The Ensign Group, Inc ENSG reported record adjusted operating earnings of 40 cents per share in fourth-quarter 2017. The bottom line surpassed the Zacks Consensus Estimate of 36 cents. Earnings increased 33.3% year over year owing to higher revenues.The Ensign Group, Inc. Price, Consensus and EPS Surprise The Ensign Group, Inc. Price, Consensus and EPS Surprise | The Ensign Group, Inc. Quote Net income was 21 cents per share, down 40% year over year.Operational UpdateTotal revenues of $487.7 million increased nearly 12.6% year over year in the reported quarter and also beat the Zacks Consensus Estimate of $459 million.Same store skilled nursing average daily revenue rates grew 4.9% year over year to $309.89 million. Same store managed care skilled nursing average daily revenue rates climbed 4.5% to $450.58 million, year over year.Total Transitional and Skilled Services segment income was $39.9 million for the quarter under review, up 40.2% from the prior-year period.Total Assisted and Independent Living Services segment revenues and income were up 13.7% to $35.8 million and 66.3% to $4.3 million, respectively, year over year.Total Home Health and Hospice Services segment revenues and income were up 27.5% to $39.7 million and 27.7% to $5.8 million, respectively, year over year.Total expenses rose 16.2% year over year to $461.6 million, primarily due to higher cost of services and general and administrative expense.Full-Year HighlightsAdjusted operating earnings of $1.40 per share were in line with the Zacks Consensus Estimate.Total revenues of $1.85 billion increased nearly 11.8% over the level in 2016 and also outpaced the Zacks Consensus Estimate of $1.80 billion.Quarterly Segment UpdateTransitional, Skilled & Assisted Living ServicesThe segment reported revenues of $403.5 million, up 11.5% year over year. Solid growth in skilled nursing and facilities drove this upside. Notably, the segment accounted for 82.7% of the total revenues in the fourth quarter.Home Health & Hospice ServicesFor this segment, total operating revenues were $39.7 billion, up 27.4% year over year. This segment contributed 8.1% to the total revenues.Other ServicesThis segment reported revenues of $8.7 million, up 1.3% from the prior-year quarter. This segment accounted for 1.8% of the total revenues.Financial UpdateTotal cash and cash equivalents decreased 26.6% to $42.3 million as of Dec 31, 2017 from $57.7 million as of Dec 31, 2016.As of Dec 31, 2017, long-term debt was $302.9 million, up from $275.5 million at the end of 2016.Cash from operations in 2017 was $72.9 million, down 1.3% year over year.Dividend UpdateEnsign Group paid 4.50 cents per share, up 5.9% over the past year.2018 GuidanceManagement expects earnings in the range of $1.80-$1.87 per share, up from $1.58 to $1.66.Revenues are anticipated to remain within the band of $2-$2.06 billion.Zacks Rank & Performance of Other InsurersEnsign Group carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.Among other firms in the medical sector having reported fourth-quarter earnings so far, the bottom line of Anthem Inc. ANTM, Humana Inc. HUM and UnitedHealth Group Inc. UNH beat the respective Zacks Consensus Estimate.The Hottest Tech Mega-Trend of AllLast year, it generated $8 billion in global revenues. By 2020, it's predicted to blast through the roof to $47 billion. Famed investor Mark Cuban says it will produce "the world's first trillionaires," but that should still leave plenty of money for regular investors who make the right trades early.See Zacks' 3 Best Stocks to Play This Trend >>Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report Humana Inc. (HUM): Free Stock Analysis Report UnitedHealth Group Incorporated (UNH): Free Stock Analysis Report Anthem, Inc. (ANTM): Free Stock Analysis Report The Ensign Group, Inc. (ENSG): Free Stock Analysis Report To read this article on Zacks.com click here. Zacks Investment Research