The Ensign Group, Inc. · NASDAQ:ENSG
The Ensign — Investor Presentation (November 2025)
57 slides from The Ensign's investor presentation, November 2025
Slide 1: Investor Presentation
ENSIGN GROUP November 2025 INVESTOR PRESENTATION www.ensigngroup.net
Slide 2: Table Of Contents
Table Of Contents About US Portfolio Our Services Financials Since 1999, the independent subsidiaries Each of the 350+ businesses are run Our independent subsidiaries offer a A clinically strong foundation combined of The Ensign Group, Inc. (ENSG) have independently encompassing services delivered b
Slide 3: Disclaimers
Disclaimers This presentation contains, and other communications of The Ensign Group, Inc. (“Ensign” or the “Company”) may contain, forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These statements can be identified by the fact that they do not r
Slide 4: Our Mission
Our Mission We rely on our culture to accomplish our mission CAPLICO Our mission is to support the operations we serve in dignifying post-acute care in the eyes of the world. We do that through “Moments of Truth” – everyday situations that are met with out-of-the-ordinary service that surpasses all
Slide 5: Leading Healthcare Services Operator With Proven Track Record
Leading Healthcare Services Operator With Proven Track Record 1999 17 Founded States 369 155 Operated Facilities Owned Properties 41,000+ 83.0% (1) Beds / Units Across the Care Continuum Occupancy Rate 55,000+ 31.7% (1) Employees Skilled Mix Days 15% 829% $5.06B (1) Annual Revenue Growth Total Share
Slide 6: Entrepreneurial Evolution Of Ensign
Entrepreneurial Evolution Of Ensign Ensign Senior living Completed the Completed spin- Continues to Ensign formed Ensign The Ensign Established New Ensign entered completes an portfolio spin-off of its off of home execute on a Captive REIT, completed 99 Group was Market CEO into the home IPO in comp
Slide 7: Ensign's Commitment to The Care Continuum
Ensign’s Commitment to The Care Continuum Denotes Ensign Business Acute Care Local leadership strategy focused on acquisitions in fragmented markets. LTACH Inpatient Outpatient Rehab High quality healthcare outcomes across the Patient Service Intensity Rehab continuum driving local reputation and Sk
Slide 8: Ensign Strategically Positioned to Deliver Long-Term Value
Ensign Strategically Positioned to Deliver Long-Term Value Experienced Management Management team with combined experience over 90 years at Ensign alone. Presence in Attractive Markets Multiple Business Lines Presence in strategic markets across 17 states with Diversified operations including skille
Slide 9: Ensign's Investment Thesis
Ensign’s Investment Thesis Ensign is Positioned to Deliver Superior Clinical Results that Will Superior Results Generate Strong Financial and Operating Results Growth Opportunities Organic, Strategic, Real Estate and New Ventures Clinical Excellence Strategic Continuum of Care Culture 9
Slide 10: Leading Operational Presence in Attractive Markets
Leading Operational Presence in Attractive Markets 18 1714 1 4 States 15 9 369 3 8 Facilities 29 37 85 11 11 41,000+ 9 Beds 40 2 2 85 55,000+ Employees Skilled Nursing Operations - 321 Senior Living Operations - 16 Campus Operations - 31 LTAC – 1 Source: Data as of 11/01/2025 10
Slide 11: High-Quality Portfolio Of Assets
High-Quality Portfolio Of Assets Ensign’s real estate portfolio includes attractive assets in appealing markets that provide the foundation for patient care and well-being. Polaris Transitional Care Pacific Haven Stonehenge of Springville Alaska California Utah Facilities are purpose-built or Assets
Slide 12: Business Leaders Drive Results
Business Leaders Drive Results Track record of attracting, empowering & retaining clinically-focused business leaders. Local Leadership Superior Clinical Local Operation Clusters Outcomes of Choice Empowering local leaders and their teams Our independent subsidiaries offer a broad Local leadership a
Slide 13: Local Leaders are Empowered by our Cluster Model
Local Leaders are Empowered by our Cluster Model Best Practices Shared Across Clusters Along with Economic and Payor Benefits at Cluster Level What is a Cluster? • Collaboration and connectivity between operations (“ops”) that are Economic Benefits geographically close together. • Sharing of resourc
Slide 14: Organizational Focus on Clinical Quality Leads to Superior Financial Results
Organizational Focus on Clinical Quality Leads to Superior Financial Results Clinical Quality Translates to Organic Growth (4) SNF Count by CMS Star Rating Ensign vs. 1-3 Star 4-5 Star Comparative States 400 Our Cycle 1 health 300 inspections are more than 9% better.(3) 200 100 Our Five Star Quality
Slide 15: Multifaceted Growth Opportunities Creating Value
Multifaceted Growth Opportunities Driven by Organic as well as Strategic Opportunities Creating Value Skilled Mix Disciplined Acquisitions Organic Occupancy Distressed Assets Strategic Fundamentals New Ventures 15
Slide 16: A Disciplined Approach to Acquisitions & Track Record of Improving Operations
A Disciplined Approach to Acquisitions & Track Record of Improving Operations to Drive Continued Growth 33.5% of Ensign’s skilled nursing operations have been Proven track record of achieving significant improvement in operated less than three full years just 5 quarters (5) Occupancy 14.2% EBITDAR M
Slide 17: Demonstrated Track Record of Significant Operational Improvements QTD Q3 2025
Demonstrated Track Record of Significant Operational Improvements QTD Q3 2025 (8)(9)(10) (8)(9)(10)(11) Skilled Mix Revenue Medicare Rates Consolidated 48.9%(7) (7) $801 Medicaid $307 50.5% 50.9% 39.3% $792 $872 $749 Same Store Transitioning Recently Acquired Same Store Transitioning Recently Acquir
Slide 18: Demonstrated Track Record of Significant Operational Improvements of YTD 2025
Demonstrated Track Record of Significant Operational Improvements of YTD 2025 (8)(9)(10) (8)(9)(10)(11) Skilled Mix Revenue Medicare Rates (7) Consolidated (7) $791 49.4% Medicaid $306 51.3% 50.9% 36.5% $787 $856 $704 Same Store Transitioning Recently Acquired Same Store Transitioning Recently Acqui
Slide 19: Track Record of Successfully Incubating New Ventures
Track Record of Successfully Incubating New Ventures Completed 2019 Completed in 2014 Completed in 2016 19 19 Spin Offs Divestitures Current 19
Slide 20: Significant Real Estate Portfolio As of November 1, 2025
Significant Real Estate Portfolio As of November 1, 2025 Real Estate Distribution on Ensign operated Ensign Triple Net Master facilities of 369 and 36 Owned Real Estate Leased Leases with Quality Third Party Operators to Third Party Operators (12) 1.9% 155 Facilities Lease • Multiple “triple-net” ma
Slide 21: Standard Bearer REIT Structure Summary & Key Benefits
Standard Bearer REIT Structure Summary & Key Benefits Independent Operating Subsidiaries • Skilled Services • Real Estate Ownership • Senior Living Services • Real Estate Management & Monitoring • New Ventures • Investment Evaluation and Execution • Real Estate Portfolio Performance Reporting Increa
Slide 22: Standard Bearer at a Glance
Standard Bearer at a Glance Geographic Footprint Key Statistics 8 $1.6B (13) 149 Real Estate 1 6 26 Properties Fair Value 1 3 1 15 14 7 6 14,801 16 3 States Operating 5 Beds / Units 18 33 2 14.1 Years 85.3% (14) Weighted Avg. Ensign Operated Lease Tenor Note: Figures represent the number of owned pr
Slide 23: Standard Bearer Continuation & Expansion of Real Estate Success
Standard Bearer Continuation & Expansion of Real Estate Success Cumulative Investments Over Time (15) $1,400 $1,361 14,000 Cumulative Real Estate Investments (in millions) $1,200 12,000 $1,088 Total No. of SNF Beds / ALF Units $1,000 10,000 $921 $832 $800 8,000 $722 $624 $600 $583 6,000 $422 $400 $3
Slide 24: Standard Bearer Strong Long Term Leases
Standard Bearer Strong Long Term Leases 14.1 years 98% (16) Weighted Average of leases expire Lease Tenor after 2031 Annualized Rent Revenue Expirations by Year Tenant Rent Coverage Summary 26 24 Q3 Q4 Q1 Q2 Q3 22 20 19.4 2024 2024 2025 2025 2025 18 16 14.8 Ensign 14 2.48 2.69 2.67 2.60 2.59 12 10.2
Slide 25: Standard Bearer Metrics Quarter Over Quarter
Standard Bearer Metrics Quarter Over Quarter Rental Revenue - Trend Other Real Estate Metrics In $ Millions $32.6 In $ Millions $31.5 $28.4 $5.0 $4.7 $24.4 $25.1 $4.5 $4.2 $4.4 $9.6 $9.1 $8.6 $7.3 $7.4 $26.8 $27.6 $23.9 $20.2 $20.7 $18.4 $19.3 $17.1 $14.8 $15.3 Q3 2024 Q4 2024 Q1 2025 Q2 2025 Q3 202
Slide 26: Ensign Represents The Growth Story
Ensign Represents The Growth Story In the Facility-Based Healthcare Services & Post-Acute Sector Revenue Adjusted EBITDAR ($mm) ($mm) % $4,260 AGR: 15 AGR: 16 % $706 2014 – 2024 C $3,729 $3,697 2024 C $623 $611 $3,025 2014 – $533 $478 $2,627 $424 $2,403 $374 $2,037 $285 $319 $1,755 $262 $1,438 $1,59
Slide 27: Liquidity Financials Measure
Liquidity Financials Measure Nine Months Ended September 30, Summary of Cash Flows (In millions) 2025 2024 Net cash provided by (used in): Operating activities $381.0 $246.7 Investing activities(23) (389.2) (223.5) Financing activities (12.6) (0.8) Net (decrease)/increase in cash and cash equivalent
Slide 28: Quarter Over Quarter Highlights
Quarter Over Quarter Highlights (in millions) Q3 2025 Q3 2024 REVENUE 19.8% $1,296.4 $1,081.8 SAME FACILITY SKILLED NURSING FACILITY 6.6% $859.6 $806.7 REVENUE CONSOLIDATED ADJUSTED NET INCOME 18.9% $96.5 $81.1 Ensign Group | Investor Presentation 28
Slide 29: Year Over Year Highlights
Year Over Year Highlights (in millions) 2025 2024 REVENUE 18.2% $3,697.2 $3,128.2 SAME FACILITY SKILLED NURSING FACILITY 6.2% $2,539.8 $2,391.1 REVENUE CONSOLIDATED ADJUSTED NET INCOME 19.7% $278.8 $232.9 Ensign Group | Investor Presentation 29
Slide 30: Guidance
Annual Revenue Guidance $5.05B to $5.07B 2025 Diluted Adjusted EPS $6.48 to $6.54 Diluted Adjusted EPS Midpoint is: 18.4% over 2024 36.5% over 2023 30
Slide 31: Strong Shareholder Returns Since IPO
Strong Shareholder Returns Since IPO Total Shareholder Return Company Since IPO 1 Yr 3 Yr 5 Yr 10 Yr 4,818% 16% 98% 210% 829% 5,200% 4,818% 4,800% 4,400% 4,000% 3,600% 3,200% 2,800% 2,400% 2,000% 1,600% 1,200% 800% 400% —% 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 20
Slide 32: Ensign Management Team
Ensign Management Team Barry Suzanne Chad Spencer Marivic Port Snapper Keetch Burton Uychiat Chief Executive Officer Chief Financial Officer, EVP Chief Investment Officer, EVP President, Chief Operating EVP of Clinical Services and and Director and Director and Secretary Officer Director 21 Years 18
Slide 33: Appendix
Appendix www.ensigngroup.net
Slide 34: Fundamentals Remain Favorable for Strong Organic Growth
Fundamentals Remain Favorable for Strong Organic Growth Key Drivers of Organic Growth Over the last 10 years the CMS Shift to value-based care, will Shift to Value- Reimbursement reimbursement rates in the SNF continue to benefit low cost, high based Care Environment industry have increased at a ste
Slide 35: Fundamentals Remain Favorable for Strong Organic Growth
Fundamentals Remain Favorable for Strong Organic Growth Key Drivers of Organic Growth (24) Aging Population over 65 projected to nearly double by 2060, Population and growth of 23% from 2022 to 2030. (25) (25) Estimated Population Over 65 Estimated Population Over 80 100,000 35,000 30,000 80,000 25,
Slide 36: One of The Largest Beneficiary Of Medicare Post-Acute Dollars
One of The Largest Beneficiary Of Medicare Post-Acute Dollars While Medicare Spending Continues to Increase (26) (27) Medicare Spending Projection Post-Acute Destinations - % of Medicare Dollars (in Billions) 2% 2,500 12% 2,000 42% 1,500 44% 1,000 500 0 2016 2018 2020 2022 2024 2026 2028 2030 2032 2
Slide 37: Reconciliation of GAAP to Non-GAAP Income
Reconciliation of GAAP to Non-GAAP Income Three Months Ended September 30, Nine Months Ended September 30, $ in millions 2025 2024 2025 2024 Net income attributable to The Ensign Group, Inc. $83,844 $78,444 $248,517 $218,286 Non-GAAP adjustments Stock-based compensation expense(29) 12,989 9,183 35,3
Slide 38: Reconciliation of GAAP to Non-GAAP Financial Measures
Reconciliation of GAAP to Non-GAAP Financial Measures Three Months Ended September 30, Nine Months Ended September 30, $ in millions 2025 2024 2025 2024 Income before provision for income taxes $106,600 $98,674 $325,538 $280,336 Non-GAAP adjustments Stock-based compensation(29) 12,989 9,183 35,375 2
Slide 39: Reconciliation of GAAP to Non-GAAP Financial Measures
Reconciliation of GAAP to Non-GAAP Financial Measures Three Months Ended September 30, Nine Months Ended September 30, $ in millions 2025 2024 2025 2024 Net income $83,911 $78,567 $248,730 $218,708 Less: net income attributable to noncontrolling interests 67 123 213 422 Interest income 6,168 7,607 1
Slide 40: Reconciliation From Segment Income to Income Before Provisions For Income Taxes QTD Q3 2025
Reconciliation From Segment Income to Income Before Provisions For Income Taxes QTD Q3 2025 $ in millions Skilled Services Standard Bearer All Other Eliminations Consolidated Total Revenue $1,239,096 $32,610 $60,578 $(35,879) $1,296,405 Cost of services(37) 989,959 596 57,921 (4,890) 1,043,586 Inter
Slide 41: Reconciliation From Segment Income to Income Before Provisions For Income Taxes YTD 2025
Reconciliation From Segment Income to Income Before Provisions For Income Taxes YTD 2025 $ in millions Skilled Services Standard Bearer All Other Eliminations Consolidated Total Revenue $3,536,226 $92,479 $170,336 $(101,826) $3,697,215 Cost of services(37) 2,814,637 1,665 140,802 (13,890) 2,943,214
Slide 42: Reconciliation From Segment Income to GAAP EBITDA and Non-GAAP EBITDA QTD Q3 2025
Reconciliation From Segment Income to GAAP EBITDA and Non-GAAP EBITDA QTD Q3 2025 $ in millions Skilled Services Standard Bearer All Other Consolidated Segment income (loss) $153,126 $9,622 $(55,075) $107,673 Interest expense (income) — 10,320 (14,517) (4,197) Depreciation and amortization 14,155 9,
Slide 43: Reconciliation From Segment Income to GAAP EBITDA and Non-GAAP EBITDA YTD 2025
Reconciliation From Segment Income to GAAP EBITDA and Non-GAAP EBITDA YTD 2025 $ in millions Skilled Services Standard Bearer All Other Consolidated Segment income (loss) $447,061 $27,331 $(147,781) $326,611 Interest expense (income) — 29,367 (41,625) (12,258) Depreciation and amortization 41,118 27
Slide 44: Skilled Services Segment
Skilled Services Segment Three Months Ended September 30, Nine Months Ended September 30, $ in millions 2025 2024 2025 2024 Statements of Income Data: Segment income(38) $153,126 $128,489 $447,061 $377,483 Depreciation and amortization 14,155 11,541 41,118 32,988 EBITDA $167,281 $140,030 $488,179 $4
Slide 45: Standard Bearer Segment
Standard Bearer Segment Three Months Ended September 30, Nine Months Ended September 30, $ in millions 2025 2024 2025 2024 Rental revenue generated from third-party tenants $4,976 $4,195 $14,185 $12,588 Rental revenue generated from Ensign’s independent subsidiaries 27,634 20,234 78,294 57,396 Total
Slide 46: Deferred Compensation Plan (DCP) Impact
Deferred Compensation Plan (DCP) Impact 5 Quarter Trend $ in millions Q3 2025 Q2 2025 Q1 2025 Q4 2024 Q3 2024 Non-GAAP Revenue 1,296,405 1,227,769 1,173,041 1,132,252 1,081,776 Non-GAAP cost of services 1,025,104 964,252 920,209 890,214 853,260 Less: DCP gain (loss) related to cost of services 1,592
Slide 47: Deferred Compensation Plan (DCP) Impact
Deferred Compensation Plan (DCP) Impact YTD Comparison Nine Months Ended September 30, $ in millions 2025 2024 Non-GAAP Revenue 3,697,215 3,128,233 Non-GAAP cost of services 2,909,565 2,461,070 Less: DCP gain (loss) related to cost of services 3,764 3,205 Non-GAAP cost of services without DCP 2,905,
Slide 48: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units Alta Mesa Health and Rehabilitation and The Groves Assisted and Independent Senior AZ Campus 176 Living Community Arrowhead Springs Healthcare CA SNF 99 Atchison Senior Village Rehabilitation and
Slide 49: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units Decatur County Healthcare TN SNF 115 Deer Creek Senior Living TX Senior Living 37 Pennant Desert Blossom Health and Rehabilitation Center AZ SNF 106 Duncanville Healthcare and Rehabilitation Cente
Slide 50: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units Madison Pointe Senior Living WI Senior Living 39 Pennant Magnolia Post Acute Care CA SNF 99 Maple Meadows Assisted Living WI Senior Living 19 Pennant Marianwood Health and Rehabilitation WA SNF 11
Slide 51: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units Panorama Gardens Nursing and Rehabilitation Center CA SNF 146 Paris Chalet Senior Living TX Senior Living 37 Pennant Park Manor of McKinney TX SNF 138 Parklane West Healthcare Center TX SNF 124 Pa
Slide 52: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units Rowlett Health & Rehabilitation Center TX SNF 150 Savannah Nursing and Rehabilitation TN SNF 117 Scandinavian Court Assisted Living WI Senior Living 19 Pennant Sea Cliff Healthcare Center and Assi
Slide 53: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units The Healthcare Resort of Leawood KS Campus 94 The Healthcare Resort of Topeka KS Campus 94 The Medical Lodge of Amarillo TX SNF 82 The Mildred & Shirley L. Garrison Geriatric Education and Care Ce
Slide 54: End Notes
End Notes www.ensigngroup.net
Slide 55: End Notes
End Notes 1 — Occupancy and Skilled Mix metrics represent same store metrics for Q3'25. Reflects midpoints of 2025 guidance ranges of $5.05B to $5.07B for annual revenue and $6.48 to $6.54 for diluted adjusted EPS. [Slide 5] 2 — Adjusted EBITDAR consists of net income before (a) interest income, (b)
Slide 56: End Notes
End Notes 19 —Segment income reflects profit or loss from operations before provision for income taxes, gain or loss from sale of real estate, insurance recoveries from real estate, and impairment of long-lived assets. Included in Standard Bearer segment income for the three months ended September 3
Slide 57: Thank You
ENSIGN <== GROUP
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