Better Health for All

The company's core services, while intended to be health-positive, have significant quality issues, with 16.9% of its skilled nursing facilities rated 1-star by CMS as of September 2025.

There have been 68 nursing home violations since 2022, including failures to protect residents from abuse, provide appropriate pain management, and prevent medication errors. The company paid $48 million for Medicare fraud due to falsely reporting care burdens. Ensign Group's investor presentation includes forward-looking statements and advises readers to review SEC filings for risks. During the COVID-19 pandemic, the company's business and operations were impacted by regulatory changes, and it cannot predict the full financial impact. The company was also named in a class-action lawsuit for failing to maintain staffing requirements, leading to lower-quality services.

Fair Money & Economic Opportunity

The Ensign Group, Inc. is a holding company that provides healthcare services, including skilled nursing facilities, rehabilitation centers, and assisted living facilities.

Its primary focus is on post-acute care and rehabilitation services. The company does not offer lending, deposit, or other consumer financial services. Therefore, all KPIs related to financial products, pricing, fees, lending compliance, wealth building outcomes, and financial literacy initiatives are not applicable to its core business model.

Fair Pay & Worker Respect

The CEO to median employee pay ratio for the 2024 fiscal year was 233:1.

Employee overall satisfaction ratings from 451 reviews on Indeed.com, covering July 2025 to December 2024, averaged 3.0 out of 5 stars (60%).

Fair Trade & Ethical Sourcing

The company, a healthcare services provider, does not procure or trade physical commodities, thus fair-trade certification is not applicable.

The Ensign Group established a Vendor Code of Conduct, finalized on February 24, 2023, which applies to all third-party vendors and contracted persons. This code includes principles, guidelines, and standards, building on existing ethics policies and procedures. It specifically mandates compliance with International Labor Organization Conventions 138 and 182 regarding child and forced labor. Additionally, a Human Rights Policy was created in 2022, guided by international human rights principles, which addresses forced labor, human trafficking, child labor, work hours, wages, and benefits.

Honest & Fair Business

The company settled a False Claims Act case in 2024 for over $47.3 million, related to allegations of illegal kickbacks to physicians for patient referrals and violations of Anti-Kickback Statutes and Stark self-referral law.

This settlement also indicated a violation of a previous Corporate Integrity Agreement from 2013. The whistleblower case that led to the 2024 settlement was filed in 2015, indicating a resolution time of approximately 9 years. The company has a formal whistleblower policy, established in its April 2020 Code of Conduct, which includes a 24/7 anonymous hotline and email reporting, explicitly prohibits retaliation, and provides annual training for all employees. New employees receive compliance education within 30 days of hire. The company's anti-corruption policy, detailed in its Code of Conduct, strictly prohibits bribes and kickbacks, covers all markets, and includes annual training for all employees.

Kind to Animals

The Ensign Group, Inc. is a holding company that provides healthcare services, including skilled nursing, rehabilitation, and assisted living facilities.

Its core business model does not involve products requiring cruelty-free certification, animal testing, animal husbandry, animal-derived ingredients, or sourcing of animal products like eggs or meat. No evidence in the provided articles indicates that the company engages in any activities related to animal welfare, animal testing, or animal agriculture. Therefore, all KPIs related to these activities are not applicable to the company's operations.

No War, No Weapons

The Ensign Group, Inc. operates in the healthcare sector, providing skilled nursing, rehabilitation, and assisted living services primarily in the United States.

There is no indication of revenue from arms or defense contracts, nor any evidence suggesting the company's offerings are used in military or dual-use applications. The company does not sell to or partner with oppressive foreign regimes. The board oversees general ESG efforts, cybersecurity risks, and fraud prevention, but there is no defense business to oversee. The company's Human Rights Policy, created in 2022, is guided by international human rights principles, including the Universal Declaration of Human Rights and the International Labor Organization’s 1998 Declaration on Fundamental Principles and Rights at Work, which indicates support in principle. Employees receive mandatory annual training on the code of conduct and other governance policies. The company does not have any assets in conflict-exposed sectors, nor does it engage in defense procurement, lobbying related to arms control, or intelligence/surveillance activities. The Elevate Charities program focuses on the senior healthcare community, not peacebuilding or disarmament. There is no evidence of investment in peace technology, or procurement from conflict-affected areas. The company has no reported ties to war crimes or genocide, indicating no exposure to controversial weapons.

Planet-Friendly Business

The company sourced 28% of its operational energy from renewables in 2024.

As of 2024, 37 of its 323 total operations are green building certified, which is approximately 11.46%. The waste diversion rate was 54.5% in 2023. The company has recorded one environmental violation with a penalty of $5,000. The company has adopted the Task Force on Climate-related Financial Disclosures (TCFD) framework. Climate scenario analysis was carried out by Hymans Robertson in September 2021, considering three scenarios including a 4°C world scenario. The company's platform provider started to produce detailed climate-change data 6-monthly, including information to explore physical and transition risk in the portfolio, such as climate value at risk and exposure to asset stranding.

Safe & Smart Tech

The Ensign Group has not experienced a material cybersecurity breach in the past five years.

The company provides comprehensive security training to all covered persons, relevant covered persons, and Board members annually, with specific training hours ranging from one to three hours depending on the role. Sensitive data is protected through encryption techniques, and the company monitors for unauthorized use of information system resources. The company continuously scans for vulnerabilities and remediates them within service level agreements, with critical vulnerabilities patched within 7-14 days on average. Security policies and systems audits are performed annually for SOX and HIPAA compliance, and penetration testing assessments are performed annually. The company aligns its cybersecurity framework to NIST Special Publication 800-53 Revision 5. While the company states it protects data by limiting access to authorized users and has a right of access for individuals, it does not provide specific details on user control over personal data or privacy settings beyond basic rights. The company also states it has standard data collection and retention practices. Third-party service providers handling ePHI undergo annual SOC certification audits.

Zero Waste & Sustainable Products

The Ensign Group, Inc. reported a waste diversion rate of 54.5% in 2023, which is an increase from 44.4% in 2022 and 42.4% in 2021.

The company has implemented some waste reduction initiatives, such as working towards a paperless office, and encourages subsidiaries to evaluate strategies like using sustainable/recyclable materials. The company utilizes reputable third-party vendors for hazardous waste disposal and requires team members to train on hazardous waste policies. However, the company incurred a $5,000 penalty for one environmental violation since 2000. The company reserves the right to monitor vendor compliance through unannounced audits but does not specify the frequency or comprehensiveness of waste audits across its own operations. A Vendor Code of Conduct is in place, requiring vendors to comply with environmental laws and support the company's environmental sustainability commitments.