Ensign : 2022 Ensign Group ESG Report

2022 ESG REPORT

ABOUT THIS REPORT

This report covers the independent operating entities affiliated with The Ensign Group throughout the United

States. All data provided is for the 2021 and 2022 calendar year, unless otherwise noted.

While we have worked diligently to ensure the accuracy of all the data presented here, and believe this report is

a fair and transparent statement about our ESG performance, the data has not been audited or externally

assured.

During this presentation we may reference operations in any or all of the skilled and assisted living operations and other businesses operated by our subsidiaries. Each such business is operated as a separate, wholly-owned independent operating subsidiary that has its own management, employees and assets. References in the presentation to the consolidated "Company" and "its" assets and activities, as well as the use of the terms "we," "us," "our," and similar verbiage are not meant to imply that The Ensign Group, Inc. has direct operating assets, employees or revenue, or that any of the operations, the Service Center, Standard Bearer Healthcare REIT, Inc., or the captive insurance subsidiary are operated by the same entity.

Since 1999, the independent operating subsidiaries of The Ensign Group (NASDAQ: ENSG) have provided a broad spectrum of skilled nursing and assisted living services, physical, occupational and speech therapies and other rehabilitative and healthcare services at multiple locations in Arizona, California, Colorado, Idaho, Iowa, Kansas, Nebraska, Nevada, South Carolina, Texas, Utah, Washington and Wisconsin.

WHO WE ARE	271	30,000+	13
Business operations	Team members and partners	States that we operate in

Skilled nursing

Senior living

Ancillary services

Standard Bearer

We provide short and long-term nursing care services for patients with chronic conditions, prolonged illness, and the elderly. We use interdisciplinary teams of experienced medical professionals to provide services prescribed by physicians. These medical professionals provide individualized comprehensive nursing care to our short-stay and long-stay patients.

Whether you are looking to simplify your life in an independent living environment or need a little assistance with day-to-day tasks in our senior living, Ensign affiliated communities offer a range of lifestyle options so you can live the way you want to live.

We have invested in and are exploring new business lines that are complementary to our existing skilled nursing services and senior living services. These new business lines consist of mobile diagnostics, dialysis and patient transportation to people in their home or at long-term care facilities.

Our captive real estate investment trust (REIT) owns and manages our real estate business. The REIT structure allows us to better demonstrated the growing value of our owned real estate and provides us with an efficient vehicle for future acquisitions.

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1. Skilled Nursing Operations

1. Senior Living Operations

1. Campus Operations

1. Mobile Diagnostic

1. Medical Transport Companies

1. Dialysis

WHERE WE OPERATE

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LETTER FROM OUR ESG COMMITTEE

Since 1999, our mission of dignifying post-acute care in the eyes of the moments of truth has permeated every aspect of our organization. We been able to serve who we have served over the last 23 years without responsibility.

In 2022, we expanded our sustainability and people efforts by Environmental, Social and Governance (ESG) Committee, which includes across a broad spectrum of departments, with oversight provided Directors.

One of our most important ESG strategies is our core value of Customer Second is our strong belief in "first who, then what." developing the right "who" is our passion. As we get that right, follow. This focus spans the entire life cycle of our people, from how we how we hire and train them and ultimately how we onboard and develop

We see ourselves as a leadership company. Our success is entirely driven developing and empowering local leaders to operate the highest quality care businesses in their respective markets. As they do so, they are able hire teams of caregivers that are motivated to provide top-notch care Since March of 2022, we have added over 2,250 employees have joined operations.

We are always evaluating and executing on other initiatives within which we believe will add value into the future.

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Environment Social

Starting on page 6

Starting on page 9

HERITAGE PARK PROJECT

EMERGENCY FUND

Governance

Starting on page 21

ESG COMMITTEE

2022 ESG HIGHLIGHTS

A multi-year efficiency project reduced carbon emissions and brought overall satisfaction to our residents.

See page 7 for details.

FOCUS ON IMPROVEMENTS

Grants made from our employee Emergency Fund surpassed $10 million.

See page 19 for details.

DIVERISITY, EQUITY

& INCLUSION

We formed our ESG Committee which is chaired by Chad Keetch, our Chief Investment Officer.

See page 23 for details.

VENDOR CODE OF CONDUCT

We have prioritized improvement efforts, both for our leased and owned properties, by focusing on projects around lighting retrofits, HVAC system upgrades, water system updates, solar projects and utility upgrades.

We established a Diversity, Equity

• Inclusion (DEI) Committee which is chaired by Barry Port, our Chief
  Executive Officer.

See page 16 for details.

HUMAN RIGHTS POLICY

In addition to our existing code of conduct, we created a vendor code of conduct.

See page 25 for details.

CYBERSECURITY

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We established a human rights	Continued board oversight of
policy guided by international	cybersecurity risks, monitoring
human rights principles.	fraud prevention programs.
See page 17 for details.	See page 26 for details.

K E N O S H A S E N I O R L I V I N G , K E N O S H A , W I

The operation of skilled nursing and senior living facilities requires a large number of highly skilled healthcare professionals and support staff. Our employees are the heart of the operations they serve and we are committed to their health, professional development and workplace satisfaction. Our core values guide us in our decision making and inspire us to be better people.

Our core values are our measures

Customer Second How we see people matters much more than what we say to them. We are a flat organization with the focus of empowering people to do the right thing.

Accountability Taking responsibility for results is the essence of accountability. We highlight peer accountability in our "cluster model", a core organizational structure in which a small group of peers huddles together to celebrate wins and fix shortfalls.

Passion for Learning We are a leadership development company where everyone has the opportunity to be a leader. We learn how to improve in our individual roles, we learn how our operations run so we can be better partners to them and we learn about our culture to enhance and achieve the mission of our organization.

Love One Another We do not see our people as objects, but as individuals who have needs, hopes, and dreams. We focus on caring for each other as a family.

Intelligent Risk Taking We have a field-driven model where the organization is not directed by a corporate office, but by each affiliated leader that are placed in the operations we serve. These leaders take measured and intelligent risks. Most companies aren't willing to take that risk. For our organization, it is a key element of what has created our success.

Celebration We celebrate by recognizing those individuals who are creating Moments of Truth for those we serve.

Ownership Ownership is a mentality and our team takes ownership in everything we do from solving problems to being resolute to owning the consequences of our actions.

OUR ESG MEASURES

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ENVIRONMENT

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S U R P R I S E H E A L T H A N D R E H A B I L I A T I O N C E N T E R , S U R P R I S E , A Z

INTELLIGENT RISK TAKING

C O R E VA L U E

Ensign affiliates have approximately $70.0 million budgeted for renovation projects in 2022. Heritage Park Healthcare and Rehabilitative Services, a skilled nursing facility located in Roy, Utah, is an example of projects that are taking place across the organization.. The facility operates over 100 beds with laundry facilities, a kitchen and a daycare.

Built in 1960, this facility has changed ownership multiple times without any major upgrades to the infrastructure. After our acquisition in 2017, we began upgrading the facility with a focus on sustainability rather than short-sightedband-aids. While the savings generated are recognized, the most impactful effect of the projects according to the director and the residents, is the dramatic improvement to the environment and comfort of the building.

The Impact

LED Lighting

New exterior doors and R-60 Insulation on Resident Rooms

Geo-thermal coupled water-source variable refrigerant flow

Low-E Glass Windows

Automated controls system for HVAC

Other items such as demand control ventilation and other efficiency updates for boilers, pumps and heating

The Impact

Reduced carbon emissions by 354 metric tons per year

$70,000 savings per year

ENERGY STAR Score increased by 71 points

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FACILITY USAGE KEY METRICS

Electricity (kWh)

Natural Gas (Therms)

Propane (Therms)

Water (kGal)

2022		2021		Change

709,691 732,134 -3.1%

20,293 20,232 0.0%

111	167	-33.5%	INTELLIGENT RISK TAKING
			C O R E VA L U E
3,928	3,999	-1.8%

Amounts above are average annual usage by facility. We believe it is meaningful to look at the average data by facility due to our expansion activity. For example, from January 1, 2020 to December 31, 2021, we expanded our operations by 20 facilities.

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