The Ensign Group, Inc. provides skilled nursing and rehabilitative care services through the operation of 103 facilities, five home health and three hospice operations located in Arizona, California, Colorado, Idaho, Iowa, Texas, Utah and Washington. Effective March 1, 2013, it acquired Legacy Rehabilitation and Living, a 150-bed skilled nursing facility in Texas. Effective March 5, 2013, it acquired Elite Home Health & Hospice. Effective April 1, 2013, it acquired San Marcos Rehabilitation and Healthcare Center, a 129-bed skilled nursing facility in San Marcos, Texas, The Courtyard Rehabilitation and Healthcare Center, a 56-bed skilled nursing facility in Victoria, Texas, and La Villa Rehabilitation and Healthcare Center, a 152-bed skilled nursing facility also in Victoria, Texas. In April 2013, Immediate Clinic Healthcare, Inc., sold Doctors Express. Effective May 1, 2013, it acquired Cascade Vista and its sister facility Cascade Plaza, both located in Redmond, Washington.