0000950170-24-022057 | 10-K | XBRL Viewer | Acadia Healthcare Company INC

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Leases - Schedule of Lease Cost (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Finance lease costs:
Depreciation of leased assets	$ 378	$ 378	$ 378
Interest of lease liabilities	1,028	1,041	2,174
Total finance lease costs	1,406	1,419	2,552
Operating lease costs	34,400	34,349	28,233
Variable lease costs	3,319	3,129	2,488
Short term lease costs	3,237	2,605	3,257
Other lease costs	5,596	5,379	4,541
Total rents and leases	46,552	45,462	38,519
Total lease costs	$ 47,958	$ 46,881	$ 41,071

Equity-Based Compensation - Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-Based Payment Arrangement [Abstract]
Options outstanding, Beginning balance	979,277	1,106,069	1,510,306
Options granted	296,340	334,260	324,320
Options exercised	(198,527)	(285,577)	(558,322)
Options cancelled	(140,545)	(175,475)	(170,235)
Options outstanding, Ending balance	936,545	979,277	1,106,069
Options exercisable, Ending balance	349,080
Options outstanding, Weighted Average Exercise Price, Beginning balance	$ 46.27	$ 42.07	$ 37.56
Options granted, Weighted Average Exercise Price	78.94	55.73	57.53
Options exercised, Weighted Average Exercise Price	41.29	40.66	39.45
Options cancelled, Weighted Average Exercise Price	55.95	46.98	40.08
Options outstanding, Weighted Average Exercise Price, Ending balance	56.21	$ 46.27	$ 42.07
Options exercisable, Weighted Average Exercise Price, Ending balance	$ 42.85
Options outstanding, Weighted Average Remaining Contractual Term, Ending balance	7 years 3 months 3 days
Options exercisable, Weighted Average Remaining Contractual Term, Ending balance	5 years 6 months 3 days
Options outstanding, Aggregate Intrinsic Value, Ending balance	$ 18,640
Options exercisable, Aggregate Intrinsic Value, Ending balance	$ 11,155

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Carrying Amounts and Fair Values of 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 December 31, 2023 and 2022 were as follows (in thousands):


	Carrying Amount				Fair Value
	December 31,				December 31,
	2023		2022		2023		2022
Credit Facility	$	455,880	$	471,488	$	455,880	$	471,488
5.500% Senior Notes due 2028	$	445,539	$	444,694	$	436,628	$	422,459
5.000% Senior Notes due 2029	$	470,348	$	469,609	$	451,534	$	433,214

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 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

Variable Interest Entities (Tables)

12 Months Ended

Dec. 31, 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 consolidated balance sheets are shown below (in thousands):


	December 31,
	2023		2022
Cash and cash equivalents	$	55,149	$	32,478
Accounts receivable, net		34,910		23,789
Other current assets		2,193		2,561
Total current assets		92,252		58,828
Property and equipment, net		438,965		313,358
Goodwill		42,384		39,564
Intangible assets, net		18,295		16,139
Operating lease right-of-use assets		5,948		6,284
Total assets	$	597,844	$	434,173

Accounts payable	$	8,235	$	4,650
Accrued salaries and benefits		9,909		6,866
Current portion of operating lease liabilities		273		233
Other accrued liabilities		2,385		6,179
Total current liabilities		20,802		17,928
Operating lease liabilities		6,160		6,433
Other liabilities		—		—
Total liabilities	$	26,962	$	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

Equity-Based Compensation - Restricted Stock Unit Activity (Detail) - Restricted Stock Units [Member] - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	1,045,202	926,627	1,022,996
Granted, Number of Shares	587,239	650,396	352,430
Cancelled, Number of Shares	(198,740)	(145,205)	(82,751)
Vested, Number of Shares	(403,223)	(386,616)	(366,048)
Unvested, Number of Shares/Units, Ending balance	1,030,478	1,045,202	926,627
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 54.89	$ 37.84	$ 28.41
Granted, Weighted Average Grant-Date Fair Value	76.32	64.65	58.32
Cancelled, Weighted Average Grant-Date Fair Value	57.21	49.03	39.63
Vested, Weighted Average Grant-Date Fair Value	50.48	32.64	30.81
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 68.38	$ 54.89	$ 37.84

Long-Term Debt (Other) - Summary of Aggregate Maturities of Long-Term Debt (Detail) $ in Thousands	Dec. 31, 2023 USD ($)
Debt Disclosure [Abstract]
2024	$ 29,219
2025	39,844
2026	388,125
2028	450,000
Thereafter	475,000
Total	$ 1,382,188

Transaction, Legal and Other Costs (Tables)

12 Months Ended

Dec. 31, 2023

Transaction Legal and Other Costs [Abstract]

Transaction, Legal and Other Costs as Incurred

Transaction, legal and other costs comprised the following costs for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023		2022		2021
Legal, accounting and other acquisition-related costs	$	31,335	$	5,741	$	7,435
Management transition costs		23,283		11,575	$	—
Termination and restructuring costs		7,408		6,476		5,343
	$	62,026	$	23,792	$	12,778

Long-Term Debt (5.625% Senior Notes due 2023) - Additional Information (Detail) - 5.625% Senior Notes Due 2023 [Member] - USD ($)	12 Months Ended
	Dec. 31, 2023	Sep. 21, 2015	Feb. 11, 2015
Debt Instrument [Line Items]
Issued Senior Notes		$ 275,000,000.0	$ 375,000,000.0
Debt instrument interest rate		5.625%	5.625%
Senior Notes		$ 650,000,000.0
Debt instrument maturity date	Feb. 15, 2023
Interest on the notes	payable semi-annually in arrears on February 15 and August 15 of each year
Term loan remaining balance due date	Mar. 17, 2021

- 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

Variable Interest Entities - Schedule of Consolidated VIEs Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Variable Interest Entity [Line Items]
Cash and cash equivalents	$ 100,073	$ 97,649
Accounts receivable, net	361,451	322,439
Other current assets	134,476	86,037
Total current assets	596,000	506,125
Property and equipment, net	2,266,610	1,952,045
Goodwill	2,225,962	2,222,805	$ 2,199,937
Intangible assets, net	73,278	76,041
Operating lease right-of-use assets	117,780	135,238
Total assets	5,358,841	4,987,901
Accounts payable	156,132	104,723
Accrued salaries and benefits	141,901	125,298
Current portion of operating lease liabilities	26,268	26,463
Other accrued liabilities	532,261	110,592
Total current liabilities	885,781	388,326
Operating lease liabilities	100,808	116,429
Other liabilities	140,113	125,033
Total liabilities	2,471,181	2,086,917
Variable Interest Entity, Primary Beneficiary [Member]
Variable Interest Entity [Line Items]
Cash and cash equivalents	55,149	32,478
Accounts receivable, net	34,910	23,789
Other current assets	2,193	2,561
Total current assets	92,252	58,828
Property and equipment, net	438,965	313,358
Goodwill	42,384	39,564
Intangible assets, net	18,295	16,139
Operating lease right-of-use assets	5,948	6,284
Total assets	597,844	434,173
Accounts payable	8,235	4,650
Accrued salaries and benefits	9,909	6,866
Current portion of operating lease liabilities	273	233
Other accrued liabilities	2,385	6,179
Total current liabilities	20,802	17,928
Operating lease liabilities	6,160	6,433
Total liabilities	$ 26,962	$ 24,361

Leases - Additional Information (Detail) $ in Millions	12 Months Ended
Leases - Additional Information (Detail) $ in Millions	Dec. 31, 2023 USD ($)
Loss on Impairment [Member]
Lessee Lease Description [Line Items]
Non-cash operating lease right-of-use asset impairment charge related to closure of facilities	$ 2.3
Minimum [Member]
Lessee Lease Description [Line Items]
Lessee operating and finance lease term of contract	5 years
Maximum [Member]
Lessee Lease Description [Line Items]
Lessee operating and finance lease term of contract	30 years
Copiers and Equipment [Member] \| Minimum [Member]
Lessee Lease Description [Line Items]
Lessee operating and finance lease term of contract	1 year
Copiers and Equipment [Member] \| Maximum [Member]
Lessee Lease Description [Line Items]
Lessee operating and finance lease term of contract	3 years

Long-Term Debt

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Long-Term Debt

13. Long-Term Debt

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


	December 31,
	2023			2022
Credit Facility:
Term Loan A	$	377,188		$	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		(10,421	)		(12,647	)
		1,371,767			1,385,791
Less: current portion		(29,219	)		(21,250	)
Long-term debt	$	1,342,548		$	1,364,541

Credit Facility

On March 17, 2021, the Company entered into a credit agreement (as amended the “Credit Facility”), which provides for a $600.0 million senior secured revolving credit facility (the “Revolving Facility”) and a senior secured term loan facility in an initial principal amount of $425.0 million (as increased by the Incremental Term Loans (as defined below), the “Term Loan Facility”), each maturing on March 17, 2026. The Revolving Facility further provides for a $20.0 million subfacility for the issuance of letters of credit.

On March 30, 2023, the Company entered into the Amendment No. 1 to the Credit Facility (the “First Amendment”), which replaces LIBOR as the reference rate applicable to borrowings under the Credit Facility 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”). After giving effect to the First Amendment, borrowings under the Credit Facility bear interest at a rate equal to, at the Company’s option, either (i) Adjusted Term SOFR plus a margin ranging from 1.375% to 2.250% or (ii) a base rate plus a margin ranging from 0.375% to 1.250%, in each case, depending on the consolidated total net leverage ratio. In addition, an unused fee that varies according to the consolidated total net leverage ratio of the Company ranging 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.

On January 18, 2024, the Company entered into Amendment No. 2 to the Credit Facility (the “Second Amendment”), which provides for the incurrence of additional senior secured term loans in an aggregate principal amount of $350.0 million (the “Incremental Term Loans”). Such Incremental Term Loans are structured as an increase of the Term Loan Facility. The maturity date, the leverage-based pricing grid, mandatory prepayment events and other terms applicable to the Incremental Term Loans are substantially identical to those applicable to the initial $425.0 million term loans incurred under the Term Loan Facility. After giving effect to the Incremental Term Loans, the Credit Facility requires quarterly principal repayments for the Term Loan Facility

of approximately $10.2 million for the quarter ending March 31, 2024, $15.4 million for each quarter ending from June 30, 2024 to March 31, 2025, and $20.5 million for each quarter ending from June 30, 2025 to December 31, 2025. The remaining outstanding principal balance of the Term Loan Facility is due on the maturity date of March 17, 2026.

The Company has the ability to increase the amount of the Credit Facility, 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 of the Company at the time of determination (the “Incremental Fixed Basket”) and (ii) additional amounts that would not cause the Company’s consolidated senior secured net leverage ratio to exceed 3.5 to 1.0 (the “Incremental Ratio Basket”). The Incremental Term Loans were incurred in reliance on the Incremental Ratio Basket, leaving the full amount of the Incremental Fixed Basket available for any future Incremental Facilities.

Subject to certain exceptions, substantially all of the Company’s existing and subsequently acquired or organized direct or indirect wholly-owned U.S. 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 in 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 4.5 to 1.0 (which may be increased to 5.0 to 1.0 for a period of up to four consecutive fiscal quarters following the consummation of certain material acquisitions) 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 such events of default, among other things, all outstanding loans under the Credit Facility may be accelerated, the lenders’ commitments terminated, and/or the lenders may exercise collateral remedies. At December 31, 2023, the Company was in compliance with all financial covenants.

During the year ended December 31, 2023, the Company borrowed $40.0 million on the Revolving Facility and repaid $35.0 million of the balance outstanding. During the year ended December 31, 2022, the Company repaid $95.0 million of the balance outstanding on the Revolving Facility. 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 December 31, 2023.

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, commencing on January 1, 2021.

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, commencing on April 15, 2021.

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 amounts set forth in the applicable indentures.

5.625% Senior Notes due 2023

On February 11, 2015, the Company issued $375.0 million of 5.625% Senior Notes due 2023 (the “5.625% Senior Notes”). On September 21, 2015, the Company issued $275.0 million of additional 5.625% Senior Notes. The additional notes formed a single class of debt securities with the 5.625% Senior Notes issued in February 2015. Giving effect to this issuance, the Company had outstanding an aggregate of $650.0 million of 5.625% Senior Notes. The 5.625% Senior Notes were to mature on February 15, 2023 and bear interest at a rate of 5.625% per annum, payable semi-annually in arrears on February 15 and August 15 of each year. On March 17, 2021, the Company redeemed the 5.625% Senior Notes.

6.500% Senior Notes due 2024

On February 16, 2016, the Company issued $390.0 million of 6.500% Senior Notes due 2024 (the “6.500% Senior Notes”). The 6.500% Senior Notes were to mature on March 1, 2024 and bear interest at a rate of 6.500% per annum, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2016. On March 1, 2021, the Company redeemed the 6.500% Senior Notes.

Redemption of 5.625% Senior Notes and 6.500% Senior Notes

On January 29, 2021, the Company issued conditional notices of full redemption providing for the redemption in full of $650 million of 5.625% Senior Notes and $390 million of 6.500% Senior Notes to the holders of such notes.

On March 1, 2021, the Company satisfied and discharged the indentures governing the 6.500% Senior Notes. In connection with the redemption of the 6.500% Senior Notes, the Company recorded debt extinguishment costs of $10.5 million, including $6.3 million cash paid for breakage costs and the write-off of deferred financing costs of $4.2 million in the consolidated statement of operations.

On March 17, 2021, the Company satisfied and discharged the indentures governing the 5.625% Senior Notes. In connection with the redemption of the 5.625% Senior Notes, the Company recorded debt extinguishment costs of $3.3 million, including the write-off of deferred financing and premiums costs in the consolidated statement of operations.

Other long-term debt

During the year ended December 31, 2021, the Company repaid other long-term debt of $3.3 million, which is reflected in repayment of long-term debt within financing activities in the consolidated statement of cash flows.

Debt Issuance Costs

Debt issuance costs are deferred and amortized to interest expense over the term of the related debt. Debt issuance costs at December 31, 2023 were $10.4 million, net of accumulated amortization of $6.8 million. Debt issuance costs at December 31, 2022 were $12.6 million, net of accumulated amortization of $4.6 million. Amortization expense related to debt issuance costs, which is included in interest expense on the consolidated statements of operations, was $2.2 million, $2.2 million and $2.8 million, respectively, for the years ended December 31, 2023, 2022 and 2021.

Other

The aggregate maturities of long-term debt at December 31, 2023 were as follows (in thousands):


2024	$	29,219
2025		39,844
2026		388,125
2027		—
2028		450,000
Thereafter		475,000
Total	$	1,382,188

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Numerator:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	$ (21,667)	$ 273,139	$ 203,276
Loss from discontinued operations			(12,641)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$ (21,667)	$ 273,139	$ 190,635
Denominator:
Weighted average shares outstanding for basic earnings per share	90,949	89,680	88,769
Effects of dilutive instruments		1,875	2,024
Shares used in computing diluted earnings per common share	90,949	91,555	90,793
Basic (loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	$ (0.24)	$ 3.05	$ 2.29
Loss from discontinued operations			(0.14)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	(0.24)	3.05	2.15
Diluted (loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	(0.24)	2.98	2.24
Loss from discontinued operations			(0.14)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$ (0.24)	$ 2.98	$ 2.1

Other Intangible Assets - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Non-cash indefinite-lived intangible asset impairment charge	$ 5.4

Variable Interest Entities - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) Facility	Dec. 31, 2022 USD ($)
Variable Interest Entity [Line Items]
Consolidated assets	$ 5,358,841	$ 4,987,901
Consolidated liabilities	$ 2,471,181	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	$ 597,844	434,173
Consolidated liabilities	$ 26,962	$ 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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Sum of the carrying amounts as of the balance sheet date of all liabilities that are recognized. Liabilities are probable future sacrifices of economic benefits arising from present obligations of an entity to transfer assets or provide services to other entities in the future.

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- 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

Accumulated Other Comprehensive Loss (Tables)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Components of Accumulated Other Comprehensive Loss

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


	Foreign Currency Translation Adjustments			Change in Fair Value of Derivative Instruments			Pension Plan			Total
Balance at January 1, 2021	$	(373,101	)	$	13,686		$	(11,950	)	$	(371,365	)
Foreign currency translation gain (loss)		(4,293	)		—			33			(4,260	)
Gain on derivative instruments, net of tax of $0.1 million		—			19			—			19
U.K. Sale		377,394			(13,705	)		11,917			375,606
Balance at December 31, 2021	$	—		$	—		$	—		$	—

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 100,073	$ 97,649
Accounts receivable, net	361,451	322,439
Other current assets	134,476	86,037
Total current assets	596,000	506,125
Property and equipment, net	2,266,610	1,952,045
Goodwill	2,225,962	2,222,805
Intangible assets, net	73,278	76,041
Deferred tax assets	6,658	2,950
Operating lease right-of-use assets	117,780	135,238
Other assets	72,553	92,697
Total assets	5,358,841	4,987,901
Current liabilities:
Current portion of long-term debt	29,219	21,250
Accounts payable	156,132	104,723
Accrued salaries and benefits	141,901	125,298
Current portion of operating lease liabilities	26,268	26,463
Other accrued liabilities	532,261	110,592
Total current liabilities	885,781	388,326
Long-term debt	1,342,548	1,364,541
Deferred tax liabilities	1,931	92,588
Operating lease liabilities	100,808	116,429
Other liabilities	140,113	125,033
Total liabilities	2,471,181	2,086,917
Redeemable noncontrolling interests	105,686	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; 91,263,989 and 89,913,659 issued and outstanding as of December 31, 2023 and 2022, respectively	913	899
Additional paid-in capital	2,649,340	2,658,440
Retained earnings	131,721	153,388
Total equity	2,781,974	2,812,727
Total liabilities and equity	$ 5,358,841	$ 4,987,901

Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2021 USD ($)
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]
Gain (Loss) on derivative instruments, tax	$ 0.1

Acquisitions - Additional Information (Detail) $ in Millions		1 Months Ended	12 Months Ended
	Dec. 31, 2021 USD ($) Bed Location Hospital	Jul. 31, 2023	Dec. 31, 2023 USD ($) Bed	Dec. 31, 2022 USD ($)
Business Acquisition [Line Items]
Number of beds \| Bed			11,200
Tax deductible			$ 0.3	$ 9.5
CenterPointe Behavioral Health System, LLC [Member]
Business Acquisition [Line Items]
Business acquisition cash consideration	$ 140.0
Revolving Facility	$ 70.0
Number of acute inpatient hospitals \| Hospital	4
Number of beds \| Bed	306
Number of outpatient locations \| Location	10
Turning Point Centers [Member]
Business Acquisition [Line Items]
Business acquisition transaction closing date		Feb. 22, 2024

Acquisitions (Tables)

12 Months Ended

Dec. 31, 2023

Business Combinations [Abstract]

Summary of Changes in Goodwill

The following table summarizes changes in goodwill for the years ended December 31, 2023 and 2022 (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		337
Increase from contributions of redeemable noncontrolling interests		2,820
Balance at December 31, 2023	$	2,225,962

- 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
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 24
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482548/350-20-55-24

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+ Details

Long-Term Debt (5.500% Senior Notes due 2028) - Additional Information (Detail) - 5.500% Senior Notes due 2028 [Member] - USD ($) $ in Millions		12 Months Ended
	Jun. 24, 2020	Dec. 31, 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, commencing on January 1, 2021

- 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

Summary of Significant Accounting Policies - Additional Information (Detail)					1 Months Ended		3 Months Ended			12 Months Ended
	Oct. 01, 2023 USD ($)	Oct. 01, 2022 USD ($) Segment	Oct. 01, 2021 USD ($) Segment	Jan. 19, 2021 USD ($)	Oct. 31, 2023 Segment	Aug. 31, 2023 USD ($)	Dec. 31, 2021 USD ($) Facility	Sep. 30, 2021 USD ($)	Jun. 30, 2021 USD ($) Bed Facility	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Significant Accounting Policies [Line Items]
Unfavorable adjustment for professional and general liability claims										$ 5,300,000	$ 5,900,000
Professional and general liability reserve										109,400,000	103,600,000
Professional and general liability reserve current										12,500,000	12,100,000
Professional and general liability reserve noncurrent										96,900,000	91,500,000
Insurance receivable										62,300,000	37,800,000
Insurance receivable - current portion										33,579,000	10,158,000
Insurance receivable noncurrent										28,700,000	27,600,000
Workers compensation insurance claims deductible per accident										500,000
Reserve for workers compensation liability										26,800,000	24,200,000
Accrued salaries and benefits										12,000,000	12,000,000.0
Other long-term liabilities										14,800,000	12,200,000
Depreciation expense										$ 132,300,000	$ 117,800,000	$ 106,700,000
Number of beds, replacement facility \| Bed									260
Non-cash property impairment charge relating to closure of facilities								$ 1,100,000	$ 23,200,000
Impairment of long-lived assets	$ 0	$ 0	$ 0
Impairment, Long-Lived Asset, Held-for-Use, Statement of Income or Comprehensive Income [Extensible Enumeration]	Other operating expenses	Other operating expenses	Other operating expenses
Number of reporting units \| Segment		1	1		1
Number of outpatient \| Facility							1		1
Proceeds from U.K. Sale							$ 1,500,000		$ 4,300,000			$ 1,511,020,000
Goodwill write down							700,000		1,800,000
Intangible assets for the disposition							$ 100,000		$ 200,000
Impairment, Intangible Asset, Indefinite-Lived (Excluding Goodwill), Statement of Income or Comprehensive Income [Extensible Enumeration]										Asset Impairment Charges
Non-cash impairment charge related to indefinite-lived assets										$ 5,400,000
Loss on Impairment [Member]
Significant Accounting Policies [Line Items]
Non-cash property impairment charge relating to closure of facilities										$ 2,000,000
ASU 2021-10 [Member]
Significant Accounting Policies [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]										true
Change in Accounting Principle, Accounting Standards Update, Adoption Date										Dec. 31, 2022
Discontinued Operations [Member] \| U.K. Facilities [Member]
Significant Accounting Policies [Line Items]
Proceeds from U.K. Sale				$ 1,525,000,000
Maximum [Member]
Significant Accounting Policies [Line Items]
Maximum self insured professional liability limit per claim						$ 5,000,000				$ 7,000,000
Maximum professional liability aggregate policy limit						75,000,000				$ 78,000,000
Maximum [Member] \| Building and Improvements [Member]
Significant Accounting Policies [Line Items]
Property plant and equipment estimated useful life										50 years
Maximum [Member] \| Equipment [Member]
Significant Accounting Policies [Line Items]
Property plant and equipment estimated useful life										7 years
Minimum [Member]
Significant Accounting Policies [Line Items]
Maximum professional liability retention limit						10,000,000				$ 10,000,000
Maximum professional liability aggregate policy limit						$ 70,000,000				$ 75,000,000
Minimum [Member] \| Building and Improvements [Member]
Significant Accounting Policies [Line Items]
Property plant and equipment estimated useful life										10 years
Minimum [Member] \| Equipment [Member]
Significant Accounting Policies [Line Items]
Property plant and equipment estimated useful life										3 years

Subsequent Events

12 Months Ended

Dec. 31, 2023

Subsequent Events [Abstract]

Subsequent Events

25. Subsequent Events

On January 18, 2024, the Company entered into the Second Amendment, which provides for the incurrence of $350 million of Incremental Term Loans. Such Incremental Term Loans are structured as an increase of the Term Loan Facility. The maturity date, the leverage-based pricing grid, mandatory prepayment events and other terms applicable to the Incremental Term Loans are substantially identical to those applicable to the initial $425.0 million term loans incurred under the Term Loan Facility. After giving effect to the Incremental Term Loans, the Credit Facility requires quarterly principal repayments for the Term Loan Facility of approximately $10.2 million for the quarter ending March 31, 2024, $15.4 million for each quarter ending from June 30, 2024 to March 31, 2025, and $20.5 million for each quarter ending from June 30, 2025 to December 31, 2025. The remaining outstanding principal balance of the Term Loan Facility is due on the maturity date of March 17, 2026.

On January 19, 2024, pursuant to the terms of the settlement agreements, the Company paid 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.

On January 30, 2024, a lawsuit styled CNRAG, Inc. as Legal Guardian of A.C. v. Garcia et al., No. D-117-CV-2024-00045 was filed in the District Court alleging similar claims as the previous five lawsuits in the Desert Hills Litigation. The lawsuit has not been formally served. The ward in this sixth lawsuit was referenced in prior criminal charges against Garcia five years ago; however, prior to this lawsuit, neither the ward nor guardian made contact with the Company about a possible claim. The Company determined that a lawsuit from this plaintiff was unlikely because no claims had ever been asserted and the statute of limitations had expired. Plaintiff’s allegations assert certain claims, which, if true, may toll the statute of limitations. At this time, the Company is not able to quantify the ultimate liability, if any, in connection with this lawsuit. No additional victims are referenced in the prior criminal charges against Garcia.

In July 2023, the Company signed a definitive agreement to acquire substantially all of the assets of 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 closed on February 22, 2024.

Equity-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Stock Option Activity

Stock option activity during 2021, 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, 2021		1,510,306		$	37.56
Options granted		324,320			57.53
Options exercised		(558,322	)		39.45
Options cancelled		(170,235	)		40.08
Options outstanding at December 31, 2021		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		296,340			78.94
Options exercised		(198,527	)		41.29
Options cancelled		(140,545	)		55.95
Options outstanding at December 31, 2023		936,545		$	56.21		7.26	$	18,640
Options exercisable at December 31, 2023		349,080		$	42.85		5.51	$	11,155

Schedule of Stock Options Valuation Assumptions

The following table summarizes the grant-date fair value of options and the assumptions used to develop the fair value estimates for options granted during the years ended December 31, 2023, 2022 and 2021:


	Year Ended December 31,
	2023			2022			2021
Weighted average grant-date fair value of options	$	30.99		$	20.72		$	20.64
Risk-free interest rate		4.2	%		2.0	%		0.9	%
Expected volatility		37	%		39	%		40	%
Expected life (in years)		5.0			5.0			5.0

Restricted Stock Unit Activity

Restricted stock unit activity during 2021, 2022 and 2023 was as follows:


	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2021		1,022,996		$	28.41
Granted		352,430			58.32
Cancelled		(82,751	)		39.63
Vested		(366,048	)		30.81
Unvested at December 31, 2021		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		587,239			76.32
Cancelled		(198,740	)		57.21
Vested		(403,223	)		50.48
Unvested at December 31, 2023		1,030,478		$	68.38

Performance Stock Unit Activity

Performance stock unit activity during 2021, 2022 and 2023 was as follows:


	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2021		1,073,062		$	20.15
Granted		149,416			61.52
Performance adjustment		465,993			25.49
Cancelled		—			—
Vested		(184,051	)		42.30
Unvested at December 31, 2021		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		407,825			17.69
Cancelled		(114,908	)		69.07
Vested		(1,408,195	)		10.60
Unvested at December 31, 2023		336,031		$	69.35

Consolidated Statements of Comprehensive (Loss) Income (Parenthetical) $ in Millions	12 Months Ended
	Dec. 31, 2021 USD ($)
Statement of Comprehensive Income [Abstract]
Gain on derivative instruments, tax	$ 0.1

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Components of Long-Term Debt

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


	December 31,
	2023			2022
Credit Facility:
Term Loan A	$	377,188		$	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		(10,421	)		(12,647	)
		1,371,767			1,385,791
Less: current portion		(29,219	)		(21,250	)
Long-term debt	$	1,342,548		$	1,364,541

Summary of Aggregate Maturities of Long-Term Debt

The aggregate maturities of long-term debt at December 31, 2023 were as follows (in thousands):


2024	$	29,219
2025		39,844
2026		388,125
2027		—
2028		450,000
Thereafter		475,000
Total	$	1,382,188

- Definition

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

+ References

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+ Details

Variable Interest Entities

12 Months Ended

Dec. 31, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Variable Interest Entities

15. 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 December 31, 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 December 31, 2023 and 2022 include total assets of variable interest entities of $597.8 million and $434.2 million, respectively, which cannot be used to settle the obligations of other entities. Consolidated liabilities at December 31, 2023 and 2022 include total liabilities of variable interest entities of $27.0 million and $24.4 million, respectively.

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


	December 31,
	2023		2022
Cash and cash equivalents	$	55,149	$	32,478
Accounts receivable, net		34,910		23,789
Other current assets		2,193		2,561
Total current assets		92,252		58,828
Property and equipment, net		438,965		313,358
Goodwill		42,384		39,564
Intangible assets, net		18,295		16,139
Operating lease right-of-use assets		5,948		6,284
Total assets	$	597,844	$	434,173

Accounts payable	$	8,235	$	4,650
Accrued salaries and benefits		9,909		6,866
Current portion of operating lease liabilities		273		233
Other accrued liabilities		2,385		6,179
Total current liabilities		20,802		17,928
Operating lease liabilities		6,160		6,433
Other liabilities		—		—
Total liabilities	$	26,962	$	24,361

Consolidated Statements of Equity - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive Loss [Member]	(Accumulated Deficit) Retained Earnings [Member]
Balance at Dec. 31, 2020	$ 1,899,456	$ 880	$ 2,580,327	$ (371,365)	$ (310,386)
Balance, shares at Dec. 31, 2020		88,024,000
Common stock issued under stock incentive plans	$ 22,029	$ 10	22,019
Common stock issued under stock incentive plans, shares	558,322	1,004,000
Repurchase of shares for payroll tax withholdings, net of proceeds from stock option exercises	$ (5,734)		(5,734)
Equity-based compensation expense	37,530		37,530
Other comprehensive income	371,365			$ 371,365
Other	2,208		2,208
Net income (loss) attributable to Acadia Healthcare Company, Inc. stockholders	190,635				190,635
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	$ 11,613	$ 9	11,604
Common stock issued under stock incentive plans, shares	285,577	886,000
Repurchase of shares for payroll tax withholdings, net of proceeds from stock option exercises	$ (17,792)		(17,792)
Equity-based compensation expense	29,635		29,635
Other	(1,357)		(1,357)
Net income (loss) attributable to Acadia Healthcare Company, Inc. stockholders	273,139				273,139
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	$ 8,197	$ 14	8,183
Common stock issued under stock incentive plans, shares	198,527	1,350,000
Repurchase of shares for payroll tax withholdings, net of proceeds from stock option exercises	$ (52,532)		(52,532)
Equity-based compensation expense	32,289		32,289
Other	2,960		2,960
Net income (loss) attributable to Acadia Healthcare Company, Inc. stockholders	(21,667)				(21,667)
Balance at Dec. 31, 2023	$ 2,781,974	$ 913	$ 2,649,340		$ 131,721
Balance, shares at Dec. 31, 2023	91,263,989	91,264,000

- Definition

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

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Amount after tax and reclassification adjustments of other comprehensive income (loss).

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

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+ Details

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Revenue	$ 2,928,738	$ 2,610,399	$ 2,314,394
Salaries, wages and benefits (including equity-based compensation expense of $32,289, $29,635 and $37,530, respectively)	1,572,330	1,393,434	1,243,804
Professional fees	176,013	158,013	136,739
Supplies	105,992	100,200	90,702
Rents and leases	46,552	45,462	38,519
Other operating expenses	388,906	349,277	301,339
Income from provider relief fund	(6,419)	(21,451)	(17,900)
Depreciation and amortization	132,349	117,769	106,717
Interest expense, net	82,125	69,760	76,993
Debt extinguishment costs			24,650
Litigation Settlement, Expense	394,181
Loss on impairment	9,790		24,293
Gain on sale of property	(9,747)
Transaction-related expenses	62,026	23,792	12,778
Total expenses	2,954,098	2,236,256	2,038,634
(Loss) income from continuing operations before income taxes	(25,360)	374,143	275,760
(Benefit from) provision for income taxes	(9,699)	94,110	67,557
(Loss) income from continuing operations	(15,661)	280,033	208,203
Loss from discontinued operations, net of taxes			(12,641)
Net (loss) income	(15,661)	280,033	195,562
Net income attributable to noncontrolling interests	(6,006)	(6,894)	(4,927)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$ (21,667)	$ 273,139	$ 190,635
Basic (loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	$ (0.24)	$ 3.05	$ 2.29
Loss from discontinued operations			(0.14)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	(0.24)	3.05	2.15
Diluted (loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	(0.24)	2.98	2.24
Loss from discontinued operations			(0.14)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$ (0.24)	$ 2.98	$ 2.1
Weighted-average shares outstanding:
Basic	90,949	89,680	88,769
Diluted	90,949	91,555	90,793

Long-Term Debt (Credit Facility) - Additional Information (Detail) - USD ($)				12 Months Ended
	Jan. 18, 2024	Mar. 30, 2023	Mar. 17, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Repayments of revolving facility				$ 35,000,000	$ 95,000,000	$ 330,000,000
New Credit Facility [Member]
Debt Instrument [Line Items]
Borrowings on revolving credit facility				40,000,000		$ 500,000,000
Credit Facility [Member]
Debt Instrument [Line Items]
Amount available under revolving line of credit				516,500,000
Repayments of revolving facility				35,000,000	95,000,000
Borrowings on revolving credit facility				$ 40,000,000
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				450.00%
Increased Consolidated Net Leverage Ratio.				5.00%
Minimum interest coverage ratio				300.00%
Credit Facility [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount	$ 425,000,000
Term loan remaining balance due date	Mar. 17, 2026
Credit Facility [Member] \| SOFR [Member]
Debt Instrument [Line Items]
Basis spread on variable rate		0.10%
Credit Facility [Member] \| December 31, 2023 to March 31, 2024 [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Term loan principal repayments	$ 10,200,000
Credit Facility [Member] \| June 30, 2024 to March 31, 2025 [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Term loan principal repayments	15,400,000
Credit Facility [Member] \| June 30, 2025 to December 31, 2025 [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Term loan principal repayments	20,500,000
Credit Facility [Member] \| Senior Secured Revolving Line of Credit [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount			$ 600,000,000.0	$ 80,000,000	75,000,000
Credit Facility [Member] \| Term Loan A- Facility [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount				377,188,000	$ 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			$ 20,000,000.0
Credit Facility [Member] \| Standby Letters of Credit [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount				$ 3,500,000
Credit Facility [Member] \| Incremental Term Loans [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount			$ 425,000,000
Credit Facility [Member] \| Incremental Term Loans [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount	425,000,000
Credit Facility [Member] \| Incremental Term Loans [Member] \| December 31, 2023 to March 31, 2024 [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Term loan principal repayments	10,200,000
Credit Facility [Member] \| Incremental Term Loans [Member] \| June 30, 2024 to March 31, 2025 [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Term loan principal repayments	15,400,000
Credit Facility [Member] \| Incremental Term Loans [Member] \| June 30, 2025 to December 31, 2025 [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Term loan principal repayments	20,500,000
Credit Facility [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Unused fee payable percentage		0.35%
Credit Facility [Member] \| Maximum [Member] \| SOFR [Member]
Debt Instrument [Line Items]
Basis spread on variable rate		2.25%
Credit Facility [Member] \| Maximum [Member] \| Base Rate Loans [Member]
Debt Instrument [Line Items]
Basis spread on variable rate		1.25%
Credit Facility [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Unused fee payable percentage		0.20%
Credit Facility [Member] \| Minimum [Member] \| SOFR [Member]
Debt Instrument [Line Items]
Basis spread on variable rate		1.375%
Credit Facility [Member] \| Minimum [Member] \| Base Rate Loans [Member]
Debt Instrument [Line Items]
Basis spread on variable rate		0.375%
Credit Facility [Member] \| First Amemdment [Member] \| Incremental Term Loans [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount	350,000,000
Credit Facility [Member] \| Second Amemdment [Member] \| Incremental Term Loans [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount	$ 350,000,000

Employee Benefit Plans - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Defined Contribution Plan [Member] \| 401(k) [Member]
Defined Benefit Plan Disclosure [Line Items]
Defined contribution expense	$ 10.9	$ 6.6	$ 2.8

Equity-Based Compensation

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Equity-Based Compensation

17. Equity-Based Compensation

Equity Incentive Plans

The Company issues stock-based awards, including stock options, restricted stock units and performance stock units, to certain officers, employees and non-employee directors under the Acadia Healthcare Company, Inc. Incentive Compensation Plan (the “Equity Incentive Plan”). At December 31, 2023, a maximum of 12,700,000 shares of the Company’s common stock were authorized for issuance as stock options, restricted stock units and performance stock units or other share-based compensation under the Equity Incentive Plan, of which 2,634,774 were available for future grant. Stock options may be granted for terms of up to ten years. The Company recognizes expense on all share-based awards on a straight-line basis over the requisite service period of the entire award. Grants to employees generally vest in annual increments of 25% each year, commencing one year after the date of grant. The exercise prices of stock options are equal to the closing price of the Company’s common stock on the most recent trading date prior to the date of grant.

The Company recognized $32.3 million, $29.6 million and $37.5 million in equity-based compensation expense for the years ended December 31, 2023, 2022 and 2021, respectively. Stock compensation expense for the years ended December 31, 2023, 2022 and 2021 is impacted by forfeiture adjustments and performance stock unit adjustments based on actual performance compared to

vesting targets. At December 31, 2023, there was $74.0 million of unrecognized compensation expense related to unvested options, restricted stock units and performance 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 $8.8 million, $8.0 million and $9.6 million for the years ended December 31, 2023, 2022 and 2021, respectively, related to equity-based compensation expense.

Stock Options

Stock option activity during 2021, 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, 2021		1,510,306		$	37.56
Options granted		324,320			57.53
Options exercised		(558,322	)		39.45
Options cancelled		(170,235	)		40.08
Options outstanding at December 31, 2021		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		296,340			78.94
Options exercised		(198,527	)		41.29
Options cancelled		(140,545	)		55.95
Options outstanding at December 31, 2023		936,545		$	56.21		7.26	$	18,640
Options exercisable at December 31, 2023		349,080		$	42.85		5.51	$	11,155

Fair values are estimated using the Black-Scholes option pricing model. The following table summarizes the grant-date fair value of options and the assumptions used to develop the fair value estimates for options granted during the years ended December 31, 2023, 2022 and 2021:


	Year Ended December 31,
	2023			2022			2021
Weighted average grant-date fair value of options	$	30.99		$	20.72		$	20.64
Risk-free interest rate		4.2	%		2.0	%		0.9	%
Expected volatility		37	%		39	%		40	%
Expected life (in years)		5.0			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 unit activity during 2021, 2022 and 2023 was as follows:


	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2021		1,022,996		$	28.41
Granted		352,430			58.32
Cancelled		(82,751	)		39.63
Vested		(366,048	)		30.81
Unvested at December 31, 2021		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		587,239			76.32
Cancelled		(198,740	)		57.21
Vested		(403,223	)		50.48
Unvested at December 31, 2023		1,030,478		$	68.38

Performance stock unit activity during 2021, 2022 and 2023 was as follows:


	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2021		1,073,062		$	20.15
Granted		149,416			61.52
Performance adjustment		465,993			25.49
Cancelled		—			—
Vested		(184,051	)		42.30
Unvested at December 31, 2021		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		407,825			17.69
Cancelled		(114,908	)		69.07
Vested		(1,408,195	)		10.60
Unvested at December 31, 2023		336,031		$	69.35

Restricted stock unit 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 unit awards were determined based on the closing price of the Company’s common stock on the trading date immediately prior to the grant date.

Performance 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 performance 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 performance 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 performance 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 performance 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.

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating activities:
Net (loss) income	$ (15,661)	$ 280,033	$ 195,562
Adjustments to reconcile net (loss) income to net cash provided by continuing operating activities:
Depreciation and amortization	132,349	117,769	106,717
Amortization of debt issuance costs	3,322	3,261	4,071
Equity-based compensation expense	32,289	29,635	37,530
Deferred income taxes	(93,984)	16,545	11,772
Loss from discontinued operations, net of taxes			12,641
Debt extinguishment costs			24,650
Legal settlements expense	394,181
Loss on impairment	9,790		24,293
Gain on sale of property	(9,747)
Other	3,168	2,680	491
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net	(39,012)	(41,978)	2,448
Other current assets	8,880	(17,626)	1,968
Other assets	989	2,252	(10,770)
Accounts payable and other accrued liabilities	17,404	5,174	6,164
Accrued salaries and benefits	16,532	6,804	9,755
Other liabilities	10,815	15,090	(14,940)
Government relief funds	(8,975)	(39,070)	(38,128)
Net cash provided by continuing operating activities	462,340	380,569	374,224
Net cash provided by discontinued operating activities			253
Net cash provided by operating activities	462,340	380,569	374,477
Investing activities:
Cash paid for acquisitions, net of cash acquired	(349)	(9,507)	(139,015)
Cash paid for capital expenditures	(424,133)	(296,149)	(244,811)
Proceeds from U.K. Sale			1,511,020
Settlement of foreign currency derivatives			(84,795)
Proceeds from sale of property and equipment	29,422	7,074	3,493
Cash paid for purchase of finance lease			(31,401)
Other	(2,159)	(7,248)	(1,394)
Net cash (used in) provided by investing activities	(397,219)	(305,830)	1,013,097
Financing activities:
Borrowings on long-term debt			425,000
Principal payments on revolving credit facility	(35,000)	(95,000)	(330,000)
Principal payments on long-term debt	(21,250)	(18,594)	(7,969)
Repayment of long-term debt			(2,227,935)
Payment of debt issuance costs			(7,964)
Repurchase of shares for payroll tax withholdings, net of proceeds from stock option exercises	(44,335)	(6,179)	16,295
Contributions from noncontrolling partners in joint ventures	2,958	15,362	4,536
Distributions to noncontrolling partners in joint ventures	(5,107)	(1,004)	(1,588)
Acquisition of ownership interests from noncontrolling partners		(5,540)
Other	37	52	(6,900)
Net cash used in financing activities	(62,697)	(110,903)	(1,636,525)
Effect of exchange rate changes on cash			4,067
Net increase (decrease) in cash and cash equivalents	2,424	(36,164)	(244,884)
Cash and cash equivalents at beginning of the period	97,649	133,813	378,697
Cash and cash equivalents at end of the period	100,073	97,649	133,813
Supplemental Cash Flow Information:
Cash paid for interest	80,745	65,687	93,669
Cash paid for income taxes	66,397	86,195	79,304
Effect of acquisitions:
Assets acquired, excluding cash	6,766	10,756	176,365
Liabilities assumed	(128)	(1,249)	(37,350)
Redeemable noncontrolling interest resulting from an acquisition	(6,289)
Cash paid for acquisitions, net of cash acquired	349	$ 9,507	139,015
New Credit Facility [Member]
Financing activities:
Borrowings on revolving credit facility	$ 40,000		$ 500,000

Acquisitions - Summary of Changes in Goodwill (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Business Combinations [Abstract]
Goodwill balance	$ 2,222,805	$ 2,199,937
Increase from acquisitions	337	9,488
Adjustments related to 2021 acquisitions		8,761
Increase from contributions of redeemable noncontrolling interests	2,820	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

Earnings Per Share

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Earnings Per Share

4. Earnings Per Share

The following table sets forth the computation of basic and diluted (loss) earnings per share for the years ended December 31, 2023, 2022 and 2021 (in thousands, except per share amounts):


	Year Ended December 31,
	2023			2022		2021
Numerator:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	$	(21,667	)	$	273,139	$	203,276
Loss from discontinued operations		—			—		(12,641	)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(21,667	)	$	273,139	$	190,635
Denominator:
Weighted average shares outstanding for basic earnings per share		90,949			89,680		88,769
Effects of dilutive instruments		—			1,875		2,024
Shares used in computing diluted earnings per common share		90,949			91,555		90,793

Basic (loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	$	(0.24	)	$	3.05	$	2.29
Loss from discontinued operations		—			—		(0.14	)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(0.24	)	$	3.05	$	2.15

Diluted (loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	$	(0.24	)	$	2.98	$	2.24
Loss from discontinued operations		—			—		(0.14	)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(0.24	)	$	2.98	$	2.10

For the year ended December 31, 2023, approximately 0.9 million outstanding shares of restricted stock and shares of common stock issuable upon exercise of outstanding stock option awards have been excluded 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 the year ended December 31, 2023 causes such securities to be anti-dilutive. Approximately 0.3 million, 0.1 million and 0.3 million shares of common stock issuable upon exercise of outstanding stock options were excluded from the calculation of diluted earnings per share for the years ended December 31, 2023, 2022 and 2021, respectively, because their effect would have been anti-dilutive.

Equity-Based Compensation - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized common stock	12,700,000
Equity incentive plan available for future grant	2,634,774
Annual increments in employee grants	25.00%
Stock options, contractual term	10 years
Equity-based compensation expense	$ 32,289	$ 29,635	$ 37,530
Unrecognized compensation expense related to unvested options	$ 74,000
Vesting period	1 year 4 months 24 days
Deferred income tax benefit	$ (93,984)	16,545	11,772
Stock Compensation Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Deferred income tax benefit	$ 8,800	$ 8,000	$ 9,600
Restricted Stock Units [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years
Restricted Stock Units [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	4 years
Performance Stock Units [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years
Performance 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%
Performance 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%

Transaction, Legal and Other Costs

12 Months Ended

Dec. 31, 2023

Transaction Legal and Other Costs [Abstract]

Transaction, Legal and Other Costs

18. Transaction, legal and other costs

Transaction, legal and other costs represent costs primarily related to legal, accounting, termination, restructuring, management transition, acquisition and other similar costs. Transaction, legal and other costs comprised the following costs for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023		2022		2021
Legal, accounting and other acquisition-related costs	$	31,335	$	5,741	$	7,435
Management transition costs		23,283		11,575	$	—
Termination and restructuring costs		7,408		6,476		5,343
	$	62,026	$	23,792	$	12,778

The CARES Act - Additional Information (Detail) - USD ($) $ in Thousands		3 Months Ended			12 Months Ended
	Apr. 24, 2020	Dec. 31, 2021	Sep. 30, 2021	Dec. 31, 2020	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
CARES Act [Line Items]
Income from relief fund				$ 32,800	$ 6,419	$ 21,451	$ 17,900
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
Unrecognized provider relief funds						9,000
Cash benefit relating to delay of payment of social security payroll taxes					39,300
CARES Act [Member] \| American Rescue Plan
CARES Act [Line Items]
Income from relief fund					$ 6,400
CARES Act [Member] \| Medicare [Member]
CARES Act [Line Items]
Percentage of increase in medicare reimbursement rate				2.00%				2.00%
Repayment of advanced payments							25,100
Percentage of reduced in medicare reimbursement rate					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		$ 17,900				21,500
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
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

Derivatives

12 Months Ended

Dec. 31, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Derivatives

24. Derivatives

The Company entered into foreign currency forward contracts during the year ended December 31, 2020 in connection with certain transfers of cash between the U.S. and U.K. under the Company’s cash management and foreign currency risk management programs. Foreign currency forward contracts limit the economic risk of changes in the exchange rate between USD and GBP associated with cash transfers.

In conjunction with the U.K. Sale in January 2021, the Company settled its cross currency swap liability and outstanding forward contracts as shown in investing activities on the consolidated statement of cash flows.

Long-Term Debt - Components of Long-Term Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Mar. 17, 2021
Debt Instrument [Line Items]
Less: unamortized debt issuance costs, discount and premium	$ (10,421)	$ (12,647)
Long-term debt	1,371,767	1,385,791
Less: current portion	(29,219)	(21,250)
Long-term debt	1,342,548	1,364,541
Credit Facility [Member] \| Term Loan A Facility [Member]
Debt Instrument [Line Items]
Revolving Facility	377,188	398,438
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

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Examination [Line Items]
(Benefit from) provision for income taxes	$ (9,699)	$ 94,110	$ 67,557
Effective tax rates	38.20%	25.20%	24.50%
Valuation allowance against deferred tax assets	$ 217,137	$ 217,705
Operating loss carryforwards expiration end year	2036
Federal net operating loss carryforwards	$ 0	0
Foreign net operating loss carryforwards	100	100
State net operating loss carry forwards	$ 175,900	191,500
Operating loss carryforwards expiration start year	2024
Expiration of State tax credits	2030
State tax credits	$ 200
Income taxes receivable	12,400	28,900
Income tax payable included in other accrued liabilities	0	1,338
Unrecognized tax benefits including interest and penalties	4,000	0
Unrecognized tax benefit that would affect effective tax rate	$ 3,800	0
Earliest Tax Year [Member] \| Internal Revenue Service (IRS) [Member]
Income Tax Examination [Line Items]
Period of examination by internal revenue service	2020
Latest Tax Year [Member] \| Internal Revenue Service (IRS) [Member]
Income Tax Examination [Line Items]
Period of examination by internal revenue service	2022
Other Assets [Member]
Income Tax Examination [Line Items]
Income taxes receivable		23,100
Other Current Assets [Member]
Income Tax Examination [Line Items]
Income taxes receivable	$ 12,400	5,800
Other Liabilities [Member]
Income Tax Examination [Line Items]
Interest and penalties	$ 900	$ 0
Foreign Tax Authority [Member]
Income Tax Examination [Line Items]
Operating loss carryforwards expiration end year	2026
Period of examination by internal revenue service minimum	2019
Period of examination by internal revenue service maximum	2022
State and Local Jurisdiction [Member]
Income Tax Examination [Line Items]
Period of examination by internal revenue service minimum	2018
Period of examination by internal revenue service maximum	2022

Income Taxes - Unrecognized Income Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Balance at January 1		$ 2,060
Additions for tax positions of prior years	$ 3,089
Reductions as a result of the lapse of applicable statutes of limitations		$ (2,060)
Balance at December 31	$ 3,089

Property and Equipment

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Property and Equipment

7. Property and Equipment

Property and equipment consisted of the following at December 31, 2023 and 2022 (in thousands):


	December 31,
	2023			2022
Land	$	183,347		$	169,137
Building and improvements		2,064,353			1,797,809
Equipment		365,826			292,200
Construction in progress		420,430			349,473
		3,033,956			2,608,619
Less: accumulated depreciation		(767,346	)		(656,574	)
Property and equipment, net	$	2,266,610		$	1,952,045

During the year ended December 31, 2023, the Company recorded non-cash property impairment charges 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 current assets on the consolidated balance sheets for closed properties actively marketed of $11.5 million and $8.3 million at December 31, 2023 and 2022, respectively.

Equity

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Equity

16. Equity

Preferred Stock

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

Common Stock

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

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-14

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 505
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481004/946-505-50-6

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480237/815-40-50-6

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480008/505-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
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+ Details

Fair Value Measurements - Additional Information (Detail)	Dec. 31, 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

Long-Term Debt (6.500% Senior Notes due 2024) - Additional Information (Detail) - 6.500% Senior Notes Due 2024 [Member] - USD ($)		12 Months Ended
	Feb. 16, 2016	Dec. 31, 2023
Debt Instrument [Line Items]
Issued Senior Notes	$ 390,000,000.0
Debt instrument interest rate	6.50%
Debt instrument maturity date	Mar. 01, 2024
Interest on the notes		per annum, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2016
Term loan remaining balance due date		Mar. 01, 2021

- 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

Property and Equipment - Additional information (Detail) - USD ($) $ in Millions	3 Months Ended		12 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Dec. 31, 2023	Dec. 31, 2022
Property Plant And Equipment [Line Items]
Non-cash property impairment charge relating to closure of facilities	$ 1.1	$ 23.2
Loss on Impairment [Member]
Property Plant And Equipment [Line Items]
Non-cash property impairment charge relating to closure of facilities			$ 2.0
Other Assets [Member]
Property Plant And Equipment [Line Items]
Assets held for sale			$ 11.5	$ 8.3

Other accrued liabilities

12 Months Ended

Dec. 31, 2023

Other Liabilities Disclosure [Abstract]

Other Accrued Liabilities

12. Other accrued liabilities

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


	December 31,
	2023		2022
Accrued Desert Hills settlement	$	393,696	$	—
Accrued expenses		80,733		26,699
Accrued interest		18,046		17,596
Insurance liability – current portion		12,486		12,128
Cost report payable		9,265		13,738
Accrued property taxes		7,097		9,009
Contract liabilities		2,165		6,653
Finance lease liabilities		990		990
Government relief funds		—		8,975
Income taxes payable		—		1,338
Other		7,783		13,466
Other accrued liabilities	$	532,261	$	110,592

Leases - Schedule of Supplemental Data (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$ 34,940	$ 33,836	$ 27,508
Operating cash flows for finance leases	1,028	1,041	2,174
Financing cash flows for finance leases	(38)	(51)	31,136
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 14,714	$ 31,294	$ 63,279

Acquisitions

12 Months Ended

Dec. 31, 2023

Business Combinations [Abstract]

Acquisitions

5. Acquisitions

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

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 closed on February 22, 2024.

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

On December 31, 2021, the Company acquired the equity of CenterPointe Behavioral Health System, LLC and certain related entities (“CenterPointe”) for cash consideration of approximately $140 million. The acquisition was funded through a combination of cash on hand and a $70.0 million draw on the Revolving Facility. At the time of the acquisition, CenterPointe operated four acute inpatient hospitals with 306 beds and ten outpatient locations primarily in Missouri.

Goodwill

The following table summarizes changes in goodwill for the years ended December 31, 2023 and 2022 (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		337
Increase from contributions of redeemable noncontrolling interests		2,820
Balance at December 31, 2023	$	2,225,962

Of the increases to goodwill from acquisitions in 2023 and 2022, the Company expects $0.3 million and $9.5 million to be tax-deductible for the years ended December 31, 2023 and 2022, respectively.

Noncontrolling Interests - Additional Information (Detail)	12 Months Ended
	Dec. 31, 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%

Other current assets (Tables)

12 Months Ended

Dec. 31, 2023

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

Other Current Assets

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


	December 31,
	2023		2022
Prepaid expenses	$	36,085	$	27,052
Insurance receivable – current portion		33,579		10,158
Other receivables		22,084		15,371
Income taxes receivable		12,416		5,767
Workers’ compensation deposits – current portion		12,000		12,000
Assets held for sale		11,496		8,347
Inventory		5,300		5,087
Other		1,516		2,255
Other current assets	$	134,476	$	86,037

Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (15,661)	$ 280,033	$ 195,562
Other comprehensive (loss) income:
Foreign currency translation loss			(4,260)
Gain on derivative instruments, net of tax of $0.1 million			19
U.K. Sale			375,606
Other comprehensive income			371,365
Comprehensive (loss) income	(15,661)	280,033	566,927
Comprehensive income attributable to noncontrolling interests	(6,006)	(6,894)	(4,927)
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc.	$ (21,667)	$ 273,139	$ 562,000

Consolidated Statements of Operations (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Equity-based compensation expense	$ 32,289	$ 29,635	$ 37,530

U.K. Sale (Tables)

12 Months Ended

Dec. 31, 2023

Discontinued Operations and Disposal Groups [Abstract]

Schedule of Financial Condition, Results of Operations and Cash Flows of U.K. Operations as Discontinued Operations

For the year ended December 31, 2021, results of operations of the U.K. operations were as follows (in thousands):


Revenue	$	62,520
Salaries, wages and benefits		35,937
Professional fees		6,815
Supplies		2,217
Rents and leases		2,509
Other operating expenses		6,682
Depreciation and amortization		—
Interest expense, net		10
Loss on sale		13,490
Loss on impairment		—
Transaction, legal and other costs		6,265
Total expenses		73,925
Loss from discontinued operations before income taxes		(11,405	)
Provision for income taxes		1,236
Loss from discontinued operations	$	(12,641	)

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

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+ Details

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 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	91,263,989	89,913,659
Common stock, shares outstanding	91,263,989	89,913,659

Summary of Significant Accounting Policies	12 Months Ended
Summary of Significant Accounting Policies	Dec. 31, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Cash and Cash Equivalents The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents. At times, cash and cash equivalent balances may exceed federally insured limits. Management believes that the Company mitigates any risks by depositing cash and investing in cash equivalents with major financial institutions. Insurance The Company is subject to medical malpractice and other lawsuits due to the nature of the services the Company provides. A portion of the Company’s professional liability risks are insured through a wholly-owned insurance subsidiary 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 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. The reserve for professional and general liability risks was estimated based on historical claims, prior settlements and judgments, industry trends, severity factors, and other actuarial assumptions. The estimated accrual for professional and general liabilities could be significantly affected should current and future occurrences differ from historical claim trends and expectations. While claims are monitored closely when estimating professional and general liability accruals, the complexity of the claims and wide range of potential outcomes often hampers timely adjustments to the assumptions used in these estimates. The Company recorded unfavorable adjustments of $5.3 million and $5.9 million to our estimated liability for self-insured professional and general liability claims during the years ended December 31, 2023 and 2022, respectively, relating to the settlement or expected settlement of certain prior year claims. The professional and general liability reserve was $109.4 million at December 31, 2023, of which $12.5 million was included in other accrued liabilities and $96.9 million was included in other long-term liabilities. The professional and general liability reserve was $103.6 million at December 31, 2022, of which $12.1 million was included in other accrued liabilities and $91.5 million was included in other long-term liabilities. The Company estimates receivables for the portion of professional and general liability reserves that are recoverable under the Company’s insurance policies. Such receivable was $62.3 million at December 31, 2023, of which $33.6 million was included in other current assets and $28.7 million was included in other assets, and such receivable was $37.8 million at December 31, 2022, of which $10.2 million was included in other current assets and $27.6 million was included in other assets. The Company’s statutory workers’ compensation program is fully insured with a $0.5 million deductible per accident. The workers’ compensation liability was $26.8 million at December 31, 2023, of which $12.0 million was included in accrued salaries and benefits and $14.8 million was included in other long-term liabilities, and such liability was $24.2 million at December 31, 2022, of which $12.0 million was included in accrued salaries and benefits and $12.2 million was included in other long-term liabilities. The reserve for workers compensation claims was based upon independent actuarial estimates of future amounts that will be paid to claimants. Management believes that adequate provisions have been made for workers’ compensation and professional and general liability risk exposures. Property and Equipment and Other Long-Lived Assets Property and equipment are recorded at cost. Depreciation is calculated on the straight-line basis over the estimated useful lives of the assets, which typically range from 10 to 50 years for buildings and improvements, three to seven years for equipment and the shorter of the lease term or estimated useful lives for leasehold improvements. When assets are sold or retired, the corresponding cost and accumulated depreciation are removed from the related accounts and any gain or loss is recorded in the period of sale or retirement. Repair and maintenance costs are expensed as incurred. Depreciation expense was $132.3 million, $117.8 million and $106.7 million for the years ended December 31, 2023, 2022 and 2021, respectively. The carrying values of long-lived assets are reviewed for possible impairment whenever events, circumstances or operating results indicate that the carrying amount of an asset may not be recoverable. If this review indicates that the asset will not be recoverable, as determined based upon the undiscounted cash flows of the operating asset over the remaining useful life, the carrying value of the asset will be reduced to its estimated fair value. Fair value estimates are based on independent appraisals, market values of comparable assets or internal evaluations of future net cash flows. During the year ended December 31, 2023, the Company recorded non-cash property impairment charges 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. During the second quarter of 2021, the Company opened a 260-bed replacement facility in Pennsylvania and recorded a non-cash property impairment charge of $23.2 million for the existing facility. Additionally, during the third quarter of 2021, the Company recorded a $1.1 million non-cash property impairment charge for one facility in Louisiana resulting from hurricane damage, both of which are included in loss on impairment on the condensed consolidated statements of operations. The Company performed an impairment review of long-lived assets in the fourth quarter of 2023, 2022 and 2021 and recorded no impairment. Goodwill and Indefinite-Lived Intangible Assets The Company’s goodwill and other indefinite-lived intangible assets, which consist of licenses and accreditations, trade names and certificates of need intangible assets that are not amortized, are evaluated for impairment annually during the fourth quarter or more frequently if events indicate the carrying value of a reporting unit may not be recoverable. As of the Company’s annual impairment tests on October 1, 2023, 2022 and 2021, the Company had one reporting unit, behavioral healthcare services. The fair value of the Company’s behavioral healthcare services reporting unit substantially exceeded its carrying value, and therefore no impairment was recorded. During the year ended December 31, 2023, the Company recorded non-cash indefinite-lived intangible asset impairment charges of $5.4 million related to the closure of certain facilities, which is included in loss on impairment in the condensed consolidated statements of operations. During the second quarter of 2021, the Company sold one outpatient facility for $4.3 million and recorded a write down of $1.8 million of goodwill and $0.2 million of intangible assets related to the disposition. During the fourth quarter of 2021, the Company sold one outpatient facility for $1.5 million and recorded a write down of $0.7 million of goodwill and $0.1 million of intangibles related to the disposition. Stock Compensation The Company measures and recognizes the cost of employee services received in exchange for awards of equity instruments based on the grant-date fair value in accordance with the Financial Accounting Standards Board (the “FASB”) Accounting Standards Codification (“ASC”) 718, “ Compensation — Stock Compensation.” The Company uses the Black-Scholes valuation model to determine grant-date fair value for stock options and recognizes straight-line amortization of share-based compensation expense over the requisite service period of the respective awards. The fair values of performance stock units are 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. Earnings Per Share Basic and diluted earnings per share are calculated in accordance with FASB ASC 260, “Earnings Per Share,” based on the weighted-average number of shares outstanding in each period and dilutive stock options and non-vested shares, to the extent such securities have a dilutive effect on earnings per share. Income Taxes The Company uses the asset and liability method of accounting for income taxes. Under this method, deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes and net operating loss and tax credit carryforwards. The amount of deferred taxes on these temporary differences is determined using the tax rates that are expected to apply in the period when the asset is realized or the liability is settled, as applicable, based on tax rates and laws in the respective tax jurisdiction enacted as of the balance sheet date. The Company reviews its deferred tax assets for recoverability and establishes a valuation allowance based on historical taxable income, projected future taxable income, applicable tax strategies, and the expected timing of the reversals of existing temporary differences. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax assets will not be realized. The Company records a liability for unrecognized tax benefits resulting from uncertain tax positions taken or expected to be taken in a tax return. The Company recognizes interest and penalties, if any, related to unrecognized tax benefits in income tax expense. The Company has accruals for taxes and associated interest that may become payable in future years as a result of audits by tax authorities. The Company accrues for tax contingencies when it is more likely than not that a liability to a taxing authority has been incurred and the amount of the contingency can be reasonably estimated. Although management believes that the positions taken on previously filed tax returns are reasonable, the Company nevertheless has established tax and interest reserves in recognition that various taxing authorities may challenge the positions taken by the Company resulting in additional liabilities for taxes and interest. These amounts are reviewed as circumstances warrant and adjusted as events occur that affect our potential liability for additional taxes, such as lapsing of applicable statutes of limitations, conclusion of tax audits, additional exposure based on current calculations, identification of new issues, release of administrative guidance, or rendering of a court decision affecting a particular tax issue. Recent Accounting Pronouncements In December 2023, the FASB issued Accounting Standards Update (“ASU”) 2023-09 “Income Taxes (“Topic 740”) “Improvements to Income Tax Disclosures Topic 740”. ASU 2023-09 is intended to enhance the transparency and decision usefulness of income tax disclosures. This guidance is effective for fiscal years beginning after December 15, 2024, with early adoption permitted, and may be applied either prospectively or retrospectively. The Company is currently evaluating the impact of ASU 2023-09 on the Company’s consolidated financial statements. In November 2021, the FASB issued 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 10 – 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 13 - 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.

The CARES Act

12 Months Ended

Dec. 31, 2023

Unusual or Infrequent Items, or Both [Abstract]

The CARES Act

10. 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 was 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 (“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 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 year ended December 31, 2023, the Company recorded $6.4 million of income from provider relief fund related to ARP funds received and

repaid the remaining balance of ARP funds to eliminate the liability. At December 31, 2022, the unrecognized funds of $9.0 million were included in other accrued liabilities on the consolidated balance sheet.

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, to eliminate the liability.

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 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.

Property and Equipment - Summary of Property and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 3,033,956	$ 2,608,619
Less: accumulated depreciation	(767,346)	(656,574)
Property and equipment, net	2,266,610	1,952,045
Land [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	183,347	169,137
Building and Improvements [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	2,064,353	1,797,809
Equipment [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	365,826	292,200
Construction in Progress [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 420,430	$ 349,473

Income Taxes - Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred tax assets:
Net operating losses and tax credit carryforwards - federal and state	$ 5,729	$ 7,333
Capital loss carryovers	215,175	215,745
Bad debt allowance	1,780	1,148
Accrued compensation and severance	18,250	18,784
Insurance reserves	17,343	20,924
Leases	948	862
Accrued expenses	1,091
Accrued Desert Hills settlement	104,636
Interest carryforward	2,430	2,639
Lease right-of-use liabilities	29,781	26,277
Fixed asset basis difference	2,914	2,128
Other assets	9,130	8,987
Total gross deferred tax assets	409,207	304,827
Less: valuation allowance	(217,137)	(217,705)
Deferred tax assets	192,070	87,122
Deferred tax liabilities:
Prepaid items	(4,609)	(3,714)
Accrued expenses		(5,713)
Intangible assets	(152,284)	(139,843)
Lease right-of-use assets	(27,800)	(24,960)
Investment in foreign subsidiary	(2,650)	(2,530)
Total deferred tax liabilities	(187,343)	(176,760)
Total net deferred tax asset (liability)	$ 4,727
Total net deferred tax asset (liability)		$ (89,638)

Document and Entity Information - USD ($) $ in Billions	12 Months Ended
Document and Entity Information - USD ($) $ in Billions	Dec. 31, 2023	Feb. 28, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Trading Symbol	ACHC
Entity Registrant Name	ACADIA HEALTHCARE COMPANY, INC.
Entity Central Index Key	0001520697
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	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 Annual Report	true
Document Transition Report	false
Entity Common Stock, Shares Outstanding		92,289,068
Entity Public Float			$ 7.1
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Auditor Name	Ernst & Young LLP
Auditor Location	Nashville, Tennessee
Auditor Firm ID	42
Documents Incorporated by Reference	Portions of the registrant’s definitive proxy statement for its 2024 annual meeting of stockholders to be held on May 23, 2024 are incorporated by reference into Part III of this Form 10-K.

Equity-Based Compensation - Performance Stock Unit Activity (Detail) - Performance Stock Units [Member] - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	1,273,800	1,504,420	1,073,062
Granted, Number of Units	177,509	105,311	149,416
Performance adjustment, Number of Units	407,825	182,543	465,993
Cancelled, Number of Units	(114,908)
Vested, Number of Units	(1,408,195)	(518,474)	(184,051)
Unvested, Number of Shares/Units, Ending balance	336,031	1,273,800	1,504,420
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 20.69	$ 23.20	$ 20.15
Granted, Weighted Average Grant-Date Fair Value	70.98	73.96	61.52
Performance adjustment, Weighted Average Grant-Date Fair Value	17.69	33.05	25.49
Cancelled, Weighted Average Grant-Date Fair Value	69.07
Vested, Weighted Average Grant-Date Fair Value	10.60	43.16	42.30
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 69.35	$ 20.69	$ 23.20

Earnings Per Share - Additional Information (Detail) - shares shares in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Excluded common stock for computation of diluted earnings per share	0.3	0.1	0.3
Restricted Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Excluded common stock for computation of diluted earnings per share	0.9

Other Intangible Assets - Other Identifiable Intangible Assets and Related Accumulated Amortization (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	$ 73,278	$ 76,041
Total	74,409	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	11,681	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	42,588	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	$ 19,009	$ 18,594

Other Intangible Assets (Tables)

12 Months Ended

Dec. 31, 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 at December 31, 2023 and 2022 (in thousands):


	Gross Carrying Amount				Accumulated Amortization
	December 31, 2023		December 31, 2022		December 31, 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		11,681		11,512		—			—
Trade names		42,588		45,935		—			—
Certificates of need		19,009		18,594		—			—
		73,278		76,041		—			—
Total	$	74,409	$	77,172	$	(1,131	)	$	(1,131	)

Other accrued liabilities - Summary of Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Accounts Payable and Accrued Liabilities, Current [Abstract]
Accrued Desert Hills settlement	$ 393,696
Accrued expenses	80,733	$ 26,699
Accrued interest	18,046	17,596
Insurance liability – current portion	12,486	12,128
Cost report payable	9,265	13,738
Accrued property taxes	7,097	9,009
Contract liabilities	2,165	6,653
Finance lease liabilities	$ 990	$ 990
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other accrued liabilities	Other accrued liabilities
Government relief funds		$ 8,975
Income taxes payable	$ 0	1,338
Other	7,783	13,466
Other accrued liabilities	$ 532,261	$ 110,592

Long-Term Debt (Other Long-term Debt) - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2021 USD ($)
Debt Disclosure [Abstract]
Repayments of other long-term debt	$ 3.3

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

19. Income Taxes

(Benefit from) provision for income taxes from continuing operations consists of the following for the periods presented (in thousands):


	Year Ended December 31,
	2023			2022		2021
Current:
Federal	$	68,939		$	63,041	$	48,292
State		14,413			13,769		6,715
Foreign		933			755		778
Total current provision		84,285			77,565		55,785
Deferred:
Federal		(72,046	)		9,808		13,339
State		(22,495	)		6,377		(1,892	)
Foreign		557			360		325
Total deferred provision		(93,984	)		16,545		11,772
(Benefit from) provision for income taxes	$	(9,699	)	$	94,110	$	67,557

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


	Year Ended December 31,
	2023			2022			2021
U.S. federal statutory rate on income before income taxed		21.0	%		21.0	%		21.0	%
Impact of foreign operations		(2.2	)		(0.1	)		1.7
State income taxes, net of federal tax effect		45.6			4.7			3.9
Nondeductible expenses and permanent differences		(30.7	)		0.4			2.1
Change in valuation allowance		(0.1	)		0.2			(2.8	)
Unrecognized tax benefit		(14.8	)		—			(0.9	)
Federal tax credits		9.8			(0.6	)		(0.8	)
Noncontrolling interest		7.4			(0.4	)		(0.4	)
Other		2.2			—			0.7
Effective income tax rate		38.2	%		25.2	%		24.5	%

For the year ended December 31, 2023, the benefit from income taxes was $(9.7) million, reflecting an effective tax rate of 38.2%, compared to the provision for income taxes of $94.1 million, reflecting an effective tax rate of 25.2%, for the year ended December 31, 2022. The Company’s lower pre-tax results for the year yields higher volatility in the items impacting the effective tax rate for the year ended December 31, 2023 when compared to prior periods.

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


	Year Ended December 31,
	2023			2022		2021
Foreign	$	5,889		$	5,420	$	5,596
Domestic		(31,249	)		368,723		270,164
(Loss) income from continuing operations before income taxes	$	(25,360	)	$	374,143	$	275,760

The tax effects of temporary differences that give rise to significant portions of the deferred tax assets and liabilities of the Company at December 31, 2023 and December 31, 2022 were as follows (in thousands):


	December 31,
	2023			2022
Deferred tax assets:
Net operating losses and tax credit carryforwards – federal and state	$	5,729		$	7,333
Capital loss carryovers		215,175			215,745
Bad debt allowance		1,780			1,148
Accrued compensation and severance		18,250			18,784
Insurance reserves		17,343			20,924
Leases		948			862
Accrued expenses		1,091			—
Accrued Desert Hills settlement		104,636			—
Interest carryforward		2,430			2,639
Lease right-of-use liabilities		29,781			26,277
Fixed asset basis difference		2,914			2,128
Other assets		9,130			8,987
Total gross deferred tax assets		409,207			304,827
Less: valuation allowance		(217,137	)		(217,705	)
Deferred tax assets		192,070			87,122
Deferred tax liabilities:
Prepaid items		(4,609	)		(3,714	)
Accrued expenses		—			(5,713	)
Intangible assets		(152,284	)		(139,843	)
Lease right-of-use assets		(27,800	)		(24,960	)
Investment in foreign subsidiary		(2,650	)		(2,530	)
Total deferred tax liabilities		(187,343	)		(176,760	)
Total net deferred tax asset (liability)	$	4,727		$	(89,638	)

The Company records a valuation allowance to reduce its net deferred tax assets to the amount that is more likely than not to be realized. At December 31, 2023 and 2022, the Company carried a valuation allowance against deferred tax assets of $217.1 million and $217.7 million, respectively. These amounts are primarily related to deferred tax assets related to the Company’s capital loss carryforward resulting from the U.K. Sale and certain state net operating losses. If the capital loss carryforward is not utilized, it will expire in 2026.

As of December 31, 2023 and 2022, the Company had no federal net operating loss carryforwards. The foreign net operating loss carryforwards at December 31, 2023 and 2022 are approximately $0.1 million and $0.1 million, respectively, and have no expiration.

The Company has state net operating loss carryforwards at December 31, 2023 and 2022 of approximately $175.9 million and $191.5 million, respectively. These net operating loss carryforwards, if not used to offset future taxable income, will expire from 2024 to 2036. In addition, the Company has certain state tax credits of $0.2 million which will begin to expire in 2030 if not utilized.

Income taxes receivable was $12.4 million and $28.9 million at December 31, 2023 and 2022, respectively. At December 31, 2023, the $12.4 million of income taxes receivable is included in other current assets, while at December 31, 2022, $5.8 million of income taxes receivable was included in other current assets and $23.1 million was included in other assets in the consolidated balance sheets. Income taxes payable of $0.0 million and $1.3 million at December 31, 2023 and 2022, respectively, was included in other accrued liabilities in the consolidated balance sheets.

The Company has recorded liabilities related to unrecognized tax benefits of $4.0 million and $0.0 million at December 31, 2023 and 2022, respectively. These amounts are inclusive of interest and penalties of $0.9 million and $0.0 million, respectively, and are included in other liabilities on the consolidated balance sheets. The amount of unrecognized tax benefit, if realized, that would affect the effective tax rate is $3.8 million and $0.0 million at December 31, 2023 and December 31, 2022, respectively. A reconciliation of the beginning and ending amount of unrecognized income tax benefits, exclusive of any interest and penalties, is as follows (in thousands):


	2023		2022		2021
Balance at January 1	$	—	$	—	$	2,060
Additions based on tax positions related to the current year		—		—		—
Additions for tax positions of prior years		3,089		—		—
Reductions as a result of the lapse of applicable statutes of limitations		—		—		(2,060	)
Balance at December 31	$	3,089	$	—	$	—

The Company and its subsidiaries file income tax returns in federal and in many state and local jurisdictions as well as foreign jurisdictions. The Company may be subject to examination by the Internal Revenue Service (“IRS”) for calendar years 2020 through 2022. Additionally, any net operating losses that were generated in prior years and utilized in these years may also be subject to examination by the IRS. While no foreign jurisdictions are presently under examination, the Company may be subject to examination for calendar years 2019 through 2022. Generally, for state tax purposes, the Company’s 2018 through 2022 tax years remain open for examination by the tax authorities. At the date of this report, there were no material audits or inquiries that had progressed sufficiently to predict their ultimate outcome.

- 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.

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+ Details

Income Taxes - Summary of Domestic and Foreign Components of (Loss) Income from Continuing Operations before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Taxes [Line Items]
(Loss) income from continuing operations before income taxes	$ (25,360)	$ 374,143	$ 275,760
Foreign Tax Authority [Member]
Income Taxes [Line Items]
(Loss) income from continuing operations before income taxes	5,889	5,420	5,596
Domestic Tax Authority [Member]
Income Taxes [Line Items]
(Loss) income from continuing operations before income taxes	$ (31,249)	$ 368,723	$ 270,164

- Definition

Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.

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+ Details

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Computation of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted (loss) earnings per share for the years ended December 31, 2023, 2022 and 2021 (in thousands, except per share amounts):


	Year Ended December 31,
	2023			2022		2021
Numerator:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	$	(21,667	)	$	273,139	$	203,276
Loss from discontinued operations		—			—		(12,641	)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(21,667	)	$	273,139	$	190,635
Denominator:
Weighted average shares outstanding for basic earnings per share		90,949			89,680		88,769
Effects of dilutive instruments		—			1,875		2,024
Shares used in computing diluted earnings per common share		90,949			91,555		90,793

Basic (loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	$	(0.24	)	$	3.05	$	2.29
Loss from discontinued operations		—			—		(0.14	)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(0.24	)	$	3.05	$	2.15

Diluted (loss) earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
(Loss) income from continuing operations attributable to Acadia Healthcare Company, Inc.	$	(0.24	)	$	2.98	$	2.24
Loss from discontinued operations		—			—		(0.14	)
Net (loss) income attributable to Acadia Healthcare Company, Inc.	$	(0.24	)	$	2.98	$	2.10

Other accrued liabilities (Tables)

12 Months Ended

Dec. 31, 2023

Other Liabilities Disclosure [Abstract]

Summary of Other Accrued Liabilities

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


	December 31,
	2023		2022
Accrued Desert Hills settlement	$	393,696	$	—
Accrued expenses		80,733		26,699
Accrued interest		18,046		17,596
Insurance liability – current portion		12,486		12,128
Cost report payable		9,265		13,738
Accrued property taxes		7,097		9,009
Contract liabilities		2,165		6,653
Finance lease liabilities		990		990
Government relief funds		—		8,975
Income taxes payable		—		1,338
Other		7,783		13,466
Other accrued liabilities	$	532,261	$	110,592

Income Taxes - Components of (Benefit from) Provision for Income Taxes From Continuing operations (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Current:
Federal	$ 68,939	$ 63,041	$ 48,292
State	14,413	13,769	6,715
Foreign	933	755	778
Total current provision	84,285	77,565	55,785
Deferred:
Federal	(72,046)	9,808	13,339
State	(22,495)	6,377	(1,892)
Foreign	557	360	325
Total deferred provision	(93,984)	16,545	11,772
(Benefit from) provision for income taxes	$ (9,699)	$ 94,110	$ 67,557

Accumulated Other Comprehensive Loss

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Accumulated Other Comprehensive Loss

23. Accumulated Other Comprehensive Loss

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


	Foreign Currency Translation Adjustments			Change in Fair Value of Derivative Instruments			Pension Plan			Total
Balance at January 1, 2021	$	(373,101	)	$	13,686		$	(11,950	)	$	(371,365	)
Foreign currency translation gain (loss)		(4,293	)		—			33			(4,260	)
Gain on derivative instruments, net of tax of $0.1 million		—			19			—			19
U.K. Sale		377,394			(13,705	)		11,917			375,606
Balance at December 31, 2021	$	—		$	—		$	—		$	—

Noncontrolling Interests (Tables)

12 Months Ended

Dec. 31, 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		16,530
Net income attributable to noncontrolling interests		6,006
Distributions to noncontrolling partners in joint ventures		(5,107	)
Balance at December 31, 2023	$	105,686

Revenue - Schedule of Revenue Attributed to Each Category (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Revenue	$ 2,928,738	$ 2,610,399	$ 2,314,394
U.S. Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	2,928,738	2,610,399	2,314,394
U.S. Facilities [Member] \| Acute Inpatient Psychiatric Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	1,489,248	1,330,757	1,126,872
U.S. Facilities [Member] \| Specialty Treatment Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	614,220	564,671	510,929
U.S. Facilities [Member] \| Comprehensive Treatment Centers [Member]
Disaggregation of Revenue [Line Items]
Revenue	500,242	419,940	385,635
U.S. Facilities [Member] \| Residential Treatment Centers [Member]
Disaggregation of Revenue [Line Items]
Revenue	$ 325,028	$ 295,031	283,169
U.S. Facilities [Member] \| Other [Member]
Disaggregation of Revenue [Line Items]
Revenue			$ 7,789

- 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

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
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479941/924-10-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 30
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-30

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-42

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-40

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-41

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-4

+ Details

Other current assets

12 Months Ended

Dec. 31, 2023

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

Other Current Assets

6. Other current assets

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


	December 31,
	2023		2022
Prepaid expenses	$	36,085	$	27,052
Insurance receivable – current portion		33,579		10,158
Other receivables		22,084		15,371
Income taxes receivable		12,416		5,767
Workers’ compensation deposits – current portion		12,000		12,000
Assets held for sale		11,496		8,347
Inventory		5,300		5,087
Other		1,516		2,255
Other current assets	$	134,476	$	86,037

Fair Value Measurements

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Fair Value Measurements

20. 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 December 31, 2023 and 2022 were as follows (in thousands):


	Carrying Amount				Fair Value
	December 31,				December 31,
	2023		2022		2023		2022
Credit Facility	$	455,880	$	471,488	$	455,880	$	471,488
5.500% Senior Notes due 2028	$	445,539	$	444,694	$	436,628	$	422,459
5.000% Senior Notes due 2029	$	470,348	$	469,609	$	451,534	$	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

Description of Business and Basis of Presentation - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($) Bed State Facility	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Accounting Policies [Abstract]
Number of facilities \| Facility	253
Number of beds \| Bed	11,200
Number of operating states \| State	38
General and administrative expenses \| $	$ 153.3	$ 124.3	$ 108.2

Long-Term Debt - Components of Long-Term Debt (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 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%
Senior notes maturity year	2028	2028
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

- 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

Revenue

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

Revenue

3. 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 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 the Company’s patients typically are under no obligation to remain admitted in the Company’s facilities.

At December 31, 2023 and 2022, estimated implicit price concessions of $68.3 million and $61.4 million, respectively, had been recorded as reductions to the Company’s accounts receivable balances to enable the Company to record its revenues and accounts receivable at the estimated amounts the Company expected to collect.

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; 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. The facilities balance therapy activities with social, academic and other activities.

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


	Year Ended December 31,
	2023		2022		2021
Acute inpatient psychiatric facilities	$	1,489,248	$	1,330,757	$	1,126,872
Specialty treatment facilities		614,220		564,671		510,929
Comprehensive treatment centers		500,242		419,940		385,635
Residential treatment centers		325,028		295,031		283,169
Other		—		—		7,789
Revenue	$	2,928,738	$	2,610,399	$	2,314,394

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 consolidated statements of operations. Bad debt expense for the years ended December 31, 2023, 2022 and 2021 was not significant.

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

Settlements under cost reimbursement agreements with third-party payors are estimated and recorded in the period in which the related services are rendered and are adjusted in future periods as final settlements are determined. Final determination of amounts earned under the Medicare and Medicaid programs often occurs in subsequent years because of audits by such programs, rights of appeal and the application of numerous technical provisions. In the opinion of management, adequate provision has been made for any adjustments and final settlements. However, there can be no assurance that any such adjustments and final settlements will not have a material effect on the Company’s financial condition or results of operations. The Company’s cost report payables were $9.3 million and $13.7 million as of December 31, 2023 and 2022, respectively, and were included in other current liabilities on the consolidated balance sheet. The net adjustments to estimated cost report settlements resulted in an increase to revenue of $1.8 million and $0.1 million, respectively, for the years ended December 31, 2023 and 2022 compared to a decrease to revenue of $5.4 million for the year ended December 31, 2021.

The Company provides care without charge to patients who are financially unable to pay for the healthcare services they receive based on Company policies and federal and state poverty thresholds. Such amounts determined to qualify as charity care are not reported as revenue. The cost of providing charity care services were $8.2 million, $6.4 million and $3.8 million for the years ended December 31, 2023, 2022 and 2021, respectively. The estimated cost of charity care services was determined using a ratio of cost to gross charges determined from the Company’s most recently filed Medicare cost reports and applying that ratio to the gross charges associated with providing charity care for the period.

The following table presents revenue by payor type and as a percentage of revenue for continuing operations for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023					2022					2021
	Amount		%			Amount		%			Amount		%
Commercial	$	820,701		28.0	%	$	788,895		30.2	%	$	684,292		29.6	%
Medicare		441,761		15.1	%		394,227		15.1	%		364,598		15.8	%
Medicaid		1,578,518		53.9	%		1,319,600		50.6	%		1,147,884		49.6	%
Self-Pay		67,583		2.3	%		76,050		2.9	%		93,425		4.0	%
Other		20,175		0.7	%		31,627		1.2	%		24,195		1.0	%
Revenue	$	2,928,738		100.0	%	$	2,610,399		100.0	%	$	2,314,394		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.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org//606/tableOfContent

+ Details

Leases - Schedule of Weighted-average Remaining Lease Terms and Discount Rates (Detail)	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Finance lease, weighted average remaining lease term (years)	20 years 10 months 24 days	21 years 10 months 24 days
Operating lease, weighted average remaining term (years)	8 years 1 month 6 days	8 years 4 months 24 days
Finance lease, weighted average discount rate percent	5.10%	5.10%
Operating lease, weighted average discount rate percent	5.70%	5.00%

Noncontrolling Interests

12 Months Ended

Dec. 31, 2023

Noncontrolling Interest [Abstract]

Noncontrolling Interests

14. 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 December 31, 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 15 – Variable Interest Entities. The noncontrolling interests are reflected as redeemable noncontrolling interests on the accompanying consolidated balance sheets based on put rights that could require the Company to purchase the noncontrolling interests upon the occurrence of a change in control.

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


Balance at January 1, 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		16,530
Net income attributable to noncontrolling interests		6,006
Distributions to noncontrolling partners in joint ventures		(5,107	)
Balance at December 31, 2023	$	105,686

Revenue - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Accounts receivable, net	$ (39,012)	$ (41,978)	$ 2,448
Cost report payables	9,300	13,700
Net adjustments to estimated cost report settlements resulted in (decreases) increases to revenue	1,800	100	(5,400)
Costs of providing charity care services	8,200	6,400	3,800
CARES Act [Member] \| Medicare [Member]
Disaggregation of Revenue [Line Items]
Repayment of advanced payments			$ 25,100
Accounting Standards Update 2014-09
Disaggregation of Revenue [Line Items]
Accounts receivable, net	$ 68,300	$ 61,400

- 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

Income Taxes - Effective Income Tax Rate (Detail)	12 Months Ended
Income Taxes - Effective Income Tax Rate (Detail)	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
U.S. federal statutory rate on income before income taxed	21.00%	21.00%	21.00%
Impact of foreign operations	(2.20%)	(0.10%)	1.70%
State income taxes, net of federal tax effect	45.60%	4.70%	3.90%
Nondeductible expenses and permanent differences	(30.70%)	0.40%	2.10%
Change in valuation allowance	(0.10%)	0.20%	(2.80%)
Unrecognized tax benefit	(14.80%)		(0.90%)
Federal tax credits	9.80%	(0.60%)	(0.80%)
Noncontrolling interest	7.40%	(0.40%)	(0.40%)
Other	2.20%		0.70%
Effective income tax rate	38.20%	25.20%	24.50%

Summary of Significant Accounting Policies (Policies)	12 Months Ended
Summary of Significant Accounting Policies (Policies)	Dec. 31, 2023
Accounting Policies [Abstract]
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents. At times, cash and cash equivalent balances may exceed federally insured limits. Management believes that the Company mitigates any risks by depositing cash and investing in cash equivalents with major financial institutions.
Insurance	Insurance The Company is subject to medical malpractice and other lawsuits due to the nature of the services the Company provides. A portion of the Company’s professional liability risks are insured through a wholly-owned insurance subsidiary 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 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. The reserve for professional and general liability risks was estimated based on historical claims, prior settlements and judgments, industry trends, severity factors, and other actuarial assumptions. The estimated accrual for professional and general liabilities could be significantly affected should current and future occurrences differ from historical claim trends and expectations. While claims are monitored closely when estimating professional and general liability accruals, the complexity of the claims and wide range of potential outcomes often hampers timely adjustments to the assumptions used in these estimates. The Company recorded unfavorable adjustments of $5.3 million and $5.9 million to our estimated liability for self-insured professional and general liability claims during the years ended December 31, 2023 and 2022, respectively, relating to the settlement or expected settlement of certain prior year claims. The professional and general liability reserve was $109.4 million at December 31, 2023, of which $12.5 million was included in other accrued liabilities and $96.9 million was included in other long-term liabilities. The professional and general liability reserve was $103.6 million at December 31, 2022, of which $12.1 million was included in other accrued liabilities and $91.5 million was included in other long-term liabilities. The Company estimates receivables for the portion of professional and general liability reserves that are recoverable under the Company’s insurance policies. Such receivable was $62.3 million at December 31, 2023, of which $33.6 million was included in other current assets and $28.7 million was included in other assets, and such receivable was $37.8 million at December 31, 2022, of which $10.2 million was included in other current assets and $27.6 million was included in other assets. The Company’s statutory workers’ compensation program is fully insured with a $0.5 million deductible per accident. The workers’ compensation liability was $26.8 million at December 31, 2023, of which $12.0 million was included in accrued salaries and benefits and $14.8 million was included in other long-term liabilities, and such liability was $24.2 million at December 31, 2022, of which $12.0 million was included in accrued salaries and benefits and $12.2 million was included in other long-term liabilities. The reserve for workers compensation claims was based upon independent actuarial estimates of future amounts that will be paid to claimants. Management believes that adequate provisions have been made for workers’ compensation and professional and general liability risk exposures.
Property and Equipment and Other Long-Lived Assets	Property and Equipment and Other Long-Lived Assets Property and equipment are recorded at cost. Depreciation is calculated on the straight-line basis over the estimated useful lives of the assets, which typically range from 10 to 50 years for buildings and improvements, three to seven years for equipment and the shorter of the lease term or estimated useful lives for leasehold improvements. When assets are sold or retired, the corresponding cost and accumulated depreciation are removed from the related accounts and any gain or loss is recorded in the period of sale or retirement. Repair and maintenance costs are expensed as incurred. Depreciation expense was $132.3 million, $117.8 million and $106.7 million for the years ended December 31, 2023, 2022 and 2021, respectively. The carrying values of long-lived assets are reviewed for possible impairment whenever events, circumstances or operating results indicate that the carrying amount of an asset may not be recoverable. If this review indicates that the asset will not be recoverable, as determined based upon the undiscounted cash flows of the operating asset over the remaining useful life, the carrying value of the asset will be reduced to its estimated fair value. Fair value estimates are based on independent appraisals, market values of comparable assets or internal evaluations of future net cash flows. During the year ended December 31, 2023, the Company recorded non-cash property impairment charges 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. During the second quarter of 2021, the Company opened a 260-bed replacement facility in Pennsylvania and recorded a non-cash property impairment charge of $23.2 million for the existing facility. Additionally, during the third quarter of 2021, the Company recorded a $1.1 million non-cash property impairment charge for one facility in Louisiana resulting from hurricane damage, both of which are included in loss on impairment on the condensed consolidated statements of operations. The Company performed an impairment review of long-lived assets in the fourth quarter of 2023, 2022 and 2021 and recorded no impairment.
Goodwill and Indefinite-Lived Intangible Assets	Goodwill and Indefinite-Lived Intangible Assets The Company’s goodwill and other indefinite-lived intangible assets, which consist of licenses and accreditations, trade names and certificates of need intangible assets that are not amortized, are evaluated for impairment annually during the fourth quarter or more frequently if events indicate the carrying value of a reporting unit may not be recoverable. As of the Company’s annual impairment tests on October 1, 2023, 2022 and 2021, the Company had one reporting unit, behavioral healthcare services. The fair value of the Company’s behavioral healthcare services reporting unit substantially exceeded its carrying value, and therefore no impairment was recorded. During the year ended December 31, 2023, the Company recorded non-cash indefinite-lived intangible asset impairment charges of $5.4 million related to the closure of certain facilities, which is included in loss on impairment in the condensed consolidated statements of operations. During the second quarter of 2021, the Company sold one outpatient facility for $4.3 million and recorded a write down of $1.8 million of goodwill and $0.2 million of intangible assets related to the disposition. During the fourth quarter of 2021, the Company sold one outpatient facility for $1.5 million and recorded a write down of $0.7 million of goodwill and $0.1 million of intangibles related to the disposition.
Stock Compensation	Stock Compensation The Company measures and recognizes the cost of employee services received in exchange for awards of equity instruments based on the grant-date fair value in accordance with the Financial Accounting Standards Board (the “FASB”) Accounting Standards Codification (“ASC”) 718, “ Compensation — Stock Compensation.” The Company uses the Black-Scholes valuation model to determine grant-date fair value for stock options and recognizes straight-line amortization of share-based compensation expense over the requisite service period of the respective awards. The fair values of performance stock units are 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.
Earnings Per Share	Earnings Per Share Basic and diluted earnings per share are calculated in accordance with FASB ASC 260, “Earnings Per Share,” based on the weighted-average number of shares outstanding in each period and dilutive stock options and non-vested shares, to the extent such securities have a dilutive effect on earnings per share.
Income Taxes	Income Taxes The Company uses the asset and liability method of accounting for income taxes. Under this method, deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes and net operating loss and tax credit carryforwards. The amount of deferred taxes on these temporary differences is determined using the tax rates that are expected to apply in the period when the asset is realized or the liability is settled, as applicable, based on tax rates and laws in the respective tax jurisdiction enacted as of the balance sheet date. The Company reviews its deferred tax assets for recoverability and establishes a valuation allowance based on historical taxable income, projected future taxable income, applicable tax strategies, and the expected timing of the reversals of existing temporary differences. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax assets will not be realized. The Company records a liability for unrecognized tax benefits resulting from uncertain tax positions taken or expected to be taken in a tax return. The Company recognizes interest and penalties, if any, related to unrecognized tax benefits in income tax expense. The Company has accruals for taxes and associated interest that may become payable in future years as a result of audits by tax authorities. The Company accrues for tax contingencies when it is more likely than not that a liability to a taxing authority has been incurred and the amount of the contingency can be reasonably estimated. Although management believes that the positions taken on previously filed tax returns are reasonable, the Company nevertheless has established tax and interest reserves in recognition that various taxing authorities may challenge the positions taken by the Company resulting in additional liabilities for taxes and interest. These amounts are reviewed as circumstances warrant and adjusted as events occur that affect our potential liability for additional taxes, such as lapsing of applicable statutes of limitations, conclusion of tax audits, additional exposure based on current calculations, identification of new issues, release of administrative guidance, or rendering of a court decision affecting a particular tax issue.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In December 2023, the FASB issued Accounting Standards Update (“ASU”) 2023-09 “Income Taxes (“Topic 740”) “Improvements to Income Tax Disclosures Topic 740”. ASU 2023-09 is intended to enhance the transparency and decision usefulness of income tax disclosures. This guidance is effective for fiscal years beginning after December 15, 2024, with early adoption permitted, and may be applied either prospectively or retrospectively. The Company is currently evaluating the impact of ASU 2023-09 on the Company’s consolidated financial statements. In November 2021, the FASB issued 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 10 – 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 13 - 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

Disclosure of accounting policy for income taxes, which may include its accounting policies for recognizing and measuring deferred tax assets and liabilities and related valuation allowances, recognizing investment tax credits, operating loss carryforwards, tax credit carryforwards, and other carryforwards, methodologies for determining its effective income tax rate and the characterization of interest and penalties in the financial statements.

+ References + Details

- Definition

Disclosure of accounting policy for award under share-based payment arrangement. Includes, but is not limited to, methodology and assumption used in measuring cost.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(ii)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(v)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 14.C.Q3)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479830/718-10-S99-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 14.D.1.Q5)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479830/718-10-S99-1

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 14.D.3.Q2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479830/718-10-S99-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 14.D.2.Q6)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479830/718-10-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//718/tableOfContent

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

+ Details

Equity - Additional Information (Detail) - shares	12 Months Ended
Equity - Additional Information (Detail) - shares	Dec. 31, 2023	Dec. 31, 2022
Equity [Line Items]
Preferred stock, number of shares proposed to be issued	10,000,000	10,000,000
Common stock, number of shares proposed to be issued	180,000,000	180,000,000
Common stock voting rights	one vote for each share
Maximum [Member]
Equity [Line Items]
Preferred stock, number of shares proposed to be issued	10,000,000
Common stock, number of shares proposed to be issued	180,000,000

U.K. Sale - Result of Operation (Detail) $ in Thousands	12 Months Ended
U.K. Sale - Result of Operation (Detail) $ in Thousands	Dec. 31, 2021 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Loss from discontinued operations	$ (12,641)
Discontinued Operations [Member] \| U.K. Sales [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	62,520
Salaries, wages and benefits	35,937
Professional fees	6,815
Supplies	2,217
Rents and leases	2,509
Other operating expenses	6,682
Interest expense, net	10
Loss on sale	13,490
Transaction, legal and other costs	6,265
Total expenses	73,925
Loss from discontinued operations before income taxes	(11,405)
Provision for income taxes	1,236
Loss from discontinued operations	$ (12,641)

Leases (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Schedule of Leases on Consolidated Balance Sheet

The Company recorded the following at December 31, 2023 and 2022 on the consolidated balance sheets (in thousands):


Right-of-Use Assets	Balance Sheet Classification	December 31, 2023		December 31, 2022
Finance lease right-of-use assets	Property and equipment, net	$	7,872	$	8,250
Operating lease right-of-use assets	Operating lease right-of-use assets		117,780		135,238
Total		$	125,652	$	143,488

Lease Liabilities	Balance Sheet Classification	December 31, 2023		December 31, 2022
Current:
Finance lease liabilities	Other accrued liabilities	$	990	$	990
Operating lease liabilities	Current portion of operating lease liabilities		26,268		26,463
Noncurrent:
Finance lease liabilities	Other liabilities		10,896		10,858
Operating lease liabilities	Operating lease liabilities		100,808		116,429
Total		$	138,962	$	154,740

Schedule of Weighted-average Remaining Lease Terms and Discount Rates

Weighted-average remaining lease terms and discount rates were as follows at December 31, 2023 and 2022:


	December 31,
	2023			2022
Weighted-average remaining lease term (in years):
Finance		20.9			21.9
Operating		8.1			8.4

Weighted-average discount rate:
Finance		5.1	%		5.1	%
Operating		5.7	%		5.0	%

Schedule of Lease Cost

The Company recorded the following lease costs for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023		2022		2021
Finance lease costs:
Depreciation of leased assets		378		378		378
Interest of lease liabilities		1,028		1,041		2,174
Total finance lease costs	$	1,406	$	1,419	$	2,552

Operating lease costs		34,400		34,349		28,233
Variable lease costs		3,319		3,129		2,488
Short term lease costs		3,237		2,605		3,257
Other lease costs		5,596		5,379		4,541
Total rents and leases	$	46,552	$	45,462	$	38,519

Total lease costs	$	47,958	$	46,881	$	41,071

Schedule of Undiscounted Cash Flows for Finance and Operating Leases

Undiscounted future cash flows for finance and operating leases recorded on the consolidated balance sheet were as follows at December 31, 2023 (in thousands):


	Finance Leases		Operating Leases
2023	$	1,006	$	32,767
2024		1,089		28,062
2025		1,089		21,578
2026		1,089		14,670
2027		1,089		11,348
Thereafter		20,733		57,375
Total minimum lease payments		26,095		165,800
Less: amount of lease payments representing interest		14,209		38,724
Present value of future minimum lease payments		11,886		127,076
Less: Current portion of lease liabilities		990		26,268
Noncurrent lease liabilities	$	10,896	$	100,808

Schedule of Supplemental Data

Supplemental data for the years ended December 31, 2023, 2022 and 2021 were as follows (in thousands):


	Year Ended December 31,
	2023			2022			2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	34,940		$	33,836		$	27,508
Operating cash flows for finance leases	$	1,028		$	1,041		$	2,174
Financing cash flows for finance leases	$	(38	)	$	(51	)	$	31,136

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	14,714		$	31,294		$	63,279
Finance leases	$	—		$	—		$	—

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

12 Months Ended

Dec. 31, 2023

Schedule of Revenue Attributed to Each Category

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


	Year Ended December 31,
	2023		2022		2021
Acute inpatient psychiatric facilities	$	1,489,248	$	1,330,757	$	1,126,872
Specialty treatment facilities		614,220		564,671		510,929
Comprehensive treatment centers		500,242		419,940		385,635
Residential treatment centers		325,028		295,031		283,169
Other		—		—		7,789
Revenue	$	2,928,738	$	2,610,399	$	2,314,394

Schedule of Revenue and Percentage Generated by Each Payor Type

The following table presents revenue by payor type and as a percentage of revenue for continuing operations for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023					2022					2021
	Amount		%			Amount		%			Amount		%
Commercial	$	820,701		28.0	%	$	788,895		30.2	%	$	684,292		29.6	%
Medicare		441,761		15.1	%		394,227		15.1	%		364,598		15.8	%
Medicaid		1,578,518		53.9	%		1,319,600		50.6	%		1,147,884		49.6	%
Self-Pay		67,583		2.3	%		76,050		2.9	%		93,425		4.0	%
Other		20,175		0.7	%		31,627		1.2	%		24,195		1.0	%
Revenue	$	2,928,738		100.0	%	$	2,610,399		100.0	%	$	2,314,394		100.0	%

Fair Value Measurements - Carrying Amounts and Fair Values of Credit Facilities and Contingent Consideration Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Carrying Amount [Member] \| Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Revolving Facility	$ 455,880	$ 471,488
Carrying Amount [Member] \| 5.500% Senior Notes due 2028 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	445,539	444,694
Carrying Amount [Member] \| 5.000% Senior Notes due 2029 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	470,348	469,609
Fair Value [Member] \| Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Secured	455,880	471,488
Fair Value [Member] \| 5.500% Senior Notes due 2028 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	436,628	422,459
Fair Value [Member] \| 5.000% Senior Notes due 2029 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	$ 451,534	$ 433,214

Leases - Schedule of Undiscounted Future Cash Flows for Finance and Operating Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Finance Leases
2023	$ 1,006
2024	1,089
2025	1,089
2026	1,089
2027	1,089
Thereafter	20,733
Total minimum lease payments	26,095
Less: amount of lease payments representing interest	14,209
Present value of future minimum lease payments	11,886
Less: Current portion of lease liabilities	990	$ 990
Noncurrent lease liabilities	10,896	10,858
Operating Leases
2023	32,767
2024	28,062
2025	21,578
2026	14,670
2027	11,348
Thereafter	57,375
Total minimum lease payments	165,800
Less: amount of lease payments representing interest	38,724
Present value of future minimum lease payments	127,076
Current portion of operating lease liabilities	26,268	26,463
Operating lease liabilities	$ 100,808	$ 116,429

Long-Term Debt (5.000% Senior Notes due 2029) - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
	Oct. 14, 2020	Dec. 31, 2023	Dec. 31, 2021	Dec. 31, 2022
Debt Instrument [Line Items]
Debt extinguishment costs			$ (24,650)
5.000% Senior Notes due 2029 [Member]
Debt Instrument [Line Items]
Issued Senior Notes	$ 475,000
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, commencing on April 15, 2021

- 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

U.K. Sale - Additional Information (Detail) - USD ($) $ in Thousands		3 Months Ended			12 Months Ended
	Jan. 19, 2021	Dec. 31, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2021	Dec. 31, 2020
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gross proceeds from sale of business		$ 1,500	$ 4,300		$ 1,511,020
Loss on sale				$ 14,300		$ 867,300
Discontinued Operation, Gain (Loss) on Disposal, Statement of Income or Comprehensive Income [Extensible Enumeration]				Debt extinguishment costs		Debt extinguishment costs
Discontinued Operations [Member] \| U.K. Sales [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gross proceeds from sale of business	$ 1,525,000
Settlement of existing foreign currency hedging liabilities	85,000
Net proceeds from sale of business	$ 1,425,000
Cash from the balance sheet to reduce debt, amount				$ 1,640,000
Goodwill impairment loss						$ 356,200

Other Current Assets - Other Current Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Prepaid expenses	$ 36,085	$ 27,052
Insurance receivable - current portion	33,579	10,158
Other receivables	22,084	15,371
Income taxes receivable	12,416	5,767
Workers’ compensation deposits – current portion	12,000	12,000
Assets held for sale	11,496	8,347
Inventory	5,300	5,087
Other	1,516	2,255
Other current assets	$ 134,476	$ 86,037

Description of Business and Basis of Presentation

12 Months Ended

Dec. 31, 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 acute inpatient psychiatric facilities, specialty treatment facilities, comprehensive treatment centers (“CTCs”), residential treatment centers and facilities providing outpatient behavioral healthcare services to serve the behavioral healthcare and recovery needs of communities throughout the United States (the “U.S.”) and Puerto Rico. At December 31, 2023, the Company operated 253 behavioral healthcare facilities with approximately 11,200 beds in 38 states and Puerto Rico.

On January 19, 2021, the Company completed the sale of its operations in the United Kingdom (the “U.K.”) to RemedcoUK Limited, a company organized under the laws of England and Wales and owned by funds managed or advised by Waterland Private Equity Fund VII (the “U.K. Sale”). The U.K. Sale allowed the Company to reduce its indebtedness and focus on its U.S. operations. As a result of the U.K. Sale, the Company reported, for all periods presented, results of operations and cash flows of the U.K. operations as discontinued operations in the accompanying financial statements. See Note 21 – U.K. Sale.

Basis of Presentation

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

The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”). The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates. The majority of the Company’s expenses are “cost of revenue” items. Costs that could be classified as general and administrative expenses include the Company’s corporate office costs, which were $153.3 million, $124.3 million and $108.2 million for the years ended December 31, 2023, 2022 and 2021, respectively.

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

Equity-Based Compensation - Schedule of Stock Options Valuation Assumptions (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-Based Payment Arrangement [Abstract]
Weighted average grant-date fair value of options	$ 30.99	$ 20.72	$ 20.64
Risk-free interest rate	4.20%	2.00%	0.90%
Expected volatility	37.00%	39.00%	40.00%
Expected life (in years)	5 years	5 years	5 years

Long-Term Debt (Debt Issuance Costs) - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
Debt issuance costs	$ 10.4	$ 12.6
Accumulated amortization	6.8	4.6
Amortization expenses reported as interest expense	$ 2.2	$ 2.2	$ 2.8

Leases

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Leases

9. Leases

The Company’s lease portfolio primarily consists of finance and operating real estate leases integral for facility operations. The original terms of the leases typically range from five to thirty years with optional renewal periods. A minimal portion of the Company’s lease portfolio consists of non-real estate leases, including copiers and equipment, which generally have lease terms of one to three years and have insignificant lease obligations.

The Company elected the accounting policy practical expedients by class of underlying asset in ASC 842 “Leases” to: (i) combine associated lease and non-lease components into a single lease component; and (ii) exclude recording short-term leases as right-of-use assets and liabilities on the consolidated balance sheets. Non-lease components, which are not significant overall, are combined with lease components.

Operating lease liabilities are recorded at the present value of remaining lease payments not yet paid for the lease term discounted using the incremental borrowing rate associated with each lease. Operating lease right-of-use assets represent operating lease liabilities adjusted for prepayments, accrued lease payments, lease incentives and initial direct costs. Certain of the Company’s leases include renewal or termination options. Calculation of operating lease right-of-use assets and liabilities include the initial lease term unless it is reasonably certain a renewal or termination option will be exercised. Variable components of lease payments fluctuating with a future index or rate, as well as those related to common area maintenance costs, are not included in determining lease liabilities and are expensed as incurred. Most of the Company’s leases do not contain implicit borrowing rates, and therefore, incremental borrowing rates were calculated based on information available at the lease commencement date. The Company reviews service agreements for embedded leases and records right-of-use assets and liabilities as necessary.

The Company recorded non-cash operating lease right-of-use asset impairment charges of $2.3 million related to the closure of certain facilities, which is included in loss on impairment in the condensed consolidated statements of operations.

Lease Position

The Company recorded the following at December 31, 2023 and 2022 on the consolidated balance sheets (in thousands):


Right-of-Use Assets	Balance Sheet Classification	December 31, 2023		December 31, 2022
Finance lease right-of-use assets	Property and equipment, net	$	7,872	$	8,250
Operating lease right-of-use assets	Operating lease right-of-use assets		117,780		135,238
Total		$	125,652	$	143,488

Lease Liabilities	Balance Sheet Classification	December 31, 2023		December 31, 2022
Current:
Finance lease liabilities	Other accrued liabilities	$	990	$	990
Operating lease liabilities	Current portion of operating lease liabilities		26,268		26,463
Noncurrent:
Finance lease liabilities	Other liabilities		10,896		10,858
Operating lease liabilities	Operating lease liabilities		100,808		116,429
Total		$	138,962	$	154,740

Weighted-average remaining lease terms and discount rates were as follows at December 31, 2023 and 2022:


	December 31,
	2023			2022
Weighted-average remaining lease term (in years):
Finance		20.9			21.9
Operating		8.1			8.4

Weighted-average discount rate:
Finance		5.1	%		5.1	%
Operating		5.7	%		5.0	%

Lease Costs

The Company recorded the following lease costs for the years ended December 31, 2023, 2022 and 2021 (in thousands):


	Year Ended December 31,
	2023		2022		2021
Finance lease costs:
Depreciation of leased assets		378		378		378
Interest of lease liabilities		1,028		1,041		2,174
Total finance lease costs	$	1,406	$	1,419	$	2,552

Operating lease costs		34,400		34,349		28,233
Variable lease costs		3,319		3,129		2,488
Short term lease costs		3,237		2,605		3,257
Other lease costs		5,596		5,379		4,541
Total rents and leases	$	46,552	$	45,462	$	38,519

Total lease costs	$	47,958	$	46,881	$	41,071

Other

Undiscounted future cash flows for finance and operating leases recorded on the consolidated balance sheet were as follows at December 31, 2023 (in thousands):


	Finance Leases		Operating Leases
2023	$	1,006	$	32,767
2024		1,089		28,062
2025		1,089		21,578
2026		1,089		14,670
2027		1,089		11,348
Thereafter		20,733		57,375
Total minimum lease payments		26,095		165,800
Less: amount of lease payments representing interest		14,209		38,724
Present value of future minimum lease payments		11,886		127,076
Less: Current portion of lease liabilities		990		26,268
Noncurrent lease liabilities	$	10,896	$	100,808

Supplemental data for the years ended December 31, 2023, 2022 and 2021 were as follows (in thousands):


	Year Ended December 31,
	2023			2022			2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	34,940		$	33,836		$	27,508
Operating cash flows for finance leases	$	1,028		$	1,041		$	2,174
Financing cash flows for finance leases	$	(38	)	$	(51	)	$	31,136

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	14,714		$	31,294		$	63,279
Finance leases	$	—		$	—		$	—

Transaction, Legal and Other Costs - Transaction, Legal and Other Costs as Incurred (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Transaction Legal and Other Costs [Abstract]
Legal, accounting and other acquisition-related costs	$ 31,335	$ 5,741	$ 7,435
Management transition costs	23,283	11,575
Termination and restructuring costs	7,408	6,476	5,343
Transaction, legal and other costs	$ 62,026	$ 23,792	$ 12,778

Commitments and Contingencies

12 Months Ended

Dec. 31, 2023

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

11. Commitments and Contingencies

The Company is, from time to time, subject to various claims, lawsuits, governmental investigations and regulatory actions, including claims for damages for personal injuries, medical malpractice, overpayments, breach of contract, securities law violations, tort and employment related claims. In these actions, plaintiffs request a variety of damages, including, in some instances, punitive and other types of damages that may not be covered by insurance. In addition, healthcare companies are subject to numerous investigations by various governmental agencies. Certain of the Company’s individual facilities have received, and from time to time, other facilities may receive, subpoenas, civil investigative demands, audit requests and other inquiries from, and may be subject to investigation by, federal and state agencies. These investigations can result in repayment obligations and violations of the 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 by a foster parent, Clarence Garcia, 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: Dorsey, as Guardian ad Litem of M.R. v. Clarence Garcia, et al., and Higgins, as Guardian ad Litem of J.H. v. Clarence Garcia, et al. While the plaintiffs in those cases had claims pending against FamilyWorks, and FamilyWorks had raised claims or potential claims against the Company, in February 2024, the parties in each of those cases jointly notified the District Court that proposed settlements of all claims had been reached and that, pending the District Court's approval of such proposed settlements, the proposed settlements would also resolve all claims between FamilyWorks and the Company. The Company currently reasonably expects the proposed settlements to be approved by the District Court in the coming months.

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.

On October 30, 2023, the Company and Desert Hills entered into settlement agreements in connection with the Inman Litigation, as well as 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”).

The settlement agreements were approved by the District Court in December 2023 and fully resolve each of the Cases with no admission of liability or wrongdoing by either the Company or Desert Hills. On January 19, 2024, pursuant to the terms of the settlement agreements, the Company paid 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.

On January 30, 2024, a sixth lawsuit styled CNRAG, Inc. as Legal Guardian of A.C. v. Garcia et al., No. D-117-CV-2024-00045 was filed in the District Court alleging similar claims as the previous five lawsuits in the Desert Hills Litigation. The lawsuit has not been formally served. The ward in this sixth lawsuit was referenced in prior criminal charges against Garcia five years ago; however, prior to this lawsuit, neither the ward nor guardian made contact with the Company about a possible claim. The Company determined that a lawsuit from this plaintiff was unlikely because no claims had ever been asserted and the statute of limitations had expired. Plaintiff’s allegations assert certain claims, which, if true, may toll the statute of limitations. At this time, the Company is not able to quantify the ultimate liability, if any, in connection with this sixth lawsuit. No additional victims are referenced in the prior criminal charges against Garcia.

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.

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.

Government Investigation

In the fall of 2017, the Office of Inspector General (the “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. In June 2023, the State of Nevada issued a subpoena relating to one of the same facilities as part of the same investigation 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 has reached a tentative agreement to resolve the matter and the anticipated financial impact of such a resolution is $19.9 million and has been recorded within other accrued liabilities on the condensed consolidated balance sheets and within transaction, legal and other costs on the condensed consolidated statement of operations.

Noncontrolling Interests - Summary of Redeemable Noncontrolling Interests (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Noncontrolling Interest [Abstract]
Beginning Balance	$ 88,257	$ 65,388
Contributions from noncontrolling partners in joint ventures	21,162	16,530
Net income attributable to noncontrolling interests	6,894	6,006
Acquisition of ownership interests from noncontrolling partners	(4,183)
Distributions to noncontrolling partners in joint ventures	(1,004)	(5,107)
Ending Balance	$ 105,686	$ 88,257

Leases - Schedule of Leases on Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Finance lease right-of-use assets	$ 7,872	$ 8,250
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Property and equipment, net	Property and equipment, net
Operating lease right-of-use assets	$ 117,780	$ 135,238
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Operating lease right-of-use assets	Operating lease right-of-use assets
Total	$ 125,652	$ 143,488
Finance lease liabilities	$ 990	$ 990
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other accrued liabilities	Other accrued liabilities
Operating lease liabilities	$ 26,268	$ 26,463
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Operating lease liabilities	Operating lease liabilities
Finance lease liabilities	$ 10,896	$ 10,858
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other liabilities	Other liabilities
Operating lease liabilities	$ 100,808	$ 116,429
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Operating lease liabilities	Operating lease liabilities
Total	$ 138,962	$ 154,740

Commitments and Contingencies (Additional Information) (Details) - USD ($) $ in Millions	Jan. 19, 2024	Jul. 07, 2023	Dec. 31, 2023
Loss Contingencies [Line Items]
Anticipated financial impact value			$ 19.9
Subsequent Event [Member]
Loss Contingencies [Line Items]
Aggregate amount on settlement agreements	$ 400.0
Inman Litigation [Member] \| Compensatory Damages [Member]
Loss Contingencies [Line Items]
Awarded plaintiff damages amount		$ 80.0
Inman Litigation [Member] \| Punitive Damages [Member]
Loss Contingencies [Line Items]
Awarded plaintiff damages amount		$ 405.0

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Summary of Property and Equipment

Property and equipment consisted of the following at December 31, 2023 and 2022 (in thousands):


	December 31,
	2023			2022
Land	$	183,347		$	169,137
Building and improvements		2,064,353			1,797,809
Equipment		365,826			292,200
Construction in progress		420,430			349,473
		3,033,956			2,608,619
Less: accumulated depreciation		(767,346	)		(656,574	)
Property and equipment, net	$	2,266,610		$	1,952,045

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net Income (Loss)	$ (21,667)	$ 273,139	$ 190,635

- Definition

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

+ References

+ Details

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Components of (Benefit from) Provision for Income Taxes

(Benefit from) provision for income taxes from continuing operations consists of the following for the periods presented (in thousands):


	Year Ended December 31,
	2023			2022		2021
Current:
Federal	$	68,939		$	63,041	$	48,292
State		14,413			13,769		6,715
Foreign		933			755		778
Total current provision		84,285			77,565		55,785
Deferred:
Federal		(72,046	)		9,808		13,339
State		(22,495	)		6,377		(1,892	)
Foreign		557			360		325
Total deferred provision		(93,984	)		16,545		11,772
(Benefit from) provision for income taxes	$	(9,699	)	$	94,110	$	67,557

Effective Income Tax Rate

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


	Year Ended December 31,
	2023			2022			2021
U.S. federal statutory rate on income before income taxed		21.0	%		21.0	%		21.0	%
Impact of foreign operations		(2.2	)		(0.1	)		1.7
State income taxes, net of federal tax effect		45.6			4.7			3.9
Nondeductible expenses and permanent differences		(30.7	)		0.4			2.1
Change in valuation allowance		(0.1	)		0.2			(2.8	)
Unrecognized tax benefit		(14.8	)		—			(0.9	)
Federal tax credits		9.8			(0.6	)		(0.8	)
Noncontrolling interest		7.4			(0.4	)		(0.4	)
Other		2.2			—			0.7
Effective income tax rate		38.2	%		25.2	%		24.5	%

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

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


	Year Ended December 31,
	2023			2022		2021
Foreign	$	5,889		$	5,420	$	5,596
Domestic		(31,249	)		368,723		270,164
(Loss) income from continuing operations before income taxes	$	(25,360	)	$	374,143	$	275,760

Deferred Tax Assets and Liabilities


	December 31,
	2023			2022
Deferred tax assets:
Net operating losses and tax credit carryforwards – federal and state	$	5,729		$	7,333
Capital loss carryovers		215,175			215,745
Bad debt allowance		1,780			1,148
Accrued compensation and severance		18,250			18,784
Insurance reserves		17,343			20,924
Leases		948			862
Accrued expenses		1,091			—
Accrued Desert Hills settlement		104,636			—
Interest carryforward		2,430			2,639
Lease right-of-use liabilities		29,781			26,277
Fixed asset basis difference		2,914			2,128
Other assets		9,130			8,987
Total gross deferred tax assets		409,207			304,827
Less: valuation allowance		(217,137	)		(217,705	)
Deferred tax assets		192,070			87,122
Deferred tax liabilities:
Prepaid items		(4,609	)		(3,714	)
Accrued expenses		—			(5,713	)
Intangible assets		(152,284	)		(139,843	)
Lease right-of-use assets		(27,800	)		(24,960	)
Investment in foreign subsidiary		(2,650	)		(2,530	)
Total deferred tax liabilities		(187,343	)		(176,760	)
Total net deferred tax asset (liability)	$	4,727		$	(89,638	)

Unrecognized Income Tax Benefits

A reconciliation of the beginning and ending amount of unrecognized income tax benefits, exclusive of any interest and penalties, is as follows (in thousands):


	2023		2022		2021
Balance at January 1	$	—	$	—	$	2,060
Additions based on tax positions related to the current year		—		—		—
Additions for tax positions of prior years		3,089		—		—
Reductions as a result of the lapse of applicable statutes of limitations		—		—		(2,060	)
Balance at December 31	$	3,089	$	—	$	—

U.K. Sale

12 Months Ended

Dec. 31, 2023

Discontinued Operations and Disposal Groups [Abstract]

U.K. Sale

22. U.K. Sale

On January 19, 2021, the Company completed the U.K. Sale pursuant to a Share Purchase Agreement in which it sold all of the securities of AHC-WW Jersey Limited, a private limited liability company incorporated in Jersey and a subsidiary of the Company, which constituted the entirety of the Company’s U.K. operations. The U.K. Sale resulted in approximately $1,525 million of gross proceeds before deducting the settlement of existing foreign currency hedging liabilities of $85 million based on the current British Pounds (“GBP”) to U.S. Dollars (“USD”) exchange rate, cash retained by the buyer and transaction costs. The Company used the net proceeds of approximately $1,425 million (excluding cash retained by the buyer) along with cash on the balance sheet to reduce debt by $1,640 million during the first quarter of 2021 as described in Note 13 – Long-Term Debt.

As a result of the U.K. Sale, the Company reported, for all periods presented, results of operations and cash flows of the U.K. operations as discontinued operations in the accompanying financial statements. In December 2020, the Company’s U.K. operations met the criteria to be classified as assets held for sale. The carrying value of the U.K. operations was written down to fair value less costs to sell in the consolidated balance sheet at December 31, 2020. This resulted in a loss on sale of $867.3 million, which includes approximately $356.2 million of non-cash goodwill impairment, recorded within discontinued operations in the

consolidated statement of operations. During the first quarter of 2021, an additional $14.3 million was recorded as a loss on sale primarily resulting from an increase in the U.K. operations carrying value.

For the year ended December 31, 2021, results of operations of the U.K. operations were as follows (in thousands):


Revenue	$	62,520
Salaries, wages and benefits		35,937
Professional fees		6,815
Supplies		2,217
Rents and leases		2,509
Other operating expenses		6,682
Depreciation and amortization		—
Interest expense, net		10
Loss on sale		13,490
Loss on impairment		—
Transaction, legal and other costs		6,265
Total expenses		73,925
Loss from discontinued operations before income taxes		(11,405	)
Provision for income taxes		1,236
Loss from discontinued operations	$	(12,641	)

Revenue - Schedule of Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 2,928,738	$ 2,610,399	$ 2,314,394
U.S. Facilities [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 2,928,738	$ 2,610,399	$ 2,314,394
Revenue, Percentage	100.00%	100.00%	100.00%
U.S. Facilities [Member] \| Commercial [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 820,701	$ 788,895	$ 684,292
Revenue, Percentage	28.00%	30.20%	29.60%
U.S. Facilities [Member] \| Medicare [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 441,761	$ 394,227	$ 364,598
Revenue, Percentage	15.10%	15.10%	15.80%
U.S. Facilities [Member] \| Medicaid [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 1,578,518	$ 1,319,600	$ 1,147,884
Revenue, Percentage	53.90%	50.60%	49.60%
U.S. Facilities [Member] \| Self-Pay [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 67,583	$ 76,050	$ 93,425
Revenue, Percentage	2.30%	2.90%	4.00%
U.S. Facilities [Member] \| Other [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 20,175	$ 31,627	$ 24,195
Revenue, Percentage	0.70%	1.20%	1.00%

- Definition

+ References

+ Details

Subsequent Events - Additional Information (Details) - USD ($) $ in Millions			1 Months Ended
	Jan. 19, 2024	Jan. 18, 2024	Jul. 31, 2023	Mar. 17, 2021
Turning Point Centers [Member]
Subsequent Event [Line Items]
Business acquisition transaction closing date			Feb. 22, 2024
Credit Facility [Member] \| Incremental Term Loans [Member]
Subsequent Event [Line Items]
Line of credit outstanding principal amount				$ 425.0
Subsequent Event [Member]
Subsequent Event [Line Items]
Aggregate amount on settlement agreements	$ 400.0
Subsequent Event [Member] \| Credit Facility [Member]
Subsequent Event [Line Items]
Line of credit outstanding principal amount		$ 425.0
Term loan remaining balance due date		Mar. 17, 2026
Subsequent Event [Member] \| Credit Facility [Member] \| Incremental Term Loans [Member]
Subsequent Event [Line Items]
Line of credit outstanding principal amount		$ 425.0
Subsequent Event [Member] \| Credit Facility [Member] \| Second Amemdment [Member] \| Incremental Term Loans [Member]
Subsequent Event [Line Items]
Line of credit outstanding principal amount		350.0
Subsequent Event [Member] \| Credit Facility [Member] \| March 31, 2024 [Member]
Subsequent Event [Line Items]
Term loan principal repayments		10.2
Subsequent Event [Member] \| Credit Facility [Member] \| March 31, 2024 [Member] \| Incremental Term Loans [Member]
Subsequent Event [Line Items]
Term loan principal repayments		10.2
Subsequent Event [Member] \| Credit Facility [Member] \| June 30, 2024 to March 31, 2025 [Member]
Subsequent Event [Line Items]
Term loan principal repayments		15.4
Subsequent Event [Member] \| Credit Facility [Member] \| June 30, 2024 to March 31, 2025 [Member] \| Incremental Term Loans [Member]
Subsequent Event [Line Items]
Term loan principal repayments		15.4
Subsequent Event [Member] \| Credit Facility [Member] \| June 30, 2025 to December 31, 2025 [Member]
Subsequent Event [Line Items]
Term loan principal repayments		20.5
Subsequent Event [Member] \| Credit Facility [Member] \| June 30, 2025 to December 31, 2025 [Member] \| Incremental Term Loans [Member]
Subsequent Event [Line Items]
Term loan principal repayments		$ 20.5

Long-Term Debt (Redemption of 5.265% Senior Notes and 6.500% Senior Notes) - Additional Information (Detail) - USD ($) $ in Thousands				12 Months Ended
	Mar. 17, 2021	Mar. 01, 2021	Jan. 29, 2021	Dec. 31, 2021
Debt Instrument [Line Items]
Debt extinguishment costs				$ (24,650)
Redemption of 5.265% Senior Notes [Member]
Debt Instrument [Line Items]
Senior Notes			$ 650,000
Debt instrument interest rate			5.625%
Debt extinguishment costs	$ 3,300
Redemption of 6.500% Senior Notes [Member]
Debt Instrument [Line Items]
Senior Notes			$ 390,000
Debt instrument interest rate			6.50%
Debt extinguishment costs		$ 10,500
Cash paid for breakage costs		6,300
Write off of deferred financing costs		$ 4,200
Redemption of 5.265% Senior Notes and 6.500% Senior Notes [Member]
Debt Instrument [Line Items]
Term loan remaining balance due date			Jan. 29, 2021

Other Intangible Assets

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Other Intangible Assets

8. Other Intangible Assets

Other identifiable intangible assets and related accumulated amortization consisted of the following at December 31, 2023 and 2022 (in thousands):


	Gross Carrying Amount				Accumulated Amortization
	December 31, 2023		December 31, 2022		December 31, 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		11,681		11,512		—			—
Trade names		42,588		45,935		—			—
Certificates of need		19,009		18,594		—			—
		73,278		76,041		—			—
Total	$	74,409	$	77,172	$	(1,131	)	$	(1,131	)

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

During the year ended December 31, 2023, the Company recorded a non-cash indefinite-lived intangible asset impairment charge of $5.4 million related to the closure of certain facilities, which is included in loss on impairment in the condensed consolidated statements of operations.

Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2021 USD ($)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	$ 1,899,456
Foreign currency translation gain (loss)	(4,260)
Gain on derivative instruments, net of tax of $0.1 million	19
U.K. Sale	375,606
Balance	2,517,489
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(373,101)
Foreign currency translation gain (loss)	(4,293)
U.K. Sale	377,394
Change in Fair Value of Derivative Instruments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	13,686
Gain on derivative instruments, net of tax of $0.1 million	19
U.K. Sale	(13,705)
Pension Plan [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(11,950)
Foreign currency translation gain (loss)	33
U.K. Sale	11,917
Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	$ (371,365)

- 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

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

+ References

+ Details

Employee Benefit Plans

12 Months Ended

Dec. 31, 2023

Retirement Benefits [Abstract]

Employee Benefit Plans

21. Employee Benefit Plans

The Company maintains a qualified defined contribution 401(k) plan covering substantially all of its employees. The Company may, at its discretion, make contributions to the plan. The Company recorded expense of $10.9 million, $6.6 million and $2.8 million related to the 401(k) plan for the years ended December 31, 2023, 2022 and 2021, respectively.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 70
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-Section 50
-Paragraph 1
-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 715
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-Paragraph 17
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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+ Details