7Baggers
Quarterly
Annual
    Unit: USD2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 2019-03-31 2018-12-31 2018-09-30 2018-06-30 2018-03-31 2017-12-31 2017-09-30 2017-06-30 2017-03-31 2016-12-31 2016-09-30 2016-06-30 2016-03-31 2015-12-31 2015-09-30 2015-06-30 2015-03-31 2014-12-31 2014-09-30 2014-06-30 2014-03-31 2013-12-31 2013-09-30 2013-06-30 2013-03-31 2012-09-30 2012-06-30 2012-03-31 2011-12-31 2011-09-30 2011-06-30 2011-03-31 2010-09-30 2010-06-30 2010-03-31 2009-12-31 2009-09-30 2009-06-30 2009-03-31 2008-12-31 2008-09-30 2008-06-30 2008-03-31 2007-12-31 2007-09-30 
      
    		                                                                      
      assets
    		                                                                      
      current assets:
    		                                                                      
      cash and cash equivalents
    		443,668,000 363,969,000 282,666,000 464,598,000 532,066,000 477,336,000 511,839,000 509,626,000 467,870,000 419,974,000 326,969,000 316,270,000 308,864,000 285,580,000 248,546,000 304,620,000 198,411,000 155,527,000 236,562,000 175,380,000 201,738,000 63,217,000 59,175,000 44,396,000 39,042,000 37,824,000 31,083,000 45,657,000 27,184,000 35,057,000 42,337,000 40,055,000 33,476,000 31,507,000 57,706,000 40,414,000 33,519,000 51,370,000 41,569,000 40,069,000 50,635,000 62,609,000 5,040,865,755,000 39,206,000 22,393,000 57,469,000 65,755,000 45,997,000 27,499,000 42,536,000 32,028,000 32,785,000 32,618,000 29,584,000 25,650,000 38,111,000 50,973,000 36,926,000 26,353,000 41,452,000 38,855,000 21,365,000 33,687,000 33,060,000 41,326,000 56,407,000 50,934,000 54,446,000 51,732,000 6,418,000 
      accounts receivable—less allowance for doubtful accounts of 7,948 and 8,435 at september 30, 2025 and december 31, 2024, respectively
    		612,744,000                                                                      
      investments—current
    		62,641,000 54,473,000 61,805,000 62,255,000 38,969,000 24,126,000 14,459,000 17,229,000 16,433,000 20,018,000 20,101,000 15,441,000 12,233,000 8,991,000 12,093,000 12,844,000 10,573,000 14,623,000 13,449,000 17,577,000 16,357,000 15,021,000 17,754,000 13,026,000 8,003,000 4,037,000 8,682,000 9,688,000 12,952,000 13,631,000 13,092,000 9,108,000 13,643,000 9,829,000 11,550,000 7,511,000 3,503,000 2,003,000 2,004,000 4,500,000 4,751,000 4,992,000 60,605,511,000 5,883,000 4,451,000 4,521,000 5,511,000 3,783,000 3,279,000 3,371,000 4,254,000 4,737,000                   
      prepaid expenses and other current assets
    		87,525,000 70,703,000 57,872,000 60,882,000 45,844,000 47,699,000 42,451,000 35,036,000 37,921,000 41,618,000 39,246,000 36,339,000 36,497,000 32,774,000 32,586,000 32,660,000 35,643,000 30,588,000 26,659,000 25,969,000 27,150,000 25,565,000 24,428,000 25,150,000 25,632,000 24,019,000 24,130,000 25,105,000 27,801,000 24,735,000 28,132,000 21,441,000 23,135,000 21,374,000 19,871,000 18,569,000 16,496,000 19,441,000 18,827,000 15,417,000 12,395,000 11,998,000 84,349,213,000 8,432,000 7,657,000 9,023,000 9,213,000 7,700,000 7,086,000 8,424,000 7,985,000 6,912,000 7,373,000 7,667,000 8,274,000 7,072,000 7,661,000 6,953,000 6,695,000 5,866,000 6,498,000 8,076,000 5,789,000 5,074,000 4,692,000 4,750,000 5,454,000 5,423,000 5,319,000 8,229,000 
      total current assets
    		1,206,578,000 1,067,195,000 986,391,000 1,157,632,000 1,196,930,000 1,115,080,000 1,088,188,000 1,046,930,000 994,347,000 927,635,000 830,497,000 781,125,000 726,848,000 682,682,000 633,111,000 668,118,000 567,104,000 513,316,000 582,956,000 526,627,000 547,306,000 433,321,000 411,081,000 393,201,000 375,546,000 357,729,000 348,072,000 348,413,000 327,569,000 344,726,000 368,076,000 339,845,000 323,845,000 305,623,000 333,862,000 308,750,000 288,014,000 293,239,000 294,970,000 269,530,000 255,945,000 255,856,000 213,642,210,996,000 193,931,000 184,192,000 203,468,000 210,996,000 185,309,000 169,380,000 174,808,000 155,749,000 154,122,000 142,963,000 140,639,000 130,688,000 134,453,000 143,804,000 127,066,000 115,839,000 124,305,000 117,327,000 89,762,000 102,710,000 101,186,000 104,448,000 114,594,000 109,600,000 118,272,000 120,363,000 70,955,000 
      property and equipment
    		1,598,401,000 1,535,185,000 1,459,378,000 1,291,354,000 1,217,689,000 1,177,822,000 1,101,560,000 1,090,771,000 1,067,902,000 1,008,744,000 1,002,052,000 992,010,000 963,465,000 908,228,000 906,777,000 791,247,000 788,601,000 779,269,000 778,244,000 783,187,000 780,439,000 783,291,000 767,565,000 708,224,000 674,892,000 627,400,000 618,874,000 593,088,000 591,580,000 541,019,000 537,084,000 531,079,000 490,386,000 490,582,000 484,498,000 350,255,000 347,203,000 311,479,000 299,633,000 257,164,000 243,881,000 192,370,000 149,708,479,770,000 127,448,000 116,784,000 496,618,000 479,770,000 479,837,000 476,671,000 450,695,000 439,233,000 420,028,000 410,773,000 403,862,000 372,797,000 321,745,000 311,372,000 254,192,000 251,320,000 241,034,000 230,774,000 181,643,000 180,274,000 176,485,000 157,029,000 141,893,000 139,846,000 128,356,000 124,861,000 106,918,000 
      right-of-use assets
    		2,047,979,000 1,930,662,000 1,896,409,000 1,861,071,000 1,904,181,000 1,842,613,000 1,821,024,000 1,756,430,000 1,773,751,000 1,771,936,000 1,790,498,000 1,450,995,000 1,349,411,000 1,305,009,000 1,294,931,000 1,175,685,000 1,112,694,000 1,050,506,000 1,025,510,000 1,027,434,000 1,032,684,000 1,044,060,000 1,046,901,000 1,062,219,000 1,074,449,000 1,045,638,000                                             
      insurance subsidiary deposits and investments
    		169,142,000 170,752,000 157,307,000 141,246,000 115,496,000 112,756,000 107,666,000 92,687,000 86,818,000 85,770,000 82,052,000 67,652,000 41,689,000 40,077,000 38,024,000 35,180,000 38,288,000 34,370,000 32,105,000 31,768,000 32,499,000 32,916,000 30,571,000 34,561,000 38,929,000 42,937,000 36,168,000 32,487,000 31,396,000 28,065,000 28,685,000 26,245,000 25,899,000 25,176,000 23,634,000 27,655,000 31,018,000 30,955,000 32,713,000 30,050,000 19,857,000 19,145,000 1,787,316,888,000 18,170,000 17,681,000 17,728,000 16,888,000 18,712,000 19,384,000 18,943,000 18,149,000 17,840,000 17,168,000 16,752,000 16,605,000 16,261,000 15,751,000 15,845,000 15,397,000 13,985,000 13,810,000 13,580,000 12,797,000 11,695,000       
      deferred tax assets
    		56,125,000 66,278,000 66,278,000 66,281,000 65,193,000 66,572,000 66,486,000 67,124,000 39,968,000 39,596,000 39,596,000 39,643,000 33,733,000 32,883,000 32,883,000 31,966,000 32,396,000 32,424,000 32,424,000 3,435,000 3,612,000 3,612,000 4,615,000 8,105,000 8,603,000 8,603,000 11,650,000 12,035,000 12,731,000 12,731,000 12,745,000                                        
      restricted and other assets
    		43,789,000 55,729,000 80,826,000 46,499,000 45,753,000 38,551,000 39,686,000 40,205,000 35,979,000 35,534,000 34,343,000 37,291,000 58,469,000 57,010,000 55,172,000 44,382,000 42,496,000 41,422,000 33,155,000 31,777,000 30,712,000 30,138,000 26,207,000 17,351,000 16,943,000 16,441,000 20,844,000 20,459,000 21,046,000 17,695,000 16,501,000 14,447,000 13,329,000 13,241,000 12,614,000 14,869,000 12,507,000 11,165,000 9,631,000 8,177,000 6,825,000 7,125,000 68,339,804,000 8,449,000 8,169,000 8,676,000 9,804,000 12,086,000 12,596,000 9,687,000 12,385,000 11,952,000 11,975,000 10,418,000 11,227,000 10,504,000 8,665,000 6,067,000 6,036,000 5,895,000 5,650,000 5,151,000 5,431,000 5,258,000  3,586,000 3,489,000 3,453,000 3,273,000 3,083,000 
      intangible assets
    		6,442,000 6,509,000 6,947,000 7,292,000 6,676,000 6,703,000 6,559,000 6,525,000 6,347,000 6,272,000 2,359,000 2,465,000 2,531,000 2,535,000 2,665,000 2,711,000 2,784,000 2,828,000 2,899,000 2,959,000 3,004,000 3,131,000 3,382,000 3,541,000 3,829,000 4,131,000 31,000,000 31,620,000 32,605,000 32,236,000 32,803,000 33,568,000 34,184,000 34,524,000 35,076,000 42,975,000 44,910,000 44,444,000 45,431,000 47,223,000 38,580,000 37,481,000 355,685,718,000 6,560,000 6,711,000 5,650,000 5,718,000 5,976,000 6,302,000 6,037,000 4,867,000 5,078,000 5,197,000 2,321,000 4,036,000 4,202,000 4,427,000 4,131,000 4,288,000 4,269,000 4,498,000 4,385,000 4,472,000 4,699,000 4,374,000 4,502,000 4,578,000 2,692,000 2,335,000 2,471,000 
      goodwill
    		97,981,000 97,981,000 106,310,000 97,981,000 77,241,000 77,241,000 77,241,000 76,869,000 76,869,000 76,869,000 76,869,000 76,869,000 76,869,000 76,869,000 76,869,000 60,469,000 60,469,000 54,469,000 54,469,000 54,469,000 54,469,000 54,469,000 54,469,000 96,199,000 97,408,000 87,062,000 80,477,000 78,612,000 81,019,000 80,963,000 81,062,000 77,663,000 73,159,000 68,926,000 67,100,000 67,100,000 69,650,000 41,034,000 40,886,000 39,736,000 32,781,000 32,781,000 3,026,923,935,000 25,719,000 24,326,000 23,966,000 23,935,000 24,754,000 23,523,000 23,523,000 22,180,000 22,180,000 19,901,000 17,177,000 14,548,000 11,751,000 10,339,000 10,524,000 10,524,000 7,432,000 7,432,000 5,769,000 5,769,000 5,769,000 2,882,000 2,882,000 2,882,000 2,882,000 2,882,000 2,882,000 
      total assets
    		5,226,437,000 4,930,291,000 4,759,846,000 4,669,356,000 4,629,159,000 4,437,338,000 4,308,410,000 4,177,541,000 4,081,981,000 3,952,356,000 3,862,238,000 3,452,022,000 3,265,274,000 3,124,671,000 3,044,559,000 2,813,379,000 2,648,553,000 2,512,500,000 2,545,578,000 2,464,990,000 2,488,157,000 2,388,006,000 2,361,909,000 2,359,549,000 2,321,521,000 2,218,359,000 1,181,958,000 1,143,575,000 1,125,847,000 1,092,709,000 1,102,433,000 1,070,848,000 1,032,184,000 984,469,000 1,001,025,000 853,415,000 840,075,000 773,681,000 747,759,000 682,503,000 628,939,000 573,294,000 493,916,760,315,000 402,879,000 380,832,000 771,478,000 760,315,000 738,240,000 723,592,000 711,500,000 667,948,000 646,921,000 625,208,000 596,339,000 566,781,000 508,276,000 501,003,000 425,139,000 410,735,000 402,908,000 391,348,000 321,850,000 314,682,000 308,330,000 296,901,000 282,611,000 276,039,000 270,447,000 267,389,000 203,404,000 
      liabilities and equity
    		                                                                      
      current liabilities:
    		                                                                      
      accounts payable
    		105,796,000 102,799,000 95,326,000 98,947,000 90,274,000 88,652,000 82,635,000 92,811,000 77,091,000 78,207,000 81,466,000 77,087,000 63,495,000 60,414,000 56,850,000 57,206,000 58,700,000 53,942,000 50,901,000 50,971,000 42,694,000 40,917,000 44,973,000 40,019,000 44,694,000 44,595,000 44,236,000 41,323,000 39,018,000 31,977,000 39,043,000 39,443,000 32,915,000 33,828,000 38,991,000 38,005,000 38,085,000 35,695,000 36,029,000 34,699,000 33,843,000 38,819,000 3,318,623,793,000 27,783,000 26,508,000 26,722,000 23,793,000 22,212,000 21,315,000 23,206,000 23,211,000 21,077,000 16,603,000 21,169,000 22,734,000 19,455,000 20,027,000 17,616,000 16,267,000 15,079,000 15,498,000 12,874,000 14,339,000 15,172,000 12,682,000 12,267,000 12,590,000 12,199,000 14,699,000 11,809,000 
      accrued wages and related liabilities
    		370,530,000 334,404,000 284,769,000 347,532,000 353,563,000 322,928,000 294,208,000 332,568,000 311,509,000 287,173,000 261,323,000 289,810,000 291,351,000 273,276,000 251,194,000 246,106,000 225,455,000 203,420,000 236,614,000 177,115,000 155,013,000 134,478,000 151,009,000 132,659,000 116,018,000 103,170,000 119,656,000 99,047,000 89,462,000 84,018,000 90,508,000 75,970,000 72,701,000 75,276,000 84,686,000 71,597,000 72,019,000 67,567,000 78,890,000 65,475,000 58,482,000 54,608,000 5,671,240,093,000 48,159,000 44,590,000 40,744,000 40,093,000 35,628,000 34,511,000 33,942,000 34,868,000 33,926,000 33,565,000 41,958,000 39,019,000 35,059,000 33,191,000 30,835,000 27,538,000 27,368,000 28,756,000 23,834,000 23,631,000 25,363,000 25,389,000 21,897,000 21,072,000 20,026,000 21,141,000 21,091,000 
      lease liabilities—current
    		110,817,000 103,825,000 97,176,000 93,475,000 93,868,000 89,176,000 85,898,000 82,526,000 80,956,000 78,733,000 77,419,000 65,796,000 60,951,000 58,769,000 57,902,000 52,050,000 51,807,000 50,056,000 48,187,000 47,342,000 46,983,000 46,055,000 44,964,000 60,817,000 59,686,000 58,220,000                                             
      accrued self-insurance liabilities—current
    		73,854,000 75,542,000 69,959,000 67,331,000 57,989,000 61,356,000 62,589,000 54,664,000 50,197,000 49,907,000 50,280,000 48,187,000 47,136,000 49,728,000 43,728,000 38,730,000 36,222,000 35,135,000 34,396,000 33,022,000 29,493,000 28,873,000 29,252,000 26,707,000 26,981,000 25,375,000 25,446,000 23,113,000 24,826,000 22,163,000 22,516,000 21,639,000 21,010,000 20,461,000 21,359,000 22,076,000 20,829,000 18,204,000 18,122,000 17,069,000 16,537,000 16,694,000 1,579,415,461,000 15,642,000 14,771,000 13,335,000 15,461,000 16,154,000 14,662,000 16,769,000 15,897,000 16,259,000 12,946,000  12,035,000 11,518,000 12,742,000 10,672,000 10,500,000 10,079,000  8,543,000 8,413,000 7,239,000  6,997,000 7,587,000 7,148,000  7,342,000 
      other accrued liabilities
    		160,042,000 134,820,000 153,857,000 132,057,000 169,195,000 164,640,000 180,408,000 168,228,000 148,128,000 121,086,000 110,938,000 97,309,000 100,193,000 85,793,000 100,161,000 85,469,000 85,793,000 97,639,000 87,318,000 89,625,000 95,921,000 77,093,000 70,273,000 84,250,000 69,816,000 69,954,000 69,784,000 74,297,000 66,972,000 63,088,000 63,815,000 66,266,000 58,787,000 61,154,000 58,763,000 57,531,000 47,353,000 46,018,000 46,205,000 43,492,000 34,431,000 34,245,000 2,463,025,698,000 26,751,000 23,697,000 23,584,000 25,698,000 21,525,000 19,216,000 23,932,000 22,615,000 18,534,000 16,912,000 18,577,000 15,968,000 13,142,000 13,445,000 13,247,000 13,442,000 11,850,000 15,375,000 10,931,000 11,448,000 12,401,000 11,050,000 10,869,000 10,515,000 10,916,000 11,137,000 11,884,000 
      current maturities of long-term debt
    		4,191,000 4,155,000 4,120,000 4,086,000 4,051,000 4,017,000 3,983,000 3,950,000 3,916,000 3,883,000 3,851,000 3,883,000 3,914,000 3,944,000 3,723,000 3,548,000 3,009,000 2,828,000 2,960,000 3,139,000 3,292,000 2,727,000 2,702,000 10,177,000 10,153,000 10,129,000 10,105,000 10,080,000 10,058,000 10,035,000 9,939,000 8,170,000 8,165,000 8,155,000 8,129,000 8,141,000 634,000 627,000 620,000 613,000 501,000 112,000 1,117,411,000 110,000  7,469,000 7,411,000 7,354,000 7,297,000 7,242,000 7,133,000 7,080,000 7,028,000 6,314,000 6,271,000 3,026,000 3,165,000 2,165,000 2,125,000 2,087,000 2,065,000 1,122,000 1,064,000 1,095,000 1,062,000 1,089,000 1,023,000 3,017,000 2,993,000 3,004,000 
      total current liabilities
    		825,230,000 755,545,000 705,207,000 743,428,000 768,940,000 730,769,000 709,721,000 734,747,000 671,797,000 618,989,000 585,277,000 582,072,000 567,040,000 531,924,000 513,558,000 483,109,000 460,986,000 443,020,000 562,399,000 525,202,000 581,038,000 330,143,000 343,173,000 354,629,000 327,348,000 311,443,000 269,227,000 247,860,000 230,336,000 211,281,000 225,821,000 222,488,000 204,578,000 209,874,000 211,928,000 199,059,000 178,920,000 168,111,000 179,866,000 161,348,000 143,794,000 150,392,000 130,433,112,456,000 118,445,000 109,566,000 111,854,000 112,456,000 150,873,000 145,001,000 153,966,000 103,724,000 96,876,000 87,054,000 100,387,000 96,027,000 82,200,000 88,722,000 74,535,000 69,872,000 71,813,000 71,768,000 57,304,000 58,895,000 61,270,000 57,637,000 53,119,000 52,787,000 53,306,000 57,394,000 55,130,000 
      long-term debt—less current maturities
    		138,557,000 139,576,000 140,585,000 141,585,000 142,577,000 143,559,000 144,533,000 145,497,000 146,453,000 147,401,000 148,339,000 149,269,000 150,191,000 151,105,000 152,010,000 140,680,000 111,287,000 111,859,000 112,544,000 113,222,000 143,893,000 344,558,000 325,217,000 265,692,000 268,179,000 240,660,000 233,135,000 245,604,000 268,066,000 280,449,000 302,990,000 287,456,000 284,465,000 258,478,000 275,486,000 162,474,000 183,722,000 145,642,000 99,051,000 69,209,000 49,019,000 3,251,000 68,279,251,895,000 3,307,000  250,019,000 251,895,000 205,046,000 206,874,000 198,687,000 192,299,000 194,069,000 195,826,000  168,130,000 137,124,000 138,656,000 105,847,000 106,363,000 106,868,000  58,632,000 58,953,000 59,181,000  59,735,000 60,032,000 60,290,000  60,825,000 
      long-term lease liabilities—less current portion
    		1,902,946,000 1,792,218,000 1,767,210,000 1,735,325,000 1,777,566,000 1,720,250,000 1,701,652,000 1,639,326,000 1,657,955,000 1,657,782,000 1,676,987,000 1,355,113,000 1,259,717,000 1,216,335,000 1,207,104,000 1,093,176,000 1,034,517,000 973,679,000 950,320,000 952,866,000 958,249,000 970,350,000 973,983,000 974,496,000 988,145,000 963,172,000                                             
      accrued self-insurance liabilities—less current portion
    		160,646,000 158,991,000 150,661,000 144,421,000 126,037,000 123,835,000 117,364,000 111,246,000 97,502,000 92,794,000 94,023,000 83,495,000 77,621,000 76,793,000 71,602,000 68,299,000 66,556,000 66,742,000 62,402,000 62,016,000 61,324,000 60,185,000 58,114,000 58,958,000 57,565,000 56,419,000 54,605,000 54,704,000 53,775,000 51,518,000 50,220,000 50,012,000 48,658,000 46,827,000 43,992,000 45,717,000 43,365,000 39,872,000 37,881,000 36,938,000 35,856,000 34,695,000 3,416,633,642,000 33,658,000 32,792,000 32,944,000 33,642,000 35,393,000 36,376,000 36,121,000 34,928,000 33,492,000 32,942,000  32,014,000 31,438,000 29,019,000 25,393,000 25,059,000 23,572,000  21,762,000 20,693,000        
      other long-term liabilities
    		76,156,000 62,978,000 66,026,000 64,169,000 63,092,000 55,854,000 51,673,000 49,408,000 42,832,000 41,997,000 37,858,000 33,273,000 28,957,000 27,821,000 28,272,000 48,821,000 46,564,000 41,620,000 39,686,000 46,140,000 25,877,000 5,955,000 5,278,000 3,968,000 2,977,000 1,662,000                                             
      total liabilities
    		3,103,535,000 2,909,308,000 2,829,689,000 2,828,928,000 2,878,212,000 2,774,267,000 2,724,943,000 2,680,224,000 2,616,539,000 2,558,963,000 2,542,484,000 2,203,222,000 2,083,526,000 2,003,978,000 1,972,546,000 1,834,085,000 1,719,910,000 1,636,920,000 1,727,351,000 1,699,446,000 1,770,381,000 1,711,191,000 1,705,765,000 1,657,743,000 1,644,214,000 1,573,356,000 579,618,000 571,199,000 575,568,000 566,766,000 602,374,000 583,685,000 561,223,000 526,159,000 540,530,000 415,795,000 415,982,000 363,485,000 320,774,000 271,306,000 232,026,000 191,598,000 236,113,403,058,000 158,561,000 145,520,000 399,670,000 403,058,000 396,470,000 393,341,000 394,584,000 337,373,000 330,472,000 321,178,000                  
      commitments and contingencies
    		                                                                      
      equity
    		                                                                      
      ensign group, inc. stockholders' equity:
    		                                                                      
      common stock: 0.001 par value; 150,000 shares authorized; 61,461 and 57,897 shares issued and shares outstanding at september 30, 2025, respectively, and 60,838 and 57,438 shares issued and shares outstanding at december 31, 2024, respectively
    		61,000                                                                      
      additional paid-in capital
    		593,781,000 572,200,000 551,867,000 528,052,000 514,336,000 499,411,000 486,336,000 465,707,000 451,883,000 440,532,000 429,783,000 415,560,000 405,555,000 398,793,000 383,181,000 363,779,000 357,451,000 349,836,000 338,177,000 328,347,000 319,770,000 315,786,000 307,914,000 303,680,000 298,891,000 292,612,000 284,384,000 278,802,000 274,982,000 270,948,000 266,058,000 262,403,000 258,632,000 255,302,000 252,493,000 248,785,000 244,755,000 241,022,000 235,076,000 231,974,000 228,912,000 225,009,000 114,293,101,364,000 110,090,000 107,876,000 104,229,000 101,364,000 98,077,000 95,703,000 93,730,000 84,881,000 82,484,000 80,552,000 77,257,000 75,695,000 73,973,000 72,861,000 69,709,000 68,699,000 68,002,000 66,765,000 66,171,000 65,262,000 64,752,000 64,110,000 63,681,000 63,099,000 62,766,000 62,142,000 2,488,000 
      retained earnings
    		1,664,458,000 1,584,233,000 1,503,442,000 1,426,762,000 1,350,664,000 1,275,657,000 1,208,074,000 1,142,653,000 1,124,358,000 1,063,738,000 1,002,976,000 946,339,000 889,069,000 835,941,000 781,290,000 688,287,000 643,906,000 597,375,000 551,055,000 507,554,000 467,219,000 429,689,000 391,523,000 426,414,000 401,996,000 378,443,000 344,901,000 321,448,000 303,157,000 285,398,000 264,691,000 255,903,000 244,049,000 235,689,000 235,021,000 218,887,000 209,778,000 200,566,000 193,420,000 181,890,000 170,355,000 159,095,000 145,846,257,502,000 136,043,000 128,721,000 269,459,000 257,502,000 245,710,000 236,689,000 225,760,000 238,831,000 226,843,000 215,685,000 204,073,000 195,001,000 184,572,000 172,757,000 150,647,000 141,802,000 133,222,000 124,910,000 117,249,000 110,491,000 103,234,000 96,237,000 89,304,000 83,328,000 77,632,000 72,119,000 66,708,000 
      common stock in treasury, at cost, 3,564 and 3,400 shares at september 30, 2025 and december 31, 2024, respectively
    		-138,835,000                                                                      
      total ensign group, inc. stockholders' equity
    		2,119,465,000 2,017,659,000 1,926,817,000 1,837,111,000 1,747,297,000 1,657,365,000 1,577,901,000 1,491,865,000 1,459,746,000 1,387,775,000 1,318,173,000 1,247,332,000 1,180,056,000 1,120,166,000 1,071,590,000 979,200,000 928,593,000 876,047,000 818,077,000 764,755,000 715,997,000 675,236,000 654,197,000 686,259,000 662,052,000 632,705,000 590,935,000 561,899,000 539,788,000 517,995,000 492,397,000 479,954,000 464,329,000 453,859,000 456,449,000 436,607,000 423,454,000 410,417,000 427,324,000 412,596,000 397,999,000 382,826,000 258,851,356,096,000 244,651,000 235,111,000 371,132,000 356,096,000 340,536,000 329,165,000 315,867,000 319,486,000 305,102,000 292,507,000                  
      non-controlling interest
    		3,437,000 3,324,000 3,340,000 3,317,000 3,650,000 5,706,000 5,566,000 5,452,000 5,696,000 5,618,000 1,581,000 1,468,000 1,692,000 527,000 423,000 94,000 50,000 -467,000 150,000 789,000 1,779,000 1,579,000 1,947,000 15,547,000 15,255,000 12,298,000 11,405,000 10,477,000 10,491,000 7,948,000 7,662,000 7,209,000 6,632,000 4,451,000 4,046,000 1,013,000 639,000 -221,000 -339,000 -1,399,000 -1,086,000 -1,130,000  -333,000 201,000 676,000 1,161,000 1,234,000 1,086,000 1,049,000 -422,000 -159,000 -58,000                  
      total equity
    		2,122,902,000 2,020,983,000 1,930,157,000 1,840,428,000 1,750,947,000 1,663,071,000 1,583,467,000 1,497,317,000 1,465,442,000 1,393,393,000 1,319,754,000 1,248,800,000 1,181,748,000 1,120,693,000 1,072,013,000 979,294,000 928,643,000 875,580,000 818,227,000 765,544,000 717,776,000 676,815,000 656,144,000 701,806,000 677,307,000 645,003,000 602,340,000 572,376,000 550,279,000 525,943,000 500,059,000 487,163,000 470,961,000 458,310,000 460,495,000 437,620,000 424,093,000 410,196,000 426,985,000 411,197,000 396,913,000 381,696,000 257,803,357,257,000 244,318,000 235,312,000 371,808,000 357,257,000 341,770,000 330,251,000 316,916,000 319,064,000 304,943,000 292,449,000                  
      total liabilities and equity
    		5,226,437,000 4,930,291,000 4,759,846,000 4,669,356,000 4,629,159,000 4,437,338,000 4,308,410,000 4,177,541,000 4,081,981,000 3,952,356,000 3,862,238,000 3,452,022,000 3,265,274,000 3,124,671,000 3,044,559,000 2,813,379,000 2,648,553,000 2,512,500,000 2,545,578,000 2,464,990,000 2,488,157,000 2,388,006,000 2,361,909,000 2,359,549,000 2,321,521,000 2,218,359,000 1,181,958,000 1,143,575,000 1,125,847,000 1,092,709,000 1,102,433,000 1,070,848,000 1,032,184,000 984,469,000 1,001,025,000 853,415,000 840,075,000 773,681,000 747,759,000 682,503,000 628,939,000 573,294,000 493,916,760,315,000 402,879,000 380,832,000 771,478,000 760,315,000 738,240,000 723,592,000 711,500,000 667,948,000 646,921,000 625,208,000                  
      accounts receivable—less allowance for doubtful accounts of 8,320 and 8,435 at june 30, 2025 and december 31, 2024, respectively
    		 578,050,000                                                                     
      common stock: 0.001 par value; 150,000 shares authorized; 61,240 and 57,676 shares issued and shares outstanding at june 30, 2025, respectively, and 60,838 and 57,438 shares issued and shares outstanding at december 31, 2024, respectively
    		 61,000                                                                     
      common stock in treasury, at cost, 3,564 and 3,400 shares at june 30, 2025 and december 31, 2024, respectively
    		 -138,835,000                                                                     
      accounts receivable—less allowance for doubtful accounts of 8,400 and 8,435 at march 31, 2025 and december 31, 2024, respectively
    		  584,048,000                                                                    
      common stock: 0.001 par value; 150,000 shares authorized; 61,031 and 57,547 shares issued and shares outstanding at march 31, 2025, respectively, and 60,838 and 57,438 shares issued and shares outstanding at december 31, 2024, respectively
    		  61,000                                                                    
      common stock in treasury, at cost, 3,484 and 3,400 shares at march 31, 2025 and december 31, 2024, respectively
    		  -128,553,000                                                                    
      accounts receivable—less allowance for doubtful accounts of 8,435 and 9,348 at december 31, 2024 and 2023, respectively
    		   569,897,000                                                                   
      common stock: 0.001 par value; 150,000 shares authorized; 60,838 and 57,438 shares issued and shares outstanding at december 31, 2024, respectively, and 59,987 and 56,597 shares issued and shares outstanding at december 31, 2023, respectively
    		   61,000                                                                   
      common stock in treasury, at cost, 3,400 and 3,390 shares at december 31, 2024 and 2023, respectively
    		   -117,764,000                                                                   
      accounts receivable—less allowance for doubtful accounts of 9,822 and 9,348 at september 30, 2024 and december 31, 2023, respectively
    		    554,091,000                                                                  
      prepaid income taxes
    		    25,960,000 18,798,000      4,643,000 15,298,000 16,336,000  4,136,000 8,814,000  1,224,000 13,550,000   739,000 2,536,000 5,934,000 148,000 6,219,000 6,509,000 8,590,000 12,794,000 19,447,000 14,122,000 10,343,000 50,000 302,000 1,325,000 7,873,000 3,254,000 8,141,000 6,792,000 4,719,000  29,929,915,000 5,078,000 10,217,000 2,665,000 9,915,000 11,435,000 10,729,000 8,400,000 3,232,000 2,616,000 246,000 5,882,000 3,857,000 1,427,000  397,000 1,245,000  1,242,000     2,177,000 1,399,000 1,495,000 5,835,000  
      common stock: 0.001 par value; 150,000 shares authorized; 60,681 and 57,281 shares issued and shares outstanding at september 30, 2024, respectively, and 59,987 and 56,597 shares issued and shares outstanding at december 31, 2023, respectively
    		    61,000                                                                  
      common stock in treasury, at cost, 3,400 and 3,390 shares at september 30, 2024 and december 31, 2023, respectively
    		    -117,764,000                                                                  
      accounts receivable—less allowance for doubtful accounts of 9,460 and 9,348 at june 30, 2024 and december 31, 2023, respectively
    		     547,121,000                                                                 
      common stock: 0.001 par value; 150,000 shares authorized; 60,449 and 57,049 shares issued and shares outstanding at june 30, 2024, respectively, and 59,987 and 56,597 shares issued and shares outstanding at december 31, 2023, respectively
    		     61,000                                                                 
      common stock in treasury, at cost, 3,400 and 3,390 shares at june 30, 2024 and december 31, 2023, respectively
    		     -117,764,000                                                                 
      accounts receivable—less allowance for doubtful accounts of 9,463 and 9,348 at march 31, 2024 and december 31, 2023, respectively
    		      519,439,000                                                                
      common stock: 0.001 par value; 150,000 shares authorized; 60,294 and 56,904 shares issued and shares outstanding at march 31, 2024, respectively, and 59,987 and 56,597 shares issued and shares outstanding at december 31, 2023, respectively
    		      60,000                                                                
      common stock in treasury, at cost, 3,390 shares at both march 31, 2024 and december 31, 2023
    		      -116,569,000                                                                
      accounts receivable—less allowance for doubtful accounts of 9,348 and 7,802 at december 31, 2023 and 2022, respectively
    		       485,039,000                                                               
      common stock: 0.001 par value; 150,000, 59,987 and 56,597 shares authorized, shares issued and shares outstanding at december 31, 2023, respectively, and 100,000, 59,029 and 55,661 shares authorized, shares issued and shares outstanding at december 31, 2022, respectively
    		       60,000                                                               
      common stock in treasury, at cost, 3,390 and 3,368 shares at december 31, 2023 and 2022, respectively
    		       -116,555,000                                                               
      accounts receivable—less allowance for doubtful accounts of 9,422 and 7,802 at september 30, 2023 and december 31, 2022, respectively
    		        472,123,000                                                              
      common stock: 0.001 par value; 150,000, 59,803 and 56,413 shares authorized, shares issued and shares outstanding at september 30, 2023, respectively, and 100,000, 59,029 and 55,661 shares authorized, shares issued and shares outstanding at december 31, 2022, respectively
    		        60,000                                                              
      common stock in treasury, at cost, 3,390 and 3,368 shares at september 30, 2023 and december 31, 2022, respectively
    		        -116,555,000                                                              
      accounts receivable—less allowance for doubtful accounts of 9,281 and 7,802 at june 30, 2023 and december 31, 2022, respectively
    		         446,025,000                                                             
      common stock: 0.001 par value; 150,000, 59,583 and 56,193 shares authorized, shares issued and outstanding at june 30, 2023, respectively, and 100,000, 59,029 and 55,661 shares authorized, shares issued and outstanding at december 31, 2022, respectively
    		         60,000                                                             
      common stock in treasury, at cost, 3,390 and 3,368 shares at june 30, 2023 and december 31, 2022, respectively
    		         -116,555,000                                                             
      accounts receivable—less allowance for doubtful accounts of 9,580 and 7,802 at march 31, 2023 and december 31, 2022, respectively
    		          444,181,000                                                            
      other indefinite-lived intangibles
    		          3,972,000 3,972,000 3,972,000 3,807,000 3,727,000 3,621,000 3,621,000 3,546,000 3,716,000 3,299,000 3,068,000 3,068,000 3,068,000 36,098,000 30,922,000 28,118,000 27,602,000 26,201,000 25,249,000 25,249,000 25,249,000 24,653,000 24,444,000 20,990,000 19,586,000 19,086,000 19,246,000 18,896,000 18,646,000 17,716,000 16,226,000 14,551,000 123,617,740,000 10,509,000 8,340,000 7,740,000 7,740,000 7,740,000 7,740,000 7,740,000 10,598,000 10,598,000 9,911,000 1,481,000 1,481,000 1,241,000 672,000 672,000 672,000            
      common stock: 0.001 par value; 100,000 shares authorized; 59,276 and 55,907 shares issued and outstanding at march 31, 2023, respectively, and 59,029 and 55,661 shares issued and outstanding at december 31, 2022, respectively
    		          60,000                                                            
      common stock in treasury, at cost, 3,369 and 3,368 shares at march 31, 2023 and december 31, 2022, respectively
    		          -114,646,000                                                            
      accounts receivable—less allowance for doubtful accounts of 7,802 and 11,213 at december 31, 2022 and 2021, respectively
    		           408,432,000                                                           
      common stock: 0.001 par value; 100,000 shares authorized; 59,029 and 55,661 shares issued and outstanding at december 31, 2022, respectively, and 58,134 and 55,190 shares issued and outstanding at december 31, 2021, respectively
    		           59,000                                                           
      common stock in treasury, at cost, 3,368 and 2,944 shares at december 31, 2022 and 2021, respectively
    		           -114,626,000                                                           
      accounts receivable—less allowance for doubtful accounts of 7,865 and 11,213 at september 30, 2022 and december 31, 2021, respectively
    		            353,956,000                                                          
      escrow deposits
    		            8,287,000 15,571,000 400,000  100,000 350,000 100,000 35,000 364,000  14,050,000 50,000  300,000 7,271,000 660,000 2,652,000 10,025,000 228,000 849,000 23,925,000 2,394,000 1,582,000 1,298,000 6,704,000 1,646,000 400,000 2,310,000 3,344,000 2,485,000 161,531,000,000 600,000 1,880,000 3,252,000 1,000,000 250,000 4,506,000 7,843,000  210,000 2,940,000 175,000 9,718,000 1,450,000  250,000  500,000 7,595,000 17,014,000   10,090,000      
      common stock: 0.001 par value; 100,000 shares authorized; 58,833 and 55,465 shares issued and outstanding at september 30, 2022, respectively, and 58,134 and 55,190 shares issued and outstanding at december 31, 2021, respectively
    		            58,000                                                          
      common stock in treasury, at cost, 3,368 and 2,944 shares at september 30, 2022 and december 31, 2021, respectively
    		            -114,626,000                                                          
      accounts receivable—less allowance for doubtful accounts of 7,827 and 11,213 at june 30, 2022 and december 31, 2021, respectively
    		             339,001,000                                                         
      common stock: 0.001 par value; 100,000 shares authorized; 58,646 and 55,278 shares issued and outstanding at june 30, 2022, respectively, and 58,134 and 55,190 shares issued and outstanding at december 31, 2021, respectively
    		             58,000                                                         
      common stock in treasury, at cost, 3,368 and 2,944 shares at june 30, 2022 and december 31, 2021, respectively
    		             -114,626,000                                                         
      accounts receivable—less allowance for doubtful accounts of 13,212 and 11,213 at march 31, 2022 and december 31, 2021, respectively
    		              339,886,000                                                        
      common stock: 0.001 par value; 100,000 shares authorized; 58,385 and 55,308 shares issued and outstanding at march 31, 2022, respectively, and 58,134 and 55,190 shares issued and outstanding at december 31, 2021, respectively
    		              58,000                                                        
      common stock in treasury, at cost, 3,077 and 2,944 shares at march 31, 2022 and december 31, 2021, respectively
    		              -92,939,000                                                        
      accounts receivable—less allowance for doubtful accounts of 11,267 and 8,718 at september 30, 2021 and december 31, 2020, respectively
    		               313,858,000                                                       
      advance payment liabilities
    		                  102,023,000                                                    
      common stock: 0.001 par value; 100,000 shares authorized; 58,059 and 55,247 shares issued and outstanding at september 30, 2021, respectively, and 57,417 and 54,626 shares issued and outstanding at december 31, 2020, respectively
    		               58,000                                                       
      common stock in treasury, at cost, 2,812 and 2,791 shares at september 30, 2021 and december 31, 2020, respectively
    		               -72,924,000                                                       
      accounts receivable—less allowance for doubtful accounts of 10,602 and 8,718 at june 30, 2021 and december 31, 2020, respectively
    		                313,663,000                                                      
      common stock: 0.001 par value; 100,000 shares authorized; 57,941 and 55,130 shares issued and outstanding at june 30, 2021, respectively, and 57,417 and 54,626 shares issued and outstanding at december 31, 2020, respectively
    		                58,000                                                      
      common stock in treasury, at cost, 2,811 and 2,791 shares at june 30, 2021 and december 31, 2020, respectively
    		                -72,822,000                                                      
      accounts receivable—less allowance for doubtful accounts of 11,090 and 8,718 at march 31, 2021 and december 31, 2020, respectively
    		                 312,578,000                                                     
      common stock: 0.001 par value; 100,000 shares authorized; 57,744 and 54,953 shares issued and outstanding at march 31, 2021, respectively, and 57,417 and 54,626 shares issued and outstanding at december 31, 2020, respectively
    		                 58,000                                                     
      common stock in treasury, at cost, 2,791 shares at both periods ended march 31, 2021 and december 31, 2020
    		                 -71,222,000                                                     
      accounts receivable—less allowance for doubtful accounts of 8,718 and 2,472 at december 31, 2020 and 2019, respectively
    		                  305,062,000                                                    
      common stock: 0.001 par value; 100,000 shares authorized; 57,417 and 54,626 shares issued and outstanding at december 31, 2020, respectively, and 56,176 and 53,487 shares issued and outstanding at december 31, 2019, respectively
    		                  58,000                                                    
      common stock in treasury, at cost, 2,791 and 2,079 shares at december 31, 2020 and 2019, respectively
    		                  -71,213,000                                                    
      accounts receivable—less allowance for doubtful accounts of 6,053 and 2,472 at september 30, 2020 and december 31, 2019, respectively
    		                   294,151,000                                                   
      cares act provider relief fund and advance payment liabilities
    		                   123,988,000                                                   
      common stock: 0.001 par value; 100,000 shares authorized; 56,926 and 54,135 shares issued and outstanding at september 30, 2020, respectively, and 56,176 and 53,487 shares issued and outstanding at december 31, 2019, respectively
    		                   57,000                                                   
      common stock in treasury, at cost, 2,791 and 2,079 shares at september 30, 2020 and december 31, 2019, respectively
    		                   -71,203,000                                                   
      accounts receivable—less allowance for doubtful accounts of 3,685 and 2,472 at june 30, 2020 and december 31, 2019, respectively
    		                    302,061,000                                                  
      cares act provider relief fund and advance payments liabilities
    		                    207,642,000                                                  
      common stock: 0.001 par value; 100,000 shares authorized; 56,543 and 53,755 shares issued and outstanding at june 30, 2020, respectively, and 56,176 and 53,487 shares issued and outstanding at december 31, 2019, respectively
    		                    57,000                                                  
      common stock in treasury, at cost, 2,788 and 2,079 shares at june 30, 2020 and december 31, 2019, respectively
    		                    -71,049,000                                                  
      accounts receivable—less allowance for doubtful accounts of 3,421 and 2,472 at march 31, 2020 and december 31, 2019, respectively
    		                     329,518,000                                                 
      common stock: 0.001 par value; 100,000 shares authorized; 56,437 and 53,666 shares issued and outstanding at march 31, 2020, respectively, and 56,176 and 53,487 shares issued and outstanding at december 31, 2019, respectively
    		                     57,000                                                 
      common stock in treasury, at cost, 2,771 and 2,079 shares at march 31, 2020 and december 31, 2019, respectively
    		                     -70,296,000                                                 
      accounts receivable—less allowance for doubtful accounts of 2,472 and 2,270 at december 31, 2019 and 2018, respectively
    		                      308,985,000                                                
      assets held for sale - current
    		                          1,859,000                                            
      current assets of discontinued operations
    		                                                                      
      long-term assets of discontinued operations
    		                                                                      
      current liabilities of discontinued operations
    		                                                                      
      deferred gain related to sale-leaseback
    		                          11,417,000 11,581,000 11,746,000 11,910,000 12,075,000 12,239,000 12,403,000                                      
      long-term liabilities of discontinued operations
    		                                                                      
      equity:
    		                                                                      
      common stock: 0.001 par value; 100,000 shares authorized; 56,176 and 53,487 shares issued and outstanding at december 31, 2019, respectively, and 55,089 and 52,584 shares issued and outstanding at december 31, 2018, respectively
    		                      56,000                                                
      common stock in treasury, at cost, 2,079 and 1,932 shares at december 31, 2019 and 2018, respectively
    		                      -45,296,000                                                
      accounts receivable—less allowance for doubtful accounts of 3,707 and 2,886 at september 30, 2019 and december 31, 2018, respectively
    		                       308,093,000                                               
      common stock; 0.001
    		                       55,000 55,000 55,000 55,000 54,000 54,000 54,000 53,000 53,000 53,000 53,000 52,000 52,000 52,000 52,000 51,000 26,000 26,000 26,000 2,222,000 23,000 23,000 22,000 22,000 22,000 22,000 22,000 22,000 22,000 22,000 22,000 22,000 21,000 21,000 21,000 21,000 21,000 21,000 21,000 21,000 21,000 21,000 21,000 21,000 21,000 21,000 14,000 
      common stock in treasury, at cost, 2,046 and 1,932 shares at september 30, 2019 and december 31, 2018, respectively
    		                       -43,890,000                                               
      accounts receivable—less allowance for doubtful accounts of 3,726 and 2,886 at june 30, 2019 and december 31, 2018, respectively
    		                        296,935,000                                              
      common stock in treasury, at cost, 1,941 and 1,932 shares at june 30, 2019 and december 31, 2018, respectively
    		                        -38,890,000                                              
      accounts receivable—less allowance for doubtful accounts of 3,380 and 2,886 at march 31, 2019 and december 31, 2018, respectively
    		                         291,701,000                                             
      common stock in treasury, at cost, 1,932 shares at march 31, 2019 and december 31, 2018, respectively
    		                         -38,405,000                                             
      accounts receivable—less allowance for doubtful accounts of 2,886 and 43,961 at december 31, 2018 and 2017, respectively
    		                          276,099,000                                            
      deferred rent and other long-term liabilities
    		                          11,234,000 11,450,000 11,645,000 11,608,000 11,268,000 11,490,000 11,119,000 10,980,000 9,124,000 8,545,000 9,975,000 9,860,000 3,976,000 3,811,000 3,357,000 3,260,000 32,353,237,000 3,151,000 3,162,000 3,222,000 3,237,000 3,155,000 3,142,000 3,213,000 3,306,000 3,312,000 3,206,000 2,864,000 2,253,000 2,643,000 2,663,000 2,951,000 2,897,000 3,415,000 2,524,000 4,913,000 4,674,000 4,791,000 4,890,000 1,887,000 2,238,000 2,462,000 2,505,000 2,675,000 
      common stock in treasury, at cost, 1,932 shares at december 31, 2018 and 2017, respectively
    		                          -38,405,000                                            
      accounts receivable—less allowance for doubtful accounts of 2,484 and 43,961 at september 30, 2018 and december 31, 2017, respectively
    		                           261,454,000                                           
      common stock in treasury, at cost, 1,932 shares at september 30, 2018 and december 31, 2017, respectively
    		                           -38,405,000                                           
      accounts receivable—less allowance for doubtful accounts of 1,643 and 43,961 at june 30, 2018 and december 31, 2017, respectively
    		                            251,042,000                                          
      common stock in treasury, at cost, 1,932 shares at june 30, 2018 and december 31, 2017, respectively
    		                            -38,405,000                                          
      accounts receivable—less allowance for doubtful accounts of 1,762 and 43,961 at march 31, 2018 and december 31, 2017, respectively
    		                             258,509,000                                         
      common stock in treasury, at cost, 1,932 shares at march 31, 2018 and december 31, 2017, respectively
    		                             -38,405,000                                         
      accounts receivable—less allowance for doubtful accounts of 43,961 and 39,791 at december 31, 2017 and 2016, respectively
    		                              265,068,000                                        
      common stock in treasury, at cost, 1,932 and 1,520 shares at december 31, 2017 and 2016, respectively
    		                              -38,405,000                                        
      accounts receivable—less allowance for doubtful accounts of 43,328 and 39,791 at september 30, 2017 and december 31, 2016, respectively
    		                               255,119,000                                       
      deferred tax asset
    		                               22,499,000 23,013,000 23,013,000 23,073,000 21,427,000 20,823,000 20,823,000 5,449,000 10,597,000 11,500,000 11,500,000 115,094,464,000 11,493,000 10,930,000 4,380,000 4,464,000 3,576,000 3,490,000 3,753,000 4,787,000 4,913,000 4,380,000 3,514,000 5,681,000 6,669,000 5,973,000 6,392,000 6,659,000 5,488,000 4,262,000 4,546,000 3,229,000 2,793,000 2,565,000 4,119,000 5,309,000 5,396,000 4,865,000 7,386,000 
      accrued charge related to class action lawsuit
    		                               11,000,000 11,000,000 11,000,000                                     
      common stock in treasury, at cost, 1,932 and 1,520 shares at september 30, 2017 and december 31, 2016, respectively
    		                               -38,405,000                                       
      accounts receivable—less allowance for doubtful accounts of 39,759 and 39,791 at june 30, 2017 and december 31, 2016, respectively
    		                                243,248,000                                      
      common stock in treasury, at cost, 1,932 and 1,520 shares at june 30, 2017 and december 31, 2016, respectively
    		                                -38,405,000                                      
      accounts receivable—less allowance for doubtful accounts of 40,422 and 39,791 at march 31, 2017 and december 31, 2016, respectively
    		                                 242,863,000                                     
      common stock in treasury, at cost, 1,863 and 1,520 shares at march 31, 2017 and december 31, 2016, respectively
    		                                 -37,185,000                                     
      accounts receivable—less allowance for doubtful accounts of 39,791 and 30,308 at december 31, 2016 and december 31, 2015, respectively
    		                                  244,433,000                                    
      common stock in treasury, at cost, 1,520 and 123 shares at december 31, 2016 and december 31, 2015, respectively
    		                                  -31,117,000                                    
      accounts receivable—less allowance for doubtful accounts of 36,960 and 30,308 at september 30, 2016 and december 31, 2015, respectively
    		                                   232,465,000                                   
      assets held for sale—current
    		                                   8,466,000              422,000                     
      liabilities held for sale—current
    		                                   1,709,000              875,000                     
      common stock in treasury, at cost, 1,520 and 123 shares at september 30, 2016 and december 31, 2015, respectively
    		                                   -31,117,000                                   
      accounts receivable—less allowance for doubtful accounts of 33,654 and 30,308 at june 30, 2016 and december 31, 2015, respectively
    		                                    226,623,000                                  
      common stock in treasury, at cost, 1,527 and 123 shares at june 30, 2016 and december 31, 2015, respectively
    		                                    -31,131,000                                  
      accounts receivable—less allowance for doubtful accounts of 32,098 and 30,308 at march 31, 2016 and december 31, 2015, respectively
    		                                     217,171,000                                 
      common stock in treasury, at cost, 1,575 and 123 shares at march 31, 2016 and december 31, 2015, respectively
    		                                     -31,223,000                                 
      restricted cash—current
    		                                        1,481,000 3,388,000 5,082,000 6,652,000 6,400,000                          
      accounts receivable—less allowance for doubtful accounts of 30,308 and 20,438 at december 31, 2015 and 2014, respectively
    		                                      209,026,000                                
      deferred tax asset—current
    		                                      15,403,000 10,736,000 10,602,000 10,602,000 106,159,232,000 8,033,000 8,633,000 9,221,000 9,232,000 13,966,000 13,351,000 13,370,000 10,178,000 10,620,000 8,676,000  11,942,000 10,147,000 8,696,000 10,707,000 8,868,000 7,615,000  8,401,000 9,690,000 8,040,000  6,663,000 6,858,000 6,558,000  8,669,000 
      common stock in treasury, at cost, 123 and 150 shares at december 31, 2015 and 2014, respectively
    		                                      -1,223,000                                
      accounts receivable—less allowance for doubtful accounts of 27,595 and 20,438 at september 30, 2015 and december 31, 2014, respectively
    		                                       192,016,000                               
      common stock in treasury, at cost, 146 and 150 shares at september 30, 2015 and december 31, 2014, respectively
    		                                       -1,294,000                               
      accounts receivable—less allowance for doubtful accounts of 23,913 and 20,438 at june 30, 2015 and december 31, 2014, respectively
    		                                        171,362,000                              
      common stock in treasury, at cost, 146 and 150 shares at june 30, 2015 and december 31, 2014, respectively
    		                                        -1,294,000                              
      accounts receivable—less allowance for doubtful accounts of 23,005 and 20,438 at march 31, 2015 and december 31, 2014, respectively
    		                                         162,267,000                             
      income tax payable
    		                                         5,914,000                             
      common stock in treasury, at cost, 149 and 150 shares at march 31, 2015 and december 31, 2014, respectively
    		                                         -1,304,000                             
      accounts receivable—less allowance for doubtful accounts of 20,438 and 16,540 at december 31, 2014 and 2013, respectively
    		                                          130,051,111,370,000                            
      fair value of interest rate swap
    		                                             1,631,000 1,828,000 2,003,000 1,948,000 2,597,000 3,116,000 2,723,000 2,150,000 2,143,000 2,090,000                
      common stock in treasury, at cost, 150 and 237 shares at december 31, 2014 and 2013, respectively
    		                                          -1,310,000                            
      accumulated other comprehensive loss
    		                                             -993,000 -1,112,000 -1,214,000 -1,186,000 -1,580,000 -1,901,000 -1,662,000 -1,313,000 -1,308,000 -1,274,000                
      accounts receivable—less allowance for doubtful accounts of 19,452 and 16,540 at september 30, 2014 and december 31, 2013, respectively
    		                                           120,647,000                           
      common stock in treasury, at cost, 202 and 237 shares at september 30, 2014 and december 31, 2013, respectively
    		                                           -1,505,000                           
      accounts receivable—less allowance for doubtful accounts of 17,909 and 16,540 at june 30, 2014 and december 31, 2013, respectively
    		                                            124,441,000                          
      restricted cash—less current portion
    		                                            1,819,000                          
      common stock in treasury, at cost, 203 and 237 shares at june 30, 2014 and december 31, 2013, respectively
    		                                            -1,509,000                          
      accounts receivable—less allowance for doubtful accounts of 17,422 and 16,540 at march 31, 2014 and december 31, 2013, respectively
    		                                             120,569,000                         
      common stock in treasury, at cost, 224 and 237 shares at march 31, 2014 and december 31, 2013, respectively
    		                                             -1,585,000                         
      accounts receivable—less allowance for doubtful accounts of 16,540 and 13,811 at december 31, 2013 and 2012, respectively
    		                                              111,370,000                        
      long-term assets held for sale
    		                                                 8,471,000                     
      accrued charge related to u.s. government inquiry
    		                                               48,000,000 48,000,000 48,000,000                     
      long-term liabilities held for sale
    		                                                                      
      common stock in treasury, at cost, 237 and 301 shares at december 31, 2013 and 2012, respectively
    		                                              -1,680,000                        
      accounts receivable—less allowance for doubtful accounts of 15,568 and 13,811 at september 30, 2013 and december 31, 2012, respectively
    		                                               102,428,000                       
      common stock in treasury, at cost, 295 and 301 shares at september 30, 2013 and december 31, 2012, respectively
    		                                               -2,059,000                       
      accounts receivable—less allowance for doubtful accounts of 14,014 and 13,811 at june 30, 2013 and december 31, 2012, respectively
    		                                                107,436,000                      
      common stock in treasury, at cost, 296 and 301 shares at june 30, 2013 and december 31, 2012, respectively
    		                                                -2,063,000                      
      accounts receivable—less allowance for doubtful accounts of 14,285 and 13,811 at march 31, 2013 and december 31, 2012, respectively
    		                                                 98,285,000                     
      long-term liabilties held for sale
    		                                                                      
      common stock in treasury, at cost, 296 and 301 shares at march 31, 2013 and december 31, 2012, respectively
    		                                                 -2,065,000                     
      accounts receivable—less allowance for doubtful accounts of 13,628 and 12,782 at september 30, 2012 and december 31, 2011, respectively
    		                                                  98,072,000                    
      temporary equity - redeemable noncontrolling interest
    		                                                  11,511,000 11,506,000 11,581,000                  
      common stock in treasury, at cost, 344 and 396 shares at september 30, 2012 and december 31, 2011, respectively
    		                                                  -2,347,000                    
      accounts receivable—less allowance for doubtful accounts of 12,232 and 12,782 at june 30, 2012 and december 31, 2011, respectively
    		                                                   96,452,000                   
      common stock in treasury, at cost, 378 and 396 shares at june 30, 2012 and december 31, 2011, respectively
    		                                                   -2,585,000                   
      accounts receivable—less allowance for doubtful accounts of 12,794 and 12,782 at march 31, 2012 and december 31, 2011, respectively
    		                                                    94,050,000                  
      common stock in treasury, at cost, 376 and 396 shares at march 31, 2012 and december 31, 2011, respectively
    		                                                    -2,439,000                  
      accounts receivable - net of allowance for doubtful accounts of 12,782 and 9,793 at december 31, 2011 and 2010, respectively
    		                                                     86,311,000                 
      deferred tax asset - current
    		                                                     11,195,000                 
      liabilities and stockholders' equity
    		                                                                      
      accrued self-insurance liabilities - current
    		                                                     12,369,000                 
      long-term debt - less current maturities
    		                                                     181,556,000                 
      accrued self-insurance liabilities - less current portion
    		                                                     31,904,000                 
      stockholders' equity:
    		                                                                      
      common stock in treasury, at cost, 396 and 582 shares at december 31, 2011 and 2010, respectively
    		                                                     -2,559,000                 
      total stockholders' equity
    		                                                     277,485,000                 
      total liabilities and stockholders' equity
    		                                                     596,339,000                 
      accounts receivable—less allowance for doubtful accounts of 12,730 and 9,793 at september 30, 2011 and december 31, 2010, respectively
    		                                                      80,965,000                
      liabilities and stockholders’ equity
    		                                                                      
      stockholders’ equity:
    		                                                                      
      common stock in treasury, at cost, 490 and 582 shares at september 30, 2011 and december 31, 2010, respectively
    		                                                      -3,177,000                
      total stockholders’ equity
    		                                                      266,267,000 254,871,000 241,943,000 216,413,000 206,544,000 197,240,000 187,559,000 179,239,000 171,467,000 163,683,000 156,021,000 148,656,000 142,053,000 136,008,000 129,677,000 64,426,000 
      total liabilities and stockholders’ equity
    		                                                      566,781,000 508,276,000 501,003,000 425,139,000 410,735,000 402,908,000 391,348,000 321,850,000 314,682,000 308,330,000 296,901,000 282,611,000 276,039,000 270,447,000 267,389,000 203,404,000 
      accounts receivable—less allowance for doubtful accounts of 11,068 and 9,793 at june 30, 2011 and december 31, 2010, respectively
    		                                                       77,696,000               
      common stock in treasury, at cost, 564 and 582 shares at june 30, 2011 and december 31, 2010, respectively
    		                                                       -3,695,000               
      accounts receivable—less allowance for doubtful accounts of 10,856 and 9,793 at march 31, 2011 and december 31, 2010, respectively
    		                                                        76,474,000              
      income taxes payable
    		                                                        6,152,000   5,350,000           
      common stock in treasury, at cost, 564 and 582 shares at march 31, 2011 and december 31, 2010, respectively
    		                                                        -3,696,000              
      accounts receivable—less allowance for doubtful accounts of 9,254 and 7,575 at september 30, 2010 and december 31, 2009, respectively
    		                                                         72,083,000             
      common stock in treasury, at cost, 609 and 638 shares at september 30, 2010 and december 31, 2009, respectively
    		                                                         -3,964,000             
      accounts receivable—less allowance for doubtful accounts of 8,095 and 7,575 at june 30, 2010 and december 31, 2009, respectively
    		                                                          72,678,000            
      common stock in treasury, at cost, 612 and 638 shares at june 30, 2010 and december 31, 2009, respectively
    		                                                          -3,978,000            
      accounts receivable—less allowance for doubtful accounts of 8,218 and 7,575 at march 31, 2010 and december 31, 2009, respectively
    		                                                           69,372,000           
      common stock in treasury, at cost, 616 and 638 shares at march 31, 2010 and december 31, 2009, respectively
    		                                                           -4,005,000           
      accounts receivable — less allowance for doubtful accounts of 7,575 and 7,266 at december 31, 2009 and 2008, respectively
    		                                                            62,606,000          
      deferred tax asset — current
    		                                                            8,126,000    9,242,000    6,862,000  
      accrued self-insurance liabilities — current
    		                                                            10,074,000    7,454,000    7,424,000  
      long-term debt — less current maturities
    		                                                            107,401,000    59,489,000    60,577,000  
      accrued self-insurance liabilities — long-term
    		                                                            22,096,000          
      common stock in treasury, at cost, 638 and 672 shares at december 31, 2009 and 2008, respectively
    		                                                            -4,137,000          
      accounts receivable—less allowance for doubtful accounts of 7,045 and 7,266 at september 30, 2009 and december 31, 2008, respectively
    		                                                             51,920,000         
      common stock in treasury, at cost, 648 and 672 shares at september 30, 2009 and december 31, 2008, respectively
    		                                                             -4,202,000         
      accounts receivable—less allowance for doubtful accounts of 6,948 and 7,266 at june 30, 2009 and december 31, 2008, respectively
    		                                                              53,544,000        
      common stock in treasury, at cost, 665 and 672 shares at june 30, 2009 and december 31, 2008, respectively
    		                                                              -4,307,000        
      accounts receivable—less allowance for doubtful accounts of 7,383 and 7,266 at march 31, 2009 and december 31, 2008, respectively
    		                                                               55,012,000       
      other investments
    		                                                               445,000       
      accrued self-insurance liability
    		                                                               19,405,000  19,214,000 18,929,000 18,381,000 17,236,000 17,623,000 
      common stock in treasury, at cost, 668 and 672 shares at march 31, 2009 and december 31, 2008, respectively
    		                                                               -4,324,000       
      accounts receivable — less allowance for doubtful accounts of 7,266 and 7,454 at december 31, 2008 and 2007, respectively
    		                                                                49,188,000      
      insurance subsidiary deposits
    		                                                                11,745,000 11,035,000 10,335,000 9,396,000 8,810,000 9,709,000 
      restricted assets
    		                                                                3,768,000      
      accrued self-insurance liabilities
    		                                                                18,864,000      
      common stock in treasury, at cost, 672 and 716 shares at december 31, 2008 and 2007, respectively
    		                                                                -4,347,000      
      accounts receivable—less allowance for doubtful accounts of 8,325 and 7,454 at september 30, 2008 and december 31, 2007, respectively
    		                                                                 44,597,000     
      common stock in treasury, at cost, 672 and 716 shares at september 30, 2008 and december 31, 2007, respectively
    		                                                                 -4,350,000     
      accounts receivable—less allowance for doubtful accounts of 7,760 and 7,454 at june 30, 2008 and december 31, 2007, respectively
    		                                                                  44,955,000    
      common stock in treasury, at cost, 679 and 716 shares at june 30, 2008 and december 31, 2007, respectively
    		                                                                  -4,395,000    
      accounts receivable—less allowance for doubtful accounts of 7,856 and 7,454 at march 31, 2008 and december 31, 2007, respectively
    		                                                                   50,350,000   
      common stock in treasury, at cost, 682 and 716 shares at march 31, 2008 and december 31, 2007, respectively
    		                                                                   -4,411,000   
      accounts receivable — less allowance for doubtful accounts of 7,454 and 7,543 at december 31, 2007 and 2006, respectively
    		                                                                    50,615,000  
      series a redeemable convertible preferred stock; 0.001 par value; 1,000 shares authorized; 0 and 685 shares issued and outstanding at december 31, 2007 and 2006, respectively; liquidation preference of 2,401 at december 31, 2006
    		                                                                      
      common stock in treasury, at cost, 716 and 755 shares at december 31, 2007 and 2006, respectively
    		                                                                    -4,605,000  
      accounts receivable—less allowance for doubtful accounts of 7,582 and 7,543 at september 30, 2007 and december 31, 2006, respectively
    		                                                                     47,639,000 
      series a redeemable convertible preferred stock; 0.001 par value; 1,000 shares authorized; 685 shares issued and outstanding at september 30, 2007 and december 31, 2006, respectively; liquidation preference of 2,330 and 2,401 at september 30, 2007 and december 31, 2006 , respectively
    		                                                                     2,725,000 
      common stock in treasury, at cost, 745 and 755 shares at september 30, 2007 and december 31, 2006, respectively
    		                                                                      
    The information provided in this report is taken from www.sec.gov and many other data providers. While we have conducted our best efforts to ensure that the parsed data is accurate, we cannot guarantee its accuracy. Please use caution and understand that any consequences of its use are your own responsibility.