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ENSGThe Ensign Group, Inc.
$166.83$9.7B
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The Ensign Group, Inc. (ENSG) Financial Ratios

Latest Ratios: P/E Ratio 28.6x · EV/EBITDA 24.9x · ROE 16.9%. (2005–2025 historical series)

Income StatementBalance SheetCash FlowRatios
AnnualQuarterly

ENSG Valuation Multiples

Price-based multiples — how expensive the stock is relative to earnings, sales, book value, and cash flow

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Market Cap$9.7B$10.3B$7.7B$6.4B$5.4B$4.8B$4.1B$2.5B$2.0B$1.1B$1.1B
Enterprise Value$13.4B$13.9B$9.2B$7.8B$6.6B$5.8B$4.9B$3.8B$2.2B$1.4B$1.3B
P/E Ratio →28.5729.8325.9530.7423.9524.5523.8323.0321.3426.9621.64
P/S Ratio1.932.031.821.721.781.821.691.251.120.690.65
P/B Ratio4.394.594.204.304.314.684.973.873.282.192.35
P/FCF26.2927.6640.9523.7829.0923.1912.5921.0512.7069.47132.23
P/OCF17.2718.1822.2917.0819.7417.3410.9013.219.3815.0314.65

P/E links to full P/E history page with 30-year chart

ENSG EV Ratios

Enterprise-value multiples — capital-structure-neutral measures of total business value

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
EV / Revenue—2.752.172.092.192.202.061.881.250.860.79
EV / EBITDA24.8925.8420.9023.7818.4818.2717.8121.2416.8415.6010.03
EV / EBIT30.8832.0623.4527.7522.2721.8321.7929.0325.1430.5214.08
EV / FCF—37.5148.9428.8135.8928.0515.3131.7214.0786.62159.81

ENSG Profitability

Margins and return-on-capital ratios measuring operating efficiency

Margins

Full margin charts and quarterly trend are on the Earnings History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Gross Margin13.7%13.7%15.7%15.8%17.1%17.8%17.0%14.3%12.5%10.8%11.4%
Operating Margin8.6%8.6%8.4%6.8%9.8%9.9%9.3%6.3%4.8%2.7%5.6%
Net Profit Margin6.8%6.8%7.0%5.6%7.4%7.4%7.1%5.4%5.3%2.5%3.0%

Return on Capital

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
ROE16.9%16.9%17.9%15.3%19.8%21.2%23.1%17.6%16.8%8.4%11.3%
ROA6.8%6.8%6.7%5.5%7.1%7.2%6.9%6.2%8.1%3.8%5.7%
ROIC7.0%7.0%8.7%7.1%9.8%10.5%9.2%7.0%8.0%4.4%11.8%
ROCE10.2%10.2%9.7%8.1%11.4%12.1%11.2%8.8%9.5%5.2%13.5%

ENSG Leverage & Debt

Solvency and debt-coverage ratios — lower is generally safer

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Debt / Equity1.861.861.071.251.261.241.362.050.400.630.62
Debt / EBITDA7.727.724.465.714.384.004.017.471.873.572.17
Net Debt / Equity—1.630.820.911.010.981.071.960.350.540.49
Net Debt / EBITDA6.786.783.414.153.503.173.167.141.633.091.73
Debt / FCF—9.857.995.036.804.872.7210.671.3717.1427.59
Interest Coverage54.3154.3147.6034.7333.3738.6724.248.425.733.2913.03

ENSG Liquidity & Efficiency

Short-term solvency ratios and asset-utilisation metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Current Ratio1.421.421.561.421.341.221.041.201.291.631.58
Quick Ratio1.421.421.561.421.341.221.041.201.291.631.58
Cash Ratio0.640.640.710.720.570.530.440.220.150.250.33
Asset Turnover—0.930.910.890.880.920.940.861.481.451.65
Inventory Turnover———————————
Days Sales Outstanding—45.9748.8247.4749.2745.6746.3455.3852.4060.5353.91

ENSG Shareholder Yields

Earnings, FCF, buyback, and dividend yields — total returns to shareholders

Dividends

Full dividend history and growth charts are on the Dividend History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Dividend Yield0.1%0.1%0.2%0.2%0.2%0.2%0.3%0.4%0.5%0.8%0.8%
Payout Ratio4.2%4.2%4.6%6.2%5.4%5.9%6.4%9.2%10.2%21.5%16.3%

Total Shareholder Return Metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Earnings Yield3.5%3.4%3.9%3.3%4.2%4.1%4.2%4.3%4.7%3.7%4.6%
FCF Yield3.8%3.6%2.4%4.2%3.4%4.3%7.9%4.8%7.9%1.4%0.8%
Buyback Yield0.2%0.2%0.0%0.0%0.6%0.2%0.6%0.3%0.1%0.7%2.8%
Total Shareholder Yield0.4%0.3%0.2%0.2%0.8%0.5%0.9%0.7%0.6%1.5%3.5%
Shares Outstanding—$59M$58M$57M$57M$57M$56M$56M$54M$53M$52M

Key Metrics

Growth RegimeAccelerating
ProfitabilityModerate
Balance SheetFortress
Cash FlowRobust
Top Statement Risk

Regulatory reimbursement and staffing

Verified Source

Metrics are mathematically derived from official filings.

SEC 10-K (2026Q1)

Premium Valuation Reflects Growth Optionality

According to current market data, ENSG trades at a forward P/E of 21.57, which appears to command a significant premium over broader healthcare peers, reflecting investor confidence in the company's unique ability to recycle capital through its decentralized cluster model and internal real estate platform.

The current PEG ratio of 2.02 suggests that the market is pricing in sustained, above-average growth, likely driven by the company's track record of successful facility turnarounds. Investors should monitor whether this valuation remains sustainable if the pace of accretive acquisitions slows or if regulatory headwinds compress the margins of the existing portfolio.

Capital Efficiency Constrained by Scale

Based on reported financial figures, ROIC has remained relatively stable in the 1.9% to 2.3% range over the last ten quarters, suggesting that while the company is successfully deploying capital, the returns on that investment are currently muted by the high fixed-cost nature of the facility base.

The modest ROIC levels indicate that Ensign's growth is capital-intensive, requiring significant ongoing investment to maintain and improve acquired facilities. Analysts should evaluate whether the company can drive higher returns as its regional clusters achieve greater density and operational synergies, or if the current return profile is a structural ceiling for the industry.

Working Capital Dynamics Remain Stable

As reported in recent quarterly filings, the company's DSO has hovered between 42 and 47 days, indicating a consistent, albeit slow, collection cycle from government and private payers that is characteristic of the post-acute care sector's reliance on complex reimbursement processes.

The stability in DSO suggests that Ensign maintains effective control over its billing and collection functions despite the geographic expansion of its operations. Investors should watch for any meaningful drift in these metrics, as an increase in days sales outstanding could signal potential friction in the reimbursement process or a shift in the payer mix toward slower-paying entities.

Conservative Leverage Supports Strategic Flexibility

According to the most recent balance sheet data, the company has significantly reduced its debt-to-equity ratio to 0.89 in 2026Q1, down from 1.86 in 2025Q4, providing a fortress-like financial position that offers substantial capacity for future acquisitions or defensive maneuvering in volatile markets.

This deleveraging trend is particularly notable given the company's active acquisition strategy, suggesting that Ensign is funding its growth through a disciplined mix of cash flow and equity rather than excessive debt. The low interest coverage ratio, which remains well above 40x, further underscores the company's minimal risk of debt service distress even in a higher interest rate environment.

Misapplication of Standard P/E Multiples

The P/E ratio is frequently misapplied to Ensign's business model because it fails to account for the significant non-cash depreciation and amortization associated with the company's extensive real estate holdings, which often mask the true underlying cash-generating power of the operational platform.

Investors should instead focus on EV/EBITDA or FCF-based metrics to better capture the value of the company's real estate ownership and its ability to generate cash from its cluster operations. Relying solely on P/E may lead to an undervaluation of the company's long-term asset-backed growth potential and its ability to monetize its property portfolio.

Download Financial Ratios Data

Includes 30+ ratios · 21 years · Updated daily

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ENSG — Frequently Asked Questions

Quick answers to the most common questions about buying ENSG stock.

What is The Ensign Group, Inc.'s P/E ratio?

The Ensign Group, Inc.'s current P/E ratio is 28.6x. The historical average is 18.9x. This places it at the 89th percentile of its historical range.

What is The Ensign Group, Inc.'s EV/EBITDA?

The Ensign Group, Inc.'s current EV/EBITDA is 24.9x. This enterprise value multiple compares the company's total value (equity + debt - cash) to its EBITDA. The historical average is 12.5x.

What is The Ensign Group, Inc.'s ROE?

The Ensign Group, Inc.'s return on equity (ROE) is 16.9%. The historical average is 20.3%.

Is ENSG stock overvalued?

Based on historical data, The Ensign Group, Inc. is trading at a P/E of 28.6x. This is at the 89th percentile of its historical P/E range. Compare with industry peers and growth rates for a complete picture.

What is The Ensign Group, Inc.'s dividend yield?

The Ensign Group, Inc.'s current dividend yield is 0.15% with a payout ratio of 4.2%.

What are The Ensign Group, Inc.'s profit margins?

The Ensign Group, Inc. has 13.7% gross margin and 8.6% operating margin.

How much debt does The Ensign Group, Inc. have?

The Ensign Group, Inc.'s Debt/EBITDA ratio is 7.7x, indicating high leverage. A ratio above 4x may signal elevated financial risk.