The Ensign Group reported GAAP diluted earnings per share of $5.84 for the year ended December 31, 2025, up 14.1% from fiscal 2024, and GAAP diluted EPS of $1.61 for Q4 2025, an 18.4% increase over the prior-year quarter. Adjusted diluted EPS for fiscal 2025 rose 19.5% to $6.57, while adjusted Q4 EPS climbed 22.1% to $1.82. GAAP net income reached $344.0 million for the full year (up 15.4%) and $95.5 million in Q4 (up 19.8%), while adjusted net income grew 20.6% to $386.6 million annually and 23.2% to $107.8 million in the quarter. Consolidated revenue for 2025 totaled $5.06 billion, an 18.7% gain, with Q4 revenue of $1.36 billion, up 20.2%. Occupancy at same facilities improved to 82.9% for the year and 83.8% in the quarter, and transitioning facility occupancy rose to 84.2% and 84.9%, respectively.

Ensign’s same-facility skilled days increased by 6.8% for the year and 8.5% in Q4, while transitioning facilities saw gains of 10.7% and 10.0%. Medicare revenue at same facilities grew 11.5% for the full year and 15.7% in Q4, and by 9.4% and 11.3% at transitioning sites. According to the latest CMS data, Ensign-affiliated facilities outperformed state peers by 24% and county peers by 33% in annual surveys, and maintained a 19% advantage in overall 4- and 5-star ratings versus peers, despite many acquired communities starting at 1- and 2-star levels.

Management issued 2026 guidance of $7.41 to $7.61 in diluted EPS, implying a 14.3% midpoint increase over 2025, and projected consolidated revenue of $5.77 billion to $5.84 billion. The outlook assumes approximately 60.0 million weighted average common shares outstanding, a 25% tax rate, normalized insurance costs, and expected acquisition closings through Q1 2026. Guidance excludes non-recurring charges, system implementation amortization, acquisition costs and share-based compensation.

Since February 1, 2026, Ensign has expanded its portfolio by acquiring real estate and operations of four skilled nursing facilities: The Chateau Waco (123 beds) in Waco, Texas; Wylie Oaks Healthcare and Rehabilitation (106 beds) in Wylie, Texas; Sunset Valley Rehabilitation and Healthcare Center (80 beds) in Littlefield, Texas; and Timber Ridge Health and Rehabilitation (48 beds) in Stevens Point, Wisconsin. In a separate transaction, the Company took over operations at Agave Grove Post Acute, a 225-bed facility in Glendale, Arizona, under a long-term triple net lease. These transactions bring Ensign’s total to 378 healthcare operations and 160 owned real estate assets across 17 states.