The Ensign Group, Inc. · NASDAQ:ENSG
The Ensign — Q2 2025 Earnings Presentation
57 slides from The Ensign's earnings presentation, Jul 25, 2025
Slide 1: Investor Presentation
ENSIGN GROUP July 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 348 146 Operated Facilities Owned Properties 39,000+ 82.1% (1) Beds / Units Across the Care Continuum Occupancy Rate 52,000+ 32.4% (1) Employees Skilled Mix Days 15% 1,525% $5.00B (1) Annual Revenue Growth Total Sha
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 78 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 3 States 15 8 348 3 8 Facilities 22 37 74 11 11 39,000+ 9 Beds 40 1 2 85 52,000+ Employees Skilled Nursing Operations - 303 Senior Living Operations - 13 Campus Operations - 31 LTAC – 1 Source: Data as of 07/01/2025 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. Silver Ridge Pacific Haven Allegiant of Mesa Idaho California Arizona Facilities are purpose-built or Assets include a mix of s
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 We partner with many other healthcare Our independent subsidi
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 (3) SNF Count by CMS Star Rating Ensign vs. 1-3 Star 4-5 Star 400 Comparative States 300 Our Cycle 1 health inspections are more than 200 11% better.(3) 100 0 21 38 45 60 77 72
Slide 15: Multifaceted Growth Opportunities
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 29.9% 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 (4) Occupancy EBITDAR 14.9% M
Slide 17: Demonstrated Track Record of Significant Operational Improvements QTD Q2 2025
Demonstrated Track Record of Significant Operational Improvements QTD Q2 2025 (7)(8)(9) (7)(8)(9)(10) Skilled Mix Revenue Medicare Rates (6) (6) Consolidated 49.2% $789 Medicaid $309 51.2% 50.4% 35.6% $787 $851 $686 Same Store Transitioning Recently Acquired Same Store Transitioning Recently Acquire
Slide 18: Demonstrated Track Record of Significant Operational Improvements YTD 2025
Demonstrated Track Record of Significant Operational Improvements of YTD 2025 (7)(8)(9) (7)(8)(9) (10) Skilled Mix Revenue Medicare Rates (6) Consolidated (6) $787 49.7% Medicaid $305 51.6% 50.9% 34.3% $784 $849 $666 Same Store Transitioning Recently Acquired Same Store Transitioning Recently Acquir
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 July 1, 2025
Significant Real Estate Portfolio As of July 1, 2025 Real Estate Distribution on Ensign operated Ensign Triple Net Master facilities of 348 and 36 Owned Real Estate Leased Leases with Quality Third Party Operators to Third Party Operators (11) 2.1% Lease • Multiple “triple-net” master leases 36 faci
Slide 21: Standard Bearer REIT Structure Summary & Key Benefits
Standard Bearer REIT Structure Summary & Key Benefits Independent Subsidiaries • Skilled Services • Real Estate Ownership • Senior Living Services • Real Estate Management & Monitoring • New Ventures • Investment Evaluation and Execution • Real Estate Portfolio Performance Reporting Increased Visibi
Slide 22: Standard Bearer at a Glance
Standard Bearer at a Glance Geographic Footprint Key Statistics 8 $1.6B (12) 140 Real Estate 1 6 25 Properties Fair Value 1 2 1 8 14 7 6 14,272 16 3 States Operating 5 Beds / Units 18 33 2 14.6 Years 84.6% (13) Weighted Avg. Ensign Operated Lease Tenor Note: Figures represent the number of owned pro
Slide 23: Standard Bearer Continuation & Expansion of Real Estate Success
Standard Bearer Continuation & Expansion of Real Estate Success Cumulative Investments Over Time (14) $1,390 $1,400 14,000 $1,334 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
Slide 24: Standard Bearer Strong Long Term Leases
Standard Bearer Strong Long Term Leases 14.6 years 98% (15) Weighted Average of leases expire Lease Tenor after 2031 Annualized Rent Revenue Expirations by Year Tenant Rent Coverage Summary 26 24 Q2 Q3 Q4 Q1 Q2 22 20 20.0 2024 2024 2024 2025 2025 18 15.1 16 Ensign 14 2.51 2.48 2.69 2.67 2.60 12 10.4
Slide 25: Standard Bearer Metrics Quarter Over Quarter
Standard Bearer Metrics Quarter Over Quarter In $ Millions Rental Revenue - Trend In $ Millions Other Real Estate Metrics $31.5 $28.4 $4.7 $25.1 $4.5 $24.4 $23.4 $4.2 $4.4 $4.2 $9.1 $8.6 $7.3 $7.4 $7.4 $26.8 $23.9 $19.2 $20.2 $20.7 $17.1 $18.4 $14.5 $14.8 $15.3 Q2 2024 Q3 2024 Q4 2024 Q1 2025 Q2 202
Slide 26: Ensign Represents The Growth Story
Ensign Represents The Growth Story In the Facility-Based Healthcare Services & Post-Acute Sector Revenue Adjusted EBITDAR ($mm) ($mm) % $4,260 AGR: 15 AGR: 16 % $706 2014 – 2024 C $3,729 2024 C $623 $3,025 2014 – $533 $478 $2,627 $424 $398 $2,403 $2,401 $374 $2,037 $285 $319 $1,755 $262 $1,438 $1,59
Slide 27: Liquidity Financials Measure
Liquidity Financials Measure Six Months Ended June 30, Summary of Cash Flows (In millions) 2025 2024 Net cash provided by (used in): Operating activities $228.0 $112.2 Investing activities(34) (311.9) (144.6) Financing activities (16.7) — Net decrease in cash and cash equivalents (100.6) (32.3) Cash
Slide 28: Quarter Over Quarter Highlights
Quarter Over Quarter Highlights (in millions) Q2 2025 Q2 2024 REVENUE 18.5% $1,227.8 $1,036.3 SAME FACILITY SKILLED NURSING FACILITY 6.5% $845.4 $793.6 REVENUE CONSOLIDATED ADJUSTED NET INCOME 22.1% $93.3 $76.4 Ensign Group | Investor Presentation 28
Slide 29: Year Over Year Highlights
Year Over Year Highlights (in millions) 2025 2024 REVENUE 17.3% $2,400.8 $2,046.5 SAME FACILITY SKILLED NURSING FACILITY 6.0% $1,680.2 $1,584.4 REVENUE CONSOLIDATED ADJUSTED NET INCOME 20.1% $182.3 $151.8 Ensign Group | Investor Presentation 29
Slide 30: Guidance
Annual Revenue Guidance $4.99B to $5.02B 2025 Diluted Adjusted EPS $6.34 to $6.46 Diluted Adjusted EPS Midpoint is: 16.4% over 2024 34.2% over 2023 30
Slide 31: Strong Shareholder Returns Since IPO
Strong Shareholder Returns Since IPO Source: Data as of 07/01/2025. 31
Slide 32: Ensign Management Team
Ensign Management Team Christopher Barry Suzanne Chad Spencer Marivic Christensen Port Snapper Keetch Burton Uychiat Executive Chairman Chief Executive Officer Chief Financial Officer, EVP Chief Investment Officer, EVP President, Chief Operating EVP of Clinical Services and 25 Years and Director and
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 (22) Aging Population over 65 projected to nearly double by 2060, Population and growth of 23% from 2022 to 2030. (23) (23) Estimated Population Over 65 Estimated Population Over 85 100,000 20,000 80,000 15,000 60,
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 (24) (25) Medicare Spending Projection Post-Acute Destinations - % of Medicare Dollars 2% (in Billions) 2,500 12% 2,000 42% 1,500 1,000 44% 500 0 2016 2018 2020 2022 2024 2026 2028 2030 2032 2
Slide 37: Skilled Services Segment
Skilled Services Segment Three Months Ended June 30, Six Months Ended June 30, $ in millions 2025 2024 2025 2024 Statements of Income Data: Segment income(26) $150,004 $122,185 $293,935 $248,994 Depreciation and amortization 13,750 10,911 26,963 21,447 EBITDA $163,754 $133,096 $320,898 $270,441 Adju
Slide 38: Standard Bearer Segment
Standard Bearer Segment Three Months Ended June 30, Six Months Ended June 30, $ in millions 2025 2024 2025 2024 Rental revenue generated from third-party tenants $4,712 $4,198 $9,209 $8,393 Rental revenue generated from Ensign’s independent subsidiaries 26,756 19,156 50,660 37,162 Total rental reven
Slide 39: Reconciliation of GAAP to Non-GAAP Income
Reconciliation of GAAP to Non-GAAP Income Three Months Ended June 30, Six Months Ended June 30, $ in millions 2025 2024 2025 2024 Net income attributable to The Ensign Group, Inc. $84,396 $71,007 $164,673 $139,842 Non-GAAP adjustments Stock-based compensation expense(28) 11,662 8,985 22,386 17,223 L
Slide 40: Reconciliation of GAAP to Non-GAAP Financial Measures
Reconciliation of GAAP to Non-GAAP Financial Measures Three Months Ended June 30, Six Months Ended June 30, $ in millions 2025 2024 2025 2024 Income before provision for income taxes $112,358 $92,064 $218,938 $181,662 Non-GAAP adjustments Stock-based compensation(28) 11,662 8,985 22,386 17,223 Litig
Slide 41: Reconciliation of GAAP to Non-GAAP Financial Measures
Reconciliation of GAAP to Non-GAAP Financial Measures Three Months Ended June 30, Six Months Ended June 30, $ in millions 2025 2024 2025 2024 Net income $84,466 $71,181 $164,819 $140,141 Less: net income attributable to noncontrolling interests 70 174 146 299 Interest income 5,240 7,084 12,123 13,54
Slide 42: Reconciliation From Segment Income to Income Before Provisions For Income Taxes QTD Q2 2025
Reconciliation From Segment Income to Income Before Provisions For Income Taxes QTD Q2 2025 $ in millions Skilled Services Standard Bearer All Other Eliminations Consolidated Total Revenue $1,173,576 $31,468 $57,332 $(34,607) $1,227,769 Cost of services 932,823 472 43,089 (4,604) 971,780 Internal re
Slide 43: 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 $2,297,130 $59,869 $109,758 $(65,947) $2,400,810 Cost of services 1,824,678 1,070 82,881 (9,000) 1,899,629 Interna
Slide 44: Reconciliation From Segment Income to GAAP EBITDA and Non-GAAP EBITDA QTD Q2 2025
Reconciliation From Segment Income to GAAP EBITDA and Non-GAAP EBITDA QTD Q2 2025 $ in millions Skilled Services Standard Bearer All Other Consolidated Segment income (loss) $150,004 $9,126 $(46,772) $112,358 Interest expense (income) — 10,311 (13,526) (3,215) Depreciation and amortization 13,750 9,
Slide 45: 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) $293,935 $17,709 $(92,706) $218,938 Interest expense (income) — 19,047 (27,108) (8,061) Depreciation and amortization 26,963 17,7
Slide 46: Deferred Compensation Plan (DCP) Impact Quarter Trend
Deferred Compensation Plan (DCP) Impact 5 Quarter Trend $ in millions Q2 2025 Q1 2025 Q4 2024 Q3 2024 Q2 2024 Non-GAAP Revenue 1,227,769 1,173,041 1,132,252 1,081,776 1,036,285 Non-GAAP cost of services 964,252 920,209 890,214 853,260 815,911 Less: DCP gain (loss) related to cost of services 2,289 (
Slide 47: Deferred Compensation Plan (DCP) Impact
Deferred Compensation Plan (DCP) Impact YTD Comparison Six Months Ended June 30, $ in millions 2025 2024 Non-GAAP Revenue 2,400,810 2,046,457 Non-GAAP cost of services 1,884,461 1,607,810 Less: DCP gain (loss) related to cost of services 2,172 1,558 Non-GAAP cost of services without DCP 1,882,289 1,
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 AZ Campus 176 Senior 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 Crestwood Health & Rehabilitation Center TX Campus 148 Decatur County Healthcare TN SNF 115 Deer Creek Senior Living TX Senior Living 37 Pennant Desert Blossom Health and Rehabilitation Center AZ
Slide 50: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units Lo-Har Senior Living CA Senior Living 29 Pennant Lotus Gardens Senior Living WI Senior Living 45 Pennant Madison Pointe Senior Living WI Senior Living 39 Pennant Magnolia Post Acute Care CA SNF 99
Slide 51: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units Olympia Transitional Care and Rehabilitation WA SNF 113 Opus Post Acute Rehabilitation SC SNF 98 Pacific Haven Subacute and Healthcare Center CA SNF 99 Panorama Gardens Nursing and Rehabilitation
Slide 52: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units Rock Canyon Respiratory & Rehabilitation Center CO SNF 81 Rock Creek of Ottawa KS Campus 146 Rock Hill Post Acute Care Center SC SNF 99 Rockbrook Assisted Living and Memory Care TX Senior Living 5
Slide 53: Standard Bearer Property Locations
Standard Bearer Property Locations # of Operating Beds / Property Name State Property Type Tenant Units 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 Center TX SNF 116 The Orchard Post Acute Care CA
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 Q2'25. Reflects midpoints of 2025 guidance ranges of $4.99B to $5.02B for annual revenue and $6.34 to $6.46 for diluted adjusted EPS. [Slide 5] 2 — Adjusted EBITDAR consists of net income before (a) interest income, (b)
Slide 56: End Notes
End Notes 18 —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 June 30, 20
Slide 57: Thank You
ENSIGN <== GROUP