The Ensign Group, Inc.

NasdaqGS-ENSG

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Operating Activities	Jun '25	Dec '24	Jun '24	Dec '23	Jun '23	Dec '22
Net Income	164.8	158.3	140.1	85.8	124.1	116.8
Net Income
Depreciation & Amortization	50	44	40.1	37.7	34.7	32.8
Depreciation and Amortization
Share-Based Compensation Expense	22.4	19	17.2	15.3	15.5	11.9
Stock-Based Compensation
Other Adjustments	2.2	2.8	0.8	23.3	2.5	-5.9
Net Income from Discontinued Operations, Net of Tax
Impairment of Long-Lived Assets and Goodwill
Amortization of Deferred Financing Fees
Amortization of Deferred Gain on Sale-Leaseback
Non-Cash Leasing Arrangement
Impairment of Long-Lived Assets
Write-Off of Deferred Financing Fees
Deferred Income Taxes
Provision for Doubtful Accounts
Excess Tax Benefit from Share-Based Compensation
Gain on Insurance Claims, Legal Finding and Asset Disposals
Cash Received from Insurance Proceeds
Gain on Sale of Assets
Gain on Insurance Claims, Legal Adjustments and Asset Disposals
Gain on Insurance Claims, Other Investments and Asset Disposals
Income Tax Refund
Gain on Sale of Urgent Care Centers
Litigation
Changes in Trade Receivables	-9	-21.6	-62.8	-40.4	-39.4	-69.6
Change in Accounts Receivable
Changes in Accounts Payable	5	8.4	-5.6	14.9	1	15.7
Change in Accounts Payable
Changes in Accrued Expenses	6.9	20.9	12.5	93.4	7.3	57.7
Change in Accrued Wages and Related Liabilities
Other Accrued Liabilities
Change in Accrued Self-Insurance Liabilities
Changes in Income Taxes Payable	—	—	—	-25.2	25.2	—
Income Taxes Payable
Changes in Other Operating Activities	-14.2	3.2	-30.1	3.9	-2.7	-16.7
Change in Prepaid Income Taxes
Change in Prepaid Expenses and Other Assets
Insurance Subsidiary Deposits and Investments
Liabilities Related to Operational Closures
Deferred Employer Portion of Social Security Taxes
Change in Cash Surrender Value of Life Insurance Policy Premiums
Change in Deferred Compensation Liability
Change in Operating Lease Obligations
Deferred Rent and Other Long-Term Liability
Other Long-Term Liability
Other Long-Term Liabilities
Cash from Operating Activities	228	234.9	112.2	208.6	168.1	142.7
Operating Activities

Investing Activities	Jun '25	Dec '24	Jun '24	Dec '23	Jun '23	Dec '22
Capital Expenditure	-92.5	-93.6	-64.6	-54.6	-51.6	-50.5
Purchase of Property and Equipment
Proceeds from Sale of Property, Plant & Equipment	3	-0.1	2.9	0.2	0	1
Cash Proceeds from the Sale of Assets and Ancillary Business
Cash Proceeds from the Sale of Assets
Cash Proceeds from the Sale of Property and Equipment and Insurance Proceeds
Cash from Insurance Proceeds and the Sale of Assets
Purchases of Intangible Assets	—	—	—	—	—	—
Cash Payments for Medicare and Medicaid Licenses
Purchases of Investments	-62.7	-69.6	-35.5	-11.2	-18.4	-18.5
Purchases of Investments
Proceeds from Sale of Investments	53.2	7.1	19.3	11	7.9	9.6
Maturities of Investments
Payments for Business Acquisitions	-204.6	-91.2	-65.4	-68.6	-0.4	-67.2
Cash Payments for Business Acquisitions
Cash Payments for Asset Acquisitions
Cash Payments for Acquisitions
Cash Payment for Asset Acquisitions
Escrow Deposits Used to Fund Business Acquisitions
Escrow Deposits Used to Fund Acquisitions
Proceeds from Business Divestments	—	—	—	—	—	—
Cash Received from Sale of Urgent Care Centers and Franchising Businesses, Net of Note Receivable
Other Investing Activities	-8.4	1.9	-1.2	2.9	0.1	16
Cash from Insurance Proceeds
Deconsolidation of an Ancillary Business
Change in Escrow Deposits
Cash Proceeds from Sale-Leaseback
Restricted and Other Assets
Change in Other Assets
Investments and Change in Other Assets
Cash Proceeds from Sale Leaseback
Change in Other Restricted Assets
Use of Restricted Cash
Cash from Investing Activities	-311.9	-245.5	-144.6	-120.3	-62.4	-109.6
Investing Activities

Financing Activities	Jun '25	Dec '24	Jun '24	Dec '23	Jun '23	Dec '22
Issuance of Long-Term Debt	—	0.4	—	0.2	—	0.2
Proceeds from Debt
Repayments of Long-Term Debt	-2	-2.4	-2	-2.1	-2	-2.2
Payments on Debt
Net Issuance / (Repayments) of Long-Term Debt	-2	-2	-2	-1.9	-2	-2
Issuance of Common Shares	13.7	12	10.3	9.8	8.6	6.6
Proceeds from Common Stock Offering
Issuance Costs in Connection with Common Stock Offering
Issuance of Treasury Stock Upon Exercise of Options
Issuance of Common Stock Upon Exercise of Options
Proceeds from Sale of Subsidiary Shares
Repurchases of Common Shares	-21.1	—	-1.2	—	-1.9	—
Repurchase of Shares of Common Stock to Satisfy Tax Withholding Obligations
Repurchase of Shares of Common Stock and Subsidiary Shares
Repurchase of Shares of Common Stock
Net Issuance / (Repurchases) of Common Shares	-7.4	12	9.1	9.8	6.6	6.6
Common Share Dividends Paid	-7.2	-6.9	-6.8	-6.5	-6.4	-6.1
Dividends Paid
Other Financing Activities	-0.1	-5.3	-0.3	-0.1	-0.2	-1
Excess Tax Benefit from Share-Based Compensation
Dividends Received from Pennant
Cash Retained by Pennant at Spin-Off
Non-Controlling Interest Distribution
Purchase of Non-Controlling Interest
Payment of Contingent Consideration
Payments of Deferred Financing Costs
Proceeds from CARES Act Provider Relief Fund and Medicare Advance Payment Program
Repayments of CARES Act Provider Relief Fund and Medicare Advance Payment Program
Cash from Financing Activities	-16.7	-2.2	0	1.3	-1.9	-2.4
Financing Activities

Free Cash Flow	Jun '25	Dec '24	Jun '24	Dec '23	Jun '23	Dec '22
Free Cash Flow	135.4	141.3	47.6	154	116.5	92.2
NOPAT	154.5	147.2	129.7	77.7	118.9	116.4
Levered Free Cash Flow	117.7	139	90.2	153.7	135.8	153.7
Unlevered Free Cash Flow	109.6	130.1	82.1	147.7	132.7	155.5
Net Change in Cash	-100.6	-12.7	-32.3	89.7	103.7	30.7