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<P style="font-size: 14pt" align="center"><B>UNITED STATES<BR>
SECURITIES AND EXCHANGE COMMISSION<BR>
<FONT
style="font-size: 12pt">Washington, D.C. 20549 </FONT></B>

<P style="font-size: 18pt" align="center"><B>FORM 8-K</B>

<P style="font-size: 12pt" align="center"><B>CURRENT REPORT<BR>
Pursuant to Section 13 or 15(d) of the Securities
Exchange Act of 1934</B>

<P style="font-size: 10pt" align="center"><B>Date of Report (Date of earliest event reported): February 3, 2009</B>

<P style="font-size: 24pt" align="center"><B>The Ensign Group, Inc.<BR>
</B><FONT style="font-size: 10pt">(Exact name
of registrant as specified in its charter) </FONT>
<TABLE style="font-size: 10pt; text-align: center" cellspacing="0" cellpadding="0" width="100%" border="0">

 <TR>
  <TD width="32%">&nbsp;</TD>
  <TD width="1%">&nbsp;</TD>
  <TD width="33%">&nbsp;</TD>
  <TD width="1%">&nbsp;</TD>
  <TD width="32%">&nbsp;</TD>
 </TR>
 <TR valign="bottom">
  <TD style="border-bottom: #000000 1px solid"><B>Delaware</B></TD>
  <TD>&nbsp;</TD>
  <TD style="border-bottom: #000000 1px solid"><B>001-33757</B></TD>
  <TD>&nbsp;</TD>
  <TD style="border-bottom: #000000 1px solid"><B>33-0861263</B></TD>
 </TR>
 <TR valign="top">
  <TD>(State or other Jurisdiction of Incorporation)</TD>
  <TD>&nbsp;</TD>
  <TD>(Commission File Number)</TD>
  <TD>&nbsp;</TD>
  <TD>(IRS Employer Identification No.)</TD>
 </TR>

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 <TR>
  <TD width="49%">&nbsp;</TD>
  <TD width="1%">&nbsp;</TD>
  <TD width="49%">&nbsp;</TD>
 </TR>
 <TR valign="bottom">
  <TD style="border-bottom: #000000 1px solid"><B>27101 Puerta Real, Suite 450, Mission Viejo, CA<BR>
</B></TD>
  <TD>&nbsp;</TD>
  <TD style="border-bottom: #000000 1px solid"><B>92691</B></TD>
 </TR>
 <TR valign="top">
  <TD>(Address of Principal Executive Offices)</TD>
  <TD>&nbsp;</TD>
  <TD>(Zip Code)</TD>
 </TR>

</TABLE>


<P style="font-size: 10pt" align="center">Registrant&#8217;s telephone number, including area code: <B>(949)
487-9500</B>
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  <TD width="100%">&nbsp;</TD>
 </TR>
 <TR>
  <TD style="border-bottom: #000000 1px solid" nowrap><B>Not Applicable<BR>
</B></TD>
 </TR>
 <TR>
  <TD nowrap>(Former name or former address if changed since last report.)</TD>
 </TR>

</TABLE>


<P style="font-size: 10pt" align="left">Check the appropriate box below if the Form 8-K filing is intended to
simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

<P style="font-size: 10pt" align="left"><FONT face="Wingdings">o</FONT> Written communications pursuant to Rule 425
under the Securities Act (17 CFR 230.425)<BR>
<BR>
<FONT face="Wingdings">o</FONT> Soliciting material pursuant to Rule
14a-12 under the Exchange Act (17 CFR 240.14a-12)<BR>
<BR>
<FONT face="Wingdings">o</FONT> Pre-commencement
communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))<BR>
<BR>
<FONT
face="Wingdings">o</FONT> Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR
240.13e-4(c))<BR>

<DIV style="margin-top: 10pt; font-size: 1pt; width: 100%; border-bottom: black 1pt solid">&nbsp;</DIV>
<DIV style="font-size: 1pt; width: 100%; border-bottom: black 2pt solid">&nbsp;</DIV>
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<P style="display: none; font-size: 10pt" align="center">1
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<P style="font-size: 10pt" align="left"><B>Item&nbsp;1.01. Entry into a Material Definitive Agreement.</B>

<P style="font-size: 10pt; text-indent: 4%" align="left">On February&nbsp;4, 2009, The Ensign
Group, Inc. (the &#8220;Company&#8221;) and certain of its subsidiaries and General Electric
Capital Corporation (&#8220;GECC&#8221;)
entered into Amendment No. 1 and Joinder Agreement (the &#8220;Amendment&#8221;) to that certain Second Amended and Restated
Loan and Security Agreement (the &#8220;Agreement&#8221;), by and among the Company and certain of its subsidiaries as
Borrowers and GECC as Lender, to add three additional subsidiaries of the Company (the
&#8220;New Borrowers&#8221;) as Borrowers under the Agreement and amend the Agreement to establish a reserve as
described in the Amendment.

<P style="font-size: 10pt; text-indent: 4%" align="left">On the same date, pursuant to the Amendment, the Borrowers
made a Second Amended and Restated Revolving Credit Note in the original principal amount of $50.0&nbsp;million (the
&#8220;Note&#8221;) for the benefit of GECC as Lender, to add the New Borrowers to the Note.

<P style="font-size: 10pt; text-indent: 4%" align="left">The foregoing description of the Amendment and Note does not
purport to be complete and is qualified in its entirety by reference to such agreement and instrument, which are
attached as Exhibits 10.1 and 10.2. to this Current Report on Form 8-K and are incorporated herein by reference.

<P style="font-size: 10pt" align="left"><B>Item&nbsp;2.03 Creation of a Direct Financial Obligation or an Obligation
under an Off-Balance Sheet Arrangement of a Registrant.</B>

<P style="font-size: 10pt; text-indent: 4%" align="left">The disclosure set forth above and referenced under
Item&nbsp;1.01 is hereby incorporated by reference into this Item 2.03.

<P style="font-size: 10pt" align="left"><B>Item&nbsp;8.01 Other Events.</B>

<P style="font-size: 10pt; text-indent: 4%" align="left">On February&nbsp;3, 2009, the Company issued a press release
regarding its expansion into the State of Colorado by acquiring four long-term care facilities in the Denver
metropolitan area, consisting of 217 licensed and operational skilled nursing facility beds and 24 operational assisted
living units. The transfer was effective February&nbsp;1, 2009. The Company paid approximately $10,800,000 for the
portfolio. A copy of the press release is attached hereto as Exhibit 99.1 and is incorporated herein by reference.

<P style="font-size: 10pt; text-indent: 4%" align="left">The foregoing information in this Current Report, including
the related exhibit attached hereto, is being furnished and shall not be deemed &#8220;filed&#8221; for the purposes of
Section&nbsp;18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to the liabilities of such
section. The foregoing information in this Current Report, including the related exhibit attached hereto, shall not be
incorporated by reference into any registration statement or other document pursuant to the Securities Act of 1933, as
amended.

<P style="font-size: 10pt" align="left"><B>Item&nbsp;9.01. Financial Statements and Exhibits.</B>

<P style="font-size: 10pt; text-indent: 4%" align="left">(d)&nbsp;Exhibits.
<DIV align="center">
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  <TD width="8%">&nbsp;</TD>
  <TD width="5%">&nbsp;</TD>
  <TD width="87%">&nbsp;</TD>
 </TR>
 <TR style="font-size: 10pt" valign="bottom">
  <TD style="border-bottom: #000000 1px solid" nowrap align="left">Exhibit No.</TD>
  <TD>&nbsp;</TD>
  <TD style="border-bottom: #000000 1px solid" nowrap align="left">Description</TD>
 </TR>
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 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">10.1 </DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">Amendment No.&nbsp;1 and Joinder Agreement, dated February&nbsp;4, 2009, to the Second
Amended and Restated Loan and Security Agreement, by and among the Company and certain of its subsidiaries as Borrowers
and GECC as Lender</TD>
 </TR>
 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">&nbsp;</DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">&nbsp;</TD>
 </TR>
 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">10.2 </DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">Second Amended and Restated Revolving Credit Note, dated February 4, 2009, by certain
subsidiaries of the Company</TD>
 </TR>
 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">&nbsp;</DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">&nbsp;</TD>
 </TR>
 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">99.1 </DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">Press Release of the Company</TD>
 </TR>
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<P style="font-size: 10pt" align="center"><B>SIGNATURES</B>

<P style="font-size: 10pt; text-indent: 4%" align="left">Pursuant to the requirements of the Securities Exchange Act of
1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

<P style="font-size: 10pt" align="left">Dated: February&nbsp;6, 2009

<P style="margin-top: -11pt; font-size: 10pt; margin-left: 46%" align="left">THE ENSIGN GROUP, INC.

<P style="font-size: 10pt; margin-left: 46%" align="left">By: <U>/s/ Alan J.
Norman&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</U><BR>
Alan
J. Norman<BR>
Chief Financial Officer<BR>


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<P style="font-size: 10pt" align="center"><B>EXHIBIT INDEX</B>
<DIV align="center">
<TABLE style="font-size: 10pt" cellspacing="0" cellpadding="0" width="100%" border="0">
<!-- Begin Table Head -->

 <TR valign="bottom">
  <TD width="8%">&nbsp;</TD>
  <TD width="5%">&nbsp;</TD>
  <TD width="87%">&nbsp;</TD>
 </TR>
 <TR style="font-size: 10pt" valign="bottom">
  <TD style="border-bottom: #000000 1px solid" nowrap align="left">Exhibit No.</TD>
  <TD>&nbsp;</TD>
  <TD style="border-bottom: #000000 1px solid" nowrap align="left">Description</TD>
 </TR>
<!-- End Table Head -->
<!-- Begin Table Body -->
 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">10.1 </DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">Amendment No.&nbsp;1 and Joinder Agreement, dated February&nbsp;4, 2009, to the Second
Amended and Restated Loan and Security Agreement, by and among the Company and certain of its subsidiaries as Borrowers
and GECC as Lender</TD>
 </TR>
 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">&nbsp;</DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">&nbsp;</TD>
 </TR>
 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">10.2 </DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">Second Amended and Restated Revolving Credit Note, dated February 4, 2009, by certain
subsidiaries of the Company</TD>
 </TR>
 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">&nbsp;</DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">&nbsp;</TD>
 </TR>
 <TR valign="bottom">
  <TD valign="top">
<DIV style="margin-left: 0px; text-indent: 0px">99.1 </DIV>
</TD>
  <TD>&nbsp;</TD>
  <TD valign="top" align="left">Press Release of the Company</TD>
 </TR>
<!-- End Table Body -->

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<P style="display: none; font-size: 10pt" align="center">4
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{"company-data": {"conformed-name": "ENSIGN GROUP, INC", "cik": "0001125376", "assigned-sic": "8051", "irs-number": "330861263"}, "filing-values": {"form-type": "8-K", "act": "34", "file-number": "001-33757", "film-number": "09578810"}, "business-address": {"street1": "27101 PUERTA REAL, SUITE 450", "city": "MISSION VIEJO", "state": "CA", "zip": "92691", "phone": "(949) 487-9500"}, "mail-address": {"street1": "27101 PUERTA REAL, SUITE 450", "city": "MISSION VIEJO", "state": "CA", "zip": "92691"}, "former-company": {"former-conformed-name": "ENSIGN GROUP INC", "date-changed": "20000930"}}
Filed by Bowne Pure Compliance
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 8-K
CURRENT REPORT
Pursuant to Section 13 or 15(d) of the Securities
Exchange Act of 1934
Date of Report (Date of earliest event reported): February 3, 2009
The Ensign Group, Inc.
(Exact name
of registrant as specified in its charter)
Delaware
001-33757
33-0861263
(State or other Jurisdiction of Incorporation)
(Commission File Number)
(IRS Employer Identification No.)
27101 Puerta Real, Suite 450, Mission Viejo, CA
92691
(Address of Principal Executive Offices)
(Zip Code)
Registrant's telephone number, including area code:
(949)
487-9500
Not Applicable
(Former name or former address if changed since last report.)
Check the appropriate box below if the Form 8-K filing is intended to
simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
o
Written communications pursuant to Rule 425
under the Securities Act (17 CFR 230.425)
o
Soliciting material pursuant to Rule
14a-12 under the Exchange Act (17 CFR 240.14a-12)
o
Pre-commencement
communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
o
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR
240.13e-4(c))
Item 1.01. Entry into a Material Definitive Agreement.
On February 4, 2009, The Ensign
Group, Inc. (the "Company") and certain of its subsidiaries and General Electric
Capital Corporation ("GECC")
entered into Amendment No. 1 and Joinder Agreement (the "Amendment") to that certain Second Amended and Restated
Loan and Security Agreement (the "Agreement"), by and among the Company and certain of its subsidiaries as
Borrowers and GECC as Lender, to add three additional subsidiaries of the Company (the
"New Borrowers") as Borrowers under the Agreement and amend the Agreement to establish a reserve as
described in the Amendment.
On the same date, pursuant to the Amendment, the Borrowers
made a Second Amended and Restated Revolving Credit Note in the original principal amount of $50.0 million (the
"Note") for the benefit of GECC as Lender, to add the New Borrowers to the Note.
The foregoing description of the Amendment and Note does not
purport to be complete and is qualified in its entirety by reference to such agreement and instrument, which are
attached as Exhibits 10.1 and 10.2. to this Current Report on Form 8-K and are incorporated herein by reference.
Item 2.03 Creation of a Direct Financial Obligation or an Obligation
under an Off-Balance Sheet Arrangement of a Registrant.
The disclosure set forth above and referenced under
Item 1.01 is hereby incorporated by reference into this Item 2.03.
Item 8.01 Other Events.
On February 3, 2009, the Company issued a press release
regarding its expansion into the State of Colorado by acquiring four long-term care facilities in the Denver
metropolitan area, consisting of 217 licensed and operational skilled nursing facility beds and 24 operational assisted
living units. The transfer was effective February 1, 2009. The Company paid approximately $10,800,000 for the
portfolio. A copy of the press release is attached hereto as Exhibit 99.1 and is incorporated herein by reference.
The foregoing information in this Current Report, including
the related exhibit attached hereto, is being furnished and shall not be deemed "filed" for the purposes of
Section 18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to the liabilities of such
section. The foregoing information in this Current Report, including the related exhibit attached hereto, shall not be
incorporated by reference into any registration statement or other document pursuant to the Securities Act of 1933, as
amended.
Item 9.01. Financial Statements and Exhibits.
(d) Exhibits.
Exhibit No.
Description
10.1
Amendment No. 1 and Joinder Agreement, dated February 4, 2009, to the Second
Amended and Restated Loan and Security Agreement, by and among the Company and certain of its subsidiaries as Borrowers
and GECC as Lender
10.2
Second Amended and Restated Revolving Credit Note, dated February 4, 2009, by certain
subsidiaries of the Company
99.1
Press Release of the Company
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of
1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
Dated: February 6, 2009
THE ENSIGN GROUP, INC.
By:
/s/ Alan J.
Norman
Alan
J. Norman
Chief Financial Officer
EXHIBIT INDEX
Exhibit No.
Description
10.1
Amendment No. 1 and Joinder Agreement, dated February 4, 2009, to the Second
Amended and Restated Loan and Security Agreement, by and among the Company and certain of its subsidiaries as Borrowers
and GECC as Lender
10.2
Second Amended and Restated Revolving Credit Note, dated February 4, 2009, by certain
subsidiaries of the Company
99.1
Press Release of the Company