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The Ensign Group Inc: Nursing Home Ownership, Facilities & Performance
The Ensign Group Inc is an operating family resolved from federal CMS ownership and enrollment records. It controls 72 Medicare-certified facilities in WhoOwnsCare's covered states (California, Texas, Pennsylvania, Ohio): 72 skilled nursing facilities. CMS lists its facilities under the affiliation entity THE ENSIGN GROUP. It also files as Flagstone Healthcare in CMS records.
Also Known As
The Ensign Group Inc does not file under one name. These names appear on the legal entities inside this family in CMS ownership records, which is why a search for them belongs here:
- Flagstone Healthcare — 3 legal entities in this family file under this name in CMS ownership records.
Names are taken from the legal entities attributed to this family, not from branding. A shared word does not imply a relationship; where another resolved family uses the same leading word it is named above.
Portfolio Overview
States of Operation
| State | Facilities | Beds | Share of state market | State page |
|---|---|---|---|---|
| California | 62 | 6,373 | 1.17% | The Ensign Group Inc in California |
| Texas | 7 | 755 | 0.18% | The Ensign Group Inc in Texas |
| Pennsylvania | 2 | 300 | 0.17% | Pennsylvania overview |
| Ohio | 1 | 99 | 0.06% | Ohio overview |
Ownership Structure
| Operating family | The Ensign Group Inc |
|---|---|
| Resolution basis | federal CMS ownership and enrollment records; grouping is WhoOwnsCare analysis, not a CMS designation |
| CMS affiliation entity | THE ENSIGN GROUP (69 facilities), CONTINUUM HEALTHCARE (2 facilities) (CMS evidence; does not define the family) |
| Legal corporate parent | none on file from the SEC/IRS evidence currently integrated |
| Recorded lender / security relationships | 6 across the portfolio (lenders are never treated as operators; names in the full report) |
| Property ownership | not derivable from the public sources currently integrated |
CMS records 10 separate legal entities for this family. 10 related legal entities identified. 5 shown publicly.
- APPALOOSA HEALTHCARE, INC.
- FLAGSTONE HEALTHCARE CENTRAL LLC
- FLAGSTONE HEALTHCARE NORTH LLC
- FLAGSTONE HEALTHCARE SOUTH LLC
- KEYSTONE CARE LLC
Operating family, CMS affiliation and legal parent are separate relationships and are never merged. A lender, trustee or property owner is never the operator.
Financial Reporting Coverage
HCRIS cost-report metrics are available for 93% of eligible facilities (67 of 72), using each facility's latest FY2024 or FY2025 period attributed to the current operator. Among reporting facilities, 96% reported a positive net result; the median facility result is positive. 93% coverage (High)
Facts: exact reporting periods, never annualised; straddling and unresolved periods excluded and counted (27 straddling, 77 unresolved). Limitation: partial-portfolio figures are not a corporate financial statement.
Performance Snapshot
| Occupancy data coverage | 99% of facilities |
|---|---|
| CMS star-rating coverage | 100% of facilities |
| Staffing (PBJ) coverage | 100% of facilities |
| Health deficiency data coverage | 100% of facilities |
Facility-level occupancy, star ratings, nurse hours, deficiencies and penalties are in the full report. Public values here are coverage only.
Distress 2.0 Distribution
72 facilities are scored on WhoOwnsCare's Distress 2.0 methodology; 2 score in the high or severe band and warrant further review.
Interpretation: bands summarise financial, occupancy, staffing, deficiency, penalty and reporting-instability signals. Facilities with fewer than two of three core signals are shown as insufficient data rather than scored. The full band breakdown, the specific facilities and the drivers behind each score are in the full report.
Ownership Activity
| Recorded ownership-change events touching the portfolio (all time) | 33 |
|---|---|
| Recent trend (36 months) | a net acquirer (exact counts by window are in the full report) |
Basis: recorded CMS changes of ownership for skilled nursing facilities through 2026-07-17. Home health and hospice have no public CHOW dataset. Openings, closures and rebrands cannot be derived from this source. Family-resolution changes are never counted as transactions.
Which Facilities Does The Ensign Group Inc Operate?
| Facility | City | State | Type |
|---|---|---|---|
| Alamitos West Health & Rehabilitation | Los Alamitos | California | Skilled Nursing Facility |
| Arbor Glen Care Center | Glendora | California | Skilled Nursing Facility |
| Arbor Rehabilitation & Nursing Center | Lodi | California | Skilled Nursing Facility |
| Arrowhead Springs Healthcare | San Bernardino | California | Skilled Nursing Facility |
| Atlantic Memorial Healthcare Center | Long Beach | California | Skilled Nursing Facility |
| Beacon Harbor Healthcare and Rehabilitation | Rockwall | Texas | Skilled Nursing Facility |
| Broadway By the Sea | Long Beach | California | Skilled Nursing Facility |
| Broadway Villa Post Acute | Sonoma | California | Skilled Nursing Facility |
| Brookfield Healthcare Center | Downey | California | Skilled Nursing Facility |
| Brookside Healthcare Center | Redlands | California | Skilled Nursing Facility |
72 facilities identified. 10 shown publicly.
The complete roster of all 72 facilities is in the company dossier, with the ownership structure, recorded transactions, financial reporting and risk analysis behind it.
Get the complete The Ensign Group Inc dossier ($79)The Ensign Group Inc by State
- The Ensign Group Inc nursing homes and providers in California (62)
- The Ensign Group Inc nursing homes and providers in Texas (7)
- Pennsylvania (2); see the Pennsylvania ownership overview
- Ohio (1); see the Ohio ownership overview
Common Questions About The Ensign Group Inc
How Many Facilities Does The Ensign Group Inc Operate?
WhoOwnsCare resolves The Ensign Group Inc to 72 Medicare-certified facilities in its covered states (California, Texas, Pennsylvania, Ohio): 72 skilled nursing facilities.
Which States Does The Ensign Group Inc Operate In?
California (62), Texas (7), Pennsylvania (2), Ohio (1). Counts are facilities resolved to this corporate family in WhoOwnsCare's seven covered states, not a national total.
Has The Ensign Group Inc Acquired Facilities Recently?
Recorded CMS changes of ownership show this family has been a net acquirer over the 36 months to 2026-07-17. Exact acquisition and divestiture counts by facility are in the full report.
Who Is the Legal Parent of The Ensign Group Inc?
No legal corporate parent is on file from the SEC and IRS evidence currently integrated. The operating family is resolved from CMS records and is not a statement about legal ownership.
Methodology
Facilities are grouped into an operating family only when multiple structural signals in federal CMS filings independently support the grouping. CMS affiliation entities and SEC-filed legal parents are recorded as separate relationships. Financial figures use exact HCRIS reporting periods attributed to the operator in control at the time. Ownership activity counts recorded CMS changes of ownership only. Read the full methodology.
The Ensign Group Inc: Corporate Family Intelligence Report
| Section | Rows | Preview |
|---|---|---|
| Complete facility portfolio (address, CCN, care setting) | 72 | |
| Ownership percentage and association date per facility | 72 | ••••% |
| Related legal entities with evidence and confidence | 10 | |
| Change-of-ownership history (acquisitions and divestitures) | all | |
| Facility-level financial and staffing measures | 72 | |
| Distress exposure across the portfolio | 72 |
The public profile shows a limited preview where records are available. The licensed package provides the complete covered roster and supporting files in HTML, JSON and CSV formats. Fields unavailable from the integrated authoritative sources remain labelled unavailable.
Ownership is reported to CMS by the enrolling provider. Entities are grouped into a corporate family where their facility portfolios overlap; this is our analysis, not a CMS designation, and it is described in full on the methodology page. A private-equity or REIT tag reflects a box the filer ticked on their own enrolment form.