Acadia Healthcare Company, Inc.

Overview

Acadia Healthcare Company, Inc. and its consolidated subsidiaries operate a nationwide platform of behavioral health facilities in the United States and Puerto Rico. The company provides inpatient, residential, and outpatient services across multiple care lines and pursues growth through expansions, joint ventures, de novo facilities, acquisitions, and care-continuum expansion.

What the company does

• Core services: acute inpatient psychiatric facilities, specialty treatment facilities, comprehensive treatment centers (CTCs), residential treatment centers, and outpatient behavioral health services.
• 2025 revenue mix by facility/service type:
  • Acute inpatient psychiatric facilities: 55%
  • Specialty treatment facilities: 17%
  • Comprehensive treatment centers (CTCs): 17%
  • Residential treatment centers: 11%
• Geography and scale (as of December 31, 2025): 277 facilities with over 12,500 beds across 40 states and Puerto Rico.
• Facilities and ownership:
  • 178 CTCs (25 owned properties, 153 leased)
  • Among non-CTC facilities, approximately 91% owned and 9% leased
• Payor mix (2025 revenue by payor):
  • Medicaid: 57.7%
  • Commercial payors: 24.6%
  • Medicare: 14.3%
  • Other: 3.4%
• Market position: Publicly traded pure-play behavioral healthcare provider with a national footprint supporting a broad continuum of care.

Scale and recent growth

• Facilities and beds:
  • 277 facilities; over 12,500 beds total
  • Net bed increase of 1,089 during 2025 (311 beds added to existing facilities; 778 beds added via one wholly-owned facility and five joint-venture facilities)
  • Five facilities totaling 382 beds closed in 2025
• 2025 developments:
  • Opened 15 CTCs
  • Opened five joint-venture facilities in partnership with Henry Ford Health, Geisinger Health, Ascension Seton, Fairview Health Services, and ECU Health
• 2024 acquisition:
  • Turning Point, a 76‑bed specialty provider in the Salt Lake City metro area (acquired February 22, 2024)

Customers and operations

• Revenue is derived from services billed to Medicaid, Medicare, commercial payors, and self-pay.
• Employees: approximately 25,000 employees as of December 31, 2025 (about 19,000 full-time).
• Management and leadership: the company highlights dependence on its management team and local facility leadership, and has experienced executive turnover around 2025–2026.

Financial highlights (selected, 2025 with 2024 and 2023 comparatives)

• Revenue:
  • 2025: $3,312.8 million
  • 2024: $3,154.0 million
  • 2023: $2,928.7 million
• Same-facility performance (2025 vs 2024):
  • Revenue growth (same facilities): 4.9%
  • Patient days growth: 2.1%
  • Admissions growth: 2.3%
  • Revenue per patient day: 2.8% growth
• Expense highlights:
  • Salaries, wages and benefits (SWB): $1,820.7 million (2025); $1,691.0 million (2024)
    • Excluding equity-based compensation: 2025 SWB = $1,789.0 million; 2024 = $1,653.9 million
    • 2025 SWB as a percentage of revenue: 54.0% (2024: 52.4%)
  • Professional fees: $195.5 million (2025); $189.7 million (2024)
  • Other operating expenses: $553.3 million (2025); $440.8 million (2024)
  • Depreciation and amortization: $189.2 million (2025); $149.6 million (2024)
  • Interest expense, net: $138.9 million (2025); $116.4 million (2024)
  • Debt extinguishment costs: $1.3 million (2025)
• Impairments and gains/losses:
  • Loss on impairment: $1,007.9 million (2025) vs. $17.3 million (2024)
    • Includes goodwill impairment of $996.2 million (2025)
  • Indefinite-lived intangible and other impairment: $0.3 million (2025)
  • Gain on sale of property: $8.7 million (2025)
• Legal and transaction costs:
  • Legal settlements expense: $151.0 million (2025; includes $147.5 million related to 2019 Securities Litigation)
  • Transaction, legal and other costs: $163.6 million (2025)
• Net (loss) and taxes (2025):
  • (Loss) before income taxes: $(1,065.9) million
  • Provision for income taxes: $26.0 million
  • Net (loss) income: $(1,091.9) million
  • Net income attributable to noncontrolling interests: $(10.8) million
  • Net (loss) income attributable to Acadia: $(1,102.8) million

Leverage and liquidity (as of December 31, 2025)

• Total debt (approximate): about $2.5 billion
• Credit facility: $1.0 billion revolving facility; $650.0 million term loan
• Outstanding notes: 5.5% Senior Notes (2028), 5.0% Senior Notes (2029), 7.375% Senior Notes (2033)
• Consolidated Total Net Leverage Ratio: 4.0x (calculated under the Credit Agreement)
• Availability under revolving facility: $594.8 million
• Standby letters of credit: $1.2 million

Cash flows and capital spending (selected, 2025)

• Cash provided by operating activities: $131.9 million
• Cash used in investing activities: $556.2 million (primarily capital expenditures of $571.8 million; net of asset sales)
• Cash provided by financing activities: $481.3 million
• Capital expenditures: $571.8 million (maintenance capital approximately 3% of revenue; includes expansion spending)

Share repurchases and cash returns

• Share repurchase program authorized up to $300 million (as of February 25, 2025)
• 2025 repurchases: 1.706 million shares for $50.4 million
• Remaining authorization under the program: $250.0 million

Notable events and contingencies

• Desert Hills litigation: settlement reached in 2023; $400.0 million paid in January 2024
• Prior debt refinanced under the 2025 Credit Facility
• Large goodwill impairment in 2025 had a major impact on net income

Management commentary and strategic outlook

• Growth strategy is built on five pathways: expansions of existing facilities, joint venture partnerships, de novo facilities, acquisitions, and expansion across the continuum of care.
• Emphasis on national marketing, breadth of services, and expanding bed capacity via organic growth and transactions, including joint ventures and de novo builds.
• Focus areas include scaling services for high‑acuity and complex‑need patients, accelerating joint ventures and de novo projects, and managing labor costs and occupancy while maintaining quality and regulatory compliance.

Regulatory and risk context

• The company operates under federal and state health regulatory regimes (Medicaid/Medicare and private payors), privacy and fraud‑and‑abuse laws (HIPAA, Part 2, Anti‑Kickback Statute, Stark Law, EKRA), and environmental and operational regulations.
• The 2025–2026 environment includes regulatory changes and ongoing reform discussions at federal and state levels that could affect reimbursement, eligibility, and operating requirements.
• Exposures include capital markets and interest rate volatility, inflation, litigation risk, cyber risk, and operational risks related to managing a large network of facilities.