On November 10, 2009, certain of real estate holding subsidiaries of The The Ensign Group, Inc. as Borrowers and General Electric Capital Corporation ('GECC') as Lender entered to that certain Fourth Amended and Restated Loan Agreement (the 'Agreement'), to add six additional real estate holding subsidiaries of the Company (the 'New Borrowers') as Borrowers under the Agreement in order to secure a $40.0 million real estate loan. On the same date, pursuant to the Agreement, the New Borrowers made a Six Project Promissory Note in the original principal amount of $40.0 million (the 'Note') for the benefit of GECC as Lender.

The Ensign Group, Inc. said that a group of its real estate holding subsidiaries has placed mortgages on six of the Company's 27 unencumbered properties to secure a $40 million five-year term loan from GE Capital's Healthcare Financial Services business. Suzanne Snapper, Ensign's Chief Financial Officer said, “With the increasing volume of compelling acquisition opportunities we believe we are seeing, it was a good time to tap some of the unleveraged equity in our 27 unencumbered facilities. Consistent with our past practice, we expect to continue leveraging our accumulated real estate equity in a disciplined fashion to support the Company's continuing expansion.” Greg Stapley, Ensign's Executive Vice President said, “We expect to use the proceeds to add more quality assets to our portfolio, to enhance our competitive position in our target markets and to further strengthen our balance sheet.” The company is actively seeking opportunities to acquire both well-performing and struggling long-term care operations across the Western United States.

The Ensign Group Inc. reported consolidated earnings results for the third quarter and nine months ended September 30, 2009. For the quarter, the company reported income from operations of $13.8 million, income before provision for income taxes of $12.7 million, net income of $7.7 million or $0.37 per diluted share on the revenue of $132.9 million compared to the income from operations of $11.8 million, income before provision for income taxes of $10.9 million, net income of $6.8 million or $0.33 per diluted share on the revenue of $116.3 million for the same period a year ago. EBITDA was $17.1 million, EBITDAR was $20.8 million compared to EBITDA of $14.2 million, EBITDAR was $17.5 million for the same period a year ago. For the nine months, the company reported income from operations of $42.8 million, income before provision for income taxes of $39.3 million, net income of $23.8 million or $1.14 per diluted share on the revenue of $395.4 million compared to the income from operations of $34.7 million, income before provision for income taxes of $32.2 million, net income of $19.7 million or $0.95 per diluted share on the revenue of $345.4 million for the same period a year ago. EBITDA was $52.2 million, EBITDAR was $63.4 million compared to EBITDA of $41.2 million, EBITDAR was $52.4 million for the same period a year ago. For the nine months, the company generated net cash from operations of $28.7 million in the nine months ended September 30, 2009. Net cash used in investing activities during the first nine months was $45.4 million, which was primarily related to business acquisitions and purchases of property and equipment. The company reaffirmed its previously-announced 2009 annual revenue guidance of $536 million to $541 million, and earnings guidance of $1.58 per share to $1.63 per share, for the year 2009. The company announced that Gregory K. Stapley, its Vice President and General Counsel since 1999, has been named Executive Vice President of the company effective as of November 2, 2009. He has been replaced by Beverly B. Wittekind as Vice President and General Counsel. Ms. Wittekind has served as Ensign's Corporate Compliance Officer, and as Vice-President and General Counsel for Ensign Facility Services Inc., its Service Center subsidiary, since 2002. Prior to joining Ensign Ms. In addition, Daniel H. Walker was named Assistant Secretary of the company, also effective November 2, 2009. Mr. Walker has served as the Deputy General Counsel of Ensign Facility Services Inc., and as the Company's Associate General Counsel for Securities, since 2007. Prior to joining Ensign, Mr. Walker was with the law firm of Lewis and Roca, LLP in Phoenix, Arizona, where he advised public and private companies on securities issues, mergers and acquisitions, and real estate and corporate transactions.