The Ensign Group IncEnsign Group added 22 operations in Q1 2026, with strong revenue growth, record occupancy, and high ROIC, indicating successful acquisition strategy.

The Ensign Group added 22 new operations in the first quarter of 2026, bringing its total acquisitions to 71 since the beginning of 2025 as part of its strategy of buying underperforming skilled nursing and senior living facilities and improving their performance. First-quarter revenues rose 18.4% year over year to $1.39 billion, adjusted earnings reached $1.85 per share, and same-store occupancy hit a record 84.3%. The company ended the quarter with more than $539 million in cash and cash equivalents, up 7.1% from year-end 2025, and $591.6 million in available borrowing capacity, while long-term debt less current maturities stood at $136.5 million. Its trailing 12-month return on invested capital was 8.1%, well above the industry average of 3.1%. Peers such as The Pennant Group and Brookdale Senior Living are also pursuing acquisition-driven growth, with Pennant expanding its home health and hospice businesses through a decentralized model and Brookdale acquiring 30 previously leased communities in 2025 while reporting first-quarter 2026 occupancy of 82.1%.
The Ensign Group IncEnsign Group added 22 operations in Q1 2026, with strong revenue growth, record occupancy, and high ROIC, indicating successful acquisition strategy.
Brookdale Senior Living Inc
Pennant Group Inc