v3.25.2
BUSINESS SEGMENTS
 6 Months Ended
Jun. 30, 2025
Segment Reporting [Abstract]  
BUSINESS SEGMENTS BUSINESS SEGMENTS
The Company has two reportable segments: (1) skilled services, which includes the operation of skilled nursing facilities and rehabilitation therapy services and (2) Standard Bearer, which is comprised of selected real estate properties owned by Standard Bearer and leased to skilled nursing and senior living operators.

As of June 30, 2025, the skilled services segment includes 303 skilled nursing and 31 campus operations that provide both skilled nursing and rehabilitative care services and senior living services. The Company's Standard Bearer segment consists of 138 owned real estate properties.

The Company also reports an “All Other” category that includes results from its senior living operations, which includes 13 stand-alone senior living operations and the senior living operations at 31 campus operations that provide both skilled nursing and rehabilitative care services and senior living services. In addition, the "All Other" category includes mobile diagnostics, medical transportation, other real estate, other ancillary operations and the Service Center. Services included in the “All Other” category are insignificant individually, and therefore do not constitute a reportable segment.

The Company’s reportable segments are significant operating segments that offer differentiated services. The segment structure reflects the Company's current operational and financial management and provides the best structure to maximize the quality of care and investment strategy provided, while maintaining financial discipline.

Segment income is defined as income before provision for income taxes, excluding gain or loss from sale of real estate, real estate insurance recoveries and impairment of long-lived assets. The Company's chief operating decision maker or CODM, who is the Chief Executive Officer, reviews segment income for each operating segment to evaluate performance and allocate capital resources. The CODM uses segment income to analyze actual results as part of operational planning and to decide whether to reinvest profits into the segments or into other parts of the Company, such as through acquisitions, to pay dividends or to recommend a stock repurchase program. The Company's CODM does not review assets by segment in his resource allocation and therefore assets by segment are not disclosed below.

Intercompany revenue is eliminated in consolidation, along with corresponding intercompany expenses. Included in segment income for Standard Bearer is expense for intercompany services provided by the Service Center as described in Note 6, Standard Bearer, as it is part of the CODM financial information.
The following tables set forth financial information for the segments:

 Three Months Ended June 30, 2025
 Skilled ServicesStandard BearerTotal
Service revenue(1)
$1,173,576 $— $1,173,576 
Rental revenue— 31,468 31,468 
Segment revenue$1,173,576 $31,468 $1,205,044 
Reconciliation of revenue:
All other revenue(2)
57,332 
Elimination of intercompany revenue(3)
(34,607)
TOTAL CONSOLIDATED REVENUE
$1,227,769 
Less:
Other segment items(4)
1,009,822 2,766 
Depreciation and amortization13,750 9,265 
Interest expense(5)
— 10,311 
Segment income
$150,004 $9,126 $159,130 
Reconciliation of profit or loss:
All other not included in segment income
(46,772)
INCOME BEFORE PROVISION FOR INCOME TAXES$112,358 
(1) Skilled services service revenue does not include intercompany service revenue generated by ancillary operations provided to the Company's independent subsidiaries and management service revenue generated by the Service Center with Standard Bearer. Intercompany service revenue is eliminated in "Elimination of intercompany revenue".
(2) All other revenue includes $54,174 of service revenue and $3,158 of rental revenue for the three months ended June 30, 2025, both of which include intercompany revenue that is eliminated in "Elimination of intercompany revenue".
(3) Elimination of intercompany revenue includes the elimination of intercompany rental revenue of $28,271 and intercompany service revenue of $6,336 for the three months ended June 30, 2025.
(4) Other segment items include cost of services and rent expense for the skilled services segment and cost of services, rent expense and general and administrative expenses for the Standard Bearer segment. Additionally, there are intercompany expenses of $34,607 during the three months ended June 30, 2025, which are eliminated in consolidation.
(5) Included in interest expense in Standard Bearer is interest from intercompany debt arrangements between Standard Bearer and The Ensign Group, Inc. of $9,023 during the three months ended June 30, 2025, which is eliminated in consolidation.
 Three Months Ended June 30, 2024
 Skilled ServicesStandard BearerTotal
Service revenue(1)
$991,285 $— $991,285 
Rental revenue— 23,354 23,354 
Segment revenue$991,285 $23,354 $1,014,639 
Reconciliation of revenue:
All other revenue(2)
47,339 
Elimination of intercompany revenue(3)
(25,693)
TOTAL CONSOLIDATED REVENUE
$1,036,285 
Less:
Other segment items(4)
858,189 2,129 
Depreciation and amortization10,911 7,166 
Interest expense(5)
— 6,699 
Segment income
$122,185 $7,360 $129,545 
Reconciliation of profit or loss:
All other not included in segment income
(37,481)
INCOME BEFORE PROVISION FOR INCOME TAXES$92,064 
(1) Skilled services service revenue does not include intercompany service revenue generated by ancillary operations provided to the Company's independent subsidiaries and management service revenue generated by the Service Center with Standard Bearer. Intercompany service revenue is eliminated in "Elimination of intercompany revenue".
(2) All Other revenue includes $44,340 of service revenue and $2,999 of rental revenue for the three months ended June 30, 2024, both of which include intercompany revenue that is eliminated in "Elimination of intercompany revenue".
(3) Elimination of intercompany revenue includes the elimination intercompany rental revenue of $20,642 and intercompany service revenue of $5,051 for the three months ended June 30, 2024.
(4) Other segment items include cost of services and rent expense for the skilled services segment and cost of services, rent expense and general and administrative expenses for the Standard Bearer segment. Additionally, there are intercompany expenses of $25,693 during the three months ended June 30, 2024, which is eliminated in consolidation.
(5) Included in interest expense in Standard Bearer is interest from intercompany debt arrangements between Standard Bearer and The Ensign Group, Inc. of $4,998 during the three months ended June 30, 2024, which is eliminated in consolidation.
 Six Months Ended June 30, 2025
 Skilled ServicesStandard Bearer
Total
Service revenue(1)
$2,297,130 $— $2,297,130 
Rental revenue
— 59,869 59,869 
Segment revenue
$2,297,130 $59,869 $2,356,999 
Reconciliation of revenue:
All other revenue(2)
109,758 
Elimination of intercompany revenue(3)
(65,947)
TOTAL CONSOLIDATED REVENUE
$2,400,810 
Less:
Other segment items(4)
1,976,232 5,372 
Depreciation and amortization26,963 17,741 
Interest expense(5)
— 19,047 
Segment income
$293,935 $17,709 $311,644 
Reconciliation of profit or loss:
All other not included in segment income
(92,706)
INCOME BEFORE PROVISION FOR INCOME TAXES
$218,938 
(1) Skilled services service revenue does not include intercompany service revenue generated by ancillary operations provided to the Company's independent subsidiaries and management service revenue generated by the Service Center with Standard Bearer. Intercompany service revenue is eliminated in "Elimination of intercompany revenue".
(2) All other revenue includes $103,601 of service revenue and $6,157 of rental revenue for the six months ended June 30, 2025, both of which include intercompany revenue that is eliminated in "Elimination of intercompany revenue".
(3) Elimination of intercompany revenue includes the elimination of intercompany rental revenue of $53,670 and intercompany service revenue of $12,277 for the six months ended June 30, 2025.
(4) Other segment items include cost of services and rent expense for the skilled services segment and cost of services, rent expense and general and administrative expenses for the Standard Bearer segment. Additionally, there are intercompany expenses of $65,947 during the six months ended June 30, 2025, which are eliminated in consolidation.
(5) Included in interest expense in Standard Bearer is interest from intercompany debt arrangements between Standard Bearer and The Ensign Group, Inc. of $16,063 during the six months ended June 30, 2025, which is eliminated in consolidation.
 Six Months Ended June 30, 2024
 Skilled ServicesStandard BearerTotal
Service revenue(1)
$1,960,887 $— $1,960,887 
Rental revenue
— 45,555 45,555 
Segment revenue
$1,960,887 $45,555 $2,006,442 
Reconciliation of revenue:
All other revenue(2)
89,911 
Elimination of intercompany revenue(3)
(49,896)
TOTAL CONSOLIDATED REVENUE
$2,046,457 
Less:
Other segment items(4)
1,690,446 4,266 
Depreciation and amortization21,447 13,995 
Interest expense(5)
— 12,676 
Segment income$248,994 $14,618 $263,612 
Reconciliation of profit or loss:
All other not included in segment income
(81,950)
INCOME BEFORE PROVISION FOR INCOME TAXES
$181,662 
(1) Skilled services service revenue does not include intercompany service revenue generated by ancillary operations provided to the Company's independent subsidiaries and management service revenue generated by the Service Center with Standard Bearer. Intercompany service revenue is eliminated in "Elimination of intercompany revenue".
(2) All Other revenue includes $83,966 of service revenue and $5,945 of rental revenue for the six months ended June 30, 2024, both of which include intercompany revenue that is eliminated in "Elimination of intercompany revenue".
(3) Elimination of intercompany revenue includes the elimination intercompany rental revenue of $40,102 and intercompany service revenue of $9,794 for the six months ended June 30, 2024.
(4) Other segment items include cost of services and rent expense for the skilled services segment and cost of services, rent expense and general and administrative expenses for the Standard Bearer segment. Additionally, there are intercompany expenses of $49,896 during the six months ended June 30, 2024, which is eliminated in consolidation.
(5) Included in interest expense in Standard Bearer is interest from intercompany debt arrangements between Standard Bearer and The Ensign Group, Inc. of $9,283 during the six months ended June 30, 2024, which is eliminated in consolidation.

Service revenue by major payor source were as follows:

 Three Months Ended June 30, 2025
 Skilled Services
All Other (3)
Total Service RevenueRevenue %
Medicaid(1)
$473,904 $11,944 $485,848 39.8 %
Medicare291,117 — 291,117 23.8 
Medicaid-skilled75,207 — 75,207 6.2 
Subtotal$840,228 $11,944 $852,172 69.8 %
Managed care229,495 — 229,495 18.8 
Private and other(2)
103,853 35,894 139,747 11.4 
TOTAL SERVICE REVENUE$1,173,576 $47,838 $1,221,414 100.0 %
 Three Months Ended June 30, 2024
 Skilled Services
All Other (3)
Total Service RevenueRevenue %
Medicaid(1)
$403,127 $8,633 $411,760 40.0 %
Medicare258,869 — 258,869 25.1 
Medicaid-skilled62,969 — 62,969 6.1 
Subtotal$724,965 $8,633 $733,598 71.2 %
Managed care191,022 — 191,022 18.5 
Private and other(2)
75,298 30,656 105,954 10.3 
TOTAL SERVICE REVENUE$991,285 $39,289 $1,030,574 100.0 %
 Six Months Ended June 30, 2025
 Skilled Services
All Other (3)
Total Service RevenueRevenue %
Medicaid(1)
$917,315 $22,373 $939,688 39.3 %
Medicare578,868 — 578,868 24.2 
Medicaid-skilled144,758 — 144,758 6.1 
Subtotal$1,640,941 $22,373 $1,663,314 69.6 %
Managed care456,712 — 456,712 19.1 
Private and other(2)
199,477 68,951 268,428 11.3 
TOTAL SERVICE REVENUE$2,297,130 $91,324 $2,388,454 100.0 %
 Six Months Ended June 30, 2024
 Skilled Services
All Other (3)
Total Service RevenueRevenue %
Medicaid(1)
$785,245 $16,678 $801,923 39.4 %
Medicare524,452 — 524,452 25.8 
Medicaid-skilled126,278 — 126,278 6.2 
Subtotal$1,435,975 $16,678 $1,452,653 71.4 %
Managed care379,126 — 379,126 18.6 
Private and other(2)
145,786 57,494 203,280 10.0 
TOTAL SERVICE REVENUE$1,960,887 $74,172 $2,035,059 100.0 %
(1) Medicaid payor includes revenue generated from senior living operations.
(2) Private and other in skilled services includes private, Veteran Affairs and hospice payors. In addition, private and other in the "all other" category includes revenue from senior living and ancillary operations.
(3) All Other incorporates intercompany eliminations.