Key Highlights

  • HCA Healthcare third-quarter revenue rose 3.6% to $19.849 billion, and management expects 2026 results in the upper half of its July ranges.
  • Chemed adjusted EPS rose 28.1% to $6.75, led by hospice unit VITAS with net patient revenue up 12.2%.
  • Ensign Group raised 2026 adjusted EPS guidance to $7.94 to $8.02 from $7.75 to $7.85 after adjusted EPS rose 23.8% to $2.03.
  • Universal Health Services adjusted EPS of $5.22 beat a $5.15 estimate as screened but fell from $5.69 a year earlier.
  • HCA repurchased $2.970 billion of stock in the quarter, against $242.1 million at Universal Health Services.

Which Hospital and Care Provider Earnings Stood Out After the Tuesday, October 27 Reports?

Four healthcare services companies reported on Tuesday, October 27, 2026, and their profit trends diverged. HCA Healthcare (NYSE:HCA) reported third-quarter revenue of $19.849 billion, up 3.6%, and said full-year results should land in the upper half of its July ranges. Chemed (NYSE:CHE) posted adjusted EPS of $6.75, up 28.1%, and Ensign Group (NASDAQ:ENSG) raised its 2026 adjusted EPS guidance after a 23.8% increase to $2.03.

Universal Health Services (NYSE:UHS) beat its screened estimate with adjusted EPS of $5.22, yet that was below the $5.69 of a year earlier. No share reactions are cited because none are stated for these names, and figures marked calculated are derived from the companies' own numbers.

HCA Healthcare: Is Guidance Really Moving to the Upper Half Despite Uninsured Volume Pressure?

HCA reported diluted EPS of $7.27 on a GAAP basis, and $7.22 as adjusted, which is 8.95% above the $6.63 estimate as screened. Adjusted EBITDA rose 1.2% to $3.918 billion, but the margin slipped to 19.7% from 20.2%, and net income attributable to the company fell 3.9% to $1.579 billion. Management estimated an unfavorable effect of about $400 million on pretax income from higher uninsured volume, mainly patients who lost exchange coverage.

The release did not publish new numeric ranges, so the upper-half signal sits within the July ranges: revenue of $77.0 billion to $79.5 billion and diluted EPS of $28.70 to $30.50. Same facility emergency room visits rose 5.1%, while outpatient surgery cases fell 3.7%. The company bought back 7.230 million shares for $2.970 billion, leaving $4.240 billion of authorization, and declared a $0.78 quarterly dividend. Operating cash flow was $4.461 billion in the quarter, and total debt was $50.493 billion at September 30.

Chemed: Why Did Adjusted EPS Jump 28.1% to $6.75?

Chemed reported revenue of $690.9 million, up 10.6%, with adjusted EPS of $6.75 against a $6.44 screen estimate, a 4.89% surprise as screened. VITAS hospice net patient revenue rose 12.2% to $457.4 million as average daily census grew 9.4%. VITAS adjusted EBITDA excluding the Medicare Cap rose 31.4% to $92.5 million.

Roto-Rooter was softer on profit. Revenue grew 7.5% to $233.5 million, yet adjusted EBITDA fell 2.5% and the margin declined 213 basis points to 20.6%. The company expects 2026 adjusted EPS at or slightly above the high end of $25.00 to $25.75 and gave no new ranges. It repurchased $66.0 million of shares in the quarter, and its call is on Wednesday, October 28 at 10 a.m. ET. Cash was $48.4 million and long-term debt $236.0 million at September 30.

Ensign Group: Why Was the 2026 Outlook Raised After a $2.03 Quarter?

Ensign reported adjusted EPS of $2.03 against $1.64 and a $1.97 estimate as screened, on revenue up 14.5% to $1,484.0 million. Same Facilities occupancy rose to 84.1% from 82.8%, and total skilled mix by nursing revenue was 49.7% against 48.9%. Adjusted EBITDA rose about 26.2% to $190.7 million.

The 2026 adjusted EPS range moved to $7.94 to $8.02 from $7.75 to $7.85, and revenue guidance is $5.89 billion to $5.92 billion, with the low end raised. The company added 22 operations during and since the quarter, with Florida a new state, and nine-month operating cash flow was $512.3 million. Its call is on Wednesday, October 28 at 10:00 a.m. Pacific. The quarterly dividend is $0.065 per share, and liquidity included about $731.6 million of available line-of-credit capacity.

Universal Health Services: Did an Adjusted EPS Beat Hide a Squeeze on Margins?

UHS reported net revenues up 5.3% to $4,733.4 million, but net income attributable to the company fell to $308.7 million from $373.0 million. Acute care pre-tax margin narrowed to 11.6% from 12.8%, and behavioral health to 18.1% from 19.2%. Net interest expense rose to $56.3 million from $38.4 million.

The quarter included a $47 million favorable effect from Medicaid supplemental payments and a $26 million reserve increase tied to a tentative settlement in the Cumberland Hospital litigation. The company bought back about $242.1 million of stock and has $735.4 million of authorization left. The release refers to the July 27 forecast of adjusted EPS of $22.28 to $23.65, and its call is on Wednesday, October 28 at 8:00 a.m. Eastern. Debt to adjusted EBITDA stood at 2.17 times.

Hospital and Care Provider Earnings Compared: Who Grew Fastest and Who Returned the Most Cash?

Ensign's 14.5% revenue growth is 10.9 percentage points above HCA's 3.6% (calculated), with Chemed at 10.6% and Universal Health Services at 5.3%. Adjusted EPS growth ran from 28.1% at Chemed and 23.8% at Ensign to 3.7% at HCA, while Universal Health Services was down about 8.3% from $5.69 to $5.22 (calculated). Its net income fell about 17.2% (calculated).

Against screened estimates, HCA's adjusted EPS beat by 8.95% and Chemed's by 4.89%, as screened, while Ensign's was about 3.0% and Universal Health Services' about 1.4% (both calculated). Ensign's EPS guidance midpoint rose $0.18 to $7.98, or about 2.3% (calculated). HCA's quarterly buyback of $2.970 billion is about 12.3 times Universal Health Services' $242.1 million (calculated).

What to Watch Next: Wednesday's Calls, Uninsured Volume and Surgical Recovery

Universal Health Services, Chemed and Ensign hold calls on Wednesday, October 28, covering the forecast, VITAS admissions and the Florida and Colorado lease integration. HCA investors will follow uninsured volume, surgical volumes after the third-quarter declines and where results land within the 2026 ranges. HCA's next dividend of $0.78 is payable on December 29 to holders of record on December 15. Chemed updates guidance once a year, so its fourth-quarter report in 2027 is the next formal update.