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Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 OCTOBER 2026 INVESTOR PRESENTATION Prevent Page Cut-off: File > Save As > PDF. When printing, the "scale" must be "Fit to Printable Area" to prevent page cut-off.
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Ensign Group 2026 Investor Presentation | 2 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Disclaimers This presentation contains, and other communications of The Ensign Group, Inc. (“Ensign” or the “Company”) may contain, forward- looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These statements can be identified by the fact that they do not relate strictly to historical or current facts. Forward-looking statements often use words such as “believe,” “expect,” “anticipate,” “intend,” “estimate,” “project,” “outlook,” “forecast,” “target,” “trend,” “plan,” “goal,” or other words of comparable meaning or future-tense or conditional verbs such as “may,” “will,” “should,” “would,” or “could.” Statements in this presentation concerning the Company’s future prospects are forward-looking statements, and are based on management’s current expectations, assumptions and beliefs about our business, financial performance, operating results, the industry in which we operate and possible future events. These statements include, but are not limited to, statements regarding our growth prospects and future operating and financial performance. Forward-looking statements convey our expectations, intentions, or forecasts about future events, circumstances, results, or aspirations. Forward-looking statements are not guarantees of future results and are subject to risks, uncertainties and assumptions, which may change over time and many of which are beyond our control, and actual results could differ materially from those expressed in any forward-looking statement. Readers should not place undue reliance on any forward-looking statements and are encouraged to review our periodic filings with the Securities and Exchange Commission, including those set forth under “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of the Company’s Annual Report on Form 10-K for the year ended December 31, 2025 (the "Annual Report") and under “Risk Factors” in Part I, Item 1A of the Annual Report", or other applicable documents that are filed or furnished by the Company with the U.S. Securities and Exchange Commission (the “SEC”), for a more complete discussion of the risks and other factors that may cause actual results or other future events, circumstances, or aspirations to differ from those in forward- looking statements. These documents are available on our website at www.ensigngroup.net (information on our website is not incorporated by reference into this presentation and should not be considered part of this document). This information is provided as of today’s date only, and except as required by federal securities law, Ensign does not undertake to publicly update or revise any forward- looking statements, whether as a result of new information, future events, changing circumstances or for any other reason after the date of this presentation. We supplement our GAAP reporting with EBITDA, adjusted EBITDA, adjusted EBITDAR, adjusted EBT, adjusted net income, adjusted EPS, Funds from Operations (FFO) metrics, as well as segment income and FFO metrics, all of which are supplemental non-GAAP financial measures. They reflect an additional way of looking at aspects of our operations that, when viewed with our GAAP results, provide a more complete understanding of factors and trends affecting our business. They should not be relied upon to the exclusion of GAAP financial measures. A more ample discussion of these Non-GAAP financial measures is available on the “Investor Relations” tab of our website and a reconciliation to GAAP is included as an Appendix to this presentation. During this presentation we may reference operations in any or all of the skilled and assisted living operations and other businesses operated by our independent subsidiaries. Each such business is operated as a separate, wholly owned independent subsidiary that has its own management, employees and assets. References in the presentation to the consolidated “Company” and “its” assets and activities, as well as the use of the terms “we,” “us,” “our,” and similar verbiage are not meant to imply that The Ensign Group, Inc. has direct operating assets, employees or revenue, or that any of the operations, the Service Center, Standard Bearer Healthcare REIT, Inc., or the captive insurance subsidiary are operated by the same entity.
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Ensign Group 2026 Investor Presentation | 3 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 SHAREHOLDER RETURN (9) GUIDANCECLINICAL STRENGTH The Ensign Group Leading Operator States 18 Owned Properties 189 Same Facilities Occupancy Rate(1) 84.1% Unique residents cared for in 2026 annualized 200K+ Total Shareholder Return in the Past 10 years 906% Total Shareholder Return Since IPO (2007) 4,072% 2026 Revenue Guidance(1) $5.91B 2026 Adjusted Diluted EPS Guidance(1)* $7.98 CMS Quality Measure vs the National Average for Same Facilities(2) 24% CMS Cycle 1 Survey Inspections vs the State Average for Same Facilities(2) 15% Founded 1999 Operated Facilities 418 Beds / units across the care continuum 47K Employees 60K Reach out to Karkhoff, Jill <JKarkhoff@EnsignServices.net> Jesse Park MPark@EnsignServices.net and Carolyn Perkins CPerkins@ensignservices.net for number of employees for the reporting period.
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Ensign Group 2026 Investor Presentation | 4 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 The Ensign Group Executive Summary Clinical excellence fuels sustainable growth Provider of choice in the communities we serve Proven model Transforms clinical and financial results Local leadership creates enduring competitive advantage
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Ensign Group 2026 Investor Presentation | 5 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 GEOGRAPHIC FOOTPRINT (3) 2 The Ensign Group At a Glance States 18 Total Operations 418 Skilled Nursing Operations 368 Senior Living Operations 16 Campus Operations 34 KEY STATISTICS (3) Elevating our mission across a fragmented healthcare landscape 22 1 85 3 2 15 29 42 46 12 107 8 10 5 11 2 9 SKILLED NURSING OPERATIONS(4) 12%2.5% Top 10 Operators 14,700 A Fragmented Industry 9
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Ensign Group 2026 Investor Presentation | 6 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 The Ensign Group Key Highlights 31 Property Acquisitions in 2026 and since(3) 24% Adjusted Diluted EPS* over Q3 2025 20% Facility CAGR since 1999 52 Average AITs throughout last year 80%+ % of Operations with 4 or 5 QM Rating(2) 88% The Emergency Fund Participation(5) Founded with a mission that fosters an enduring culture. Every person, process, and system is aligned around delivering exceptional patient outcomes. Empowered local leaders build trusted partnerships, supported by the strength of our mission. Leading operator with a long history of growing operations in a fragmented market Disciplined investments that support long-term operational and strategic real estate growth. Strong financial results are the natural outcome of living our mission and values. MISSION LEADERSHIP GROWTH REAL ESTATE FINANCIALS 4 or 5 QM rating - PowerBI - QM Rating provider count selected
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Ensign Group 2026 Investor Presentation | 7 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 The Ensign Group Our Mission and Values Everyday situations met with out-of-the- ordinary service that surpasses all reasonable expectations. To dignify post-acute care in the eyes of the world through Moments of Truth What is a Moment of Truth? CUSTOMER SECOND, ACCOUNTABILITY, PASSION FOR LEARNING, LOVE ONE ANOTHER, INTELLIGENT RISK TAKING, CELEBRATION, OWNERSHIP A values-based leadership framework driving behavior, decision-making and organizational performance
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Ensign Group 2026 Investor Presentation | 8 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 After learning that a Mystic Park resident had once authored a book, Lily D., Medication Aide purchased a copy and spent personal time reading it back to the resident. The gesture reflects a culture of honoring each resident’s identity, accomplishments and life story, extending care well beyond clinical needs. After learning that a resident was approaching a 57th wedding anniversary, Oliver M., Certified Nursing Assistant , went above and beyond to create a surprise anniversary dinner for the couple. The thoughtful gesture reflects a culture of knowing our residents personally and creating meaningful moments beyond their clinical needs. Albert G., a retired Park Manor leader volunteered his time and expertise to help a cluster facility improve their facility. His actions reflect a culture of servant leadership and collaboration that extends beyond individual operations. A Culture of Caring for Our Residents – Highlights from the quarter 2026 SUBMISSIONS Moments of Truth Number taken from monthly email from Tracy Jenkin <tjenkins@EnsignServices.net Will need to update MOT for the Q
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Ensign Group 2026 Investor Presentation | 9 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Winning The Flag is one of Ensign’s highest honors, recognizing operations that excel in clinical quality, culture, compliance, employee engagement, and financial performance. What Defines a Flag Winner • Best-in-Class Compliance • Highly Engaged Workforce • Exceptional Clinical Outcomes 49 Winners in 2025 The Ensign Group Winning the Ensign Flag • Proven Local Leadership • Industry-Leading Retention • Strong Community Reputation • Consistent Operational Execution
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Ensign Group 2026 Investor Presentation | 10 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 The Ensign Group Clinical Focus Our residents improve their functional abilities better than the state average by 30% Superior rehospitalization rates outperform the national average by 14% Short-stay residents go to outpatient emergency departments less than the state average by 13% Antipsychotic medication is used less than the state average by 28% Long-stay residents go to outpatient emergency departments less than the state average by 18% Residents fall are less than the national average by 19% We retain our administrator leadership better than the state average by (2) 45% We retain our Registered Nurses better than the state average by (2) 11% Our average administrators in training throughout the last 12 months 52 Source: CMS Care Compare Data as of September 2026 OneClinical unites nursing and therapy as one team, creating enhanced clinical outcomes through shared expertise and accountability. Mary Spaeder, Therapy Leader LONG-STAY MEASURES FOR SAME FACILITIES (2) TEAM RETENTIONSHORT-STAY MEASURES FOR SAME FACILITIES (2) Clinicals from report built by data team - they are building the automated process for every quarter https://ensignservices-my.sharepoint.com/:x:/r/personal/atruong_ensignservices_net/_layouts/15/Doc.aspx?sourcedoc=%7B860638C8-5AC6-4297-AF8C-B58A59831B9F %7D&file=CMS_Data_Request_for_Sep_20261012.xlsx&fromShare=true&action=default&mobileredirect=true
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Ensign Group 2026 Investor Presentation | 11 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Operational Spotlight Bainbridge Island Health and Rehabilitation sits across Puget Sound from Seattle and has been a part of Ensign since 2015. Great Leaders Build Exceptional Results CMS Overall Rating (2) CMS Quality Measures (2) CMS Health Inspection (2) CMS Staffing Rating (2) • Led by homegrown leaders developed through our administrator and director of nursing training programs and grounded in a strong clinical pedigree. • Staffing and RN turnover are 48% and 66% better than the rest of the state • CMS High-Performing facility – Only 12% of Skilled Nursing Facilities Nationally • 59% of our Washington market are CMS High- Performing facilities. Acquired 2015 Washington
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Ensign Group 2026 Investor Presentation | 12 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Operational Spotlight Decatur County Healthcare operates in Tennessee, a state we entered in 2024 as part of our continued expansion across the Southeast. Elevating Experienced Leaders CMS Overall Rating (2) CMS Quality Measures (2) CMS Health Inspection (2) Occupancy Increase in Last Year +23% • Long-tenured leadership team (Executive Director and Director of Nursing) with more than 45 years of combined experience at this operation. • With OneClinical, therapy moved from a contracted vendor to in-house partners at transition. • Local leadership drives results, amplified by cluster and resource support. Acquired 2025 Tennessee
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Ensign Group 2026 Investor Presentation | 13 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Past Operational Spotlights Our stories are told locally Raising the Standard of Care Finding Growth in a Mature Operation Building a Foundation for Growth Purpose Built for We are excited to bring you these defining stories on every quarterly earnings calls Q2 2026 Q1 2026 Q1 2026 Q1 2026
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Ensign Group 2026 Investor Presentation | 14 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 41.3% 15.0% 200920102011201220132014201520162017201820192020202120222023202420252026 Quality Outcomes SAME FACILITIES CYCLE 1 SCORES FROM 2022 THROUGH SEPTEMBER 2026 (2) 15% Better State Average Average Track Record of Turning Around Underperforming Operations A History of Outperformance in Health Inspections Lower / Better Clinical quality is the foundation of everything we do. Achieving strong Cycle 1 health inspection results not only validates the quality of care we provide, but also strengthens referral relationships, supports census growth, and reinforces our ability to deliver sustainable long-term performance. Marivic Uychiat, Registered Nurse Clinical Leader 1-STAR FACILITY TREND (2) 2022 2023 2024 2025 2026
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Ensign Group 2026 Investor Presentation | 15 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Peers by scale https://data.cms.gov/quality-of-care/nursing-home-chain-performance-measures -sort facility number from largest to smallest -ENSG facility count comes from data team that reflects number of facilities that make to CMS data base as of the quarter end. Same Facility Quality measure from 2022 - Sep 2026 Clinical Data Service → Five Star File → QM Rating tab → Filter for latest Month update → Same Store only → use CMS: QM Rating and CMS: QM Rating State Peer 1 Peer 2 Peer 3 Peer 4 100 150 200 250 300 350 4003 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 Quality Outcomes SAME FACILITIES QUALITY MEASURE FROM 2022 THROUGH SEPTEMBER 2026 (2) TOTAL QUALITY MEASURE VERSUS TOP PEERS BY SCALE (2) 24% Better National Average Average Demonstrates Our Ability to Scale While Maintaining Quality A History of Outperformance in Quality Measures Higher / Better 3.6 National Average Facility Count CMS Quality Measure Rating What is the CMS Quality Measure Rating? CMS Quality Measures reflect resident outcomes and clinical effectiveness, tracking how successfully facilities improve health, function, and quality of life. A higher score is better. 2022 2023 2024 2025 2026 25% Better At County Level (2)
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Ensign Group 2026 Investor Presentation | 16 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Great clinical outcomes rarely happen in isolation. Our cluster model connects local caregivers and clinical leaders so that best practices, expertise, and support can move quickly across operations, helping us deliver better care for every resident we serve. Local Leadership What is a Cluster? Regional collaboration and connectivity between operations with shared accountability and best practices. CLUSTER MODEL Payor Benefits Clusters create scale, alignment, and market influence across the continuum of care Performance transparency and shared accountability drive superior clinical outcomes Economic Benefits Scale efficiencies are achieved through shared resources and expertise Clusters coordinate market strategy to accelerate growth and market penetration Barry Port, Chief Executive Officer Cultural Benefits Powerful network of local leaders who share ideas, challenge one another, and hold themselves accountable to delivering exceptional outcomes for patients, residents, and employees.
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Ensign Group 2026 Investor Presentation | 17 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Partnerships that Advance Our Mission Collaborate with accountable care organizations and managed care organizations to improve outcomes, reduce costs, and advance value-based care. Deploy captive ancillary businesses that are purpose- built to meet evolving patient and partner needs. Drive outcomes for patients, market share and occupancy Preferred Partnerships Value-Based Partnerships Post-Acute Care Continuum
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Ensign Group 2026 Investor Presentation | 18 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 ACQUISITION TYPE BY STATE Operational Growth Operations Acquired Real Estate Only 22 1 Iowa • 1 Skilled Nursing Facility 3 Wisconsin • 1 Skilled Nursing Facility • 2 Real Estate Only and Leased to Third Party California • 1 Real Estate Only and Leased to Third Party • 2 Real Estate Only Operation Expansions 45 Operational Beds and Units Added 5,345 Real Estate Total Acquisitions 31 Real Estate Leased to Ensign Affiliates 23 Real Estate Previously Leased to Ensign Affiliates 5 Real Estate Leased to Third Parties 3 Cash Spent on Acquisitions $540 million BY THE NUMBERS (YEAR TO DATE 2026) (3) Texas • 20 Skilled Nursing Facilities • 2 Campuses 3 4 Arizona • 1 Skilled Nursing Facility • 3 Real Estate Only 4 Washington • 4 Skilled Nursing Facility 7 Colorado • 6 Skilled Nursing Facilities • 1 Campus 9 Florida • 8 Skilled Nursing Facilities • 1 Campus
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Ensign Group 2026 Investor Presentation | 19 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 7 13 19 23 38 40 43 53 57 59 72 77 93 98 107 121 150 175 187 194 223 228 245 271 297 327 373 418 199920002001200220032004200520062007200820092010 2011 2012 2013 2014 2015 2016 2017 2018 2019 20202021 20222023202420252026 Q3 Healthcare Facilities Operated 20% Facility CAGR Founded in 1999 with three facilities in Texas Completed spin-off Completed IPO Formed captive REIT Completed spin-off The Ensign Group History of Growth (3)
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Ensign Group 2026 Investor Presentation | 20 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 16% 8% 10% Facility-Based Healthcare Services Post-acute $1,027$1,183$1,438$1,598$1,755$2,037$2,403$2,627$3,025 $3,729 $4,260 $5,058 $4,314 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Q3 2026 We view growth not as an end in itself, but as a means to advance our mission, expand access to quality care, and create lasting value for our stakeholders. Ensign Represents the Growth Story REVENUE CAGR: 16% Spencer Burton, Chief Operating Officer Dollars presented in millions (7) (8) (6) Facility-based healthcare services refer to both acute care (hospital, etc.) and post-acute care (SNF, LTAC, HHH)
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Ensign Group 2026 Investor Presentation | 21 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 $159 $221 $262 $285 $319 $374 $424 $478 $533 $623 $706 $842 $742 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Q3 2026 16% 8% 14% Facility-Based Healthcare Services Post-acute Ensign Represents the Growth Story ADJUSTED EBITDAR* CAGR: 16% (6) Dollars presented in millions (7) (8)
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Ensign Group 2026 Investor Presentation | 22 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 $234 $280 $315 $365 $428 $516 $460 2020 2021 2022 2023 2024 2025 Q3 2026 17% 7% 10% Facility-Based Healthcare Services Post-acute Ensign Represents the Growth Story ADJUSTED EBT* CAGR: 17% Dollars presented in millions (7) (8)
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Ensign Group 2026 Investor Presentation | 23 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Insert Picture 8.5% 14.3% 42.7% 5th Quarter 15th Quarter 45th Quarter 26.8% 47.4% 59.8% 5th Quarter 15th Quarter 45th Quarter Achieving Significant Improvements Over 45 Quarters SKILLED MIX REVENUE INCREASE (10) ADJUSTED EBITDAR* INCREASE (10) UPDATED - EY 10/12/2026 keep it as 9/30 ** Add back golden hills from files in Q3?? ** - Added During QE, use the other linked version that includes subsequent acquisitions. All SNF facilities that we operates, campus also included, bottom two graphs present change over change Acquisition Stats File Path: P:\Accounting Share\01 End User Computing Tools\Investor Relations\2026\Q2\Investor Presentation\Support\Acquisition Stats
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Ensign Group 2026 Investor Presentation | 24 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 0% 1000% 2000% 3000% 4000% 5000% 6000% 4,072% Growth Since IPO(9) Strong Shareholder Return Since IPO 640% Growth During Same Period(9) 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Request from Horstkamp, Jacob Edward <jacob.edward.horstkamp@citi.com> - Citi, as of 9/30/2026 P:\Accounting Share\01 End User Computing Tools\Investor Relations\2026\Q3\Investor Presentation\Support Updated as of 6/30/2026 - Pending to update as of 7/24/26 Request as needed - at least on a quarterly basis.
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Ensign Group 2026 Investor Presentation | 25 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 GEOGRAPHIC FOOTPRINT (3) 17 1 8 6 1 7 7 29 21 15 41 5 3 55 2 Number of owned properties per state Standard Bearer At a Glance Properties 183 Real estate fair value (11) $2.4B States 17 Operating beds/unit 18.7K Weighted avg. Lease tenor 14.1 Years Ensign operated (11) 90% Percentage of Leases Expiring After 2031 (11) 99% KEY STATISTICS (3) Standard Bearer allows us to align outstanding operations with strategic real estate ownership, creating a platform that supports growth, preserves flexibility, and compounds value over the long term. Chad Keetch, Chief Investment Officer 1
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Ensign Group 2026 Investor Presentation | 26 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 High-Quality Portfolio Of Assets POLARIS TRANSITIONAL CARE ALASKA STONEHENGE OF SPRINGVILLE UTAH PACIFIC HAVEN CALIFORNIA Ensign’s real estate portfolio includes attractive assets in appealing markets that provide the foundation for patient care and well-being. Facilities are purpose-built or customized to accommodate specialty needs Assets include a mix of state-of-the-art and hands-on therapeutic approaches to provide specific care plans for each individual Facilities offer a wide variety of services that provide all the benefits of being at home
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Ensign Group 2026 Investor Presentation | 27 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 $19.3 $20.4 $21.6 $24.7 $27.3 $9.6 $10.3 $10.8 $12.1 $13.8 FFO* Segment Income Q3 2025 Q4 2025 Q1 2026 Q2 2026 Q3 2026 $27.6 $29.3 $30.8 $37.8 $42.1 $5.0 $5.2 $5.3 $6.3 $5.6 Ensign Affiliated LeaseThird-Party Lease Q3 2025 Q4 2025 Q1 2026 Q2 2026 Q3 2026 Standard Bearer Performance RENTAL REVENUE OTHER REAL ESTATE METRICS (12) Dollars presented in millions
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Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 56% 2% 33% 9% Significant Real Estate Portfolio Triple Net Lease Structure Offers Predictability Lease Structure Multiple triple-net master leases with quality third party operators Typical Terms Initial terms from 10 to 20 years with extension options Rent Terms CPI-based escalators Expenses Third-party operators responsible for maintenance, capital expenditures, property taxes, insurance and other expenses Other Terms Customary covenants and events of default Key Tenants 1 2 3 4 5 Leased (without a Purchase Option) Owned and Affiliate Operated Owned and Leased to Third-Party Operators Leased (with a Purchase Option) 260 facilities 39 Facilities 150 Facilities 8 Facilities (13) (13)
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Ensign Group 2026 Investor Presentation | 29 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Insert Picture $945 $997 Q3 2025 Q3 2026 Insert Picture $1,296 $1,484 Q3 2025 Q3 2026 $3,697 $4,314 Q3 2025 Q3 2026 $2,788 $2,965 Q3 2025 Q3 2026 Quarter Financial Highlights 14% 17% Year to DateQuarter to Date CONSOLIDATED REVENUE 6% 6% Year to DateQuarter to Date SAME FACILITY SKILLED NURSING REVENUE (14) SAME FACILITY OCCUPANCY % Dollars presented in millions 82.4% 84.2% 82.8% 84.1% 10/14/2026 EY Consolidated Adjusted Net Income from Press Release % Change Revenue: Re-calculate in millions. Not disclosed. SS SNF Rev: Refer to 10-Q Consolidated Adj NI: Ties to PR; re-calculate in thousands.
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Ensign Group 2026 Investor Presentation | 30 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 CONSOLIDATED MEDICAID CONSOLIDATED 32.2% 29.3% 25.9% Same Store Transitioning Recently Acquired 84.1% 86.1% 77.4% Same Store Transitioning Recently Acquired $812 $881 $776 Same Store Transitioning Recently Acquired 51.2% 49.3% 43.2% Same Store Transitioning Recently Acquired Demonstrated Track Record of Significant Operational Improvements QTD Q3 2026 MEDICARE RATES ( 14 )SKILLED MIX REVENUE (14 ) SKILLED MIX DAYS ( 14 )SNF OCCUPANCY ( 14 ) 49.7% CONSOLIDATED $817 83.1% CONSOLIDATED 30.7% $313
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Ensign Group 2026 Investor Presentation | 31 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Insert Picture CONSOLIDATED ADJUSTED DILUTED EPS $4.75 $5.80 Q3 2025 Q3 2026 $1.64 $2.03 Q3 2025 Q3 2026 Insert Picture $96 $120 Q3 2025 Q3 2026 $279 $345 Q3 2025 Q3 2026 Quarter Financial Highlights 25% 24% Year to DateQuarter to Date CONSOLIDATED ADJUSTED NET INCOME (IN MILLIONS) 24% 22% Year to DateQuarter to Date 10/14/2026 EY Consolidated Adjusted Net Income from Press Release % Change Revenue: Re-calculate in millions. Not disclosed. SS SNF Rev: Refer to 10-Q Consolidated Adj NI: Ties to PR; re-calculate in thousands.
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Ensign Group 2026 Investor Presentation | 32 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 $ in thousands Nine Months Ended September 30, 2026 2025 Net cash provided by (used in) Operating activities $512,348 $380,950 Investing activities (15) (690,937) (389,237) Financing activities 12,300 (12,643) Net decrease in cash and cash equivalents $(166,289) $(20,930) Cash and cash equivalents beginning of period $503,881 $464,598 Cash and cash equivalents end of period $337,592 $443,668 Other liquidity metrics: Availability under the Credit Facility (16) $731,598 $592,598 Net Debt to Adjusted EBITDAR 1.95x 1.86x Over $1.1 billion in dry powder available for future investments Liquidity Financial Measures Our disciplined approach to capital allocation has allowed us to maintain both financial strength and acquisition capacity. The result is a balance sheet that supports growth today while preserving flexibility for tomorrow. Suzanne Snapper, Chief Financial Officer
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Ensign Group 2026 Investor Presentation | 33 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 EPS Guidance Raised $5.89B to $5.92B Annual Revenue $7.94 to $8.02 Adjusted Diluted EPS* 21% over 2025 45% over 2024 Adjusted Diluted EPS* Midpoint Same Facilities Growth Better Clinical Outcomes Stronger Census Transitioning Facilities Growth Acquisition Activity
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Ensign Group 2026 Investor Presentation | 34 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 A Culture of Experienced Leaders Driving the Mission Barry Port Chief Executive Officer and Chairman of the Board 22 YEARS • COO, Ensign Services • President of Keystone Care, Inc. • CEO of Bella Vita Health and Rehabilitation Center (Ensign Affiliate) • Leader of Strategic Sourcing Initiatives for Sprint Corporation Suzanne Snapper Chief Financial Officer, EVP and Director 19 YEARS • Vice President of Finance • Senior Manager at KPMG LLP Chad Keetch Chief Investment Officer, EVP 15 YEARS • Executive Vice President and Secretary • Vice President of Acquisitions and Business Legal Affairs • Assistant Secretary • Attorney at Kirkland & Ellis LLP Spencer Burton President, Chief Operating Officer 20 YEARS • President of Pennant Healthcare • CEO of Pacific Care and Rehabilitation (Ensign Affiliate) • Utah State Office of Legislative Research Marivic Uychiat Registered Nurse, EVP of Clinical Services and Director 22 YEARS • Director of Clinical Services, Flagstone • Director of Nursing, Vista Knoll You can find everything here https://investor.ensigngroup.net/corporate-governance/management on our website in their bios. Hire dates: CRC – April 1999 (workday has CRC start date as of 1/1/2000) BP – 4/1/2004 SS – 4/23/2007 CK – 12/1/2010 SB – 8/21/2006 (Update to 20 years in Q3'26)
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Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 APPENDIX
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Ensign Group 2026 Investor Presentation | 36 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Fragmented Industry = Acquisition Opportunities 4+ million more people in 5 years A Favorable Backdrop for Growth in the Skilled Services Industry 80+ Population To Double by 2060 POPULATION PROJECTIONS OF 80+ YEAR OLDS FROM 2022 THROUGH 2065 (MILLIONS) Source: United States Census Bureau Bar Chart - https://www.census.gov/programs-surveys/popproj/data/tables.html / new source for both graph: https://www.census.gov/data-tools/demo/idb/#/pop? dashboard_page=country&COUNTRY_YR_ANIM=2024&menu=popViz&COUNTRY_YEAR=2025&CCODE=US&CCODE_SINGLE=US&subnat_map_admin=ADM1&POP_YEARS=2022,2025,2030,2 035,2040,2045,2050,2055,2060,2065&popPages=BYAGE&ageGroup=O 2023 : Main Series, Table D. Project Population by Age Group – Updated with 2023 Report, as of 10/20/2025 • New report releases range from 2 to 6 years. • table 2. projected population by age group 12.7 14.7 18.8 22.9 26.8 29.4 30.1 30.1 30.5 32.2 2022 2025 2030 2035 2040 2045 2050 2055 2060 2065
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Ensign Group 2026 Investor Presentation | 37 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 LTACH 2% IRF 13% Home Health 43% Skilled Nursing 42% POST-ACUTE DESTINATIONS - % OF MEDICARE DOLLARSMEDICARE SPENDING PROJECTION One of The Largest Beneficiary Of Medicare Post-Acute Dollars While Medicare Spending Continues to Increase (IN BILLIONS) Source: MedPAC and US HHS Department as of March 2026. Source: 2025 and 2026 Medicare Trustees Report. Graph 1: Medicare spending projection: Data: 2026 Medicare Trustees Report, PDF page 186 - latest release 6/9/2026, last checked as of 10/10/2026 • Table V.B1 - "Total Medicare Income, Expenditures, and Trust Fund Assets during Calendar Years 19xx - 20xx" • CMS - https://www.cms.gov/data-research/statistics-trends-and-reports/trustees-report-trust-funds Graph: March 2025 MedPAC Report, PDF pg 42, Report pg 12, Figure 1-2 - uses 2024 table data - latest release as of 3/12/2026 (2026 report does not have $ amount - the CY dot uses 2025 medpac report) Graph 2: Post-Acute Destinations - % of Medicare Dollars: obtained from www.medpac.gov (http://www.medpac.gov) Report to the Congress: Medicare Payment Policy > Saved in support folder • March 2026 MedPAC Report, Post acute destinations: PDF page 263 - Table 8-5 "FFS Medicare beneficiaries' first post-acute care site after an IPPS hospital stay, 2019 - 2024" - latest release as of 3/12/2026 reports 2024 data SNF 17.3% > 41.9% of total HH 18.0% > 43.6% of total IRF 5.3% > 12.8% of total LTAC 0.7% > 1.7% of total Why HH increased over SNF: Before the pandemic, SNFs were the most frequent first post-acute care (PAC) destination among beneficiaries receiving formal PAC, with home health care services being the second most frequent PAC destination (Table 7-3 in MedPac report). In 2020, the two services switched ranks in their share of use after an inpatient hospital stay. Home health care services became the most frequent first PAC service; the share receiving SNF services dropped to the second most frequent first PAC service. 2016 2018 2020 2022 2024 2026 2028 2030 2032 20340 500 1000 1500 2000 2500
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Ensign Group 2026 Investor Presentation | 38 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Reconciliation of GAAP to Non-GAAP Income $ in thousands except earnings per share Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Net income attributable to The Ensign Group, Inc. $104,262 $83,844 $303,668 $248,517 Adjustments: Stock-based compensation expense 19,044 12,989 49,105 35,375 Costs incurred related to system implementations 1,721 701 6,920 1,472 Acquisition related costs(17) 213 528 1,013 1,663 (Gain) loss on long-lived assets and business interruption recoveries, net (564) (1,660) 720 (2,660) Litigation(18) — 12,000 — 12,000 Gain on other investments(19) — (2,437) — (2,437) Write off deferred financing fees(20) 159 — 159 — Depreciation and amortization – patient base(20) — — — 1,020 Provision for income taxes on Non-GAAP adjustments(21) (4,379) (9,491) (16,621) (16,184) Adjusted net income $120,456 $96,474 $344,964 $278,766 Average number of diluted shares outstanding 59,303 58,956 59,455 58,713 Diluted Earnings Per Share $1.76 $1.42 $5.11 $4.23 Adjusted Diluted Earnings Per Share $2.03 $1.64 $5.80 $4.75 EY 10/14/2026 Found in 8k
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Ensign Group 2026 Investor Presentation | 39 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Reconciliation of GAAP to Non-GAAP Financial Measures $ in thousands Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Income before provision for income taxes $140,198 $106,600 $402,444 $325,538 Adjustments: Stock-based compensation expense 19,044 12,989 49,105 35,375 Costs incurred related to system implementations 1,721 701 6,920 1,472 Acquisition related cost(17) 213 528 1,013 1,663 (Gain) loss on long-lived assets and business interruption recoveries, net (564) (1,660) 720 (2,660) Litigation(18) — 12,000 — 12,000 Gain on other investments(19) — (2,437) — (2,437) Write off deferred financing fees(20) 159 — 159 — Depreciation and amortization – patient base(20) — — — 1,020 Adjusted EBT $160,771 $128,721 $460,361 $371,971 ROLLED - EY 10/14/2026 TIED OUT - EY 10/14/2026 Found in 8k
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Ensign Group 2026 Investor Presentation | 40 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Deferred Compensation Plan (DCP) Impact on the P&L $ in thousands Three Months Ended September 30, Q3 2026 Q2 2026 Q1 2026 Q4 2025 Q3 2025 Consolidated Revenue $1,484,002 $1,440,481 $1,389,196 $1,360,626 $1,296,405 Non-GAAP Cost of Services (COS) with DCP 1,154,339 1,122,995 1,085,091 1,066,369 1,025,104 Less: DCP gain (loss) related to COS (437) 3,902 (799) 627 1,592 Non-GAAP COS without DCP 1,154,776 1,119,093 1,085,890 1,065,742 1,023,512 Non-GAAP COS as a percentage of revenue with DCP 77.8 % 78.0 % 78.2 % 78.3 % 79.1 % Non-GAAP COS as a percentage of revenue without DCP 77.8 % 77.7 % 78.3 % 78.3 % 79.0 % Non-GAAP General and Administrative (G&A) with DCP 71,644 78,299 66,466 65,405 62,364 Less: DCP gain (loss) related to G&A (437) 3,902 (799) 627 1,592 Non-GAAP G&A without DCP $72,081 $74,397 $67,265 $64,778 $60,772 Non-GAAP G&A as a percentage of revenue with DCP 4.9 % 5.4 % 4.8 % 4.8 % 4.8 % Non-GAAP G&A as a percentage of revenue without DCP 4.9 % 5.1 % 4.9 % 4.8 % 4.7 % Non-GAAP Income from Operations with DCP 158,403 141,369 143,332 137,618 120,776 Less: DCP gain (loss) related to COS & G&A (874) 7,804 (1,598) 1,254 3,184 Non-GAAP Income from Operations without DCP 157,529 149,173 141,734 138,872 123,960 Non-GAAP Income from Operations as a percentage of revenue 10.6 % 9.8 % 10.3 % 10.1 % 9.3 % Non-GAAP Income from Operation as a percentage of revenue without DCP 10.6 % 10.4 % 10.2 % 10.2 % 9.6 % ROLLED - EY TIED OUT & RX - EY 1/28/2026 Calculation: File “DCP impact analysis”; Path: P:\Accounting Share\01 End User Computing Tools\Investor Relations\2024\Q3\Investor Presentation Tab “DCP”
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Ensign Group 2026 Investor Presentation | 41 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Reconciliation of GAAP to Non-GAAP Financial Measures $ in thousands Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Net income $104,384 $83,911 $303,974 $248,730 Less: Net income attributable to noncontrolling interests 122 67 306 213 Interest income 4,717 6,168 15,886 18,291 Add: Provision for income taxes 35,814 22,689 98,470 76,808 Depreciation and amortization 32,646 26,633 92,853 76,606 Interest expense 2,286 1,971 6,151 6,033 EBITDA $170,291 $128,969 $485,256 $389,673 Adjustments to EBITDA: Stock-based compensation expense 19,044 12,989 49,105 35,375 Costs incurred related to system implementations 1,721 701 6,920 1,472 Acquisition related costs(17) 213 528 1,013 1,663 (Gain) loss on long-lived assets and business interruption recoveries, net (564) (1,660) 720 (2,660) Litigation(18) — 12,000 — 12,000 Gain on other investments(19) — (2,437) — (2,437) Adjusted EBITDA $190,705 $151,090 $543,014 $435,086 Rent – cost of services 66,970 61,528 198,888 175,799 Adjusted EBITDAR $257,675 $741,902 EY 10/14/2026 Found in 8k • Due to re-classification in Q2’24, for PY numbers from 2023, tie-out to Q3’24 8-K.
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Ensign Group 2026 Investor Presentation | 42 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Reconciliation From Segment Income to Income Before Provisions For Income Taxes QTD Q3 2026 $ in thousands Three Months Ended September 30, Skilled Services Standard Bearer All Other Eliminations Consolidated Total Revenue $1,421,971 $47,704 $66,927 $(52,600) $1,484,002 Cost of Services 1,121,332 323 51,081 (5,934) 1,166,802 Internal rent expense(22) 38,883 — 4,927 (43,810) — External rent expense 61,279 362 5,329 — 66,970 General and administrative expenses(22) — 3,003 79,448 (2,856) 79,595 Depreciation and amortization 15,279 13,565 3,802 — 32,646 Other expense (income), net(23) — 16,700 (18,909) — (2,209) Total expenses $1,236,773 $33,953 $125,678 $(52,600) $1,343,804 Income before provision for income taxes $185,198 $13,751 $(58,751) $— $140,198
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Ensign Group 2026 Investor Presentation | 43 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Reconciliation From Segment Income to Income Before Provisions For Income Taxes YTD 2026 $ in thousands Nine Months Ended September 30, Skilled Services Standard Bearer All Other Eliminations Consolidated Total Revenue $4,132,718 $127,939 $193,451 $(140,429) $4,313,679 Cost of Services 3,263,165 1,448 149,950 (17,698) 3,396,865 Internal rent expense(22) 101,638 — 13,429 (115,067) — External rent expense 183,045 973 14,870 — 198,888 General and administrative expenses(22) — 8,010 239,381 (7,664) 239,727 Depreciation and amortization 46,034 37,024 9,795 — 92,853 Other expense (income), net(23) — 43,854 (60,952) — (17,098) Total expenses $3,593,882 $91,309 $366,473 $(140,429) $3,911,235 Income before provision for income taxes $538,836 $36,630 $(173,022) $— $402,444
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Ensign Group 2026 Investor Presentation | 44 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Reconciliation From Segment Income to EBITDA and Adjusted EBITDA QTD Q3 2026 $ in thousands Three Months Ended September 30, Skilled Services Standard Bearer All Other Consolidated Segment income (loss) $185,198 $13,751 $(58,751) $140,198 Interest expense (income) — 16,700 (19,131) (2,431) Depreciation and amortization 15,279 13,565 3,802 32,646 Less: net income attributable to non-controlling interests — — 122 122 Consolidated EBITDA $200,477 $44,016 $(74,202) $170,291 Adjustments: Stock based compensation 12,299 25 6,720 19,044 Cost incurred related to system implementations — — 1,721 1,721 Acquisition related costs(17) — — 213 213 Gain on long-lived assets — — (564) (564) Consolidated Adjusted EBITDA $212,776 $44,041 $(66,112) $190,705 To update with final numbers when available TIED OUT &RX - EY 10/19/2026 EAG • QoPQ: Segment EBITDAR
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Ensign Group 2026 Investor Presentation | 45 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 $ in thousands Nine Months Ended September 30, Skilled Services Standard Bearer All Other Consolidated Segment income (loss) $538,836 $36,630 $(173,022) $402,444 Interest expense (income) — 43,854 (53,589) (9,735) Depreciation and amortization 46,034 37,024 9,795 92,853 Less: net income attributable to non-controlling interests — — 306 306 Consolidated EBITDA $584,870 $117,508 $(217,122) $485,256 Adjustments: Stock based compensation 31,335 73 17,697 49,105 Cost incurred related to system implementations — — 6,920 6,920 Acquisition related costs(17) — — 1,013 1,013 Loss on long-lived assets, net — — 720 720 Consolidated Adjusted EBITDA 616,205 117,581 (190,772) 543,014 Reconciliation From Segment Income to EBITDA and Adjusted EBITDA YTD 2026 To update with final numbers when available TIED OUT , RX - EY - 10/19/2026 EAG • YoY: Segment Results
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Ensign Group 2026 Investor Presentation | 46 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Skilled Service Segment $ in thousands Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Statements of Income Data: Segment income(24) $185,198 $153,126 $538,836 $447,061 Depreciation and amortization 15,279 14,155 46,034 41,118 EBITDA $200,477 $167,281 $584,870 $488,179 Adjustments to EBITDA: Stock-based compensation expense 12,299 8,327 31,335 22,774 Gain on insurance recoveries — (2,733) — (3,733) Adjusted EBITDA $212,776 $172,875 $616,205 $507,220 EY 10/19/2026
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Ensign Group 2026 Investor Presentation | 47 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Standard Bearer Segment $ in thousands Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Rental revenue generated from third-party tenants $5,562 $4,976 $17,180 $14,185 Rental revenue generated from Ensign’s independent subsidiaries 42,142 27,634 110,759 78,294 Total rental revenue $47,704 $32,610 $127,939 $92,479 Segment income (12) 13,751 9,622 36,630 27,331 Depreciation and amortization 13,565 9,709 37,024 27,450 FFO (11) $27,316 $19,331 $73,654 $54,781 EY tied out 7/20/2026
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Ensign Group 2026 Investor Presentation | 48 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Ensign is Strategically Positioned to Deliver Long-Term Value Ensign’s Commitment to The Care Continuum Local leadership strategy focused on acquisitions in fragmented markets High quality healthcare outcomes across the continuum driving local reputation and partnerships Opportunistically drive new ventures in ancillary businesses and markets through its unique leadership model Access to care continuum through Ensign Pennant Care Continuum (EPCC) Skilled Nursing Senior Living Outpatient Rehab Acute Care Home Care (EPCC) Home Health (EPCC) Hospice (EPCC) Inpatient Rehab LTACH Patient Service Intensity Patient Illness Intensity Denotes Ensign Business
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Ensign Group 2026 Investor Presentation | 49 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 Hospital IRF LTACH SNF$0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 LTACH 2% IRF 13% Skilled Nursing 42% Home Health 43% COST OF CARE BY FACILITY TYPE PER DAYDISCHARGE TO POST-ACUTE CARE SETTINGS Lower Cost Provider of Higher Acuity Care High Acuity Lower Cost Source: Medicare Payment Advisory Commission (MedPAC) Source: MedPAC and US HHS Department as of March 2026. Graph 1: Post-Acute Destinations - % of Medicare Dollars: obtained from www.medpac.gov (http://www.medpac.gov) Report to the Congress: Medicare Payment Policy > Saved in support folder • March 2026 MedPAC Report, Post acute destinations: PDF page 263 - Table 8-5 "FFS Medicare beneficiaries' first post-acute care site after an IPPS hospital stay, 2019 - 2024" - latest release as of 3/12/2026 reports 2024 data SNF 17.3% > 41.7% of total HH 18.0% > 43.4% of total IRF 5.3% > 12.8% of total LTAC 0.9% > 2.2% of total Graph 2: Cost of Care by facility type Data requested from Frank Inserra <frank.inserra@citi.com> - latest data as of 2023, files saved in investor folder MDCR INPT HOSP – Payments per Covered Day is on Tab “4” under Column R: Short-Stay Hospital: $3,100 IRF: $1,957 LTAC: $1,788 MDCR SNF – Payments per Covered Day is on Tab “1” under Column M: SNF: $577 Why HH increased over SNF: Before the pandemic, SNFs were the most frequent first postacute care (PAC) destination among beneficiaries receiving formal PAC, with home health care services being the second most frequent PAC destination (Table 7-3 in MedPac report). In 2020, the two services switched ranks in their share of use after an inpatient hospital stay. Home health care services became the most frequent first PAC service; the share receiving SNF services dropped to the second most frequent first PAC service.
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Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 END NOTES
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Ensign Group 2026 Investor Presentation | 51 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 End Notes * — Non-GAAP (adjusted) measures are reconciled to GAAP measures in the Appendix. 1 — Occupancy metric represent Same Facilities metric for Q3'26. Reflects midpoints of 2026 guidance ranges of $5.89B to $5.92B for annual revenue and $7.94 to $8.02 for diluted adjusted EPS. 2 — The data source for clinical results is from Centers for Medicare & Medicaid Services (CMS) Care Compare Five-Star Quality Rating System, September 2026. Cycle 1 survey inspection results are based on the latest CMS-reported regulatory inspection cycle which reflects results as of Q1 2026. State-wide averages represent the average reported performance of facilities within the states in which we operate. National averages represent the average performance of all facilities included in the CMS Care Compare database nationwide. Over the last few years, CMS has made significant changes to the star rating requirements that makes obtaining a 4 or 5-Star rating more difficult, which impacted our overall star rating. 3 — The number of operations and number of real estate is as of October 1, 2026. 4 — Ensign affiliates owns 2.5% of the total facilities in the U.S and 12% of Ensign affiliates are in the Top 10 Providers listing. These metrics are calculated using CMS Care Compare Nursing Home Provider Data September 2026. Includes Medicare-certified skilled nursing facilities and nursing homes nationwide 5 — The Emergency Fund participation percentage represents the percentage of our 60,000 employees who contribute to a public charity that provides financial assistance to employees of healthcare organizations facing unexpected hardship, offering critical support when they need it most. 6 — Revenue and adjusted EBITDAR does not reflect the impact of the Pennant spin-off on 10/1/2019. As a result, 2019 includes 9 months of Pennant financial data. 7 — Represents average of peer growth from 2014-2025, except for peers that were not in existence for the entire time period, in which case the longest time period available was used. Peers grouped by subsector include HCA, CYH, THC, UHS, ACHC, SGRY, DVA, ADUS, CHE, USPH, EHAB, BKD, EHC, SEM, PACS, and NHC . 8 — Represents 2014 – 2025 average of ADUS, CHE, BKD, EHC, SEM and PACS. 9 — Since IPO returns are calculated from November 2007 through October 2026 and assumes the reinvestment of dividends for both ENSG and the S&P 500. Last 10 year returns are calculated from October 2016 through October 2026 and assumes the reinvestment of dividends for ENSG. 10 — The average EBITDAR margins and average skilled mix revenue percentages for the 5th quarter, 15th quarter and 45th quarter are 16.9%, 18.1% and 19.1%, respectively; and 45.0%, 45.7%, and 52.8%, respectively, for acquisitions made through June 30, 2025, December 31, 2022 and June 30, 2015.
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Ensign Group 2026 Investor Presentation | 52 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 End Notes 11 — Real estate fair value reflects the most recent third-party valuation. Ensign-operated percentage is based on percentage of annualized rent for assets as of September 30, 2026. Funds from Operations (FFO) for our Standard Bearer segment consists of segment income, excluding depreciation and amortization related to real estate, gains or losses from the sale of real estate, insurance recoveries related to real estate and impairment of long-lived assets. FFO, in accordance with the definition used by the National Association of Real Estate Investment Trusts, means net income attributable to common stockholders, computed in accordance with U.S. GAAP, excluding gains from sales of real estate, insurance recoveries related to real estate and impairment of long-lived assets, while including depreciation and amortization related to real estate earnings. 12 — Segment income reflects profit or loss from operations before provision for income taxes, gain or loss from sale of real estate, insurance recoveries from real estate, and impairment of long- lived assets. Included in Standard Bearer segment income for the three months ended September 30, 2026, June 30, 2026, March 31, 2026, December 31, 2025, and September 30, 2025, are management fees of $2.9M, $2.6M, $2.2M, $2.1M, and $2.0M, respectively, and interest expense of $14.9M, $14.1M, $9.8M, $9.5M, and $9.1M, respectively, associated with the intercompany agreements between Standard Bearer and the Company and its independent subsidiaries including the Service Center. 13 — Included in our real estate portfolio of 189 facilities are 183 facilities that are affiliates of Standard Bearer Healthcare REIT, Inc. and six facilities that are other real estate including the Service Center in California. 14 — At the end of Q3'26, there were 382 skilled nursing facilities in operation. Same Facilities represents all skilled nursing operations purchased prior to January 1, 2023, totaling 259 facilities. Transitioning represents all skilled nursing operations purchased from January 1, 2023 to December 31, 2024 totaling 54 facilities. Recently Acquired represents all skilled nursing operations purchased on or subsequent to January 1, 2025 totaling 69 facilities. Transitioning includes the operations in states which, on average, have a higher occupancy and reimbursement rate than our average operation. 15 — Investing activities includes $539.9M outflow to fund 2026 acquisitions. 16 — Availability under the credit facility increased by $200 million to $800 million as a result of the amendment in August 2026. 17 — Represents costs incurred to acquire operations that are not capitalizable. 18 — Represents litigation relates to specific proceedings and adjustments arising outside of the ordinary course of business. 19 — Represents gains on the sale of investments that are not part of our core business operations. These investments have no observable market prices and are held at historical cost basis until sold or impaired. 20 — Represent the write-off of deferred financing fees associated with the Credit Facility.
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Ensign Group 2026 Investor Presentation | 53 Primary Colors R: 0 G: 0 B: 0 #000000 R: 245 G: 245 B: 240 #f5f5f0 R: 255 G: 255 B: 255 #ffffff R: 35 G: 55 B: 41 #233729 R: 53 G: 83 B: 63 #35522f R: 69 G: 110 B: 83 #456e53 R: 133 G: 178 B: 148 #85b294 R: 174 G: 204 B: 184 #aeccb8 R: 214 G: 229 B: 220 #d6e5dc R: 230 G: 234 B: 227 #e6eae3 R: 197 G: 219 B: 243 #c5dbf3 R: 49 G: 147 B: 214 #317fd6 R: 218 G: 236 B: 183 #daecb7 R: 163 G: 209 B: 80 #a3d150 R: 151 G: 228 B: 255 #97e4ff R: 220 G: 227 B: 150 #c8e396 End Notes 20 — Represents amortization expenses related to patient base intangible assets at newly acquired skilled nursing and senior living facilities. 21 — Represents an adjustment to the provision for income tax to our historical effective tax rate of 25.0%. 22 — Included in general and administrative expenses is internal rent expense for the Service Center for the three months ended September 30, 2026 , of $0.6 million and management fee of $2.9 million. This amount is eliminated in the eliminations column. Included in general and administrative expenses is internal rent expense for the Service Center for the nine months ended September 30, 2026, of $1.5 million and management fee of $7.7 million. This amount is eliminated in the eliminations column. 23 — Included in interest expense in Standard Bearer is interest expense incurred from intercompany debt arrangements between Standard Bearer and The Ensign Group, Inc. 24 — Segment income reflects profit from operations before provision for income taxes and impairment charges from operations. General and administrative expenses are not allocated to the skilled services segment for purposes of determining segment profit or loss.