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UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands | Total | Common Stock | Additional Paid-In Capital | Retained Earnings | Treasury Stock | Non-Controlling Interest
--- | --- | --- | --- | --- | --- | ---
Common stock, balance at beginning of period (in shares) at Dec. 31, 2023 |  | 56,597 |  |  |  |
Balance at beginning of period at Dec. 31, 2023 | $ 1,497,317 | $ 60 | $ 465,707 | $ 1,142,653 | $ (116,555) | $ 5,452
Treasury stock, balance at beginning of period (in shares) at Dec. 31, 2023 |  |  |  |  | 3,390 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options (in shares) |  | 219 |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options | 6,229 |  | 6,229 |  |  |
Issuance of restricted stock, net of forfeitures (in shares) |  | 88 |  |  |  |
Issuance of restricted stock, net of forfeitures | 6,165 |  | 6,165 |  |  |
Shares of common stock used to satisfy tax withholding obligations | (14) |  |  |  | $ (14) |
Dividends declared | (3,414) |  |  | (3,414) |  |
Employee stock award compensation | 8,231 |  | 8,231 |  |  |
Acquisition of noncontrolling interest shares | (10) |  | (10) |  |  |
Net income attributable to noncontrolling interest | 125 |  |  |  |  | 125
Noncontrolling interests attributable to subsidiary equity plan | 3 |  | 14 |  |  | (11)
Net income attributable to the Ensign Group, Inc. | 68,835 |  |  | 68,835 |  |
Common stock, balance at end of period (in shares) at Mar. 31, 2024 |  | 56,904 |  |  |  |
Balance at end of period at Mar. 31, 2024 | 1,583,467 | $ 60 | 486,336 | 1,208,074 | $ (116,569) | 5,566
Treasury stock, balance at end of period (in shares) at Mar. 31, 2024 |  |  |  |  | 3,390 |
Common stock, balance at beginning of period (in shares) at Dec. 31, 2023 |  | 56,597 |  |  |  |
Balance at beginning of period at Dec. 31, 2023 | 1,497,317 | $ 60 | 465,707 | 1,142,653 | $ (116,555) | 5,452
Treasury stock, balance at beginning of period (in shares) at Dec. 31, 2023 |  |  |  |  | 3,390 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |
Net income attributable to noncontrolling interest | 422 |  |  |  |  |
Net income attributable to the Ensign Group, Inc. | 218,286 |  |  |  |  |
Common stock, balance at end of period (in shares) at Sep. 30, 2024 |  | 57,281 |  |  |  |
Balance at end of period at Sep. 30, 2024 | 1,750,947 | $ 61 | 514,336 | 1,350,664 | $ (117,764) | 3,650
Treasury stock, balance at end of period (in shares) at Sep. 30, 2024 |  |  |  |  | 3,400 |
Common stock, balance at beginning of period (in shares) at Mar. 31, 2024 |  | 56,904 |  |  |  |
Balance at beginning of period at Mar. 31, 2024 | 1,583,467 | $ 60 | 486,336 | 1,208,074 | $ (116,569) | 5,566
Treasury stock, balance at beginning of period (in shares) at Mar. 31, 2024 |  |  |  |  | 3,390 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options (in shares) |  | 117 |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options | 4,090 | $ 1 | 4,089 |  |  |
Issuance of restricted stock, net of forfeitures (in shares) |  | 38 |  |  |  |
Shares of common stock used to satisfy tax withholding obligations (in shares) |  | (10) |  |  | (10) |
Shares of common stock used to satisfy tax withholding obligations | (1,195) |  |  |  | $ (1,195) |
Dividends declared | (3,424) |  |  | (3,424) |  |
Employee stock award compensation | 8,978 |  | 8,978 |  |  |
Acquisition of noncontrolling interest shares | (29) |  | (29) |  |  |
Net income attributable to noncontrolling interest | 174 |  |  |  |  | 174
Noncontrolling interests attributable to subsidiary equity plan | 3 |  | 37 |  |  | (34)
Net income attributable to the Ensign Group, Inc. | 71,007 |  |  | 71,007 |  |
Common stock, balance at end of period (in shares) at Jun. 30, 2024 |  | 57,049 |  |  |  |
Balance at end of period at Jun. 30, 2024 | 1,663,071 | $ 61 | 499,411 | 1,275,657 | $ (117,764) | 5,706
Treasury stock, balance at end of period (in shares) at Jun. 30, 2024 |  |  |  |  | 3,400 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options (in shares) |  | 205 |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options | 7,977 |  | 7,977 |  |  |
Issuance of restricted stock, net of forfeitures (in shares) |  | 27 |  |  |  |
Dividends declared | (3,437) |  |  | (3,437) |  |
Employee stock award compensation | 9,177 |  | 9,177 |  |  |
Acquisition of noncontrolling interest shares | (4,411) |  | (2,387) |  |  | (2,024)
Net income attributable to noncontrolling interest | 123 |  |  |  |  | 123
Noncontrolling interests attributable to subsidiary equity plan | 3 |  | 158 |  |  | (155)
Net income attributable to the Ensign Group, Inc. | 78,444 |  |  | 78,444 |  |
Common stock, balance at end of period (in shares) at Sep. 30, 2024 |  | 57,281 |  |  |  |
Balance at end of period at Sep. 30, 2024 | $ 1,750,947 | $ 61 | 514,336 | 1,350,664 | $ (117,764) | 3,650
Treasury stock, balance at end of period (in shares) at Sep. 30, 2024 |  |  |  |  | 3,400 |
Common stock, balance at beginning of period (in shares) at Dec. 31, 2024 | 57,438 | 57,438 |  |  |  |
Balance at beginning of period at Dec. 31, 2024 | $ 1,840,428 | $ 61 | 528,052 | 1,426,762 | $ (117,764) | 3,317
Treasury stock, balance at beginning of period (in shares) at Dec. 31, 2024 | 3,400 |  |  |  | 3,400 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options (in shares) |  | 106 |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options | $ 5,050 |  | 5,050 |  |  |
Issuance of restricted stock, net of forfeitures (in shares) |  | 87 |  |  |  |
Issuance of restricted stock, net of forfeitures | 8,003 |  | 8,003 |  |  |
Shares of common stock used to satisfy tax withholding obligations | (14) |  |  |  | $ (14) |
Dividends declared | (3,597) |  |  | (3,597) |  |
Employee stock award compensation | 10,691 |  | 10,691 |  |  |
Repurchase of common stock (in shares) |  | (84) |  |  | (84) |
Repurchase of common stock | (10,775) |  |  |  | $ (10,775) |
Acquisition of noncontrolling interest shares | (11) |  | (11) |  |  |
Net income attributable to noncontrolling interest | 76 |  |  |  |  | 76
Noncontrolling interests attributable to subsidiary equity plan | 29 |  | 82 |  |  | (53)
Net income attributable to the Ensign Group, Inc. | 80,277 |  |  | 80,277 |  |
Common stock, balance at end of period (in shares) at Mar. 31, 2025 |  | 57,547 |  |  |  |
Balance at end of period at Mar. 31, 2025 | $ 1,930,157 | $ 61 | 551,867 | 1,503,442 | $ (128,553) | 3,340
Treasury stock, balance at end of period (in shares) at Mar. 31, 2025 |  |  |  |  | 3,484 |
Common stock, balance at beginning of period (in shares) at Dec. 31, 2024 | 57,438 | 57,438 |  |  |  |
Balance at beginning of period at Dec. 31, 2024 | $ 1,840,428 | $ 61 | 528,052 | 1,426,762 | $ (117,764) | 3,317
Treasury stock, balance at beginning of period (in shares) at Dec. 31, 2024 | 3,400 |  |  |  | 3,400 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options (in shares) | 455 |  |  |  |  |
Net income attributable to noncontrolling interest | $ 213 |  |  |  |  |
Net income attributable to the Ensign Group, Inc. | $ 248,517 |  |  |  |  |
Common stock, balance at end of period (in shares) at Sep. 30, 2025 | 57,897 | 57,897 |  |  |  |
Balance at end of period at Sep. 30, 2025 | $ 2,122,902 | $ 61 | 593,781 | 1,664,458 | $ (138,835) | 3,437
Treasury stock, balance at end of period (in shares) at Sep. 30, 2025 | 3,564 |  |  |  | 3,564 |
Common stock, balance at beginning of period (in shares) at Mar. 31, 2025 |  | 57,547 |  |  |  |
Balance at beginning of period at Mar. 31, 2025 | $ 1,930,157 | $ 61 | 551,867 | 1,503,442 | $ (128,553) | 3,340
Treasury stock, balance at beginning of period (in shares) at Mar. 31, 2025 |  |  |  |  | 3,484 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options (in shares) |  | 168 |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options | 8,652 |  | 8,652 |  |  |
Issuance of restricted stock, net of forfeitures (in shares) |  | 41 |  |  |  |
Shares of common stock used to satisfy tax withholding obligations (in shares) |  | (7) |  |  | (7) |
Shares of common stock used to satisfy tax withholding obligations | (1,057) |  |  |  | $ (1,057) |
Dividends declared | (3,605) |  |  | (3,605) |  |
Employee stock award compensation | 11,628 |  | 11,628 |  |  |
Repurchase of common stock (in shares) |  | (73) |  |  | (73) |
Repurchase of common stock | (9,225) |  |  |  | $ (9,225) |
Acquisition of noncontrolling interest shares | (64) |  | (64) |  |  |
Net income attributable to noncontrolling interest | 70 |  |  |  |  | 70
Noncontrolling interests attributable to subsidiary equity plan | 31 |  | 117 |  |  | (86)
Net income attributable to the Ensign Group, Inc. | 84,396 |  |  | 84,396 |  |
Common stock, balance at end of period (in shares) at Jun. 30, 2025 |  | 57,676 |  |  |  |
Balance at end of period at Jun. 30, 2025 | 2,020,983 | $ 61 | 572,200 | 1,584,233 | $ (138,835) | 3,324
Treasury stock, balance at end of period (in shares) at Jun. 30, 2025 |  |  |  |  | 3,564 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options (in shares) |  | 181 |  |  |  |
Issuance of common stock to employees and directors resulting from the exercise of stock options | 9,024 |  | 9,024 |  |  |
Issuance of restricted stock, net of forfeitures (in shares) |  | 40 |  |  |  |
Dividends declared | (3,619) |  |  | (3,619) |  |
Employee stock award compensation | 12,868 |  | 12,868 |  |  |
Acquisition of noncontrolling interest shares | (382) |  | (382) |  |  |
Net income attributable to noncontrolling interest | 67 |  |  |  |  | 67
Noncontrolling interests attributable to subsidiary equity plan | 117 |  | 71 |  |  | 46
Net income attributable to the Ensign Group, Inc. | $ 83,844 |  |  | 83,844 |  |
Common stock, balance at end of period (in shares) at Sep. 30, 2025 | 57,897 | 57,897 |  |  |  |
Balance at end of period at Sep. 30, 2025 | $ 2,122,902 | $ 61 | $ 593,781 | $ 1,664,458 | $ (138,835) | $ 3,437
Treasury stock, balance at end of period (in shares) at Sep. 30, 2025 | 3,564 |  |  |  | 3,564 |

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