Mission Viejo, California — The Ensign Group, the country’s largest nursing home operator, has crossed a line few chains ever reach: more than 400 facilities. The milestone arrived with a batch of deals announced Friday, and the company picked a big stage for its newest act — Florida, a state it has never operated in until now.
The expansion covers nine operations in Florida, seven in Colorado and four in Washington. In Florida, Ensign picked up eight facilities totaling 831 beds in one transaction, then paired with its real estate affiliate, Standard Bearer Healthcare REIT, to buy the property and operations of the 118-bed Englewood Heights Nursing and Rehabilitation in a second.
The company now operates in 18 states, with 418 healthcare operations including 50 senior living communities, and owns 189 properties through its subsidiaries.
Why Florida, why now
Ensign executives have been signaling the Southeast for months. On the company’s second quarter earnings call this summer, Chief Investment Officer Chad Keetch called the region a huge population center with a good labor environment and, historically, a friendly regulatory one. He predicted growth in neighboring states this year or next.
The numbers back up the interest. Florida has the second-largest population of older adults in the nation, and its share of residents aged 65 and older is expected to grow 39% between 2022 and 2030. Florida, California and Texas together account for nearly 30% of the country’s projected nursing home need in coming years, with each state likely to need more than 250 new facilities by 2030, according to industry projections.
Ensign isn’t chasing that demand alone. Its largest rival, PACS Group, announced last month that its subsidiaries had acquired operations at 32 Florida skilled nursing facilities with 4,049 licensed beds. The land grab fits a broader consolidation wave — one another big operator is already riding in Oregon.
How the deals are structured
The Colorado deals add 760 skilled nursing beds and 47 independent living units; the Washington buildings add 532 more. All run under long-term triple-net leases with Ensign-affiliated operators. The company also shifted real estate for five facilities — 755 beds — into long-term leases with Standard Bearer subsidiaries.
“Throughout our history, we have been thoughtful and deliberate when entering new states, seeking opportunities where exceptional local leadership, strong community ties and long-term growth potential align with our operating philosophy,” CEO Barry Port said in announcing the deals. “We are excited to make this investment into one of the largest and most dynamic healthcare markets in the country.”
Port noted that the Florida expansion is being led by a seasoned leader who relocated to the state to learn its market dynamics and scout first deals.
What it means for the market
Scale keeps concentrating at the top of the industry, and independent operators face stiffer competition for referrals, staff and capital as a result. Ensign is betting Florida’s growing senior population rewards the move. How that bet plays out for residents is the next test.
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