Ensign Group
The Ensign Group is the largest U.S. nursing home operator, providing skilled nursing, senior living, and rehabilitative care across 396 facilities in 17 states. Revenue derives primarily from Medicare and Medicaid through operations paired with captive real estate ownership via Standard Bearer Healthcare REIT.
- Company typePublic
- Founded2002
- HeadquartersMission Viejo, United States
- Headcount5,001–10,000
- GTM typeB2C
- OfferingServices
Ensign Group firmographics
Firmographics- Name
- Ensign Group
- Legal name
- The Ensign Group, Inc.
- Website
- https://ensigngroup.net
- Company type
- Public
- Founded year
- 2002
- Operating status
- Operating
- Headcount range
- 5,001–10,000 employees
- Short description
- The Ensign Group is the largest U.S. nursing home operator, providing skilled nursing, senior living, and rehabilitative care across 396 facilities in 17 states. Revenue derives primarily from Medicare and Medicaid through operations paired with captive real estate ownership via Standard Bearer Healthcare REIT.
- Ownership category
- akta.pro rank
Ensign Group industry classification
Industry- Product category
- Skilled Nursing and Post-Acute Care
- NAICS
- Nursing Care Facilities (Skilled Nursing Facilities) (623110), Nursing Care Facilities (Skilled Nursing Facilities) (62311), Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly (6233)
- SIC
- Services-Skilled Nursing Care Facilities (8051), Services-Nursing & Personal Care Facilities (8050)
- akta.pro primary industry
- Skilled Nursing Facility (SNF)-Based Rehab Units (HLADAJAB)
- akta.pro secondary industries
- Long-Term Care Nursing Homes (Custodial LTC) (HLADADAB), Memory Care Units within Skilled Nursing Facilities (SNF/Nursing Homes) (HLADACAC), Private Duty 24/7 Nursing (RN/LPN) In-Home Care (HSABAHAJ)
Keywords
Where Ensign Group is headquartered
LocationHeadquarters
- HQ city
- Mission Viejo
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Ensign Group business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Infrastructure, Supply Chain, Technology or R&D
Revenue model
- Skilled Nursing Services: Core revenue stream from skilled nursing facilities, contributing 95.6% of total revenue. Services include post-acute care, nursing care, and rehabilitative services paid primarily through Medicare and Medicaid.
- Senior Living Services: Senior living facilities providing residential care services to elderly patients. Revenue generated from private payors and potentially Medicaid.
- Real Estate Rental Income: Standard Bearer Healthcare REIT generates rental income from owned real estate assets leased to affiliated and third-party operators under triple-net lease structures.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Pay-as-you-go | Medicare and Medicaid services |
Go-to-market motion2 records
Distribution channels2 records
Ensign Group product offering
Product offeringCore offering
The Ensign Group operates skilled nursing, senior living, and rehabilitative care services across 396 facilities in 17 U.S. states, primarily reimbursed by Medicare and Medicaid. The company pairs clinical operations with healthcare real estate ownership through captive REIT Standard Bearer Healthcare REIT, which acquires properties and leases them back to affiliated and third-party operators under long-term triple-net leases.
Product overview
The Ensign Group operates a vertically integrated healthcare services model combining real estate ownership through its Standard Bearer Healthcare REIT platform with skilled nursing, senior living, and rehabilitative care operations. The company operates 396 healthcare facilities across 17 U.S. states, providing post-acute care services primarily funded by Medicare and Medicaid. The business model involves acquiring struggling facilities, improving operations through a decentralized cluster approach, and leveraging real estate ownership to support expansion.
Differentiator
Problem solved
Functional benefit
Products and services
- Skilled Nursing Services
- Senior Living Services
- Rehabilitative Care Services
- Standard Bearer Healthcare REIT
Quantifiable outcome
- Record occupancy rates of 84.3% for Same Facilities and 84.9% for transitioning facilities
- +3 more outcomes
Companies that use Ensign Group
Customer profileNamed customers4 records
Segments3 records
Ideal customer profiles3 records
Ensign Group technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Ensign Group partnerships and signals
Strategic signalPartnerships
Four partnerships are on record, tiered core and minor.
- Standard Bearer Healthcare REITcoreStandard Bearer Healthcare REIT is Ensign Group's captive real estate subsidiary that owns healthcare real estate assets. The REIT acquires properties and leases them back to affiliated operators and third-party operators under triple-net lease structures. Generated $20.4 million in funds from operations for Q4 2025, a 33.9% increase year-over-year. The REIT owned 181 real estate assets as of June 2026.
- Gateway Healthcare LLCcoreEnsign's Iowa-based subsidiary that operates skilled nursing facilities including Woodland Health and Rehabilitation in Mount Pleasant, Iowa. Operates under Standard Bearer Healthcare REIT real estate ownership.
- Third-Party OperatorsminorThird-party operators who lease and manage healthcare facilities owned by Standard Bearer Healthcare REIT. Example: Memory Care of Contra Costa in Pleasant Hill, California is operated by a third-party operator under a triple net lease structure.
- The Pennant GroupminorThe Pennant Group (NASDAQ: PNTG) was spun out of The Ensign Group six years ago (approximately 2020). It operates home health and hospice services and was mentioned as a top stock pick by Turtle Creek Asset Management. Q1 2026 revenue of $285.4 million, representing 36% increase from prior year period.
Scale indicators18 records
Recent moves5 records
Expansion highlights5 records
Ensign Group competitors and assessment
Company assessmentDirect peers
- PACS Group: PACS Group (NYSE: PACS) is the second-largest skilled nursing facility operator in the US, directly competing with Ensign in post-acute and skilled nursing services with a similar cluster-based acquisition strategy.
- Genesis HealthCare: Genesis HealthCare is one of the largest skilled nursing and post-acute care providers in the US, directly comparable to Ensign in service mix, payor exposure (Medicare/Medicaid), and geographic footprint.
- The Pennant Group: Pennant Group (NASDAQ: PNTG) was spun off from Ensign in 2019 and operates home health, hospice, and senior living services, providing a direct read on Ensign's prior playbook and the broader post-acute continuum.
- National HealthCare Corporation: NHC (NYSE: NHC) operates skilled nursing facilities, assisted living, home health, and hospice across the Southeast and Midwest, with a similar integrated post-acute model to Ensign.
Broad incumbents
- Brookdale Senior Living: Brookdale (NYSE: BKD) is the largest US senior living operator with overlapping exposure to Ensign's assisted living and memory care segments, though Brookdale focuses on independent and assisted living rather than skilled nursing.
- Omega Healthcare Investors: Omega Healthcare (NYSE: OHI) is a healthcare REIT that owns skilled nursing and senior housing properties, comparable to Standard Bearer Healthcare REIT's real estate ownership strategy on a much larger scale.
- Sabra Health Care REIT: Sabra Health Care REIT (NASDAQ: SBRA) is a healthcare REIT with significant skilled nursing and senior housing exposure, comparable to Standard Bearer Healthcare REIT's triple-net lease model.
- Welltower: Welltower (NYSE: WELL) is a major healthcare REIT with senior housing and post-acute exposure, providing a relevant comparator for Ensign's integrated real estate-plus-operations model.
- Encompass Health: Encompass Health (NYSE: EHC) operates inpatient rehabilitation hospitals, serving overlapping post-acute patient populations with Ensign's SNF-based rehabilitation units.
Emerging players
- Addus HomeCare: Addus HomeCare (NASDAQ: ADUS) provides home and community-based services to elderly and disabled patients, representing a complementary care setting to Ensign's facility-based skilled nursing model.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks5 records
Key highlights6 records
Customer concentration
Ensign Group social profiles
Digital presenceEnsign Group financial estimates
Financial estimateRevenue estimate
Valuation estimate
Ensign Group leadership team
Management profileNumber of profiles
Profiles12 records
Ensign Group subsidiaries and ownership
Company hierarchySubsidiaries3 records
Ensign Group funding detail
Funding detailFunding overview
Funding rounds5 records
Investors10 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Ensign Group M&A and investment
M&A and investmentM&A3 records
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Ensign Group
What does Ensign Group do?
The Ensign Group operates skilled nursing, senior living, and rehabilitative care services across 396 facilities in 17 U.S. states, primarily reimbursed by Medicare and Medicaid. The company pairs clinical operations with healthcare real estate ownership through captive REIT Standard Bearer Healthcare REIT, which acquires properties and leases them back to affiliated and third-party operators under long-term triple-net leases.
Is Ensign Group a public or private company?
Ensign Group is a public company. It is classified as public and is currently operating.
When was Ensign Group founded?
Ensign Group was founded in 2002. It employs 5,001 to 10,000 people.
Where is Ensign Group based?
Ensign Group is headquartered in Mission Viejo, United States, in the North America region.
How does Ensign Group make money?
Three revenue lines are on record. Skilled Nursing Services are the primary driver. The others are senior Living Services and real Estate Rental Income.
Who are Ensign Group's main competitors?
Direct peers on record are PACS Group, Genesis HealthCare, The Pennant Group and National HealthCare Corporation. Broad incumbents are Brookdale Senior Living, Omega Healthcare Investors, Sabra Health Care REIT, Welltower and Encompass Health. Addus HomeCare is listed as an emerging player.
Does Ensign Group have an API?
No public API is recorded for Ensign Group.
What industry is Ensign Group in?
Ensign Group's product category is Skilled Nursing and Post-Acute Care. Its primary akta.pro industry code is HLADAJAB, Skilled Nursing Facility (SNF)-Based Rehab Units, with a secondary code of HLADADAB, Long-Term Care Nursing Homes (Custodial LTC). Its NAICS code is 623110 and its SIC code is 8051.