The Ensign Group (ENSG) Q3 2026 earnings summary

Executive summary

• Q3 revenue was $1.484B, up 14.5% YoY; GAAP diluted EPS was $1.76 and adjusted diluted EPS was $2.03, up 23.9% and 23.8%, respectively.

• Strong quarterly results, occupancy and skilled-mix momentum supported higher FY 2026 diluted EPS guidance of $7.94-$8.02.

• Acquisitions expanded operations across 18 states, with 418 healthcare operations as of October 1, 2026.

Financial highlights

• Q3 GAAP net income was $104.3M, up 24.4% YoY; adjusted net income was $120.5M, up 24.9%.

• Q3 total revenue was $1.484B versus $1.296B; 9M revenue was $4.314B versus $3.697B, up 16.7%.

• 9M GAAP diluted EPS was $5.11 versus $4.23; adjusted diluted EPS was $5.80 versus $4.75.

• 9M operating cash flow was $512.3M versus $381.0M; investing cash outflow was $690.9M, primarily reflecting higher acquisition spending.

Outlook and guidance

• FY 2026 diluted EPS guidance increased to $7.94-$8.02 from $7.75-$7.85; revenue guidance is $5.89B-$5.92B.

• Guidance midpoint implies 21.5% growth over 2025 and 45.1% over 2024; assumptions include ~59.5M diluted weighted-average shares and a 25% tax rate.

• Guidance reflects same-facility growth, stronger census and skilled mix, acquisition activity, and expected Q4 acquisitions; it excludes certain non-ordinary charges and share-based compensation.

• Renovation projects were budgeted at $175.0M for 2026; 9M capital expenditures were $135.9M.