Shares of The Ensign Group, Inc. ENSG gained 2.9% since it reported first-quarter 2025 results on April 29, 2025. The quarterly results were aided by increased occupancy rates across its skilled nursing and transitioning facilities and robust growth in patient days. However, the upside was partly offset by an escalating expense base due to higher cost of services and rent-cost of services.

ENSG reported first-quarter 2025 adjusted earnings per share (EPS) of $1.52, which surpassed the Zacks Consensus Estimate by 1.3%. The bottom line advanced 16.9% year over year. (See the Zacks Earnings Calendar to stay ahead of market-making news.)

Operating revenues were $1.2 billion, which rose 16.1% year over year. The top line beat the consensus mark by 0.2%.

The Ensign Group, Inc. Price, Consensus and EPS SurpriseThe Ensign Group, Inc. Price, Consensus and EPS Surprise

The Ensign Group, Inc. price-consensus-eps-surprise-chart | The Ensign Group, Inc. Quote

ENSG’s Q1 Update

Ensign Group’s adjusted net income improved 18% year over year to $89 million in the quarter under review, which beat our estimate of $88.3 million.

Same-facilities occupancy improved 230 basis points (bps) while transitioning-facilities occupancy expanded 400 bps year over year.

Total expenses of $1.07 billion escalated 15.5% year over year, higher than our estimate of $1.06 billion.

Ensign Group’s Segmental Update

Skilled Services: The segment’s revenues grew 15.9% year over year to $1.12 billion in the first quarter, which marginally missed the Zacks Consensus Estimate of $1.13 billion but beat our estimate of $1.11 billion. The metric benefited on the back of higher occupancy rates and improved patient days. Segment income of $143.9 million advanced 13.5% year over year.

Skilled nursing facilities and campus operations of the segment totaled 297 and 31, respectively, at the first-quarter end.

Standard Bearer: Rental revenues totaled $28.4 million, which advanced 27.9% year over year in the quarter under review. The metric was aided by buyouts. Segment income improved 18.3% year over year to $8.6 million.

Funds from operations were $17.1 million, which rose 21.1% year over year.

ENSG’s Financial Update (as of March 31, 2025)

Ensign Group exited the first quarter with cash and cash equivalents of $282.7 million, which dropped 39.2% from the 2024-end figure. It had a leftover capacity of $572.1 million under its line of credit at the first-quarter end.

Total assets of $4.8 billion inched up 1.9% from the level at 2024-end.

Long-term debt-less current maturities were $140.6 million, which dipped 0.7% from the figure as of Dec. 31, 2024. Current maturities of long-term debt amounted to $4.1 million.

Story Continues

Total equity of $1.9 billion improved 4.9% from the 2024-end figure.

ENSG generated net cash from operations of $72.2 million in the quarter under review, which more than doubled year over year.

Ensign Group’s Capital-Deployment Update

Ensign Group bought back shares worth $10.8 million in the first quarter of 2025. In the same time frame, management paid dividends worth $3.6 million.

ENSG’s 2025 Outlook Revised

Revenues are anticipated to lie within $4.89-$4.94 billion, up from the prior guidance of $4.83-$4.91 billion. The mid-point of the updated outlook indicates an improvement of 15.4% from the 2024 figure.

Adjusted EPS is forecasted between $6.22 and $6.38 for 2025, higher than the earlier view of $6.16-$6.34. The mid-point of the revised guidance indicates 14.5% growth from the 2024 figure.

The weighted average common shares outstanding is continued to be estimated at around 59.5 million and the tax rate is reiterated to be 25%.

ENSG’s Zacks Rank

Ensign Group currently carries a Zacks Rank #3 (Hold).  You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

Other Medical Sector Releases

Of the Medical sector players that have reported first-quarter 2025 results so far, the bottom-line results of Elevance Health, Inc. ELV, Centene Corporation CNC and HCA Healthcare, Inc. HCA beat the respective Zacks Consensus Estimate.

Elevance Health reported first-quarter 2025 adjusted EPS of $11.97, which surpassed the Zacks Consensus Estimate by 6.8%. The bottom line increased 10.5% year over year. Operating revenues of $48.8 billion rose 15.4% year over year. Moreover, the top line beat the consensus mark by 6%. Medical membership of Elevance Health was around 45.8 million as of March 31, 2025, which slipped 0.5% year over year. Premiums increased 14.5% year over year to $40.9 billion.

Product revenues of $5.8 billion increased 29.1% year over year. Net investment income rose 26.9% year over year to $590 million. The adjusted operating margin deteriorated 70 bps year over year to 6.7%. The operating expense ratio improved 70 bps year over year to 10.9%. The benefit expense ratio of 86.4% deteriorated 80 bps year over year. In the Health Benefits segment, operating revenues totaled $41.4 billion, which increased 11.2% year over year. Operating gains declined 3.1% year over year to $2.22 billion.

Centene’s first-quarter 2025 adjusted EPS of $2.90 surpassed the Zacks Consensus Estimate by 22.9%. Moreover, the bottom line climbed 28% year over year. Revenues advanced 15.4% year over year to $46.6 billion. The top line beat the consensus mark by 7.2%. Revenues from Medicaid grew 4% year over year to $22.3 billion, while Medicare revenues of $8.8 billion soared 48% year over year in the quarter under review. Meanwhile, commercial revenues improved 31% year over year to $10.1 billion.

Centene's premiums totaled $41.7 billion, which advanced 17.4% year over year. Service revenues of $777 million decreased 3.8% year over year in the first quarter. Investment and other income dropped 29.9% year over year to $382 million. Total membership was 27.9 million as of March 31, 2025, which dipped 1.7% year over year. Centene’s health benefits ratio (HBR) of 87.5% deteriorated 40 bps year over year in the quarter under review. Adjusted net earnings improved 18.7% year over year to $1.4 billion.

HCA Healthcare reported first-quarter 2025 adjusted EPS of $6.45, which outpaced the Zacks Consensus Estimate of $5.77. The bottom line advanced 20.3% year over year. Revenues rose 5.7% year over year to $18.3 billion. The top line beat the consensus mark by 0.1%. Same-facility equivalent admissions improved 2.6% year over year in the first quarter, while same-facility admissions advanced 2.8% year over year. Same-facility revenue per equivalent admission grew 2.9% year over year.

Same-facility inpatient surgeries increased 0.2% year over year. Same-facility outpatient surgeries dipped 2.1% year over year. Additionally, same-facility emergency room visits rose 4% year over year in the first quarter.  Adjusted EBITDA of $3.7 billion increased from the year-ago figure of $3.4 billion. HCA Healthcare operated 192 hospitals and roughly 2,500 ambulatory sites of care across 20 states and the United Kingdom as of March 31, 2025.

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