Ensign Raises 2026 Earnings Guidance After Occupancy Gains

The Tip Desk · November 8, 2026 · 3 min read

The post-acute operator lifted its 2026 earnings outlook to $7.94–$8.02 a share after GAAP diluted earnings of $1.76 a share and a $1.48 billion revenue quarter.

The Ensign Group (ENSG) raised its 2026 annual earnings guidance to $7.94 to $8.02 a share after a third quarter in which GAAP diluted earnings reached $1.76 a share, up 23.9% from a year earlier, and adjusted diluted earnings were $2.03 a share.

The post-acute healthcare operator said the lift reflected strength in the third quarter and confidence in the fourth. The midpoint of the new earnings range represents a 21.5% increase over 2025, the company said. Its annual revenue guidance is $5.89 billion to $5.92 billion.

GAAP net income was $104.3 million, up 24.4% from the year-ago quarter. Adjusted net income was $120.5 million. Consolidated revenue was $1.48 billion, up 14.5% from the year-ago quarter, after 18.4% year-over-year growth in the first quarter.

Chief Executive Officer Barry Port said the company continued to see strong demand and experienced growth in occupancy and skilled mix. Same Facilities occupancy was 84.1%, up 1.6% from the year-ago quarter. Transitioning Facilities occupancy was 86.1%, up 3.9%.

Same Facilities skilled mix revenue rose 10.7% from the year-ago quarter, and skilled days rose 7.2%. Transitioning Facilities skilled mix revenue rose 10.5%, and skilled days rose 7.9%. Port said year-over-year growth appeared across all skilled payor categories, with Medicare particularly strong. Same Facilities Medicare revenue rose 11.1% and Medicare days rose 7.6%. Transitioning Facilities Medicare revenue rose 7.8% and Medicare days rose 6.3%.

Managed care revenue rose 9.1% at Same Facilities and 7.2% at Transitioning Facilities. Managed care days rose 3.1% and 3.8%, respectively.

Standard Bearer, the real estate segment, generated $47.7 million of rental revenue, up 46.3% from the year-ago quarter, and $27.3 million of funds from operations. Of the rental revenue, $42.1 million came from Ensign-affiliated operations.

During the quarter and since, the company added 22 new operations, including three real estate assets and 19 leased operations, and entered Florida. Chief Investment Officer Chad Keetch said Ensign had sourced, underwritten, closed and transitioned 122 new operations since 2024. The portfolio now consists of 418 healthcare operations across 18 states, 34 of which also include senior living. Ensign owns 189 real estate assets, 150 of which are operated by an Ensign affiliate.

Clinical highlights included Same Facilities CMS Quality Measure ratings 21% better than industry peers in operating states, Cycle 1 survey results 15% better, and over 80% of skilled nursing operations earning a 4- or 5-star CMS Quality Measure rating. Short-stay functional improvement rates were 30% better than peers, and administrator turnover at Same Facilities was 45% lower.

Cash on hand was approximately $337.6 million, with $731.6 million of available capacity under the line of credit. The company paid a quarterly cash dividend of $0.065 a share. Management’s annual guidance assumes about 59.5 million diluted weighted average shares, a 25.0% tax rate, normalized insurance costs, acquisitions expected to close through the fourth quarter of 2026, and current expectations on reimbursement rates.