprise
Ensign Group’s adjusted net income of $107.8 million rose 23.2% year over year in the quarter under review. Same-facilities occupancy improved 240 basis points (bps) to 83.8%, while transitioning-facilities occupancy increased 290 bps year over year to 84.9%.
Total expenses escalated 19.9% year over year to $1.24 billion due to higher cost of services, rent and G&A costs, but came lower than our estimate of $1.25 billion.
Ensign Group’s Segmental Update
Skilled Services: The segment’s revenues were $1.3 billion in the fourth quarter, which grew 20.2% year over year but missed our estimate by 1.5%. The metric benefited from the back of higher occupancy rates and improved patient days. Segment income of $169.3 million advanced from $141 million a year ago. Skilled nursing facilities and campus operations of the segment totaled 326 and 31, respectively, at the quarter-end.
Standard Bearer: Rental revenues climbed 37.2% year over year to $34.5 million in the quarter under review. The metric was aided by buyouts. Segment income of $10.3 million advanced 38.3% year over year. Funds from operations were $20.4 million, which increased 33.9% year over year.
ENSG’s Financial Update (As of Dec. 31, 2025)
Ensign Group exited the fourth quarter with cash and cash equivalents of $503.9 million, which rose from the 2024-end figure of $464.6 million. It had a leftover capacity of $591.6 million under its line of credit at the fourth-quarter end. Total assets of $5.5 billion increased from the $ 4.7 billion level at 2024-end.
Long-term debt — less current maturities — was $137.5 million, down from the $141.6 million figure as of Dec. 31, 2024. Current maturities of long-term debt amounted to $4.2 million.
Total equity of $2.2 billion advanced from the 2024-end figure of $1.8 billion.
ENSG generated net cash from operations of $564.3 million in 2025, which increased from $347.2 million.
ENSG Provides 2026 Outlook
Revenues are forecasted to lie between $5.77 billion and $5.84 billion in 2026, up from the 2025 level of $5.06 billion, which grew 18.7% year over year. Adjusted EPS is anticipated to be within $7.41-$7.61 for 2026, higher than the 2025 level of $6.57, which grew 19.5% from a year ago.
The weighted average common shares outstanding is currently estimated at around 60 million and the tax rate is expected to be 25%.
Companies belonging to the broader Medical space, like HCA Healthcare, Inc. (HCA - Free Report) , Elevance Health, Inc. (ELV - Free Report) and UnitedHealth Group Incorporated (UNH - Free Report) , have also reported results for the December quarter. Here’s how they have performed:
HCA Healthcare reported fourth-quarter 2025 adjusted EPS of $8.01, which outpaced the Zacks Consensus Estimate by 8.8% on the back of strong admissions. Modest gains in emergency room visits and a rise in revenue per equivalent admission also supported performance. However, the upside was partly offset by HCA Healthcare’s elevated operating expenses.
Elevance Health reported fourth-quarter 2025 adjusted EPS of $3.33, which surpassed the Zacks Consensus Estimate by 7.3%, on the back of strong growth in premiums. Segment-wise, the Carelon division posted a robust revenue surge, aided by buyout and scaling risk-based services, while Health Benefits saw increased premium yields and Medicare Advantage membership growth. However, the upside was partly offset by a decline in Elevance Health’s overall medical membership and an elevated expense level.
UnitedHealth Group reported fourth-quarter 2025 adjusted earnings per share of $2.11, which beat the Zacks Consensus Estimate of $2.09 on higher commercial fee-based membership and the strength witnessed in Optum Rx. However, the bottom line declined 69% year over year due to elevated medical costs. UnitedHealth’s revenues rose 12% year over year to $113.2 billion. The top line marginally missed the consensus mark.
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Ensign Group Q4 Earnings Beat Estimates on Growing Occupancy
Key Takeaways
The Ensign Group, Inc. (ENSG - Free Report) reported a fourth-quarter 2025 adjusted EPS of $1.82, which beat the Zacks Consensus Estimate by 4%. The bottom line improved 19.5% year over year.
Operating revenues advanced 20.2% year over year to $1.36 billion. The top line missed the consensus mark by 0.5%.
The strong earnings were supported by improved occupancy rates, higher patient days and higher skilled service performance. The positives were partly offset by higher expenses.
The Ensign Group, Inc. Price, Consensus and EPS Surprise
The Ensign Group, Inc. price-consensus-eps-surprise-chart | The Ensign Group, Inc. Quote
ENSG’s Q4 Update
Ensign Group’s adjusted net income of $107.8 million rose 23.2% year over year in the quarter under review. Same-facilities occupancy improved 240 basis points (bps) to 83.8%, while transitioning-facilities occupancy increased 290 bps year over year to 84.9%.
Total expenses escalated 19.9% year over year to $1.24 billion due to higher cost of services, rent and G&A costs, but came lower than our estimate of $1.25 billion.
Ensign Group’s Segmental Update
Skilled Services: The segment’s revenues were $1.3 billion in the fourth quarter, which grew 20.2% year over year but missed our estimate by 1.5%. The metric benefited from the back of higher occupancy rates and improved patient days. Segment income of $169.3 million advanced from $141 million a year ago. Skilled nursing facilities and campus operations of the segment totaled 326 and 31, respectively, at the quarter-end.
Standard Bearer: Rental revenues climbed 37.2% year over year to $34.5 million in the quarter under review. The metric was aided by buyouts. Segment income of $10.3 million advanced 38.3% year over year. Funds from operations were $20.4 million, which increased 33.9% year over year.
ENSG’s Financial Update (As of Dec. 31, 2025)
Ensign Group exited the fourth quarter with cash and cash equivalents of $503.9 million, which rose from the 2024-end figure of $464.6 million. It had a leftover capacity of $591.6 million under its line of credit at the fourth-quarter end. Total assets of $5.5 billion increased from the $ 4.7 billion level at 2024-end.
Long-term debt — less current maturities — was $137.5 million, down from the $141.6 million figure as of Dec. 31, 2024. Current maturities of long-term debt amounted to $4.2 million.
Total equity of $2.2 billion advanced from the 2024-end figure of $1.8 billion.
ENSG generated net cash from operations of $564.3 million in 2025, which increased from $347.2 million.
ENSG Provides 2026 Outlook
Revenues are forecasted to lie between $5.77 billion and $5.84 billion in 2026, up from the 2025 level of $5.06 billion, which grew 18.7% year over year. Adjusted EPS is anticipated to be within $7.41-$7.61 for 2026, higher than the 2025 level of $6.57, which grew 19.5% from a year ago.
The weighted average common shares outstanding is currently estimated at around 60 million and the tax rate is expected to be 25%.
Ensign currently has a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.
How Other Medical Companies Performed?
Companies belonging to the broader Medical space, like HCA Healthcare, Inc. (HCA - Free Report) , Elevance Health, Inc. (ELV - Free Report) and UnitedHealth Group Incorporated (UNH - Free Report) , have also reported results for the December quarter. Here’s how they have performed:
HCA Healthcare reported fourth-quarter 2025 adjusted EPS of $8.01, which outpaced the Zacks Consensus Estimate by 8.8% on the back of strong admissions. Modest gains in emergency room visits and a rise in revenue per equivalent admission also supported performance. However, the upside was partly offset by HCA Healthcare’s elevated operating expenses.
Elevance Health reported fourth-quarter 2025 adjusted EPS of $3.33, which surpassed the Zacks Consensus Estimate by 7.3%, on the back of strong growth in premiums. Segment-wise, the Carelon division posted a robust revenue surge, aided by buyout and scaling risk-based services, while Health Benefits saw increased premium yields and Medicare Advantage membership growth. However, the upside was partly offset by a decline in Elevance Health’s overall medical membership and an elevated expense level.
UnitedHealth Group reported fourth-quarter 2025 adjusted earnings per share of $2.11, which beat the Zacks Consensus Estimate of $2.09 on higher commercial fee-based membership and the strength witnessed in Optum Rx. However, the bottom line declined 69% year over year due to elevated medical costs. UnitedHealth’s revenues rose 12% year over year to $113.2 billion. The top line marginally missed the consensus mark.