The Ensign Group (ENSG) Q2 2026 earnings summary

Executive summary

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

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

• 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.

• Standard Bearer REIT added $374.6 million in real estate assets and generated $44.1 million in rental revenue, supporting future growth.

• Clinical quality, leadership stability, and a mission-focused culture drive sustainable growth and competitive advantage.

Financial highlights

• Consolidated GAAP and adjusted revenues reached $1.44 billion for Q2 2026, a 17.3% increase year-over-year; year-to-date revenue was $2.83 billion, up 18%.

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

• Cash and cash equivalents stood at $262.3 million; cash flows from operations were $272.1 million for H1 2026.

• Lease-adjusted net debt to EBITDA/EBITDAR ratio was about 2x, reflecting disciplined leverage.

• Gross margin improved as cost of services as a percentage of revenue decreased by 0.6% to 78.9%.

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.

• 2026 annual revenue guidance increased to $5.87–$5.92 billion.

• Guidance incorporates expected acquisitions, operational momentum, 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 $175 million budgeted for 2026.