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☑ ☐ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington , D.C. 20549 FORM 10 - K ANNUAL REPORT PURSUANT TO SECTION 13 OR 15 ( d ) OF THE SECURITIES EXCHANGE ACT OF 1934 . For the fiscal year ended December 31 , 2020 . OR TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 ( d ) OF THE SECURITIES EXCHANGE ACT OF 1934 . For the transition period from to Commission file number : 001-33757 THE ENSIGN GROUP , INC . ( Exact Name of Registrant as Specified in Its Charter ) Delaware ( State or Other Jurisdiction of Incorporation or Organization ) Title of each class Common Stock , par value $ 0.001 per share 29222 Rancho Viejo Road , Suite 127 San Juan Capistrano , CA 92675 ( Address of Principal Executive Offices and Zip Code ) ( 949 ) 487-9500 ( Registrant's Telephone Number , Including Area Code ) Securities registered pursuant to Section 12 ( b ) of the Act : Trading Symbol ( s ) . ENSG Securities registered pursuant to Section 12 ( g ) of the Act : None 33-0861263 ( I.R.S. Employer Identification No. ) Name of each exchange on which registered NASDAQ Global Select Market ☑ Yes ☐ Yes Yes ✓ Yes Indicate by check mark : if the registrant is a well - known seasoned issuer , as defined in Rule 405 of the Securities Act . if the registrant is not required to file reports pursuant to Section 13 or Section 15 ( d ) of the Act . whether the registrant ( 1 ) has filed all reports required to be filed by Section 13 or 15 ( d ) of the Securities Exchange Act of 1934 during the preceding 12 months ( or for such shorter period that the registrant was required to file such reports ) , and ( 2 ) has been subject to such filing ☑ requirements for the past 90 days . whether the registrant has submitted electronically , every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S - T ( $ 232.405 of this chapter ) during the preceding 12 months ( or for such shorter period that the registrant was required to submit such files ) . whether the registrant is a large accelerated filer , an accelerated filer , non - accelerated filer , a smaller reporting company , or an emerging growth company . See the definitions of " large accelerated filer , ” “ accelerated filer , ” “ smaller reporting company , " and " emerging growth company " in Rule 12b - 2 of the Exchange Act : Large accelerated filer Accelerated filer If an emerging growth company , indicate if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13 ( a ) of the Exchange Act . ✓ ☐ Non - accelerated filer ☐ Smaller reporting company ☐ Emerging growth company ☐ ☐ No | ☑ No ☐ No ☐ No Yes ☐ No Whether the registrant has filed a report on and attestation to its management's assessment of the effectiveness of its internal control over financial reporting under Section - 404 ( b ) of the Sarbanes - Oxley Act ( 15 U.S.C. 7262 ( b ) ) by the registered public accounting firm that prepared or issued its audit report . ✓ Yes ☐ No ☐ Yes ☑ No whether the registrant is a shell company ( as defined in Rule 12b - 2 of the Exchange Act ) . As of June 30 , 2020 , the aggregate market value of the Registrant's Common Stock held by non - affiliates was : Common Stock The aggregate market value of Common Stock was computed by reference to the closing price as of the last business day of the registrant's most recently completed second fiscal quarter . Shares of Common Stock held by each executive officer , director and each person owning more than 10 % of the outstanding Common Stock of the registrant have been excluded ( in the amount of $ 809,280,000 ) in that such persons may be deemed to be affiliates of the registrant . This determination of affiliate status is not necessarily a conclusive determination for other purposes . $ 1,314,711,000