The Ensign Group (ENSG) investor relations material

Executive summary

• Achieved record quarterly results with consolidated revenue up 17.3% to $1.44B, driven by clinical excellence, leadership stability, and robust acquisition activity, including 20–25 new operations primarily in Texas and Iowa.

• Over 80% of skilled nursing operations earned a CMS Quality Measure rating of four or five stars, with significant improvements in occupancy, skilled mix, and managed care revenue year-over-year.

• Standard Bearer REIT added $374.6M in real estate assets and generated $44.1M in rental revenue and $24.7M in FFO for the quarter.

• Board authorized an increase in the share repurchase program and paid a cash dividend of $0.065 per share, marking 23 consecutive years of dividend increases.

• Clinical excellence, local leadership, and a proven operational model drive sustainable growth and competitive advantage.

Financial highlights

• GAAP diluted EPS was $1.68 (up 16.7% YoY); adjusted diluted EPS was $1.92 (up 20.8% YoY); GAAP net income was $99.7M (up 18.2% YoY); adjusted net income was $114.3M (up 22.5% YoY).

• Consolidated revenue for Q2 2026 was $1.44B, up 17.3% YoY; year-to-date revenue reached $2.83B, up 18%.

• Adjusted EBITDA for Q2 2026 was $181.1M, up from $146.6M in Q2 2025; adjusted EBITDAR was $247.6M.

• Cash and cash equivalents stood at $262.3M; cash flows from operations were $272.1M for the first half of 2026.

• Lease-adjusted net debt to EBITDA ratio was 2x; over $850M in available liquidity.

Outlook and guidance

• 2026 annual earnings guidance raised to $7.75–$7.85 per diluted share, midpoint up 18.7% over 2025 and 41.8% over 2024.

• Annual revenue guidance increased to $5.87B–$5.92B.

• Guidance incorporates expected acquisitions, operational momentum, stable reimbursement rates, normalized insurance costs, and a 25% tax rate.

• Management expects continued growth from recent acquisitions and organic improvements in occupancy and acuity.

• Ongoing investment in facility renovations and system implementations is planned, with $175M budgeted for 2026.