ensg-20260401

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

SCHEDULE 14A

Proxy Statement Pursuant to Section 14(a) of the

Securities Exchange Act of 1934 (Amendment No.)

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THE ENSIGN GROUP, INC.

(Name of Registrant as Specified in Its Charter)

(Name of Person(s) Filing Proxy Statement, if other than the Registrant)


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o			Fee computed on table in exhibit required by Item 25(b) per Exchange Act Rules 14a-6(i)(1) and 0-11

NOTICE OF 2026 ANNUAL MEETING OF STOCKHOLDERS

WHEN À

WHERE

WHO CAN VOTE

RECORD DATE

Wednesday, May 13, 2026

at 10:00 a.m. PDT

Ensign Services, Inc. Service Center 29222 Rancho Viejo Rd. Suite 127
San Juan Capistrano, California 92675

Owners of Ensign's issued and

outstanding common stock as of the

close of business on the record date.

March 18, 2026

Items of Business

Board Recommendation

Election of four nominees named in the proxy statement to serve on The Ensign Group's Board of Directors

FOR each director nominee

See pg 3

Ratification of the appointment of Deloitte & Touche LLP as the independent registered public accounting firm of the Company for 2026

FOR

See pg 17

Advisory approval of the Company's named executive officer compensation

FOR

See pg 37

We will also address any other business which may properly come before the Annual Meeting or any adjournment or postponement. Following the formal meeting, management intends to discuss our developments of the past year and respond to questions of general interest to stockholders.

How To Vote

IMPORTANT NOTICE REGARDING THE AVAILABILITY OF PROXY MATERIALS FOR THE ANNUAL MEETING OF STOCKHOLDERS

Ensign’s Proxy Statement for the 2026 Annual Meeting of Stockholders (the “Proxy Statement”) and 2025 Annual Report on Form 10-K (the “2025 Form 10-K”) are available at www.proxyvote.com.

Your vote is important. Please vote as soon as possible by one of the methods shown below. Be sure to have your proxy card, voting instruction form or Notice of Internet Availability of Proxy Materials in hand and follow the below instructions:

By Internet

You can vote your shares online at www.proxyvote.com

By Phone

(

You can vote your shares by calling 800-690-6903

By Mail

Complete, sign, date and return your proxy card or voting instruction form in the postage-paid envelope provided

Date of Mailing

April 2, 2026

Our intended date to mail a Notice of Internet Availability of Proxy Materials.

In accordance with rules and regulations adopted by the Securities and Exchange Commission (the "SEC"), we have elected to furnish our proxy materials to stockholders by providing access to the materials on the Internet. Accordingly, a Notice of Internet Availability of Proxy Materials (the "Notice") has been mailed to the majority of our stockholders, while other stockholders have instead received paper copies of the documents accessible on the Internet. It is important that your shares be represented and voted whether or not you plan to attend the Annual Meeting in person. If you are the registered holder of your shares and are viewing the Proxy Statement on the Internet, you may grant your proxy electronically via the Internet by following the instructions on the Notice previously mailed to you and the instructions listed on the Internet site. If you are receiving a paper copy of the proxy statement, you may vote by completing and mailing the proxy card enclosed with the Proxy Statement, or you may grant your proxy electronically via the Internet or by telephone by following the instructions on the proxy card. If your shares are held in “street name,” which means that your shares are held of record by a broker, bank or other nominee, you should review the Notice used by that firm to determine whether and how you will be able to submit your proxy by telephone or over the Internet. Submitting a proxy over the Internet, by telephone or by mailing a proxy card will ensure your shares are represented at the Annual Meeting.

THE ENSIGN GROUP, INC.

BY ORDER OF THE BOARD OF DIRECTORS

BARRY R. PORT

CHIEF EXECUTIVE OFFICER

San Juan Capistrano, California

Dated: April 2, 2026

TABLE OF CONTENTS


NOTICE OF ANNUAL MEETING OF S TOCK HOLDERS
Proxy Statement																											1
Our 2025 Year in Review																											2


CORPORATE GOVERNANCE																											3
Proposal 1: Election of Directors																											3
Nominees and Directors																											4
Board Structure and Practices																											7
Director Compensation																											12
Board Oversight of Risk																											14






AUDIT MATTERS																											17
Proposal 2: Approval of Independent Registered Public Accounting Firm																											17
Audit Committee Report																											18

COMPENSATION DISCUSSION AND ANALYSIS																											19
Executive Officers																											25
Pay Ratio Disclosure																											26
Compensation Committee Report																											27
Executive Compensation																											28
Pay versus Performance																											32
Equity Compensation Plan Information																											36
Proposal 3: Advisory Vote on Named Executive Officer Compensation																											37





STOCK OWNERSHIP INFORMATION																											38
Security Ownership of Certain Beneficial Owners and Management																											38

Certain Relationships and Related Party Transactions																											39

OTHER MATTERS																											40
S tock holder Proposals																											40
Other Matters																											41
Available Information																											41

PROXY STATEMENT

We are pleased to take advantage of SEC rules that allow companies to furnish their proxy materials over the Internet. Accordingly, we sent to the majority of our stockholders a Notice of Internet Availability of Proxy Materials or "Notice" regarding the Internet availability of the proxy materials. Other stockholders were instead sent paper copies of the proxy materials accessible on the Internet if the preference to receive a paper copy was requested. Instructions on how to access the proxy materials over the Internet or to request a paper copy can be found on the Notice. In addition, stockholders may request to receive proxy materials in printed form by mail or electronically by e-mail on an ongoing basis by going to www.proxyvote.com and following the instructions. A stockholder’s election to receive proxy materials by mail or e-mail will remain in effect until the stockholder elects otherwise.

The enclosed Proxy Statement is solicited by the Board of Directors (the "Board") of The Ensign Group, Inc., ("Ensign") a Delaware corporation, for use at the 2026 Annual Meeting of Stockholders (the "Annual Meeting"). Our principal executive offices are located at 29222 Rancho Viejo Road, Suite 127, San Juan Capistrano, California 92675. This proxy statement is first being made available to stockholders on or about April 2, 2026. When used in this Proxy Statement, the terms “we,” “us,” “our” or the “Company” refer to The Ensign Group, Inc. and its consolidated subsidiaries; however, The Ensign Group, Inc. is a holding company and all of our subsidiaries referenced herein are operated by separate, wholly-owned independent subsidiaries that have their own management, employees and assets. References herein to the consolidated "Company" and "its" assets and activities, as well as the use of “we,” “us,” “our” and similar words in this Proxy Statement are not meant to imply, nor should it be construed as meaning that The Ensign Group, Inc. has direct operating assets, employees or revenue, or that any of the subsidiaries are operated by The Ensign Group, Inc.

The expenses of preparing, assembling, printing and mailing the Notice, this Proxy Statement and the materials used in the solicitation of proxies will be borne by the Company. Proxies will be solicited through the Internet and the mail. Our directors, officers, and other employees, without additional compensation, may also solicit proxies personally or in writing, by telephone, e-mail, or otherwise. We do not anticipate paying any compensation to any other party for the solicitation of proxies, but may reimburse brokerage firms and others for their reasonable expenses in forwarding solicitation material to beneficial owners.

Any stockholder who executes and delivers a proxy has the right to revoke it at any time before it is exercised by delivering to the Secretary of the Company an instrument revoking it or a duly executed proxy bearing a later date, or by attending the Annual Meeting and voting in person. Subject to revocation, the proxy holders will vote all shares represented by a properly executed proxy received in time for the Annual Meeting in accordance with the instructions on the proxy. If no instruction is specified with respect to a matter to be acted upon, the shares represented by the proxy will be voted in accordance with the recommendation of the Board.

Quorum, Voting Securities and Vote Required

Holders of record of Ensign's common stock at the close of business on March 18, 2026 will be entitled to vote at the Annual Meeting. On that date, 58,413,971 shares of the Company's common stock were issued and outstanding. Each share of common stock is entitled to one vote on every matter submitted to the stockholders at the Annual Meeting. In order to constitute a quorum for the conduct of business at the Annual Meeting, the holders of a majority of the issued and outstanding shares of common stock entitled to vote at the Annual Meeting must be present in person or represented by proxy at the Annual Meeting. Under Delaware law, shares represented at the Annual Meeting by proxies that reflect abstentions or broker non-votes will be counted for purposes of determining the presence of a quorum. A “broker non-vote” occurs when a bank, broker or other holder of record holding shares for a beneficial owner does not vote on a particular proposal because that holder does not have discretionary voting power for that particular item and has not received instructions from the beneficial owner.

Proposal 1: Election of the four named director nominees will require the affirmative approval of a majority of the votes cast with respect to each director's election. A majority of votes cast with respect to a director's election means that the number of votes cast "FOR" a director's election exceeds the number of votes cast "AGAINST" that director's election, with abstentions and broker non-votes not counted as a vote cast either "FOR" or "AGAINST" that director's election. Unless instructed to the contrary, the shares represented by proxies will be voted FOR the election of the four named director nominees.

Proposals 2 and 3: The proposals referenced will require the affirmative vote of a majority of the issued and outstanding shares of common stock present in person or represented by proxy at the Annual Meeting and entitled to vote at the meeting. In determining whether each proposal has received the requisite number of affirmative votes, abstentions will be counted as shares entitled to vote and will have the same effect as votes against the proposals. Broker non-votes will not have an impact on the outcome of the proposals. Properly executed, unrevoked proxies will be voted FOR Proposals 2 and 3 unless a vote against such proposals or abstention is specifically indicated in the proxy.

Your vote is very important. Accordingly, whether or not you plan to attend the Annual Meeting in person, you should vote by using one of the methods described in the Notice. You may vote your shares at the Annual Meeting by attending and voting in person, by voting via the Internet or by telephone as described in the Notice, or by having your shares represented at the Annual Meeting by a valid proxy.

While the vote on Proposal 3 is required by law, the vote is not binding, will not create or imply any change in the fiduciary duties of, nor impose any additional fiduciary duty on, us or our Board. However, the Compensation Committee of our Board will take into account the outcome of the advisory votes when considering future executive compensation decisions.

If your shares are not registered directly in your name (e.g., you hold your shares in a stock brokerage account or through a bank or other holder of record), you may vote by following the instructions detailed on the notice or voting instruction form you receive from your broker or other nominee. If your shares are registered directly in your name with our transfer agent, you are considered, with respect to those shares, the “stockholder of record.” In that case, the Notice of Annual Meeting, this Proxy Statement and our 2025 Form 10-K have been sent directly to you.

Please note that you cannot vote your shares by filling out and returning the Notice. The Notice does, however, include instructions on how to vote your shares.

OUR 2025 YEAR IN REVIEW

2025 marked another strong year of performance and momentum across our organization. Our local teams continued to deliver strong clinical outcomes and disciplined operational execution, contributing to significant improvements in occupancy, skilled mix, and financial results. Their commitment to a culture of clinical excellence and hands‑on leadership remained the driving force behind our success, allowing us to build on our strong foundation and accelerate growth across multiple markets.

Operational Performance

Our operational performance highlights in 2025 include:

•Same Facility(1) occupancy increased to 82.9%, up 2.5% from the prior year.

•Transitioning Facilities(2) occupancy rose to 84.2%, an increase of 4.2% from the prior year.

•Same Facility and Transitioning skilled mix days increased to 31.8%, an increase of 4.3% from prior year.

•Skilled days growth remained strong, increasing 6.8% at Same Facilities(1) and 10.7% at Transitioning Facilities(2) over the prior year.

•Both Medicare revenue and Managed Care revenue increased, improving 11.5% and 10.2% at Same Facilities(1), respectively, and 9.4% and 22.1% at Transitioning Facilities(2), respectively, over the prior year.

•Total skilled services revenue reached $4.84 billion, up 18.7% from the prior year.

•We expanded our portfolio by adding 46 operations across 14 states and 28 real estate properties, expanding our presence into Alabama, Alaska and Oregon.

Financial Results

Our 2025 financial highlights include:

•Consolidated revenue grew to $5.06 billion, an increase of 18.7% year-over-year.

•Over the last five years, our total revenue increase represents a 16% compound annual growth rate (CAGR) and our diluted EPS growth represents a 14% CAGR.

•Our liquidity remains strong. We generated cash flow from operations of $564.3 million while maintaining our strong balance sheets.

•We again increased our quarterly dividend, marking the 23rd consecutive year of dividend increases.

We are extremely proud of what our teams accomplished in 2025. Our continued momentum in occupancy, skilled mix, and overall operational performance reflects the power of our locally driven leadership model and the resiliency of our culture. With dozens of recently acquired operations in various stages of transition, we see significant opportunity ahead to unlock further operational efficiencies, elevate clinical capabilities, and expand market share.

With the strength of our leadership teams, our proven operational fundamentals, and the overall health of our organization, we are well‑positioned for another outstanding year in 2026 and beyond.

1 Same Facility results represent all facilities purchased prior to January 1, 2022.

2 Transitioning Facility results represent all facilities purchased from January 1, 2022 to December 31, 2023.

CORPORATE GOVERNANCE

We are committed to continually enhancing our strong corporate governance practices, which we believe helps us sustain our success and build long-term value for our stockholders. Our Board sets high standards for our employees, officers and directors. Implicit in this philosophy is the importance of sound corporate governance. It is the duty of the Board to serve as a prudent fiduciary for stockholders and to oversee the management of the Company's business. Our governance structure is designed to enable independent, experienced and accomplished directors to provide advice, insight, guidance and oversight to advance the interests of the Company and our stockholders.

Our Board continues to evaluate the Company’s corporate governance policies and practices to ensure that the right mix of individuals are present in our boardroom to best serve the stockholders we represent by ensuring effective oversight of our strategy and management. We are committed to maintaining the highest standards of corporate governance and have established a strong and effective framework by which the Company is governed and reviewed.

The Company has a classified Board of Directors consisting of three classes of directors, each serving staggered three-year terms and each class as nearly equal in number as possible as determined by our Board. As a result, a portion of our Board will be elected each year.

Proposal 1:

Election of Directors

Recommendation of the Board:

FOR each director nominee

Upon the recommendation of the Nominating and Corporate Governance Committee, our Board, including its independent directors, selected and approved Mr. Barry M. Smith, Ms. Swati B. Abbott and Ms. Suzanne D. Snapper as nominees for election as Class I directors, the class being elected at the Annual Meeting. Each nominee is to serve for a term of three years, expiring at the 2029 annual meeting of stockholders or until his or her successor is duly appointed or elected and qualified or until his or her earlier death, resignation or removal.

Also, upon the recommendation of the Nominating and Corporate Governance Committee, our Board, including its independent directors, selected and appointed Ms. Marivic Uychiat Pison for service on the Board of Directors for a term starting on September 1, 2025 and ending on the date of the Company’s 2026 Annual Meeting. In addition, Ms. Marivic Uychiat Pison is a nominee for election as a Class II director. If Ms. Marivic Uychiat Pison is elected to serve as a director for the initial one-year term, the Board of Directors anticipates that Ms. Marivic Uychiat Pison will be nominated for election to serve a three-year term as a Class II director at the 2027 Annual Meeting with a term that would expire in 2030.

We are not aware of any arrangements or understandings between the director nominees and any other person pursuant to which such persons were selected as a director nominee.

Mr. Barry M. Smith, Ms. Swati B. Abbott, Ms. Suzanne D. Snapper and Ms. Marivic Uychiat Pison currently serve as members of our Board and if elected have agreed to continue to serve on the Board and on the committees set forth below. In the event the nominees named herein are unable to serve or decline to serve at the time of the Annual Meeting, the persons named in the enclosed proxy will exercise discretionary authority to vote for substitutes. Unless otherwise instructed, the proxy holders will vote the proxies received by them FOR the nominees. This proxy cannot be voted for a greater number of persons than four and cumulated voting is not permitted.

Committee Membership

Name

Age

Director Since

Board of Directors

Audit Committee

Quality Assurance & Compliance

Nominating & Corporate Governance

Compensation

Barry M. Smith

2014

Chair

Swati B. Abbott

2020

Chair

Suzanne D. Snapper

2022

Marivic Uychiat Pison

2025

Background information regarding the nominees and all other directors as of March 18, 2026, including some of the attributes that led to their selection, appears below. In addition, the Board firmly believes that the experience, attributes and skills of any single director nominee should not be viewed in isolation, but rather in the context of the experience, attributes, and skills that all director nominees bring to the Board as a whole, each of which contributes to the function of an effective Board.

Determinations Regarding Director and Nominee Independence

The Company's common stock is listed on the Nasdaq Global Select Market. The Nasdaq Listing Rules require that a majority of the members of a listed company’s board of directors qualify as “independent”. After review of all of the relevant transactions or relationships between each director (and his or her family members) and us, our senior management and our independent registered public accounting firm, our Board has affirmatively determined that each of Drs. Ann S. Blouin and John O. Agwunobi, Ms. Swati B. Abbott, and Messrs. Daren J. Shaw, Barry M. Smith and Mark V. Parkinson are "independent" within the meaning of the applicable Nasdaq Listing Rules.

Further, each member of our Board serving on our Audit Committee, Compensation and Nominating and Corporate Governance Committee is “independent” within the meaning of the applicable Nasdaq Listing Rules and, as applicable, the Securities Exchange Act of 1934, as amended (the "Exchange Act").

NOMINEES AND DIRECTORS

The following biographical information sets forth certain information with respect to the nominees for election as well as the continuing directors whose terms expire at the annual meeting of stockholders in 2027 and 2028. The information is current as of March 18, 2026. The information presented below for each director includes the specific experience, qualifications, attributes and skills that led us to the conclusion that such director should be nominated to serve on our Board in light of our business.

Nominees for Election to the Board of Directors

Class I Directors with Terms Ending at the 2029 Annual Meeting of Stockholders

Barry M. Smith

AGE

DIRECTOR SINCE

COMMITTEES

Lead Independent Director

2014

Compensation Committee and Nominating & Corporate Governance (Chair)

Experience

Mr. Smith has served as a member of our Board of Directors since 2014. He most recently served as Chairman and Chief Executive Officer of Magellan Health, Inc. (NASDAQ: MGLN), the nation’s largest provider of behavioral health services and a leading national provider of radiology benefit management services, specialty pharmacy and prescription benefit management services, since 2013. He retired from Magellan at the end of 2019. He founded and served as Chairman, President and Chief Executive Officer of VistaCare, Inc., a national provider of hospice services, from 1996 to 2002, and he served as Chairman of VistaCare in 2003. From 1990 through 1995, Mr. Smith served as Chairman and Chief Executive Officer of Value Rx, Inc., which was then one of the country’s largest pharmacy benefit management companies and, prior to that, served as vice president of operations for PCS Health Systems, also a pharmacy benefit management firm. We believe Mr. Smith’s extensive experience as a proven and experienced leader in numerous healthcare businesses that are closely related to our businesses and his valuable strategic and other management insights support the conclusion that he should serve as our Lead Independent Director.

Swati B. Abbott

AGE

DIRECTOR SINCE

COMMITTEES

Director

2020

Audit Committee, Compensation Committee (Chair), and Nominating & Corporate Governance

Experience

Ms. Abbott has served as a member of our Board since 2020. Ms. Abbott most recently served as the President and Chief Executive Officer of Health Intelligence Company LLC, doing business as Blue Health Intelligence, a healthcare data and analytics company, from May 2011 to March 2022. Prior to joining Blue Health Intelligence, Ms. Abbott served as the president of MEDai, Inc., an industry leader in AI based predictive analytics, prior to its acquisition by Reed Elsevier in 2008. She also served as Managing Director for the Medical Management Strategic Business Unit at ViPS. Currently, Ms. Abbott also serves on the board of TalkSpace, Inc. (NASDAQ: TALK), an online and mobile therapy company. She also served as a Director of Magellan Health Inc. (NASDAQ: MGLN) from May 2018, until its acquisition by Centene in January 2022. We believe that Ms. Abbott's extensive experience and leadership in the healthcare services industry supports the conclusion that she should serve as one of our directors.

Suzanne D. Snapper

AGE

DIRECTOR SINCE

COMMITTEES

Chief Financial Officer, Executive Vice President and Director

2022

Quality Assurance & Compliance

Ms. Snapper has served in a multifaceted role within the Company since joining in April 2007. With a proven track record in corporate finance, Ms. Snapper was instrumental in the spin-offs of Care Trust REIT (NASDAQ: CTRE) in 2014 and Pennant Group (NASDAQ: PNTG) in 2019, implementing strategies to meet market needs and enhance shareholder value. She also played a key role in forming Standard Bearer REIT in 2022, driving financial structuring and growth initiatives that solidified the Company's leadership in real estate investment. Since August 2009, she has served as our Chief Financial Officer, following her role as Vice President of Finance upon joining Ensign in 2007, overseeing various critical functions including accounting, finance, information technology, tax, internal controls, investor relations, managed care, treasury, and finance risk management. Ms. Snapper has served as a member of the Company’s Board of Directors since 2022. In 2024, she became President of Insignia Pathways, supporting the future nursing workforce and international nurses entering the U.S. healthcare system. In May 2025, she joined The Pennant Group’s Board of Directors. We believe that Ms. Snapper's leadership experience, her knowledge of our business and operations, and extensive finance experience with public companies, support the conclusion that she should serve as one of our directors.

Class II Director with Term Ending at the 2027 Annual Meeting of Stockholders

Marivic Uychiat Pison

AGE

DIRECTOR SINCE

COMMITTEES

Vice President of Clinical Services and Director

2025

Quality Assurance & Compliance

Ms. Uychiat Pison has served as Vice President of Clinical Services at Ensign Services, Inc. since 2016, bringing nearly three decades of leadership in the Skilled Nursing and Post-Acute Care industry. Before assuming her current role, Ms. Uychiat Pison served as Director of Clinical Services for the company’s California operations beginning in 2012. Her extensive background also includes a decade-long tenure as Director of Nursing at Vista Knoll Specialized Care, where she oversaw comprehensive care for psychiatric/neurobehavioral, dementia, and short-term post-acute rehabilitation patients. Under her leadership, the facility achieved and maintained a flawless compliance record, with zero harm tags throughout her time there. Ms. Uychiat Pison is a mission-driven healthcare leader committed to clinical excellence, operational efficiency, and leadership development. Her approach has consistently driven performance improvements across Ensign's portfolio, including year-over-year gains in CMS 5-Star Ratings and Quality Measures that exceed the national average by 100%. Ms. Uychiat Pison holds a Bachelor’s Degree in Nursing, graduating Cum Laude from the University of St. La Salle and completed the Chief Nursing Officer Program at UCI Paul Merage School of Business. Her professional expertise spans skilled healthcare management, clinical program development, and policy-making—all aligned with Ensign’s mission to dignify long-term and post-acute care in the eyes of the world. Ms. Uychiat Pison has served as a member of the Company’s Board of Directors since September 2025. We believe that Ms. Uychiat Pison leadership experience and her knowledge of our business and operations, and extensive clinical expertise support the conclusion that she should serve as one of our directors.

Continuing Members of the Board of Directors

Class II Directors with Terms Ending at the 2027 Annual Meeting of Stockholders

Daren J. Shaw

AGE

DIRECTOR SINCE

COMMITTEES

Director

2012

Audit (Chair) and Compensation Committee

Experience

Mr. Shaw has been a member of the Board since 2012 and brings more than 35 years of leadership experience in the financial services industry. Since February 2025, he has also served on the Board of Trustees of the Keystone Private Income Fund, a private closed-end credit fund. He retired in 2019 as a Managing Director in the Investment Banking Group at D.A. Davidson & Co., a middle-market, full-service investment banking firm, where he served on the Senior Management Committee and the board of directors and acted as lead investment banker on numerous public offerings, private placements, and merger and acquisition transactions. Prior to D.A. Davidson & Co., Mr. Shaw spent 12 years at Pacific Crest Securities in senior roles, including Managing Director. His extensive investment banking and leadership experience provides deep financial expertise and supports his role as Chair of the Audit Committee. We believe that Mr. Shaw’s extensive experience and leadership in working with financial institutions supports the conclusion that he should serve as one of our directors.

Mark V. Parkinson

AGE

DIRECTOR SINCE

COMMITTEES

Director

2024

Quality Assurance & Compliance and Nominating & Corporate Governance

Experience

Mr. Parkinson has served as a member of our Board since 2024. Mr. Parkinson has held several positions in both the public and private sector and is currently the Principal of the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL), which represents more than 14,000 nursing homes, assisted living communities, and intermediate care facilities for individuals with disabilities. Previously, Mr. Parkinson was the association’s President and CEO for 14 years from 2011 to 2024. Under Mr. Parkinson’s leadership, AHCA/NCAL focused on delivering policy solutions to Congress and the Executive Branch, with a special emphasis on quality care. During his tenure, AHCA/NCAL remained the largest association in long term care and enjoyed record membership. Prior to his role as President and CEO for AHCA/NCAL, Mr. Parkinson served as the 45th Governor of the State of Kansas from 2009 to 2011, the 47th Lieutenant Governor of the State of Kansas from 2007 to 2009, and a Kansas state legislator. He also built, owned, and operated nursing home and senior living facilities in Kansas and Missouri between 1996 and 2006. Mr. Parkinson earned his Bachelor of Arts degree from Wichita State University and his Juris Doctor from the University of Kansas. We believe that Mr. Parkinson's extensive experience in public health programs and governmental agencies relevant to the healthcare industry support the conclusion that he should serve as one of our directors.

Class III Directors with Terms Ending at the 2028 Annual Meeting of Stockholders

Ann S. Blouin

AGE

DIRECTOR SINCE

COMMITTEES

Director

2018

Quality Assurance & Compliance (Chair) and Nominating & Corporate Governance

Experience

Dr. Blouin has served as a member of our Board since 2018. Dr. Blouin retired in 2018 from her role as Executive Vice President of Customer Relations at The Joint Commission, an independent, nonprofit organization that accredits U.S. health care organizations and programs. Prior to that, she served as Executive Vice President of Accreditation and Certification Operations from 2008 to 2012. In both roles, she provided leadership in aligning the strategic and operating goals of the organization with its client base. The Joint Commission has accreditation and certification programs across the care continuum, including long-term care. With more than 30 years of health care administration, consulting and clinical nursing experience, Dr. Blouin has held key senior leadership positions at community teaching hospitals and academic medical centers. While serving in key leadership roles with the consulting firms of Deloitte LLP, Ernst & Young Global Limited, Cap Gemini SE and Huron Consulting Group, she worked with multiple health systems across the United States and Canada to help them improve operating cost efficiency and effectiveness, revenue management, care coordination, and quality and patient safety. From May 2018-May 2025, Dr. Blouin served as President of PSQ Advisory, a consulting firm specializing in quality, safety, nursing and clinical care. In this capacity, she collaborated with boards and senior leadership teams to provide strategic guidance aimed at advancing patient care quality and safety across America's health systems. In addition, Dr. Blouin also serves on the Institute for Healthcare Improvement Board of Directors as Board Secretary; the Superior Health QIN-QIO Executive Leadership Council; and the Carol Emmott Foundation Leadership Council. Dr. Blouin is an Assistant Professor at Loyola University of Chicago. Dr. Blouin earned her Doctor of Philosophy (PhD) in Nursing Sciences and Master in Business Administration (MBA) from the University of Illinois at Chicago. Dr. Blouin received her Master of Science in Nursing (MSN) from Loyola University of Chicago, and Bachelor of Science in Nursing (BSN) from Lewis University in Romeoville, Illinois. We believe that Dr. Blouin’s extensive experience and leadership supports the conclusion that she should serve as one of our directors.

John O. Agwunobi

AGE

DIRECTOR SINCE

COMMITTEES

Director

2023

Audit Committee and Quality Assurance & Compliance

Dr. Agwunobi has served as a member of our Board since 2023. Dr. Agwunobi is a senior healthcare executive with experience across the public and private sectors. He served as Chief Executive Officer of Herbalife Nutrition Inc. from March 2020 to October 2022 and as Chairman from April 2020 to October 2022. Prior to that, he was Chief Health and Nutrition Officer beginning in 2016, leading global training and education, science and clinical strategy, and product development. He also served as Co-President of Herbalife from May 2018 to March 2020. Before joining Herbalife, Dr. Agwunobi was an independent consultant to privately held, health-related companies, including serving on the advisory board of Shopko Stores Operating Co., LLC on behalf of Sun Capital Partners. He was also a board member of Magellan Health, Inc. from December 2014 to June 2019, contributing to oversight of managed healthcare services for special populations and pharmacy benefit solutions. From 2007 to 2014, Dr. Agwunobi served as Senior Vice President and President of Health and Wellness at Walmart U.S. (NYSE: WMT), where he led the growth of the health and wellness business and advised on the company’s health reform strategy. Earlier, from 2005 to 2007, he was Assistant Secretary of Health at the U.S. Department of Health and Human Services, with responsibility for disease prevention and health promotion, including oversight of the Centers for Disease Control and Prevention, National Institutes of Health, U.S. Food and Drug Administration, the Office of the U.S. Surgeon General, and other federal public health programs. We believe that Dr. Agwunobi's extensive experience in public health programs and governmental agencies relevant to the healthcare industry support the conclusion that he should serve as one of our directors.

Barry R. Port

AGE

DIRECTOR SINCE

COMMITTEES

Chief Executive Officer and Chairman of the Board

2019

Quality Assurance & Compliance

Experience

Mr. Port has served as Chief Executive Officer and Board Member since 2019 and was appointed to Chairman of the Board in September 2025. A recognized leader in the post-acute care sector, he also serves on the Board of Directors of the American Health Care Association (AHCA) and co-chairs Partners Advancing Post-Acute Care (formerly CPAC), an organization representing more than 14,000 facilities nationwide working on key policy issues and legislative efforts impacting the sector. In 2024, he joined the board of Insignia Pathways, a nonprofit dedicated to attracting and developing the next generation of nursing professionals, with a special focus on supporting international nurses as they transition into the U.S. workforce. Prior to becoming CEO, Mr. Port was Chief Operating Officer of Ensign Services, Inc. (2012–2019), where he directed field support and administrative services for affiliated skilled nursing and senior living operations across the country. From 2006 to 2011, he served as President of Keystone Care, Inc., overseeing a network of facilities throughout Texas. His career in healthcare leadership began with operational roles directing skilled nursing campuses in Arizona and Texas, experiences that continue to shape his customer second approach to leadership today. Mr. Port holds a bachelor’s degree from Brigham Young University and master’s degrees in both Business Administration and Health Services Administration from the W.P. Carey School of Business at Arizona State University. We believe that Mr. Port’s extensive operating experience, his leadership and business skills, support the conclusion that he should serve as one of our directors.

BOARD STRUCTURE AND PRACTICES

Our Board believes that combining the roles of Chairman of the Board and Chief Executive Officer is the appropriate leadership structure for the Company at this time. This structure provides unified leadership and clear accountability for the execution of our long‑term strategy. Our current Chairman of the Board and Chief Executive Officer has extensive knowledge and experience with the Company, industry dynamics, and strategic priorities, enabling strong, informed leadership at both the management and Board levels.

To ensure independent oversight, The Board established the position of a Lead Independent Director (the “Lead Independent Director”), to designate a non-employee independent director of the Board to serve as such Lead Independent Director, and to have such Lead Independent Director serve in a lead capacity to, among other things: (i) coordinate the activities of the other independent directors of the Board; (ii) provide guidance and assistance to the Company’s management and a liaison with the Chairman and management; (iii) evaluate the Board and Committee performance, effectiveness and composition; (iv) communicate to stockholders; and (v) perform such other duties and responsibilities as the Board of Directors or the other independent directors may determine, from time to time. The Board reviews its leadership structure annually and believes that the combination of the Executive Chairman and CEO role with a strong Lead Independent Director provides effective oversight and governance aligned with the Company’s needs.

Below are some highlights of our corporate governance practices:

Board Structure and Practices

Board's Role in Risk Oversight

Each of our Board members is elected at least every three years.

Our Board actively oversees the Company's risk and enterprise-wide risk management process in a way that balances managing risks while enhancing the long-term value of the Company for the benefit of the stockholders.

We have majority voting for our director elections.

Six of our Board members are independent, in accordance with Nasdaq Listing Rules and our Corporate Governance guidelines at investor.ensigngroup.net/governance.

Our Board focuses on effective risk oversight to set the Company's tone and culture towards effective risk management by developing and establishing a mutual understanding with management of the Company's risk philosophy and overall appetite for risk.

Our Lead independent Director helps to facilitate free and open discussion and communication among the independent directors of the Board and between the Board and management. Our Lead Independent Director guidelines are at investor.ensigngroup.net/governance.

Our Board is actively involved with management assessment of existing risk management processes and how management identifies, assesses and manages the Company's most significant risk exposures. Our Board expects frequent updates from management about the Company's most significant risks so as to enable it to evaluate whether management is responding appropriately.

Average director tenure of approximately eight years.

Our Board is actively engaged in managing talent and long-term succession planning for executives.

We have adopted a process to enable stockholders to nominate directors in accordance with our Bylaws

Our independent directors meet frequently in executive session.

Our Board relies on each of its sub-committees (the "Board Committees") to help oversee the risk management responsibilities relating to the functions performed by such Board Committees. Each of the Board Committees are required to make regular reports of its actions and communicate any recommendations to the Board, including recommendations to assist the Board with its overall risk oversight function.

†Our Audit Committee periodically discusses with management the Company's major financial risk exposures and the steps management has taken to monitor and control such exposures, including the Company's risk assessment and risk management policies.

†Our Compensation Committee helps the Board to identify the Company's exposure to any risks potentially created by our compensation programs and practices. For a further discussion of how the Compensation Committee helps mitigate this risk, see the section titled "Compensation Discussion and Analysis - Compensation Policy and Objectives".

†Our Nominating and Corporate Governance Committee helps the Board establish qualifications for a director nominee, including qualities and skills. They oversee the corporate governance policies, procedures and guidelines for the Company.

†Our Quality Assurance and Compliance Committee oversee risks relating to the Company's policies and assists the Board and management in promoting an organizational culture that encourages commitment to ethical conduct and a commitment to compliance with the law.

Key Focus Areas



Business Strategy Our Board is committed to delivering high-quality healthcare services to the local communities we serve. Our business strategy is focused on expanding our reach and improving patient outcomes through the implementation of care pathways based on the unique needs of each community. The Board strategy is to advise management on positioning our organization to ensure that our services meet the needs of our residents, and employees. Our Board does this through supporting and advising on both short and long term strategic initiative that foster our core values and mission.
People The Board and management share a fundamental belief that people matter. Our team members are indispensable and responsible for saving and improving thousands of lives each day. Their dedication and efforts continue to beneficially impact our employees and patients. Their strength and willpower to do everything to care for our patients and the healthcare community have impacted lives of individuals, clinical quality and the long-term care industry.
Risk Oversight The Board regularly considers our risk profile when reviewing our overall business strategy. Individual performance objectives of the executive leadership team are aligned with the Company’s top enterprise-wide risks.

Engaging with Our Stockholders

Management and directors engage with our stockholders throughout the year in a variety of forums. Members of the executive management team attended meetings and presented at conferences. Our interactions cover a broad range of governance and business topics, including proxy access, board elections, compensation practices, peer group composition, business strategy and environmental and social issues. Our engagement activities provide us with a valuable understanding of our stockholders' perspectives and an opportunity to share views with them. We look forward to maintaining an open line of dialogue with our stockholders.

We encourage you to visit the Governance area of the "Investor Relations" section of our website (http://investor.ensigngroup.net/governance) where you will find detailed information about our corporate governance practices and policies including each of our Committee's Charters. Information on our website is not incorporated by reference into this Proxy Statement and should not be considered part of this document.

The Company's Director Nomination Process

Our Nominating and Corporate Governance Committee oversees the director nomination process. This committee is responsible for assisting the Board in establishing minimum qualifications for director nominees, including qualities and skills that members of our Board are expected to possess. These criteria include the candidate's personal and professional integrity, the candidate's financial literacy or other professional or business experience relevant to an understanding of the Company and our business, the candidate's demonstrated ability to think and act independently and with sound judgment, and the candidate's ability to be effective, in conjunction with other members or nominees of the Board in collectively serving the long-term interests of the Company and our stockholders. Our Nominating and Corporate Governance Committee identifies and evaluates individuals qualified to become members of our Board. Our Nominating and Corporate Governance Committee then recommends that our Board select the director nominees for the election at the next annual meeting of stockholders, or to fill vacancies on our Board of Directors occurring between annual meetings of stockholders.

We believe it is important to have an appropriate mix of experience and skills for the optimal functionality of the Board. Our Nominating and Corporate Governance Committee charter requires that the committee considers each candidate's qualities and skills and our Nominating and Corporate Governance Committee considers each candidate's background, ability, judgment, skills and experience in the context of the needs and current make-up of the Board when evaluating director nominees. The Board believes it is important for each member of the Board to possess skills and knowledge in the areas of leadership of large, complex organizations, finance, strategic planning, laws and regulations, government relations and relevant industries, especially the healthcare and skilled nursing industries. These considerations help the Board as a whole to have the appropriate mix of characteristics, skills and experiences for the optimal functioning of the Board of Directors in its oversight of our Company. As part of its periodic self-assessment process, the Nominating and Corporate Governance Committee reviews and evaluates its performance, including overall composition of the Board and the criteria that it uses for selecting nominees in light of the specific skills and characteristics necessary for the optimal functioning of the Board in its oversight of our Company. The Nominating and Corporate Governance Committee considers all of the criteria described above in identifying and selecting nominees and in the future may establish additional minimum criteria for nominees. The number of our directors that have special expertise in the following skills and experience are shown below:

Leadership

9/9

Financial Expertise

8/9

People and Culture

9/9

Public Policy and Government

7/9

Corporate Governance

8/9

Healthcare Experience

8/9

Risk Management

9/9

Innovation, Technology,

Privacy and Security

6/9

Nomination Right of All Stockholders under Section 3.02 of our Bylaws. Pursuant to Section 3.02 of our amended and restated bylaws (our “Bylaws”), any stockholder may nominate one or more persons for election as a director at an annual meeting of stockholders. To do so, the stockholder must comply with the timely notice, information and consent provisions contained in our Bylaws. In order for an eligible stockholder's director nomination to be timely, the stockholder must deliver written notice to our corporate Secretary: (i) in the case of an annual meeting, not later than the close of business on the 60th day, nor earlier than the 90th day, prior to the anniversary date of the immediately preceding annual meeting of stockholders; provided, however, that in the event that no annual meeting of stockholders was held in the previous year or the annual meeting of stockholders is called for on a date that is not within 30 days of such anniversary date, notice by the stockholder must be so received no earlier than the close of business on the 90th day prior to such annual meeting of stockholders and not later than the close of business on the 60th day prior to such annual meeting of stockholders or not later than the close of business on the 10th day following the day on which public disclosure of the date of the meeting was made by the Company, whichever occurs first, or (ii) in the case of a special meeting of the stockholders called for the purpose of electing directors, not later than the close of business on the 10th day following the day on which notice of the date of the special meeting was mailed or public disclosure of the date of the special meeting was made by the Company, whichever first occurs. The written notice must include the information about the director nominee that is required to be provided pursuant to Section 3.02(a)-(i) of our Bylaws and the written consent of each proposed nominee to serve as a director if so elected. Notwithstanding the foregoing, in order to include information with respect to a stockholder nomination in the proxy statement and form of proxy for a stockholder’s meeting, stockholders must comply with the requirements of the Exchange Act, and the regulations promulgated thereunder. The presiding officer of an annual meeting of stockholders shall refuse to acknowledge the nomination of any person not made in compliance with the foregoing procedure.

Right of All Stockholders to Recommend Director Nominees to the Nominating and Corporate Governance Committee. Pursuant to Section 5 of the Nominating and Corporate Governance Committee charter, the Nominating and Corporate Governance Committee will consider nominees for the Board recommended by stockholders. If an eligible stockholder wishes to recommend a director nominee to the Nominating and Corporate Governance Committee, he or she should submit such recommendation in writing to the Chair, Nominating and Corporate Governance Committee, care of the Secretary of the Company, Chad A. Keetch, The Ensign Group, Inc., 29222 Rancho Viejo Road, Suite 127, San Juan Capistrano, California 92675, by the deadline for stockholder proposals set forth in the Company's last proxy statement, specifying the information about the director nominee that is required to be provided pursuant to Section 5 of the Nominating and Corporate Governance Committee charter. All such recommendations will be brought to the attention of the Nominating and Corporate Governance Committee, and the Nominating and Corporate Governance Committee shall evaluate such suggested director nominees in accordance with the same criteria applicable to the evaluation of all director nominees. The Nominating and Corporate Governance Committee is not required to include, or recommend to the Board for inclusion in the proxy statement, any proposed director nominees of the Board who are recommended by stockholders through this process.

Committees of the Board of Directors and Related Matters

During fiscal year 2025, our Board had four standing Board Committees: the Compensation Committee, the Audit Committee, the Nominating and Corporate Governance Committee, and the Quality Assurance and Compliance Committee. The Board, upon recommendation of the Nominating and Corporate Governance Committee, makes Board Committee and Board Committee chair assignments annually at its meeting immediately preceding the annual meeting of stockholders, although further changes to committee assignments are made from time to time as deemed appropriate by the Board. The Board Committees operate pursuant to written charters, copies of which are available on our website at investor.ensigngroup.net/governance. Information on our website is not incorporated by reference into this Proxy Statement and should not be considered part of this document.

Attendance at Board, Committee and Annual Meetings

During the year ended December 31, 2025, our Board met five times. Each of the directors attended at least 75 percent of the meetings of our Board and the meetings of any of our Board Committees on which they served that were held during the term of each director. Our Board and the Board Committees also acted by way of unanimous written consents six times during the year ended December 31, 2025. In addition, the Compensation Committee, the Audit Committee and the Board met, at times, without management present in executive session. During the year ended December 31, 2025, the Audit Committee met at least once without management present in executive session.

Although we do not have a formal policy regarding attendance by members of our Board at our Annual Meeting of Stockholders, we encourage our directors to attend. At the 2025 Annual Meeting, eight members of the Board were in attendance and we expect that at least a majority of our Board will attend the 2026 Annual Meeting.

An overview of the current composition of each Board Committee and the Board composition matrix is set forth below.

Director

Compensation Committee

Audit Committee

Nominating and Corporate Governance Committee

Quality Assurance and Compliance Committee

Barry R. Port «

Barry M. Smith O

Daren J. Shaw

Ann S. Blouin

Swati B. Abbott

John O. Agwunobi

Mark V. Parkinson

Suzanne D. Snapper

Marivic Uychiat Pison

l Member

C Chair

« Chairman of the Board

O Lead Independent Director

COMPENSATION COMMITTEE


Committee Members	The primary functions of the Compensation Committee include:
Swati B. Abbott (Chair)	l	developing and reviewing policies relating to compensation and benefits;

Barry M. Smith	l	determining or recommending to our Board the cash and non-cash compensation of our executive officers;

Daren J. Shaw	l	evaluating the performance of our executive officers and overseeing management succession planning;

Number of Meetings in Fiscal Year 2025: 6	l	administering or making recommendations to our Board with respect to the administration of our equity-based and other incentive compensation plans; and
	l	overseeing the preparation of the Compensation Discussion and Analysis and the related Compensation Committee Report for inclusion in our annual proxy statement.


All members of the Compensation Committee are independent directors, as such term is defined in the Nasdaq Listing Rules. The Compensation Committee has not delegated any powers or authority to the Chief Executive Officer or any other executive officer of the Company in determining executive officer compensation. On a routine basis, our Compensation Committee retains the services of a national consulting firm to assist in the development and validation of our executive compensation and incentive programs. The Compensation Committee used the most recent study to enhance, validate and refine the executive compensation and incentive program in 2025. For a discussion of the processes and procedures for determining executive and director compensation and the role of compensation consultants in recommending the amount or form of compensation, see the “Compensation Discussion and Analysis” section.

NOMINATING AND CORPORATE GOVERNANCE COMMITTEE


Committee Members	The primary functions of the Nominating and Corporate Governance Committee include:
Barry M. Smith (Chair)	l	assisting the Board in establishing the minimum qualifications for a director nominee, including the qualities and skills that members of our Board are expected to possess;

Ann S. Blouin	l	management succession planning;

Mark V. Parkinson	l	developing, assessing, and recommending corporate governance policies to our Board;

Swati B. Abbott	l	selecting, or recommending that our Board selects, the director nominees for election at the next annual meeting of stockholders, or to fill vacancies on our Board occurring between annual meetings of stockholders;

Number of Meetings in Fiscal Year 2025: 5	l	identifying and evaluating individuals qualified to become members of our Board, consistent with criteria approved by our Board and our Nominating and Corporate Governance Committee; and
	l	overseeing the Company's Environmental, Social and Governance (ESG) and Unity Committee initiatives, goals and practices. This includes oversight of the ESG Committee's focus on the Company's sustainability risks related to quality of care and patient safety, data protection, employee relations and the management of energy and waste.

All members of the Nominating and Corporate Governance Committee are independent directors, as such term is defined in the Nasdaq Listing Rules.

QUALITY ASSURANCE AND COMPLIANCE COMMITTEE


Committee Members	The primary functions of the Quality Assurance and Compliance Committee include:
Ann S. Blouin (Chair)	l	overseeing our officers' response, as appropriate, to compliance and quality control issues and corrective actions;

Barry R. Port	l	overseeing a system for internal monitoring and auditing of compliance and quality control issues;

John O. Agwunobi	l	designating a corporate compliance officer, and functioning as the compliance committee to which such compliance officer reports;

Mark V. Parkinson	l	ensuring that means exist for the delivery of appropriate compliance training and education to the officers and employees of our independent subsidiaries; and

Marivic Uychiat Pison	l	overseeing the promulgation, and the updating from time to time as appropriate, of a written corporate compliance program that substantially conforms to the Office of the Inspector General Program Guidance for Nursing Facilities, including written policies, procedures and standards of conduct, as well as disciplinary guidelines to assist officers and employees charged with direct enforcement responsibility.
Suzanne D. Snapper
Number of Meetings in Fiscal Year 2025: 4

Of the members of the Quality Assurance and Compliance Committee, Dr. Blouin, Dr. Agwunobi and Mr. Parkinson are independent directors, as such term is defined in the Nasdaq Listing Rules.

AUDIT COMMITTEE


Committee Members	The primary functions of the Audit Committee include:
Daren J. Shaw (Chair)	l	overseeing the Company's compliance programs and any legal or regulatory matters that may have a material impact on the Company's financial statements;

John O. Agwunobi	l	overseeing portions of our code of ethics and business conduct that relate to the integrity of our financial reports.

Swati B. Abbott	l	overseeing the functioning of our internal controls and overseeing and participating in the resolution of internal control issues, where identified;

Number of Meetings in Fiscal Year 2025: 5	l	reviewing and approving our transactions with related persons;
	l	pre-approving audit and permissible non-audit services to be performed by our independent accountants, and the fees to be paid in connection therewith;
	l	overseeing the engagement, replacement, compensation, qualifications, independence and performance of our independent auditors, and the conduct of the annual independent audit of our financial statements;
	l	overseeing procedures for the receipt, retention and treatment of complaints regarding accounting, internal accounting controls or auditing matters, and for the confidential, anonymous submission by our employees of concerns regarding questionable accounting or auditing matters;
	l	overseeing the conduct of our financial reporting process and the integrity of our financial statements and other financial information provided by us to the public or any governmental or regulatory body;
	l	setting the "tone at the top" and emphasizing the importance of an environment that supports integrity in the financial reporting process;
	l	overseeing processes for monitoring auditor independence;
	l	overseeing implementation of new accounting standards;
	l	communicating with the outside auditor on matters related to the conduct of the audit and on critical audit matters expected to be described in the auditor's report;
	l	reviewing and understanding non-GAAP measures, and related company policies and disclosure controls; and
	l	overseeing the Company’s cybersecurity risk management program, policies, and procedures.

All members of the Audit Committee are independent directors, as such term is defined in the Nasdaq Listing Rules and Rule 10A-3 of the Exchange Act. Each member of our Audit Committee can read, and has an understanding of, fundamental financial statements. Our Board has determined that each of the members of the Audit Committee qualify as an “audit committee financial expert” as that term is defined in the rules and regulations established by the SEC. This designation is a disclosure requirement of the SEC related to Mr. Shaw, Dr. Agwunobi and Ms. Abbott's experience and understanding with respect to certain accounting and auditing matters. The designation does not impose on Mr. Shaw, Dr. Agwunobi and Ms. Abbott any duties, obligations or liability that are greater than those generally imposed on them as a member of our Audit Committee and our Board, and their designation as audit committee financial experts pursuant to this SEC requirement does not affect the duties, obligations or liability of any other member of our Audit Committee or Board. Representatives of our independent registered public accounting firm and our internal financial personnel regularly meet privately with the Audit Committee and have unrestricted access to this committee.

DIRECTOR COMPENSATION

In fiscal year 2025, our Chief Executive Officer, Chief Financial Officer, and Vice President of Clinical Services, all of whom serve on the Board, received only their respective annual salaries, and no additional compensation was paid to them for their service on the Board. The annual salaries of our Chief Executive Officer and Chief Financial Officer are disclosed in the Executive Compensation section of this Proxy Statement. Each of our non-employee directors received an annual retainer of $30,000. In addition, each non-employee member of the Board Committees received the following retainers:


	Chair		Member
Committees	Retainer		Retainer
Audit	$	30,000	$	10,000
Quality Assurance and Compliance	30,000		6,000
Nominating and Corporate Governance	12,000		2,000
Compensation	15,000		3,000

We do not compensate our non-employee directors other than for their service on our Board or Board Committees. Compensation for Board and Board Committee service is partially based upon relevant market data that we obtain by reviewing director compensation by other public companies in the skilled nursing industry as well as in consultation with Willis Towers Watson. To establish board compensation, our Compensation Committee reviews the published director compensation information of other healthcare and real estate investment trust companies, including our peer group companies, Amedisys, Inc., CareTrust REIT Inc., Encompass Healthcare Corp., LTC Properties, Inc., National Healthcare Corporation, National Health Investors, Inc., Omega Healthcare Investors, Inc., PACS Group, Inc., Select Medical Holdings Corp., and Welltower Inc. Based on these reviews, the Compensation Committee sets its annual retainers for outside directors and retainers to the chairpersons of each Board Committee at levels that we believe are comparable to the median cash compensation paid to directors of these companies.

Our Amended and Restated 2022 Omnibus Incentive Plan (the Amended and Restated Plan) contains an automatic stock grant program (the Automatic Stock Grant Program) for our non-employee directors. Each non-employee director receives a quarterly restricted stock grant on the 15th day of the month following each quarter end and such shares will vest over a three-year period, beginning with the first anniversary of the grant date. Directors elected to fill less than a three-year term will receive a pro rata stock award.

All unvested restricted stock grants will become fully vested on the date any such non-employee director ceases serving on the Board unless such director is removed for cause. Pursuant to the Automatic Stock Grant Program, Board members receiving stock grants must maintain ownership of a minimum of thirty-three percent (33%) of the cumulative shares granted to him or her. Our Board and Compensation Committee considered the total compensation paid to directors of the peer group companies named above in deciding to award these automatic stock awards. However, our Board and Compensation Committee, with reference to the most recent Willis Towers Watson study, determined the amount of stock awards based upon what they considered to be an appropriate incentive for board service to our Company, and they did not attempt to base this number upon the amount awarded to directors of these other companies. Our Board has also determined that it may be necessary to provide additional incentives to prospective directors in order to recruit talented leaders to serve on the Board.

None of our directors or director nominees has any agreement or arrangement with any third party that relates to compensation or other payment in connection with that person’s candidacy or service as a director of our Company.

The following table summarizes the compensation earned by our non‑employee directors in 2025. Our directors who also serve as employees or executive officers do not receive any compensation for their service as directors and have therefore been omitted from this table. These individuals consist of: (i) Mr. Port, the Company’s Chief Executive Officer; (ii) Ms. Snapper, the Company's Chief Financial Officer; and (iii) Ms. Uychiat Pison, the Company's Vice President of Clinical Services. Mr. Port and Ms. Snapper are each one of our Named Executive Officers (NEOs), and their compensation is disclosed in the Executive Compensation section of this Proxy Statement.


	Fees	Stock	All Other
	Earned	Awards	Compensation	Total
Name	($)	($)(1)	($)	($)

Daren J. Shaw	63,000	349,674	—	412,674
Barry M. Smith	45,000	349,674	—	394,674

Swati B. Abbott	57,000	349,674	—	406,674
Ann S. Blouin	62,000	349,674	—	411,674
John O. Agwunobi	46,000	349,674	—	395,674
Mark V. Parkinson	38,000	349,674	—	387,674

(1)This column reflects the total dollar amount to be recognized for financial statement reporting purposes with respect to the fair value of the stock awards granted to each of the directors during the 2025 fiscal year in accordance with Accounting Standard Codification (ASC) 718, Stock Compensation. Compensation expense for stock awards granted to directors were recognized in full on the date these awards were granted. Awards granted to Drs. Blouin and Agwunobi, Ms. Abbott and Messrs. Shaw and Smith vest over a three-year period beginning on the first anniversary of the grant date. The table below outlines the details of the stock awards which were granted to directors during the 2025 fiscal year:


Date of Grant	Awards Granted to Each Recipient	Fair Value on Grant Date	Recipients
1/15/2025	600	$134.58	Drs. Blouin and Agwunobi, Ms. Abbott and Messrs. Smith, Shaw and Parkinson
4/15/2025	600	129.09	Drs. Blouin and Agwunobi, Ms. Abbott and Messrs. Smith, Shaw and Parkinson
7/15/2025	600	141.18	Drs. Blouin and Agwunobi, Ms. Abbott and Messrs. Smith, Shaw and Parkinson
10/15/2025	600	177.94	Drs. Blouin and Agwunobi, Ms. Abbott and Messrs. Smith, Shaw and Parkinson

Communications with Directors

Stockholders who would like to send communications to our Board, any Board Committee or to any individual director may do so by submitting such communications to the Secretary of the Company, Chad A. Keetch, The Ensign Group, Inc., 29222 Rancho Viejo Road, Suite 127, San Juan Capistrano, California 92675. We suggest, but do not require, that such submissions include the name and contact information of the stockholder making the submission and a description of the matter that is the subject of the communication. Mr. Keetch will then distribute such information to our Board and the Board Committee chair for review, depending on the facts and circumstances outlined in the communications. Communications received by the Company may be reviewed by Mr. Keetch to ensure appropriate and careful review of the matter. In that regard, the Company's Board has requested that certain items that are unrelated to the duties and responsibilities of the Board should be excluded, such as: service complaints, service inquiries, new service suggestions, resumes and other forms of job inquiries, surveys, business solicitations or advertisements.

In addition, material that is unduly hostile, threatening, illegal or similarly unsuitable will be excluded, with the provision that any communication that is filtered out must be made available to any non-management director upon request.

Code of Conduct and Ethics

We have adopted a code of ethics and business conduct that applies to all employees, including employees of our independent subsidiaries, as well as each member of our Board. The code of ethics and business conduct is available on our website at investor.ensigngroup.net/governance. Information on our website is not incorporated by reference into this Proxy Statement and should not be considered part of this document.

We intend to satisfy any disclosure requirement under Item 5.05 of Form 8-K regarding an amendment to, or waiver from, a provision of this code of ethics by posting such information on our website, at the address specified above.

BOARD OVERSIGHT OF RISK

Effective risk management is critical to our ability to dignify and transform post-acute care. Our Board of Directors exercises direct oversight of risks to the Company and other risk areas not delegated to one of the Board Committees. Our Board of Directors looks to the expertise of its Board Committees to provide strategic oversight in their areas of focus. The Board Committees are charged with specific areas of risk oversight and regularly report back to the full Board.

We believe that sustainable development practices and consistent attention to social and governance priorities will help enhance long-term value for stockholders. In addition, our Board of Directors recognizes the importance of our sustainability initiatives and the need to provide effective oversight of those initiatives. In 2021 and under the direction and oversight of the Nominating and Corporate Governance Committee, we formed a sub-committee, the ESG Committee. The ESG Committee’s purpose is to oversee and support the Company’s commitment to social, environmental and other public policy initiatives, including, among other things, climate change impacts, sustainability, and unity of our people. The ESG Committee consists of employees across all professional levels and functional areas as well as a member of the Board of Directors. The formation of the ESG Committee is intended to continue the Company's effort to align our corporate governance policies and practices with the long-term interests of our business and our stockholders.

In 2025, the ESG Committee continued to focus on the Company's risks related to environmental sustainability related to various areas including social sustainability, data protection, artificial intelligence, employee relations and the management of energy and waste. In addition to the ESG Committee, the Audit Committee oversees our cybersecurity risk management program as part of its broader responsibility for monitoring risk.

Environmental Sustainability

Ensign's environmental management team ("EMT") is part of our ESG Committee. The EMT is led by the Service Center's leadership team members including Construction and Asset Development as well as its Executive Management. The “Service Center” refers to certain of our wholly-owned independent subsidiaries that provide centralized accounting, payroll, human resources, information technology, legal, risk management and other centralized services to the other independent subsidiaries through contractual relationships with such subsidiaries. The EMT is responsible for:

•Implementation and continuous execution of our environment management system and policy.

•Development of the Company's environmental management policy.

•Identification of climate related risks under the Task Force on Climate-Related Financial Disclosures framework.

•Providing structure and support to our independent subsidiaries that are led by local operators to make decisions on their capital expenditure projects at their facilities. The team advises our local field operators on best practices and identifies opportunities for them to assess priorities of projects that may be chosen to be executed.

•Overseeing environmental programs which include the evaluation and installation of LED lighting, solar panel, improved doors and insulation, automated HVAC controls and thermal efficiency projects related to micro-turbine, demand control ventilation.

•Development of target goals for reduction of carbon emissions, savings and ENERGY STAR scores.

•Tracking and monitoring of currently available environmental metrics such as utility usage and development of an energy management system that tracks greenhouse gas emissions and more.

•Preparing for applicable environmental filings and audits in the future.

We understand the importance of addressing environmental sustainability and have undertaken initiatives to responsibly manage our overall environmental footprint. We have mainly focused on three areas to drive environmental improvements: energy consumption, water use and waste.

We have made, and will continue to make, various capital investments with these three initiatives in mind. We continue to implement energy conservation measures throughout our locations such as light-emitting diode (LED) lighting retrofits, heating, ventilation, and air conditioning (HVAC) upgrades, roofing improvements and changes in community maintenance. In similar ways, our water initiatives include smart controls, leak detection and repair, and behavioral changes, demonstrating our continued efforts to reduce water use. We are continuing our efforts to divert waste generated in our operations through effective recycling and waste reduction measures. Additionally, we partner with our vendors to purchase products and services that help our operations reduce their impact on the environment. For the year ended December 31, 2025, we spent approximately $190.0 million on capital expenditures of property and equipment, which included facility modernization initiatives.

Social Sustainability

One of the ways in which we measure the Company's policies and procedures to address sustainability risks, including, but not limited, to quality of care and patient safety risks, is the Five-Star Quality Rating System introduced by the Centers for Medicare and Medicaid Services ("CMS"). The Five-Star Quality Rating System gives each skilled nursing operation a rating between one and five stars in various categories including health inspections, staffing and quality measures ("QM") as follows:

•The health inspection star rating is based on each nursing home's current health inspection and two previous years of inspections, as well as findings from the most recent 3 years of complaint inspections and 3 years of infection control inspections. The inspections are focused on standards for providing adequate care, managing medications properly, protecting residents from physical and mental abuse and storing and preparing food properly. The regulations include a broad range of changing healthcare metrics including but not limited to staffing and infection control protocols.

•The QM star rating measures parts of nursing home performance in certain areas of care for short-stay and long-stay measures, such as if residents have gotten their flu shots, are in pain, or are losing weight.

At the time of acquisition, the majority of our facilities have 1 and 2-Star ratings. As new assessments are conducted post-acquisition, the star ratings see consistent improvement. We have a strong history of quickly improving the quality of care in the facilities we acquire.


	As of December 31,
	2021	2022	2023	2024	2025

4 and 5-Star Quality Rated skilled nursing facilities	114	113	130	129	153

According to CMS data published in February 2026, same‑store Ensign-affiliated facilities exceeded state and county benchmarks in annual survey results by 24% and 33%, respectively. Our operations also maintained a 19% advantage in the percentage of 4- and 5-star rated facilities when compared to peers. These results are particularly significant given that many of these facilities carried 1- and 2‑star ratings at the time of acquisition, underscoring consistent improvement and long-term clinical performance.

Over the last few years, CMS has modified the star rating requirements. These changes have been significant and made it more difficult to achieve a 4 or 5-Star rating, resulting in certain skilled nursing operations losing stars in their "Quality" and "Staffing" ratings, which negatively impacted the "Overall" ratings. Therefore, depending on the changes, we may experience periods of time where the number of facilities with 4 or 5-Star ratings decline. Nevertheless, we continue to demonstrate strong performance in the Five-Star Quality Rating System.

In addition, we aim to have an enduring impact on the communities in which we live and work by embodying our Company's core values. Elevate Charities is a non-profit organization that is dedicated to elevating the condition and quality of life for members of the senior healthcare community - employees, caregivers, family members, patients and residents. Of the three unique funds within Elevate Charities, the Emergency Fund is a way of helping qualified families whose lives are affected by tragedy. This program is primarily funded through contributions by Company team members. In 2025, approximately 89% of our employees employed by our independent subsidiaries contributed to the Emergency Fund. When in need of financial help due to financial hardships such as fire, hurricane, illness, accidents or other crises, team members or their fellow teammates on their behalf can apply to receive financial assistance. In 2025, the public charity distributed approximately $4.9 million in grants to team members of our independent subsidiaries. To date, the Emergency Fund program has distributed over 25,620 grants totaling $25.8 million to qualified recipients in their time of need.

In 2025, we donated $10.0 million to Insignia Pathway (Insignia), an independent public charity established to create new pathways for expanding the U.S. post‑acute care workforce. Insignia is dedicated to empowering, supporting, and inspiring the current and next generation to pursue careers in the long‑term and post‑acute care fields by providing resources, education, housing, and advocacy to enhance professional growth, job satisfaction, and community impact. In its first year of operation, Insignia awarded 139 in grants to Registered Nurses from 23 countries who have committed to work for U.S.-based skilled nursing providers. Through these efforts, Insignia aims to address workforce challenges, foster equity, and attract and retain caregivers to serve the nation’s most vulnerable senior patient populations.

Beyond contributing to these charities, our Company upholds the following policies and philosophies for maintaining and growing our social sustainability and responsibility:

•Human Rights & Responsibilities. We are committed to the dignity and rights of all people, especially those whose lives may be impacted by our operations. Among other things we are dedicated to prohibiting child labor, forced labor and discrimination while promoting the basic dignity of each resident, patient and employee at our facilities. We support our employees' occupational health and safety through providing sanitary facilities, abiding by all health and safety laws, ordinances and regulations governing facility uses and operations, and generally exceeding acceptable levels of health and safety.

•Tenant Social Responsibility. Our tenant corporate responsibility aims to assist our triple-net tenants in maintaining, renovating, developing and operating their facilities in a manner consistent with generally accepted standards of sound governance.

•Accessibility to Care. We have dedicated ourselves to providing and transforming dignified post-acute and long-term care and firmly believe accessibility to this care is a human right to everyone. Our facilities aim to be the operation of choice within their local communities by providing superior quality, affordable care. We rise to meet the needs of all our patients to ensure reliability and dignity for everyone.

•Human Capital. Our employees are at the heart of our Company and we are committed to their health, professional development and workplace satisfaction. Our core values, which focus on developing our employees, fostering an ownership mentality and allowing for intelligent risk taking, guide us in our decision making and inspire us to be better people, both professionally and personally. Our philosophies and policies in this regard relate to, among other things, our commitment to maintaining a workplace free of unlawful discrimination, competitive compensation and benefits for our employees, our commitment to employee retention, training, promotion, and engagement and satisfaction.

•Unity. Our commitment to inclusion is deeply rooted in our core values, including Love One Another, where we foster a welcoming and supportive environment for residents and their families and ensure that every individual—whether resident, family member, or team member—feels valued, informed, and comfortable to work together. Our commitment is to provide equal opportunity and fair treatment to all individuals based on merit and without discrimination. Our teams enable us to be a more relevant, competitive, and resilient organization.

While we believe we have a good foundation, we are continuing to work on strengthening our sustainability strategy and results. We know that a focus on sustainability has a positive effect on our communities, employees, caregivers, family members, patients and residents.

Cybersecurity

We utilize information technology that enables our operational leaders to access and share with their peers, both clinical and financial performance data in real time. Such uses of information systems give rise to cybersecurity risks, including system disruption, security breach, ransomware, theft, espionage and inadvertent release of information.

Our Audit Committee receives quarterly reports on our information security and cyber fraud prevention programs from the Service Center's Chief Information Officer and Chief Information Security Officer, who each have over 25 years of experience in IT, including various leadership roles at other large corporations. One of the three members of our Audit Committee is a cybersecurity expert.

The Information Security Office ("ISO") has been established by the Service Center's Chief Information Officer, with dedicated cyber security staff focusing on security monitoring, vulnerability management, incident response, risk assessments, employee training, security engineering and management of cyber security policies, standards and regulatory compliance. Like many organizations, we follow a Cyber Security Framework and take a risk-based approach during control assessment and implementation. We align to the National Institute of Standards and Technology (NIST) Special Publication 800-53 Revision 5, a globally recognized cyber security framework of Policies, Standards and Controls is comprised of five categories of defense (NIST Cyber Security Framework CSF) – Govern, Identify, Protect, Detect, Respond and Recover. We are committed to the protection of our data, systems, network and continually invest in enhancements to mitigate or reduce the impact from a cyber security threat. We conduct periodic tests to maintain readiness and resiliency while regularly reviewing policies in the interest of protecting data security. External companies or agencies may be called upon to provide consulting, guidance, assistance, or some other form of support in response to a cybersecurity incident. These companies have an ongoing and standing relationship with the Information Security Office. The regular training of employees, at least annually, on the ever-present threat of cybersecurity helps maintain data security.

AUDIT MATTERS

Proposal 2:

Approval of Independent Registered Public Accounting Firm

Recommendation of the Board:

FOR

The Audit Committee is directly responsible for the appointment, compensation, retention and oversight of the independent external audit firm retained to audit the Company’s financial statements. As a matter of good corporate governance, we are asking the stockholders to ratify the selection of Deloitte & Touche LLP ("Deloitte") as our independent registered public accounting firm for the year ending December 31, 2026. The affirmative vote of a majority of the common stock having voting power present in person or represented by proxy and entitled to vote will be required to ratify the selection of Deloitte.

Stockholders are not required to ratify the appointment of Deloitte as our independent registered public accounting firm. If stockholders fail to ratify the appointment, the Audit Committee will consider whether or not to retain Deloitte. Even if the appointment is ratified, the Audit Committee may direct the appointment of a different independent registered public accounting firm at any time during the year if it determines that such a change would be in the best interests of the Company and our stockholders.

Representatives of Deloitte will be present at the Annual Meeting, will have the opportunity to make a statement if they desire to do so, and will be available to respond to appropriate questions.

Principal Accountant Fees and Services

The following table presents fees for professional services rendered by Deloitte for the years ended December 31, 2025 and 2024:

SEC Form DEF 14A filed by The Ensign Group Inc.