Document and Entity Information - USD ($) $ in Billions	12 Months Ended
Document and Entity Information - USD ($) $ in Billions	Dec. 31, 2018	Mar. 01, 2019	Jun. 30, 2018
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	FY
Trading Symbol	ACHC
Entity Registrant Name	Acadia Healthcare Company, Inc.
Entity Central Index Key	0001520697
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		88,455,125
Entity Public Float			$ 3.5

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 50,510	$ 67,290
Accounts receivable, net	318,087	296,925
Other current assets	81,820	107,335
Total current assets	450,417	471,550
Property and equipment:
Land	430,771	450,342
Building and improvements	2,423,594	2,370,918
Equipment	444,538	400,596
Construction in progress	294,848	173,693
Less accumulated depreciation	(485,985)	(347,419)
Property and equipment, net	3,107,766	3,048,130
Goodwill	2,396,412	2,751,174
Intangible assets, net	88,990	87,348
Deferred tax assets	3,468	3,731
Derivative instrument assets	60,524	12,997
Other assets	64,927	49,572
Total assets	6,172,504	6,424,502
Current liabilities:
Current portion of long-term debt	34,112	34,830
Accounts payable	117,740	102,299
Accrued salaries and benefits	113,299	99,047
Other accrued liabilities	151,226	141,213
Total current liabilities	416,377	377,389
Long-term debt	3,159,375	3,205,058
Deferred tax liabilities	80,372	80,333
Other liabilities	154,267	166,434
Total liabilities	3,810,391	3,829,214
Redeemable noncontrolling interests	28,806	22,417
Equity:
Preferred stock, $0.01 par value; 10,000,000 shares authorized, no shares issued
Common stock, $0.01 par value; 180,000,000 shares authorized; 87,444,473 and 87,060,114 issued and outstanding as of December 31, 2018 and 2017, respectively	874	871
Additional paid-in capital	2,541,987	2,517,545
Accumulated other comprehensive loss	(462,377)	(374,118)
Retained earnings	252,823	428,573
Total equity	2,333,307	2,572,871
Total liabilities and equity	$ 6,172,504	$ 6,424,502

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2018	Dec. 31, 2017
Statement Of Financial Position [Abstract]
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, authorized	10,000,000	10,000,000
Preferred stock, issued	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	180,000,000	180,000,000
Common stock, shares issued	87,444,473	87,060,114
Common stock, shares outstanding	87,444,473	87,060,114

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Statement [Abstract]
Revenue before provision for doubtful accounts									$ 3,012,442	$ 2,877,234	$ 2,852,823
Provision for doubtful accounts										(40,918)	(41,909)
Revenue	$ 743,547	$ 760,916	$ 765,738	$ 742,241	$ 724,512	$ 716,714	$ 715,896	$ 679,194	3,012,442	2,836,316	2,810,914
Salaries, wages and benefits (including equity-based compensation expense of $22,001, $23,467 and $28,345, respectively)									1,659,348	1,536,160	1,541,854
Professional fees									227,425	196,223	185,486
Supplies									119,314	114,439	117,425
Rents and leases									80,282	76,775	73,348
Other operating expenses									354,498	331,827	312,556
Depreciation and amortization									158,832	143,010	135,103
Interest expense, net									185,410	176,007	181,325
Debt extinguishment costs									1,815	810	4,253
Legal settlements expense	22,100								22,076
Loss on impairment	337,900								337,889
Loss on divestiture											178,809
Gain on foreign currency derivatives											(523)
Transaction-related expenses									34,507	24,267	48,323
Total expenses									3,181,396	2,599,518	2,777,959
(Loss) income before income taxes	(341,336)	55,036	69,258	48,088	60,689	61,459	66,216	48,484	(168,954)	236,798	32,955
Provision for income taxes									6,532	37,209	28,779
Net (loss) income									(175,486)	199,589	4,176
Net (income) loss attributable to noncontrolling interests									(264)	246	1,967
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$ (331,637)	$ 46,232	$ 58,836	$ 50,819	$ 69,629	$ 45,618	$ 49,630	$ 34,958	$ (175,750)	$ 199,835	$ 6,143
Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$ (3.80)	$ 0.53	$ 0.67	$ 0.58	$ 0.80	$ 0.52	$ 0.57	$ 0.40	$ (2.01)	$ 2.30	$ 0.07
Diluted	$ (3.80)	$ 0.53	$ 0.67	$ 0.58	$ 0.80	$ 0.52	$ 0.57	$ 0.40	$ (2.01)	$ 2.30	$ 0.07
Weighted-average shares outstanding:
Basic									87,288	86,948	85,701
Diluted									87,288	87,060	85,972

Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Statement Of Income And Comprehensive Income [Abstract]
Net (loss) income	$ (175,486)	$ 199,589	$ 4,176
Other comprehensive (loss) income:
Foreign currency translation (loss) gain	(127,521)	206,784	(477,967)
Gain (loss) on derivative instruments, net of tax of $12.7 million, $(22.9) million and $29.1, respectively	36,799	(33,431)	40,598
Pension liability adjustment, net of tax of $0.3 million, $0.4 million and $(1.3) million, respectively	2,463	2,099	(7,554)
Other comprehensive (loss) gain	(88,259)	175,452	(444,923)
Comprehensive (loss) income	(263,745)	375,041	(440,747)
Comprehensive (income) loss attributable to noncontrolling interests	(264)	246	1,967
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc.	$ (264,009)	$ 375,287	$ (438,780)

Consoidated Statements of Comprehensive (Loss) Income (Parenthetical) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Statement Of Income And Comprehensive Income [Abstract]
Loss on derivative instruments, tax	$ 12.7	$ (22.9)	$ 29.1
Pension liability adjustment, tax	$ 0.3	$ 0.4	$ (1.3)

Consolidated Statements of Equity - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive Loss [Member]	Earnings (Accumulated Deficit) [Member]
Balance at Dec. 31, 2015	$ 1,683,028	$ 707	$ 1,572,972	$ (104,647)	$ 213,996
Balance, shares at Dec. 31, 2015		70,746,000
Common stock issued under stock incentive plans	$ 1,384	$ 5	1,379
Common stock issued under stock incentive plans, shares	57,397	408,000
Common stock withheld for minimum statutory taxes	$ (10,230)		(10,230)
Equity-based compensation expense	28,345		28,345
Issuance of common stock, net	901,979	$ 155	901,824
Issuance of common stock, net, shares		15,534,000
Other comprehensive loss	(444,923)			(444,923)
Other	1,998		1,998
Net income (Loss) attributable to Acadia Healthcare Company, Inc. stockholders	6,143				6,143
Balance at Dec. 31, 2016	2,167,724	$ 867	2,496,288	(549,570)	220,139
Balance, shares at Dec. 31, 2016		86,688,000
Common stock issued under stock incentive plans	$ 2,069	$ 4	2,065
Common stock issued under stock incentive plans, shares	87,367	372,000
Common stock withheld for minimum statutory taxes	$ (5,524)		(5,524)
Equity-based compensation expense	23,467		23,467
Cumulative effect of change in accountingprinciple	8,599				8,599
Other comprehensive loss	175,452			175,452
Other	1,249		1,249
Net income (Loss) attributable to Acadia Healthcare Company, Inc. stockholders	199,835				199,835
Balance at Dec. 31, 2017	$ 2,572,871	$ 871	2,517,545	(374,118)	428,573
Balance, shares at Dec. 31, 2017	87,060,114	87,060,000
Common stock issued under stock incentive plans	$ 374	$ 3	371
Common stock issued under stock incentive plans, shares	20,989	384,000
Common stock withheld for minimum statutory taxes	$ (3,781)		(3,781)
Equity-based compensation expense	22,001		22,001
Other comprehensive loss	(88,259)			(88,259)
Other	5,851		5,851
Net income (Loss) attributable to Acadia Healthcare Company, Inc. stockholders	(175,750)				(175,750)
Balance at Dec. 31, 2018	$ 2,333,307	$ 874	$ 2,541,987	$ (462,377)	$ 252,823
Balance, shares at Dec. 31, 2018	87,444,473	87,444,000

Consolidated Statements of Cash Flows $ in Thousands, £ in Millions	12 Months Ended
	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Operating activities:
Net (loss) income	$ (175,486)	$ 199,589	$ 4,176
Adjustments to reconcile net (loss) income to net cash provided by continuing operating activities:
Depreciation and amortization	158,832	143,010	135,103
Amortization of debt issuance costs	10,456	9,855	10,324
Equity-based compensation expense	22,001	23,467	28,345
Deferred income taxes	(9,714)	31,372	28,647
Debt extinguishment costs	1,815	810	4,253
Legal settlements expense	22,076
Loss on impairment	337,889
Loss on divestiture			178,809
Gain on foreign currency derivatives			(523)
Other	12,371	11,412	4,715
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net	(16,821)	(28,570)	(15,718)
Other current assets	13,864	20,808	(20,648)
Other assets	2,762	(3,176)	(4,354)
Accounts payable and other accrued liabilities	26,054	(10,113)	22,693
Accrued salaries and benefits	15,748	(8,988)	(8,572)
Other liabilities	(5,219)	11,794	4,484
Net cash provided by continuing operating activities	416,628	401,270	371,734
Net cash used in discontinued operating activities	(2,548)	(1,693)	(10,256)
Net cash provided by operating activities	414,080	399,577	361,478
Investing activities:
Cash paid for acquisitions, net of cash acquired		(18,191)	(683,455)
Cash paid for capital expenditures	(341,462)	(274,177)	(307,472)
Cash paid for real estate acquisitions	(18,383)	(41,057)	(40,757)
Settlement of foreign currency derivatives			523
Cash received on divestitures			373,266
Other	(1,119)	(3,101)	(2,470)
Net cash used in investing activities	(360,964)	(336,526)	(660,365)
Financing activities:
Borrowings on long-term debt			1,480,000
Borrowings on revolving credit facility			179,000
Principal payments on revolving credit facility			(337,000)
Principal payments on long-term debt	(39,738)	(34,805)	(49,941)
Repayment of assumed debt			(1,348,389)
Repayment of long-term debt	(21,920)	(22,500)	(200,594)
Payment of debt issuance costs			(36,649)
Issuances of common stock, net			685,097
Common stock withheld for minimum statutory taxes, net	(3,407)	(3,455)	(8,846)
Other	(2,265)	686	(3,837)
Net cash (used in) provided by financing activities	(67,330)	(60,074)	358,841
Effect of exchange rate changes on cash	(2,566)	7,250	(14,106)
Net (decrease) increase in cash and cash equivalents	(16,780)	10,227	45,848
Cash and cash equivalents at beginning of the period	67,290	57,063	11,215
Cash and cash equivalents at end of the period	50,510	67,290	57,063
Supplemental Cash Flow Information:
Cash paid for interest	175,204	159,098	161,146
Cash paid for income taxes	$ 6,720	10,291	15,483
Effect of acquisitions:
Assets acquired, excluding cash		19,649	2,516,880
Liabilities assumed		(1,458)	(1,616,543)
Issuance of common stock in connection with acquisition			(216,882)
Cash paid for acquisitions, net of cash acquired		$ 18,191	$ 683,455

Description of Business and Basis of Presentation

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Description of Business and Basis of Presentation

1. Description of Business and Basis of Presentation

Description of Business

Acadia Healthcare Company, Inc. (the “Company”) develops and operates inpatient psychiatric facilities, residential treatment centers, group homes, substance abuse facilities and facilities providing outpatient behavioral healthcare services to serve the behavioral health and recovery needs of communities throughout the United States (“U.S.”), the United Kingdom (“U.K.”) and Puerto Rico. At December 31, 2018, the Company operated 583 behavioral healthcare facilities with approximately 18,100 beds in 40 states, the U.K. and Puerto Rico.

Basis of Presentation

The business of the Company is conducted through limited liability companies, partnerships and C-corporations. The Company’s consolidated financial statements include the accounts of the Company and all subsidiaries controlled by the Company through its’ direct or indirect ownership of majority interests and exclusive rights granted to the Company as the controlling member of an entity. All intercompany accounts and transactions have been eliminated in consolidation.

The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”). The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates. The majority of the Company’s expenses are “cost of revenue” items. Costs that could be classified as general and administrative expenses include the Company’s corporate office costs, which were $86.6 million, $76.4 million and $86.8 million for the years ended December 31, 2018, 2017 and 2016, respectively.

Certain reclassifications have been made to prior years to conform to the current year presentation.

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies

Cash and Cash Equivalents

The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents. At times, cash and cash equivalent balances may exceed federally insured limits. Management believes that the Company mitigates any risks by depositing cash and investing in cash equivalents with major financial institutions.

Insurance

The Company is subject to medical malpractice and other lawsuits due to the nature of the services the Company provides. A portion of the Company’s professional liability risks are insured through a wholly-owned insurance subsidiary. The Company is self-insured for professional liability claims up to $3.0 million per claim and has obtained reinsurance coverage from a third party to cover claims in excess of the retention limit. The reinsurance policy has a coverage limit of $75.0 million in the aggregate. The Company’s reinsurance receivables are recognized consistent with the related liabilities and include known claims and any incurred but not reported claims that are covered by current insurance policies in place. The reserve for professional and general liability risks was estimated based on historical claims, demographic factors, industry trends, severity factors, and other actuarial assumptions. The estimated accrual for professional and general liabilities could be significantly affected should current and future occurrences differ from historical claim trends and expectations. While claims are monitored closely when estimating professional and general liability accruals, the complexity of the claims and wide range of potential outcomes often hampers timely adjustments to the assumptions used in these estimates. The professional and general liability reserve was $42.8 million at December 31, 2018, of which $5.0 million was included in other accrued liabilities and $37.8 million was included in other long-term liabilities. The professional and general liability reserve was $55.0 million at December 31, 2017, of which $22.8 million was included in other accrued liabilities and $32.2 million was included in other long-term liabilities. The Company estimates receivables for the portion of professional and general liability reserves that are recoverable under the Company’s insurance policies. Such receivable was $8.2 million at December 31, 2018, of which $2.1 million was included in other current assets and $6.1 million was included in other assets, and such receivable was $22.7 million at December 31, 2017, of which $17.6 million was included in other current assets and $5.1 million was included in other assets.

The Company’s statutory workers’ compensation program is fully insured with a $0.5 million deductible per accident. The workers’ compensation liability was $19.3 million at December 31, 2018, of which $10.0 million was included in accrued salaries and benefits and $9.3 million was included in other long-term liabilities, and such liability was $18.5 million at December 31, 2017, of which $10.0 million was included in accrued salaries and benefits and $8.5 million was included in other long-term liabilities. The reserve for workers compensation claims was based upon independent actuarial estimates of future amounts that will be paid to claimants. Management believes that adequate provisions have been made for workers’ compensation and professional and general liability risk exposures.

Property and Equipment and Other Long-Lived Assets

Property and equipment are recorded at cost. Depreciation is calculated on the straight-line basis over the estimated useful lives of the assets, which typically range from 10 to 50 years for buildings and improvements, three to seven years for equipment and the shorter of the lease term or estimated useful lives for leasehold improvements. When assets are sold or retired, the corresponding cost and accumulated depreciation are removed from the related accounts and any gain or loss is recorded in the period of sale or retirement. Repair and maintenance costs are expensed as incurred. Depreciation expense was $158.8 million, $143.0 million and $134.8 million for the years ended years ended December 31, 2018, 2017 and 2016, respectively.

The carrying values of long-lived assets are reviewed for possible impairment whenever events, circumstances or operating results indicate that the carrying amount of an asset may not be recoverable. If this review indicates that the asset will not be recoverable, as determined based upon the undiscounted cash flows of the operating asset over the remaining useful lives, the carrying value of the asset will be reduced to its estimated fair value. Fair value estimates are based on independent appraisals, market values of comparable assets or internal evaluations of future net cash flows.

The Company performed its impairment review of long-lived assets in the fourth quarter of 2018, which indicated the carrying amounts of certain long-lived assets in our U.K. Facilities may not be recoverable. This created a non-cash loss on impairment of $12.0 million for the year ended December 31, 2018, which was recorded in loss on impairment on our consolidated statements of operation. No impairment was recorded for the years ended December 31, 2017 and 2016.

Goodwill and Indefinite-Lived Intangible Assets

In January 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) ASU 2017-04, “Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment” (“ASU 2017-04”). ASU 2017-04 simplifies the measurement of goodwill by eliminating the requirement to calculate the implied fair value of goodwill (step 2 of the current impairment test) to measure the goodwill impairment charge. Instead, entities will record impairment charges based on the excess of a reporting unit’s carrying amount over its fair value. ASU 2017-04 is effective for fiscal years beginning after December 15, 2019. Early adoption is permitted. The Company elected to early adopt ASU 2017-04 on January 1, 2018.

The Company’s goodwill and other indefinite-lived intangible assets, which consist of license and accreditations, trade names and certificates of need intangible assets that are not amortized, are evaluated for impairment annually during the fourth quarter or more frequently if events indicate the carrying value of a reporting unit may not be recoverable. The Company has two operating segments, the Company’s facilities in the U.S (the “U.S. Facilities”) and the facilities in the U.K. (the “U.K. Facilities”), for segment reporting purposes, each of which represents a reporting unit for purposes of the Company’s goodwill impairment test.

The Company’s annual goodwill impairment test performed as of October 1, 2018 considered the recent financial performance, including the labor market pressures faced by the U.K. Facilities. The impairment test for the U.S. Facilities indicated estimated fair value exceeded carrying value, and therefore no impairment was recorded. The impairment test for the U.K. Facilities indicated carrying value exceeded the estimated fair value. The difference was recorded as a non-cash loss on impairment of $325.9 million for the year ended December 31, 2018 within loss on impairment in the consolidated statements of operations. The Company’s annual impairment tests of goodwill and other indefinite-lived intangible assets in 2017 and 2016 resulted in no impairment charges.

In performing the goodwill impairment test, the Company used a combination of the income and market approaches to estimate fair value of our reporting units. Determining fair value requires substantial judgement and use significant unobservable inputs, which are categorized as Level 3 fair value measurements. For the income approach, the Company used a discounted cash flow model in which cash flows are projected using internal forecasts over future periods, plus a terminal value, and are discounted to present value using a risk-adjusted rate of return. The Company’s internal forecasts include estimates of growth rates based on our current views of the long-term outlook of each reporting unit and may materially differ from actual results. Discount rate assumptions are based on an assessment of the risk inherent in the future cash flows of each reporting unit. The discount rates used in its analysis range from 9.0% to 10.5% and correspond to the risks inherent in each reporting unit. For the market approach, we compared our reporting units to guideline companies actively traded in public markets and included a control premium, which was based on acquisition premiums of selected companies similar to our reporting units. Estimating fair values of our reporting units includes substantial judgement and significant estimates and may materially differ from actual results. Changes in assumptions, industry or peer groups could negatively impact estimated fair value.

Other Current Assets

Other current assets consisted of the following (in thousands):

	December 31,
	2018		2017
Prepaid expenses	$	30,802	$	27,320
Other receivables		19,205		21,427
Cost report receivable		10,340		9,028
Workers’ compensation deposits – current portion		10,000		10,000
Inventory		5,055		4,787
Insurance receivable – current portion		2,049		17,588
Income taxes receivable		2,380		15,056
Other		1,989		2,129
Other current assets	$	81,820	$	107,335

Other Accrued Liabilities

Other accrued liabilities consisted of the following (in thousands):

	December 31,
	2018		2017
Accrued expenses	$	44,938	$	37,268
Accrued interest		32,838		36,370
Unearned income		32,154		31,342
Accrued legal settlements		22,076		—
Insurance liability – current portion		4,956		22,788
Accrued property taxes		4,136		3,945
Income taxes payable		3,041		1,012
Other		7,087		8,488
Other accrued liabilities	$	151,226	$	141,213

Stock Compensation

The Company measures and recognizes the cost of employee services received in exchange for awards of equity instruments based on the grant-date fair value in accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 718, “ Compensation—Stock Compensation .” The Company uses the Black-Scholes valuation model to determine grant-date fair value for equity awards and uses straight-line amortization of share-based compensation expense over the requisite service period of the respective awards.

Earnings Per Share

Basic and diluted earnings per share are calculated in accordance with FASB ASC 260, “Earnings Per Share,” based on the weighted-average number of shares outstanding in each period and dilutive stock options and non-vested shares, to the extent such securities have a dilutive effect on earnings per share.

Income Taxes

The Company uses the asset and liability method of accounting for income taxes. Under this method, deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes and net operating loss and tax credit carryforwards. The amount of deferred taxes on these temporary differences is determined using the tax rates that are expected to apply in the period when the asset is realized or the liability is settled, as applicable, based on tax rates and laws in the respective tax jurisdiction enacted as of the balance sheet date.

The Company reviews its deferred tax assets for recoverability and establishes a valuation allowance based on historical taxable income, projected future taxable income, applicable tax strategies, and the expected timing of the reversals of existing temporary differences. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax assets will not be realized.

The Company records a liability for unrecognized tax benefits resulting from uncertain tax positions taken or expected to be taken in a tax return. The Company recognizes interest and penalties, if any, related to unrecognized tax benefits in income tax expense.

The Tax Act was enacted on December 22, 2017. The Tax Act reduced the U.S. federal corporate tax rate from 35% to 21%, required companies to pay a one-time transition tax on earnings of certain foreign subsidiaries that were previously tax deferred and created new taxes on certain foreign sourced earnings. See additional disclosure described in Note 10 – Income Taxes.

Recent Accounting Pronouncements

In August 2018, the FASB issued ASU 2018-15, “Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract” (“ASU 2018-15”). ASU 2018-15 requires a customer in a cloud computing arrangement that is a service contract to follow the internal-use software guidance in ASC 350-402 to determine which implementation costs to capitalize as assets. ASU 2018-15 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2019. Early adoption is permitted. Management is evaluating the impact of ASU 2018-15 on the Company’s consolidated financial statements.

In August 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2017-12, “Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities” (“ASU 2017-12”). ASU 2017-12 amends the hedge accounting model to enable entities to better portray the economics of their risk management activities in the financial statements and simplifies the application of hedge accounting in certain situations. ASU 2017-12 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2018. Early adoption is permitted. Management is evaluating the impact of ASU 2017-12 on the Company’s consolidated financial statements.

In August 2016, the FASB issued ASU 2016-15, “Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments” (“ASU 2016-15”). ASU 2016-15 addresses treatment of how certain cash receipts and cash payments are presented and classified in the statement of cash flows to reduce the diversity in practice. ASU 2016-15 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017. The Company adopted ASU 2016-15 on January 1, 2018. There is no significant impact on the Company’s consolidated financial statements.

In March 2016, the FASB issued ASU 2016-02, “Leases” (“ASU 2016-02”). ASU 2016-02’s core principle is to increase transparency and comparability among organizations by recognizing lease assets and liabilities on the balance sheet and disclosing key information. ASU 2016-02 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2018. Additionally, ASU 2016-02 would permit both public and nonpublic organizations to adopt the new standard early. ASU 2016-02 requires application either retrospectively to each prior reporting period presented in the financial statements or retrospectively at the beginning of the period of adoption.

The Company will adopt ASU 2016-02 retrospectively at the beginning of the period of adoption and will record a cumulative-effect adjustment to retained earnings on January 1, 2019. The Company expects to elect the package of practical expedients offered in the transition guidance which allows management to not reassess lease identification, lease classification and initial direct costs. The Company also expects to elect the accounting policy practical expedients by class of underlying asset to: (i) combine associated lease and non-lease components into a single lease component; and (ii) exclude recording short-term leases as right-of-use assets and liabilities on the balance sheet.

The Company has substantially completed its evaluation of the financial impact of the new standard as it relates to the Company’s lease portfolio, which primarily consists of real estate leases integral for facility operations. Management believes the largest effect of adopting the new standard will be to record a significant amount of right-of-use assets and liabilities for current operating leases. Management continues to evaluate the impact ASU 2016-02 will have on the Company’s internal controls, policies, and procedures. See Note 13 – Leases for the Company’s aggregate minimum lease payments under non-cancelable operating leases under accounting guidance at December 31, 2018.

The Company is continuing to refine its approach under ASU 2016-02, including finalizing its transition calculations, controls and disclosure policies. The Company will finalize its accounting assessment and quantitative impact of adoption of ASU 2016-02 during the first quarter of 2019. The Company will continue to monitor industry activities and any additional accounting guidance and will adjust the Company’s assessment and implementation plans accordingly.

In January 2016, the FASB issued ASU 2016-01, “Financial Instruments-Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities” (“ASU 2016-01”). ASU 2016-01 amends how entities recognize, measure, present and disclose certain financial assets and financial liabilities. It requires entities to measure equity investments (except for those accounted for under equity method) at fair value and recognize any changes in fair value in net income. ASU 2016-15 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017. The Company adopted ASU 2016-01 on January 1, 2018. There was no significant impact on the Company’s consolidated financial statements.

In May 2014, the FASB and the International Accounting Standards Board issued ASU 2014-09, “Revenue from Contracts with Customers (Topic 606)” (“ASU 2014-09”). ASU 2014-09’s core principle is that a company will recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. ASU 2014-09 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017. The Company adopted ASU 2014-09 on January 1, 2018 as described in Note 3 – Revenue.

Revenue

12 Months Ended

Dec. 31, 2018

Revenue From Contract With Customer [Abstract]

Revenue

3. Revenue

ASU 2014-09 requires companies to exercise more judgment and recognize revenue using a five-step process. The Company adopted ASU 2014-09 using the modified retrospective method for all contracts effective January 1, 2018 and is using a portfolio approach to group contracts with similar characteristics and analyze historical cash collections trends. Modified retrospective adoption requires entities to apply the standard retrospectively to the most current period presented in the financial statements, requiring the cumulative effect of the retrospective application as an adjustment to the opening balance of retained earnings at the date of initial application. Prior periods have not been adjusted. No cumulative-effect adjustment in retained earnings was recorded as the adoption of ASU 2014-09 did not significantly impact the Company’s reported historical revenue.

As a result of certain changes required by ASU 2014-09, the majority of the Company’s provision for doubtful accounts are recorded as a direct reduction to revenue instead of being presented as a separate line item on the consolidated statements of operations. The adoption of ASU 2014-09 has no impact on the Company’s accounts receivable as it was historically recorded net of allowance for doubtful accounts and contractual adjustments, and the Company has eliminated the presentation of allowance for doubtful accounts on the consolidated balance sheets. At December 31, 2018 and 2017, estimated implicit price concessions of $47.0 million and $40.9 million, respectively, had been recorded as reductions to our accounts receivable balances to enable us to record our revenues and accounts receivable at the estimated amounts we expected to collect. The adoption of ASU 2014-09 did not have a significant impact on the Company’s consolidated statements of operations. The impact of adopting ASU 2014-09 on the consolidated statements of operations for the year ended December 31, 2018 was as follows (in thousands):

	Year Ended December 31, 2018
	As Reported		Prior to Adopting ASU 2014-09
Revenue before provision for doubtful accounts	$	3,012,442	$	3,060,180
Provision for doubtful accounts		—		(47,738	)
Revenue	$	3,012,442	$	3,012,442

The Company evaluated the nature, amount, timing and uncertainty of revenue and cash flows using the five-step process provided within ASU 2014-09.

Revenue is primarily derived from services rendered to patients for inpatient psychiatric and substance abuse care, outpatient psychiatric care and residential treatment. The services provided by the Company have no fixed duration and can be terminated by the patient or the facility at any time, and therefore, each treatment is its own stand-alone contract.

Services ordered by a healthcare provider in an episode of care are not separately identifiable and therefore have been combined into a single performance obligation for each contract. The Company recognizes revenue as its performance obligations are completed. The performance obligation is satisfied over time as the customer simultaneously receives and consumes the benefits of the healthcare services provided. For inpatient services, the Company recognizes revenue equally over the patient stay on a daily basis. For outpatient services, the Company recognizes revenue equally over the number of treatments provided in a single episode of care. Typically, patients and third-party payors are billed within several days of the service being performed or the patient being discharged, and payments are due based on contract terms.

As our performance obligations relate to contracts with a duration of one year or less, the Company elected the optional exemption in ASC 606-10-50-14(a). Therefore, the Company is not required to disclose the transaction price for the remaining performance obligations at the end of the reporting period or when the Company expects to recognize the revenue. The Company has minimal unsatisfied performance obligations at the end of the reporting period as our patients typically are under no obligation to remain admitted in our facilities.

The Company disaggregates revenue from contracts with customers by service type and by payor within each of the Company’s segments.

U.S. Facilities

The Company’s U.S. Facilities and services provided by the U.S. Facilities can generally be classified into the following categories: acute inpatient psychiatric facilities; specialty treatment facilities; residential treatment centers; and outpatient community-based services.

Acute inpatient psychiatric facilities. Acute inpatient psychiatric facilities provide a high level of care in order to stabilize patients that are either a threat to themselves or to others. The acute setting provides 24-hour observation, daily intervention and monitoring by psychiatrists.

Specialty treatment facilities. Specialty treatment facilities include residential recovery facilities, eating disorder facilities and comprehensive treatment centers. The Company provides a comprehensive continuum of care for adults with addictive disorders and co-occurring mental disorders. Inpatient, including detoxification and rehabilitation, partial hospitalization and outpatient treatment programs give patients access to the least restrictive level of care.

Residential treatment centers. Residential treatment centers treat patients with behavioral disorders in a non-hospital setting, including outdoor programs. The facilities balance therapy activities with social, academic and other activities.

Outpatient community-based services. Outpatient community-based programs are designed to provide therapeutic treatment to children and adolescents who have a clinically-defined emotional, psychiatric or chemical dependency disorder while enabling the youth to remain at home and within their community.

The table below presents total U.S. revenue attributed to each category (in thousands):

	Year Ended December 31,
	2018		2017		2016
Acute inpatient psychiatric facilities	$	814,124	$	757,211	$	694,151
Specialty treatment facilities		761,017		725,151		702,225
Residential treatment centers		293,053		284,637		256,539
Outpatient community-based services		36,501		42,845		45,610
Revenue	$	1,904,695	$	1,809,844	$	1,698,525

The Company receives payments from the following sources for services rendered in our U.S. Facilities: (i) state governments under their respective Medicaid and other programs; (ii) commercial insurers; (iii) the federal government under the Medicare program administered by the Centers for Medicare and Medicaid Services (“CMS”); and (iv) individual patients and clients. As the period between the time of service and time of payment is typically one year or less, the Company elected the practical expedient under ASC 606-10-32-18 and did not adjust for the effects of a significant financing component.

The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients and implicit price concessions. Contractual adjustments and discounts are based on contractual agreements, discount policies and historical experience. Implicit price concessions are based on historical collection experience. Most of our U.S. Facilities have contracts containing variable consideration. However, it is unlikely a significant reversal of revenue will occur when the uncertainty is resolved, and therefore, the Company has included the variable consideration in the estimated transaction price. Subsequent changes resulting from a patient’s ability to pay are recorded as bad debt expense, which is included as a component of other operating expenses in the consolidating statements of operations. Bad debt expense for the year ended December 31, 2018 was not significant.

The Company derives a significant portion of its revenue from Medicare, Medicaid and other payors that receive discounts from established billing rates. The Medicare and Medicaid regulations and various managed care contracts under which these discounts must be calculated are complex, subject to interpretation and adjustment, and may include multiple reimbursement mechanisms for different types of services provided in the Company’s inpatient facilities and cost settlement provisions. Management estimates the transaction price on a payor-specific basis given its interpretation of the applicable regulations or contract terms. The services authorized and provided and related reimbursement are often subject to interpretation that could result in payments that differ from the Company’s estimates. Additionally, updated regulations and contract renegotiations occur frequently, necessitating regular review and assessment of the estimation process by management.

Settlements under cost reimbursement agreements with third-party payors are estimated and recorded in the period in which the related services are rendered and are adjusted in future periods as final settlements are determined. Final determination of amounts earned under the Medicare and Medicaid programs often occurs in subsequent years because of audits by such programs, rights of appeal and the application of numerous technical provisions. In the opinion of management, adequate provision has been made for any adjustments and final settlements. However, there can be no assurance that any such adjustments and final settlements will not have a material effect on the Company’s financial condition or results of operations. The Company’s cost report receivables were $10.3 million and $9.0 million for the years ended December 31, 2018 and 2017, respectively, and were included in other current assets in the consolidated balance sheets. Management believes that these receivables are properly stated and are not likely to be settled for a significantly different amount. The net adjustments to estimated cost report settlements resulted in increases to revenue of $0.5 million, $0.2 million and $0.7 million for the years ended December 31, 2018, 2017 and 2016, respectively.

The Company provides care without charge to patients who are financially unable to pay for the healthcare services they receive based on Company policies and federal and state poverty thresholds. Such amounts determined to qualify as charity care are not reported as revenue. The cost of providing charity care services were $4.7 million, $5.3 million and $5.6 million for the years ended December 31, 2018, 2017 and 2016, respectively. The estimated cost of charity care services was determined using a ratio of cost to gross charges determined from our most recently filed Medicare cost reports and applying that ratio to the gross charges associated with providing charity care for the period.

The following table presents revenue by payor type and as a percentage of revenue in our U.S. Facilities for the years ended December 31, 2018, 2017 and 2016 (in thousands):

	Year Ended December 31,
	2018					2017						2016
	Amount		%			Amount			%			Amount			%
Commercial	$	573,089		30.1	%	$	569,242			30.8	%	$	534,468			30.7	%
Medicare		280,340		14.7	%		281,270			15.2	%		266,868			15.3	%
Medicaid		893,644		46.9	%		796,375			43.0	%		725,508			41.7	%
Self-Pay		134,054		7.1	%		169,727			9.2	%		185,094			10.6	%
Other		23,568		1.2	%		33,942			1.8	%		28,418			1.7	%
Revenue before provision for doubtful accounts		1,904,695		100.0	%		1,850,556			100.0	%		1,740,356			100.0	%
Provision for doubtful accounts		—					(40,712	)					(41,831	)
Revenue	$	1,904,695				$	1,809,844					$	1,698,525

U.K. Facilities

The Company’s U.K. Facilities and services provided by the U.K. Facilities can generally be classified into the following categories: healthcare facilities, education and children’s services, adult care facilities and elderly care facilities.

Healthcare facilities. Healthcare facilities provide psychiatric treatment and nursing for sufferers of mental disorders, including for patients whose risk of harm to others and risk of escape from hospitals cannot be managed safely within other mental health settings. In order to manage the risks involved with treating patients, the facility is managed through the application of a range of security measures depending on the level of dependency and risk exhibited by the patient.

Education and children’s services. Education and children’s services provide specialist education for children and young people with special educational needs, including autism, Asperger’s Syndrome, social, emotional and mental health, and specific learning difficulties, such as dyslexia. The division also offers standalone children’s homes for children that require 52-week residential care to support complex and challenging behavior and fostering services.

Adult care facilities. Adult care focuses on care of individuals with a variety of learning difficulties, mental health illnesses and adult autism spectrum disorders. It also includes long-term, short-term and respite nursing care to high-dependency elderly individuals who are physically frail or suffering from dementia. Care is provided in a number of settings, including in residential care homes and through supported living.

The table below presents total U.K. revenue attributed to each category (in thousands):

	Year Ended December 31,
	2018		2017		2016
Healthcare facilities	$	615,741	$	567,747	$	683,467
Education and Children’s Services		192,129		170,328		146,703
Adult Care facilities		299,877		288,397		280,191
Revenue	$	1,107,747	$	1,026,472	$	1,110,361

The Company receives payments from approximately 500 public funded sources in the U.K. (including the National Health Service (“NHS”), Clinical Commissioning Groups (“CCGs”) and local authorities in England, Scotland and Wales) and individual patients and clients. The Company determines the transaction price based on established billing rates by payor and is reduced by implicit price concessions. Implicit price concessions are insignificant in our U.K. Facilities. There is no significant variable consideration in our U.K. Facilities’ contracts. As the period between the time of service and time of payment is typically one year or less, the Company elected the practical expedient under ASC 606-10-32-18 and did not adjust for the effects of a significant financing component.

The following table presents revenue by payor type and as a percentage of revenue in our U.K. Facilities for the years ended December 31, 2018, 2017 and 2016 (in thousands):

	Year Ended December 31,
	2018					2017						2016
	Amount		%			Amount			%			Amount			%
U.K. public funded sources	$	1,000,828		90.3	%	$	922,159			89.8	%	$	1,021,888			92.0	%
Self-Pay		104,824		9.5	%		95,687			9.3	%		83,066			7.5	%
Other		2,095		0.2	%		8,832			0.9	%		5,485			0.5	%
Revenue before provision for doubtful accounts		1,107,747		100.0	%		1,026,678			100.0	%		1,110,439			100.0	%
Provision for doubtful accounts		—					(206	)					(78	)
Revenue	$	1,107,747				$	1,026,472					$	1,110,361

The Company’s contract liabilities primarily consist of unearned revenue in our U.K. Facilities due to the timing of payments received mainly in our education and children’s services and healthcare facilities. Contract liabilities are included in other accrued liabilities on the consolidated balance sheets. A summary of the activity in unearned revenue in the U.K. Facilities is as follows (in thousands):

Balance at December 31, 2017	$	30,812
Payments received		167,604
Revenue recognized		(164,917	)
Foreign currency translation loss		(2,260	)
Balance at December 31, 2018	$	31,239

Earnings Per Share

12 Months Ended

Dec. 31, 2018

Earnings Per Share [Abstract]

Earnings Per Share

4. Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the years ended December 31, 2018, 2017 and 2016 (in thousands except per share amounts):

	Year Ended December 31,
	2018			2017		2016
Numerator:
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(175,750	)	$	199,835	$	6,143
Denominator:
Weighted average shares outstanding for basic earnings per share		87,288			86,948		85,701
Effects of dilutive instruments		—			112		271
Shares used in computing diluted earnings per common share		87,288			87,060		85,972
Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$	(2.01	)	$	2.30	$	0.07
Diluted	$	(2.01	)	$	2.30	$	0.07

For the year ended December 31, 2018, approximately 0.1 million of the outstanding restricted stock and shares of common stock issuable upon exercise of outstanding stock option awards have been excluded from the calculation of diluted earnings per share because the net loss for the year ended December 31, 2018 causes such securities to be anti-dilutive. Approximately 1.9 million, 1.4 million and 1.1 million shares of common stock issuable upon exercise of outstanding stock options were excluded from the calculation of diluted earnings per share for the years ended December 31, 2018, 2017 and 2016, respectively, because their effect would have been anti-dilutive.

Acquisitions

12 Months Ended

Dec. 31, 2018

Business Combinations [Abstract]

Acquisitions

5. Acquisitions

The Company’s strategy is to acquire and develop behavioral healthcare facilities and improve operating results within its facilities and its other behavioral healthcare operations.

2019 Acquisitions

On February 15, 2019, the Company completed the acquisition of Whittier Pavilion (“Whittier”), an inpatient psychiatric facility with 71 beds located in Haverhill, Massachusetts, for cash consideration of approximately $17.9 million. Also on February 15, 2019, the Company completed the acquisition of Mission Treatment (“Mission Treatment”) for cash consideration of approximately $22.5 million and a working capital settlement. Mission Treatment operates nine comprehensive treatment centers in California, Nevada, Arizona and Oklahoma.

2017 Acquisition

On November 13, 2017, we completed the acquisition of Aspire Scotland, an education facility with 36 beds located in Scotland, for cash consideration of approximately $21.3 million.

2016 U.S. Acquisitions

On June 1, 2016, the Company completed the acquisition of Pocono Mountain Recovery Center (“Pocono Mountain”), an inpatient psychiatric facility with 108 beds located in Henryville, Pennsylvania, for cash consideration of approximately $25.4 million.

On May 1, 2016, the Company completed the acquisition of TrustPoint Hospital (“TrustPoint”), an inpatient psychiatric facility with 100 beds located in Murfreesboro, Tennessee, for cash consideration of approximately $62.7 million.

On April 1, 2016, the Company completed the acquisition of Serenity Knolls (“Serenity Knolls”), an inpatient psychiatric facility with 30 beds located in Forest Knolls, California, for cash consideration of approximately $10.0 million.

Priory

On February 16, 2016, the Company completed the acquisition of Priory Group No. 1 Limited (“Priory”) for a total purchase price of approximately $2.2 billion, including cash consideration of approximately $1.9 billion and the issuance of 4,033,561 shares of its common stock to shareholders of Priory. Priory was the leading independent provider of behavioral healthcare services in the U.K. operating 324 facilities with approximately 7,100 beds at February 16, 2016.

The Competition and Markets Authority (the “CMA”) in the U.K. reviewed the Company’s acquisition of Priory. On July 14, 2016, the CMA announced that the Company’s acquisition of Priory was referred for a phase 2 investigation unless the Company offered acceptable undertakings to address the CMA’s competition concerns relating to the provision of behavioral healthcare services in certain markets. On July 28, 2016, the CMA announced that the Company had offered undertakings to address the CMA’s concerns and that, in lieu of a phase 2 investigation, the CMA would consider the Company’s undertakings.

On October 18, 2016, the Company signed a definitive agreement with BC Partners (“BC Partners”) for the sale of 21 existing U.K. behavioral health facilities and one de novo behavioral health facility with an aggregate of approximately 1,000 beds (collectively, the “U.K. Disposal Group”). On November 10, 2016, the CMA accepted the Company’s undertakings to sell the U.K. Disposal Group to BC Partners and confirmed that the divestiture satisfied the CMA’s concerns about the impact of the Company’s acquisition of Priory on competition for the provision of behavioral healthcare services in certain markets in the U.K. As a result of the CMA’s acceptance of the undertakings, the Company’s acquisition of Priory was not referred for a phase 2 investigation. On November 30, 2016, the Company completed the sale of the U.K. Disposal Group to BC Partners for £320 million cash (the “U.K. Divestiture”).

In conjunction with the sale, the Company recorded a loss on divestiture of $175.0 million in the consolidated statements of operations for the year ended December 31, 2016. The loss on divestiture consisted of an allocation of goodwill to the U.K. Disposal Group of $106.9 million, loss on the sale of properties of $42.0 million and estimated transaction-related expenses of $26.1 million. The allocation of goodwill was based on the fair value of the U.K. Disposal Group relative to the total fair value of the Company’s U.K. Facilities segment.

The consolidated statements of operations for the year ended December 31, 2016 include revenue of $154.7 million and income before income taxes of $81.2 million related to the U.K. Disposal Group excluding the loss on divestiture.

Transaction-related expenses

Transaction-related expenses represent costs primarily related to our acquisitions and related integration efforts and, for 2018, to the Chief Executive Officer (“CEO”) transition. In December 2018, Mr. Joey A. Jacobs was removed from his positions as CEO and Chairman of the Board of directors (the “Board”) of the Company. Also in December 2018, Ms. Debra K. Osteen was elected by the Board to serve as the Company’s CEO. In connection with this CEO transition, the Company recorded a charge of $14.0 million, which was comprised of cash payments to Mr. Jacobs of $8.1 million, the accelerated vesting of Mr. Jacobs’ restricted stock awards of $5.0 million, a cash payment to Ms. Osteen of $0.4 million and other costs of $0.5 million. CEO transition costs of $14.0 million were recorded in transaction-related expenses in the consolidated statements of operations.

Transaction-related expenses comprised the following costs for the years ended years ended December 31, 2018, 2017 and 2016 (in thousands):

	Year Ended December 31,
	2018		2017		2016
CEO transition costs	$	14,033	$	—	$	—
Termination and closure costs		11,829		16,190		15,449
Legal, accounting and other		8,645		8,077		18,024
Advisory and financing commitment fees		—		—		14,850
	$	34,507	$	24,267	$	48,323

Other Intangible Assets

12 Months Ended

Dec. 31, 2018

Goodwill And Intangible Assets Disclosure [Abstract]

Other Intangible Assets

6. Other Intangible Assets

Other identifiable intangible assets and related accumulated amortization consisted of the following at December 31, 2018 and 2017 (in thousands):

	Gross Carrying Amount				Accumulated Amortization
	December 31, 2018		December 31, 2017		December 31, 2018			December 31, 2017
Intangible assets subject to amortization:
Contract intangible assets	$	2,100	$	2,100	$	(2,100	)	$	(2,100	)
Non-compete agreements		1,147		1,147		(1,147	)		(1,147	)
		3,247		3,247		(3,247	)		(3,247	)
Intangible assets not subject to amortization:
Licenses and accreditations		12,343		12,266		—			—
Trade names		60,109		60,586		—			—
Certificates of need		16,538		14,496		—			—
		88,990		87,348		—			—
Total	$	92,237	$	90,595	$	(3,247	)	$	(3,247	)

All the Company’s definite-lived intangible assets are fully amortized. The Company’s licenses and accreditations, trade names and certificate of need intangible assets have indefinite lives and are, therefore, not subject to amortization.

Long-Term Debt

12 Months Ended

Dec. 31, 2018

Debt Disclosure [Abstract]

Long-Term Debt

7. Long-Term Debt

Long-term debt consisted of the following (in thousands):

	December 31, 2018			December 31, 2017
Amended and Restated Senior Credit Facility:
Senior Secured Term A Loans	$	365,750		$	380,000
Senior Secured Term B Loans		1,372,912			1,398,400
Senior Secured Revolving Line of Credit		—			—
6.125% Senior Notes due 2021		150,000			150,000
5.125% Senior Notes due 2022		300,000			300,000
5.625% Senior Notes due 2023		650,000			650,000
6.500% Senior Notes due 2024		390,000			390,000
9.0% and 9.5% Revenue Bonds		—			21,920
Other long-term debt		5,953			—
Less: unamortized debt issuance costs, discount and premium		(41,128	)		(50,432	)
		3,193,487			3,239,888
Less: current portion		(34,112	)		(34,830	)
Long-term debt	$	3,159,375		$	3,205,058

Amended and Restated Senior Credit Facility

The Company entered into a senior secured credit facility (the “Senior Secured Credit Facility”) on April 1, 2011. On December 31, 2012, the Company entered into an Amended and Restated Credit Agreement (the “Amended and Restated Credit Agreement”) which amended and restated the Senior Secured Credit Facility (the “Amended and Restated Senior Credit Facility”). The Company has amended the Amended and Restated Credit Agreement from time to time as described in the Company’s prior filings with the SEC.

On May 10, 2017, the Company entered into a Third Repricing Amendment (the “Third Repricing Amendment”) to the Amended and Restated Credit Agreement. The Third Repricing Amendment reduced the Applicable Rate with respect to the Term Loan B facility Tranche B-1 (the “Tranche B-1 Facility”) and the Term Loan B facility Tranche B-2 (the “Tranche B-2 Facility”) from 3.00% to 2.75% in the case of Eurodollar Rate loans and from 2.00% to 1.75% in the case of Base Rate Loans. In connection with the Third Repricing Amendment, the Company recorded a debt extinguishment charge of $0.8 million, including the discount and write-off of deferred financing costs, which was recorded in debt extinguishment costs in the consolidated statements of operations.

On March 22, 2018, the Company entered into a Second Repricing Facilities Amendment (the “Second Repricing Facilities Amendment”) to the Amended and Restated Credit Agreement. The Second Repricing Facilities Amendment (i) replaced the Tranche B-1 Facility and the Tranche B-2 Facility with a new Term Loan B facility Tranche B-3 (the “Tranche B-3 Facility”) and a new Term Loan B facility Tranche B-4 (the “Tranche B-4 Facility”), respectively, and (ii) reduced the Applicable Rate from 2.75% to 2.50% in the case of Eurodollar Rate loans and reduced the Applicable Rate from 1.75% to 1.50% in the case of Base Rate Loans.

On March 29, 2018, the Company entered into a Third Repricing Facilities Amendment to the Amended and Restated Credit Agreement (the “Third Repricing Facilities Amendment”, and together with the Second Repricing Facilities Amendment, the “Repricing Facilities Amendments”). The Third Repricing Facilities Amendment replaced the existing revolving credit facility and Term Loan A facility (“TLA Facility”) with a new revolving credit facility and TLA Facility, respectively. The Company’s line of credit on its revolving credit facility remains at $500.0 million and the Third Repricing Facility Amendment reduced the size of the TLA Facility from $400.0 million to $380.0 million to reflect the then current outstanding principal. The Third Repricing Facilities Amendment reduced the Applicable Rate by 25 basis points for the revolving credit facility and the TLA Facility by amending the definition of “Applicable Rate.”

In connection with the Repricing Facilities Amendments, the Company recorded a debt extinguishment charge of $0.9 million, including the discount and write-off of deferred financing costs, which was recorded in debt extinguishment costs in the consolidated statements of operations.

On February 6, 2019, the Company entered into the Eleventh Amendment (the “Eleventh Amendment”) to the Amended and Restated Credit Agreement. The Eleventh Amendment, among other things, amended the definition of “Consolidated EBITDA” to remove the cap on non-cash charges, losses and expenses related to the impairment of goodwill, which in turn provided increased flexibility to the Company in terms of the Company’s financial covenants.

On February 27, 2019, the Company entered into the Twelfth Amendment (the “Twelfth Amendment”) to the Amended and Restated Credit Agreement. The Twelfth Amendment, among other things, modified certain definitions, including “Consolidated EBITDA”, and increased our permitted Maximum Consolidated Leverage Ratio, thereby providing increased flexibility to the Company in terms of the Company’s financial covenants.

The Company had $486.7 million of availability under the revolving line of credit and had standby letters of credit outstanding of $13.3 million related to security for the payment of claims required by its workers’ compensation insurance program at December 31, 2018. Borrowings under the revolving line of credit are subject to customary conditions precedent to borrowing. The Amended and Restated Credit Agreement requires quarterly term loan principal repayments of our TLA Facility of $4.8 million for March 31, 2019 to December 31, 2019, $7.1 million for March 31, 2020 to December 31, 2020, and $9.5 million for March 31, 2021 to September 30, 2021, with the remaining principal balance of the TLA Facility due on the maturity date of November 30, 2021. The Company is required to repay the Tranche B-3 Facility in equal quarterly installments of $1.2 million on the last business day of each March, June, September and December, with the outstanding principal balance of the Tranche B-3 Facility due on February 11, 2022. The Company is required to repay the Tranche B-4 Facility in equal quarterly installments of approximately $2.3 million on the last business day of each March, June, September and December, with the outstanding principal balance of the Tranche B-4 Facility due on February 16, 2023. On December 29, 2017, the Company made an additional payment of $22.5 million, including $7.7 million on the Tranche B-1 Facility and $14.8 million on the Tranche B-2 Facility. On April 17, 2018, the Company made an additional payment of $15.0 million, including $5.1 million on the Tranche B-3 Facility and $9.9 million on the Tranche B-4 Facility.

Borrowings under the Amended and Restated Senior Credit Facility are guaranteed by each of the Company’s wholly-owned domestic subsidiaries (other than certain excluded subsidiaries) and are secured by a lien on substantially all of the assets of the Company and such subsidiaries. Borrowings with respect to the TLA Facility and the Company’s revolving credit facility (collectively, “Pro Rata Facilities”) under the Amended and Restated Credit Agreement bear interest at a rate tied to Acadia’s Consolidated Leverage Ratio (defined as consolidated funded debt net of up to $50.0 million of unrestricted and unencumbered cash to consolidated EBITDA, in each case as defined in the Amended and Restated Credit Agreement). The Applicable Rate (as defined in the Amended and Restated Credit Agreement) for the Pro Rata Facilities was 2.5% for Eurodollar Rate Loans (as defined in the Amended and Restated Credit Agreement) and 1.5% for Base Rate Loans (as defined in the Amended and Restated Credit Agreement) at December 31, 2018. Eurodollar Rate Loans with respect to the Pro Rata Facilities bear interest at the Applicable Rate plus the Eurodollar Rate (as defined in the Amended and Restated Credit Agreement) (based upon the LIBOR Rate (as defined in the Amended and Restated Credit Agreement) prior to commencement of the interest rate period). Base Rate Loans with respect to the Pro Rata Facilities bear interest at the Applicable Rate plus the highest of (i) the federal funds rate plus 0.50%, (ii) the prime rate and (iii) the Eurodollar Rate plus 1.0%. At December 31, 2018, the Pro Rata Facilities bore interest at a rate of LIBOR plus 2.5%. In addition, the Company is required to pay a commitment fee on undrawn amounts under the revolving line of credit.

The Amended and Restated Credit Agreement requires the Company and its subsidiaries to comply with customary affirmative, negative and financial covenants, including a fixed charge coverage ratio, consolidated leverage ratio and senior secured leverage ratio. The Company may be required to pay all of its indebtedness immediately if it defaults on any of the numerous financial or other restrictive covenants contained in any of its material debt agreements. The Company was in compliance with such covenants.

Senior Notes

6.125% Senior Notes due 2021

On March 12, 2013, the Company issued $150.0 million of 6.125% Senior Notes due 2021 (the “6.125% Senior Notes”). The 6.125% Senior Notes mature on March 15, 2021 and bear interest at a rate of 6.125% per annum, payable semi-annually in arrears on March 15 and September 15 of each year.

5.125% Senior Notes due 2022

On July 1, 2014, the Company issued $300.0 million of 5.125% Senior Notes due 2022 (the “5.125% Senior Notes”). The 5.125% Senior Notes mature on July 1, 2022 and bear interest at a rate of 5.125% per annum, payable semi-annually in arrears on January 1 and July 1 of each year.

5.625% Senior Notes due 2023

On February 11, 2015, the Company issued $375.0 million of 5.625% Senior Notes due 2023 (the “5.625% Senior Notes”). On September 21, 2015, the Company issued $275.0 million of additional 5.625% Senior Notes. The additional notes formed a single class of debt securities with the 5.625% Senior Notes issued in February 2015. Giving effect to this issuance, the Company has outstanding an aggregate of $650.0 million of 5.625% Senior Notes. The 5.625% Senior Notes mature on February 15, 2023 and bear interest at a rate of 5.625% per annum, payable semi-annually in arrears on February 15 and August 15 of each year.

6.500% Senior Notes due 2024

On February 16, 2016, the Company issued $390.0 million of 6.500% Senior Notes due 2024 (the “6.500% Senior Notes”). The 6.500% Senior Notes mature on March 1, 2024 and bear interest at a rate of 6.500% per annum, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2016.

The indentures governing the 6.125% Senior Notes, 5.125% Senior Notes, 5.625% Senior Notes and 6.500% Senior Notes (together, the “Senior Notes”) contain covenants that, among other things, limit the Company’s ability and the ability of its restricted subsidiaries to: (i) pay dividends, redeem stock or make other distributions or investments; (ii) incur additional debt or issue certain preferred stock; (iii) transfer or sell assets; (iv) engage in certain transactions with affiliates; (v) create restrictions on dividends or other payments by the restricted subsidiaries; (vi) merge, consolidate or sell substantially all of the Company’s assets; and (vii) create liens on assets.

The Senior Notes issued by the Company are guaranteed by each of the Company’s subsidiaries that guarantee the Company’s obligations under the Amended and Restated Senior Credit Facility. The guarantees are full and unconditional and joint and several.

The Company may redeem the Senior Notes at its option, in whole or part, at the dates and amounts set forth in the indentures.

9.0% and 9.5% Revenue Bonds

On November 11, 2012, in connection with the acquisition of The Pavilion at HealthPark, LLC (“Park Royal”), the Company assumed debt of $23.0 million. The fair market value of the debt assumed was $25.6 million and resulted in a debt premium balance being recorded as of the acquisition date. The debt consisted of $7.5 million and $15.5 million of Lee County (Florida) Industrial Development Authority Healthcare Facilities Revenue Bonds, Series 2010 with stated interest rates of 9.0% and 9.5% (“9.0% and 9.5% Revenue Bonds”), respectively.

On December 1, 2018, the Company exercised the option to redeem in whole the 9.0% and 9.5% Revenue Bonds at a redemption price equal to the sum of 104% of the principal amount of the 9.0% and 9.5% Revenue Bonds plus accrued and unpaid interest. In connection with the redemption of the 9.0% and 9.5% Revenue Bonds, the Company recorded a debt extinguishment charge of $0.9 million, which was recorded in debt extinguishment costs in the consolidated statements of operations.

The 9.0% bonds in the amount of $7.5 million had a maturity date of December 1, 2030 and required yearly principal payments beginning in 2013. The 9.5% bonds in the amount of $15.5 million had a maturity date of December 1, 2040 and required yearly principal payments beginning in 2031. The principal payments established a bond sinking fund to be held with the trustee and shall be sufficient to redeem the principal amounts of the 9.0% and 9.5% Revenue Bonds on their respective maturity dates. At December 31, 2017, $2.3 million was recorded within other assets on the consolidated balance sheets related to the debt service reserve fund requirements. The yearly principal payments, which established a bond sinking fund, will increase the debt service reserve fund requirements. The bond premium amount of $2.6 million was amortized as a reduction of interest expense over the life of the revenue bonds using the effective interest method.

Debt Issuance Costs

Debt issuance costs are deferred and amortized to interest expense over the term of the related debt. Debt issuance costs at December 31, 2018 were $37.8 million, net of accumulated amortization of $36.5 million. Debt issuance costs at December 31, 2017 were $46.5 million, net of accumulated amortization of $27.5 million. Amortization expense related to debt issuance costs, which is included in interest expense on the consolidated statements of operations, was $9.0 million, $8.6 million and $8.6 million, respectively, for the years ended December 31, 2018, 2017 and 2016.

Other

The aggregate maturities of long-term debt at December 31, 2018 were as follows (in thousands):

2019	$	34,112
2020		43,679
2021		483,501
2022		764,855
2023		1,518,468
Thereafter		390,000
Total	$	3,234,615

Equity

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Equity

8. Equity

Preferred Stock

The Company’s amended and restated certificate of incorporation provides that up to 10,000,000 shares of preferred stock may be issued. The Board of Directors has the authority to issue preferred stock in one or more series and to fix for each series the voting powers (full, limited or none), and the designations, preferences and relative participating, optional or other special rights and qualifications, limitations or restrictions on the stock and the number of shares constituting any series and the designations of this series, without any further vote or action by the stockholders.

Common Stock

The Company’s amended and restated certificate of incorporation provides that up to 180,000,000 shares of common stock may be issued. Holders of the Company’s common stock are entitled to one vote for each share held of record on all matters on which stockholders may vote. There are no preemptive, conversion, redemption or sinking fund provisions applicable to shares of the Company’s common stock. In the event of liquidation, dissolution or winding up, holders of the Company’s common stock are entitled to share ratably in the assets available for distribution, subject to any prior rights of any holders of preferred stock then outstanding. Delaware law prohibits the Company from paying any dividends unless it has capital surplus or net profits available for this purpose. In addition, the Amended and Restated Senior Credit Facility imposes restrictions on the Company’s ability to pay dividends.

Equity-Based Compensation

12 Months Ended

Dec. 31, 2018

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Equity-Based Compensation

9. Equity-Based Compensation

Equity Incentive Plans

The Company issues stock-based awards, including stock options, restricted stock and restricted stock units, to certain officers, employees and non-employee directors under the Acadia Healthcare Company, Inc. Incentive Compensation Plan (the “Equity Incentive Plan”). At December 31, 2018, a maximum of 8,200,000 shares of the Company’s common stock were authorized for issuance as stock options, restricted stock and restricted stock units or other share-based compensation under the Equity Incentive Plan, of which 3,261,276 were available for future grant. Stock options may be granted for terms of up to ten years. The Company recognizes expense on all share-based awards on a straight-line basis over the requisite service period of the entire award. Grants to employees generally vest in annual increments of 25% each year, commencing one year after the date of grant. The exercise prices of stock options are equal to the closing price of the Company’s common stock on the most recent trading date prior to the date of grant.

The Company recognized $22.0 million, $23.5 million and $28.3 million in equity-based compensation expense for the years ended December 31, 2018, 2017 and 2016, respectively. Stock compensation expense for the years ended December 31, 2018 and 2017 included forfeiture adjustments and restricted stock unit adjustments based on actual performance compared to vesting targets of $(5.5) million and $(5.7) million, respectively. At December 31, 2018, there was $34.7 million of unrecognized compensation expense related to unvested options, restricted stock and restricted stock units, which is expected to be recognized over the remaining weighted average vesting period of 1.2 years.

At December 31, 2018, there were no warrants outstanding and exercisable. The Company recognized a deferred income tax benefit of $7.0 million and $9.2 million for the years ended December 31, 2018 and 2017, respectively, related to equity-based compensation expense.

Stock Options

Stock option activity during 2016, 2017 and 2018 was as follows (aggregate intrinsic value in thousands):

	Number of Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (in years)		Aggregate Intrinsic Value
Options outstanding at January 1, 2016		694,743		$	42.87		7.70	$	20,717
Options granted		503,850			57.98		9.28		297
Options exercised		(57,397	)		31.92	N/A			1,530
Options cancelled		(140,250	)		57.13	N/A		N/A
Options outstanding at December 31, 2016		1,000,946			48.42		7.46		8,166
Options granted		259,300			42.25		9.30		205
Options exercised		(87,367	)		25.92	N/A			1,636
Options cancelled		(198,313	)		54.71	N/A		N/A
Options outstanding at December 31, 2017		974,566			47.89		7.46		3,802
Options granted		374,700			37.54		9.21		246
Options exercised		(20,989	)		17.83	N/A			383
Options cancelled		(128,737	)		50.83	N/A		N/A
Options outstanding at December 31, 2018		1,199,540		$	44.64		7.26	$	2,717
Options exercisable at December 31, 2017		405,634		$	41.20		6.05	$	3,549
Options exercisable at December 31, 2018		534,164		$	44.98		5.73	$	2,386

Fair values are estimated using the Black-Scholes option pricing model. The following table summarizes the grant-date fair value of options and the assumptions used to develop the fair value estimates for options granted during the years ended December 31, 2018, 2017 and 2016:

	Year Ended December 31,
	2018			2017			2016
Weighted average grant-date fair value of options	$	13.67		$	14.39		$	18.96
Risk-free interest rate		2.2	%		2.0	%		1.4	%
Expected volatility		37	%		33	%		33	%
Expected life (in years)		5.1			5.5			5.5

The Company’s estimate of expected volatility for stock options is based upon the volatility of our stock price over the expected life of the award. The risk-free interest rate is the approximate yield on U. S. Treasury Strips having a life equal to the expected option life on the date of grant. The expected life is an estimate of the number of years an option will be held before it is exercised.

Other Stock-Based Awards

Restricted stock activity during 2016, 2017 and 2018 was as follows:

	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2016		944,562		$	52.74
Granted		387,347			55.38
Cancelled		(122,178	)		57.02
Vested		(365,312	)		47.18
Unvested at December 31, 2016		844,419		$	55.76
Granted		404,224			42.38
Cancelled		(145,981	)		55.03
Vested		(292,794	)		53.07
Unvested at December 31, 2017		809,868		$	50.19
Granted		480,137			36.84
Cancelled		(88,989	)		47.57
Vested		(395,959	)		50.41
Unvested at December 31, 2018		805,057		$	42.40

Restricted stock unit activity during 2016, 2017 and 2018 was as follows:

	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2016		218,084		$	56.97
Granted		230,750			56.95
Cancelled		—			—
Vested		(175,235	)		52.71
Unvested at December 31, 2016		273,599		$	59.68
Granted		219,840			43.23
Cancelled		—			—
Vested		(132,530	)		58.67
Unvested at December 31, 2017		360,909		$	50.04
Granted		285,358			42.26
Cancelled		(89,173	)		55.44
Vested		(72,983	)		49.64
Unvested at December 31, 2018		484,111		$	44.52

Restricted stock awards are time-based vesting awards that vest over a period of three or four years and are subject to continuing service of the employee or non-employee director over the ratable vesting periods. The fair values of the restricted stock awards were determined based on the closing price of the Company’s common stock on the trading date immediately prior to the grant date.

Restricted stock units are granted to employees and are subject to Company performance compared to pre-established targets and, in the case of the 2018 awards, Company performance compared to peers. In addition to Company performance, these performance-based restricted stock units are subject to the continuing service of the employee during the two- or three-year period covered by the awards. The performance condition for the restricted stock units is based on the Company’s achievement of annually established targets for diluted earnings per share. Additionally, the number of shares issuable pursuant to restricted stock units granted during 2018 is subject to adjustment based on the Company’s three-year annualized total stockholder return relative to a peer group consisting of S&P 1500 companies within the Healthcare Providers & Services 6 digit GICS industry group and selected other companies deemed to be peers. The number of shares issuable at the end of the applicable vesting period of restricted stock units ranges from 0% to 200% of the targeted units based on the Company’s actual performance compared to the targets and, for 2018 awards, performance compared to peers.

The fair values of restricted stock units were determined based on the closing price of the Company’s common stock on the trading date immediately prior to the grant date for units subject to performance conditions, or at its Monte-Carlo simulation value for units subject to market conditions.

Income Taxes

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Income Taxes

10. Income Taxes

Provision for income taxes consists of the following for the periods presented (in thousands):

	Year Ended December 31,
	2018			2017			2016
Current:
Federal	$	13,961		$	3,325		$	572
State		1,113			680			(863	)
Foreign		1,172			1,832			423
Total current		16,246			5,837			132
Deferred:
Federal		(7,176	)		27,179			45,077
State		(10	)		4,408			1,491
Foreign		(2,528	)		(215	)		(17,921	)
Total deferred provision		(9,714	)		31,372			28,647
Provision for income taxes	$	6,532		$	37,209		$	28,779

A reconciliation of the U.S. federal statutory rate to the effective tax rate is as follows for the periods presented:

	Year Ended December 31,
	2018			2017			2016
U.S. federal statutory rate on income before income taxes		21.0	%		35.0	%		35.0	%
Impact of foreign operations		9.5			(14.1	)		(13.5	)
Impact of foreign divestiture		—			—			39.2
Impacts of SAB 118		6.7			—			—
Effects of statutory rate change		—			(8.5	)		(14.5	)
State income taxes, net of federal tax effect		(1.4	)		2.1			7.5
Permanent differences		(4.1	)		1.8			8.3
Goodwill impairment		(36.6	)		—			—
Transaction-related items		—			—			25.9
Change in valuation allowance		(1.4	)		1.6			2.8
Unrecognized tax benefit release		3.1			(0.8	)		(7.2	)
Interest disallowance		(2.2	)		—			—
Federal tax credits		1.0			—			—
Other		0.5			(1.4	)		3.8
Effective income tax rate		(3.9	)%		15.7	%		87.3	%

The domestic and foreign components of income (loss) before income taxes are as follows (in thousands):

	Year Ended December 31,
	2018			2017		2016
Foreign	$	(228,350	)	$	120,905	$	(144,717	)
Domestic		59,396			115,893		177,672
Total	$	(168,954	)	$	236,798	$	32,955

The tax effects of temporary differences that give rise to significant portions of the deferred tax assets and liabilities of the Company at December 31, 2018 and December 31, 2017 were as follows (in thousands):

	December 31,
	2018			2017
Deferred tax assets:
Net operating losses and tax credit carryforwards – federal and state	$	27,294		$	29,409
Bad debt allowance		898			827
Accrued compensation and severance		15,229			14,179
Pension reserves		595			1,494
Insurance reserves		13,994			13,483
Leases		5,374			5,332
Accrued expenses		4,231			3,114
Interest carryforwards		32,272			5,074
Other assets		2,284			1,747
Total gross deferred tax assets		102,171			74,659
Less: valuation allowance		(24,079	)		(21,155	)
Deferred tax assets		78,092			53,504
Deferred tax liabilities:
Fixed asset basis difference		(48,698	)		(54,214	)
Prepaid items		(1,728	)		(1,490	)
Intangible assets		(87,628	)		(70,820	)
Accrued expenses		—			—
Other liabilities		(16,942	)		(3,582	)
Total deferred tax liabilities		(154,996	)		(130,106	)
Total net deferred tax liability	$	(76,904	)	$	(76,602	)

The Company records a valuation allowance to reduce its net deferred tax assets to the amount that is more likely than not to be realized. At December 31, 2018 and 2017, the Company carried a valuation allowance against deferred tax assets of $24.1 million and $21.2 million, respectively.

The Company had domestic net operating loss carryforwards at December 31, 2018 and 2017 of approximately $0.0 million and $12.2 million, respectively. The foreign net operating loss carryforwards at December 31, 2018 and 2017 are approximately $81.0 million and $93.9 million, respectively, and have no expiration.

The Company has state net operating loss carryforwards at December 31, 2018 and 2017 of approximately $236.0 million and $256.9 million, respectively. These net operating loss carryforwards, if not used to offset future taxable income, will expire from 2019 to 2037. In addition, the Company has certain state tax credits of $0.9 million which will begin to expire in 2028 if not utilized.

Income taxes receivable was $2.4 million and $15.1 million at December 31, 2018 and 2017, respectively, and was included in other current assets in the consolidated balance sheets. Income taxes payable of $3.0 million and $1.0 million at December 31, 2018 and 2017, respectively, was included in other accrued liabilities in the consolidated balance sheets.

The Company has recorded income taxes payable related to unrecognized tax benefits of $0.9 million and $6.4 million at December 31, 2018 and 2017, respectively, in other liabilities in the consolidated balance sheets. A reconciliation of the beginning and ending amount of unrecognized income tax benefits net of the federal benefit is as follows (in thousands):

	2018			2017
Balance at January 1	$	6,104		$	6,949
Additions based on tax positions related to the current year		52			5,488
Additions for tax positions of prior years		—			95
Reductions as a result of the lapse of applicable statutes of limitations and settlements with tax authorities		(5,443	)		(6,428	)
Balance at December 31	$	713		$	6,104

The Company recognizes interest and penalties related to unrecognized tax benefits in its consolidated balance sheets. At December 31, 2018 and 2017, the cumulative amounts recognized were $0.1 million and $0.1 million, respectively. It is possible the amount of unrecognized tax benefit could change in the next twelve months as a result of a lapse of the statute of limitations and settlements with taxing authorities; however, management does not anticipate the change will have a material impact on the Company’s consolidated financial statements.

The Company’s uncertain tax positions are related to tax years that remain subject to examination by the relevant taxing authorities. The Company and its subsidiaries file income tax returns in federal and in many state and local jurisdictions as well as foreign jurisdictions. The Company may be subject to examination by the Internal Revenue Service (“IRS”) for calendar year 2015 through 2017. Additionally, any net operating losses that were generated in prior years and utilized in these years may also be subject to examination by the IRS. In foreign jurisdictions, the Company may be subject to examination for calendar years 2014 through 2017. Generally, for state tax purposes, the Company’s 2012 through 2017 tax years remain open for examination by the tax authorities. At the date of this report there were no audits or inquires that had progressed sufficiently to predict their ultimate outcome.

One of the Company’s Puerto Rico subsidiaries was granted a tax exemption for which a tax credit of up to 15% of eligible payroll expenses is available to offset up to 50% of the income taxes attributed to that entity.

U.S. Tax Reform

On December 22, 2017, Public Law 115-97, informally referred to as The Tax Cuts and Jobs Act (the “Tax Act”) was enacted into law. The Tax Act provided for significant changes to the U.S. tax code that has impacted businesses. Effective January 1, 2018, the Tax Act reduced the U.S. federal tax rate for corporations from 35% to 21%, for U.S. taxable income. The Tax Act included other changes, including, but not limited to, a general elimination of U.S. federal income taxes on dividends from foreign subsidiaries, a new provision designed to tax global intangible low-taxed income, a limitation of the deduction for net operating losses, elimination of net operating loss carrybacks, immediate deductions for depreciation expense for certain qualified property, additional limitations on the deductibility of executive compensation and limitations on the deductibility of interest.

ASC 740 “Income Taxes” (“ASC 740”) requires the Company to recognize the effect of tax law changes in the period of enactment. However, the SEC staff issued Staff Accounting Bulletin 118 (“SAB 118”) which allowed the Company to record provisional amounts during a measurement period similar to the measurement period used when accounting for business combinations.

The Tax Act required a one-time remeasurement of deferred taxes to reflect their value at a lower tax rate of 21% and a one-time transition tax on certain repatriated earnings of foreign subsidiaries that is payable over eight years. At December 31, 2018, the Company has completed its accounting for the tax effects of the enactment of the Tax Act. At December 31, 2018, the Company has recorded a reduction in net deferred taxes of $20.6 million related to the remeasurement of its deferred tax balance. In addition, the Company has recorded a one-time transition tax liability in relation to its foreign subsidiaries of $0.0 million at December 31, 2018. The Company continues to assess the impact of the Tax Act on its business.

Deferred Tax Assets and Liabilities

The Company remeasured certain deferred tax assets and liabilities based on the rates at which they are expected to reverse in the future, which is generally 21%. As a result of the reduction in the corporate income tax rate, the Company was required to revalue its net deferred tax assets and liabilities to account for the future impact of lower corporate tax rates on this deferred amount and record any change in the value of such asset or liability as a one-time non-cash charge or benefit on its income statement. The Company recorded a reduction in net deferred taxes of $20.2 million as of December 31, 2017 and an additional reduction of $0.4 million as of December 31, 2018 for a total reduction in net deferred taxes of $20.6 million related to the remeasurement of its deferred tax balance.

U.S. Tax on Foreign Earnings

The one-time transition tax is based on total post-1986 earnings and profits that the Company previously deferred from U.S. income taxes. At December 31, 2018, the Company has completed the earnings and profits analysis for its foreign subsidiaries to calculate the effects of the one-time transition tax and has recorded a one-time transition tax liability amount of $0.0 million. As part of the analysis of the Tax Act, the Company made an adjustment regarding the treatment of foreign dividends of $10.9 million during the twelve months ended December 31, 2018. The change in the provisional estimate recorded at December 31, 2017 was recognized under the law that existed prior to December 22, 2017.

The Company has continued to analyze the impacts for Global Intangible Low-Taxed Income (“GILTI”), Foreign-Derived Intangible Income, the Base Erosion and Anti-Abuse Tax and any remaining impacts of the foreign income provisions of the Tax Act. At December 31, 2018, the Company has recorded a tax liability amount of $0.0 million relating to such items.

The Tax Act subjects a U.S. shareholder to tax on GILTI earned by certain foreign subsidiaries. The FASB Staff Q&A, Topic 740, No. 5, “Accounting for Global Intangible Low-Taxed Income”, states that an entity can make an accounting policy election to either recognize deferred taxes for temporary basis differences expected to reverse as GILTI in future years or to provide for the tax expense related to GILTI in the year the tax is incurred as a period expense only. The Company elects to account for GILTI in the year the tax is incurred.

Derivatives

12 Months Ended

Dec. 31, 2018

Derivative Instruments And Hedging Activities Disclosure [Abstract]

Derivatives

11. Derivatives

The Company entered into foreign currency forward contracts during the years ended December 31, 2018 and 2017 in connection with certain transfers of cash between the U.S. and U.K. under the Company’s cash management and foreign currency risk management programs. Foreign currency forward contracts limit the economic risk of changes in the exchange rate between US Dollars (“USD”) and British Pounds (“GBP”) associated with cash transfers.

In May 2016, the Company entered into multiple cross currency swap agreements with an aggregate notional amount of $650.0 million to manage foreign currency risk by effectively converting a portion of its fixed-rate USD-denominated senior notes, including the semi-annual interest payments thereunder, to fixed-rate GBP-denominated debt of £449.3 million. The senior notes effectively converted include $150.0 million aggregate principal amount of 6.125% Senior Notes, $300.0 million aggregate principal amount of 5.125% Senior Notes and $200.0 million aggregate principal amount of 5.625% Senior Notes. During the term of the swap agreements, the Company will receive semi-annual interest payments in USD from the counterparties at fixed interest rates, and the Company will make semi-annual interest payments in GBP to the counterparties at fixed interest rates. The interest payments under the cross-currency swap agreements result in £24.7 million of annual cash flows, from the Company’s U.K. business being converted to $35.8 million (at a 1.45 exchange rate).

The Company has designated the cross currency swap agreements and certain forward contracts entered into during 2017 and 2018 as qualifying hedging instruments and is accounting for these as net investment hedges. The fair value of these derivatives at December 31, 2018 and 2017 of $60.5 million and $13.0 million, respectively, are recorded as a derivative instruments asset on the consolidated balance sheets. The gains and losses resulting from fair value adjustments to the cross currency swap agreements are recorded in accumulated other comprehensive income as the swaps are effective in hedging the designated risk. Cash flows related to the cross currency swaps are included in operating activities in the consolidated statements of cash flows.

Fair Value Measurements

12 Months Ended

Dec. 31, 2018

Fair Value Disclosures [Abstract]

Fair Value Measurements

12. Fair Value Measurements

The carrying amounts reported for cash and cash equivalents, accounts receivable, other current assets, accounts payable and other current liabilities approximate fair value because of the short-term maturity of these instruments.

The carrying amounts and fair values of the Company’s Amended and Restated Senior Credit Facility, 6.125% Senior Notes, 5.125% Senior Notes, 5.625% Senior Notes, 6.500% Senior Notes, 9.0% and 9.5% Revenue Bonds, other long-term debt and derivative instruments at December 31, 2018 and 2017 were as follows (in thousands):

	Carrying Amount				Fair Value
	December 31,				December 31,
	2018		2017		2018		2017
Amended and Restated Senior Credit Facility	$	1,715,338	$	1,749,185	$	1,715,338	$	1,749,185
6.125% Senior Notes due 2021	$	148,657	$	148,098	$	147,542	$	150,134
5.125% Senior Notes due 2022	$	296,946	$	296,174	$	283,583	$	296,914
5.625% Senior Notes due 2023	$	643,289	$	641,891	$	609,516	$	651,519
6.500% Senior Notes due 2024	$	383,304	$	382,251	$	369,888	$	397,541
9.0% and 9.5% Revenue Bonds	$	—	$	22,289	$	—	$	22,289
Other long-term debt	$	5,953	$	—	$	5,953	$	—
Derivative instruments	$	60,524	$	12,997	$	60,524	$	12,997

The Company’s Amended and Restated Senior Credit Facility, 6.125% Senior Notes, 5.125% Senior Notes, 5.625% Senior Notes, 6.500% Senior Notes, 9.0% and 9.5% Revenue Bonds and other long-term debt were categorized as Level 2 in the GAAP fair value hierarchy. Fair values were based on trading activity among the Company’s lenders and the average bid and ask price as determined using published rates.

The fair values of the derivative instruments were categorized as Level 2 in the GAAP fair value hierarchy and were based on observable market inputs including applicable exchange rates and interest rates.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Leases

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Leases

13. Leases

The Company is obligated under certain operating leases to rent space for its facilities and other office space. The original terms of the leases typically range from five to 30 years, with optional renewal periods.

Aggregate minimum lease payments under non-cancelable operating leases with original or remaining lease terms in excess of one year were as follows at December 31, 2018 (in thousands):

2019	$	64,958
2020		61,704
2021		57,195
2022		51,570
2023		47,684
Thereafter		777,684
Total minimum rental obligations	$	1,060,795

During the years ended December 31, 2018, 2017 and 2016, rent expense was $80.3 million, $76.8 million and $73.3 million, respectively.

Commitments and Contingencies

12 Months Ended

Dec. 31, 2018

Commitments And Contingencies Disclosure [Abstract]

Commitments and Contingencies

14. Commitments and Contingencies

The Company is, from time to time, subject to various claims, lawsuits, governmental investigations and regulatory actions, including claims for damages for personal injuries, medical malpractice, overpayments, breach of contract, securities law violations, tort and employment related claims. In these actions, plaintiffs request a variety of damages, including, in some instances, punitive and other types of damages that may not be covered by insurance. In addition, healthcare companies are subject to numerous investigations by various governmental agencies. Certain of the Company’s individual facilities have received, and from time to time, other facilities may receive, subpoenas, civil investigative demands, audit requests and other inquiries from, and may be subject to investigation by, federal and state agencies. These investigations can result in repayment obligations, and violations of the False Claims Act can result in substantial monetary penalties and fines, the imposition of a corporate integrity agreement and exclusion from participation in governmental health programs. In addition, the federal False Claims Act permits private parties to bring qui tam, or “whistleblower,” suits against companies that submit false claims for payments to, or improperly retain overpayments from, the government. Some states have adopted similar state whistleblower and false claims provisions.

During the third quarter of 2018, the U.S. Attorney’s Office for the Southern District of West Virginia served subpoenas on seven of our comprehensive treatment centers located in West Virginia requesting various documents from January 2012 to present. The U.S. Attorney’s Office has advised us that the civil aspect of the investigation is a False Claims Act investigation focused on claims submitted by the centers for certain lab services. The Company is cooperating fully with the government’s investigation and has established a reserve of $19.0 million relating to the Company’s billing for lab services in West Virginia which was recorded in other accrued liabilities on the consolidated balance sheets and in legal settlements expense on the consolidated statements of operations. Changes in the reserve may be required in future periods as discussions with the government continue and additional information becomes available.

In the fall of 2017, the Department of Health and Human Services Office of Inspector General issued subpoenas to three of the Company’s facilities requesting certain documents from January 2013 to the date of the subpoenas. The U.S. Attorney’s Office for the Middle District of Florida issued a civil investigative demand to one of the Company’s facilities in December 2017 requesting certain documents from November 2012 to the date of the demand. The government’s investigation of these four facilities is focused on claims not eligible for payment because of alleged violations of certain regulatory requirements relating to, among other things, medical necessity, admission eligibility, discharge decisions, length of stay and patient care issues. The Company is cooperating with the government’s investigation but is not able to quantify any potential liability in connection with these investigations.

On January 15, 2019, the Company paid $3.1 million in connection with a class action lawsuit filed in 2011 on behalf of the shareholders of PHC, Inc. d/b/a Pioneer Behavioral Health (“PHC”) related to the merger of the Company with PHC. At December 31, 2018 $3.1 million was recorded in other accrued liabilities on the consolidated balance sheets and in legal settlements expense on the consolidated statements of operations.

Noncontrolling Interests

12 Months Ended

Dec. 31, 2018

Noncontrolling Interest [Abstract]

Noncontrolling Interests

15. Noncontrolling Interests

Noncontrolling interests in the consolidated financial statements represents the portion of equity held by noncontrolling partners in the Company’s non-wholly owned subsidiaries. At December 31, 2018, the Company operated four facilities and owns between 60% and 80% of the equity interests, and noncontrolling partners own the remaining equity interests. The initial value of the noncontrolling interests is based on the fair value of contributions, and the Company consolidates the operations of each facility based on its equity ownership and its control of the entity. The noncontrolling interests are reflected as redeemable noncontrolling interests on the accompanying consolidated balance sheets based on put rights that could require the Company to purchase the noncontrolling interests upon the occurrence of a change in control.

The components of redeemable noncontrolling interests are as follows (in thousands):

Balance at January 1, 2017	$	17,754
Acquisition of redeemable noncontrolling interests		4,909
Net loss attributable to noncontrolling interests		(246	)
Balance at December 31, 2017		22,417
Acquisition of redeemable noncontrolling interests		6,125
Net income attributable to noncontrolling interests		264
Balance at December 31, 2018	$	28,806

Segment Information

12 Months Ended

Dec. 31, 2018

Segment Reporting [Abstract]

Segment Information

16. Segment Information

The Company operates in one line of business, which is operating acute inpatient psychiatric facilities, specialty treatment facilities, residential treatment centers and facilities providing outpatient behavioral healthcare services. As management reviews the operating results of its U.S. Facilities and its U.K. Facilities separately to assess performance and make decisions, the Company’s operating segments include its U.S. Facilities and U.K. Facilities. At December 31, 2018, the U.S. Facilities included 213 behavioral healthcare facilities with approximately 9,300 beds in 40 states and Puerto Rico, and the U.K. Facilities included 370 behavioral healthcare facilities with approximately 8,800 beds in the U.K.

The following tables set forth the financial information by operating segment, including a reconciliation of Segment EBITDA to income before income taxes (in thousands):

	Year Ended December 31,
	2018			2017			2016
Revenue:
U.S. Facilities	$	1,904,695		$	1,809,844		$	1,698,525
U.K. Facilities		1,107,747			1,026,472			1,110,361
Corporate and Other		—			—			2,028
	$	3,012,442		$	2,836,316		$	2,810,914
Segment EBITDA (1) :
U.S. Facilities	$	488,207		$	475,260		$	443,341
U.K. Facilities		185,755			198,566			245,046
Corporate and Other		(80,386	)		(69,467	)		(79,797	)
	$	593,576		$	604,359		$	608,590

	Year Ended December 31,
	2018			2017			2016
Segment EBITDA(1)	$	593,576		$	604,359		$	608,590
Plus (less):
Equity-based compensation expense		(22,001	)		(23,467	)		(28,345	)
Debt extinguishment costs		(1,815	)		(810	)		(4,253	)
Legal settlements expense		(22,076	)		—			—
Loss on impairment		(337,889	)		—			—
Loss on divestiture		—			—			(178,809	)
Gain on foreign currency derivatives		—			—			523
Transaction-related expenses		(34,507	)		(24,267	)		(48,323	)
Interest expense, net		(185,410	)		(176,007	)		(181,325	)
Depreciation and amortization		(158,832	)		(143,010	)		(135,103	)
(Loss) income before income taxes	$	(168,954	)	$	236,798		$	32,955

	U.S. Facilities		U.K. Facilities			Corporate and Other		Consolidated
Goodwill:
Balance at January 1, 2018	$	2,042,592	$	708,582		$	—	$	2,751,174
Loss on impairment		—		(325,875	)		—		(325,875	)
Increase from contribution of redeemable noncontrolling interests		2,245		—			—		2,245
Foreign currency translation loss		—		(31,894	)		—		(31,894	)
Prior year purchase price adjustments		—		762			—		762
Balance at December 31, 2018	$	2,044,837	$	351,575		$	—	$	2,396,412

	December 31,
	2018		2017
Assets (2) :
U.S. Facilities	$	3,779,040	$	3,567,126
U.K. Facilities		2,175,809		2,647,150
Corporate and Other		217,655		210,226
	$	6,172,504	$	6,424,502

(1)

Segment EBITDA is defined as income before provision for income taxes, equity-based compensation expense, debt extinguishment costs, legal settlements expense, loss on impairment, loss on divestiture, gain on foreign currency derivatives, transaction-related expenses, interest expense and depreciation and amortization. The Company uses Segment EBITDA as an analytical indicator to measure the performance of the Company’s segments and to develop strategic objectives and operating plans for those segments. Segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Segment EBITDA should not be considered as a measure of financial performance under GAAP, and the items excluded from Segment EBITDA are significant components in understanding and assessing financial performance. Because Segment EBITDA is not a measurement determined in accordance with GAAP and is thus susceptible to varying calculations, Segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies.

(2)

Assets include property and equipment for the U.S. Facilities of $1.4 billion, U.K. Facilities of $1.7 billion and corporate and other of $44.9 million at December 31, 2018. Assets include property and equipment for the U.S. Facilities of $1.2 billion, U.K. Facilities of $1.8 billion and corporate and other of $49.2 million at December 31, 2017.

Employee Benefit Plans

12 Months Ended

Dec. 31, 2018

Compensation And Retirement Disclosure [Abstract]

Employee Benefit Plans

17. Employee Benefit Plans

Defined Contribution Plan

The Company maintains a qualified defined contribution 401(k) plan covering substantially all of its employees in the U.S. The Company may, at its discretion, make contributions to the plan. The Company recorded expense of $3.5 million, $0.2 million, and $0.1 million related to the 401(k) plan for the years ended December 31, 2018, 2017 and 2016, respectively.

Partnerships in Care Pension Plan

As part of the acquisition of Partnerships in Care on July 1, 2014, the Company assumed a frozen contributory defined benefit retirement plan (“Partnerships in Care Pension Plan”) covering substantially all of the employees of Partnerships in Care and its subsidiaries prior to May 1, 2005 at which time, the Partnerships in Care Plan was frozen to new participants. Effective May 2015, the active participants no longer accrue benefits. The benefits under the Partnerships in Care Pension Plan were primarily based on years of service and final average earnings.

The Company accounts for the Partnerships in Care Pension Plan in accordance with ASC 715-30 “Compensation — Defined Benefit Plans”, (“ASC 715-30”). In accordance with ASC 715-30, the Company recognizes the unfunded liability of the Partnerships in Care Pension Plan on the Company’s consolidated balance sheet and unrecognized gains (losses) and prior service credits (costs) as changes in other comprehensive income (loss). The measurement date of the Partnerships in Care Pension Plan’s assets and liabilities coincides with the Company’s year-end. The Company’s pension benefit obligation is measured using actuarial calculations that incorporate discount rates, rate of compensation increases, when applicable, expected long-term returns on plan assets and consider expected age of retirement and mortality. Expected return on plan assets is determined by using the specific asset distribution at the measurement date.

The following table summarizes the funded status (unfunded liability) of the Partnerships in Care Pension Plan based upon actuarial valuations prepared at December 31, 2018 and 2017 (in thousands):

	2018		2017
Projected benefit obligation	$	57,993	$	67,288
Fair value of plan assets		54,491		58,493
Unfunded liability	$	3,502	$	8,795

The following table summarizes changes in the Partnerships in Care Pension Plan net pension liability at December 31, 2018 and 2017 (in thousands):

	2018			2017
Net pension liability at beginning of period	$	8,795		$	10,700
Employer contributions		(2,267	)		(809	)
Net pension expense		283			426
Pension liability adjustment		(2,803	)		(2,544	)
Foreign currency translation (loss) gain		(506	)		1,022
Net pension liability at end of period	$	3,502		$	8,795

A pension liability of $3.5 million and $8.8 million were recorded within other liabilities on the consolidated balance sheets at December 31, 2018 and 2017. The following assumptions were used to determine the plan benefit obligation:

Discount rate		2.8	%		2.5	%
Compensation increase rate		3.3	%		3.3	%
Measurement date	December 31, 2018			December 31, 2017

A summary of the components of net pension plan expense for the years ended December 31, 2018 and 2017 is as follows (in thousands):

	2018			2017
Interest cost on projected benefit obligation	$	1,602		$	1,738
Expected return on assets		(1,319	)		(1,312	)
Net pension expense	$	283		$	426

Assumptions used to determine the net periodic pension plan expense for the years ended December 31, 2018 and 2017 were as follows:

	2018			2017
Discount rate		2.8	%		2.5	%
Expected long-term rate of return on plan assets		2.8	%		2.5	%

The Company recognizes changes in the funded status of the pension plan as a direct increase or decrease to stockholders’ equity through accumulated other comprehensive income. The accumulated other comprehensive income (loss) related to the Partnerships in Care Pension Plan, net of taxes, for the years ended December 31, 2018, 2017 and 2016 was $(1.8) million, $(4.5) million and $(6.1) million, respectively.

The trustees of the Partnerships in Care Pension Plan are required to invest assets in the best interest of the Partnerships in Care Pension Plan’s members and also ensure liquid assets are available to make benefit payments as they become due. Performance of the Partnerships in Care Pension Plan’s assets are monitored quarterly, at a minimum, and asset allocations are adjusted as needed. The Partnerships in Care Pension Plan’s weighted-average asset allocations by asset category at December 31, 2018 and 2017 were as follows:

	December 31, 2018			December 31, 2017
Cash and cash equivalents		1.3	%		0.7	%
U.K. government obligation		15.0	%		19.0	%
Annuity contracts		38.6	%		38.6	%
Equity securities		25.4	%		29.4	%
Debt securities		15.8	%		9.9	%
Other		3.9	%		2.4	%

At December 31, 2018 and 2017, the Partnerships in Care Pension Plan cash and cash equivalents were classified as Level 1 in the GAAP fair value hierarchy. Fair values were based on utilizing quoted prices (unadjusted) in active markets for identical assets. The U.K. government obligations, annuity contracts, equity securities, debt securities and other investments were classified as Level 2 in the GAAP fair value hierarchy. Fair values were based on data points that are observable, such as quoted prices, interest rates and yield curves.

Other Comprehensive Loss

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Other Comprehensive Loss

18. Other Comprehensive Loss

The components of accumulated other comprehensive loss are as follows (in thousands):

	Foreign Currency Translation Adjustments			Change in Fair Value of Derivative Instruments			Pension Plan			Total
Balance at January 1, 2016	$	(106,309	)	$	—		$	1,662		$	(104,647	)
Foreign currency translation loss		(477,772	)		—			(195	)		(477,967	)
Gain on derivative instruments, net of tax of $29.1 million		—			40,598			—			40,598
Pension liability adjustment, net of tax of $(1.3) million		—			—			(7,554	)		(7,554	)
Balance at December 31, 2016		(584,081	)		40,598			(6,087	)		(549,570	)
Foreign currency translation gain		207,341			—			(557	)		206,784
Loss on derivative instruments, net of tax of $(22.9) million		—			(33,431	)		—			(33,431	)
Pension liability adjustment, net of tax of $0.4 million		—			—			2,099			2,099
Balance at December 31, 2017		(376,740	)		7,167			(4,545	)		(374,118	)
Foreign currency translation gain		(127,788	)		—			267			(127,521	)
Gain on derivative instruments, net of tax of $12.7 million		—			36,799			—			36,799
Pension liability adjustment, net of tax of $0.3 million		—			—			2,463			2,463
Balance at December 31, 2018	$	(504,528	)	$	43,966		$	(1,815	)	$	(462,377	)

Quarterly Information (Unaudited)

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Quarterly Information (Unaudited)

19. Quarterly Information (Unaudited)

The tables below present summarized unaudited quarterly results of operations for the years ended December 31, 2018 and 2017. Management believes that all necessary adjustments have been included in the amounts stated below for a fair presentation of the results of operations for the periods presented when read in conjunction with the Company’s consolidated financial statements for the years ended December 31, 2018 and 2017. Results of operations for a particular quarter are not necessarily indicative of results of operations for an annual period and are not predictive of future periods.

	Quarter Ended
	March 31,			June 30,		September 30,		December 31,
	(In thousands except per share amounts)
2018:
Revenue	$	742,241		$	765,738	$	760,916	$	743,547
Income (loss) before income taxes	$	48,088		$	69,258	$	55,036	$	(341,336	)
Net income (loss) attributable to Acadia Healthcare Company, Inc. stockholders	$	50,819	⁽¹⁾	$	58,836	$	46,232	$	(331,637	)	⁽²⁾
Basic earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$	0.58	⁽¹⁾	$	0.67	$	0.53	$	(3.80	)	⁽²⁾
Diluted earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$	0.58	⁽¹⁾	$	0.67	$	0.53	$	(3.80	)	⁽²⁾
2017:
Revenue	$	679,194		$	715,896	$	716,714	$	724,512
Income before income taxes	$	48,484		$	66,216	$	61,459	$	60,689
Net income attributable to Acadia Healthcare Company, Inc. stockholders	$	34,958		$	49,630	$	45,618	$	69,629		⁽³⁾
Basic earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$	0.40		$	0.57	$	0.52	$	0.80		⁽³⁾
Diluted earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$	0.40		$	0.57	$	0.52	$	0.80		⁽³⁾

(1)	Includes tax benefits of $10.5 million pursuant to a change in the Company’s provisional amounts recorded at December 31, 2017 related to the enactment of the Tax Act.

(2)	Includes loss on impairment of $337.9 million and legal settlements expense of $22.1 million.

(3)	Includes a one-time tax benefit of $20.2 million on revaluation of deferred tax items pursuant to the enactment of the Tax Act.

Subsequent Events

12 Months Ended

Dec. 31, 2018

Subsequent Events [Abstract]

Subsequent Events

20. Subsequent Events

On February 15, 2019, the Company completed the acquisition of Whittier, an inpatient psychiatric facility with 71 beds located in Haverhill, Massachusetts, for cash consideration of approximately $17.9 million. Also on February 15, 2019, the Company completed the acquisition of Mission Treatment for cash consideration of approximately $22.5 million and a working capital settlement. Mission Treatment operates nine comprehensive treatment centers in California, Nevada, Arizona and Oklahoma.

On February 6, 2019, the Company entered into the Eleventh Amendment to the Amended and Restated Credit Agreement. The Eleventh Amendment, among other things, amended the definition of “Consolidated EBITDA” to remove the cap on non-cash charges, losses and expenses related to the impairment of goodwill, which in turn provided increased flexibility to the Company in terms of the Company’s financial covenants.

On February 27, 2019, the Company entered into the Twelfth Amendment to the Amended and Restated Credit Agreement. The Twelfth Amendment, among other things, modified certain definitions, including “Consolidated EBITDA”, and increased our permitted Maximum Consolidated Leverage Ratio, thereby providing increased flexibility to the Company in terms of the Company’s financial covenants.

Financial Information for the Company and Its Subsidiaries

12 Months Ended

Dec. 31, 2018

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Financial Information for the Company and Its Subsidiaries

21. Financial Information for the Company and Its Subsidiaries

The Company conducts substantially all of its business through its subsidiaries. The 6.125% Senior Notes, 5.125% Senior Notes, 5.625% Senior Notes and 6.500% Senior Notes are jointly and severally guaranteed on an unsecured senior basis by all of the Company’s subsidiaries that guarantee the Company’s obligations under the Amended and Restated Senior Credit Facility. Presented below is condensed consolidating financial information for the Company and its subsidiaries at December 31, 2018 and 2017, and for the years ended December 31, 2018, 2017 and 2016. The information segregates the parent company (Acadia Healthcare Company, Inc.), the combined wholly-owned subsidiary guarantors, the combined non-guarantor subsidiaries and eliminations.

Acadia Healthcare Company, Inc.

Condensed Consolidating Balance Sheets

December 31, 2018

(In thousands)

	Parent		Combined Subsidiary Guarantors		Combined Non- Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Current assets:
Cash and cash equivalents	$	—	$	32,471	$	18,039	$	—		$	50,510
Accounts receivable, net		—		248,218		69,869		—			318,087
Other current assets		—		60,160		21,660		—			81,820
Total current assets		—		340,849		109,568		—			450,417
Property and equipment, net		—		1,219,803		1,887,963		—			3,107,766
Goodwill		—		1,936,057		460,355		—			2,396,412
Intangible assets, net		—		56,611		32,379		—			88,990
Deferred tax assets – noncurrent		1,841		—		3,468		(1,841	)		3,468
Derivative instruments		60,524		—		—		—			60,524
Investment in subsidiaries		5,190,771		—		—		(5,190,771	)		—
Other assets		306,495		52,824		9,548		(303,940	)		64,927
Total assets	$	5,559,631	$	3,606,144	$	2,503,281	$	(5,496,552	)	$	6,172,504
Current liabilities:
Current portion of long-term debt	$	34,112	$	—	$	—	$	—		$	34,112
Accounts payable		—		79,463		38,277		—			117,740
Accrued salaries and benefits		—		84,150		29,149		—			113,299
Other accrued liabilities		32,837		42,062		76,327		—			151,226
Total current liabilities		66,949		205,675		143,753		—			416,377
Long-term debt		3,159,375		—		303,940		(303,940	)		3,159,375
Deferred tax liabilities – noncurrent		—		31,874		50,339		(1,841	)		80,372
Other liabilities		—		107,866		46,401		—			154,267
Total liabilities		3,226,324		345,415		544,433		(305,781	)		3,810,391
Redeemable noncontrolling interests		—		—		28,806		—			28,806
Total equity		2,333,307		3,260,729		1,930,042		(5,190,771	)		2,333,307
Total liabilities and equity	$	5,559,631	$	3,606,144	$	2,503,281	$	(5,496,552	)	$	6,172,504

Acadia Healthcare Company, Inc.

Condensed Consolidating Balance Sheets

December 31, 2017

(In thousands)

	Parent		Combined Subsidiary Guarantors		Combined Non- Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Current assets:
Cash and cash equivalents	$	—	$	46,860	$	20,430	$	—		$	67,290
Accounts receivable, net		—		230,890		66,035		—			296,925
Other current assets		—		85,746		21,589		—			107,335
Total current assets		—		363,496		108,054		—			471,550
Property and equipment, net		—		1,086,802		1,961,328		—			3,048,130
Goodwill		—		1,936,057		815,117		—			2,751,174
Intangible assets, net		—		57,628		29,720		—			87,348
Deferred tax assets – noncurrent		2,370		—		3,731		(2,370	)		3,731
Derivative instruments		12,997		—		—		—			12,997
Investment in subsidiaries		5,429,386		—		—		(5,429,386	)		—
Other assets		381,913		38,860		7,807		(379,008	)		49,572
Total assets	$	5,826,666	$	3,482,843	$	2,925,757	$	(5,810,764	)	$	6,424,502
Current liabilities:
Current portion of long-term debt	$	34,550	$	—	$	280	$	—		$	34,830
Accounts payable		—		70,767		31,532		—			102,299
Accrued salaries and benefits		—		69,057		29,990		—			99,047
Other accrued liabilities		36,196		27,676		77,341		—			141,213
Total current liabilities		70,746		167,500		139,143		—			377,389
Long-term debt		3,183,049		—		401,017		(379,008	)		3,205,058
Deferred tax liabilities – noncurrent		—		27,975		54,728		(2,370	)		80,333
Other liabilities		—		103,112		63,322		—			166,434
Total liabilities		3,253,795		298,587		658,210		(381,378	)		3,829,214
Redeemable noncontrolling interests		—		—		22,417		—			22,417
Total equity		2,572,871		3,184,256		2,245,130		(5,429,386	)		2,572,871
Total liabilities and equity	$	5,826,666	$	3,482,843	$	2,925,757	$	(5,810,764	)	$	6,424,502

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Comprehensive Income (Loss)

Year Ended December 31, 2018

(In thousands)

	Parent			Combined Subsidiary Guarantors		Combined Non- Guarantors			Consolidating Adjustments		Total Consolidated Amounts
Revenue	$	—		$	1,788,757	$	1,223,685		$	—		3,012,442
Salaries, wages and benefits		22,001			965,419		671,928			—		1,659,348
Professional fees		—			98,441		128,984			—		227,425
Supplies		—			76,526		42,788			—		119,314
Rents and leases		—			33,101		47,181			—		80,282
Other operating expenses		—			225,446		129,052			—		354,498
Depreciation and amortization		—			74,341		84,491			—		158,832
Interest expense, net		65,588			92,983		26,839			—		185,410
Debt extinguishment costs		940			—		875			—		1,815
Legal settlements expense		—			22,076		—			—		22,076
Loss on impairment		—			—		337,889			—		337,889
Transaction-related expenses		—			29,720		4,787			—		34,507
Total expenses		88,529			1,618,053		1,474,814			—		3,181,396
(Loss) income before income taxes		(88,529	)		170,704		(251,129	)		—		(168,954	)
Equity in earnings of subsidiaries		(98,669	)		—		—			98,669		—
(Benefit from) provision for income taxes		(11,712	)		19,045		(801	)		—		6,532
Net (loss) income		(175,486	)		151,659		(250,328	)		98,669		(175,486	)
Net income attributable to noncontrolling interests		—			—		(264	)		—		(264	)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(175,486	)	$	151,659	$	(250,592	)	$	98,669	$	(175,750	)
Other comprehensive income:
Foreign currency translation loss		—			—		(127,521	)		—		(127,521	)
Gain on derivative instruments		36,799			—		—			—		36,799
Pension liability adjustment, net		—			—		2,463			—		2,463
Other comprehensive income (loss)		36,799			—		(125,058	)		—		(88,259	)
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc.	$	(138,687	)	$	151,659	$	(375,650	)	$	98,669	$	(264,009	)

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Comprehensive Income (Loss)

Year Ended December 31, 2017

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Revenue before provision for doubtful accounts	$	—		$	1,746,656		$	1,130,578		$	—		$	2,877,234
Provision for doubtful accounts		—			(35,636	)		(5,282	)		—			(40,918	)
Revenue		—			1,711,020			1,125,296			—			2,836,316
Salaries, wages and benefits		23,467			902,180			610,513			—			1,536,160
Professional fees		—			93,991			102,232			—			196,223
Supplies		—			75,248			39,191			—			114,439
Rents and leases		—			33,365			43,410			—			76,775
Other operating expenses		—			217,900			113,927			—			331,827
Depreciation and amortization		—			66,482			76,528			—			143,010
Interest expense, net		61,872			81,274			32,861			—			176,007
Debt extinguishment costs		810			—			—			—			810
Transaction-related expenses		—			11,236			13,031			—			24,267
Total expenses		86,149			1,481,676			1,031,693			—			2,599,518
(Loss) income before income taxes		(86,149	)		229,344			93,603			—			236,798
Equity in earnings of subsidiaries		259,282			—			—			(259,282	)		—
(Benefit from) provision for income taxes		(26,456	)		69,882			(6,217	)		—			37,209
Net income (loss)		199,589			159,462			99,820			(259,282	)		199,589
Net loss attributable to noncontrolling interests		—			—			246			—			246
Net income (loss) attributable to Acadia Healthcare Company, Inc.	$	199,589		$	159,462		$	100,066		$	(259,282	)	$	199,835
Other comprehensive income:
Foreign currency translation gain		—			—			206,784			—			206,784
Loss on derivative instruments		(33,431	)		—			—			—			(33,431	)
Pension liability adjustment, net		—			—			2,099			—			2,099
Other comprehensive (loss) income		(33,431	)		—			208,883			—			175,452
Comprehensive income (loss) attributable to Acadia Healthcare Company, Inc.	$	166,158		$	159,462		$	308,949		$	(259,282	)	$	375,287

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Comprehensive Income (Loss)

Year Ended December 31, 2016

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Revenue before provision for doubtful accounts	$	—		$	1,662,734		$	1,190,089		$	—		$	2,852,823
Provision for doubtful accounts		—			(38,349	)		(3,560	)		—			(41,909	)
Revenue		—			1,624,385			1,186,529			—			2,810,914
Salaries, wages and benefits		28,345			865,104			648,405			—			1,541,854
Professional fees		—			89,062			96,424			—			185,486
Supplies		—			76,246			41,179			—			117,425
Rents and leases		—			34,540			38,808			—			73,348
Other operating expenses		—			206,308			106,248			—			312,556
Depreciation and amortization		—			58,018			77,085			—			135,103
Interest expense, net		50,921			75,848			54,556			—			181,325
Debt extinguishment costs		4,253			—			—			—			4,253
Loss on divestiture		—			778			178,031			—			178,809
Gain on foreign currency derivatives		(523	)		—			—			—			(523	)
Transaction-related expenses		—			32,173			16,150			—			48,323
Total expenses		82,996			1,438,077			1,256,886			—			2,777,959
(Loss) income before income taxes		(82,996	)		186,308			(70,357	)		—			32,955
Equity in earnings of subsidiaries		65,560			—			—			(65,560	)		—
(Benefit from) provision for income taxes		(21,612	)		68,335			(17,944	)		—			28,779
Net income (loss)		4,176			117,973			(52,413	)		(65,560	)		4,176
Net loss attributable to noncontrolling interests		—			—			1,967			—			1,967
Net income (loss) attributable to Acadia Healthcare Company, Inc.	$	4,176		$	117,973		$	(50,446	)	$	(65,560	)	$	6,143
Other comprehensive income:
Foreign currency translation loss		—			—			(477,967	)		—			(477,967	)
Gain on derivative instruments		40,598			—			—			—			40,598
Pension liability adjustment, net		—			—			(7,554	)		—			(7,554	)
Other comprehensive income (loss)		40,598			—			(485,521	)		—			(444,923	)
Comprehensive income (loss) attributable to Acadia Healthcare Company, Inc.	$	44,774		$	117,973		$	(535,967	)	$	(65,560	)	$	(438,780	)

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Cash Flows

Year Ended December 31, 2018

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Operating activities:
Net (loss) income	$	(175,486	)	$	151,659		$	(250,328	)	$	98,669		$	(175,486	)
Adjustments to reconcile net (loss) income to net cash (used in) provided by continuing operating activities:
Equity in earnings of subsidiaries		98,669			—			—			(98,669	)		—
Depreciation and amortization		—			74,341			84,491			—			158,832
Amortization of debt issuance costs		10,825			—			(369	)		—			10,456
Equity-based compensation expense		22,001			—			—			—			22,001
Deferred income taxes		529			(8,795	)		(1,448	)		—			(9,714	)
Debt extinguishment costs		940			—			875			—			1,815
Legal settlements expense		—			22,076			—			—			22,076
Loss on impairment		—			—			337,889			—			337,889
Other		6,981			5,457			(67	)		—			12,371
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net		—			(17,328	)		507			—			(16,821	)
Other current assets		—			14,881			(1,017	)		—			13,864
Other assets		4,596			118			2,644			(4,596	)		2,762
Accounts payable and other accrued liabilities		—			15,743			10,311			—			26,054
Accrued salaries and benefits		—			15,094			654			—			15,748
Other liabilities		—			3,014			(8,233	)		—			(5,219	)
Net cash (used in) provided by continuing operating activities		(30,945	)		276,260			175,909			(4,596	)		416,628
Net cash used in discontinued operating activities		—			(2,548	)		—			—			(2,548	)
Net cash (used in) provided by operating activities		(30,945	)		273,712			175,909			(4,596	)		414,080
Investing activities:
Cash paid for capital expenditures		—			(210,023	)		(131,439	)		—			(341,462	)
Cash paid for real estate acquisitions		—			(14,096	)		(4,287	)		—			(18,383	)
Other		—			(4,199	)		3,080			—			(1,119	)
Net cash used in investing activities		—			(228,318	)		(132,646	)		—			(360,964	)
Financing activities:
Principal payments on long-term debt		(39,738	)		(169	)		(4,427	)		4,596			(39,738	)
Repayment of long-term debt		—			—			(21,920	)		—			(21,920	)
Common stock withheld for minimum statutory taxes, net		(3,407	)		—			—			—			(3,407	)
Other		(1,742	)		2,094			(2,617	)		—			(2,265	)
Cash provided by (used in) intercompany activity		75,832			(61,708	)		(14,124	)		—			—
Net cash provided by (used in) financing activities		30,945			(59,783	)		(43,088	)		4,596			(67,330	)
Effect of exchange rate changes on cash		—			—			(2,566	)		—			(2,566	)
Net decrease in cash and cash equivalents		—			(14,389	)		(2,391	)		—			(16,780	)
Cash and cash equivalents at beginning of the period		—			46,860			20,430			—			67,290
Cash and cash equivalents at end of the period	$	—		$	32,471		$	18,039		$	—		$	50,510

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Cash Flows

Year Ended December 31, 2017

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Operating activities:
Net income (loss)	$	199,589		$	159,462		$	99,820		$	(259,282	)	$	199,589
Adjustments to reconcile net income (loss) to net cash (used in) provided by continuing operating activities:
Equity in earnings of subsidiaries		(259,282	)		—			—			259,282			—
Depreciation and amortization		—			66,482			76,528			—			143,010
Amortization of debt issuance costs		10,270			—			(415	)		—			9,855
Equity-based compensation expense		23,467			—			—			—			23,467
Deferred income taxes		1,236			28,882			1,254			—			31,372
Debt extinguishment costs		810			—			—			—			810
Other		4,189			2,498			4,725			—			11,412
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net		—			(21,791	)		(6,779	)		—			(28,570	)
Other current assets		—			(6,429	)		27,237			—			20,808
Other assets		24,549			(3,277	)		101			(24,549	)		(3,176	)
Accounts payable and other accrued liabilities		—			4,909			(15,022	)		—			(10,113	)
Accrued salaries and benefits		—			(3,974	)		(5,014	)		—			(8,988	)
Other liabilities		—			8,794			3,000			—			11,794
Net cash provided by (used in) continuing operating activities		4,828			235,556			185,435			(24,549	)		401,270
Net cash used in discontinued operating activities		—			(1,693	)		—			—			(1,693	)
Net cash provided by (used in) operating activities		4,828			233,863			185,435			(24,549	)		399,577
Investing activities:
Cash paid for acquisitions, net of cash acquired		—			—			(18,191	)		—			(18,191	)
Cash paid for capital expenditures		—			(161,312	)		(112,865	)		—			(274,177	)
Cash paid for real estate acquisitions		—			(37,047	)		(4,010	)		—			(41,057	)
Other		—			(7,944	)		4,843			—			(3,101	)
Net cash used in investing activities		—			(206,303	)		(130,223	)		—			(336,526	)
Financing activities:
Principal payments on long-term debt		(34,550	)		(14,250	)		(10,554	)		24,549			(34,805	)
Repayment of long-term debt		(22,500	)		—			—			—			(22,500	)
Common stock withheld for minimum statutory taxes, net		(3,455	)		—			—			—			(3,455	)
Other		(539	)		1,225			—			—			686
Cash provided by (used in) intercompany activity		56,216			16,644			(72,860	)		—			—
Net cash (used in) provided by financing activities		(4,828	)		3,619			(83,414	)		24,549			(60,074	)
Effect of exchange rate changes on cash		—			—			7,250			—			7,250
Net increase (decrease) in cash and cash equivalents		—			31,179			(20,952	)		—			10,227
Cash and cash equivalents at beginning of the period		—			15,681			41,382			—			57,063
Cash and cash equivalents at end of the period	$	—		$	46,860		$	20,430		$	—		$	67,290

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Cash Flows

Year Ended December 31, 2016

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Operating activities:
Net income (loss)	$	4,176		$	117,973		$	(52,413	)	$	(65,560	)	$	4,176
Adjustments to reconcile net income (loss) to net cash (used in) provided by continuing operating activities:
Equity in earnings of subsidiaries		(65,560	)		—			—			65,560			—
Depreciation and amortization		—			58,018			77,085			—			135,103
Amortization of debt issuance costs		10,751			—			(427	)		—			10,324
Equity-based compensation expense		28,345			—			—			—			28,345
Deferred income taxes		(2,172	)		50,611			(19,792	)		—			28,647
Loss from discontinued operations, net of taxes		—			—			—			—			—
Debt extinguishment costs		4,253			—			—			—			4,253
Loss on divestiture		—			778			178,031			—			178,809
(Gain) loss on foreign currency derivatives		(523	)		—			—			—			(523	)
Other		—			4,022			693			—		4715
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net		—			(24,017	)		8,299			—			(15,718	)
Other current assets		—			(3,138	)		(17,510	)		—			(20,648	)
Other assets		(3,109	)		(4,048	)		(306	)		3,109			(4,354	)
Accounts payable and other accrued liabilities		—			(45,552	)		68,245			—			22,693
Accrued salaries and benefits		—			3,844			(12,416	)		—			(8,572	)
Other liabilities		—			4,050			434			—			4,484
Net cash (used in) provided by continuing operating activities		(23,839	)		162,541			229,923			3,109			371,734
Net cash used in discontinued operating activities		—			(10,256	)		—			—			(10,256	)
Net cash (used in) provided by operating activities		(23,839	)		152,285			229,923			3,109			361,478
Investing activities:
Cash paid for acquisitions, net of cash acquired		—			(103,359	)		(580,096	)		—			(683,455	)
Cash paid for capital expenditures		—			(177,593	)		(129,879	)		—			(307,472	)
Cash paid for real estate acquisitions		—			(28,956	)		(11,801	)		—			(40,757	)
Settlement of foreign currency derivatives		—			523			—			—			523
Cash received for divestiture		370,000			7,859			(4,593	)		—			373,266
Other		—			(1,573	)		(897	)		—			(2,470	)
Net cash used in investing activities		370,000			(303,099	)		(727,266	)		—			(660,365	)
Financing activities:
Borrowings on long-term debt		1,480,000			—			—			—			1,480,000
Borrowings on revolving credit facility		179,000			—			—			—			179,000
Principal payments on revolving credit facility		(337,000	)		—			—			—			(337,000	)
Principal payments on long-term debt		(49,706	)		(293,000	)		(3,344	)		296,109			(49,941	)
Repayment of assumed debt		(1,348,389	)		—			—			—			(1,348,389	)
Repayment of long-term debt		(200,594	)		—			—			—			(200,594	)
Payment of debt issuance costs		(36,649	)		—			—			—			(36,649	)
Issuance of common stock		685,097			—			—			—			685,097
Common stock withheld for minimum statutory taxes, net		(8,846	)		—			—			—			(8,846	)
Other		(1,149	)		(2,688	)		—			—			(3,837	)
Cash (used in) provided by intercompany activity		(707,925	)		460,196			546,947			(299,218	)		—
Net cash (used in) provided by financing activities		(346,161	)		164,508			543,603			(3,109	)		358,841
Effect of exchange rate changes on cash		—			—			(14,106	)		—			(14,106	)
Net increase in cash and cash equivalents		—			13,694			32,154			—			45,848
Cash and cash equivalents at beginning of the period		—			1,987			9,228			—			11,215
Cash and cash equivalents at end of the period	$	—		$	15,681		$	41,382		$	—		$	57,063

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Cash and Cash Equivalents

Insurance

Property and Equipment and Other Long-Lived Assets

Goodwill and Indefinite-Lived Intangible Assets

Other Current Assets

Other current assets consisted of the following (in thousands):

	December 31,
	2018		2017
Prepaid expenses	$	30,802	$	27,320
Other receivables		19,205		21,427
Cost report receivable		10,340		9,028
Workers’ compensation deposits – current portion		10,000		10,000
Inventory		5,055		4,787
Insurance receivable – current portion		2,049		17,588
Income taxes receivable		2,380		15,056
Other		1,989		2,129
Other current assets	$	81,820	$	107,335

Other Accrued Liabilities

Other accrued liabilities consisted of the following (in thousands):

	December 31,
	2018		2017
Accrued expenses	$	44,938	$	37,268
Accrued interest		32,838		36,370
Unearned income		32,154		31,342
Accrued legal settlements		22,076		—
Insurance liability – current portion		4,956		22,788
Accrued property taxes		4,136		3,945
Income taxes payable		3,041		1,012
Other		7,087		8,488
Other accrued liabilities	$	151,226	$	141,213

Stock Compensation

Earnings Per Share

Income Taxes

Recent Accounting Pronouncements

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Other Current Assets

Other current assets consisted of the following (in thousands):

	December 31,
	2018		2017
Prepaid expenses	$	30,802	$	27,320
Other receivables		19,205		21,427
Cost report receivable		10,340		9,028
Workers’ compensation deposits – current portion		10,000		10,000
Inventory		5,055		4,787
Insurance receivable – current portion		2,049		17,588
Income taxes receivable		2,380		15,056
Other		1,989		2,129
Other current assets	$	81,820	$	107,335

Summary of Other Accrued Liabilities

Other accrued liabilities consisted of the following (in thousands):

	December 31,
	2018		2017
Accrued expenses	$	44,938	$	37,268
Accrued interest		32,838		36,370
Unearned income		32,154		31,342
Accrued legal settlements		22,076		—
Insurance liability – current portion		4,956		22,788
Accrued property taxes		4,136		3,945
Income taxes payable		3,041		1,012
Other		7,087		8,488
Other accrued liabilities	$	151,226	$	141,213

Revenue (Tables)

12 Months Ended

Dec. 31, 2018

Summary of the Activity in Unearned Revenue in the U.K. Facilities

A summary of the activity in unearned revenue in the U.K. Facilities is as follows (in thousands):

Balance at December 31, 2017	$	30,812
Payments received		167,604
Revenue recognized		(164,917	)
Foreign currency translation loss		(2,260	)
Balance at December 31, 2018	$	31,239

U.S. Facilities [Member]

Schedule of Revenue Attributed to Each Category

The table below presents total U.S. revenue attributed to each category (in thousands):

	Year Ended December 31,
	2018		2017		2016
Acute inpatient psychiatric facilities	$	814,124	$	757,211	$	694,151
Specialty treatment facilities		761,017		725,151		702,225
Residential treatment centers		293,053		284,637		256,539
Outpatient community-based services		36,501		42,845		45,610
Revenue	$	1,904,695	$	1,809,844	$	1,698,525

Schedule of Revenue and Percentage Generated by Each Payor Type

The following table presents revenue by payor type and as a percentage of revenue in our U.S. Facilities for the years ended December 31, 2018, 2017 and 2016 (in thousands):

	Year Ended December 31,
	2018					2017						2016
	Amount		%			Amount			%			Amount			%
Commercial	$	573,089		30.1	%	$	569,242			30.8	%	$	534,468			30.7	%
Medicare		280,340		14.7	%		281,270			15.2	%		266,868			15.3	%
Medicaid		893,644		46.9	%		796,375			43.0	%		725,508			41.7	%
Self-Pay		134,054		7.1	%		169,727			9.2	%		185,094			10.6	%
Other		23,568		1.2	%		33,942			1.8	%		28,418			1.7	%
Revenue before provision for doubtful accounts		1,904,695		100.0	%		1,850,556			100.0	%		1,740,356			100.0	%
Provision for doubtful accounts		—					(40,712	)					(41,831	)
Revenue	$	1,904,695				$	1,809,844					$	1,698,525

U.K. Facilities [Member]

Schedule of Revenue Attributed to Each Category

The table below presents total U.K. revenue attributed to each category (in thousands):

	Year Ended December 31,
	2018		2017		2016
Healthcare facilities	$	615,741	$	567,747	$	683,467
Education and Children’s Services		192,129		170,328		146,703
Adult Care facilities		299,877		288,397		280,191
Revenue	$	1,107,747	$	1,026,472	$	1,110,361

Schedule of Revenue and Percentage Generated by Each Payor Type

The following table presents revenue by payor type and as a percentage of revenue in our U.K. Facilities for the years ended December 31, 2018, 2017 and 2016 (in thousands):

	Year Ended December 31,
	2018					2017						2016
	Amount		%			Amount			%			Amount			%
U.K. public funded sources	$	1,000,828		90.3	%	$	922,159			89.8	%	$	1,021,888			92.0	%
Self-Pay		104,824		9.5	%		95,687			9.3	%		83,066			7.5	%
Other		2,095		0.2	%		8,832			0.9	%		5,485			0.5	%
Revenue before provision for doubtful accounts		1,107,747		100.0	%		1,026,678			100.0	%		1,110,439			100.0	%
Provision for doubtful accounts		—					(206	)					(78	)
Revenue	$	1,107,747				$	1,026,472					$	1,110,361

Accounting Standards Update 2014-09 [Member]

Summary of Impact of Adoption of Accounting Standards

The impact of adopting ASU 2014-09 on the consolidated statements of operations for the year ended December 31, 2018 was as follows (in thousands):

	Year Ended December 31, 2018
	As Reported		Prior to Adopting ASU 2014-09
Revenue before provision for doubtful accounts	$	3,012,442	$	3,060,180
Provision for doubtful accounts		—		(47,738	)
Revenue	$	3,012,442	$	3,012,442

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2018

Earnings Per Share [Abstract]

Computation of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the years ended December 31, 2018, 2017 and 2016 (in thousands except per share amounts):

	Year Ended December 31,
	2018			2017		2016
Numerator:
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(175,750	)	$	199,835	$	6,143
Denominator:
Weighted average shares outstanding for basic earnings per share		87,288			86,948		85,701
Effects of dilutive instruments		—			112		271
Shares used in computing diluted earnings per common share		87,288			87,060		85,972
Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$	(2.01	)	$	2.30	$	0.07
Diluted	$	(2.01	)	$	2.30	$	0.07

Acquisitions (Tables)

12 Months Ended

Dec. 31, 2018

Business Combinations [Abstract]

Transaction-related expenses comprised the following costs for the years ended years ended December 31, 2018, 2017 and 2016 (in thousands):

	Year Ended December 31,
	2018		2017		2016
CEO transition costs	$	14,033	$	—	$	—
Termination and closure costs		11,829		16,190		15,449
Legal, accounting and other		8,645		8,077		18,024
Advisory and financing commitment fees		—		—		14,850
	$	34,507	$	24,267	$	48,323

Other Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2018

Goodwill And Intangible Assets Disclosure [Abstract]

Other Identifiable Intangible Assets and Related Accumulated Amortization

Other identifiable intangible assets and related accumulated amortization consisted of the following at December 31, 2018 and 2017 (in thousands):

	Gross Carrying Amount				Accumulated Amortization
	December 31, 2018		December 31, 2017		December 31, 2018			December 31, 2017
Intangible assets subject to amortization:
Contract intangible assets	$	2,100	$	2,100	$	(2,100	)	$	(2,100	)
Non-compete agreements		1,147		1,147		(1,147	)		(1,147	)
		3,247		3,247		(3,247	)		(3,247	)
Intangible assets not subject to amortization:
Licenses and accreditations		12,343		12,266		—			—
Trade names		60,109		60,586		—			—
Certificates of need		16,538		14,496		—			—
		88,990		87,348		—			—
Total	$	92,237	$	90,595	$	(3,247	)	$	(3,247	)

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2018

Debt Disclosure [Abstract]

Components of Long-Term Debt

Long-term debt consisted of the following (in thousands):

	December 31, 2018			December 31, 2017
Amended and Restated Senior Credit Facility:
Senior Secured Term A Loans	$	365,750		$	380,000
Senior Secured Term B Loans		1,372,912			1,398,400
Senior Secured Revolving Line of Credit		—			—
6.125% Senior Notes due 2021		150,000			150,000
5.125% Senior Notes due 2022		300,000			300,000
5.625% Senior Notes due 2023		650,000			650,000
6.500% Senior Notes due 2024		390,000			390,000
9.0% and 9.5% Revenue Bonds		—			21,920
Other long-term debt		5,953			—
Less: unamortized debt issuance costs, discount and premium		(41,128	)		(50,432	)
		3,193,487			3,239,888
Less: current portion		(34,112	)		(34,830	)
Long-term debt	$	3,159,375		$	3,205,058

Summary of Aggregate Maturities of Long-Term Debt

The aggregate maturities of long-term debt at December 31, 2018 were as follows (in thousands):

2019	$	34,112
2020		43,679
2021		483,501
2022		764,855
2023		1,518,468
Thereafter		390,000
Total	$	3,234,615

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 1A
-URI http://asc.fasb.org/extlink&oid=114775744&loc=d3e28541-108399

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 6
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21506-112644

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08.(e),(f))
-URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=114775744&loc=d3e28551-108399

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21521-112644

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21538-112644

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 470
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=75038535&loc=d3e64711-112823

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 55
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=114775985&loc=d3e28878-108400

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21475-112644

+ Details

Equity-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2018

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock Option Activity

Stock option activity during 2016, 2017 and 2018 was as follows (aggregate intrinsic value in thousands):

	Number of Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (in years)		Aggregate Intrinsic Value
Options outstanding at January 1, 2016		694,743		$	42.87		7.70	$	20,717
Options granted		503,850			57.98		9.28		297
Options exercised		(57,397	)		31.92	N/A			1,530
Options cancelled		(140,250	)		57.13	N/A		N/A
Options outstanding at December 31, 2016		1,000,946			48.42		7.46		8,166
Options granted		259,300			42.25		9.30		205
Options exercised		(87,367	)		25.92	N/A			1,636
Options cancelled		(198,313	)		54.71	N/A		N/A
Options outstanding at December 31, 2017		974,566			47.89		7.46		3,802
Options granted		374,700			37.54		9.21		246
Options exercised		(20,989	)		17.83	N/A			383
Options cancelled		(128,737	)		50.83	N/A		N/A
Options outstanding at December 31, 2018		1,199,540		$	44.64		7.26	$	2,717
Options exercisable at December 31, 2017		405,634		$	41.20		6.05	$	3,549
Options exercisable at December 31, 2018		534,164		$	44.98		5.73	$	2,386

Schedule of Stock Options Valuation Assumptions

The following table summarizes the grant-date fair value of options and the assumptions used to develop the fair value estimates for options granted during the years ended December 31, 2018, 2017 and 2016:

	Year Ended December 31,
	2018			2017			2016
Weighted average grant-date fair value of options	$	13.67		$	14.39		$	18.96
Risk-free interest rate		2.2	%		2.0	%		1.4	%
Expected volatility		37	%		33	%		33	%
Expected life (in years)		5.1			5.5			5.5

Restricted Stock Activity

Restricted stock activity during 2016, 2017 and 2018 was as follows:

	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2016		944,562		$	52.74
Granted		387,347			55.38
Cancelled		(122,178	)		57.02
Vested		(365,312	)		47.18
Unvested at December 31, 2016		844,419		$	55.76
Granted		404,224			42.38
Cancelled		(145,981	)		55.03
Vested		(292,794	)		53.07
Unvested at December 31, 2017		809,868		$	50.19
Granted		480,137			36.84
Cancelled		(88,989	)		47.57
Vested		(395,959	)		50.41
Unvested at December 31, 2018		805,057		$	42.40

Restricted Stock Unit Activity

Restricted stock unit activity during 2016, 2017 and 2018 was as follows:

	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2016		218,084		$	56.97
Granted		230,750			56.95
Cancelled		—			—
Vested		(175,235	)		52.71
Unvested at December 31, 2016		273,599		$	59.68
Granted		219,840			43.23
Cancelled		—			—
Vested		(132,530	)		58.67
Unvested at December 31, 2017		360,909		$	50.04
Granted		285,358			42.26
Cancelled		(89,173	)		55.44
Vested		(72,983	)		49.64
Unvested at December 31, 2018		484,111		$	44.52

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Components of Provision for Income Taxes

Provision for income taxes consists of the following for the periods presented (in thousands):

	Year Ended December 31,
	2018			2017			2016
Current:
Federal	$	13,961		$	3,325		$	572
State		1,113			680			(863	)
Foreign		1,172			1,832			423
Total current		16,246			5,837			132
Deferred:
Federal		(7,176	)		27,179			45,077
State		(10	)		4,408			1,491
Foreign		(2,528	)		(215	)		(17,921	)
Total deferred provision		(9,714	)		31,372			28,647
Provision for income taxes	$	6,532		$	37,209		$	28,779

Effective Income Tax Rate

A reconciliation of the U.S. federal statutory rate to the effective tax rate is as follows for the periods presented:

	Year Ended December 31,
	2018			2017			2016
U.S. federal statutory rate on income before income taxes		21.0	%		35.0	%		35.0	%
Impact of foreign operations		9.5			(14.1	)		(13.5	)
Impact of foreign divestiture		—			—			39.2
Impacts of SAB 118		6.7			—			—
Effects of statutory rate change		—			(8.5	)		(14.5	)
State income taxes, net of federal tax effect		(1.4	)		2.1			7.5
Permanent differences		(4.1	)		1.8			8.3
Goodwill impairment		(36.6	)		—			—
Transaction-related items		—			—			25.9
Change in valuation allowance		(1.4	)		1.6			2.8
Unrecognized tax benefit release		3.1			(0.8	)		(7.2	)
Interest disallowance		(2.2	)		—			—
Federal tax credits		1.0			—			—
Other		0.5			(1.4	)		3.8
Effective income tax rate		(3.9	)%		15.7	%		87.3	%

Summary of Domestic and Foreign Components of Income (Loss) before Income Taxes

The domestic and foreign components of income (loss) before income taxes are as follows (in thousands):

	Year Ended December 31,
	2018			2017		2016
Foreign	$	(228,350	)	$	120,905	$	(144,717	)
Domestic		59,396			115,893		177,672
Total	$	(168,954	)	$	236,798	$	32,955

Deferred Tax Assets and Liabilities

	December 31,
	2018			2017
Deferred tax assets:
Net operating losses and tax credit carryforwards – federal and state	$	27,294		$	29,409
Bad debt allowance		898			827
Accrued compensation and severance		15,229			14,179
Pension reserves		595			1,494
Insurance reserves		13,994			13,483
Leases		5,374			5,332
Accrued expenses		4,231			3,114
Interest carryforwards		32,272			5,074
Other assets		2,284			1,747
Total gross deferred tax assets		102,171			74,659
Less: valuation allowance		(24,079	)		(21,155	)
Deferred tax assets		78,092			53,504
Deferred tax liabilities:
Fixed asset basis difference		(48,698	)		(54,214	)
Prepaid items		(1,728	)		(1,490	)
Intangible assets		(87,628	)		(70,820	)
Accrued expenses		—			—
Other liabilities		(16,942	)		(3,582	)
Total deferred tax liabilities		(154,996	)		(130,106	)
Total net deferred tax liability	$	(76,904	)	$	(76,602	)

Unrecognized Income Tax Benefits Net of Federal Benefit

A reconciliation of the beginning and ending amount of unrecognized income tax benefits net of the federal benefit is as follows (in thousands):

	2018			2017
Balance at January 1	$	6,104		$	6,949
Additions based on tax positions related to the current year		52			5,488
Additions for tax positions of prior years		—			95
Reductions as a result of the lapse of applicable statutes of limitations and settlements with tax authorities		(5,443	)		(6,428	)
Balance at December 31	$	713		$	6,104

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2018

Fair Value Disclosures [Abstract]

Carrying Amounts and Fair Values of Company's Amended and Restated Senior Credit Facilities and Contingent Consideration Liabilities

	Carrying Amount				Fair Value
	December 31,				December 31,
	2018		2017		2018		2017
Amended and Restated Senior Credit Facility	$	1,715,338	$	1,749,185	$	1,715,338	$	1,749,185
6.125% Senior Notes due 2021	$	148,657	$	148,098	$	147,542	$	150,134
5.125% Senior Notes due 2022	$	296,946	$	296,174	$	283,583	$	296,914
5.625% Senior Notes due 2023	$	643,289	$	641,891	$	609,516	$	651,519
6.500% Senior Notes due 2024	$	383,304	$	382,251	$	369,888	$	397,541
9.0% and 9.5% Revenue Bonds	$	—	$	22,289	$	—	$	22,289
Other long-term debt	$	5,953	$	—	$	5,953	$	—
Derivative instruments	$	60,524	$	12,997	$	60,524	$	12,997

Leases (Tables)

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Schedule of Aggregate Minimum Lease Payments under Non-cancelable Operating Leases

Aggregate minimum lease payments under non-cancelable operating leases with original or remaining lease terms in excess of one year were as follows at December 31, 2018 (in thousands):

2019	$	64,958
2020		61,704
2021		57,195
2022		51,570
2023		47,684
Thereafter		777,684
Total minimum rental obligations	$	1,060,795

Noncontrolling Interests (Tables)

12 Months Ended

Dec. 31, 2018

Noncontrolling Interest [Abstract]

Summary of Redeemable Noncontrolling Interests

The components of redeemable noncontrolling interests are as follows (in thousands):

Balance at January 1, 2017	$	17,754
Acquisition of redeemable noncontrolling interests		4,909
Net loss attributable to noncontrolling interests		(246	)
Balance at December 31, 2017		22,417
Acquisition of redeemable noncontrolling interests		6,125
Net income attributable to noncontrolling interests		264
Balance at December 31, 2018	$	28,806

Segment Information (Tables)

12 Months Ended

Dec. 31, 2018

Summary of Reconciliation of Segment EBITDA to Income before Income Taxes

The following tables set forth the financial information by operating segment, including a reconciliation of Segment EBITDA to income before income taxes (in thousands):

	Year Ended December 31,
	2018			2017			2016
Revenue:
U.S. Facilities	$	1,904,695		$	1,809,844		$	1,698,525
U.K. Facilities		1,107,747			1,026,472			1,110,361
Corporate and Other		—			—			2,028
	$	3,012,442		$	2,836,316		$	2,810,914
Segment EBITDA (1) :
U.S. Facilities	$	488,207		$	475,260		$	443,341
U.K. Facilities		185,755			198,566			245,046
Corporate and Other		(80,386	)		(69,467	)		(79,797	)
	$	593,576		$	604,359		$	608,590

	Year Ended December 31,
	2018			2017			2016
Segment EBITDA(1)	$	593,576		$	604,359		$	608,590
Plus (less):
Equity-based compensation expense		(22,001	)		(23,467	)		(28,345	)
Debt extinguishment costs		(1,815	)		(810	)		(4,253	)
Legal settlements expense		(22,076	)		—			—
Loss on impairment		(337,889	)		—			—
Loss on divestiture		—			—			(178,809	)
Gain on foreign currency derivatives		—			—			523
Transaction-related expenses		(34,507	)		(24,267	)		(48,323	)
Interest expense, net		(185,410	)		(176,007	)		(181,325	)
Depreciation and amortization		(158,832	)		(143,010	)		(135,103	)
(Loss) income before income taxes	$	(168,954	)	$	236,798		$	32,955

Summary of Assets by Operating Segment

	December 31,
	2018		2017
Assets (2) :
U.S. Facilities	$	3,779,040	$	3,567,126
U.K. Facilities		2,175,809		2,647,150
Corporate and Other		217,655		210,226
	$	6,172,504	$	6,424,502

(1)

(2)

Goodwill [Member]

Summary of Assets by Operating Segment

	U.S. Facilities		U.K. Facilities			Corporate and Other		Consolidated
Goodwill:
Balance at January 1, 2018	$	2,042,592	$	708,582		$	—	$	2,751,174
Loss on impairment		—		(325,875	)		—		(325,875	)
Increase from contribution of redeemable noncontrolling interests		2,245		—			—		2,245
Foreign currency translation loss		—		(31,894	)		—		(31,894	)
Prior year purchase price adjustments		—		762			—		762
Balance at December 31, 2018	$	2,044,837	$	351,575		$	—	$	2,396,412

Employee Benefit Plans (Tables)

12 Months Ended

Dec. 31, 2018

Compensation And Retirement Disclosure [Abstract]

Summary of Funded Status (Unfunded Liability) of Partnerships in Care Pension Plan Based Upon Actuarial Valuations

The following table summarizes the funded status (unfunded liability) of the Partnerships in Care Pension Plan based upon actuarial valuations prepared at December 31, 2018 and 2017 (in thousands):

	2018		2017
Projected benefit obligation	$	57,993	$	67,288
Fair value of plan assets		54,491		58,493
Unfunded liability	$	3,502	$	8,795

Summary of Changes in Partnerships in Care Pension Plan Net Pension Liability

The following table summarizes changes in the Partnerships in Care Pension Plan net pension liability at December 31, 2018 and 2017 (in thousands):

	2018			2017
Net pension liability at beginning of period	$	8,795		$	10,700
Employer contributions		(2,267	)		(809	)
Net pension expense		283			426
Pension liability adjustment		(2,803	)		(2,544	)
Foreign currency translation (loss) gain		(506	)		1,022
Net pension liability at end of period	$	3,502		$	8,795

Summary of Assumptions Used to Determine Plan Benefit obligation

Discount rate		2.8	%		2.5	%
Compensation increase rate		3.3	%		3.3	%
Measurement date	December 31, 2018			December 31, 2017

Assumptions used to determine the net periodic pension plan expense for the years ended December 31, 2018 and 2017 were as follows:

	2018			2017
Discount rate		2.8	%		2.5	%
Expected long-term rate of return on plan assets		2.8	%		2.5	%

Summary of Components of Net Pension Plan Expense

A summary of the components of net pension plan expense for the years ended December 31, 2018 and 2017 is as follows (in thousands):

	2018			2017
Interest cost on projected benefit obligation	$	1,602		$	1,738
Expected return on assets		(1,319	)		(1,312	)
Net pension expense	$	283		$	426

Schedule of Weighted-Average Asset Allocation by Asset Category in Partnerships in Care Pension Plan

The Partnerships in Care Pension Plan’s weighted-average asset allocations by asset category at December 31, 2018 and 2017 were as follows:

	December 31, 2018			December 31, 2017
Cash and cash equivalents		1.3	%		0.7	%
U.K. government obligation		15.0	%		19.0	%
Annuity contracts		38.6	%		38.6	%
Equity securities		25.4	%		29.4	%
Debt securities		15.8	%		9.9	%
Other		3.9	%		2.4	%

Other Comprehensive Loss (Tables)

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Components Of Accumulated Other Comprehensive Loss

The components of accumulated other comprehensive loss are as follows (in thousands):

	Foreign Currency Translation Adjustments			Change in Fair Value of Derivative Instruments			Pension Plan			Total
Balance at January 1, 2016	$	(106,309	)	$	—		$	1,662		$	(104,647	)
Foreign currency translation loss		(477,772	)		—			(195	)		(477,967	)
Gain on derivative instruments, net of tax of $29.1 million		—			40,598			—			40,598
Pension liability adjustment, net of tax of $(1.3) million		—			—			(7,554	)		(7,554	)
Balance at December 31, 2016		(584,081	)		40,598			(6,087	)		(549,570	)
Foreign currency translation gain		207,341			—			(557	)		206,784
Loss on derivative instruments, net of tax of $(22.9) million		—			(33,431	)		—			(33,431	)
Pension liability adjustment, net of tax of $0.4 million		—			—			2,099			2,099
Balance at December 31, 2017		(376,740	)		7,167			(4,545	)		(374,118	)
Foreign currency translation gain		(127,788	)		—			267			(127,521	)
Gain on derivative instruments, net of tax of $12.7 million		—			36,799			—			36,799
Pension liability adjustment, net of tax of $0.3 million		—			—			2,463			2,463
Balance at December 31, 2018	$	(504,528	)	$	43,966		$	(1,815	)	$	(462,377	)

Quarterly Information (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Schedule of Quarterly Financial Information

	Quarter Ended
	March 31,			June 30,		September 30,		December 31,
	(In thousands except per share amounts)
2018:
Revenue	$	742,241		$	765,738	$	760,916	$	743,547
Income (loss) before income taxes	$	48,088		$	69,258	$	55,036	$	(341,336	)
Net income (loss) attributable to Acadia Healthcare Company, Inc. stockholders	$	50,819	⁽¹⁾	$	58,836	$	46,232	$	(331,637	)	⁽²⁾
Basic earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$	0.58	⁽¹⁾	$	0.67	$	0.53	$	(3.80	)	⁽²⁾
Diluted earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$	0.58	⁽¹⁾	$	0.67	$	0.53	$	(3.80	)	⁽²⁾
2017:
Revenue	$	679,194		$	715,896	$	716,714	$	724,512
Income before income taxes	$	48,484		$	66,216	$	61,459	$	60,689
Net income attributable to Acadia Healthcare Company, Inc. stockholders	$	34,958		$	49,630	$	45,618	$	69,629		⁽³⁾
Basic earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$	0.40		$	0.57	$	0.52	$	0.80		⁽³⁾
Diluted earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$	0.40		$	0.57	$	0.52	$	0.80		⁽³⁾

(1)	Includes tax benefits of $10.5 million pursuant to a change in the Company’s provisional amounts recorded at December 31, 2017 related to the enactment of the Tax Act.

(2)	Includes loss on impairment of $337.9 million and legal settlements expense of $22.1 million.

(3)	Includes a one-time tax benefit of $20.2 million on revaluation of deferred tax items pursuant to the enactment of the Tax Act.

Financial Information for the Company and Its Subsidiaries (Tables)

12 Months Ended

Dec. 31, 2018

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Summary of Condensed Consolidating Balance Sheets

Acadia Healthcare Company, Inc.

Condensed Consolidating Balance Sheets

December 31, 2018

(In thousands)

	Parent		Combined Subsidiary Guarantors		Combined Non- Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Current assets:
Cash and cash equivalents	$	—	$	32,471	$	18,039	$	—		$	50,510
Accounts receivable, net		—		248,218		69,869		—			318,087
Other current assets		—		60,160		21,660		—			81,820
Total current assets		—		340,849		109,568		—			450,417
Property and equipment, net		—		1,219,803		1,887,963		—			3,107,766
Goodwill		—		1,936,057		460,355		—			2,396,412
Intangible assets, net		—		56,611		32,379		—			88,990
Deferred tax assets – noncurrent		1,841		—		3,468		(1,841	)		3,468
Derivative instruments		60,524		—		—		—			60,524
Investment in subsidiaries		5,190,771		—		—		(5,190,771	)		—
Other assets		306,495		52,824		9,548		(303,940	)		64,927
Total assets	$	5,559,631	$	3,606,144	$	2,503,281	$	(5,496,552	)	$	6,172,504
Current liabilities:
Current portion of long-term debt	$	34,112	$	—	$	—	$	—		$	34,112
Accounts payable		—		79,463		38,277		—			117,740
Accrued salaries and benefits		—		84,150		29,149		—			113,299
Other accrued liabilities		32,837		42,062		76,327		—			151,226
Total current liabilities		66,949		205,675		143,753		—			416,377
Long-term debt		3,159,375		—		303,940		(303,940	)		3,159,375
Deferred tax liabilities – noncurrent		—		31,874		50,339		(1,841	)		80,372
Other liabilities		—		107,866		46,401		—			154,267
Total liabilities		3,226,324		345,415		544,433		(305,781	)		3,810,391
Redeemable noncontrolling interests		—		—		28,806		—			28,806
Total equity		2,333,307		3,260,729		1,930,042		(5,190,771	)		2,333,307
Total liabilities and equity	$	5,559,631	$	3,606,144	$	2,503,281	$	(5,496,552	)	$	6,172,504

Acadia Healthcare Company, Inc.

Condensed Consolidating Balance Sheets

December 31, 2017

(In thousands)

	Parent		Combined Subsidiary Guarantors		Combined Non- Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Current assets:
Cash and cash equivalents	$	—	$	46,860	$	20,430	$	—		$	67,290
Accounts receivable, net		—		230,890		66,035		—			296,925
Other current assets		—		85,746		21,589		—			107,335
Total current assets		—		363,496		108,054		—			471,550
Property and equipment, net		—		1,086,802		1,961,328		—			3,048,130
Goodwill		—		1,936,057		815,117		—			2,751,174
Intangible assets, net		—		57,628		29,720		—			87,348
Deferred tax assets – noncurrent		2,370		—		3,731		(2,370	)		3,731
Derivative instruments		12,997		—		—		—			12,997
Investment in subsidiaries		5,429,386		—		—		(5,429,386	)		—
Other assets		381,913		38,860		7,807		(379,008	)		49,572
Total assets	$	5,826,666	$	3,482,843	$	2,925,757	$	(5,810,764	)	$	6,424,502
Current liabilities:
Current portion of long-term debt	$	34,550	$	—	$	280	$	—		$	34,830
Accounts payable		—		70,767		31,532		—			102,299
Accrued salaries and benefits		—		69,057		29,990		—			99,047
Other accrued liabilities		36,196		27,676		77,341		—			141,213
Total current liabilities		70,746		167,500		139,143		—			377,389
Long-term debt		3,183,049		—		401,017		(379,008	)		3,205,058
Deferred tax liabilities – noncurrent		—		27,975		54,728		(2,370	)		80,333
Other liabilities		—		103,112		63,322		—			166,434
Total liabilities		3,253,795		298,587		658,210		(381,378	)		3,829,214
Redeemable noncontrolling interests		—		—		22,417		—			22,417
Total equity		2,572,871		3,184,256		2,245,130		(5,429,386	)		2,572,871
Total liabilities and equity	$	5,826,666	$	3,482,843	$	2,925,757	$	(5,810,764	)	$	6,424,502

Summary of Condensed Consolidating Statement of Comprehensive Income (Loss)

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Comprehensive Income (Loss)

Year Ended December 31, 2018

(In thousands)

	Parent			Combined Subsidiary Guarantors		Combined Non- Guarantors			Consolidating Adjustments		Total Consolidated Amounts
Revenue	$	—		$	1,788,757	$	1,223,685		$	—		3,012,442
Salaries, wages and benefits		22,001			965,419		671,928			—		1,659,348
Professional fees		—			98,441		128,984			—		227,425
Supplies		—			76,526		42,788			—		119,314
Rents and leases		—			33,101		47,181			—		80,282
Other operating expenses		—			225,446		129,052			—		354,498
Depreciation and amortization		—			74,341		84,491			—		158,832
Interest expense, net		65,588			92,983		26,839			—		185,410
Debt extinguishment costs		940			—		875			—		1,815
Legal settlements expense		—			22,076		—			—		22,076
Loss on impairment		—			—		337,889			—		337,889
Transaction-related expenses		—			29,720		4,787			—		34,507
Total expenses		88,529			1,618,053		1,474,814			—		3,181,396
(Loss) income before income taxes		(88,529	)		170,704		(251,129	)		—		(168,954	)
Equity in earnings of subsidiaries		(98,669	)		—		—			98,669		—
(Benefit from) provision for income taxes		(11,712	)		19,045		(801	)		—		6,532
Net (loss) income		(175,486	)		151,659		(250,328	)		98,669		(175,486	)
Net income attributable to noncontrolling interests		—			—		(264	)		—		(264	)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(175,486	)	$	151,659	$	(250,592	)	$	98,669	$	(175,750	)
Other comprehensive income:
Foreign currency translation loss		—			—		(127,521	)		—		(127,521	)
Gain on derivative instruments		36,799			—		—			—		36,799
Pension liability adjustment, net		—			—		2,463			—		2,463
Other comprehensive income (loss)		36,799			—		(125,058	)		—		(88,259	)
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc.	$	(138,687	)	$	151,659	$	(375,650	)	$	98,669	$	(264,009	)

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Comprehensive Income (Loss)

Year Ended December 31, 2017

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Revenue before provision for doubtful accounts	$	—		$	1,746,656		$	1,130,578		$	—		$	2,877,234
Provision for doubtful accounts		—			(35,636	)		(5,282	)		—			(40,918	)
Revenue		—			1,711,020			1,125,296			—			2,836,316
Salaries, wages and benefits		23,467			902,180			610,513			—			1,536,160
Professional fees		—			93,991			102,232			—			196,223
Supplies		—			75,248			39,191			—			114,439
Rents and leases		—			33,365			43,410			—			76,775
Other operating expenses		—			217,900			113,927			—			331,827
Depreciation and amortization		—			66,482			76,528			—			143,010
Interest expense, net		61,872			81,274			32,861			—			176,007
Debt extinguishment costs		810			—			—			—			810
Transaction-related expenses		—			11,236			13,031			—			24,267
Total expenses		86,149			1,481,676			1,031,693			—			2,599,518
(Loss) income before income taxes		(86,149	)		229,344			93,603			—			236,798
Equity in earnings of subsidiaries		259,282			—			—			(259,282	)		—
(Benefit from) provision for income taxes		(26,456	)		69,882			(6,217	)		—			37,209
Net income (loss)		199,589			159,462			99,820			(259,282	)		199,589
Net loss attributable to noncontrolling interests		—			—			246			—			246
Net income (loss) attributable to Acadia Healthcare Company, Inc.	$	199,589		$	159,462		$	100,066		$	(259,282	)	$	199,835
Other comprehensive income:
Foreign currency translation gain		—			—			206,784			—			206,784
Loss on derivative instruments		(33,431	)		—			—			—			(33,431	)
Pension liability adjustment, net		—			—			2,099			—			2,099
Other comprehensive (loss) income		(33,431	)		—			208,883			—			175,452
Comprehensive income (loss) attributable to Acadia Healthcare Company, Inc.	$	166,158		$	159,462		$	308,949		$	(259,282	)	$	375,287

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Comprehensive Income (Loss)

Year Ended December 31, 2016

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Revenue before provision for doubtful accounts	$	—		$	1,662,734		$	1,190,089		$	—		$	2,852,823
Provision for doubtful accounts		—			(38,349	)		(3,560	)		—			(41,909	)
Revenue		—			1,624,385			1,186,529			—			2,810,914
Salaries, wages and benefits		28,345			865,104			648,405			—			1,541,854
Professional fees		—			89,062			96,424			—			185,486
Supplies		—			76,246			41,179			—			117,425
Rents and leases		—			34,540			38,808			—			73,348
Other operating expenses		—			206,308			106,248			—			312,556
Depreciation and amortization		—			58,018			77,085			—			135,103
Interest expense, net		50,921			75,848			54,556			—			181,325
Debt extinguishment costs		4,253			—			—			—			4,253
Loss on divestiture		—			778			178,031			—			178,809
Gain on foreign currency derivatives		(523	)		—			—			—			(523	)
Transaction-related expenses		—			32,173			16,150			—			48,323
Total expenses		82,996			1,438,077			1,256,886			—			2,777,959
(Loss) income before income taxes		(82,996	)		186,308			(70,357	)		—			32,955
Equity in earnings of subsidiaries		65,560			—			—			(65,560	)		—
(Benefit from) provision for income taxes		(21,612	)		68,335			(17,944	)		—			28,779
Net income (loss)		4,176			117,973			(52,413	)		(65,560	)		4,176
Net loss attributable to noncontrolling interests		—			—			1,967			—			1,967
Net income (loss) attributable to Acadia Healthcare Company, Inc.	$	4,176		$	117,973		$	(50,446	)	$	(65,560	)	$	6,143
Other comprehensive income:
Foreign currency translation loss		—			—			(477,967	)		—			(477,967	)
Gain on derivative instruments		40,598			—			—			—			40,598
Pension liability adjustment, net		—			—			(7,554	)		—			(7,554	)
Other comprehensive income (loss)		40,598			—			(485,521	)		—			(444,923	)
Comprehensive income (loss) attributable to Acadia Healthcare Company, Inc.	$	44,774		$	117,973		$	(535,967	)	$	(65,560	)	$	(438,780	)

Summary of Condensed Consolidating Statement of Cash Flows

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Cash Flows

Year Ended December 31, 2018

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Operating activities:
Net (loss) income	$	(175,486	)	$	151,659		$	(250,328	)	$	98,669		$	(175,486	)
Adjustments to reconcile net (loss) income to net cash (used in) provided by continuing operating activities:
Equity in earnings of subsidiaries		98,669			—			—			(98,669	)		—
Depreciation and amortization		—			74,341			84,491			—			158,832
Amortization of debt issuance costs		10,825			—			(369	)		—			10,456
Equity-based compensation expense		22,001			—			—			—			22,001
Deferred income taxes		529			(8,795	)		(1,448	)		—			(9,714	)
Debt extinguishment costs		940			—			875			—			1,815
Legal settlements expense		—			22,076			—			—			22,076
Loss on impairment		—			—			337,889			—			337,889
Other		6,981			5,457			(67	)		—			12,371
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net		—			(17,328	)		507			—			(16,821	)
Other current assets		—			14,881			(1,017	)		—			13,864
Other assets		4,596			118			2,644			(4,596	)		2,762
Accounts payable and other accrued liabilities		—			15,743			10,311			—			26,054
Accrued salaries and benefits		—			15,094			654			—			15,748
Other liabilities		—			3,014			(8,233	)		—			(5,219	)
Net cash (used in) provided by continuing operating activities		(30,945	)		276,260			175,909			(4,596	)		416,628
Net cash used in discontinued operating activities		—			(2,548	)		—			—			(2,548	)
Net cash (used in) provided by operating activities		(30,945	)		273,712			175,909			(4,596	)		414,080
Investing activities:
Cash paid for capital expenditures		—			(210,023	)		(131,439	)		—			(341,462	)
Cash paid for real estate acquisitions		—			(14,096	)		(4,287	)		—			(18,383	)
Other		—			(4,199	)		3,080			—			(1,119	)
Net cash used in investing activities		—			(228,318	)		(132,646	)		—			(360,964	)
Financing activities:
Principal payments on long-term debt		(39,738	)		(169	)		(4,427	)		4,596			(39,738	)
Repayment of long-term debt		—			—			(21,920	)		—			(21,920	)
Common stock withheld for minimum statutory taxes, net		(3,407	)		—			—			—			(3,407	)
Other		(1,742	)		2,094			(2,617	)		—			(2,265	)
Cash provided by (used in) intercompany activity		75,832			(61,708	)		(14,124	)		—			—
Net cash provided by (used in) financing activities		30,945			(59,783	)		(43,088	)		4,596			(67,330	)
Effect of exchange rate changes on cash		—			—			(2,566	)		—			(2,566	)
Net decrease in cash and cash equivalents		—			(14,389	)		(2,391	)		—			(16,780	)
Cash and cash equivalents at beginning of the period		—			46,860			20,430			—			67,290
Cash and cash equivalents at end of the period	$	—		$	32,471		$	18,039		$	—		$	50,510

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Cash Flows

Year Ended December 31, 2017

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Operating activities:
Net income (loss)	$	199,589		$	159,462		$	99,820		$	(259,282	)	$	199,589
Adjustments to reconcile net income (loss) to net cash (used in) provided by continuing operating activities:
Equity in earnings of subsidiaries		(259,282	)		—			—			259,282			—
Depreciation and amortization		—			66,482			76,528			—			143,010
Amortization of debt issuance costs		10,270			—			(415	)		—			9,855
Equity-based compensation expense		23,467			—			—			—			23,467
Deferred income taxes		1,236			28,882			1,254			—			31,372
Debt extinguishment costs		810			—			—			—			810
Other		4,189			2,498			4,725			—			11,412
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net		—			(21,791	)		(6,779	)		—			(28,570	)
Other current assets		—			(6,429	)		27,237			—			20,808
Other assets		24,549			(3,277	)		101			(24,549	)		(3,176	)
Accounts payable and other accrued liabilities		—			4,909			(15,022	)		—			(10,113	)
Accrued salaries and benefits		—			(3,974	)		(5,014	)		—			(8,988	)
Other liabilities		—			8,794			3,000			—			11,794
Net cash provided by (used in) continuing operating activities		4,828			235,556			185,435			(24,549	)		401,270
Net cash used in discontinued operating activities		—			(1,693	)		—			—			(1,693	)
Net cash provided by (used in) operating activities		4,828			233,863			185,435			(24,549	)		399,577
Investing activities:
Cash paid for acquisitions, net of cash acquired		—			—			(18,191	)		—			(18,191	)
Cash paid for capital expenditures		—			(161,312	)		(112,865	)		—			(274,177	)
Cash paid for real estate acquisitions		—			(37,047	)		(4,010	)		—			(41,057	)
Other		—			(7,944	)		4,843			—			(3,101	)
Net cash used in investing activities		—			(206,303	)		(130,223	)		—			(336,526	)
Financing activities:
Principal payments on long-term debt		(34,550	)		(14,250	)		(10,554	)		24,549			(34,805	)
Repayment of long-term debt		(22,500	)		—			—			—			(22,500	)
Common stock withheld for minimum statutory taxes, net		(3,455	)		—			—			—			(3,455	)
Other		(539	)		1,225			—			—			686
Cash provided by (used in) intercompany activity		56,216			16,644			(72,860	)		—			—
Net cash (used in) provided by financing activities		(4,828	)		3,619			(83,414	)		24,549			(60,074	)
Effect of exchange rate changes on cash		—			—			7,250			—			7,250
Net increase (decrease) in cash and cash equivalents		—			31,179			(20,952	)		—			10,227
Cash and cash equivalents at beginning of the period		—			15,681			41,382			—			57,063
Cash and cash equivalents at end of the period	$	—		$	46,860		$	20,430		$	—		$	67,290

Acadia Healthcare Company, Inc.

Condensed Consolidating Statement of Cash Flows

Year Ended December 31, 2016

(In thousands)

	Parent			Combined Subsidiary Guarantors			Combined Non- Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Operating activities:
Net income (loss)	$	4,176		$	117,973		$	(52,413	)	$	(65,560	)	$	4,176
Adjustments to reconcile net income (loss) to net cash (used in) provided by continuing operating activities:
Equity in earnings of subsidiaries		(65,560	)		—			—			65,560			—
Depreciation and amortization		—			58,018			77,085			—			135,103
Amortization of debt issuance costs		10,751			—			(427	)		—			10,324
Equity-based compensation expense		28,345			—			—			—			28,345
Deferred income taxes		(2,172	)		50,611			(19,792	)		—			28,647
Loss from discontinued operations, net of taxes		—			—			—			—			—
Debt extinguishment costs		4,253			—			—			—			4,253
Loss on divestiture		—			778			178,031			—			178,809
(Gain) loss on foreign currency derivatives		(523	)		—			—			—			(523	)
Other		—			4,022			693			—		4715
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net		—			(24,017	)		8,299			—			(15,718	)
Other current assets		—			(3,138	)		(17,510	)		—			(20,648	)
Other assets		(3,109	)		(4,048	)		(306	)		3,109			(4,354	)
Accounts payable and other accrued liabilities		—			(45,552	)		68,245			—			22,693
Accrued salaries and benefits		—			3,844			(12,416	)		—			(8,572	)
Other liabilities		—			4,050			434			—			4,484
Net cash (used in) provided by continuing operating activities		(23,839	)		162,541			229,923			3,109			371,734
Net cash used in discontinued operating activities		—			(10,256	)		—			—			(10,256	)
Net cash (used in) provided by operating activities		(23,839	)		152,285			229,923			3,109			361,478
Investing activities:
Cash paid for acquisitions, net of cash acquired		—			(103,359	)		(580,096	)		—			(683,455	)
Cash paid for capital expenditures		—			(177,593	)		(129,879	)		—			(307,472	)
Cash paid for real estate acquisitions		—			(28,956	)		(11,801	)		—			(40,757	)
Settlement of foreign currency derivatives		—			523			—			—			523
Cash received for divestiture		370,000			7,859			(4,593	)		—			373,266
Other		—			(1,573	)		(897	)		—			(2,470	)
Net cash used in investing activities		370,000			(303,099	)		(727,266	)		—			(660,365	)
Financing activities:
Borrowings on long-term debt		1,480,000			—			—			—			1,480,000
Borrowings on revolving credit facility		179,000			—			—			—			179,000
Principal payments on revolving credit facility		(337,000	)		—			—			—			(337,000	)
Principal payments on long-term debt		(49,706	)		(293,000	)		(3,344	)		296,109			(49,941	)
Repayment of assumed debt		(1,348,389	)		—			—			—			(1,348,389	)
Repayment of long-term debt		(200,594	)		—			—			—			(200,594	)
Payment of debt issuance costs		(36,649	)		—			—			—			(36,649	)
Issuance of common stock		685,097			—			—			—			685,097
Common stock withheld for minimum statutory taxes, net		(8,846	)		—			—			—			(8,846	)
Other		(1,149	)		(2,688	)		—			—			(3,837	)
Cash (used in) provided by intercompany activity		(707,925	)		460,196			546,947			(299,218	)		—
Net cash (used in) provided by financing activities		(346,161	)		164,508			543,603			(3,109	)		358,841
Effect of exchange rate changes on cash		—			—			(14,106	)		—			(14,106	)
Net increase in cash and cash equivalents		—			13,694			32,154			—			45,848
Cash and cash equivalents at beginning of the period		—			1,987			9,228			—			11,215
Cash and cash equivalents at end of the period	$	—		$	15,681		$	41,382		$	—		$	57,063

Description of Business and Basis of Presentation - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2018 USD ($) Facility Bed State	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Accounting Policies [Abstract]
Number of facilities \| Facility	583
Number of beds \| Bed	18,100
Number of operating states \| State	40
General and administrative expenses \| $	$ 86.6	$ 76.4	$ 86.8

Summary of Significant Accounting Policies - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2018 USD ($) Segment	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Significant Accounting Policies [Line Items]
Maximum professional liability aggregate policy limit	$ 75,000,000
Professional and general liability reserve	42,800,000	$ 55,000,000
Professional and general liability reserve current	5,000,000	22,800,000
Professional and general liability reserve noncurrent	37,800,000	32,200,000
Insurance receivable	8,200,000	22,700,000
Insurance receivable - current portion	2,049,000	17,588,000
Insurance receivable noncurrent	6,100,000	5,100,000
Workers compensation insurance claims deductible per accident	500,000
Reserve for workers compensation liability	19,300,000	18,500,000
Accrued salaries and benefits	10,000,000	10,000,000
Other long-term liabilities	9,300,000	8,500,000
Depreciation expense	$ 158,800,000	143,000,000	$ 134,800,000
Impairment of long-lived assets		0	0
Number of operating segment \| Segment	2
Number of reporting unit \| Segment	2
Intangible assets impairment charges		$ 0	$ 0
U.S. federal corporate tax rate	21.00%	35.00%	35.00%
U.K. Facilities [Member]
Significant Accounting Policies [Line Items]
Impairment of long-lived assets	$ 12,000,000
Intangible assets impairment charges	325,900,000
U.S. Facilities [Member]
Significant Accounting Policies [Line Items]
Intangible assets impairment charges	0
Maximum [Member]
Significant Accounting Policies [Line Items]
Maximum self insured professional liability limit per claim	$ 3,000,000
Maximum [Member] \| Discount Rate [Member]
Significant Accounting Policies [Line Items]
Impairment of goodwill, measurement input	0.105
Maximum [Member] \| Building and Improvements [Member]
Significant Accounting Policies [Line Items]
Property plant and equipment estimated useful life	50 years
Maximum [Member] \| Equipment [Member]
Significant Accounting Policies [Line Items]
Property plant and equipment estimated useful life	7 years
Minimum [Member]
Significant Accounting Policies [Line Items]
Maximum professional liability retention limit	$ 3,000,000
Minimum [Member] \| Discount Rate [Member]
Significant Accounting Policies [Line Items]
Impairment of goodwill, measurement input	0.090
Minimum [Member] \| Building and Improvements [Member]
Significant Accounting Policies [Line Items]
Property plant and equipment estimated useful life	10 years
Minimum [Member] \| Equipment [Member]
Significant Accounting Policies [Line Items]
Property plant and equipment estimated useful life	3 years

Summary of Significant Accounting Policies - Other Current Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Prepaid expenses	$ 30,802	$ 27,320
Other receivables	19,205	21,427
Cost report receivable	10,340	9,028
Workers’ compensation deposits – current portion	10,000	10,000
Inventory	5,055	4,787
Insurance receivable - current portion	2,049	17,588
Income taxes receivable	2,380	15,056
Other	1,989	2,129
Other current assets	$ 81,820	$ 107,335

Summary of Significant Accounting Policies - Summary of Other Accrued Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Accounts Payable And Accrued Liabilities Current [Abstract]
Accrued expenses	$ 44,938	$ 37,268
Accrued interest	32,838	36,370
Unearned income	32,154	31,342
Accrued legal settlements	22,076
Insurance liability – current portion	4,956	22,788
Accrued property taxes	4,136	3,945
Income taxes payable	3,041	1,012
Other	7,087	8,488
Other accrued liabilities	$ 151,226	$ 141,213

Revenue - Additional Information (Detail) - USD ($)	12 Months Ended
Revenue - Additional Information (Detail) - USD ($)	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Reductions to accounts receivable	$ (16,821,000)	$ (28,570,000)	$ (15,718,000)
Cost report receivables	10,340,000	9,028,000
Net adjustments to estimated cost report settlements resulted in increases to revenue	500,000	200,000	700,000
Costs of providing charity care services	4,700,000	5,300,000	$ 5,600,000
Accounting Standards Update 2014-09 [Member]
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Cumulative-effect adjustment in retained earnings	0
Reductions to accounts receivable	$ 47,000,000	$ 40,900,000

Revenue - Summary of Impact of Adoption of Accounting Standards (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Revenue before provision for doubtful accounts									$ 3,012,442	$ 2,877,234	$ 2,852,823
Provision for doubtful accounts										(40,918)	(41,909)
Revenue	$ 743,547	$ 760,916	$ 765,738	$ 742,241	$ 724,512	$ 716,714	$ 715,896	$ 679,194	3,012,442	$ 2,836,316	$ 2,810,914
Calculated under Revenue Guidance in Effect before Topic 606 [Member]
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Revenue before provision for doubtful accounts									3,060,180
Provision for doubtful accounts									(47,738)
Revenue									$ 3,012,442

Revenue - Schedule of U.S. Revenue Attributed to Each Category (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disaggregation of Revenue [Line Items]
Revenue	$ 743,547	$ 760,916	$ 765,738	$ 742,241	$ 724,512	$ 716,714	$ 715,896	$ 679,194	$ 3,012,442	$ 2,836,316	$ 2,810,914
U.S. Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue									1,904,695	1,809,844	1,698,525
U.S. Facilities [Member] \| Acute Inpatient Psychiatric Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue									814,124	757,211	694,151
U.S. Facilities [Member] \| Specialty Treatment Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue									761,017	725,151	702,225
U.S. Facilities [Member] \| Residential Treatment Centers [Member]
Disaggregation of Revenue [Line Items]
Revenue									293,053	284,637	256,539
U.S. Facilities [Member] \| Outpatient Community-Based Services [Member]
Disaggregation of Revenue [Line Items]
Revenue									$ 36,501	$ 42,845	$ 45,610

Revenue - Schedule of U.S. Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 3,012,442	$ 2,877,234	$ 2,852,823
Provision for doubtful accounts										(40,918)	(41,909)
Revenue	$ 743,547	$ 760,916	$ 765,738	$ 742,241	$ 724,512	$ 716,714	$ 715,896	$ 679,194	3,012,442	2,836,316	2,810,914
U.S. Facilities [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									1,904,695	1,850,556	1,740,356
Provision for doubtful accounts										(40,712)	(41,831)
Revenue									$ 1,904,695	$ 1,809,844	$ 1,698,525
Revenue before provision for doubtful accounts, Percentage									100.00%	100.00%	100.00%
U.S. Facilities [Member] \| Commercial [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 573,089	$ 569,242	$ 534,468
Revenue before provision for doubtful accounts, Percentage									30.10%	30.80%	30.70%
U.S. Facilities [Member] \| Medicare [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 280,340	$ 281,270	$ 266,868
Revenue before provision for doubtful accounts, Percentage									14.70%	15.20%	15.30%
U.S. Facilities [Member] \| Medicaid [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 893,644	$ 796,375	$ 725,508
Revenue before provision for doubtful accounts, Percentage									46.90%	43.00%	41.70%
U.S. Facilities [Member] \| Self-Pay [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 134,054	$ 169,727	$ 185,094
Revenue before provision for doubtful accounts, Percentage									7.10%	9.20%	10.60%
U.S. Facilities [Member] \| Other [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 23,568	$ 33,942	$ 28,418
Revenue before provision for doubtful accounts, Percentage									1.20%	1.80%	1.70%

Revenue - Schedule of U.K. Revenue Attributed to Each Category (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disaggregation of Revenue [Line Items]
Revenue	$ 743,547	$ 760,916	$ 765,738	$ 742,241	$ 724,512	$ 716,714	$ 715,896	$ 679,194	$ 3,012,442	$ 2,836,316	$ 2,810,914
U.K. Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue									1,107,747	1,026,472	1,110,361
U.K. Facilities [Member] \| Health Care Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue									615,741	567,747	683,467
U.K. Facilities [Member] \| Education and Children's Services [Member]
Disaggregation of Revenue [Line Items]
Revenue									192,129	170,328	146,703
U.K. Facilities [Member] \| Adult Care Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue									$ 299,877	$ 288,397	$ 280,191

Revenue - Schedule of U.K. Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 3,012,442	$ 2,877,234	$ 2,852,823
Provision for doubtful accounts										(40,918)	(41,909)
Revenue	$ 743,547	$ 760,916	$ 765,738	$ 742,241	$ 724,512	$ 716,714	$ 715,896	$ 679,194	3,012,442	2,836,316	2,810,914
U.K. Facilities [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									1,107,747	1,026,678	1,110,439
Provision for doubtful accounts										(206)	(78)
Revenue									$ 1,107,747	$ 1,026,472	$ 1,110,361
Revenue before provision for doubtful accounts, Percentage									100.00%	100.00%	100.00%
U.K. Facilities [Member] \| U.K. Public Funded Sources [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 1,000,828	$ 922,159	$ 1,021,888
Revenue before provision for doubtful accounts, Percentage									90.30%	89.80%	92.00%
U.K. Facilities [Member] \| Self-Pay [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 104,824	$ 95,687	$ 83,066
Revenue before provision for doubtful accounts, Percentage									9.50%	9.30%	7.50%
U.K. Facilities [Member] \| Other [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue before provision for doubtful accounts									$ 2,095	$ 8,832	$ 5,485
Revenue before provision for doubtful accounts, Percentage									0.20%	0.90%	0.50%

Revenue - Summary of the Activity in Unearned Revenue (Detail) - U.K. Facilities [Member] - Unearned Revenue [Member] $ in Thousands	12 Months Ended
	Dec. 31, 2018 USD ($)
Disaggregation of Revenue [Line Items]
Beginning Balance	$ 30,812
Payments received	167,604
Revenue recognized	(164,917)
Foreign currency translation loss	(2,260)
Ending Balance	$ 31,239

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Numerator:
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$ (331,637)	$ 46,232	$ 58,836	$ 50,819	$ 69,629	$ 45,618	$ 49,630	$ 34,958	$ (175,750)	$ 199,835	$ 6,143
Denominator:
Weighted average shares outstanding for basic earnings per share									87,288	86,948	85,701
Effects of dilutive instruments										112	271
Shares used in computing diluted earnings per common share									87,288	87,060	85,972
Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$ (3.80)	$ 0.53	$ 0.67	$ 0.58	$ 0.80	$ 0.52	$ 0.57	$ 0.40	$ (2.01)	$ 2.30	$ 0.07
Diluted	$ (3.80)	$ 0.53	$ 0.67	$ 0.58	$ 0.80	$ 0.52	$ 0.57	$ 0.40	$ (2.01)	$ 2.30	$ 0.07

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 220
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(19))
-URI http://asc.fasb.org/extlink&oid=114873790&loc=SL114874131-224263

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 260
-SubTopic 10
-Section 45
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=109260490&loc=d3e1337-109256

Reference 3: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 260
-SubTopic 10
-Section 55
-Paragraph 52
-URI http://asc.fasb.org/extlink&oid=109256448&loc=d3e4984-109258

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(21))
-URI http://asc.fasb.org/extlink&oid=115205541&loc=SL114868664-224227

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+ Details

- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

+ References

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+ Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

Acquisitions - 2019 Acquisitions - Additional Information (Detail) $ in Millions	Feb. 15, 2019 USD ($) Bed Center	Dec. 31, 2018 Bed
Business Acquisition [Line Items]
Number of beds \| Bed		18,100
Subsequent Event [Member] \| Whittier Pavilion [Member] \| Massachusetts [Member]
Business Acquisition [Line Items]
Number of beds \| Bed	71
Business acquisition cash consideration \| $	$ 17.9
Subsequent Event [Member] \| Mission Treatment [Member] \| California, Nevada, Arizona and Oklahoma [Member]
Business Acquisition [Line Items]
Business acquisition cash consideration \| $	$ 22.5
Number of comprehensive treatment centers operate \| Center	9

Acquisitions - 2017 Acquisitions - Additional Information (Detail) $ in Millions	Nov. 13, 2017 USD ($) Bed	Dec. 31, 2018 Bed
Business Acquisition [Line Items]
Number of beds		18,100
Aspire [Member]
Business Acquisition [Line Items]
Number of beds	36
Business acquisition cash consideration \| $	$ 21.3

Acquisitions - 2016 US Acquisitions - Additional Information (Detail) $ in Millions	Jun. 01, 2016 USD ($) Bed	May 01, 2016 USD ($) Bed	Apr. 01, 2016 USD ($) Bed	Dec. 31, 2018 Bed
Business Acquisition [Line Items]
Number of beds				18,100
Pocono Mountain Recovery Center [Member]
Business Acquisition [Line Items]
Number of beds	108
Business acquisition cash consideration \| $	$ 25.4
TrustPoint Hospital [Member] \| Tennessee [Member]
Business Acquisition [Line Items]
Business acquisition cash consideration \| $		$ 62.7
Number of beds		100
Serenity Knolls Inc [Member]
Business Acquisition [Line Items]
Business acquisition cash consideration \| $			$ 10.0
Number of beds			30

Acquisitions - Priory Acquisition - Additional Information (Detail) $ in Thousands, £ in Millions				3 Months Ended								12 Months Ended
	Nov. 30, 2016 GBP (£)	Oct. 18, 2016 Facility Bed	Feb. 16, 2016 USD ($) Facility Bed shares	Dec. 31, 2018 USD ($)	Sep. 30, 2018 USD ($)	Jun. 30, 2018 USD ($)	Mar. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Sep. 30, 2017 USD ($)	Jun. 30, 2017 USD ($)	Mar. 31, 2017 USD ($)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Business Acquisition [Line Items]
Number of beds to be sold \| Bed		1,000
Cash received on divestitures	£ 320													$ 373,266
Loss on divestiture														(178,809)
Income before income taxes				$ (341,336)	$ 55,036	$ 69,258	$ 48,088	$ 60,689	$ 61,459	$ 66,216	$ 48,484	$ (168,954)	$ 236,798	32,955
U.K. Behavioral Health Facilities [Member]
Business Acquisition [Line Items]
Number of facilities to be sold \| Facility		21
De novo Behavioral Health Facility [Member]
Business Acquisition [Line Items]
Number of facilities to be sold \| Facility		1
U.K. Disposal Group [Member]
Business Acquisition [Line Items]
Loss on divestiture														175,000
Revenue														154,700
Income before income taxes														81,200
U.K. Disposal Group [Member] \| Allocation of Goodwill [Member]
Business Acquisition [Line Items]
Loss on divestiture														106,900
U.K. Disposal Group [Member] \| Loss on Sale of Properties [Member]
Business Acquisition [Line Items]
Loss on divestiture														42,000
U.K. Disposal Group [Member] \| Estimated Transaction Related Expense [Member]
Business Acquisition [Line Items]
Loss on divestiture														$ 26,100
Priory [Member]
Business Acquisition [Line Items]
Business acquisition cash consideration			$ 2,200,000
Business acquisition cash paid			$ 1,900,000
Shares issued for acquisition \| shares			4,033,561
Number of facilities acquired \| Facility			324
Number of beds \| Bed			7,100

Acquisitions - Transaction-Related Expenses - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2018 USD ($)
Jacobs [Member]
Business Acquisition [Line Items]
CEO transition costs	$ 14.0
Cash paid for business acquisitions	8.1
Accelerated vesting of restricted stock awards	5.0
Osteen [Member]
Business Acquisition [Line Items]
CEO transition costs	14.0
Cash paid for business acquisitions	0.4
Payments for acquisition and other costs	$ 0.5

Acquisitions - Transaction Related Expenses as Incurred (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Termination and closure costs	$ 11,829	$ 16,190	$ 15,449
Legal, accounting and other	8,645	8,077	18,024
Advisory and financing commitment fees			14,850
Transaction-related expenses	34,507	$ 24,267	$ 48,323
Chief Executive Officer [Member]
Business Acquisition [Line Items]
CEO transition costs	$ 14,033

Other Intangible Assets - Other Identifiable Intangible Assets and Related Accumulated Amortization (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Schedule Of Finite And Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets subject to amortization, Gross Carrying Amount	$ 3,247	$ 3,247
Intangible assets not subject to amortization, Gross Carrying Amount	88,990	87,348
Total	92,237	90,595
Intangible assets subject to amortization, Accumulated Amortization	(3,247)	(3,247)
Intangible assets not subject to amortization, Accumulated Amortization	0	0
Total	(3,247)	(3,247)
Contract Intangible Assets [Member]
Schedule Of Finite And Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets subject to amortization, Gross Carrying Amount	2,100	2,100
Intangible assets subject to amortization, Accumulated Amortization	(2,100)	(2,100)
Non-Compete Agreements [Member]
Schedule Of Finite And Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets subject to amortization, Gross Carrying Amount	1,147	1,147
Intangible assets subject to amortization, Accumulated Amortization	(1,147)	(1,147)
Licenses and Accreditations [Member]
Schedule Of Finite And Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	12,343	12,266
Intangible assets not subject to amortization, Accumulated Amortization	0	0
Trade Names [Member]
Schedule Of Finite And Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	60,109	60,586
Intangible assets not subject to amortization, Accumulated Amortization	0	0
Certificates of Need [Member]
Schedule Of Finite And Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	16,538	14,496
Intangible assets not subject to amortization, Accumulated Amortization	$ 0	$ 0

Long-Term Debt - Components of Long-Term Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017	Sep. 21, 2015
Debt Instrument [Line Items]
Other long-term debt	$ 5,953
Less: unamortized debt issuance costs, discount and premium	(41,128)	$ (50,432)
Long-term debt	3,193,487	3,239,888
Less: current portion	(34,112)	(34,830)
Long-term debt	3,159,375	3,205,058
Amended and Restated Senior Credit Facility [Member] \| Senior Secured Term A Loans [Member]
Debt Instrument [Line Items]
Senior Secured	365,750	380,000
Amended and Restated Senior Credit Facility [Member] \| Senior Secured Term B Loans [Member]
Debt Instrument [Line Items]
Senior Secured	1,372,912	1,398,400
6.125% Senior Notes Due 2021 [Member]
Debt Instrument [Line Items]
Senior Notes	150,000	150,000
5.125% Senior Notes Due 2022 [Member]
Debt Instrument [Line Items]
Senior Notes	300,000	300,000
5.625% Senior Notes Due 2023 [Member]
Debt Instrument [Line Items]
Senior Notes	650,000	650,000	$ 650,000
6.500% Senior Notes Due 2024 [Member]
Debt Instrument [Line Items]
Senior Notes	$ 390,000	390,000
9.0% and 9.5% Revenue Bonds [Member]
Debt Instrument [Line Items]
9.0% and 9.5% Revenue Bonds		$ 21,920

Long-Term Debt - Components of Long-Term Debt (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 01, 2018	Feb. 16, 2016	Sep. 21, 2015	Feb. 11, 2015	Jul. 01, 2014	Mar. 12, 2013
6.125% Senior Notes Due 2021 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	6.125%	6.125%						6.125%
Senior notes maturity year	2021	2021
5.125% Senior Notes Due 2022 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.125%	5.125%					5.125%
Senior notes maturity year	2022	2022
5.625% Senior Notes Due 2023 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.625%	5.625%			5.625%	5.625%
Senior notes maturity year	2023	2023
6.500% Senior Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	6.50%	6.50%		6.50%
Senior notes maturity year	2024	2024
9.0% Revenue Bonds [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	9.00%	9.00%	9.00%
9.5% Revenue Bonds [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	9.50%	9.50%	9.50%

Long-Term Debt (Amended and Restated Senior Credit Facility) - Additional Information (Detail) - USD ($) $ in Thousands													3 Months Ended				12 Months Ended
	Feb. 27, 2019	Feb. 06, 2019	Apr. 17, 2018	Mar. 29, 2018	Mar. 22, 2018	Mar. 21, 2018	Dec. 29, 2017	May 10, 2017	May 09, 2017	Dec. 15, 2015	Dec. 31, 2012	Apr. 01, 2011	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 15, 2014
Debt Instrument [Line Items]
Debt extinguishment costs																	$ (1,815)	$ (810)	$ (4,253)
Term loan repayments			$ 15,000				$ 22,500
Consolidated funded debt, unrestricted and unencumbered cash to consolidated EBITDA																				$ 50,000
Term Loan A- Facility [Member]
Debt Instrument [Line Items]
Line of credit				$ 400,000
Tranche B-1 Repricing Amendment [Member]
Debt Instrument [Line Items]
Term loan repayments							7,700
Tranche B-2 Repricing Amendment [Member]
Debt Instrument [Line Items]
Term loan repayments							$ 14,800
Tranche B-3 Facility [Member]
Debt Instrument [Line Items]
Term loan repayments			5,100
Tranche B-4 Facilities [Member]
Debt Instrument [Line Items]
Term loan repayments			$ 9,900
Eurodollar [Member]
Debt Instrument [Line Items]
Interest on borrowings																	2.50%
Base Rate Loans [Member]
Debt Instrument [Line Items]
Interest on borrowings																	1.50%
Amended and Restated Senior Credit Facility [Member]
Debt Instrument [Line Items]
Date entered into an agreement											Dec. 31, 2012	Apr. 01, 2011
Amount available under revolving line of credit																	$ 486,700
Debt instrument maturity date										Nov. 30, 2021								Feb. 11, 2022
Term loan repayments																$ 1,200
Amended and Restated Senior Credit Facility [Member] \| March 31, 2019 to December 31, 2019 [Member]
Debt Instrument [Line Items]
Term loan principal repayments										$ 4,800
Term loan repayments															$ 1,200
Amended and Restated Senior Credit Facility [Member] \| March 31, 2020 to December 31, 2020 [Member]
Debt Instrument [Line Items]
Term loan principal repayments										7,100
Term loan repayments													$ 1,200
Amended and Restated Senior Credit Facility [Member] \| March 31, 2021 to September 30, 2021 [Member]
Debt Instrument [Line Items]
Term loan principal repayments										$ 9,500
Amended and Restated Senior Credit Facility [Member] \| September 30, 2015 to December 31, 2015 [Member]
Debt Instrument [Line Items]
Term loan repayments														$ 1,200
Amended and Restated Senior Credit Facility [Member] \| Standby Letters of Credit [Member]
Debt Instrument [Line Items]
Standby letters of credit outstanding																	$ 13,300
Amended and Restated Senior Credit Facility [Member] \| TLB Facility Due on February 16, 2023 [Member]
Debt Instrument [Line Items]
Term loan repayments																$ 2,300
Amended and Restated Senior Credit Facility [Member] \| TLB Facility Due on February 16, 2023 [Member] \| March 31, 2019 to December 31, 2019 [Member]
Debt Instrument [Line Items]
Term loan repayments															$ 2,300
Amended and Restated Senior Credit Facility [Member] \| TLB Facility Due on February 16, 2023 [Member] \| March 31, 2020 to December 31, 2020 [Member]
Debt Instrument [Line Items]
Term loan repayments													$ 2,300
Amended and Restated Senior Credit Facility [Member] \| TLB Facility Due on February 16, 2023 [Member] \| September 30, 2015 to December 31, 2015 [Member]
Debt Instrument [Line Items]
Term loan repayments														$ 2,300
Amended and Restated Senior Credit Facility [Member] \| Third Repricing Amendment [Member]
Debt Instrument [Line Items]
Debt extinguishment costs								$ 800
Amended and Restated Senior Credit Facility [Member] \| Repricing Facilities Amendments [Member]
Debt Instrument [Line Items]
Debt extinguishment costs					$ 900
Revolving credit facility applicable rate				0.25%
Amended and Restated Senior Credit Facility [Member] \| Repricing Facilities Amendments [Member] \| Senior Secured Revolving Line of Credit [Member]
Debt Instrument [Line Items]
Line of credit				$ 500,000
Amended and Restated Senior Credit Facility [Member] \| Repricing Facilities Amendments [Member] \| Term Loan A- Facility [Member]
Debt Instrument [Line Items]
Line of credit				$ 380,000
Amended and Restated Senior Credit Facility [Member] \| Eurodollar [Member]
Debt Instrument [Line Items]
Basis spread on variable rate																	1.00%
Amended and Restated Senior Credit Facility [Member] \| Eurodollar [Member] \| Third Repricing Amendment [Member]
Debt Instrument [Line Items]
Interest on borrowings								2.75%	3.00%
Amended and Restated Senior Credit Facility [Member] \| Eurodollar [Member] \| Repricing Facilities Amendments [Member]
Debt Instrument [Line Items]
Interest on borrowings					2.50%	2.75%
Amended and Restated Senior Credit Facility [Member] \| Base Rate Loans [Member]
Debt Instrument [Line Items]
Basis spread on variable rate																	0.50%
Amended and Restated Senior Credit Facility [Member] \| Base Rate Loans [Member] \| Third Repricing Amendment [Member]
Debt Instrument [Line Items]
Interest on borrowings								1.75%	2.00%
Amended and Restated Senior Credit Facility [Member] \| Base Rate Loans [Member] \| Repricing Facilities Amendments [Member]
Debt Instrument [Line Items]
Interest on borrowings					1.50%	1.75%
Amended and Restated Senior Credit Facility [Member] \| London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument [Line Items]
Interest on borrowings																	2.50%
Eleventh Amendment [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Date entered into an agreement		Feb. 06, 2019
Twelfth Amendment [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Date entered into an agreement	Feb. 27, 2019

Long-Term Debt (6.125% Senior Notes due 2021) - Additional Information (Detail) - 6.125% Senior Notes Due 2021 [Member] - USD ($)		12 Months Ended
	Mar. 12, 2013	Dec. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Issued Senior Notes	$ 150,000,000
Debt instrument interest rate	6.125%	6.125%	6.125%
Debt instrument maturity date	Mar. 15, 2021
Interest on the notes		Payable semi-annually in arrears on March 15 and September 15 of each year.

Long-Term Debt (5.125% Senior Notes due 2022) - Additional Information (Detail) - 5.125% Senior Notes Due 2022 [Member] - USD ($)		12 Months Ended
	Jul. 01, 2014	Dec. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Issued Senior Notes	$ 300,000,000
Debt instrument interest rate	5.125%	5.125%	5.125%
Debt instrument maturity date	Jul. 01, 2022
Interest on the notes		Payable semi-annually in arrears on January 1 and July 1 of each year.

Long-Term Debt (5.625% Senior Notes due 2023) - Additional Information (Detail) - 5.625% Senior Notes Due 2023 [Member] - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Sep. 21, 2015	Feb. 11, 2015
Debt Instrument [Line Items]
Issued Senior Notes			$ 275,000,000	$ 375,000,000
Debt instrument interest rate	5.625%	5.625%	5.625%	5.625%
Senior Notes	$ 650,000,000	$ 650,000,000	$ 650,000,000
Debt instrument maturity date	Feb. 15, 2023
Interest on the notes	Payable semi-annually in arrears on February 15 and August 15 of each year.

Long-Term Debt (6.500% Senior Notes due 2024) - Additional Information (Detail) - 6.500% Senior Notes Due 2024 [Member] - USD ($)		12 Months Ended
	Feb. 16, 2016	Dec. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Issued Senior Notes	$ 390,000,000
Debt instrument interest rate	6.50%	6.50%	6.50%
Debt instrument maturity date	Mar. 01, 2024
Interest on the notes		Payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2016.

Long-Term Debt (9.0% and 9.5% Revenue Bonds) - Additional Information (Detail) - USD ($) $ in Thousands			12 Months Ended
	Dec. 01, 2018	Nov. 11, 2012	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Debt extinguishment charge			$ (1,815)	$ (810)	$ (4,253)
9.0% and 9.5% Revenue Bonds [Member]
Debt Instrument [Line Items]
9.0% and 9.5% Revenue Bonds				21,920
9.0% and 9.5% Revenue Bonds [Member] \| Park Royal [Member]
Debt Instrument [Line Items]
9.0% and 9.5% Revenue Bonds		$ 23,000
Debt service reserve fund within other assets				$ 2,300
Debt instrument premium		2,600
9.0% and 9.5% Revenue Bonds [Member] \| Fair Value [Member] \| Park Royal [Member]
Debt Instrument [Line Items]
9.0% and 9.5% Revenue Bonds		25,600
9.0% Revenue Bonds [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	9.00%		9.00%	9.00%
Debt instrument, redemption price percentage of principal amount	104.00%
Debt instrument, Redemption date	Dec. 01, 2018
Debt extinguishment charge	$ (900)
9.0% Revenue Bonds [Member] \| Park Royal [Member]
Debt Instrument [Line Items]
9.0% and 9.5% Revenue Bonds		$ 7,500
Debt instrument interest rate		9.00%
Debt instrument maturity date		Dec. 01, 2030
9.5% Revenue Bonds [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	9.50%		9.50%	9.50%
Debt instrument, redemption price percentage of principal amount	104.00%
Debt instrument, Redemption date	Dec. 01, 2018
Debt extinguishment charge	$ (900)
9.5% Revenue Bonds [Member] \| Park Royal [Member]
Debt Instrument [Line Items]
9.0% and 9.5% Revenue Bonds		$ 15,500
Debt instrument interest rate		9.50%
Debt instrument maturity date		Dec. 01, 2040

Long-Term Debt (Debt Issuance Costs) - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Debt Disclosure [Abstract]
Debt issuance costs	$ 37.8	$ 46.5
Accumulated amortization	36.5	27.5
Amortization expenses reported as interest expense	$ 9.0	$ 8.6	$ 8.6

Long-Term Debt (Other) - Summary of Aggregate Maturities of Long-Term Debt (Detail) $ in Thousands	Dec. 31, 2018 USD ($)
Debt Disclosure [Abstract]
2019	$ 34,112
2020	43,679
2021	483,501
2022	764,855
2023	1,518,468
Thereafter	390,000
Total	$ 3,234,615

Equity - Additional Information (Detail) - shares	12 Months Ended
Equity - Additional Information (Detail) - shares	Dec. 31, 2018	Dec. 31, 2017
Equity [Line Items]
Preferred stock, number of shares proposed to be issued	10,000,000	10,000,000
Common stock, number of shares proposed to be issued	180,000,000	180,000,000
Common stock voting rights	one vote for each share
Maximum [Member]
Equity [Line Items]
Preferred stock, number of shares proposed to be issued	10,000,000
Common stock, number of shares proposed to be issued	180,000,000

Equity-Based Compensation - Additional Information (Detail) - USD ($)	3 Months Ended	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Authorized common stock		8,200,000
Equity incentive plan available for future grant		3,261,276
Annual increments in employee grants		25.00%
Stock options, contractual term		10 years
Equity-based compensation expense		$ 22,001,000	$ 23,467,000	$ 28,345,000
Vesting targets		(5,500,000)	(5,700,000)
Unrecognized compensation expense related to unvested options		$ 34,700,000
Vesting period		1 year 2 months 12 days
Warrant outstanding		$ 0
Deferred income tax benefit	$ 20,200,000	(9,714,000)	31,372,000	$ 28,647,000
Stock Compensation Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Deferred income tax benefit		$ 7,000,000	$ 9,200,000
Restricted Stock Award [Member] \| Minimum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period		3 years
Restricted Stock Award [Member] \| Maximum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period		4 years
Restricted Stock Units [Member] \| Minimum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period		2 years
Number of shares issuable at the end of the vesting period, percentage		0.00%
Restricted Stock Units [Member] \| Maximum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period		3 years
Number of shares issuable at the end of the vesting period, percentage		200.00%

Equity-Based Compensation - Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Options outstanding, Beginning balance	974,566	1,000,946	694,743
Options granted	374,700	259,300	503,850
Options exercised	(20,989)	(87,367)	(57,397)
Options cancelled	(128,737)	(198,313)	(140,250)
Options outstanding, Ending balance	1,199,540	974,566	1,000,946	694,743
Options exercisable, Ending balance	534,164	405,634
Options outstanding, Weighted Average Exercise Price, Beginning balance	$ 47.89	$ 48.42	$ 42.87
Options granted, Weighted Average Exercise Price	37.54	42.25	57.98
Options exercised, Weighted Average Exercise Price	17.83	25.92	31.92
Options cancelled, Weighted Average Exercise Price	50.83	54.71	57.13
Options outstanding, Weighted Average Exercise Price, Ending balance	44.64	47.89	$ 48.42	$ 42.87
Options exercisable, Weighted Average Exercise Price, Ending balance	$ 44.98	$ 41.20
Options outstanding, Weighted Average Remaining Contractual Term	7 years 3 months 3 days	7 years 5 months 15 days	7 years 5 months 15 days	7 years 8 months 12 days
Options granted, Weighted Average Remaining Contractual Term	9 years 2 months 15 days	9 years 3 months 18 days	9 years 3 months 10 days
Options exercisable, Weighted Average Remaining Contractual Term, Ending balance	5 years 8 months 23 days	6 years 18 days
Options outstanding, Aggregate Intrinsic Value	$ 2,717	$ 3,802	$ 8,166	$ 20,717
Options granted, Aggregate Intrinsic Value	246	205	297
Options exercised, Aggregate Intrinsic Value	383	1,636	1,530
Options cancelled, Aggregate Intrinsic Value	0	0	$ 0
Options exercisable, Aggregate Intrinsic Value, Ending balance	$ 2,386	$ 3,549

Equity-Based Compensation - Schedule of Stock Options Valuation Assumptions (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Weighted average grant-date fair value of options	$ 13.67	$ 14.39	$ 18.96
Risk-free interest rate	2.20%	2.00%	1.40%
Expected volatility	37.00%	33.00%	33.00%
Expected life (in years)	5 years 1 month 6 days	5 years 6 months	5 years 6 months

Equity-Based Compensation - Restricted Stock Activity (Detail) - Restricted Stock Award [Member] - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	809,868	844,419	944,562
Granted, Number of Shares	480,137	404,224	387,347
Cancelled, Number of Shares	(88,989)	(145,981)	(122,178)
Vested, Number of Shares	(395,959)	(292,794)	(365,312)
Unvested, Number of Shares/Units, Ending balance	805,057	809,868	844,419
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 50.19	$ 55.76	$ 52.74
Granted, Weighted Average Grant-Date Fair Value	36.84	42.38	55.38
Cancelled, Weighted Average Grant-Date Fair Value	47.57	55.03	57.02
Vested, Weighted Average Grant-Date Fair Value	50.41	53.07	47.18
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 42.40	$ 50.19	$ 55.76

Equity-Based Compensation - Restricted Stock Unit Activity (Detail) - Restricted Stock Units [Member] - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	360,909	273,599	218,084
Granted, Number of Units	285,358	219,840	230,750
Cancelled, Number of Units	(89,173)
Vested, Number of Units	(72,983)	(132,530)	(175,235)
Unvested, Number of Shares/Units, Ending balance	484,111	360,909	273,599
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 50.04	$ 59.68	$ 56.97
Granted, Weighted Average Grant-Date Fair Value	42.26	43.23	56.95
Cancelled, Weighted Average Grant-Date Fair Value	55.44
Vested, Weighted Average Grant-Date Fair Value	49.64	58.67	52.71
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 44.52	$ 50.04	$ 59.68

Income Taxes - Components of Provision for Income Taxes (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Current:
Federal		$ 13,961	$ 3,325	$ 572
State		1,113	680	(863)
Foreign		1,172	1,832	423
Total current		16,246	5,837	132
Deferred:
Federal		(7,176)	27,179	45,077
State		(10)	4,408	1,491
Foreign		(2,528)	(215)	(17,921)
Total deferred provision	$ 20,200	(9,714)	31,372	28,647
Provision for income taxes		$ 6,532	$ 37,209	$ 28,779

Income Taxes - Effective Income Tax Rate (Detail)	12 Months Ended
Income Taxes - Effective Income Tax Rate (Detail)	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
U.S. federal statutory rate on income before income taxes	21.00%	35.00%	35.00%
Impact of foreign operations	9.50%	(14.10%)	(13.50%)
Impact of foreign divestiture			39.20%
Impacts of SAB 118	6.70%
Effects of statutory rate change		(8.50%)	(14.50%)
State income taxes, net of federal tax effect	(1.40%)	2.10%	7.50%
Permanent differences	(4.10%)	1.80%	8.30%
Goodwill impairment	(36.60%)
Transaction-related items			25.90%
Change in valuation allowance	(1.40%)	1.60%	2.80%
Unrecognized tax benefit release	3.10%	(0.80%)	(7.20%)
Interest disallowance	(2.20%)
Federal tax credits	1.00%
Other	0.50%	(1.40%)	3.80%
Effective income tax rate	(3.90%)	15.70%	87.30%

Income Taxes - Summary of Domestic and Foreign Components of Income (Loss) before Income Taxes (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Taxes [Line Items]
Income (loss) before income taxes	$ (341,336)	$ 55,036	$ 69,258	$ 48,088	$ 60,689	$ 61,459	$ 66,216	$ 48,484	$ (168,954)	$ 236,798	$ 32,955
Foreign Tax Authority [Member]
Income Taxes [Line Items]
Income (loss) before income taxes									(228,350)	120,905	(144,717)
Domestic Tax Authority [Member]
Income Taxes [Line Items]
Income (loss) before income taxes									$ 59,396	$ 115,893	$ 177,672

Income Taxes - Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Deferred tax assets:
Net operating losses and tax credit carryforwards – federal and state	$ 27,294	$ 29,409
Bad debt allowance	898	827
Accrued compensation and severance	15,229	14,179
Pension reserves	595	1,494
Insurance reserves	13,994	13,483
Leases	5,374	5,332
Accrued expenses	4,231	3,114
Interest carryforwards	32,272	5,074
Other assets	2,284	1,747
Total gross deferred tax assets	102,171	74,659
Less: valuation allowance	(24,079)	(21,155)
Deferred tax assets	78,092	53,504
Deferred tax liabilities:
Fixed asset basis difference	(48,698)	(54,214)
Prepaid items	(1,728)	(1,490)
Intangible assets	(87,628)	(70,820)
Other liabilities	(16,942)	(3,582)
Total deferred tax liabilities	(154,996)	(130,106)
Total net deferred tax liability	$ (76,904)	$ (76,602)

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Examination [Line Items]
Valuation allowance against deferred tax assets	$ 24,079	$ 21,155
Domestic net operating loss carryforward	0	12,200
Foreign net operating loss carryforwards	81,000	93,900
State net operating loss carry forwards	$ 236,000	256,900
Operating loss carryforwards expiration start year	2019
Operating loss carryforwards expiration end year	2037
Expiration of State tax credits	2028
State tax credits	$ 900
Income taxes receivable	2,380	15,056
Income tax payable included in other accrued liabilities	3,041	1,012
Unrecognized tax benefits	713	6,104	$ 6,949
Interest and penalties related to unrecognized tax benefits	$ 100	$ 100
Exemption of tax credit	1.00%
U.S. federal statutory rate on income before income taxes	21.00%	35.00%	35.00%
Deferred tax balance	$ 20,600
Transition tax on certain repatriated earnings of foreign subsidiaries payable period	8 years
One-time transition tax liability, foreign earnings	$ 0
Reduction to deferred tax balance	400	$ 20,200
Provisional amount of transition tax liability, foreign subsidiaries	0
Foreign dividends	10,900
Foreign earnings tax liability	$ 0
Maximum [Member]
Income Tax Examination [Line Items]
Exemption of tax credit	50.00%
Foreign Tax Authority [Member]
Income Tax Examination [Line Items]
Period of examination by internal revenue service minimum	2014
Period of examination by internal revenue service maximum	2017
State and Local Jurisdiction [Member]
Income Tax Examination [Line Items]
Period of examination by internal revenue service minimum	2012
Period of examination by internal revenue service maximum	2017
Payroll [Member] \| Maximum [Member]
Income Tax Examination [Line Items]
Exemption of tax credit	15.00%
Earliest Tax Year [Member] \| Internal Revenue Service (IRS) [Member]
Income Tax Examination [Line Items]
Period of examination by internal revenue service	2015
Latest Tax Year [Member] \| Internal Revenue Service (IRS) [Member]
Income Tax Examination [Line Items]
Period of examination by internal revenue service	2017
Other Liabilities [Member]
Income Tax Examination [Line Items]
Unrecognized tax benefits	$ 900	$ 6,400

Income Taxes - Unrecognized Income Tax Benefits Net of Federal Benefit (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Balance at January 1	$ 6,104	$ 6,949
Additions based on tax positions related to the current year	52	5,488
Additions for tax positions of prior years		95
Reductions as a result of the lapse of applicable statutes of limitations and settlements with tax authorities	(5,443)	(6,428)
Balance at December 31	$ 713	$ 6,104

Derivatives - Additional Information (Detail)	1 Months Ended
Derivatives - Additional Information (Detail)	May 31, 2016 USD ($)	May 31, 2016 GBP (£)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	May 31, 2016 GBP (£)	Sep. 21, 2015 USD ($)	Feb. 11, 2015 USD ($)	Jul. 01, 2014 USD ($)	Mar. 12, 2013 USD ($)
Derivative [Line Items]
Cross currency swap assets			$ 60,500,000	$ 13,000,000
6.125% Senior Notes Due 2021 [Member]
Derivative [Line Items]
Principal amount									$ 150,000,000
Debt instrument interest rate			6.125%	6.125%					6.125%
5.125% Senior Notes Due 2022 [Member]
Derivative [Line Items]
Principal amount								$ 300,000,000
Debt instrument interest rate			5.125%	5.125%				5.125%
5.625% Senior Notes Due 2023 [Member]
Derivative [Line Items]
Principal amount						$ 275,000,000	$ 375,000,000
Debt instrument interest rate			5.625%	5.625%		5.625%	5.625%
Cross Currency Swap Assets [Member]
Derivative [Line Items]
Notional amount	$ 650,000,000				£ 449,300,000
Cross currency swap agreement cash flow due to interest payment	$ 35,800,000	£ 24,700,000
Derivative exchange rate	1.45				1.45
Cross Currency Swap Assets [Member] \| 6.125% Senior Notes Due 2021 [Member]
Derivative [Line Items]
Principal amount	$ 150,000,000
Debt instrument interest rate	6.125%				6.125%
Cross Currency Swap Assets [Member] \| 5.125% Senior Notes Due 2022 [Member]
Derivative [Line Items]
Principal amount	$ 300,000,000
Debt instrument interest rate	5.125%				5.125%
Cross Currency Swap Assets [Member] \| 5.625% Senior Notes Due 2023 [Member]
Derivative [Line Items]
Principal amount	$ 200,000,000
Debt instrument interest rate	5.625%				5.625%

Fair Value Measurements - Carrying Amounts and Fair Values of Company's Amended and Restated Senior Credit Facilities and Contingent Consideration Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Other long-term debt	$ 5,953
Derivative instrument assets	60,524	$ 12,997
Carrying Amount [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Other long-term debt	5,953
Derivative instrument assets	60,524	12,997
Carrying Amount [Member] \| Amended and Restated Senior Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Secured	1,715,338	1,749,185
Carrying Amount [Member] \| 6.125% Senior Notes Due 2021 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	148,657	148,098
Carrying Amount [Member] \| 5.125% Senior Notes Due 2022 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	296,946	296,174
Carrying Amount [Member] \| 5.625% Senior Notes Due 2023 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	643,289	641,891
Carrying Amount [Member] \| 6.500% Senior Notes due 2024 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	383,304	382,251
Carrying Amount [Member] \| 9.0% and 9.5% Revenue Bonds [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
9.0% and 9.5% Revenue Bonds		22,289
Fair Value [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Derivative instrument assets	60,524	12,997
Other long-term debt	5,953
Fair Value [Member] \| Amended and Restated Senior Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Amended and Restated Senior Credit Facility	1,715,338	1,749,185
Fair Value [Member] \| 6.125% Senior Notes Due 2021 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	147,542	150,134
Fair Value [Member] \| 5.125% Senior Notes Due 2022 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	283,583	296,914
Fair Value [Member] \| 5.625% Senior Notes Due 2023 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	609,516	651,519
Fair Value [Member] \| 6.500% Senior Notes due 2024 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	$ 369,888	397,541
Fair Value [Member] \| 9.0% and 9.5% Revenue Bonds [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
9.0% and 9.5% Revenue Bonds		$ 22,289

Fair Value Measurements - Additional Information (Detail)	Dec. 31, 2018	Dec. 01, 2018	Dec. 31, 2017	Feb. 16, 2016	Sep. 21, 2015	Feb. 11, 2015	Jul. 01, 2014	Mar. 12, 2013
6.125% Senior Notes Due 2021 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	6.125%		6.125%					6.125%
5.125% Senior Notes Due 2022 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.125%		5.125%				5.125%
5.625% Senior Notes Due 2023 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.625%		5.625%		5.625%	5.625%
6.500% Senior Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	6.50%		6.50%	6.50%
9.0% Revenue Bonds [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	9.00%	9.00%	9.00%
9.5% Revenue Bonds [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	9.50%	9.50%	9.50%

Leases - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Operating Leased Assets [Line Items]
Rent expense	$ 80,282	$ 76,775	$ 73,348
Minimum [Member]
Operating Leased Assets [Line Items]
Original terms of the leases	5 years
Maximum [Member]
Operating Leased Assets [Line Items]
Original terms of the leases	30 years

Leases - Schedule of Aggregate Minimum Lease Payments under Non-cancelable Operating Leases (Detail) $ in Thousands	Dec. 31, 2018 USD ($)
Leases [Abstract]
2019	$ 64,958
2020	61,704
2021	57,195
2022	51,570
2023	47,684
Thereafter	777,684
Total minimum rental obligations	$ 1,060,795

Commitments and Contingencies - Additional Information (Detail) $ in Millions		9 Months Ended
	Jan. 15, 2019 USD ($)	Sep. 30, 2018 Facility	Dec. 31, 2018 USD ($)
Pioneer Behavioral Health [Member] \| Subsequent Event [Member]
Loss Contingencies [Line Items]
Legal settlement amount paid	$ 3.1
Other Accrued Liabilities [Member] \| Pioneer Behavioral Health [Member]
Loss Contingencies [Line Items]
Litigation reserve			$ 3.1
West Virginia [Member]
Loss Contingencies [Line Items]
Number of comprehensive treatment centers operate \| Facility		7
West Virginia [Member] \| Other Accrued Liabilities [Member]
Loss Contingencies [Line Items]
Litigation reserve			$ 19.0

Noncontrolling Interests - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2018 Facility
Noncontrolling Interest [Line Items]
Number of facilities operated by non-wholly owned subsidiaries	4
Non-Wholly Owned Subsidiaries [Member] \| Minimum [Member]
Noncontrolling Interest [Line Items]
Equity ownership interests percentage in the facility	60.00%
Non-Wholly Owned Subsidiaries [Member] \| Maximum [Member]
Noncontrolling Interest [Line Items]
Equity ownership interests percentage in the facility	80.00%

Noncontrolling Interests - Summary of Redeemable Noncontrolling Interests (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Noncontrolling Interest [Abstract]
Beginning Balance	$ 22,417	$ 17,754
Acquisition of redeemable noncontrolling interests	6,125	4,909
Net income (loss) attributable to noncontrolling interests	264	(246)
Ending Balance	$ 28,806	$ 22,417

Segment Information - Additional Information (Detail)	12 Months Ended
Segment Information - Additional Information (Detail)	Dec. 31, 2018 Facility Bed State
Segment Reporting Information [Line Items]
Number of facilities \| Facility	583
Number of beds \| Bed	18,100
Number of operating states \| State	40
U.S. Facilities [Member]
Segment Reporting Information [Line Items]
Number of facilities \| Facility	213
Number of beds \| Bed	9,300
Number of operating states \| State	40
U.K. Facilities [Member]
Segment Reporting Information [Line Items]
Number of facilities \| Facility	370
Number of beds \| Bed	8,800

Segment Information - Summary of Reconciliation of Segment EBITDA to Income before Income Taxes (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Segment Reporting Information [Line Items]
Revenue	$ 743,547	$ 760,916	$ 765,738	$ 742,241	$ 724,512	$ 716,714	$ 715,896	$ 679,194	$ 3,012,442	$ 2,836,316	$ 2,810,914
Segment EBITDA									593,576	604,359	608,590
Equity-based compensation expense									(22,001)	(23,467)	(28,345)
Debt extinguishment costs									(1,815)	(810)	(4,253)
Legal settlements expense	(22,100)								(22,076)
Loss on impairment	(337,900)								(337,889)
Loss on divestiture											(178,809)
Gain on foreign currency derivatives											523
Transaction-related expenses									(34,507)	(24,267)	(48,323)
Interest expense, net									(185,410)	(176,007)	(181,325)
Depreciation and amortization									(158,832)	(143,010)	(135,103)
(Loss) income before income taxes	$ (341,336)	$ 55,036	$ 69,258	$ 48,088	$ 60,689	$ 61,459	$ 66,216	$ 48,484	(168,954)	236,798	32,955
U.S. Facilities [Member]
Segment Reporting Information [Line Items]
Revenue									1,904,695	1,809,844	1,698,525
U.S. Facilities [Member] \| Operating Segment [Member]
Segment Reporting Information [Line Items]
Revenue									1,904,695	1,809,844	1,698,525
Segment EBITDA									488,207	475,260	443,341
U.K. Facilities [Member]
Segment Reporting Information [Line Items]
Revenue									1,107,747	1,026,472	1,110,361
U.K. Facilities [Member] \| Operating Segment [Member]
Segment Reporting Information [Line Items]
Revenue									1,107,747	1,026,472	1,110,361
Segment EBITDA									185,755	198,566	245,046
Corporate and Other [Member] \| Corporate Reconciling Items and Eliminations [Member]
Segment Reporting Information [Line Items]
Revenue											2,028
Segment EBITDA									$ (80,386)	$ (69,467)	$ (79,797)

Segment Information - Summary of Financial Information by Operating Segment, Goodwill (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2018 USD ($)
Goodwill:
Beginning balance	$ 2,751,174
Loss on impairment	(325,875)
Increase from contribution of redeemable noncontrolling interests	2,245
Foreign currency translation loss	(31,894)
Prior year purchase price adjustments	762
Ending balance	2,396,412
U.S. Facilities [Member] \| Operating Segment [Member]
Goodwill:
Beginning balance	2,042,592
Increase from contribution of redeemable noncontrolling interests	2,245
Ending balance	2,044,837
U.K. Facilities [Member] \| Operating Segment [Member]
Goodwill:
Beginning balance	708,582
Loss on impairment	(325,875)
Foreign currency translation loss	(31,894)
Prior year purchase price adjustments	762
Ending balance	$ 351,575

Segment Information - Summary of Financial Information by Operating Segment, Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Assets:
Assets	$ 6,172,504	$ 6,424,502
U.S. Facilities [Member] \| Operating Segment [Member]
Assets:
Assets	3,779,040	3,567,126
U.K. Facilities [Member] \| Operating Segment [Member]
Assets:
Assets	2,175,809	2,647,150
Corporate and Other [Member] \| Corporate Reconciling Items and Eliminations [Member]
Assets:
Assets	$ 217,655	$ 210,226

Segment Information - Summary of Financial Information by Operating Segment, Assets (Parenthetical) (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Segment Reporting, Asset Reconciling Item [Line Items]
Property and equipment, net	$ 3,107,766	$ 3,048,130
Operating Segment [Member] \| U.S. Facilities [Member]
Segment Reporting, Asset Reconciling Item [Line Items]
Property and equipment, net	1,400,000	1,200,000
Operating Segment [Member] \| U.K. Facilities [Member]
Segment Reporting, Asset Reconciling Item [Line Items]
Property and equipment, net	1,700,000	1,800,000
Corporate Reconciling Items and Eliminations [Member] \| Corporate and Other [Member]
Segment Reporting, Asset Reconciling Item [Line Items]
Property and equipment, net	$ 44,900	$ 49,200

Employee Benefit Plans - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Defined Benefit Plan Disclosure [Line Items]
Employee benefit plan, Accumulated other comprehensive income (loss) , Net	$ (1,800)	$ (4,500)	$ (6,100)
Defined Contribution Plan [Member] \| 401(k) [Member]
Defined Benefit Plan Disclosure [Line Items]
Defined contribution expense	3,500	200	$ 100
Pension Plan [Member] \| Partnership in Care Benefits Plan [Member]
Defined Benefit Plan Disclosure [Line Items]
Pension liability under defined benefit pension plan	57,993	67,288
Pension Plan [Member] \| Partnership in Care Benefits Plan [Member] \| Other Liabilities [Member]
Defined Benefit Plan Disclosure [Line Items]
Pension liability under defined benefit pension plan	$ 3,500	$ 8,800

Employee Benefit Plans - Summary of Funded Status (Unfunded Liability) of Partnerships in Care Pension Plan Based Upon Actuarial Valuations (Detail) - Pension Plan [Member] - Partnership in Care Benefits Plan [Member] - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Defined Benefit Plan Disclosure [Line Items]
Projected benefit obligation	$ 57,993	$ 67,288
Fair value of plan assets	54,491	58,493
Unfunded liability	$ 3,502	$ 8,795	$ 10,700

Employee Benefit Plans - Summary of Changes in Partnerships in Care Pension Plan Net Pension Liability (Detail) - Pension Plan [Member] - Partnership in Care Benefits Plan [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Defined Benefit Plan Disclosure [Line Items]
Net pension liability at beginning of period	$ 8,795	$ 10,700
Employer contributions	(2,267)	(809)
Net pension expense	283	426
Pension liability adjustment	(2,803)	(2,544)
Foreign currency translation (loss) gain	(506)	1,022
Net pension liability at end of period	$ 3,502	$ 8,795

Employee Benefit Plans - Summary of Assumptions Used to Determine Plan Benefit Obligation (Detail) - Pension Plan [Member] - Partnership in Care Benefits Plan [Member]	Dec. 31, 2018	Dec. 31, 2017
Defined Benefit Plan Disclosure [Line Items]
Discount rate	2.80%	2.50%
Compensation increase rate	3.30%	3.30%

Employee Benefit Plans - Summary of Components of Net Pension Plan Expense (Detail) - Pension Plan [Member] - Partnership in Care Benefits Plan [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Defined Benefit Plan Disclosure [Line Items]
Interest cost on projected benefit obligation	$ 1,602	$ 1,738
Expected return on assets	(1,319)	(1,312)
Net pension expense	$ 283	$ 426

Employee Benefit Plans - Schedule of Weighted-Average Asset Allocation by Asset Category in Partnerships in Care Pension Plan (Detail) - Pension Plan [Member] - Partnership in Care Benefits Plan [Member]	Dec. 31, 2018	Dec. 31, 2017
Cash and Cash Equivalents [Member]
Defined Benefit Plan Disclosure [Line Items]
Weighted-average asset allocation	1.30%	0.70%
Foreign Government Debt Securities [Member] \| United Kingdom [Member]
Defined Benefit Plan Disclosure [Line Items]
Weighted-average asset allocation	15.00%	19.00%
Annuity Contracts [Member]
Defined Benefit Plan Disclosure [Line Items]
Weighted-average asset allocation	38.60%	38.60%
Equity Securities [Member]
Defined Benefit Plan Disclosure [Line Items]
Weighted-average asset allocation	25.40%	29.40%
Debt Securities [Member]
Defined Benefit Plan Disclosure [Line Items]
Weighted-average asset allocation	15.80%	9.90%
Other [Member]
Defined Benefit Plan Disclosure [Line Items]
Weighted-average asset allocation	3.90%	2.40%

Other Comprehensive Loss - Components Of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	$ 2,572,871	$ 2,167,724	$ 1,683,028
Foreign currency translation (loss) gain	(127,521)	206,784	(477,967)
Gain (loss) on derivative instruments, net of tax of $12.7 million, $(22.9) million and $29.1, respectively	36,799	(33,431)	40,598
Pension liability adjustment, net of tax of $0.3 million, $0.4 million and $(1.3) million, respectively	2,463	2,099	(7,554)
Balance	2,333,307	2,572,871	2,167,724
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(376,740)	(584,081)	(106,309)
Foreign currency translation (loss) gain	(127,788)	207,341	(477,772)
Balance	(504,528)	(376,740)	(584,081)
Change in Fair Value of Derivative Instruments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	7,167	40,598
Gain (loss) on derivative instruments, net of tax of $12.7 million, $(22.9) million and $29.1, respectively	36,799	(33,431)	40,598
Balance	43,966	7,167	40,598
Pension Plan [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(4,545)	(6,087)	1,662
Foreign currency translation (loss) gain	267	(557)	(195)
Pension liability adjustment, net of tax of $0.3 million, $0.4 million and $(1.3) million, respectively	2,463	2,099	(7,554)
Balance	(1,815)	(4,545)	(6,087)
Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(374,118)	(549,570)	(104,647)
Balance	$ (462,377)	$ (374,118)	$ (549,570)

Other Comprehensive Loss - Components Of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accumulated Other Comprehensive Income Loss Net Of Tax [Abstract]
Gain (Loss) on derivative instruments, tax	$ 12.7	$ (22.9)	$ 29.1
Pension liability adjustment, tax	$ 0.3	$ 0.4	$ (1.3)

Quarterly Information (Unaudited) - Schedule of Quarterly Financial Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Revenue	$ 743,547	$ 760,916	$ 765,738	$ 742,241	$ 724,512	$ 716,714	$ 715,896	$ 679,194	$ 3,012,442	$ 2,836,316	$ 2,810,914
Income (loss) before income taxes	(341,336)	55,036	69,258	48,088	60,689	61,459	66,216	48,484	(168,954)	236,798	32,955
Net income (loss) attributable to Acadia Healthcare Company, Inc. stockholders	$ (331,637)	$ 46,232	$ 58,836	$ 50,819	$ 69,629	$ 45,618	$ 49,630	$ 34,958	$ (175,750)	$ 199,835	$ 6,143
Basic earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$ (3.80)	$ 0.53	$ 0.67	$ 0.58	$ 0.80	$ 0.52	$ 0.57	$ 0.40	$ (2.01)	$ 2.30	$ 0.07
Diluted earnings per share attributable to Acadia Healthcare Company, Inc. stockholders	$ (3.80)	$ 0.53	$ 0.67	$ 0.58	$ 0.80	$ 0.52	$ 0.57	$ 0.40	$ (2.01)	$ 2.30	$ 0.07

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

Quarterly Information (Unaudited) - Schedule of Quarterly Financial Information (Parenthetical) (Detail) - USD ($) $ in Thousands	3 Months Ended			12 Months Ended
	Dec. 31, 2018	Mar. 31, 2018	Dec. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information [Line Items]
Tax benefits				$ (6,532)	$ (37,209)	$ (28,779)
Loss on impairment	$ 337,900			337,889
Legal settlements expense	$ 22,100			22,076
Deferred income tax expense			$ 20,200	$ (9,714)	$ 31,372	$ 28,647
Change in Accounting Method Accounted for as Change in Estimate [Member]
Quarterly Financial Information [Line Items]
Tax benefits		$ 10,500

Subsequent Events - Additional Information (Detail) $ in Millions	Feb. 27, 2019	Feb. 15, 2019 USD ($) Bed Center	Feb. 06, 2019	Dec. 31, 2018 Bed
Subsequent Event [Line Items]
Number of beds \| Bed				18,100
Subsequent Event [Member] \| Eleventh Amendment [Member]
Subsequent Event [Line Items]
Date entered into an agreement			Feb. 06, 2019
Subsequent Event [Member] \| Twelfth Amendment [Member]
Subsequent Event [Line Items]
Date entered into an agreement	Feb. 27, 2019
Subsequent Event [Member] \| Whittier Pavilion [Member] \| Massachusetts [Member]
Subsequent Event [Line Items]
Number of beds \| Bed		71
Business acquisition cash consideration \| $		$ 17.9
Subsequent Event [Member] \| Mission Treatment [Member] \| California, Nevada, Arizona and Oklahoma [Member]
Subsequent Event [Line Items]
Business acquisition cash consideration \| $		$ 22.5
Number of comprehensive treatment centers operate \| Center		9

Financial Information for the Company and Its Subsidiaries - Additional Information (Detail)	Dec. 31, 2018	Dec. 31, 2017	Feb. 16, 2016	Sep. 21, 2015	Feb. 11, 2015	Jul. 01, 2014	Mar. 12, 2013
6.125% Senior Notes Due 2021 [Member]
Line of Credit Facility [Line Items]
Debt instrument interest rate	6.125%	6.125%					6.125%
5.125% Senior Notes Due 2022 [Member]
Line of Credit Facility [Line Items]
Debt instrument interest rate	5.125%	5.125%				5.125%
5.625% Senior Notes Due 2023 [Member]
Line of Credit Facility [Line Items]
Debt instrument interest rate	5.625%	5.625%		5.625%	5.625%
6.500% Senior Notes Due 2024 [Member]
Line of Credit Facility [Line Items]
Debt instrument interest rate	6.50%	6.50%	6.50%

Financial Information for the Company and Its Subsidiaries - Summary of Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 50,510	$ 67,290	$ 57,063	$ 11,215
Accounts receivable, net	318,087	296,925
Other current assets	81,820	107,335
Total current assets	450,417	471,550
Property and equipment, net	3,107,766	3,048,130
Goodwill	2,396,412	2,751,174
Intangible assets, net	88,990	87,348
Deferred tax assets – noncurrent	3,468	3,731
Derivative instruments	60,524	12,997
Other assets	64,927	49,572
Total assets	6,172,504	6,424,502
Current liabilities:
Current portion of long-term debt	34,112	34,830
Accounts payable	117,740	102,299
Accrued salaries and benefits	113,299	99,047
Other accrued liabilities	151,226	141,213
Total current liabilities	416,377	377,389
Long-term debt	3,159,375	3,205,058
Deferred tax liabilities – noncurrent	80,372	80,333
Other liabilities	154,267	166,434
Total liabilities	3,810,391	3,829,214
Redeemable noncontrolling interests	28,806	22,417	17,754
Total equity	2,333,307	2,572,871	2,167,724	1,683,028
Total liabilities and equity	6,172,504	6,424,502
Consolidating Adjustments [Member]
Current assets:
Deferred tax assets – noncurrent	(1,841)	(2,370)
Investment in subsidiaries	(5,190,771)	(5,429,386)
Other assets	(303,940)	(379,008)
Total assets	(5,496,552)	(5,810,764)
Current liabilities:
Long-term debt	(303,940)	(379,008)
Deferred tax liabilities – noncurrent	(1,841)	(2,370)
Total liabilities	(305,781)	(381,378)
Total equity	(5,190,771)	(5,429,386)
Total liabilities and equity	(5,496,552)	(5,810,764)
Parent [Member]
Current assets:
Deferred tax assets – noncurrent	1,841	2,370
Derivative instruments	60,524	12,997
Investment in subsidiaries	5,190,771	5,429,386
Other assets	306,495	381,913
Total assets	5,559,631	5,826,666
Current liabilities:
Current portion of long-term debt	34,112	34,550
Other accrued liabilities	32,837	36,196
Total current liabilities	66,949	70,746
Long-term debt	3,159,375	3,183,049
Total liabilities	3,226,324	3,253,795
Total equity	2,333,307	2,572,871
Total liabilities and equity	5,559,631	5,826,666
Combined Subsidiary Guarantors [Member]
Current assets:
Cash and cash equivalents	32,471	46,860	15,681	1,987
Accounts receivable, net	248,218	230,890
Other current assets	60,160	85,746
Total current assets	340,849	363,496
Property and equipment, net	1,219,803	1,086,802
Goodwill	1,936,057	1,936,057
Intangible assets, net	56,611	57,628
Other assets	52,824	38,860
Total assets	3,606,144	3,482,843
Current liabilities:
Accounts payable	79,463	70,767
Accrued salaries and benefits	84,150	69,057
Other accrued liabilities	42,062	27,676
Total current liabilities	205,675	167,500
Deferred tax liabilities – noncurrent	31,874	27,975
Other liabilities	107,866	103,112
Total liabilities	345,415	298,587
Total equity	3,260,729	3,184,256
Total liabilities and equity	3,606,144	3,482,843
Combined Non-Guarantors [Member]
Current assets:
Cash and cash equivalents	18,039	20,430	$ 41,382	$ 9,228
Accounts receivable, net	69,869	66,035
Other current assets	21,660	21,589
Total current assets	109,568	108,054
Property and equipment, net	1,887,963	1,961,328
Goodwill	460,355	815,117
Intangible assets, net	32,379	29,720
Deferred tax assets – noncurrent	3,468	3,731
Other assets	9,548	7,807
Total assets	2,503,281	2,925,757
Current liabilities:
Current portion of long-term debt		280
Accounts payable	38,277	31,532
Accrued salaries and benefits	29,149	29,990
Other accrued liabilities	76,327	77,341
Total current liabilities	143,753	139,143
Long-term debt	303,940	401,017
Deferred tax liabilities – noncurrent	50,339	54,728
Other liabilities	46,401	63,322
Total liabilities	544,433	658,210
Redeemable noncontrolling interests	28,806	22,417
Total equity	1,930,042	2,245,130
Total liabilities and equity	$ 2,503,281	$ 2,925,757

Financial Information for the Company and Its Subsidiaries - Summary of Condensed Consolidating Statement of Comprehensive Income (Loss) (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Condensed Financial Statements, Captions [Line Items]
Revenue before provision for doubtful accounts									$ 3,012,442	$ 2,877,234	$ 2,852,823
Provision for doubtful accounts										(40,918)	(41,909)
Revenue	$ 743,547	$ 760,916	$ 765,738	$ 742,241	$ 724,512	$ 716,714	$ 715,896	$ 679,194	3,012,442	2,836,316	2,810,914
Salaries, wages and benefits									1,659,348	1,536,160	1,541,854
Professional fees									227,425	196,223	185,486
Supplies									119,314	114,439	117,425
Rents and leases									80,282	76,775	73,348
Other operating expenses									354,498	331,827	312,556
Depreciation and amortization									158,832	143,010	135,103
Interest expense, net									185,410	176,007	181,325
Debt extinguishment costs									1,815	810	4,253
Legal settlements expense	22,100								22,076
Loss on impairment	337,900								337,889
Loss on divestiture											178,809
Gain on foreign currency derivatives											(523)
Transaction-related expenses									34,507	24,267	48,323
Total expenses									3,181,396	2,599,518	2,777,959
(Loss) income before income taxes	(341,336)	55,036	69,258	48,088	60,689	61,459	66,216	48,484	(168,954)	236,798	32,955
(Benefit from) provision for income taxes									6,532	37,209	28,779
Net (loss) income									(175,486)	199,589	4,176
Net income attributable to noncontrolling interests									(264)	246	1,967
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$ (331,637)	$ 46,232	$ 58,836	$ 50,819	$ 69,629	$ 45,618	$ 49,630	$ 34,958	(175,750)	199,835	6,143
Other comprehensive income:
Foreign currency translation (loss) gain									(127,521)	206,784	(477,967)
Gain (loss) on derivative instruments									36,799	(33,431)	40,598
Pension liability adjustment, net of tax of $0.3 million, $0.4 million and $(1.3) million, respectively									2,463	2,099	(7,554)
Other comprehensive (loss) gain									(88,259)	175,452	(444,923)
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc.									(264,009)	375,287	(438,780)
Consolidating Adjustments [Member]
Condensed Financial Statements, Captions [Line Items]
Equity in earnings of subsidiaries									98,669	(259,282)	(65,560)
Net (loss) income									98,669	(259,282)	(65,560)
Net (loss) income attributable to Acadia Healthcare Company, Inc.									98,669	(259,282)	(65,560)
Other comprehensive income:
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc.									98,669	(259,282)	(65,560)
Parent [Member]
Condensed Financial Statements, Captions [Line Items]
Salaries, wages and benefits									22,001	23,467	28,345
Interest expense, net									65,588	61,872	50,921
Debt extinguishment costs									940	810	4,253
Gain on foreign currency derivatives											(523)
Total expenses									88,529	86,149	82,996
(Loss) income before income taxes									(88,529)	(86,149)	(82,996)
Equity in earnings of subsidiaries									(98,669)	259,282	65,560
(Benefit from) provision for income taxes									(11,712)	(26,456)	(21,612)
Net (loss) income									(175,486)	199,589	4,176
Net (loss) income attributable to Acadia Healthcare Company, Inc.									(175,486)	199,589	4,176
Other comprehensive income:
Gain (loss) on derivative instruments									36,799	(33,431)	40,598
Other comprehensive (loss) gain									36,799	(33,431)	40,598
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc.									(138,687)	166,158	44,774
Combined Subsidiary Guarantors [Member]
Condensed Financial Statements, Captions [Line Items]
Revenue before provision for doubtful accounts										1,746,656	1,662,734
Provision for doubtful accounts										(35,636)	(38,349)
Revenue									1,788,757	1,711,020	1,624,385
Salaries, wages and benefits									965,419	902,180	865,104
Professional fees									98,441	93,991	89,062
Supplies									76,526	75,248	76,246
Rents and leases									33,101	33,365	34,540
Other operating expenses									225,446	217,900	206,308
Depreciation and amortization									74,341	66,482	58,018
Interest expense, net									92,983	81,274	75,848
Legal settlements expense									22,076
Loss on divestiture											778
Transaction-related expenses									29,720	11,236	32,173
Total expenses									1,618,053	1,481,676	1,438,077
(Loss) income before income taxes									170,704	229,344	186,308
(Benefit from) provision for income taxes									19,045	69,882	68,335
Net (loss) income									151,659	159,462	117,973
Net (loss) income attributable to Acadia Healthcare Company, Inc.									151,659	159,462	117,973
Other comprehensive income:
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc.									151,659	159,462	117,973
Combined Non-Guarantors [Member]
Condensed Financial Statements, Captions [Line Items]
Revenue before provision for doubtful accounts										1,130,578	1,190,089
Provision for doubtful accounts										(5,282)	(3,560)
Revenue									1,223,685	1,125,296	1,186,529
Salaries, wages and benefits									671,928	610,513	648,405
Professional fees									128,984	102,232	96,424
Supplies									42,788	39,191	41,179
Rents and leases									47,181	43,410	38,808
Other operating expenses									129,052	113,927	106,248
Depreciation and amortization									84,491	76,528	77,085
Interest expense, net									26,839	32,861	54,556
Debt extinguishment costs									875
Loss on impairment									337,889
Loss on divestiture											178,031
Transaction-related expenses									4,787	13,031	16,150
Total expenses									1,474,814	1,031,693	1,256,886
(Loss) income before income taxes									(251,129)	93,603	(70,357)
(Benefit from) provision for income taxes									(801)	(6,217)	(17,944)
Net (loss) income									(250,328)	99,820	(52,413)
Net income attributable to noncontrolling interests									(264)	246	1,967
Net (loss) income attributable to Acadia Healthcare Company, Inc.									(250,592)	100,066	(50,446)
Other comprehensive income:
Foreign currency translation (loss) gain									(127,521)	206,784	(477,967)
Pension liability adjustment, net of tax of $0.3 million, $0.4 million and $(1.3) million, respectively									2,463	2,099	(7,554)
Other comprehensive (loss) gain									(125,058)	208,883	(485,521)
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc.									$ (375,650)	$ 308,949	$ (535,967)

Financial Information for the Company and Its Subsidiaries - Summary of Condensed Consolidating Statement of Cash Flows (Detail) $ in Thousands, £ in Millions		3 Months Ended		12 Months Ended
	Nov. 30, 2016 GBP (£)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Operating activities:
Net (loss) income				$ (175,486)	$ 199,589	$ 4,176
Adjustments to reconcile net (loss) income to net cash (used in) provided by continuing operating activities:
Depreciation and amortization				158,832	143,010	135,103
Amortization of debt issuance costs				10,456	9,855	10,324
Equity-based compensation expense				22,001	23,467	28,345
Deferred income taxes			$ 20,200	(9,714)	31,372	28,647
Debt extinguishment costs				1,815	810	4,253
Legal settlements expense		$ 22,100		22,076
Loss on impairment		337,900		337,889
Loss on divestiture						178,809
(Gain) loss on foreign currency derivatives						(523)
Other				12,371	11,412	4,715
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net				(16,821)	(28,570)	(15,718)
Other current assets				13,864	20,808	(20,648)
Other assets				2,762	(3,176)	(4,354)
Accounts payable and other accrued liabilities				26,054	(10,113)	22,693
Accrued salaries and benefits				15,748	(8,988)	(8,572)
Other liabilities				(5,219)	11,794	4,484
Net cash provided by continuing operating activities				416,628	401,270	371,734
Net cash used in discontinued operating activities				(2,548)	(1,693)	(10,256)
Net cash provided by operating activities				414,080	399,577	361,478
Investing activities:
Cash paid for acquisitions, net of cash acquired					(18,191)	(683,455)
Cash paid for capital expenditures				(341,462)	(274,177)	(307,472)
Cash paid for real estate acquisitions				(18,383)	(41,057)	(40,757)
Settlement of foreign currency derivatives						523
Cash received on divestitures	£ 320					373,266
Other				(1,119)	(3,101)	(2,470)
Net cash used in investing activities				(360,964)	(336,526)	(660,365)
Financing activities:
Borrowings on long-term debt						1,480,000
Borrowings on revolving credit facility						179,000
Principal payments on revolving credit facility						(337,000)
Principal payments on long-term debt				(39,738)	(34,805)	(49,941)
Repayment of assumed debt						(1,348,389)
Repayment of long-term debt				(21,920)	(22,500)	(200,594)
Payment of debt issuance costs						(36,649)
Issuances of common stock, net						685,097
Common stock withheld for minimum statutory taxes, net				(3,407)	(3,455)	(8,846)
Other				(2,265)	686	(3,837)
Net cash (used in) provided by financing activities				(67,330)	(60,074)	358,841
Effect of exchange rate changes on cash				(2,566)	7,250	(14,106)
Net (decrease) increase in cash and cash equivalents				(16,780)	10,227	45,848
Cash and cash equivalents at beginning of the period				67,290	57,063	11,215
Cash and cash equivalents at end of the period		50,510	67,290	50,510	67,290	57,063
Consolidating Adjustments [Member]
Operating activities:
Net (loss) income				98,669	(259,282)	(65,560)
Adjustments to reconcile net (loss) income to net cash (used in) provided by continuing operating activities:
Equity in earnings of subsidiaries				(98,669)	259,282	65,560
Change in operating assets and liabilities, net of effect of acquisitions:
Other assets				(4,596)	(24,549)	3,109
Net cash provided by continuing operating activities				(4,596)	(24,549)	3,109
Net cash provided by operating activities				(4,596)	(24,549)	3,109
Financing activities:
Principal payments on long-term debt				4,596	24,549	296,109
Cash provided by (used in) intercompany activity						(299,218)
Net cash (used in) provided by financing activities				4,596	24,549	(3,109)
Parent [Member]
Operating activities:
Net (loss) income				(175,486)	199,589	4,176
Adjustments to reconcile net (loss) income to net cash (used in) provided by continuing operating activities:
Equity in earnings of subsidiaries				98,669	(259,282)	(65,560)
Amortization of debt issuance costs				10,825	10,270	10,751
Equity-based compensation expense				22,001	23,467	28,345
Deferred income taxes				529	1,236	(2,172)
Debt extinguishment costs				940	810	4,253
(Gain) loss on foreign currency derivatives						(523)
Other				6,981	4,189
Change in operating assets and liabilities, net of effect of acquisitions:
Other assets				4,596	24,549	(3,109)
Net cash provided by continuing operating activities				(30,945)	4,828	(23,839)
Net cash provided by operating activities				(30,945)	4,828	(23,839)
Investing activities:
Cash received on divestitures						370,000
Net cash used in investing activities						370,000
Financing activities:
Borrowings on long-term debt						1,480,000
Borrowings on revolving credit facility						179,000
Principal payments on revolving credit facility						(337,000)
Principal payments on long-term debt				(39,738)	(34,550)	(49,706)
Repayment of assumed debt						(1,348,389)
Repayment of long-term debt					(22,500)	(200,594)
Payment of debt issuance costs						(36,649)
Issuances of common stock, net						685,097
Common stock withheld for minimum statutory taxes, net				(3,407)	(3,455)	(8,846)
Other				(1,742)	(539)	(1,149)
Cash provided by (used in) intercompany activity				75,832	56,216	(707,925)
Net cash (used in) provided by financing activities				30,945	(4,828)	(346,161)
Combined Subsidiary Guarantors [Member]
Operating activities:
Net (loss) income				151,659	159,462	117,973
Adjustments to reconcile net (loss) income to net cash (used in) provided by continuing operating activities:
Depreciation and amortization				74,341	66,482	58,018
Deferred income taxes				(8,795)	28,882	50,611
Legal settlements expense				22,076
Loss on divestiture						778
Other				5,457	2,498	4,022
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net				(17,328)	(21,791)	(24,017)
Other current assets				14,881	(6,429)	(3,138)
Other assets				118	(3,277)	(4,048)
Accounts payable and other accrued liabilities				15,743	4,909	(45,552)
Accrued salaries and benefits				15,094	(3,974)	3,844
Other liabilities				3,014	8,794	4,050
Net cash provided by continuing operating activities				276,260	235,556	162,541
Net cash used in discontinued operating activities				(2,548)	(1,693)	(10,256)
Net cash provided by operating activities				273,712	233,863	152,285
Investing activities:
Cash paid for acquisitions, net of cash acquired						(103,359)
Cash paid for capital expenditures				(210,023)	(161,312)	(177,593)
Cash paid for real estate acquisitions				(14,096)	(37,047)	(28,956)
Settlement of foreign currency derivatives						523
Cash received on divestitures						7,859
Other				(4,199)	(7,944)	(1,573)
Net cash used in investing activities				(228,318)	(206,303)	(303,099)
Financing activities:
Principal payments on long-term debt				(169)	(14,250)	(293,000)
Other				2,094	1,225	(2,688)
Cash provided by (used in) intercompany activity				(61,708)	16,644	460,196
Net cash (used in) provided by financing activities				(59,783)	3,619	164,508
Net (decrease) increase in cash and cash equivalents				(14,389)	31,179	13,694
Cash and cash equivalents at beginning of the period				46,860	15,681	1,987
Cash and cash equivalents at end of the period		32,471	46,860	32,471	46,860	15,681
Combined Non-Guarantors [Member]
Operating activities:
Net (loss) income				(250,328)	99,820	(52,413)
Adjustments to reconcile net (loss) income to net cash (used in) provided by continuing operating activities:
Depreciation and amortization				84,491	76,528	77,085
Amortization of debt issuance costs				(369)	(415)	(427)
Deferred income taxes				(1,448)	1,254	(19,792)
Debt extinguishment costs				875
Loss on impairment				337,889
Loss on divestiture						178,031
Other				(67)	4,725	693
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net				507	(6,779)	8,299
Other current assets				(1,017)	27,237	(17,510)
Other assets				2,644	101	(306)
Accounts payable and other accrued liabilities				10,311	(15,022)	68,245
Accrued salaries and benefits				654	(5,014)	(12,416)
Other liabilities				(8,233)	3,000	434
Net cash provided by continuing operating activities				175,909	185,435	229,923
Net cash provided by operating activities				175,909	185,435	229,923
Investing activities:
Cash paid for acquisitions, net of cash acquired					(18,191)	(580,096)
Cash paid for capital expenditures				(131,439)	(112,865)	(129,879)
Cash paid for real estate acquisitions				(4,287)	(4,010)	(11,801)
Cash received on divestitures						(4,593)
Other				3,080	4,843	(897)
Net cash used in investing activities				(132,646)	(130,223)	(727,266)
Financing activities:
Principal payments on long-term debt				(4,427)	(10,554)	(3,344)
Repayment of long-term debt				(21,920)
Other				(2,617)
Cash provided by (used in) intercompany activity				(14,124)	(72,860)	546,947
Net cash (used in) provided by financing activities				(43,088)	(83,414)	543,603
Effect of exchange rate changes on cash				(2,566)	7,250	(14,106)
Net (decrease) increase in cash and cash equivalents				(2,391)	(20,952)	32,154
Cash and cash equivalents at beginning of the period				20,430	41,382	9,228
Cash and cash equivalents at end of the period		$ 18,039	$ 20,430	$ 18,039	$ 20,430	$ 41,382