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ENSG Tops Q1 EPS Estimates on Patient Growth, Raises '26 Outlook

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Key Takeaways

  • ENSG beat Q1 EPS estimates with 21.7% growth, driven by higher occupancy and patient days.
  • Revenues rose 18.4% to $1.4B, aided by acquisitions and rental income, but missed estimates slightly.
  • Ensign Group raised 2026 outlook, projecting up to $5.86B revenues and EPS between $7.48 and $7.62.

The Ensign Group, Inc. (ENSG - Free Report) reported a first-quarter 2026 adjusted EPS of $1.85, which beat the Zacks Consensus Estimate by 3.4%. The bottom line improved 21.7% year over year.

Operating revenues advanced 18.4% year over year to $1.4 billion. The top line marginally missed the consensus mark by 0.07%.

ENSG’s strong results were driven by higher occupancy, improved patient days and contributions from acquired and transitioning facilities, along with growth in rental income. The positives were partly offset by higher expenses.

The Ensign Group, Inc. Price, Consensus and EPS Surprise

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 Q1 Update

Ensign Group’s adjusted net income of $110.2 million rose 23.9% year over year. Same-facilities occupancy improved 190 basis points (bps) to 84.3%, while transitioning-facilities occupancy increased 310 bps year over year to 85.1%.

Total expenses escalated 18% year over year to $1.26 billion due to higher cost of services, rent and G&A costs, but came in lower than our estimate of $1.27 billion.

Ensign Group’s Segmental Update

Skilled Services: The segment’s revenues totaled $1.3 billion, which grew 18.4% year over year but missed our estimate by 0.4%. The metric benefited from higher occupancy rates and improved patient days. Segment income of $174 million advanced 20.9% year over year. Skilled nursing facilities and campus operations were 331 and 31, respectively.

Standard Bearer: Rental revenues climbed 27.1% year over year to $36.1 million in the quarter. The metric benefited from real estate purchases and increased annual rent. Segment income of $10.8 million advanced 25.9% year over year. Funds from operations amounted to $21.6 million, which increased 26.6% year over year.

ENSG’s Financial Update (As of March 31, 2026)

Ensign Group exited the first quarter with cash and cash equivalents of $539.5 million, which rose from the 2025-end figure of $503.9 million. It had $591.6 million of available capacity under its line-of-credit. Total assets of $5.6 billion increased from $ 5.5 billion at the end of 2025.

Long-term debt — less current maturities — totaled $136.5 million, down from $137.5 million as of Dec. 31, 2025. Current maturities of long-term debt amounted to $4.3 million.

Total equity of $2.4 billion advanced from the 2025-end figure of $2.2 billion.

ENSG generated net cash from operations of $100.2 million, up from $72.2 million.

Ensign Group’s Capital-Deployment Update

As of March 31, 2026, $20.0 million remained available under the company’s stock repurchase program. The company also paid a quarterly cash dividend of 6.5 cents per share of Ensign common stock.

ENSG’s 2026 Outlook

ENSG has raised its full-year 2026 outlook. Revenues are now expected to range between $5.81 billion and $5.86 billion compared with the prior guidance of $5.77-$5.84 billion. Adjusted EPS is projected to be in the band of $7.48-$7.62 per share, up from the earlier estimate of $7.41-$7.61.

The weighted average common shares outstanding is currently estimated to be around 60 million and the tax rate is anticipated to be 25%.

ENSG’s Zacks Rank

Ensign currently has a Zacks Rank #4 (Sell).

You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

Other Medical Sector Releases

Here are some stocks from the broader Medical space that have also reported their quarterly results: HCA Healthcare, Inc. (HCA - Free Report) , UnitedHealth Group Incorporated (UNH - Free Report) and Elevance Health, Inc. (ELV - Free Report) .

HCA Healthcare reported first-quarter 2026 adjusted earnings per share of $7.15, slightly below the Zacks Consensus Estimate of $7.17, though up 10.9% year over year. Revenues increased 4.3% to $19.1 billion but narrowly missed the consensus estimate by 0.1%. HCA’s performance was affected by declines in same-facility inpatient and outpatient surgeries, along with elevated operating expenses, partially offset by modest growth in emergency room visits.

UnitedHealth Group reported first-quarter 2026 adjusted earnings per share of $7.23, which surpassed the Zacks Consensus Estimate of $6.46 and increased 0.4% year over year. Revenues rose 2% to $111.7 billion and exceeded the consensus estimate by 2.1%. UNH’s performance was driven by growth in commercial fee-based membership and strength in Optum Rx, partially offset by weakness in Optum Health and a decline in risk-based membership.

Elevance Health reported first-quarter 2026 adjusted earnings per share of $12.58, which beat the Zacks Consensus Estimate by 17.8% on the back of strong premium growth. The bottom line increased 5.1% year over year. ELV’s operating revenues rose 1.5% to $49.5 billion and exceeded the consensus estimate by 3.7%. Segment-wise, the Carelon division delivered robust revenue growth, supported by the scaling of risk-based services, while the Health Benefits segment benefited from higher premium yields.

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