The Ensign Group, Inc. provides health care services in the post-acute care continuum and other ancillary businesses in the United States. It operates through three segments: Transitional and Skilled Services; Assisted and Independent Living Services; and Home Health and Hospice Services. The Transitional and Skilled Services segment provides a range of medical, nursing, rehabilitative, and pharmacy services, as well as routine services comprising daily dietary, social, and recreational services to Medicaid, private pay, managed care, and Medicare payors. The Assisted and Independent Living Services segment offers residential accommodation, meal, security, housekeeping, and assistance services in the activities of daily living to independent seniors. The Home Health and Hospice Services segment provides nursing, speech, occupational and physical therapists, medical social workers, and certified home health aide services; and hospice care services, such as physical, spiritual, and psychosocial needs, including palliative and clinical care, education, and counseling for terminally ill individuals and their families. The company also provides mobile ancillary services, such as digital X-ray, ultrasound, electrocardiograms, sub-acute services, and patient transportation. As of December 31, 2016, it had 210 healthcare facilities and 39 home health and home care hospice agencies in Arizona, California, Colorado, Idaho, Iowa, Kansas, Nebraska, Nevada, Oregon, South Carolina, Texas, Utah, Washington, and Wisconsin. The company was founded in 1999 and is based in Mission Viejo, California.