OPTIONS AND AWARDS - Narrative (Details) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended				9 Months Ended
	Sep. 30, 2025 USD ($) plan shares	Mar. 31, 2025 USD ($)	Sep. 30, 2024 USD ($) shares	Mar. 31, 2024 USD ($)	Sep. 30, 2025 USD ($) plan installment $ / shares shares	Sep. 30, 2024 USD ($) $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of stock incentive plans \| plan	1				1
Grant date intrinsic value (in dollars per share)					$ 0	$ 0
Aggregate intrinsic value of options that vested in period \| $	$ 40,633		$ 34,971		$ 40,633	$ 34,971
Intrinsic value of options exercised in period \| $					$ 44,962	$ 50,840
Share-based compensation, restricted awards, exercise price (in dollars per share)					$ 0
Share-based compensation, options expected to vest, number (in shares) \| shares	1,916				1,916
Share-based compensation, options outstanding, weighted average remaining contractual term					6 years 8 months 12 days
Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period					5 years
Restricted stock awards granted (in shares) \| shares	43		29		177	116
Granted (in dollars per share)					$ 141.85
Annual bonuses settled in vested awards \| $		$ 8,003		$ 6,165
Share-based compensation, nonvested awards, cost not yet recognized \| $	$ 42,557				$ 42,557
Restricted Stock Awards \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in dollars per share)					$ 126.34	$ 116.65
Restricted Stock Awards \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in dollars per share)					$ 169.24	$ 146.37
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, nonvested awards, cost not yet recognized \| $	$ 94,617				$ 94,617
Share-based compensation, nonvested awards, cost not yet recognized, period for recognition					3 years 8 months 12 days
Share-based compensation, nonvested awards (in shares) \| shares	2,075				2,075
Non-employee Directors \| Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted stock awards granted (in shares) \| shares	4				11
Non-employee Directors \| Restricted Stock Awards \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in dollars per share)					$ 129.09
Non-employee Directors \| Restricted Stock Awards \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in dollars per share)					$ 141.18
Amended and Restated Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized (in shares) \| shares	4,231				4,231
Conversion to reduce shares availability					1
Other than options, conversion to reduce shares availability					2
Award vesting period					5 years
Award vesting rights, percentage					20.00%
Expiration period					10 years
Number of shares available for grant (in shares) \| shares	3,724				3,724
Amended and Restated Plan \| Non-employee Directors
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of installments \| installment					3
Award requisite service period					3 years

ENSIGN GROUP, INC 10-Q