ENSG vs. FMS: Ensign vs. Fresenius Medical Care Stock Comparison

November 11, 2026

How do Ensign (ENSG) and Fresenius Medical Care (FMS) stack up? This page sets them side by side across company profile, performance and risk, profitability, growth, financial strength, dividends, and valuation, with selected fundamentals also measured against each stock's industry-group peers.

Company Profile

Ensign (ENSG) and Fresenius Medical Care (FMS) both belong to the Health Care Providers & Services industry, though ENSG is classified under Health Care Facilities while FMS falls under Health Care Services.

Ensign (ENSG) trades as ordinary local shares, while Fresenius Medical Care (FMS) trades as an ADR — compare with FX exposure, depositary-program fees, and dividend-withholding-tax differences in mind.

Company profile comparison for Ensign (ENSG) and Fresenius Medical Care (FMS)
Profile Item	ENSG	FMS
Name	The Ensign Group, Inc.	Fresenius Medical Care AG - Depositary Receipt
Country/Region	United States	Germany
GICS Sector	Health Care	Health Care
GICS Industry Group	Health Care Equipment & Services	Health Care Equipment & Services
GICS Industry	Health Care Providers & Services	Health Care Providers & Services
GICS Sub-Industry	Health Care Facilities	Health Care Services
Market Capitalization	10.56 billion USD	12.15 billion USD
Currency	USD	USD
Exchange	Nasdaq	NYSE
Listing Date	November 9, 2007	September 17, 1996
Security Type	Common Stock	ADR

Price Performance

Cumulative Growth

ENSG

FMS

GSPC

Ensign (ENSG) vs. Fresenius Medical Care (FMS), with S&P 500 (GSPC) for reference: Growth of a $10,000 investment over the past five years. Adjusted for dividends and splits.

Trailing Returns

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Trailing total returns for Ensign (ENSG) and Fresenius Medical Care (FMS). Returns over one year are annualized.

Calendar-Year Returns

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Calendar-year total returns for Ensign (ENSG) and Fresenius Medical Care (FMS). Each bar is that year's total return, measured year-end to year-end.

Performance Metrics

Price performance metrics for Ensign (ENSG) and Fresenius Medical Care (FMS)
Metric	ENSG	FMS
Total Return (1Y)	1.36%	-0.71%
Total Return (3Y, Annualized)	21.65%	13.88%
Total Return (5Y, Annualized)	17.48%	-4.69%

Risk Profile

Drawdown History

ENSG

FMS

GSPC

Ensign (ENSG) vs. Fresenius Medical Care (FMS), with S&P 500 (GSPC) for reference: Drawdown from the running peak over the past five years. Each line shows the decline from its prior peak; 0% marks a new high.

Return Distribution

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Distribution of monthly total returns for Ensign (ENSG) and Fresenius Medical Care (FMS). Each bar is the share of months whose return fell in that 5% bucket.

Risk Metrics

Risk profile metrics for Ensign (ENSG) and Fresenius Medical Care (FMS)
Metric	ENSG	FMS
Volatility (1Y, Annualized)	29.85%	30.61%
Beta (5Y)	0.65	0.77
Max Drawdown (5Y)	-31.81%	-62.33%
Avg. Volume (3M)	353.46K	954.21K

Risk-Adjusted Performance

Risk-Return Positioning

ENSG and FMS are plotted by 1-year volatility (risk) and 1-year return. The dashed Capital Allocation Line runs from the risk-free rate through the shared industry median.

Risk-Adjusted Metrics

Risk-adjusted metrics for Ensign (ENSG) and Fresenius Medical Care (FMS)
Metric	ENSG	FMS
Sharpe Ratio (1Y)	-0.10	-0.16
Sortino Ratio (1Y)	-0.16	-0.21

Profitability

ROE (TTM)

Ensign (ENSG) at 17.05% sits in the top ROE quartile, while Fresenius Medical Care (FMS) at 7.84% is closer to the peer norm — stronger capital efficiency for ENSG.

ENSG

Health Care Equipment & Services industry group

17.05%

Max: 47.61%
ENSG: 17.05%
Q3: 14.36%
Median: 5.45%
Q1: -10.67%
Min: -47.01%

FMS

Health Care Equipment & Services industry group

7.84%

Max: 47.61%
Q3: 14.36%
FMS: 7.84%
Median: 5.45%
Q1: -10.67%
Min: -47.01%

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their ROE against the Health Care Equipment & Services industry group benchmark.

Net Margin (TTM)

Both Ensign (ENSG) at 7.03% and Fresenius Medical Care (FMS) at 4.22% keep about the typical share of revenue as profit for their industries — neither bottom line stands out from peers.

ENSG

Health Care Equipment & Services industry group

7.03%

Max: 29.35%
Q3: 9.33%
ENSG: 7.03%
Median: 2.18%
Q1: -6.29%
Min: -28.46%

FMS

Health Care Equipment & Services industry group

4.22%

Max: 29.35%
Q3: 9.33%
FMS: 4.22%
Median: 2.18%
Q1: -6.29%
Min: -28.46%

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their net margin against the Health Care Equipment & Services industry group benchmark.

Operating Margin (TTM)

Both Ensign (ENSG) at 9.23% and Fresenius Medical Care (FMS) at 9.63% run core operations about as efficiently as their industries’ norm — neither stands out on operating profitability.

ENSG

Health Care Equipment & Services industry group

9.23%

Max: 35.43%
Q3: 14.14%
ENSG: 9.23%
Median: 6.81%
Q1: -0.28%
Min: -16.29%

FMS

Health Care Equipment & Services industry group

9.63%

Max: 35.43%
Q3: 14.14%
FMS: 9.63%
Median: 6.81%
Q1: -0.28%
Min: -16.29%

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their operating margin against the Health Care Equipment & Services industry group benchmark.

Profitability Metrics

Profitability metrics for Ensign (ENSG) and Fresenius Medical Care (FMS)
Metric	ENSG	FMS
ROE (TTM)	17.05%	7.84%
ROA (TTM)	5.59%	3.94%
Net Margin (TTM)	7.03%	4.22%
Operating Margin (TTM)	9.23%	9.63%
Gross Margin (TTM)	17.10%	26.46%

Growth

Revenue Growth

Ensign (ENSG) at 18.72% is around its peer norm for revenue growth, while Fresenius Medical Care (FMS) at 1.51% drops into the bottom quartile, signaling weaker demand or pricing momentum.

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their Revenue Growth across different time periods.

EPS Growth

Fresenius Medical Care (FMS) at 83.61% sits in the top EPS growth quartile, while Ensign (ENSG) at 14.06% is closer to the peer norm — faster per-share earnings growth for FMS.

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their EPS Growth across different time periods.

Growth Metrics

Growth metrics for Ensign (ENSG) and Fresenius Medical Care (FMS)
Metric	ENSG	FMS
Revenue Growth (YoY)	18.72%	1.51%
Revenue Growth (3Y CAGR)	18.68%	0.39%
EPS Growth (YoY)	14.06%	83.61%
EPS Growth (3Y CAGR)	13.92%	13.47%

Financial Strength

Current Ratio (MRQ)

Both Ensign (ENSG) at 1.20 and Fresenius Medical Care (FMS) at 0.99 run current ratio in the tighter-liquidity quartile of industry peers, leaving thinner cushions against current liabilities than typical competitors.

ENSG

Health Care Equipment & Services industry group

1.20

Max: 7.59
Q3: 4.00
Median: 1.98
Q1: 1.37
ENSG: 1.20
Min: 0.30

FMS

Health Care Equipment & Services industry group

0.99

Max: 7.59
Q3: 4.00
Median: 1.98
Q1: 1.37
FMS: 0.99
Min: 0.30

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their current ratio against the Health Care Equipment & Services industry group benchmark.

Debt / Equity (MRQ)

Both Ensign (ENSG) at 0.89 and Fresenius Medical Care (FMS) at 0.79 fund their balance sheets with roughly industry-typical debt-to-equity mixes.

ENSG

Health Care Equipment & Services industry group

0.89

Max: 1.88
Q3: 0.91
ENSG: 0.89
Median: 0.58
Q1: 0.16
Min: 0.00

FMS

Health Care Equipment & Services industry group

0.79

Max: 1.88
Q3: 0.91
FMS: 0.79
Median: 0.58
Q1: 0.16
Min: 0.00

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their debt-to-equity ratio against the Health Care Equipment & Services industry group benchmark.

Financial Strength Metrics

Financial strength metrics for Ensign (ENSG) and Fresenius Medical Care (FMS)
Metric	ENSG	FMS
Current Ratio (MRQ)	1.20	0.99
Debt / Equity (MRQ)	0.89	0.79
Net Debt / EBITDA	3.05	3.63

Dividends

Dividend Yield (TTM)

Both Ensign (ENSG) at 0.14% and Fresenius Medical Care (FMS) at 6.30% yield above their industries’ entire benchmark ranges — high enough that dividend safety, not income, becomes the first question.

ENSG

Health Care Equipment & Services industry group

0.14%

ENSG: 0.14%
Max: 0.00%
Q3: 0.00%
Median: 0.00%
Q1: 0.00%
Min: 0.00%

FMS

Health Care Equipment & Services industry group

6.30%

FMS: 6.30%
Max: 0.00%
Q3: 0.00%
Median: 0.00%
Q1: 0.00%
Min: 0.00%

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their dividend yield against the Health Care Equipment & Services industry group benchmark.

Dividend Payout Ratio (TTM)

Both Ensign (ENSG) at 3.87% and Fresenius Medical Care (FMS) at 50.14% pay out more of their earnings than any of their industry peers — the thinnest cover in their groups, so dividend headroom deserves attention.

ENSG

Health Care Equipment & Services industry group

3.87%

ENSG: 3.87%
Max: 0.00%
Q3: 0.00%
Median: 0.00%
Q1: 0.00%
Min: 0.00%

FMS

Health Care Equipment & Services industry group

50.14%

FMS: 50.14%
Max: 0.00%
Q3: 0.00%
Median: 0.00%
Q1: 0.00%
Min: 0.00%

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their payout ratio against the Health Care Equipment & Services industry group benchmark.

Dividend Metrics

Dividend metrics for Ensign (ENSG) and Fresenius Medical Care (FMS)
Metric	ENSG	FMS
Dividend Yield (TTM)	0.14%	6.30%
Dividend Payout Ratio (TTM)	3.87%	50.14%

Valuation

P/E Ratio (TTM)

Fresenius Medical Care (FMS) at 13.53 sits in the cheaper P/E ratio quartile, while Ensign (ENSG) at 26.95 is closer to its industry’s usual earnings multiple — a discount for FMS, though growth and earnings durability still matter.

ENSG

Health Care Equipment & Services industry group

26.95

Max: 80.41
Q3: 47.62
Median: 29.93
ENSG: 26.95
Q1: 21.19
Min: 4.21

FMS

Health Care Equipment & Services industry group

13.53

Max: 80.41
Q3: 47.62
Median: 29.93
Q1: 21.19
FMS: 13.53
Min: 4.21

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their P/E ratio against the Health Care Equipment & Services industry group benchmark.

P/S Ratio (TTM)

Fresenius Medical Care (FMS) at 0.62 sits in the cheaper P/S ratio quartile while Ensign (ENSG) at 1.86 prices around its industry’s middle — FMS costs less per dollar of sales, though read it alongside growth and margins.

ENSG

Health Care Equipment & Services industry group

1.86

Max: 8.80
Q3: 4.32
Median: 2.13
ENSG: 1.86
Q1: 1.10
Min: 0.03

FMS

Health Care Equipment & Services industry group

0.62

Max: 8.80
Q3: 4.32
Median: 2.13
Q1: 1.10
FMS: 0.62
Min: 0.03

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their P/S ratio against the Health Care Equipment & Services industry group benchmark.

P/B Ratio (MRQ)

Fresenius Medical Care (FMS) at 0.85 sits in the lower P/B ratio quartile against book while Ensign (ENSG) at 4.09 is valued near its industry’s middle — FMS is cheaper on assets, though weigh it against ROE and asset quality.

ENSG

Health Care Equipment & Services industry group

4.09

Max: 11.68
Q3: 6.12
ENSG: 4.09
Median: 3.00
Q1: 1.73
Min: -1.31

FMS

Health Care Equipment & Services industry group

0.85

Max: 11.68
Q3: 6.12
Median: 3.00
Q1: 1.73
FMS: 0.85
Min: -1.31

Ensign (ENSG) vs. Fresenius Medical Care (FMS): A comparison of their P/B ratio against the Health Care Equipment & Services industry group benchmark.

Valuation Metrics

Valuation metrics for Ensign (ENSG) and Fresenius Medical Care (FMS)
Metric	ENSG	FMS
P/E Ratio (TTM)	26.95	13.53
P/S Ratio (TTM)	1.86	0.62
P/B Ratio (MRQ)	4.09	0.85
Free Cash Flow Yield (TTM)	3.52%	12.29%