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ENSGThe Ensign Group, Inc.Sell5.4·$168.22+2.06%
SellModerate Confidence
Investment thesis

ENSG has beaten consensus four consecutive quarters and trades roughly 27% below the analyst-derived target of $191.75 with a risk/reward of approximately 3.9-to-1 in your favor, but a severe momentum breakdown — RSI at 25 with falling volume and confirming bearish technicals — and a pending legal news overhang argue for waiting until price stabilizes before establishing a position.

Thesis pillars

  • Four Consecutive Earnings BeatsStable
  • Favorable Risk Reward GeometryStable
  • Momentum Breakdown Blocks EntryStable
  • +1 more pillar — see the Why tab for full reasoning

Full reasoning →

Open full analysis

The Ensign Group, Inc. (ENSG) Stock Analysis

Recovery setup · Catalyst-Driven edge

SellModerate Confidence

Healthcare · Medical Care Facilities

Sell if holding. At $168.22, A.R:R 0.9:1 is below the 1.5:1 minimum. Reward from here is too thin for a buy — the engine flags exit. Additional concerns: Below 200-day MA; Concentration risk — Product: skilled nursing facilities (95.6%).

The Ensign Group operates 373 skilled nursing and senior living facilities across 17 states, generating approximately 95.6% of revenue from skilled nursing. Revenue flows from Medicaid (45.8% of 2025 total revenue), Medicare (23.7% of service revenue), managed care, and private... Read more

$168.22+14.0% A.UpsideScore 5.4/10#23 of 36 Medical Care Facilities
QualityF-score7 / 9FCF yield2.96%
IncomeYield0.15%(5y avg 0.21%)Payout4.15%sustainable
Stop $156.58Target $191.75(analyst − 13%)A.R:R 0.9:1
Analyst target$220.40+31.0%5 analysts
$191.75our TP
$168.22price
$220.40mean
$230

Sell if holding. At $168.22, A.R:R 0.9:1 is below the 1.5:1 minimum. Reward from here is too thin for a buy — the engine flags exit. Additional concerns: Below 200-day MA; Concentration risk — Product: skilled nursing facilities (95.6%). Chart setup: Death cross but MACD improving, RSI 75. Score 5.4/10, moderate confidence.

Passes 6/9 gates (positive momentum, clean insider activity, no SEC red flags, earnings proximity 20d clear, semi cycle peak clear, materials cycle peak clear). Fails on favorable risk/reward ratio. Suitability: moderate.

10-K grounded · weekly refresh

About The Ensign Group, Inc.

About The Ensign Group, Inc.

The Ensign Group operated 373 skilled nursing and senior living facilities with 37,911 operational skilled nursing beds across 17 states at December 31, 2025, generating approximately 95.6% of revenue from skilled nursing services. Medicaid accounted for 45.8% of 2025 total revenue—the largest single source—while Medicare contributed 23.7% of service revenue. Between January 2021 and December 2025, the company added 145 facilities and 14,739 operational skilled nursing beds through acquisition, bringing the cumulative total to 37,911 beds from 25,032 in 2021.

Ensign earns skilled services revenue from four payer channels—Medicaid (46.6% of skilled services revenue in 2025), Medicare (24.7%), managed care, and private pay—by operating high-acuity post-acute care facilities serving patients recovering from strokes, cardiovascular conditions, neurological disorders, and joint replacements. The Standard Bearer subsidiary owns 152 real estate properties under a captive REIT structure; 116 are leased to the company's own independent subsidiaries (eliminated in consolidation) while 37 are leased to third-party operators, contributing $19.3 million in non-eliminated rental revenue out of total rental revenues of $126.9 million in 2025. Senior living, mobile diagnostics, transportation, and other ancillary services together comprise approximately 4.6% of annual revenue. Ensign's Five-Star Quality Rating average across all facilities was 6.8% above the national average at December 2025.

Show full overview

Ensign's Medicaid dependency exposes the company to federal and state budget decisions that may alter reimbursement terms rapidly. The OBBB, signed into law July 4, 2025, imposed work requirements for Medicaid eligibility, mandated state eligibility redeterminations every six months rather than annually, and prohibited new provider taxes—removing a mechanism many states used to generate Medicaid funding. California, Texas, and Arizona are specifically named in the 10-K as states where budget reductions or delays could adversely affect net patient service revenue and profitability, representing a geographic concentration within an already Medicaid-dependent revenue model.

See also: Healthcare · Medical Care Facilities

From The Ensign Group, Inc.'s most recent 10-K filing, extracted June 10, 2026.

news + 30-day 8-K events · 5-min refresh

Recent developments

updated 2026-07-06
TrendMatrix Research · upcoming catalyst calendar

Upcoming dated catalysts

Thu, Jul 23, 202620d to earnings· next earnings call

Thesis

Rewards
Strong earnings beat streak (4/4)
Risks
Concentration risk — Product: skilled nursing facilities (95.6%)
Below 200-day MA

Key Metrics

P/E (TTM)27.4
P/E (Fwd)20.2
Mkt Cap$9.8B
EV/EBITDA20.5
Profit Mgn6.9%
ROE16.9%
Rev Growth18.4%
Beta0.69
Dividend0.15%
Rating analysts11

Quality Signals

Piotroski F7/9

Options Flow

P/C1.29bearish
IV59%elevated

Concentration Risks(10-K Item 1A)

  • HIGHProductskilled nursing facilities96%
    10-K Item 1: 'we generated approximately 95.6% of our revenue from our skilled nursing facilities'
  • MEDIUMCustomerMedicaid46%
    10-K Item 1A: 'Medicaid is our largest source of revenue, accounting for 45.8% and 46.0% of our revenue for the years ended December 31, 2025 and 2024, respectively'
  • LOWCustomerMedicare24%
    10-K Item 1A: 'We derived 23.7% and 24.9% of our service revenue from the Medicare programs for the years ended December 31, 2025 and 2024, respectively'

Model-generated analysis — not investment advice. Not a registered investment advisor. Past performance does not guarantee future results.

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About TrendMatrix. TrendMatrix is a publisher of general securities research and market commentary. We publish on a regular schedule. All content is the same for every subscriber in a tier — we do not provide personalized investment advice and we do not take into account any individual subscriber's financial situation, investment objectives, risk tolerance, tax situation, or holdings.

Not investment advice. TrendMatrix is not a registered investment adviser. Our content is for informational and educational purposes only. Consult your own licensed investment adviser, broker, or tax professional before making any investment decision.

Conflicts and positions. The TrendMatrix editorial team frequently holds personal long-term positions in securities discussed. We disclose positions held at the time of publication on each piece. We maintain a trading-window policy: we do not initiate or close positions in the same direction as a TrendMatrix publication within 24 hours before or 72 hours after publication.

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Performance. Past performance is not indicative of future results. Performance figures reflect the published model only and do not reflect any individual subscriber's actual results.

Methodology · Editorial policy & full disclaimer

Rating Breakdown

1 floor-breaker

Technicals below the gate floor. Component breakdown shows what dragged the score down.static

Support Resistance
1.0
Bollinger
1.2
52w Position
5.4
GatesA.R:R 0.9 < 1.5@spotMomentum 5.4<5.5 (soft — BUY_NOW allowed but watch)Death cross (50MA < 200MA)Momentum 5.4>=4.5Insider activity: OKNo SEC red flagsEARNINGS PROXIMITY 20d clearSEMI CYCLE PEAK CLEARMATERIALS CYCLE PEAK CLEARRecoverySuitability: Moderate
RSI
75 · Overbought
20D MA 50D MA 200D MADEATH CROSSSupport $141.52Resistance $171.19

Price Targets

$157
$192
A.Upside+14.0%
A.R:R0.9:1

Position Sizing

ConvictionNone
Suggested %0.5%
Max %1%
RegimeSteady

Risk Alerts

! asymmetry at 0.9 (below the engine's 1.5 threshold)@spot

Earnings

B
B
B
B
4/4 beats
Next Earnings2026-07-23 (20d)

Verdict History

reverse chrono — latest first
Loading history...
Verdicts are recorded on every nightly pipeline run. Rows capture transitions (verdict flips, score deltas ≥0.3, entry/TP/SL changes). Rows with a ▶ can be expanded to see the change reason. Aggregate cohort performance is tracked in the recommendation ledger.
Frequently Asked Questions
Is ENSG stock a buy right now?

Sell if holding. At $168.22, A.R:R 0.9:1 is below the 1.5:1 minimum. Reward from here is too thin for a buy — the engine flags exit. Additional concerns: Below 200-day MA; Concentration risk — Product: skilled nursing facilities (95.6%). Chart setup: Death cross but MACD improving, RSI 75. Prior stop was $156.58. Score 5.4/10, moderate confidence.

What is the ENSG stock price target?

Take-profit target: $191.75 (+14.0% upside). Prior stop was $156.58. Stop-loss: $156.58.

What are the risks of investing in ENSG?

Concentration risk — Product: skilled nursing facilities (95.6%); Below 200-day MA.

Is ENSG overvalued or undervalued?

The Ensign Group, Inc. trades at a P/E of 27.4 (forward 20.2). TrendMatrix value score: 5.4/10. Verdict: Sell.

What do analysts say about ENSG?

11 analysts cover ENSG with a consensus score of 4.2/5. Average price target: $220.

What does The Ensign Group, Inc. do?The Ensign Group operates 373 skilled nursing and senior living facilities across 17 states, generating approximately...

The Ensign Group operates 373 skilled nursing and senior living facilities across 17 states, generating approximately 95.6% of revenue from skilled nursing. Revenue flows from Medicaid (45.8% of 2025 total revenue), Medicare (23.7% of service revenue), managed care, and private pay. The company also owns 158 real estate properties through its captive REIT subsidiary, Standard Bearer, generating $126.9 million in rental revenues in 2025.

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