Highlights

  • Second quarter 2026 total revenue was $1,440,481 thousand, and net income attributable to Ensign was $99,738 thousand, or $1.68 per diluted share.
  • Skilled services same facility occupancy was 84.1% in the second quarter of 2026, compared with 81.9% in the second quarter of 2025.
  • The board approved a repurchase program of up to $40.0 million, later amended to add $60.0 million, with $60.0 million remaining.
  • Cash and cash equivalents were $262.3 million at June 30, 2026, with no outstanding borrowings under the $600.0 million credit facility.

Ensign Group (NASDAQ: ENSG) shares were trading at USD 170.32 on October 27, 2026, down 3.73%, with a relative volume at time of 2.57. The post-acute care operator approved a share repurchase program on May 13, 2026, amended it on June 12, 2026, and filed its quarterly report on Form 10-Q for the quarter ended June 30, 2026 on July 27, 2026.

The Ensign Group, Inc. is a Delaware corporation with principal executive offices at 29222 Rancho Viejo Road, San Juan Capistrano, California. It is a holding company with no direct operating assets, employees or revenue. Its independent subsidiaries provide health care services across the post-acute care continuum and own, acquire, develop and lease skilled nursing, senior living and other healthcare-related properties. As of June 30, 2026, they operated 396 facilities and other ancillary operations in 17 states, with approximately 40,700 operational skilled nursing beds and 3,400 senior living units. Its fiscal year ends December 31.

Second Quarter 2026 Results

Total revenue was $1,440,481 thousand for the three months ended June 30, 2026, compared with $1,227,769 thousand a year earlier, an increase of $212.7 million, or 17.3%. Income from operations was $122,504 thousand, and income before provision for income taxes was $133,674 thousand.

Net income was $99,834 thousand. Net income attributable to The Ensign Group, Inc. was $99,738 thousand, or $1.72 per basic share and $1.68 per diluted share, compared with $84,396 thousand, or $1.48 and $1.44, in the second quarter of 2025. Adjusted earnings per share, a non-GAAP measure, was $1.92, compared with $1.59. Adjusted EBITDA, a non-GAAP measure, was $181,149 thousand.

For the six months ended June 30, 2026, total revenue was $2,829,677 thousand and diluted EPS was $3.35, compared with $2.81.

Operating Metrics and Acquisitions

Skilled services revenue was $1,379,912 thousand in the quarter, with occupancy of 82.9% of operational beds, compared with 81.3%. Same facility occupancy was 84.1%, and transitioning facility occupancy was 84.7%. The company said recently acquired facilities added $133.5 million to revenue.

During the six months ended June 30, 2026, the company added 21 stand-alone skilled nursing operations and two campus operations in four states, adding 2,724 operational skilled nursing beds and 135 operational senior living units. After June 30, 2026, it added two stand-alone skilled nursing operations in Texas with 250 operational skilled nursing beds. Its captive REIT, Standard Bearer, added $374.6 million of real estate assets during the six months.

Balance Sheet, Cash Flow and Capital

Cash and cash equivalents were $262.3 million at June 30, 2026. Cash paid to fund acquisitions was $376.0 million for the six months. Capital expenditures for property and equipment were $88.3 million, and the company said it has approximately $175.0 million budgeted for renovation projects in 2026.

Net cash provided by operating activities was $272,108 thousand for the six months, and net cash used in investing activities was $478,893 thousand. The company repurchased 257 thousand shares for $40.0 million during the quarter. It has no outstanding borrowings under its revolving credit facility of up to $600.0 million, which matures on April 8, 2027. Mortgage loans insured with HUD and a promissory note totaled $142.3 million.

Legal and Regulatory Matters

The filing discloses several open matters. California's Office of Health Care Affordability issued an investigatory subpoena on October 10, 2025 in a Cost and Market Impact Review, and the company filed a petition in Orange County Superior Court seeking a declaration that the review regulations are void as applied to it. A purported stockholder filed a derivative complaint on July 16, 2026 against current and former directors and officers, with the company as nominal defendant. The company also received a Civil Investigative Demand from the U.S. Department of Justice in 2024 and has recorded an accrual of $12,000 thousand related to a proposed California wage and hour class settlement pending court approval.