0000950170-23-058814 | 10-Q | XBRL Viewer | Acadia Healthcare Company INC

Description of Business and Basis of Presentation	9 Months Ended
Sep. 30, 2023
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.”) and Puerto Rico. At September 30, 2023, the Company operated 253 behavioral healthcare facilities with approximately 11,100 beds in 39 states 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”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for fair presentation of the Company’s financial position and results of operations have been included. The Company’s fiscal year ends on December 31 and interim results are not necessarily indicative of results for a full year or any other interim period. The condensed consolidated balance sheet at December 31, 2022 has been derived from the audited financial statements as of that date. The information contained in these condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements and notes thereto for the fiscal year ended December 31, 2022 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on February 28, 2023. 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. Certain reclassifications have been made to the prior year to conform to the current year presentation.

Description of Business and Basis of Presentation

9 Months Ended

Sep. 30, 2023

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.”) and Puerto Rico. At September 30, 2023, the Company operated 253 behavioral healthcare facilities with approximately 11,100 beds in 39 states 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”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for fair presentation of the Company’s financial position and results of operations have been included. The Company’s fiscal year ends on December 31 and interim results are not necessarily indicative of results for a full year or any other interim period. The condensed consolidated balance sheet at December 31, 2022 has been derived from the audited financial statements as of that date. The information contained in these condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements and notes thereto for the fiscal year ended December 31, 2022 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on February 28, 2023. 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.

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

Long-Term Debt (5.500% Senior Notes due 2028) - Additional Information (Detail) - 5.500% Senior Notes due 2028 [Member] - USD ($) $ in Millions		9 Months Ended
	Jun. 24, 2020	Sep. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Issued Senior Notes	$ 450.0
Debt instrument interest rate	5.50%	5.50%	5.50%
Debt instrument maturity date	Jul. 01, 2028
Interest on the notes		payable semi-annually in arrears on January 1 and July 1 of each year

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Acquisitions - Transaction Related Expenses as Incurred (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Business Combinations [Abstract]
Legal, accounting and other acquisition-related costs	$ 4,196	$ 2,020	$ 6,761	$ 4,696
Management transition costs	3,615	5,626	14,590	7,826
Termination and restructuring costs	3,436	3,213	5,441	5,859
Transaction-related expenses	$ 11,247	$ 10,859	$ 26,792	$ 18,381

Variable Interest Entities (Tables)

9 Months Ended

Sep. 30, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Consolidated VIEs Assets and Liabilities

The consolidated VIEs assets and liabilities in the Company’s condensed consolidated balance sheets are shown below (in thousands):


	September 30, 2023		December 31, 2022

Cash and cash equivalents	$	50,531	$	32,478
Accounts receivable, net		28,643		23,789
Other current assets		2,757		2,561
Total current assets		81,931		58,828
Property and equipment, net		387,159		313,358
Goodwill		42,384		39,564
Intangible assets, net		18,263		16,139
Operating lease right-of-use assets		6,034		6,284
Total assets	$	535,771	$	434,173


Accounts payable	$	6,419	$	4,650
Accrued salaries and benefits		6,531		6,866
Current portion of operating lease liabilities		263		233
Other accrued liabilities		6,044		6,179
Total current liabilities		19,257		17,928
Operating lease liabilities		6,232		6,433
Total liabilities	$	25,489	$	24,361

- Definition

Tabular disclosure of the significant judgments and assumptions made in determining whether a variable interest (as defined) held by the entity requires the variable interest entity (VIE) (as defined) to be consolidated and (or) disclose information about its involvement with the VIE, individually or in aggregate (as applicable); the nature of restrictions, if any, on the consolidated VIE's assets and on the settlement of its liabilities reported by an entity in its statement of financial position, including the carrying amounts of such assets and liabilities; the nature of, and changes in, the risks associated with involvement in the VIE; how involvement with the VIE affects the entity's financial position, financial performance, and cash flows; the lack of recourse if creditors (or beneficial interest holders) of the consolidated VIE have no recourse to the general credit of the primary beneficiary (if applicable); the terms of arrangements, giving consideration to both explicit arrangements and implicit variable interests, if any, that could require the entity to provide financial support to the VIE, including events or circumstances that could expose the entity to a loss; the methodology used by the entity for determining whether or not it is the primary beneficiary of the variable interest entity; the significant factors considered and judgments made in determining that the power to direct the activities of a VIE that most significantly impact the VIE's economic performance are shared (as defined); the carrying amounts and classification of assets and liabilities of the VIE included in the statement of financial position; the entity's maximum exposure to loss, if any, as a result of its involvement with the VIE, including how the maximum exposure is determined and significant sources of the entity's exposure to the VIE; a comparison of the carrying amounts of the assets and liabilities and the entity's maximum exposure to loss; information about any liquidity arrangements, guarantees, and (or) other commitments by third parties that may affect the fair value or risk of the entity's variable interest in the VIE; whether or not the entity has provided financial support or other support (explicitly or implicitly) to the VIE that it was not previously contractually required to provide or whether the entity intends to provide that support, including the type and amount of the support and the primary reasons for providing the support; and supplemental information the entity determines necessary to provide.

+ References + Details

Revenue

9 Months Ended

Sep. 30, 2023

Revenue from Contract with Customer [Abstract]

Revenue

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 the Company’s performance obligations relate to contracts with a duration of one year or less, the Company elected the optional exemption in Accounting Standards Codification (“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 its patients typically are under no obligation to remain admitted in the Company’s facilities.

The Company disaggregates revenue from contracts with customers by service type and by payor.

The Company’s facilities and services provided by the facilities can generally be classified into the following categories: acute inpatient psychiatric facilities; specialty treatment facilities; comprehensive treatment centers (“CTCs”); and residential treatment centers.

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 and eating disorder facilities. 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.

Comprehensive treatment centers. CTCs specialize in providing medication-assisted treatment in an outpatient setting to
individuals addicted to opioids such as opioid analgesics (prescription pain medications).

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.

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


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Acute inpatient psychiatric facilities	$	382,406	$	340,929	$	1,113,632	$	984,224
Specialty treatment facilities		158,705		145,799		462,916		419,764
Comprehensive treatment centers		129,645		106,679		368,618		310,080
Residential treatment centers		79,578		73,325		240,772		221,036
Revenue	$	750,334	$	666,732	$	2,185,938	$	1,935,104

The Company receives payments from the following sources for services rendered in its 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 other programs; and (iv) individual patients and clients.

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 the Company’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 condensed consolidated statements of operations. Bad debt expense for the three and nine months ended September 30, 2023 and 2022 was not significant.

The following table presents the Company’s revenue by payor type and as a percentage of revenue (in thousands):


	Three Months Ended September 30,										Nine Months Ended September 30,
	2023					2022					2023					2022
	Amount		%			Amount		%			Amount		%			Amount		%
Commercial	$	212,328		28.3	%	$	193,626		29.0	%	$	625,330		28.6	%	$	590,966		30.5	%
Medicare		117,348		15.6	%		101,246		15.2	%		335,819		15.4	%		293,339		15.2	%
Medicaid		400,483		53.4	%		343,067		51.5	%		1,156,766		52.9	%		970,591		50.2	%
Self-Pay		15,524		2.1	%		20,013		3.0	%		52,026		2.4	%		58,390		3.0	%
Other		4,651		0.6	%		8,780		1.3	%		15,997		0.7	%		21,818		1.1	%
Revenue	$	750,334		100.0	%	$	666,732		100.0	%	$	2,185,938		100.0	%	$	1,935,104		100.0	%

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

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+ Details

Long-Term Debt - Components of Long-Term Debt (Parenthetical) (Detail)	9 Months Ended	12 Months Ended
	Sep. 30, 2023	Dec. 31, 2022	Oct. 14, 2020	Jun. 24, 2020
5.000% Senior Notes due 2029 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.00%	5.00%	5.00%
Senior notes maturity year	2029	2029
5.500% Senior Notes due 2028 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.50%	5.50%		5.50%
Senior notes maturity year	2028	2028

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Insider Trading Arrangements	9 Months Ended
Insider Trading Arrangements	Sep. 30, 2023
Trading Arrangements, by Individual
Title	directors or officers
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Fair Value Measurements (Tables)

9 Months Ended

Sep. 30, 2023

Fair Value Disclosures [Abstract]

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

The carrying amounts and fair values of the Credit Facility, 5.500% Senior Notes and 5.000% Senior Notes at September 30, 2023 and December 31, 2022 were as follows (in thousands):


	Carrying Amount				Fair Value
	September 30, 2023		December 31, 2022		September 30, 2023		December 31, 2022
Credit Facility	$	461,033	$	471,489	$	461,033	$	471,489
5.500% Senior Notes due 2028	$	445,325	$	444,694	$	416,379	$	422,459
5.000% Senior Notes due 2029	$	470,159	$	469,609	$	423,754	$	433,214

Condensed Consolidated Statements of Equity (Unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings (Accumulated Deficit) [Member]
Balance at Dec. 31, 2021	$ 2,517,489	$ 890	$ 2,636,350	$ (119,751)
Balance, shares at Dec. 31, 2021		89,028,000
Common stock issued under stock incentive plans	3,749	$ 7	3,742
Common stock issued under stock incentive plans, shares		633,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(15,490)		(15,490)
Equity-based compensation expense	7,925		7,925
Net income attributable to Acadia Healthcare Company, Inc.	60,837			60,837
Balance at Mar. 31, 2022	2,574,510	$ 897	2,632,527	(58,914)
Balance, shares at Mar. 31, 2022		89,661,000
Balance at Dec. 31, 2021	2,517,489	$ 890	2,636,350	(119,751)
Balance, shares at Dec. 31, 2021		89,028,000
Net income attributable to Acadia Healthcare Company, Inc.	212,015
Balance at Sep. 30, 2022	2,743,708	$ 899	2,650,545	92,264
Balance, shares at Sep. 30, 2022		89,875,000
Balance at Dec. 31, 2021	$ 2,517,489	$ 890	2,636,350	(119,751)
Balance, shares at Dec. 31, 2021		89,028,000
Common stock issued under stock incentive plans, shares	285,577
Balance at Dec. 31, 2022	$ 2,812,727	$ 899	2,658,440	153,388
Balance, shares at Dec. 31, 2022	89,913,659	89,914,000
Balance at Mar. 31, 2022	$ 2,574,510	$ 897	2,632,527	(58,914)
Balance, shares at Mar. 31, 2022		89,661,000
Common stock issued under stock incentive plans	3,148	$ 1	3,147
Common stock issued under stock incentive plans, shares		113,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(1,275)		(1,275)
Equity-based compensation expense	6,580		6,580
Net income attributable to Acadia Healthcare Company, Inc.	80,079			80,079
Balance at Jun. 30, 2022	2,663,042	$ 898	2,640,979	21,165
Balance, shares at Jun. 30, 2022		89,774,000
Common stock issued under stock incentive plans	3,067	$ 1	3,066
Common stock issued under stock incentive plans, shares		101,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(740)		(740)
Equity-based compensation expense	7,240		7,240
Net income attributable to Acadia Healthcare Company, Inc.	71,099			71,099
Balance at Sep. 30, 2022	2,743,708	$ 899	2,650,545	92,264
Balance, shares at Sep. 30, 2022		89,875,000
Common stock issued under stock incentive plans	1,649		1,649
Common stock issued under stock incentive plans, shares		39,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(287)		(287)
Equity-based compensation expense	7,890		7,890
Other	(1,357)		(1,357)
Net income attributable to Acadia Healthcare Company, Inc.	61,124			61,124
Balance at Dec. 31, 2022	$ 2,812,727	$ 899	2,658,440	153,388
Balance, shares at Dec. 31, 2022	89,913,659	89,914,000
Common stock issued under stock incentive plans	$ 1,203	$ 11	1,192
Common stock issued under stock incentive plans, shares		1,039,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(48,874)		(48,874)
Equity-based compensation expense	7,629		7,629
Other	902		902
Net income attributable to Acadia Healthcare Company, Inc.	66,015			66,015
Balance at Mar. 31, 2023	2,839,602	$ 910	2,619,289	219,403
Balance, shares at Mar. 31, 2023		90,953,000
Balance at Dec. 31, 2022	$ 2,812,727	$ 899	2,658,440	153,388
Balance, shares at Dec. 31, 2022	89,913,659	89,914,000
Common stock issued under stock incentive plans, shares	161,507
Net income attributable to Acadia Healthcare Company, Inc.	$ (79,396)
Balance at Sep. 30, 2023	$ 2,712,562	$ 912	2,637,658	73,992
Balance, shares at Sep. 30, 2023	91,204,474	91,205,000
Balance at Mar. 31, 2023	$ 2,839,602	$ 910	2,619,289	219,403
Balance, shares at Mar. 31, 2023		90,953,000
Common stock issued under stock incentive plans	3,784	$ 1	3,783
Common stock issued under stock incentive plans, shares		176,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(2,017)		(2,017)
Equity-based compensation expense	7,348		7,348
Net income attributable to Acadia Healthcare Company, Inc.	72,299			72,299
Balance at Jun. 30, 2023	2,921,016	$ 911	2,628,403	291,702
Balance, shares at Jun. 30, 2023		91,129,000
Common stock issued under stock incentive plans	1,554	$ 1	1,553
Common stock issued under stock incentive plans, shares		76,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(843)		(843)
Equity-based compensation expense	8,163		8,163
Other	382		382
Net income attributable to Acadia Healthcare Company, Inc.	(217,710)			(217,710)
Balance at Sep. 30, 2023	$ 2,712,562	$ 912	$ 2,637,658	$ 73,992
Balance, shares at Sep. 30, 2023	91,204,474	91,205,000

- Definition

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

+ References

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+ Details

- Definition

Amount of equity (deficit) attributable to parent. Excludes temporary equity and equity attributable to noncontrolling interest.

+ References

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+ Details

Equity-Based Compensation - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized common stock	12,700,000		12,700,000
Annual increments in employee grants			25.00%
Equity incentive plan available for future grant	2,667,821		2,667,821
Stock options, contractual term			10 years
Equity-based compensation expense	$ 8,163	$ 7,240	$ 23,140	$ 21,745
Unrecognized compensation expense related to unvested options			$ 80,900
Vesting period			1 year 4 months 24 days
Deferred income tax benefit			$ (21,655)	20,176
Stock Compensation Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Deferred income tax benefit	$ 2,200	$ 2,000	$ 6,300	$ 5,900
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]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			3 years
Restricted Stock Units [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
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]
Number of shares issuable at the end of the vesting period, percentage			200.00%

Long-Term Debt - Components of Long-Term Debt (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022	Mar. 17, 2021
Debt Instrument [Line Items]
Less: unamortized debt issuance costs, discount and premium	$ (10,983)	$ (12,647)
Long-term debt	1,376,517	1,385,791
Less: current portion	(26,563)	(21,250)
Long-term debt	1,349,954	1,364,541
Credit Facility [Member] \| Term Loan A [Member]
Debt Instrument [Line Items]
Revolving Facility	382,500	398,438	$ 425,000
Credit Facility [Member] \| Senior Secured Revolving Line of Credit [Member]
Debt Instrument [Line Items]
Revolving Facility	80,000	75,000	$ 600,000
5.500% Senior Notes due 2028 [Member]
Debt Instrument [Line Items]
Senior Notes	450,000	450,000
5.000% Senior Notes due 2029 [Member]
Debt Instrument [Line Items]
Senior Notes	$ 475,000	$ 475,000

Recently Issued Accounting Standards

9 Months Ended

Sep. 30, 2023

Accounting Changes and Error Corrections [Abstract]

Recently Issued Accounting Standards

In November 2021, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) 2021-10, “Government Assistance (Topic 832)” (“ASU 2021-10”). ASU 2021-10 provides guidance to increase the transparency of government assistance including the disclosure of (1) the types of assistance, (2) an entity’s accounting for the assistance, and (3) the effect of the assistance on an entity’s financial statements. ASU 2021-10 applies to all business entities except for not-for-profit entities within the scope of Topic 958, Not-for-Profit Entities, and employee benefit plans within the scope of Topic 960, Plan Accounting—Defined Benefit Pension Plans, Topic 962, Plan Accounting—Defined Contribution Pension Plans, and Topic 965, Plan Accounting—Health and Welfare Benefit Plans that account for a transaction with a government by applying a grant or contribution accounting model by analogy to other accounting guidance (for example, a grant model within IAS 20, Accounting for Government Grants and Disclosure of Government Assistance, or Subtopic 958-605, Not-For-Profit Entities—Revenue Recognition). ASU 2021-10 is effective for fiscal years beginning after December 15, 2021. The Company adopted ASU 2021-10 for the year ended December 31, 2022. See Note 9 – The CARES Act for additional information on the Company’s accounting for government grants received.

In March 2020, the FASB issued ASU 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting” (“ASU 2020-04”). ASU 2020-04 provides optional guidance for a limited period of time to ease the potential burden in accounting for or recognizing the effects of reference rate reform on financial reporting and applies only to contracts, hedging relationships, and other transactions that reference the London Interbank Offered Rate (“LIBOR”) or another reference rate expected to be discontinued because of reference rate reform. ASU 2020-04 is effective as of March 12, 2020 through December 31, 2024. Entities may adopt ASU 2020-04 as of any date from the beginning of an interim period that includes or is subsequent to March 12, 2020 or prospectively from a date within an interim period that includes or is subsequent to March 12, 2020, up to the date that the financial statements are available to be issued. The Company adopted ASU 2020-04 for the quarter ended

March 31, 2023. See Note 11 – Long Term Debt for additional information on the Company’s accounting for the reference rate reform. There is no significant impact on the Company’s consolidated financial statements.

- Definition

The entire disclosure for change in accounting principle. Includes, but is not limited to, nature, reason, and method of adopting amendment to accounting standards or other change in accounting principle.

+ References

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+ Details

Earnings Per Share

9 Months Ended

Sep. 30, 2023

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 three and nine months ended September 30, 2023 and 2022 (in thousands, except per share amounts):


	Three Months Ended September 30,					Nine Months Ended September 30,
	2023			2022		2023			2022
Numerator:
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(217,710	)	$	71,099	$	(79,396	)	$	212,015
Denominator:
Weighted average shares outstanding for basic earnings per share		91,168			89,833		90,852			89,607
Effects of dilutive instruments		—			1,890		—			2,061
Shares used in computing diluted earnings per common share		91,168			91,723		90,852			91,668

(Loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$	(2.39	)	$	0.79	$	(0.87	)	$	2.37
Diluted	$	(2.39	)	$	0.78	$	(0.87	)	$	2.31

For the three and nine months ended September 30, 2023, approximately 0.5 million and 0.8 million, respectively, outstanding shares of restricted stock and shares of common stock issuable upon exercise of outstanding stock option awards have been included in the calculation of weighted-average shares outstanding-diluted. These shares are excluded from the calculation of diluted earnings per share in the condensed consolidated statement of operations because the net loss for both the three and nine months ended September 30, 2023 causes such securities to be anti-dilutive. Approximately 0.4 million shares of common stock issuable upon exercise of outstanding stock option awards were excluded from the calculation of diluted earnings per share for both the three and nine months ended September 30, 2023, respectively, because their effect would have been anti-dilutive. Approximately 0.1 million and 0.6 million shares of common stock issuable upon exercise of outstanding stock option awards were excluded from the calculation of diluted earnings per share for the three and nine months ended September 30, 2022, respectively, because their effect would have been anti-dilutive.

Equity-Based Compensation - Restricted Stock Activity (Detail) - Restricted Stock Award [Member] - $ / shares	9 Months Ended	12 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	1,045,202	926,627
Granted, Number of Shares	515,202	650,396
Cancelled, Number of Shares	(175,705)	(145,205)
Vested, Number of Shares	(373,983)	(386,616)
Unvested, Number of Shares/Units, Ending balance	1,010,716	1,045,202
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 54.89	$ 37.84
Granted, Weighted Average Grant-Date Fair Value	76.53	64.65
Cancelled, Weighted Average Grant-Date Fair Value	56.55	49.03
Vested, Weighted Average Grant-Date Fair Value	49.44	32.64
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 67.65	$ 54.89

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2023	Dec. 31, 2022
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	91,204,474	89,913,659
Common stock, shares outstanding	91,204,474	89,913,659

Acquisitions (Tables)

9 Months Ended

Sep. 30, 2023

Business Combinations [Abstract]

Summary of Changes in Goodwill

The changes in goodwill are as follows (in thousands):


Balance at January 1, 2022	$	2,199,937
Increase from acquisitions		9,488
Adjustments related to 2021 acquisitions		8,761
Increase from contributions of redeemable noncontrolling interests		4,619
Balance at December 31, 2022		2,222,805
Increase from acquisitions		336
Increase from contributions of redeemable noncontrolling interests		2,821
Balance at September 30, 2023	$	2,225,962

Transaction-related expenses comprised the following costs for the three and nine months ended September 30, 2023 and 2022 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Legal, accounting and other acquisition-related costs	$	4,196	$	2,020	$	6,761	$	4,696
Management transition costs		3,615		5,626		14,590		7,826
Termination and restructuring costs		3,436		3,213		5,441		5,859
	$	11,247	$	10,859	$	26,792	$	18,381

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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+ Details

Other Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2023

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 (in thousands):


	Gross Carrying Amount				Accumulated Amortization
	September 30, 2023		December 31, 2022		September 30, 2023			December 31, 2022
Intangible assets subject to amortization:
Non-compete agreements	$	1,131	$	1,131	$	(1,131	)	$	(1,131	)

Intangible assets not subject to amortization:
Licenses and accreditations		11,651		11,512		—			—
Trade names		43,210		45,935		—			—
Certificates of need		18,950		18,594		—			—
		73,811		76,041		—			—
Total	$	74,942	$	77,172	$	(1,131	)	$	(1,131	)

Equity-Based Compensation - Restricted Stock Unit Activity (Detail) - Restricted Stock Units [Member] - $ / shares	9 Months Ended	12 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	1,273,800	1,504,420
Granted, Number of Units	177,509	105,311
Performance adjustment, Number of Units	388,124	182,543
Cancelled, Number of Units	(114,908)
Vested, Number of Units	(1,408,195)	(518,474)
Unvested, Number of Shares/Units, Ending balance	316,330	1,273,800
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 20.69	$ 23.20
Granted, Weighted Average Grant-Date Fair Value	70.98	73.96
Performance adjustment, Weighted Average Grant-Date Fair Value	15.47	33.05
Cancelled, Weighted Average Grant-Date Fair Value	69.07
Vested, Weighted Average Grant-Date Fair Value	10.60	43.16
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 69.84	$ 20.69

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Operating activities:
Net (loss) income	$ (75,418)	$ 216,888
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	96,969	87,627
Amortization of debt issuance costs	2,485	2,440
Equity-based compensation expense	23,140	21,745
Deferred income taxes	(21,655)	20,176
Legal settlements expense	394,181
Loss on impairment	8,694
Other	1,423	2,422
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net	(40,227)	(35,538)
Other current assets	(77,165)	(28,692)
Other assets	309	3,373
Accounts payable and other accrued liabilities	23,057	7,729
Accrued salaries and benefits	(3,038)	(8,831)
Other liabilities	17,723	10,303
Government relief funds	(4,442)	(32,617)
Net cash provided by operating activities	346,036	267,025
Investing activities:
Cash paid for acquisitions, net of cash acquired	(349)
Cash paid for capital expenditures	(285,410)	(208,792)
Proceeds from sale of property and equipment	633	1,784
Other	(1,925)	(6,802)
Net cash used in investing activities	(287,051)	(213,810)
Financing activities:
Borrowings on revolving credit facility	40,000
Principal payments on revolving credit facility	(35,000)	(85,000)
Principal payments on long-term debt	(15,938)	(13,281)
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(45,193)	(7,541)
Contributions from noncontrolling partners in joint ventures	2,538	13,178
Distributions to noncontrolling partners in joint ventures	(3,480)	(1,004)
Other	30	39
Net cash used in financing activities	(57,043)	(93,609)
Net increase (decrease) in cash and cash equivalents	1,942	(40,394)
Cash and cash equivalents at beginning of the period	97,649	133,813
Cash and cash equivalents at end of the period	99,591	$ 93,419
Effect of acquisitions:
Assets acquired, excluding cash	6,766
Liabilities assumed	(128)
Redeemable noncontrolling interest resulting from an acquisition	(6,289)
Cash paid for acquisitions, net of cash acquired	$ 349

Property and Equipment

9 Months Ended

Sep. 30, 2023

Property, Plant and Equipment [Abstract]

Property and Equipment

Property and equipment consisted of the following (in thousands):


	September 30, 2023			December 31, 2022
Land	$	182,393		$	169,137
Building and improvements		1,997,522			1,797,809
Equipment		345,873			292,200
Construction in progress		353,001			349,473
		2,878,789			2,608,619
Less: accumulated depreciation		(733,190	)		(656,574	)
Property and equipment, net	$	2,145,599		$	1,952,045

During the nine months ended September 30, 2023, the Company recorded a non-cash property impairment charge of $2.0 million and a non-cash operating lease right-of-use asset impairment charge of $2.0 million related to the closure of certain facilities, which is included in loss on impairment in the condensed consolidated statements of operations.

The Company has recorded assets held for sale within other assets on the condensed consolidated balance sheets for closed properties actively marketed of $30.5 million and $8.3 million at September 30, 2023 and December 31, 2022, respectively.

Other Current Assets (Tables)

9 Months Ended

Sep. 30, 2023

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Other Current Assets

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


	September 30, 2023		December 31, 2022
Income taxes receivable	$	102,365	$	5,767
Prepaid expenses		38,082		27,052
Insurance receivable – current portion		36,579		10,158
Assets held for sale		30,522		8,347
Other receivables		14,288		15,371
Workers’ compensation deposits – current portion		12,000		12,000
Inventory		5,475		5,087
Other		1,907		2,255
Other current assets	$	241,218	$	86,037

Income Taxes - Additional Information (Detail)	3 Months Ended		9 Months Ended
Income Taxes - Additional Information (Detail)	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Effective tax rates	25.00%	24.80%	(28.40%)	24.20%

Other Accrued Liabilities (Tables)

9 Months Ended

Sep. 30, 2023

Other Liabilities Disclosure [Abstract]

Summary of Other Accrued Liabilities

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


	September 30, 2023		December 31, 2022
Accrued legal settlements	$	394,181	$	—
Insurance liability – current portion		38,690		12,128
Accrued expenses		35,000		26,699
Cost report payable		20,527		13,738
Accrued interest		17,400		17,596
Accrued property taxes		11,684		9,009
Government relief funds		4,534		8,975
Contract liabilities		2,585		6,653
Finance lease liabilities		990		990
Income taxes payable		696		1,338
Other		13,660		13,466
Other accrued liabilities	$	539,947	$	110,592

Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2023	Nov. 03, 2023
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Trading Symbol	ACHC
Entity Registrant Name	Acadia Healthcare Company, Inc.
Entity Central Index Key	0001520697
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common Stock, $.01 par value
Security Exchange Name	NASDAQ
Entity File Number	001-35331
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	45-2492228
Entity Address, Address Line One	6100 Tower Circle
Entity Address, Address Line Two	Suite 1000
Entity Address, City or Town	Franklin
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37067
City Area Code	615
Local Phone Number	861-6000
Document Quarterly Report	true
Document Transition Report	false
Entity Common Stock, Shares Outstanding		92,216,476

Variable Interest Entities

9 Months Ended

Sep. 30, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Variable Interest Entities

14.

Variable Interest Entities

For legal entities where the Company has a financial relationship, the Company evaluates whether it has a variable interest and determines if the entity is considered a variable interest entity (“VIE”). If the Company concludes an entity is a VIE and the Company is the primary beneficiary, the entity is consolidated. The primary beneficiary analysis is a qualitative analysis based on power and benefits. A reporting entity has a controlling financial interest in a VIE and must consolidate the VIE if it has both power and benefits. It must have the power to direct the activities that most significantly impact the VIE’s economic performance and the obligation to absorb losses of the VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE.

At September 30, 2023, the Company operated ten facilities through non-wholly owned subsidiaries. The Company owns between approximately 65% and 87% of the equity interests of these entities, and noncontrolling partners own the remaining equity interests. The Company manages each of these facilities, is responsible for the day-to-day operations and, therefore, has the power to direct the activities that most significantly impact the VIE’s economic performance and the obligation to absorb losses or receive benefits from the VIE that could potentially be significant to the VIE. These activities include, but are not limited to, behavioral healthcare services, human resource and employment-related decisions, marketing and finance. The terms of the agreements governing each of the Company’s VIEs prohibit the Company from using the assets of each VIE to satisfy the obligations of other entities. Consolidated assets at September 30, 2023 and December 31, 2022 include total assets of variable interest entities of $535.8 million and $434.2 million, respectively, which cannot be used to settle the obligations of other entities. Consolidated liabilities at

September 30, 2023 and December 31, 2022 include total liabilities of variable interest entities of $25.5 million and $24.4 million, respectively.

The consolidated VIEs assets and liabilities in the Company’s condensed consolidated balance sheets are shown below (in thousands):


	September 30, 2023		December 31, 2022

Cash and cash equivalents	$	50,531	$	32,478
Accounts receivable, net		28,643		23,789
Other current assets		2,757		2,561
Total current assets		81,931		58,828
Property and equipment, net		387,159		313,358
Goodwill		42,384		39,564
Intangible assets, net		18,263		16,139
Operating lease right-of-use assets		6,034		6,284
Total assets	$	535,771	$	434,173


Accounts payable	$	6,419	$	4,650
Accrued salaries and benefits		6,531		6,866
Current portion of operating lease liabilities		263		233
Other accrued liabilities		6,044		6,179
Total current liabilities		19,257		17,928
Operating lease liabilities		6,232		6,433
Total liabilities	$	25,489	$	24,361

Equity-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2023

Share-Based Payment Arrangement [Abstract]

Stock Option Activity

Stock option activity during 2022 and 2023 was as follows:


	Number of Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (in years)		Aggregate Intrinsic Value (in thousands)
Options outstanding at January 1, 2022		1,106,069		$	42.07
Options granted		334,260			55.73
Options exercised		(285,577	)		40.66
Options cancelled		(175,475	)		46.98
Options outstanding at December 31, 2022		979,277			46.27
Options granted		271,740			79.32
Options exercised		(161,507	)		40.50
Options cancelled		(99,990	)		56.68
Options outstanding at September 30, 2023		989,520		$	55.24		7.39	$	20,815
Options exercisable at September 30, 2023		392,795		$	42.69		5.73	$	12,705

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 nine months ended September 30, 2023 and year ended December 31, 2022:


	September 30, 2023			December 31, 2022
Weighted average grant-date fair value of options	$	31.11		$	20.72
Risk-free interest rate		4.1	%		2.0	%
Expected volatility		37	%		39	%
Expected life (in years)		5.0			5.0

Restricted Stock Activity

Restricted stock activity during 2022 and 2023 was as follows:


	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2022		926,627		$	37.84
Granted		650,396			64.65
Cancelled		(145,205	)		49.03
Vested		(386,616	)		32.64
Unvested at December 31, 2022		1,045,202		$	54.89
Granted		515,202			76.53
Cancelled		(175,705	)		56.55
Vested		(373,983	)		49.44
Unvested at September 30, 2023		1,010,716		$	67.65

Restricted Stock Unit Activity

Restricted stock unit activity during 2022 and 2023 was as follows:


	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2022		1,504,420		$	23.20
Granted		105,311			73.96
Performance adjustment		182,543			33.05
Cancelled		—			—
Vested		(518,474	)		43.16
Unvested at December 31, 2022		1,273,800		$	20.69
Granted		177,509			70.98
Performance adjustment		388,124			15.47
Cancelled		(114,908	)		69.07
Vested		(1,408,195	)		10.60
Unvested at September 30, 2023		316,330		$	69.84

Equity-Based Compensation - Stock Option Activity (Detail) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2023 USD ($) $ / shares shares	Dec. 31, 2022 $ / shares shares
Share-Based Payment Arrangement [Abstract]
Options outstanding, Beginning balance \| shares	979,277	1,106,069
Options granted \| shares	271,740	334,260
Options exercised \| shares	(161,507)	(285,577)
Options cancelled \| shares	(99,990)	(175,475)
Options outstanding, Ending balance \| shares	989,520	979,277
Options exercisable, Ending balance \| shares	392,795
Options outstanding, Weighted Average Exercise Price, Beginning balance \| $ / shares	$ 46.27	$ 42.07
Options granted, Weighted Average Exercise Price \| $ / shares	79.32	55.73
Options exercised, Weighted Average Exercise Price \| $ / shares	40.5	40.66
Options cancelled, Weighted Average Exercise Price \| $ / shares	56.68	46.98
Options outstanding, Weighted Average Exercise Price, Ending balance \| $ / shares	55.24	$ 46.27
Options exercisable, Weighted Average Exercise Price, Ending balance \| $ / shares	$ 42.69
Options outstanding, Weighted Average Remaining Contractual Term	7 years 4 months 20 days
Options exercisable, Weighted Average Remaining Contractual Term, Ending balance	5 years 8 months 23 days
Options outstanding, Aggregate Intrinsic Value \| $	$ 20,815
Options exercisable, Aggregate Intrinsic Value, Ending balance \| $	$ 12,705

Other Intangible Assets

9 Months Ended

Sep. 30, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Other Intangible Assets

Other identifiable intangible assets and related accumulated amortization consisted of the following (in thousands):


	Gross Carrying Amount				Accumulated Amortization
	September 30, 2023		December 31, 2022		September 30, 2023			December 31, 2022
Intangible assets subject to amortization:
Non-compete agreements	$	1,131	$	1,131	$	(1,131	)	$	(1,131	)

Intangible assets not subject to amortization:
Licenses and accreditations		11,651		11,512		—			—
Trade names		43,210		45,935		—			—
Certificates of need		18,950		18,594		—			—
		73,811		76,041		—			—
Total	$	74,942	$	77,172	$	(1,131	)	$	(1,131	)

All of the Company’s definite-lived intangible assets are fully amortized. The Company’s licenses and accreditations, trade names and certificates of need have indefinite lives and are, therefore, not subject to amortization. During the nine months ended September 30, 2023, the Company recorded a non-cash indefinite-lived intangible asset impairment charge of $4.7 million related to the closure of certain facilities, which is included in loss on impairment in the condensed consolidated statements of operations.

Noncontrolling Interests - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2023 Facility
Noncontrolling Interest [Line Items]
Number of facilities operated by non-wholly owned subsidiaries	10
Non-Wholly Owned Subsidiaries [Member] \| Minimum [Member]
Noncontrolling Interest [Line Items]
Equity ownership interests percentage in the facility	65.00%
Non-Wholly Owned Subsidiaries [Member] \| Maximum [Member]
Noncontrolling Interest [Line Items]
Equity ownership interests percentage in the facility	87.00%

Fair Value Measurements - Carrying Amounts and Fair Values of Company's Credit Facilities and Contingent Consideration Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Carrying Amount [Member] \| Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Revolving Facility	$ 461,033	$ 471,489
Carrying Amount [Member] \| 5.500% Senior Notes due 2028 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	445,325	444,694
Carrying Amount [Member] \| 5.000% Senior Notes due 2029 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	470,159	469,609
Fair Value [Member] \| Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Secured	461,033	471,489
Fair Value [Member] \| 5.500% Senior Notes due 2028 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	416,379	422,459
Fair Value [Member] \| 5.000% Senior Notes due 2029 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	$ 423,754	$ 433,214

Other Accrued Liabilities

9 Months Ended

Sep. 30, 2023

Other Liabilities Disclosure [Abstract]

Other Accrued Liabilities

10.

Other Accrued Liabilities

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


	September 30, 2023		December 31, 2022
Accrued legal settlements	$	394,181	$	—
Insurance liability – current portion		38,690		12,128
Accrued expenses		35,000		26,699
Cost report payable		20,527		13,738
Accrued interest		17,400		17,596
Accrued property taxes		11,684		9,009
Government relief funds		4,534		8,975
Contract liabilities		2,585		6,653
Finance lease liabilities		990		990
Income taxes payable		696		1,338
Other		13,660		13,466
Other accrued liabilities	$	539,947	$	110,592

Property and Equipment (Tables)

9 Months Ended

Sep. 30, 2023

Property, Plant and Equipment [Abstract]

Summary of Property and Equipment

Property and equipment consisted of the following (in thousands):


	September 30, 2023			December 31, 2022
Land	$	182,393		$	169,137
Building and improvements		1,997,522			1,797,809
Equipment		345,873			292,200
Construction in progress		353,001			349,473
		2,878,789			2,608,619
Less: accumulated depreciation		(733,190	)		(656,574	)
Property and equipment, net	$	2,145,599		$	1,952,045

Income Taxes

9 Months Ended

Sep. 30, 2023

Income Tax Disclosure [Abstract]

Income Taxes

16.

Income Taxes

The provision for income taxes for the three months ended September 30, 2023 and 2022 reflects effective tax rates of 25.0% and 24.8%, and 28.4% and 24.2% for the nine months ended September 30, 2023 and 2022, respectively.

As the Company continues to monitor the implications of potential tax legislation in each of its jurisdictions, the Company may adjust estimates and record additional amounts for tax assets and liabilities. Any adjustments to the Company’s tax assets and liabilities could materially impact the provision for income taxes and its effective tax rate in the periods in which they are made.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Fair Value Measurements

9 Months Ended

Sep. 30, 2023

Fair Value Disclosures [Abstract]

Fair Value Measurements

17.

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 Credit Facility, 5.500% Senior Notes and 5.000% Senior Notes at September 30, 2023 and December 31, 2022 were as follows (in thousands):


	Carrying Amount				Fair Value
	September 30, 2023		December 31, 2022		September 30, 2023		December 31, 2022
Credit Facility	$	461,033	$	471,489	$	461,033	$	471,489
5.500% Senior Notes due 2028	$	445,325	$	444,694	$	416,379	$	422,459
5.000% Senior Notes due 2029	$	470,159	$	469,609	$	423,754	$	433,214

The Credit Facility, 5.500% Senior Notes and 5.000% Senior Notes 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.

- 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

Other Current Assets

9 Months Ended

Sep. 30, 2023

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Other Current Assets

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


	September 30, 2023		December 31, 2022
Income taxes receivable	$	102,365	$	5,767
Prepaid expenses		38,082		27,052
Insurance receivable – current portion		36,579		10,158
Assets held for sale		30,522		8,347
Other receivables		14,288		15,371
Workers’ compensation deposits – current portion		12,000		12,000
Inventory		5,475		5,087
Other		1,907		2,255
Other current assets	$	241,218	$	86,037

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended							9 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Dec. 31, 2022	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ (217,710)	$ 72,299	$ 66,015	$ 61,124	$ 71,099	$ 80,079	$ 60,837	$ (79,396)	$ 212,015

- Definition

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

+ References

+ Details

Other Intangible Assets - Other Identifiable Intangible Assets and Related Accumulated Amortization (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	$ 73,811	$ 76,041
Total	74,942	77,172
Total	(1,131)	(1,131)
Non-Compete Agreements [Member]
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets subject to amortization, Gross Carrying Amount	1,131	1,131
Intangible assets subject to amortization, Accumulated Amortization	(1,131)	(1,131)
Licenses and Accreditations [Member]
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	11,651	11,512
Trade Names [Member]
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	43,210	45,935
Certificates of Need [Member]
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	$ 18,950	$ 18,594

Revenue - Schedule of Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 750,334	$ 666,732	$ 2,185,938	$ 1,935,104
U.S. Facilities [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 750,334	$ 666,732	$ 2,185,938	$ 1,935,104
Revenue, Percentage	100.00%	100.00%	100.00%	100.00%
U.S. Facilities [Member] \| Commercial [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 212,328	$ 193,626	$ 625,330	$ 590,966
Revenue, Percentage	28.30%	29.00%	28.60%	30.50%
U.S. Facilities [Member] \| Medicare [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 117,348	$ 101,246	$ 335,819	$ 293,339
Revenue, Percentage	15.60%	15.20%	15.40%	15.20%
U.S. Facilities [Member] \| Medicaid [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 400,483	$ 343,067	$ 1,156,766	$ 970,591
Revenue, Percentage	53.40%	51.50%	52.90%	50.20%
U.S. Facilities [Member] \| Self-Pay [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 15,524	$ 20,013	$ 52,026	$ 58,390
Revenue, Percentage	2.10%	3.00%	2.40%	3.00%
U.S. Facilities [Member] \| Other [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 4,651	$ 8,780	$ 15,997	$ 21,818
Revenue, Percentage	0.60%	1.30%	0.70%	1.10%

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 924
-SubTopic 10
-Name Accounting Standards Codification
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+ Details

Description of Business and Basis of Presentation - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2023 Bed State Facility
Accounting Policies [Abstract]
Number of facilities \| Facility	253
Number of beds \| Bed	11,100
Number of operating states \| State	39

Other Current Assets - Other Current Assets (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Income taxes receivable	$ 102,365	$ 5,767
Prepaid expenses	38,082	27,052
Insurance receivable – current portion	36,579	10,158
Assets held for sale	30,522	8,347
Other receivables	14,288	15,371
Workers’ compensation deposits – current portion	12,000	12,000
Inventory	5,475	5,087
Other	1,907	2,255
Other current assets	$ 241,218	$ 86,037

Property and Equipment - Summary of Property and Equipment (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 2,878,789	$ 2,608,619
Less: accumulated depreciation	(733,190)	(656,574)
Property and equipment, net	2,145,599	1,952,045
Land [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	182,393	169,137
Building and Improvements [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	1,997,522	1,797,809
Equipment [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	345,873	292,200
Construction in Progress [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 353,001	$ 349,473

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 99,591	$ 97,649
Accounts receivable, net	362,666	322,439
Other current assets	241,218	86,037
Total current assets	703,475	506,125
Property and equipment, net	2,145,599	1,952,045
Goodwill	2,225,962	2,222,805
Intangible assets, net	73,811	76,041
Deferred tax assets	2,850	2,950
Operating lease right-of-use assets	122,090	135,238
Other assets	72,431	92,697
Total assets	5,346,218	4,987,901
Current liabilities:
Current portion of long-term debt	26,563	21,250
Accounts payable	149,874	104,723
Accrued salaries and benefits	122,264	125,298
Current portion of operating lease liabilities	26,242	26,463
Other accrued liabilities	539,947	110,592
Total current liabilities	864,890	388,326
Long-term debt	1,349,954	1,364,541
Deferred tax liabilities	70,450	92,588
Operating lease liabilities	104,873	116,429
Other liabilities	145,907	125,033
Total liabilities	2,536,074	2,086,917
Redeemable noncontrolling interests	97,582	88,257
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; 91,204,474 and 89,913,659 issued and outstanding at September 30, 2023 and December 31, 2022, respectively	912	899
Additional paid-in capital	2,637,658	2,658,440
Retained earnings	73,992	153,388
Total equity	2,712,562	2,812,727
Total liabilities and equity	$ 5,346,218	$ 4,987,901

Revenue - Schedule of Revenue Attributed to Each Category (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Disaggregation of Revenue [Line Items]
Revenue	$ 750,334	$ 666,732	$ 2,185,938	$ 1,935,104
U.S. Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	750,334	666,732	2,185,938	1,935,104
U.S. Facilities [Member] \| Acute Inpatient Psychiatric Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	382,406	340,929	1,113,632	984,224
U.S. Facilities [Member] \| Specialty Treatment Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	158,705	145,799	462,916	419,764
U.S. Facilities [Member] \| Comprehensive Treatment Centers [Member]
Disaggregation of Revenue [Line Items]
Revenue	129,645	106,679	368,618	310,080
U.S. Facilities [Member] \| Residential Treatment Centers [Member]
Disaggregation of Revenue [Line Items]
Revenue	$ 79,578	$ 73,325	$ 240,772	$ 221,036

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

+ References

+ Details

Commitments and Contingencies

9 Months Ended

Sep. 30, 2023

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

12.

Commitments and Contingencies

Professional and General Liability

A portion of the Company’s professional liability risks are insured through a wholly-owned insurance subsidiary providing coverage for up to $5.0 million per claim and $10.0 million for certain other claims through August 31, 2023, and $7.0 million and $10.0 million for certain other claims thereafter. The Company has obtained reinsurance coverage from a third party to cover claims in excess of those retention limits. The reinsurance policy has a coverage limit of $75.0 million or $70.0 million in the aggregate for certain other claims through August 31, 2023, and $78.0 million or $75.0 million in the aggregate for certain other claims thereafter. 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.

Legal Proceedings

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, the Company's 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 federal 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 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.

Desert Hills

From October 2018 to August 2020, the Company, its subsidiary Youth and Family Centered Services of New Mexico (“Desert Hills”), and FamilyWorks, a not-for-profit treatment foster care program to which Desert Hills provided management services, including day-to-day administration of the program, via a management services agreement, were among a number of defendants named in five lawsuits (collectively, the “Desert Hills Litigation”) filed in New Mexico State District Court (the “District Court”). These lawsuits each related to abuse that occurred in foster homes where FamilyWorks had placed children. In 2021, the Company finalized out-of-court settlements for two of the five cases for amounts covered under the Company’s professional liability insurance.

On July 7, 2023, in connection with one of the lawsuits in the Desert Hills Litigation styled Inman v. Garcia, et al, Case No. D-117-CV-2019-00136 (the “Inman Litigation”), a jury awarded the plaintiff compensatory damages of $80.0 million and punitive damages of $405.0 million. This award far exceeded the Company’s reasonable expectation based on the previously resolved complaints and far exceeded any precedent for comparable cases. The parties made substantial progress during mediation proceedings on October 6, 2023 and October 7, 2023 in an effort to reach settlement agreements to resolve the Inman Litigation as well as the two other related cases – Rael v. Garcia, et al, Case No. D-117-CV-2019-00135 and Endicott-Quinones v. Garcia, et al, Case No. D-117-CV-2019-00137 (together with the Inman Litigation, the “Cases”). On October 11, 2023, the Company and Desert Hills, in connection with the Inman Litigation, filed an unopposed motion to stay the District Court’s requirement of posting a bond and execution of its judgment on the Company, Desert Hills or Family Works, in order to allow for settlement discussions and efforts to finalize a written agreement regarding the Cases to continue unimpeded. The motion was granted by the District Court on October 16, 2023.

On October 30, 2023, the Company and Desert Hills entered into settlement agreements in connection with each of the Cases. Under the terms of the settlement agreements, the Company will pay an aggregate amount of $400.0 million in exchange for the release and discharge of all claims arising from, relating to, concerning or with respect to all harm, injuries or damages asserted or that may be asserted in the future. The settlement agreements fully resolve each of the Cases and include no admission of liability or wrongdoing by either the Company or Desert Hills.

The settlement agreements are subject to approval by the District Court. The Company currently intends to pay the funds associated with the settlement agreements from a combination of insurance, cash on hand and existing credit lines. The settlement amounts must be paid within 30 days from the District Court’s approval of the settlement agreements. In respect of the Cases, the Company has recorded a legal settlements liability of $394.2 million, which is inclusive of associated legal fees and net of reinsurance receivables, within other accrued liabilities and other current assets, respectively, on the condensed consolidated balance sheet at September 30, 2023.

Securities Litigation

On April 1, 2019, a consolidated complaint was filed against the Company and certain former and current officers in the lawsuit styled St. Clair County Employees’ Retirement System v. Acadia Healthcare Company, Inc., et al., Case No. 3:19-cv-00988, which is pending in the United States District Court for the Middle District of Tennessee. The complaint is brought on behalf of a class consisting of all persons (other than defendants) who purchased securities of the Company between April 30, 2014 and November 15, 2018, and alleges that defendants violated Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 (the “Exchange Act”) and Rule 10b-5 promulgated thereunder. On September 30, 2022, the court entered an order certifying a class consisting of all persons who purchased or otherwise acquired the common stock of the Company between April 30, 2014 and November 15, 2018. At this time, the Company is not able to quantify any potential liability in connection with this litigation because the case is in its early stages.

Derivative Actions

On February 21, 2019, a purported stockholder filed a related derivative action on behalf of the Company against certain former and current officers and directors in the lawsuit styled Davydov v. Jacobs, et al., Case No. 3:19-cv-00167, which is pending in the United States District Court for the Middle District of Tennessee. The complaint alleges claims for violations of Section 10(b) and 14(a) of the Exchange Act, breach of fiduciary duty, waste of corporate assets, and unjust enrichment. On May 23, 2019, a purported stockholder filed a second related derivative action on behalf of the Company against certain former and current officers and directors in the lawsuit styled Beard v. Jacobs, et al., Case No. 3:19-cv-0441, which is pending the United States District Court for the Middle District of Tennessee. The complaint alleges claims for violations of Sections 10(b), 14(a), and 21D of the Exchange Act, breach of fiduciary duty, waste of corporate assets, unjust enrichment, and insider selling. On June 11, 2019, the Davydov and Beard actions were consolidated. On February 22, 2021, the court entered an order staying the case. On October 23, 2020, a purported stockholder filed a third related derivative action on behalf of the Company against former and current officers and directors in the lawsuit styled Pfenning v. Jacobs, et al., Case No. 2020-0915-NAC, which is pending in the Court of Chancery of the State of Delaware. The complaint alleges claims for breach of fiduciary duty. On February 17, 2021, the court entered an order staying the case. On February 24, 2021, a purported stockholder filed a fourth derivative action on behalf of the Company against former and current officers and directors in the lawsuit styled Solak v. Jacobs, et al., Case No. 2021-0163-NAC, which is pending in the Court of Chancery of the State of Delaware. The complaint alleges claims for breach of fiduciary duty, unjust enrichment, waste of corporate assets, and insider

selling. At this time, the Company is not able to quantify any potential liability in connection with this litigation because the cases are in their early stages.

Government Investigation

In the fall of 2017, the Office of Inspector General (“OIG”) 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. In April 2019, the OIG issued subpoenas relating to six additional facilities requesting certain documents and information from January 2013 to the date of the subpoenas. The government’s investigation of each of these 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.

Variable Interest Entities - Additional Information (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2023 USD ($) Facility	Dec. 31, 2022 USD ($)
Variable Interest Entity [Line Items]
Consolidated assets	$ 5,346,218	$ 4,987,901
Consolidated liabilities	$ 2,536,074	2,086,917
Variable Interest Entity, Primary Beneficiary [Member]
Variable Interest Entity [Line Items]
Number of facilities operated through non-wholly owned subsidiaries \| Facility	10
Consolidated assets	$ 535,771	434,173
Consolidated liabilities	$ 25,489	$ 24,361
Variable Interest Entity, Primary Beneficiary [Member] \| Minimum [Member]
Variable Interest Entity [Line Items]
Variable interest entity, ownership percentage	65.00%
Variable Interest Entity, Primary Beneficiary [Member] \| Maximum [Member]
Variable Interest Entity [Line Items]
Variable interest entity, ownership percentage	87.00%

- Definition

Sum of the carrying amounts as of the balance sheet date of all assets that are recognized. Assets are probable future economic benefits obtained or controlled by an entity as a result of past transactions or events.

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+ Details

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Condensed Consolidated Statements of Operations (Unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Equity-based compensation expense	$ 8,163	$ 7,240	$ 23,140	$ 21,745

Long-Term Debt

9 Months Ended

Sep. 30, 2023

Debt Disclosure [Abstract]

Long-Term Debt

11.

Long-Term Debt

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


	September 30, 2023			December 31, 2022
Credit Facility:
Term Loan A	$	382,500		$	398,438
Revolving Line of Credit		80,000			75,000
5.500% Senior Notes due 2028		450,000			450,000
5.000% Senior Notes due 2029		475,000			475,000
Less: unamortized debt issuance costs, discount and premium		(10,983	)		(12,647	)
		1,376,517			1,385,791
Less: current portion		(26,563	)		(21,250	)
Long-term debt	$	1,349,954		$	1,364,541

Credit Facility

The Company entered into a credit agreement establishing a new senior credit facility (the “Credit Facility”) on March 17, 2021. The Credit Facility provides for a $600.0 million senior secured revolving credit facility (the “Revolving Facility”) and a $425.0 million senior secured term loan facility (the “Term Loan Facility” and, together with the Revolving Facility, the “Senior Facilities”), with each maturing on March 17, 2026. The Revolving Facility further provides for (i) up to $20.0 million, which may be utilized for the issuance of letters of credit and (ii) the availability of a swingline facility under which the Company may borrow up to $20.0 million.

On March 30, 2023, the Company entered into the First Amendment to the Credit Facility (the “First Amendment”). The First Amendment replaced LIBOR with the Secured Overnight Financing Rate as determined for a term of, at the Company’s option, one, three or six months, plus an adjustment of 0.10% (“Adjusted Term SOFR”). Borrowings under the Credit Facility bear interest at a rate equal to, at the Company’s option, either (a) a base rate determined by reference to the highest of (i) the federal funds rate plus 0.50%, (ii) the prime rate of Bank of America or (iii) Adjusted Term SOFR for a one month interest period or (b) Adjusted Term SOFR, in each case plus an applicable margin that varies according to the total leverage ratio of the Company from 0.375% to 1.250% in the case of base rate loans and from 1.375% to 2.250% in the case of Adjusted Term SOFR loans. In addition, an unused fee that varies according to the total leverage ratio of the Company from 0.200% to 0.350% is payable quarterly in arrears based on the average daily undrawn portion of the commitments in respect of the Revolving Facility. There is no significant impact on the Company’s consolidated financial statements as a result of the First Amendment.

During the nine months ended September 30, 2023, the Company borrowed $40.0 million on the Revolving Facility and repaid $35.0 million of the balance outstanding. The Company had $516.5 million of availability under the Revolving Facility and had standby letters of credit outstanding of $3.5 million related to security for the payment of claims required by its workers’ compensation insurance program at September 30, 2023.

The Credit Facility requires quarterly term loan principal repayments for the Term Loan Facility of approximately $5.3 million for December 31, 2023 to March 31, 2024, approximately $8.0 million for June 30, 2024 to March 31, 2025, and approximately $10.6 million for June 30, 2025 to December 31, 2025, with the remaining principal balance of the Term Loan Facility due on the maturity date of March 17, 2026.

The Company has the ability to increase the amount of the Senior Facilities, which may take the form of increases to the Revolving Facility or the Term Loan Facility or the issuance of one or more incremental term loan facilities (collectively, the “Incremental Facilities”), upon obtaining additional commitments from new or existing lenders and the satisfaction of customary conditions precedent for such Incremental Facilities. Such Incremental Facilities may not exceed the sum of (i) the greater of $480.0 million and an amount equal to 100% of the Consolidated EBITDA (as defined in the Credit Facility) of the Company and (ii) additional amounts that would not cause the Consolidated Senior Secured Net Leverage Ratio (as defined in the Credit Facility) to exceed 3.5 to 1.0.

Subject to certain exceptions, substantially all of the Company’s existing and subsequently acquired or organized direct or indirect wholly-owned subsidiaries are required to guarantee the repayment of the Company’s obligations under the Credit Facility. The Company and such guarantor subsidiaries have granted a security interest on substantially all personal property assets as collateral for the obligations under the Credit Facility.

The Credit Facility contains customary representations and affirmative and negative covenants, including limitations on the Company’s and its subsidiaries’ ability to incur additional debt, grant or permit additional liens, make investments and acquisitions, merge or consolidate with others, dispose of assets, pay dividends and distributions, pay junior indebtedness and enter into affiliate transactions, in each case, subject to customary exceptions. In addition, the Credit Facility contains financial covenants requiring the Company on a consolidated basis to maintain, as of the last day of any consecutive four fiscal quarter period, a consolidated total net leverage ratio of not more than 5.0 to 1.0 and an interest coverage ratio of at least 3.0 to 1.0. The Credit Facility also includes events of default customary for facilities of this type and upon the occurrence of any such event of default, among other things, all outstanding loans under the Senior Facilities may be accelerated, the lenders’ commitments may be terminated, and/or the lenders may exercise collateral remedies. At September 30, 2023, the Company was in compliance with all financial covenants.

Senior Notes

5.500% Senior Notes due 2028

On June 24, 2020, the Company issued $450.0 million of 5.500% Senior Notes due 2028 (the “5.500% Senior Notes”). The 5.500% Senior Notes mature on July 1, 2028, and bear interest at a rate of 5.500% per annum, payable semi-annually in arrears on January 1 and July 1 of each year.

5.000% Senior Notes due 2029

On October 14, 2020, the Company issued $475.0 million of 5.000% Senior Notes due 2029 (the “5.000% Senior Notes”). The 5.000% Senior Notes mature on April 15, 2029, and bear interest at a rate of 5.000% per annum, payable semi-annually in arrears on April 15 and October 15 of each year.

The indentures governing the 5.500% Senior Notes and the 5.000% 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 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 in the amounts set forth in the applicable indentures.

Noncontrolling Interests - Summary of Redeemable Noncontrolling Interests (Detail) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Noncontrolling Interest [Abstract]
Beginning Balance	$ 88,257	$ 65,388
Contributions from noncontrolling partners in joint ventures	8,827	21,162
Net income attributable to noncontrolling interests	3,978	6,894
Acquisition of ownership interests from noncontrolling partners		(4,183)
Distributions to noncontrolling partners in joint ventures	(3,480)	(1,004)
Ending Balance	$ 97,582	$ 88,257

Property and Equipment - Additional Information (Detail) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Other Assets [Member]
Property Plant And Equipment [Line Items]
Assets held for sale	$ 30.5	$ 8.3
Loss on Impairment [Member]
Property Plant And Equipment [Line Items]
Non-cash property impairment charge relating to closure of facilities	2.0
Non-cash operating lease right-of-use asset impairment charge related to closure of facilities	$ 2.0

Noncontrolling Interests

9 Months Ended

Sep. 30, 2023

Noncontrolling Interest [Abstract]

Noncontrolling Interests

13.

Noncontrolling Interests

Noncontrolling interests in the consolidated financial statements represent the portion of equity held by noncontrolling partners in the Company’s non-wholly owned subsidiaries. At September 30, 2023, the Company operated ten facilities through non-wholly owned subsidiaries. The Company owns between approximately 65% and 87% of the equity interests of these entities, and noncontrolling partners own the remaining equity interests. The initial value of the noncontrolling interests is based on the fair value of contributions. The Company consolidates the operations of each facility based on its status as primary beneficiary, as further discussed in Note 14 – Variable Interest Entities. The noncontrolling interests are reflected as redeemable noncontrolling interests on the accompanying condensed 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, 2022	$	65,388
Contributions from noncontrolling partners in joint ventures		21,162
Net income attributable to noncontrolling interests		6,894
Acquisition of ownership interests from noncontrolling partners		(4,183	)
Distributions to noncontrolling partners in joint ventures		(1,004	)
Balance at December 31, 2022		88,257
Contributions from noncontrolling partners in joint ventures		8,827
Net income attributable to noncontrolling interests		3,978
Distributions to noncontrolling partners in joint ventures		(3,480	)
Balance at September 30, 2023	$	97,582

Earnings Per Share (Tables)

9 Months Ended

Sep. 30, 2023

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 three and nine months ended September 30, 2023 and 2022 (in thousands, except per share amounts):


	Three Months Ended September 30,					Nine Months Ended September 30,
	2023			2022		2023			2022
Numerator:
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(217,710	)	$	71,099	$	(79,396	)	$	212,015
Denominator:
Weighted average shares outstanding for basic earnings per share		91,168			89,833		90,852			89,607
Effects of dilutive instruments		—			1,890		—			2,061
Shares used in computing diluted earnings per common share		91,168			91,723		90,852			91,668

(Loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$	(2.39	)	$	0.79	$	(0.87	)	$	2.37
Diluted	$	(2.39	)	$	0.78	$	(0.87	)	$	2.31

Long-Term Debt (5.000% Senior Notes due 2029) - Additional Information (Detail) - 5.000% Senior Notes due 2029 [Member] - USD ($) $ in Millions		9 Months Ended
	Oct. 14, 2020	Sep. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Issued Senior Notes	$ 475.0
Debt instrument interest rate	5.00%	5.00%	5.00%
Debt instrument maturity date	Apr. 15, 2029
Interest on the notes		payable semi-annually in arrears on April 15 and October 15 of each year.

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Long-Term Debt (Credit Facility) - Additional Information (Detail) - USD ($)			9 Months Ended
	Mar. 30, 2023	Mar. 17, 2021	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Debt Instrument [Line Items]
Borrowings on revolving credit facility			$ 40,000,000
Repayments of revolving facility			35,000,000	$ 85,000,000
Credit Facility [Member]
Debt Instrument [Line Items]
Date entered into an agreement		Mar. 17, 2021
Borrowings on revolving credit facility			40,000,000
Amount available under revolving line of credit			516,500,000
Repayments of revolving facility			$ 35,000,000
Term loan remaining balance due date			Mar. 17, 2026
Maximum incremental debt amount					$ 480,000,000
Incremental debt amount maximum percentage of consolidated EBITDA			100.00%
Consolidated senior secured net leverage ratio			350.00%
Maximum consolidated net leverage ratio			500.00%
Minimum interest coverage ratio			300.00%
Credit Facility [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Unused fee payable percentage	0.35%
Credit Facility [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Unused fee payable percentage	0.20%
Credit Facility [Member] \| Base Rate Loans [Member]
Debt Instrument [Line Items]
Basis spread on variable rate	0.50%
Credit Facility [Member] \| Base Rate Loans [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Basis spread on variable rate	1.25%
Credit Facility [Member] \| Base Rate Loans [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Basis spread on variable rate	0.375%
Credit Facility [Member] \| SOFR Loans [Member]
Debt Instrument [Line Items]
Basis spread on variable rate	0.10%
Credit Facility [Member] \| SOFR Loans [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Basis spread on variable rate	2.25%
Credit Facility [Member] \| SOFR Loans [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Basis spread on variable rate	1.375%
Credit Facility [Member] \| September 30, 2023 to March 31, 2024 [Member]
Debt Instrument [Line Items]
Term loan principal repayments			$ 5,300,000
Credit Facility [Member] \| June 30, 2024 to March 31, 2025 [Member]
Debt Instrument [Line Items]
Term loan principal repayments			8,000,000.0
Credit Facility [Member] \| June 30, 2025 to December 31, 2025 [Member]
Debt Instrument [Line Items]
Term loan principal repayments			10,600,000
Credit Facility [Member] \| Senior Secured Revolving Line of Credit [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount		$ 600,000,000	80,000,000		75,000,000
Credit Facility [Member] \| Term Loan A- Facility [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount		$ 425,000,000	382,500,000		$ 398,438,000
Debt instrument maturity date		Mar. 17, 2026
Credit Facility [Member] \| Letters of Credit [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount		$ 20,000,000
Credit Facility [Member] \| Swingline Facility [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount		$ 20,000,000
Credit Facility [Member] \| Standby Letters of Credit [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount			$ 3,500,000

The CARES Act

9 Months Ended

Sep. 30, 2023

Unusual or Infrequent Items, or Both [Abstract]

The CARES Act

As part of the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”), the U.S. government announced it would offer $100 billion of relief to eligible healthcare providers. On April 24, 2020, then President Trump signed into law the Paycheck Protection Program and Health Care Enhancement Act (the “PPP Act”). Among other things, the PPP Act allocated $75 billion to eligible healthcare providers to help offset losses and expenses related to the novel coronavirus known as COVID-19 (“COVID-19”). The $75 billion allocated under the PPP Act was in addition to the $100 billion allocated to healthcare providers for the same purposes in the CARES Act and has been disbursed to providers under terms and conditions similar to the CARES Act funds. The Company accounts for government grants by analogizing to the grant model in accordance with International Accounting Standard (“IAS”) 20, Accounting for Government Grants and Disclosure of Government Assistance, and as such, has recognized income from grants in line with the recognition of expenses or the loss of revenues for which the grants are intended to compensate. The Company recognizes grants once both of the following conditions are met: (i) the Company is able to comply with the relevant terms and conditions of the grant and (ii) the grant will be received.

During 2020, the Company participated in certain relief programs offered through the CARES Act, including receipt of approximately $34.9 million relating to the Public Health and Social Services Emergency Fund (the “PHSSE Fund”), also known as the Provider Relief Fund. During the fourth quarter of 2020, the Company recorded approximately $32.8 million of income from provider relief fund related to PHSSE Fund amounts received in 2020.

In 2021, the Company received $24.2 million of additional funds from the PHSSE Fund. During the fourth quarter of 2021, the Company recorded $17.9 million of income from provider relief fund related to the PHSSE Fund amounts received. During the year ended December 31, 2022, the Company received $7.7 million of additional funds from the PHSSE Fund and $14.2 million from the American Rescue Plan (“ARP”) Rural Payments for Hospitals. During the year ended December 31, 2022, the Company recorded $21.5 million of income from provider relief fund related to PHSSE Fund and ARP funds received. During the third quarter of 2023, the Company recorded $4.4 million of income from provider relief fund related to ARP funds received. The remaining unrecognized funds of $4.5 million and $9.0 million are included in other accrued liabilities on the condensed consolidated balance sheets at September 30, 2023 and December 31, 2022, respectively. The Company continues to evaluate its compliance with the terms and conditions to, and the financial impact of, the additional funds received, including potential repayment of the remaining balance.

Healthcare providers were required to sign an attestation confirming receipt of the PHSSE Fund amounts and agree to the terms and conditions of payment. Under the terms and conditions for receipt of the payment, the Company was allowed to use the funds to cover lost revenues and healthcare costs related to COVID-19, and the Company was required to properly and fully document the use of these funds to the U.S. Department of Health and Human Services. The reporting of the funds is subject to future audit for compliance with the terms and conditions. The Company recognized PHSSE Fund amounts to the extent it had qualifying COVID-19 expenses or lost revenues as permitted under the terms and conditions.

During 2020, the Company applied for and received approximately $45.2 million of payments from the CMS Accelerated and Advance Payment Program. Of the $45.2 million of advance payments received in 2020, the Company repaid approximately $25.1 million of advance payments during 2021 and made additional repayments of approximately $20.1 million during the year ended December 31, 2022.

In addition, the Company received a 2% increase in facilities’ Medicare reimbursement rate as a result of the temporary suspension of Medicare sequestration from May 1, 2020 to March 31, 2022, which was reduced to 1% on April 1, 2022 and was eliminated effective July 1, 2022.

The CARES Act also provided for certain federal income and other tax changes. The Company received a cash benefit of approximately $39.3 million for 2020 relating to the delay of payment of the employer portion of Social Security payroll taxes. The Company repaid half of the $39.3 million of payroll tax deferrals during the third quarter of 2021 and repaid the remaining portion in the third quarter of 2022 to eliminate the liability.

These regulatory changes were temporary and expired at the end of the COVID-19 public health emergency on May 11, 2023.

The Company is continuing to evaluate the terms and conditions and financial impact of funds received under the CARES Act and other government relief programs.

Fair Value Measurements - Additional Information (Detail)	Sep. 30, 2023	Dec. 31, 2022	Oct. 14, 2020	Jun. 24, 2020
5.500% Senior Notes due 2028 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.50%	5.50%		5.50%
5.000% Senior Notes due 2029 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.00%	5.00%	5.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Subsequent Events	9 Months Ended
Subsequent Events	Sep. 30, 2023
Subsequent Events [Abstract]
Subsequent Events	18. Subsequent Events See Note 12 – Commitments and Contingencies for a discussion of developments related to the Cases following September 30, 2023.

Earnings Per Share - Additional Information (Detail) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Excluded common stock for computation of diluted earnings per share	0.4	0.1	0.4	0.6
Restricted Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Excluded common stock for computation of diluted earnings per share	0.5		0.8

Revenue (Tables) - U.S. Facilities [Member]

9 Months Ended

Sep. 30, 2023

Schedule of Revenue Attributed to Each Category

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


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Acute inpatient psychiatric facilities	$	382,406	$	340,929	$	1,113,632	$	984,224
Specialty treatment facilities		158,705		145,799		462,916		419,764
Comprehensive treatment centers		129,645		106,679		368,618		310,080
Residential treatment centers		79,578		73,325		240,772		221,036
Revenue	$	750,334	$	666,732	$	2,185,938	$	1,935,104

Schedule of Revenue and Percentage Generated by Each Payor Type

The following table presents the Company’s revenue by payor type and as a percentage of revenue (in thousands):


	Three Months Ended September 30,										Nine Months Ended September 30,
	2023					2022					2023					2022
	Amount		%			Amount		%			Amount		%			Amount		%
Commercial	$	212,328		28.3	%	$	193,626		29.0	%	$	625,330		28.6	%	$	590,966		30.5	%
Medicare		117,348		15.6	%		101,246		15.2	%		335,819		15.4	%		293,339		15.2	%
Medicaid		400,483		53.4	%		343,067		51.5	%		1,156,766		52.9	%		970,591		50.2	%
Self-Pay		15,524		2.1	%		20,013		3.0	%		52,026		2.4	%		58,390		3.0	%
Other		4,651		0.6	%		8,780		1.3	%		15,997		0.7	%		21,818		1.1	%
Revenue	$	750,334		100.0	%	$	666,732		100.0	%	$	2,185,938		100.0	%	$	1,935,104		100.0	%

The CARES Act - Additional Information (Detail) - USD ($) $ in Thousands		3 Months Ended			9 Months Ended		12 Months Ended
	Apr. 24, 2020	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
CARES Act [Line Items]
Income from relief fund		$ 4,442	$ 7,656		$ 4,442	$ 16,206			$ 32,800
Expected repay of payroll tax deferrals				$ 39,300
CARES Act [Member]
CARES Act [Line Items]
Offer of eligible relief amount					100,000,000
Additional offer of eligible relief amount	$ 75,000,000
Cash benefit relating to delay of payment of social security payroll taxes					39,300
Remaining unrecognized provider relief funds		4,500			$ 4,500		$ 9,000
CARES Act [Member] \| American Rescue Plan [Member]
CARES Act [Line Items]
Income from relief fund		$ 4,400
CARES Act [Member] \| Medicare [Member]
CARES Act [Line Items]
Repayment of advanced payments								$ 25,100
Percentage of increase in medicare reimbursement rate									2.00%
Percentage of reduced in medicare reimbursement rate		1.00%			1.00%
CARES Act [Member] \| Public Health and Social Services Emergency Fund [Member]
CARES Act [Line Items]
Receipt of CARES Act of 2020 aid amount									$ 34,900
Income from relief fund							21,500	17,900
Receipt of additional CARES Act of 2020 aid amount							7,700	$ 24,200
CARES Act [Member] \| Public Health and Social Services Emergency Fund [Member] \| American Rescue Plan [Member]
CARES Act [Line Items]
Receipt of additional CARES Act of 2020 aid amount							14,200
CARES Act [Member] \| CMS' Accelerated and Advance Payment Program [Member]
CARES Act [Line Items]
Repayment of advanced payments							$ 20,100
CARES Act [Member] \| CMS' Accelerated and Advance Payment Program [Member] \| Medicare [Member]
CARES Act [Line Items]
Amount of advance payment received									$ 45,200

Noncontrolling Interests (Tables)

9 Months Ended

Sep. 30, 2023

Noncontrolling Interest [Abstract]

Summary of Redeemable Noncontrolling Interests

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


Balance at January 1, 2022	$	65,388
Contributions from noncontrolling partners in joint ventures		21,162
Net income attributable to noncontrolling interests		6,894
Acquisition of ownership interests from noncontrolling partners		(4,183	)
Distributions to noncontrolling partners in joint ventures		(1,004	)
Balance at December 31, 2022		88,257
Contributions from noncontrolling partners in joint ventures		8,827
Net income attributable to noncontrolling interests		3,978
Distributions to noncontrolling partners in joint ventures		(3,480	)
Balance at September 30, 2023	$	97,582

Commitments and Contingencies - Additional Information (Detail) - USD ($)			1 Months Ended	9 Months Ended
	Oct. 30, 2023	Jul. 07, 2023	Aug. 31, 2023	Sep. 30, 2023
Loss Contingencies [Line Items]
Legal settlement agreement terms				The Company currently intends to pay the funds associated with the settlement agreements from a combination of insurance, cash on hand and existing credit lines. The settlement amounts must be paid within 30 days from the District Court’s approval of the settlement agreements.
Legal settlements libility				$ 394,181,000
Inman Litigation [Member] \| Compensatory Damages [Member]
Loss Contingencies [Line Items]
Awarded plaintiff damages amount		$ 80,000,000
Inman Litigation [Member] \| Punitive Damages [Member]
Loss Contingencies [Line Items]
Awarded plaintiff damages amount		$ 405,000,000
Subsequent Event [Member]
Loss Contingencies [Line Items]
Aggregate amount on settlement agreements	$ 400,000,000
Maximum [Member]
Loss Contingencies [Line Items]
Maximum coverage limit per claim			$ 5,000,000	7,000,000
Reinsurance policy aggregate policy limit			75,000,000	78,000,000
Minimum [Member]
Loss Contingencies [Line Items]
Maximum professional liability for certain other claims thereafter			10,000,000	10,000,000
Reinsurance policy aggregate policy limit			$ 70,000,000	$ 75,000,000

Other Accrued Liabilities - Summary of Other Accrued Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Accounts Payable and Accrued Liabilities, Current [Abstract]
Accrued legal settlements	$ 394,181
Insurance liability – current portion	38,690	$ 12,128
Accrued expenses	35,000	26,699
Cost report payable	20,527	13,738
Accrued interest	17,400	17,596
Accrued property taxes	11,684	9,009
Government relief funds	4,534	8,975
Contract liabilities	2,585	6,653
Finance lease liabilities	990	990
Income taxes payable	696	1,338
Other	13,660	13,466
Other accrued liabilities	$ 539,947	$ 110,592

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended							9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Dec. 31, 2022	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Numerator:
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$ (217,710)	$ 72,299	$ 66,015	$ 61,124	$ 71,099	$ 80,079	$ 60,837	$ (79,396)	$ 212,015
Denominator:
Weighted average shares outstanding for basic earnings per share	91,168				89,833			90,852	89,607
Effects of dilutive instruments					1,890				2,061
Shares used in computing diluted earnings per common share	91,168				91,723			90,852	91,668
Basic earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$ (2.39)				$ 0.79			$ (0.87)	$ 2.37
Diluted earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Diluted	$ (2.39)				$ 0.78			$ (0.87)	$ 2.31

Equity-Based Compensation

9 Months Ended

Sep. 30, 2023

Share-Based Payment Arrangement [Abstract]

Equity-Based Compensation

15.

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 September 30, 2023, a maximum of 12,700,000 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 2,667,821 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 most recent closing price of the Company’s common stock on the most recent trading date prior to the date of grant.

The Company recognized $8.2 million and $7.2 million in equity-based compensation expense for the three months ended September 30, 2023 and 2022 and $23.1 million and $21.7 million for the nine months ended September 30, 2023 and 2022, respectively. Stock compensation expense for the nine months ended September 30, 2023 and 2022 is impacted by forfeiture adjustments and restricted stock unit adjustments based on actual performance compared to vesting targets. At September 30, 2023, there was $80.9 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 1.4 years.

The Company recognized a deferred income tax benefit of $2.2 million and $2.0 million for the three months ended September 30, 2023 and 2022, respectively, related to equity-based compensation expense. The Company recognized a deferred income tax benefit of $6.3 million and $5.9 million for the nine months ended September 30, 2023 and 2022, respectively.

Stock Options

Stock option activity during 2022 and 2023 was as follows:


	Number of Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (in years)		Aggregate Intrinsic Value (in thousands)
Options outstanding at January 1, 2022		1,106,069		$	42.07
Options granted		334,260			55.73
Options exercised		(285,577	)		40.66
Options cancelled		(175,475	)		46.98
Options outstanding at December 31, 2022		979,277			46.27
Options granted		271,740			79.32
Options exercised		(161,507	)		40.50
Options cancelled		(99,990	)		56.68
Options outstanding at September 30, 2023		989,520		$	55.24		7.39	$	20,815
Options exercisable at September 30, 2023		392,795		$	42.69		5.73	$	12,705

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 nine months ended September 30, 2023 and year ended December 31, 2022:


	September 30, 2023			December 31, 2022
Weighted average grant-date fair value of options	$	31.11		$	20.72
Risk-free interest rate		4.1	%		2.0	%
Expected volatility		37	%		39	%
Expected life (in years)		5.0			5.0

The Company’s estimate of expected volatility for stock options is based upon the volatility of its 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 2022 and 2023 was as follows:


	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2022		926,627		$	37.84
Granted		650,396			64.65
Cancelled		(145,205	)		49.03
Vested		(386,616	)		32.64
Unvested at December 31, 2022		1,045,202		$	54.89
Granted		515,202			76.53
Cancelled		(175,705	)		56.55
Vested		(373,983	)		49.44
Unvested at September 30, 2023		1,010,716		$	67.65

Restricted stock unit activity during 2022 and 2023 was as follows:


	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2022		1,504,420		$	23.20
Granted		105,311			73.96
Performance adjustment		182,543			33.05
Cancelled		—			—
Vested		(518,474	)		43.16
Unvested at December 31, 2022		1,273,800		$	20.69
Granted		177,509			70.98
Performance adjustment		388,124			15.47
Cancelled		(114,908	)		69.07
Vested		(1,408,195	)		10.60
Unvested at September 30, 2023		316,330		$	69.84

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. In addition to Company performance, these performance-based restricted stock units are subject to the continuing service of the employee during the 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. 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.

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.

Acquisitions - Summary of Changes in Goodwill (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Business Combinations [Abstract]
Goodwill balance	$ 2,222,805	$ 2,199,937
Goodwill, Acquired During Period	336	9,488
Adjustments related to 2021 acquisitions		8,761
Increase from contributions of redeemable noncontrolling interests	2,821	4,619
Goodwill balance	$ 2,225,962	$ 2,222,805

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Revenue	$ 750,334	$ 666,732	$ 2,185,938	$ 1,935,104
Salaries, wages and benefits (including equity-based compensation expense of $8,163, $7,240, $23,140 and $21,745, respectively)	394,150	352,582	1,171,960	1,027,732
Professional fees	45,540	40,367	130,468	117,718
Supplies	27,147	25,570	79,312	74,291
Rents and leases	11,731	11,339	34,880	33,780
Other operating expenses	104,048	88,993	290,798	255,355
Income from provider relief fund	(4,442)	(7,656)	(4,442)	(16,206)
Depreciation and amortization	33,388	29,573	96,969	87,627
Interest expense, net	20,742	18,003	61,651	50,355
Legal settlements expense	394,181		394,181
Loss on impairment			8,694
Transaction-related expenses	11,247	10,859	26,792	18,381
Total expenses	1,037,732	569,630	2,291,263	1,649,033
(Loss) income before income taxes	(287,398)	97,102	(105,325)	286,071
(Benefit from) provision for income taxes	(71,873)	24,056	(29,907)	69,183
Net (loss) income	(215,525)	73,046	(75,418)	216,888
Net income attributable to noncontrolling interests	(2,185)	(1,947)	(3,978)	(4,873)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$ (217,710)	$ 71,099	$ (79,396)	$ 212,015
(Loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$ (2.39)	$ 0.79	$ (0.87)	$ 2.37
Diluted	$ (2.39)	$ 0.78	$ (0.87)	$ 2.31
Weighted-average shares outstanding:
Basic	91,168	89,833	90,852	89,607
Diluted	91,168	91,723	90,852	91,668

Recently Issued Accounting Standards (Additional Information) (Details)	Sep. 30, 2023
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Immaterial Effect	true
ASU 2021-10 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Dec. 31, 2022
ASU 2020-04 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Mar. 31, 2023

- Definition

Indicates (true false) whether accounting standards update was adopted.

+ References

+ Details

- Definition

Date accounting standards update was adopted, in YYYY-MM-DD format.

+ References

+ Details

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

Acquisitions

9 Months Ended

Sep. 30, 2023

Business Combinations [Abstract]

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.

On November 7, 2022, the Company completed the acquisition of four CTCs located in Georgia from Brand New Start Treatment Centers.

In July 2023, the Company signed a definitive agreement to acquire substantially all of the assets of Turning Point Centers (“Turning Point”), a 76-bed specialty provider of substance use disorder and primary mental health treatment services that supports the Salt Lake City, Utah, metropolitan market. Turning Point provides a full continuum of treatment services, including residential, partial hospitalization and intensive outpatient services. The transaction is expected to close by the end of 2023.

Goodwill

The changes in goodwill are as follows (in thousands):


Balance at January 1, 2022	$	2,199,937
Increase from acquisitions		9,488
Adjustments related to 2021 acquisitions		8,761
Increase from contributions of redeemable noncontrolling interests		4,619
Balance at December 31, 2022		2,222,805
Increase from acquisitions		336
Increase from contributions of redeemable noncontrolling interests		2,821
Balance at September 30, 2023	$	2,225,962

Transaction-related expenses

Transaction-related expenses represent costs primarily related to legal, accounting, termination, restructuring, management transition, acquisition and other similar costs. Transaction-related expenses comprised the following costs for the three and nine months ended September 30, 2023 and 2022 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Legal, accounting and other acquisition-related costs	$	4,196	$	2,020	$	6,761	$	4,696
Management transition costs		3,615		5,626		14,590		7,826
Termination and restructuring costs		3,436		3,213		5,441		5,859
	$	11,247	$	10,859	$	26,792	$	18,381

Long-Term Debt (Tables)

9 Months Ended

Sep. 30, 2023

Debt Disclosure [Abstract]

Components of Long-Term Debt

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


	September 30, 2023			December 31, 2022
Credit Facility:
Term Loan A	$	382,500		$	398,438
Revolving Line of Credit		80,000			75,000
5.500% Senior Notes due 2028		450,000			450,000
5.000% Senior Notes due 2029		475,000			475,000
Less: unamortized debt issuance costs, discount and premium		(10,983	)		(12,647	)
		1,376,517			1,385,791
Less: current portion		(26,563	)		(21,250	)
Long-term debt	$	1,349,954		$	1,364,541

- 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.

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-URI https://asc.fasb.org//1943274/2147481112/505-10-50-7

+ Details

Variable Interest Entities - Schedule of Consolidated VIEs Assets and Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022	Dec. 31, 2021
Variable Interest Entity [Line Items]
Cash and cash equivalents	$ 99,591	$ 97,649
Accounts receivable, net	362,666	322,439
Other current assets	241,218	86,037
Total current assets	703,475	506,125
Property and equipment, net	2,145,599	1,952,045
Goodwill	2,225,962	2,222,805	$ 2,199,937
Intangible assets, net	73,811	76,041
Operating lease right-of-use assets	122,090	135,238
Total assets	5,346,218	4,987,901
Accounts payable	149,874	104,723
Accrued salaries and benefits	122,264	125,298
Current portion of operating lease liabilities	26,242	26,463
Other accrued liabilities	539,947	110,592
Total current liabilities	864,890	388,326
Operating lease liabilities	104,873	116,429
Other liabilities	145,907	125,033
Total liabilities	2,536,074	2,086,917
Variable Interest Entity, Primary Beneficiary [Member]
Variable Interest Entity [Line Items]
Cash and cash equivalents	50,531	32,478
Accounts receivable, net	28,643	23,789
Other current assets	2,757	2,561
Total current assets	81,931	58,828
Property and equipment, net	387,159	313,358
Goodwill	42,384	39,564
Intangible assets, net	18,263	16,139
Operating lease right-of-use assets	6,034	6,284
Total assets	535,771	434,173
Accounts payable	6,419	4,650
Accrued salaries and benefits	6,531	6,866
Current portion of operating lease liabilities	263	233
Other accrued liabilities	6,044	6,179
Total current liabilities	19,257	17,928
Operating lease liabilities	6,232	6,433
Total liabilities	$ 25,489	$ 24,361

Equity-Based Compensation - Schedule of Stock Options Valuation Assumptions (Detail) - $ / shares	9 Months Ended	12 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Weighted average grant-date fair value of options	$ 31.11	$ 20.72
Risk-free interest rate	4.10%	2.00%
Expected volatility	37.00%	39.00%
Expected life (in years)	5 years	5 years

Other Intangible Assets - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Non-cash indefinite-lived intangible asset impairment charge	$ 4.7