Key Highlights

  • Adjusted diluted EPS rose 23.8% to $2.03 from $1.64, versus a screened estimate of $1.97.
  • Total revenue rose 14.5% to $1,484.0 million from $1,296.4 million.
  • 2026 adjusted EPS guidance was raised to $7.94 to $8.02 from $7.75 to $7.85.
  • Same Facilities occupancy was 84.1% versus 82.8%, and total skilled mix by nursing revenue was 49.7%.
  • Adjusted EBITDA rose about 26.2% to $190.7 million from $151.1 million.

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

The Ensign Group (NASDAQ:ENSG) reported third-quarter adjusted diluted EPS of $2.03 on Tuesday, October 27, up 23.8% from $1.64 and above the $1.97 estimate as screened. GAAP diluted EPS was $1.76 versus $1.42. Revenue rose 14.5% to $1,484.0 million.

The company raised 2026 adjusted EPS guidance to a range of $7.94 to $8.02 from $7.75 to $7.85, citing the strength of the third quarter and confidence in the fourth. Revenue guidance is $5.89 billion to $5.92 billion, with the low end raised and the high end held.

Occupancy and Skilled Mix: What Is Behind the Revenue Growth?

Same Facilities occupancy rose to 84.1% from 82.8%, and Transitioning Facilities occupancy rose to 86.1% from 82.9%. Total occupancy on operational beds was 83.1% versus 82.3%, and patient days rose 13.1% to 3,136,313.

Total skilled mix by nursing revenue was 49.7% versus 48.9%, and the average daily skilled nursing rate was $431.41 versus $420.16. The chief executive said occupancy and skilled mix are more than financial metrics.

Medicaid revenue, including senior living, rose 14.6% to $590.5 million, or 40.0% of service revenue. Medicare revenue rose 13.1% to $342.9 million, and managed care rose 16.2% to $276.5 million.

Profitability: How Wide Were the Earnings Gains?

Adjusted EBITDA rose about 26.2% to $190.7 million, and adjusted net income rose 24.9% to $120.5 million. GAAP net income attributable to the company was $104.3 million, up 24.4%, and income from operations reached $138.0 million versus $96.2 million.

Skilled Services segment income was $185.2 million versus $153.1 million, on skilled services revenue of $1,422.0 million, up 14.8%. Standard Bearer, the real estate arm, reported rental revenue of $47.7 million, up 46.3%, and funds from operations of $27.3 million, up 41.3%.

For nine months, adjusted EPS was $5.80 versus $4.75 and revenue was $4,313.7 million versus $3,697.2 million.

Acquisitions and Balance Sheet: How Is Growth Being Funded?

The company added 22 operations during and since the quarter, including 19 leased operations and 3 real estate assets, with Florida a new state. The leased operations total about 2,005 skilled nursing beds in Colorado, Washington and Florida, by our calculation from the listed bed counts.

Nine-month operating cash flow was $512.3 million versus $381.0 million, while investing outflows reached $690.9 million. Cash was $337.6 million, long-term debt was $194.7 million, and liquidity included about $731.6 million of available line-of-credit capacity.

The quarterly dividend is $0.065 per share. Guidance assumes about 59.5 million diluted shares and a 25.0% tax rate.

What to Watch Next: What Will the October 28 Call Show?

The call is scheduled for Wednesday, October 28, at 10:00 a.m. Pacific. Investors will watch the fourth-quarter pace implied by the guidance, integration of the Florida and Colorado leases, skilled mix trends, and any further real estate purchases by Standard Bearer.