The Ensign Group, Inc.

Overview

• The Ensign Group, Inc. is a holding company with independent subsidiaries that provide skilled nursing, senior living and rehabilitative services, plus ancillary services (including mobile diagnostics and medical transportation) across 17 states.
• The company also owns and leases real estate to service the post-acute care continuum, primarily through its captive REIT, Standard Bearer Healthcare REIT, Inc. (Standard Bearer).

2025 operational footprint

Facilities

• 373 facilities total across skilled nursing and senior living as of December 31, 2025.
• Of these 373 facilities, 253 are operated under long-term lease arrangements, with options to purchase 8 of the 253.

Real estate ownership and leases

• 158 owned real estate properties.
  • 120 facilities are owned and operated by Ensign.
  • 38 real estate properties are operated by third-party operators under lease.
  • The Service Center operates from its California location (included among the 38 third-party-operated properties).
• Among the 38 third-party-operated properties, one senior living operation is located on the same property as a skilled nursing operation that Ensign owns and operates.

Real estate strategy and Standard Bearer REIT

• Standard Bearer was formed in January 2022 to own and manage the real estate business.
• Standard Bearer is taxed as a REIT for U.S. federal income tax purposes (beginning with its taxable year ending December 31, 2022).
• Standard Bearer’s real estate portfolio comprises 152 of Ensign’s 158 owned properties.
• 2025 acquisitions by Standard Bearer:
  • 25 stand-alone skilled nursing operations
  • 1 stand-alone senior living operation
  • 2 campus operations
• Of these additions, 4 stand-alone skilled nursing operations are leased to third-party operators; the remaining additions are operated by Ensign’s independent subsidiaries.

Segments and reporting

• Two reportable segments:
  • Skilled services: operation of skilled nursing facilities and rehabilitation therapy services.
  • Standard Bearer: select properties owned by Ensign through the captive REIT and leased to skilled nursing and senior living operations (including Ensign subsidiaries and third-party operators).
• All Other includes senior living operations, other real estate, other ancillary operations, and the Service Center; these items are insignificant individually and are not presented as a separate reportable segment.
• The Chief Executive Officer (CODM) reviews segment income to evaluate performance and allocate capital resources.
• For the year ended December 31, 2025, approximately 95.6% of Ensign’s revenue was generated from skilled nursing facilities.

Corporate structure and services

• Ensign is a holding company with no direct operating assets, employees, or revenues.
• Independent subsidiaries, including the Service Center, provide centralized services (accounting, payroll, HR, IT, legal, risk management, etc.) to other subsidiaries under contractual arrangements.
• The captive insurance entity provides claims-made coverage to independent subsidiaries for general and professional liability and certain workers’ compensation liabilities.
• Standard Bearer owns and manages the real estate portfolio and serves as the REIT vehicle for Ensign’s real estate activities.