0000950170-24-052085 | 10-Q | XBRL Viewer | Acadia Healthcare Company INC

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Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Mar. 31, 2024	Dec. 31, 2023
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	91,573,596	91,263,989
Common stock, shares outstanding	91,573,596	91,263,989

Acquisitions

3 Months Ended

Mar. 31, 2024

Business Combinations [Abstract]

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.

On February 22, 2024, the Company acquired 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.

Goodwill

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


Balance at January 1, 2023	$	2,222,805
Increase from acquisitions		337
Increase from contributions of redeemable noncontrolling interests		2,820
Balance at December 31, 2023		2,225,962
Increase from acquisitions		35,064
Balance at March 31, 2024	$	2,261,026

Long-Term Debt (5.000% Senior Notes due 2029) - Additional Information (Detail) - 5.000% Senior Notes due 2029 [Member] - USD ($) $ in Millions		3 Months Ended
	Oct. 14, 2020	Mar. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Issued Senior Notes	$ 475.0
Debt instrument interest rate	5.00%	5.00%	5.00%
Debt instrument maturity date	Apr. 15, 2029
Interest on the notes		payable semi-annually in arrears on April 15 and October 15 of each year, 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

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+ Details

Other Accrued Liabilities

3 Months Ended

Mar. 31, 2024

Other Liabilities Disclosure [Abstract]

Other Accrued Liabilities

11.

Other Accrued Liabilities

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


	March 31, 2024		December 31, 2023
Accrued expenses	$	63,582	$	80,733
Accrued interest		18,446		18,046
Insurance liability – current portion		12,486		12,486
Accrued property taxes		6,381		7,097
Cost report payable		4,363		9,265
Contract liabilities		2,154		2,165
Finance lease liabilities		990		990
Accrued Desert Hills settlement		—		393,696
Other		11,509		7,783
Other accrued liabilities	$	119,911	$	532,261

Equity-Based Compensation - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized common stock	12,700,000
Equity incentive plan available for future grant	2,253,481
Stock options, contractual term	10 years
Equity-based compensation expense	$ 8,678	$ 7,629
Unrecognized compensation expense related to unvested options	$ 87,900
Vesting period	1 year 3 months 18 days
Deferred income tax benefit	$ 17,476	212
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual increments in employee grants	25.00%
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual increments in employee grants	33.00%
Stock Compensation Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Deferred income tax benefit	$ 2,400	$ 2,100
Restricted Stock Units [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years
Number of shares issuable at the end of the vesting period, percentage	0.00%
Restricted Stock Units [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	4 years
Number of shares issuable at the end of the vesting period, percentage	200.00%
Performance Stock Units [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years

Long-Term Debt - Components of Long-Term Debt (Parenthetical) (Detail)	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023	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

Noncontrolling Interests - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2024 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%

Equity-Based Compensation - Schedule of Stock Options Valuation Assumptions (Detail) - $ / shares	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Weighted average grant-date fair value of options	$ 30.99	$ 30.99
Risk-free interest rate	4.00%	4.20%
Expected volatility	34.00%	37.00%
Expected life (in years)	5 years	5 years

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

3 Months Ended

Mar. 31, 2024

Schedule of Revenue Attributed to Each Category

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


	Three Months Ended March 31,
	2024		2023
Acute inpatient psychiatric facilities	$	406,422	$	361,811
Specialty treatment facilities		143,832		147,303
Comprehensive treatment centers		132,167		115,501
Residential treatment centers		85,630		79,652
Revenue	$	768,051	$	704,267

Schedule of Revenue and Percentage Generated by Each Payor Type

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


	Three Months Ended March 31,
	2024					2023
	Amount		%			Amount		%
Commercial	$	196,017		25.5	%	$	203,619		28.9	%
Medicare		109,388		14.2	%		108,640		15.4	%
Medicaid		436,422		56.9	%		364,306		51.8	%
Self-Pay		16,427		2.1	%		20,698		2.9	%
Other		9,797		1.3	%		7,004		1.0	%
Revenue	$	768,051		100.0	%	$	704,267		100.0	%

Noncontrolling Interests - Summary of Redeemable Noncontrolling Interests (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Noncontrolling Interest [Abstract]
Beginning Balance	$ 105,686	$ 88,257
Contributions from noncontrolling partners in joint ventures	2,280	16,530
Net income attributable to noncontrolling interests	2,387	6,006
Distributions to noncontrolling partners in joint ventures	(1,020)	(5,107)
Ending Balance	$ 109,333	$ 105,686

Other Accrued Liabilities (Tables)

3 Months Ended

Mar. 31, 2024

Other Liabilities Disclosure [Abstract]

Summary of Other Accrued Liabilities

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


	March 31, 2024		December 31, 2023
Accrued expenses	$	63,582	$	80,733
Accrued interest		18,446		18,046
Insurance liability – current portion		12,486		12,486
Accrued property taxes		6,381		7,097
Cost report payable		4,363		9,265
Contract liabilities		2,154		2,165
Finance lease liabilities		990		990
Accrued Desert Hills settlement		—		393,696
Other		11,509		7,783
Other accrued liabilities	$	119,911	$	532,261

Property and Equipment (Tables)

3 Months Ended

Mar. 31, 2024

Property Plant And Equipment [Abstract]

Summary of Property and Equipment

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


	March 31, 2024			December 31, 2023
Land	$	195,216		$	183,347
Building and improvements		2,088,489			2,064,353
Equipment		383,053			365,826
Construction in progress		506,010			420,430
		3,172,768			3,033,956
Less: accumulated depreciation		(796,709	)		(767,346	)
Property and equipment, net	$	2,376,059		$	2,266,610

The Company has recorded assets held for sale within other current assets on the consolidated balance sheets for closed properties actively marketed of $12.9 million and $11.5 million at March 31, 2024 and December 31, 2023, respectively.

Fair Value Measurements (Tables)

3 Months Ended

Mar. 31, 2024

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 March 31, 2024 and December 31, 2023 were as follows (in thousands):


	Carrying Amount				Fair Value
	March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023
Credit Facility	$	939,450	$	455,880	$	939,450	$	455,880
5.500% Senior Notes due 2028	$	445,760	$	445,539	$	433,502	$	436,628
5.000% Senior Notes due 2029	$	470,538	$	470,348	$	444,658	$	451,534

The CARES Act

3 Months Ended

Mar. 31, 2024

Extraordinary And Unusual Items [Abstract]

The CARES Act

As part of the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”), the U.S. government announced it would offer $100 billion of relief to eligible healthcare providers. The Company accounts for government grants by analogizing to the grant model in accordance with International Accounting Standard 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.

The Company has participated in certain relief programs offered through the CARES Act, including receipt of funds relating to the Public Health and Social Services Emergency Fund (“PHSSE Fund”), also known as the Provider Relief Fund, and the American Rescue Plan (“ARP”) Rural Payments for Hospitals. 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.

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 the novel coronavirus known as COVID-19 (“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 these 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.

Equity-Based Compensation - Restricted Stock Unit Activity (Detail) - Restricted Stock Units [Member] - $ / shares	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	1,030,478	1,045,202
Granted, Number of Shares	366,652	587,239
Cancelled, Number of Shares	(20,668)	(198,740)
Vested, Number of Shares	(192,282)	(403,223)
Unvested, Number of Shares/Units, Ending balance	1,184,180	1,030,478
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 68.38	$ 54.89
Granted, Weighted Average Grant-Date Fair Value	79.36	76.32
Cancelled, Weighted Average Grant-Date Fair Value	65.79	57.21
Vested, Weighted Average Grant-Date Fair Value	57.59	50.48
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 73.57	$ 68.38

Condensed Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Revenue	$ 768,051	$ 704,267
Salaries, wages and benefits (including equity-based compensation expense of $8,678 and $7,629, respectively)	417,523	391,177
Professional fees	45,688	41,125
Supplies	26,652	26,021
Rents and leases	11,863	11,424
Other operating expenses	101,073	90,838
Depreciation and amortization	36,347	31,569
Interest expense, net	27,214	19,999
Transaction, legal and other costs	2,847	6,471
Total expenses	669,207	618,624
Income before income taxes	98,844	85,643
Provision for income taxes	20,074	19,085
Net income	78,770	66,558
Net income attributable to noncontrolling interests	(2,387)	(543)
Net income attributable to Acadia Healthcare Company, Inc.	$ 76,383	$ 66,015
Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$ 0.84	$ 0.73
Diluted	$ 0.83	$ 0.72
Weighted-average shares outstanding:
Basic	91,363	90,101
Diluted	92,010	91,391

Description of Business and Basis of Presentation - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2024 Bed State Facility
Accounting Policies [Abstract]
Number of facilities \| Facility	258
Number of beds \| Bed	11,300
Number of operating states \| State	38

Other Accrued Liabilities - Summary of Other Accrued Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Accounts Payable And Accrued Liabilities Current [Abstract]
Accrued expenses	$ 63,582	$ 80,733
Accrued interest	18,446	18,046
Insurance liability – current portion	12,486	12,486
Accrued property taxes	6,381	7,097
Cost report payable	4,363	9,265
Contract liabilities	2,154	2,165
Finance lease liabilities	$ 990	$ 990
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other accrued liabilities	Other accrued liabilities
Accrued Desert Hills settlement		$ 393,696
Other	$ 11,509	7,783
Other accrued liabilities	$ 119,911	$ 532,261

Other Current Assets

3 Months Ended

Mar. 31, 2024

Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]

Other Current Assets

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


	March 31, 2024		December 31, 2023
Income taxes receivable	$	38,427	$	12,416
Prepaid expenses		30,190		36,085
Insurance receivable – current portion		23,586		33,579
Other receivables		22,867		22,084
Assets held for sale		12,865		11,496
Workers’ compensation deposits – current portion		12,000		12,000
Inventory		5,745		5,300
Other		1,632		1,516
Other current assets	$	147,312	$	134,476

Variable Interest Entities (Tables)

3 Months Ended

Mar. 31, 2024

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Schedule of Consolidated VIEs Assets and Liabilities

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


	March 31, 2024		December 31, 2023
Cash and cash equivalents	$	63,571	$	55,149
Accounts receivable, net		36,746		34,910
Other current assets		2,739		2,193
Total current assets		103,056		92,252
Property and equipment, net		476,150		438,965
Goodwill		42,384		42,384
Intangible assets, net		18,313		18,295
Operating lease right-of-use assets		10,231		5,948
Total assets	$	650,134	$	597,844

Accounts payable	$	8,611	$	8,235
Accrued salaries and benefits		6,714		9,909
Current portion of operating lease liabilities		554		273
Other accrued liabilities		3,097		2,385
Total current liabilities		18,976		20,802
Operating lease liabilities		10,208		6,160
Total liabilities	$	29,184	$	26,962

- 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

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Operating activities:
Net income	$ 78,770	$ 66,558
Adjustments to reconcile net income to net cash (used in) provided by operating activities:
Depreciation and amortization	36,347	31,569
Amortization of debt issuance costs	1,016	824
Equity-based compensation expense	8,678	7,629
Deferred income taxes	17,476	212
Other	(4,094)	1,089
Change in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable, net	(22,930)	(23,968)
Other current assets	(15,629)	(23,430)
Other assets	696	(1,436)
Accounts payable and other accrued liabilities	(403,340)	13,633
Accrued salaries and benefits	(25,024)	(30,386)
Other liabilities	6,749	2,114
Net cash (used in) provided by operating activities	(321,285)	44,408
Investing activities:
Cash paid for acquisitions, net of cash acquired	(50,353)
Cash paid for capital expenditures	(142,410)	(66,525)
Proceeds from sale of property and equipment	9,056	409
Other	(907)	(794)
Net cash used in investing activities	(184,614)	(66,910)
Financing activities:
Borrowings on long-term debt	350,000
Principal payments on revolving credit facility	(15,000)
Principal payments on long-term debt	(10,242)	(5,313)
Payment of debt issuance costs	(1,518)
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(1,013)	(47,671)
Contributions from noncontrolling partners in joint ventures	2,280	1,655
Distributions to noncontrolling partners in joint ventures	(1,020)
Other	(358)	11
Net cash provided by (used in) financing activities	483,129	(11,318)
Net decrease in cash and cash equivalents	(22,770)	(33,820)
Cash and cash equivalents at beginning of the period	100,073	97,649
Cash and cash equivalents at end of the period	77,303	63,829
Effect of acquisitions:
Assets acquired, excluding cash	55,309
Liabilities assumed	(3,456)
Contingent consideration issued in connection with an acquisition	(1,500)
Cash paid for acquisitions, net of cash acquired	50,353
New Credit Facility [Member]
Financing activities:
Borrowings on revolving credit facility	$ 160,000	$ 40,000

Other Current Assets - Other Current Assets (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Income taxes receivable	$ 38,427	$ 12,416
Prepaid expenses	30,190	36,085
Insurance receivable – current portion	23,586	33,579
Other receivables	22,867	22,084
Assets held for sale	12,865	11,496
Workers’ compensation deposits – current portion	12,000	12,000
Inventory	5,745	5,300
Other	1,632	1,516
Other current assets	$ 147,312	$ 134,476

Variable Interest Entities

3 Months Ended

Mar. 31, 2024

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Variable Interest Entities

14.

Variable Interest Entities

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

At March 31, 2024, 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 March 31, 2024 and December 31, 2023 include total assets of variable interest entities of $650.1 million and $597.8 million, respectively, which cannot be used to settle the obligations of other entities. Consolidated liabilities at March 31, 2024 and December 31, 2023 include total liabilities of variable interest entities of $29.2 million and $27.0 million, respectively.

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


	March 31, 2024		December 31, 2023
Cash and cash equivalents	$	63,571	$	55,149
Accounts receivable, net		36,746		34,910
Other current assets		2,739		2,193
Total current assets		103,056		92,252
Property and equipment, net		476,150		438,965
Goodwill		42,384		42,384
Intangible assets, net		18,313		18,295
Operating lease right-of-use assets		10,231		5,948
Total assets	$	650,134	$	597,844

Accounts payable	$	8,611	$	8,235
Accrued salaries and benefits		6,714		9,909
Current portion of operating lease liabilities		554		273
Other accrued liabilities		3,097		2,385
Total current liabilities		18,976		20,802
Operating lease liabilities		10,208		6,160
Total liabilities	$	29,184	$	26,962

Acquisitions (Tables)

3 Months Ended

Mar. 31, 2024

Business Combinations [Abstract]

Summary of Changes in Goodwill

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


Balance at January 1, 2023	$	2,222,805
Increase from acquisitions		337
Increase from contributions of redeemable noncontrolling interests		2,820
Balance at December 31, 2023		2,225,962
Increase from acquisitions		35,064
Balance at March 31, 2024	$	2,261,026

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Paragraph 1
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Section 50
-Paragraph 1
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Section 50
-Paragraph 1
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Name Accounting Standards Codification
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Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Name Accounting Standards Codification
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-Paragraph 1
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Name Accounting Standards Codification
-Section 50
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1A

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-2

+ Details

Fair Value Measurements - Carrying Amounts and Fair Values of Credit Facilities and Contingent Consideration Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Carrying Amount [Member] \| Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Revolving Facility	$ 939,450	$ 455,880
Carrying Amount [Member] \| 5.500% Senior Notes due 2028 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	445,760	445,539
Carrying Amount [Member] \| 5.000% Senior Notes due 2029 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	470,538	470,348
Fair Value [Member] \| Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Secured	939,450	455,880
Fair Value [Member] \| 5.500% Senior Notes due 2028 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	433,502	436,628
Fair Value [Member] \| 5.000% Senior Notes due 2029 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	$ 444,658	$ 451,534

Long-Term Debt

3 Months Ended

Mar. 31, 2024

Debt Disclosure [Abstract]

Long-Term Debt

12.

Long-Term Debt

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


	March 31, 2024			December 31, 2023
Credit Facility:
Term Loan A	$	716,945		$	377,188
Revolving Line of Credit		225,000			80,000
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		(11,197	)		(10,421	)
		1,855,748			1,371,767
Less: current portion		(61,452	)		(29,219	)
Long-term debt	$	1,794,296		$	1,342,548

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 Amendment No. 1 to the Credit Facility (the “First Amendment”), which replaced the London Interbank Offered Rate (“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 $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 March 31, 2024, the Company was in compliance with all financial covenants.

During the three months ended March 31, 2024, the Company borrowed $160.0 million on the Revolving Facility and repaid $15.0 million of the balance outstanding. During the three months ended March 31, 2023, the Company borrowed $40.0 million on the Revolving Facility. The Company had $371.5 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 March 31, 2024.

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 indentures.

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Mar. 31, 2024
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

Property and Equipment

3 Months Ended

Mar. 31, 2024

Property Plant And Equipment [Abstract]

Property and Equipment

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


	March 31, 2024			December 31, 2023
Land	$	195,216		$	183,347
Building and improvements		2,088,489			2,064,353
Equipment		383,053			365,826
Construction in progress		506,010			420,430
		3,172,768			3,033,956
Less: accumulated depreciation		(796,709	)		(767,346	)
Property and equipment, net	$	2,376,059		$	2,266,610

Equity-Based Compensation

3 Months Ended

Mar. 31, 2024

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Equity-Based Compensation

15.

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 March 31, 2024, 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 2,253,481 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% or 33% each year, commencing one year after the date of grant. The exercise prices of stock options are equal to the most recent closing price of the Company’s common stock on the most recent trading date prior to the date of grant.

The Company recognized $8.7 million and $7.6 million in equity-based compensation expense for the three months ended March 31, 2024 and 2023, respectively. Stock compensation expense for the three months ended March 31, 2024 and 2023 is impacted by forfeiture adjustments and performance stock unit adjustments based on actual performance compared to vesting targets. At March 31, 2024, there was $87.9 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 1.3 years.

The Company recognized a deferred income tax benefit of $2.4 million and $2.1 million for the three months ended March 31, 2024 and 2023, respectively, related to equity-based compensation expense.

Stock Options

Stock option activity during 2023 and 2024 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, 2023		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
Options granted		1,000			84.18
Options exercised		(90,178	)		45.49
Options cancelled		(22,888	)		62.76
Options outstanding at March 31, 2024		824,479		$	57.24		7.10	$	18,435
Options exercisable at March 31, 2024		448,934		$	47.76		6.02	$	14,197

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 three months ended March 31, 2024 and year ended December 31, 2023:


	March 31, 2024			December 31, 2023
Weighted average grant-date fair value of options	$	30.99		$	30.99
Risk-free interest rate		4.0	%		4.2	%
Expected volatility		34	%		37	%
Expected life (in years)		5.0			5.0

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

Other Stock-Based Awards

Restricted stock unit activity during 2023 and 2024 was as follows:


	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2023		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
Granted		366,652			79.36
Cancelled		(20,668	)		65.79
Vested		(192,282	)		57.59
Unvested at March 31, 2024		1,184,180		$	73.57

Performance stock unit activity during 2023 and 2024 was as follows:


	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2023		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
Granted		—			—
Performance adjustment		(9,241	)		72.99
Cancelled		(98,504	)		61.52
Vested		—			—
Unvested at March 31, 2024		228,286		$	72.58

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 restricted stock units ranges from 0% to 200% of the targeted units based on the Company’s actual performance compared to the targets.

The fair values of 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.

Long-Term Debt (Credit Facility) - Additional Information (Detail) - USD ($)				3 Months Ended
	Jan. 18, 2024	Mar. 30, 2023	Mar. 17, 2021	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Debt Instrument [Line Items]
Repayments of revolving facility				$ 15,000,000
Credit Facility [Member]
Debt Instrument [Line Items]
Amount available under revolving line of credit				371,500,000
Repayments of revolving facility				15,000,000
Borrowings on revolving credit facility				$ 160,000,000	$ 40,000,000
Term loan remaining balance due date	Mar. 17, 2026
Maximum incremental debt amount						$ 480,000,000
Incremental debt amount maximum percentage of consolidated EBITDA				100.00%
Consolidated senior secured net leverage ratio				3.50%
Maximum consolidated net leverage ratio				4.50%
Increased consolidated net leverage ratio				5.00%
Minimum interest coverage ratio				3.00%
Credit Facility [Member] \| SOFR [Member]
Debt Instrument [Line Items]
Basis spread on variable rate		0.10%
Credit Facility [Member] \| June 30, 2024 to March 31, 2025 [Member]
Debt Instrument [Line Items]
Term loan principal repayments	$ 15,400,000
Credit Facility [Member] \| June 30, 2025 to December 31, 2025 [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	$ 225,000,000		80,000,000
Credit Facility [Member] \| Term Loan A- Facility [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount				716,945,000		$ 377,188,000
Debt instrument maturity date			Mar. 17, 2026
Credit Facility [Member] \| Letters of Credit [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount			$ 20,000,000
Credit Facility [Member] \| 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		$ 425,000,000
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]
Debt Instrument [Line Items]
Line of credit outstanding principal amount	$ 350,000,000

Equity-Based Compensation - Performance Stock Unit Activity (Detail) - Performance Stock Units [Member] - $ / shares	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	336,031	1,273,800
Granted, Number of Units		177,509
Performance adjustment, Number of Units	(9,241)	407,825
Cancelled, Number of Units	(98,504)	(114,908)
Vested, Number of Units		(1,408,195)
Unvested, Number of Shares/Units, Ending balance	228,286	336,031
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 69.35	$ 20.69
Granted, Weighted Average Grant-Date Fair Value		70.98
Performance adjustment, Weighted Average Grant-Date Fair Value	72.99	17.69
Cancelled, Weighted Average Grant-Date Fair Value	61.52	69.07
Vested, Weighted Average Grant-Date Fair Value		10.6
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 72.58	$ 69.35

Revenue

3 Months Ended

Mar. 31, 2024

Revenue From Contract With Customer [Abstract]

Revenue

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

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

As the Company’s performance obligations relate to contracts with a duration of one year or less, the Company elected the optional exemption in Accounting Standards Codification (“ASC”) 606-10-50-14(a). Therefore, the Company is not required to disclose the transaction price for the remaining performance obligations at the end of the reporting period or when the Company

expects to recognize the revenue. The Company has minimal unsatisfied performance obligations at the end of the reporting period as its patients typically are under no obligation to remain admitted in the Company’s facilities.

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

The Company’s facilities and services provided by the facilities can generally be classified into the following categories: acute inpatient psychiatric facilities; specialty treatment facilities; 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 attributed to each category (in thousands):


	Three Months Ended March 31,
	2024		2023
Acute inpatient psychiatric facilities	$	406,422	$	361,811
Specialty treatment facilities		143,832		147,303
Comprehensive treatment centers		132,167		115,501
Residential treatment centers		85,630		79,652
Revenue	$	768,051	$	704,267

The Company receives payments from the following sources for services rendered in its facilities: (i) state governments under their respective Medicaid and other programs; (ii) commercial insurers; (iii) the federal government under the Medicare program administered by the Centers for Medicare and Medicaid Services (“CMS”) and other programs; and (iv) individual patients and clients.

The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients and implicit price concessions. Contractual adjustments and discounts are based on contractual agreements, discount policies and historical experience. Implicit price concessions are based on historical collection experience. Most of the Company’s facilities have contracts containing variable consideration. However, it is unlikely a significant reversal of revenue will occur when the uncertainty is resolved, and therefore, the Company has included the variable consideration in the estimated transaction price. Subsequent changes resulting from a patient’s ability to pay are recorded as bad debt expense, which is included as a component of other operating expenses in the condensed consolidated statements of operations. Bad debt expense for the three months ended March 31, 2024 and 2023 was not significant.

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


	Three Months Ended March 31,
	2024					2023
	Amount		%			Amount		%
Commercial	$	196,017		25.5	%	$	203,619		28.9	%
Medicare		109,388		14.2	%		108,640		15.4	%
Medicaid		436,422		56.9	%		364,306		51.8	%
Self-Pay		16,427		2.1	%		20,698		2.9	%
Other		9,797		1.3	%		7,004		1.0	%
Revenue	$	768,051		100.0	%	$	704,267		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

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023
Numerator:
Net income attributable to Acadia Healthcare Company, Inc.	$ 76,383	$ 57,729	$ (217,710)	$ 72,299	$ 66,015
Denominator:
Weighted average shares outstanding for basic earnings per share	91,363				90,101
Effects of dilutive instruments	647				1,290
Shares used in computing diluted earnings per common share	92,010				91,391
Basic earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$ 0.84				$ 0.73
Diluted earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Diluted	$ 0.83				$ 0.72

Long-Term Debt (5.500% Senior Notes due 2028) - Additional Information (Detail) - 5.500% Senior Notes due 2028 [Member] - USD ($) $ in Millions		3 Months Ended
	Jun. 24, 2020	Mar. 31, 2024	Dec. 31, 2023
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

Transaction, Legal and Other Costs - Transaction, Legal and Other Costs as Incurred (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Transaction, Legal and Other Costs [Abstract]
Legal, accounting and other acquisition-related costs	$ 5,238	$ 1,640
Management transition costs	1,009	4,800
Termination and restructuring	(3,400)	31
Transaction, legal and other costs	$ 2,847	$ 6,471

Equity-Based Compensation (Tables)

3 Months Ended

Mar. 31, 2024

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock Option Activity

Stock option activity during 2023 and 2024 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, 2023		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
Options granted		1,000			84.18
Options exercised		(90,178	)		45.49
Options cancelled		(22,888	)		62.76
Options outstanding at March 31, 2024		824,479		$	57.24		7.10	$	18,435
Options exercisable at March 31, 2024		448,934		$	47.76		6.02	$	14,197

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 three months ended March 31, 2024 and year ended December 31, 2023:


	March 31, 2024			December 31, 2023
Weighted average grant-date fair value of options	$	30.99		$	30.99
Risk-free interest rate		4.0	%		4.2	%
Expected volatility		34	%		37	%
Expected life (in years)		5.0			5.0

Restricted Stock Activity

Restricted stock unit activity during 2023 and 2024 was as follows:


	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2023		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
Granted		366,652			79.36
Cancelled		(20,668	)		65.79
Vested		(192,282	)		57.59
Unvested at March 31, 2024		1,184,180		$	73.57

Performance stock unit activity

Performance stock unit activity during 2023 and 2024 was as follows:


	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2023		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
Granted		—			—
Performance adjustment		(9,241	)		72.99
Cancelled		(98,504	)		61.52
Vested		—			—
Unvested at March 31, 2024		228,286		$	72.58

Acquisitions - Summary of changes in goodwill (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Business Combinations [Abstract]
Goodwill balance	$ 2,225,962	$ 2,222,805
Increase from acquisitions	35,064	337
Increase from contributions of redeemable noncontrolling interests		2,820
Goodwill balance	$ 2,261,026	$ 2,225,962

- 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 (Tables)

3 Months Ended

Mar. 31, 2024

Earnings Per Share [Abstract]

Computation of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2024 and 2023 (in thousands, except per share amounts):


	Three Months Ended March 31,
	2024		2023
Numerator:
Net income attributable to Acadia Healthcare Company, Inc.	$	76,383	$	66,015
Denominator:
Weighted average shares outstanding for basic earnings per share		91,363		90,101
Effects of dilutive instruments		647		1,290
Shares used in computing diluted earnings per common share		92,010		91,391

Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$	0.84	$	0.73
Diluted	$	0.83	$	0.72

Transaction, Legal and Other Costs

3 Months Ended

Mar. 31, 2024

Transaction, Legal and Other Costs [Abstract]

Transaction, Legal and Other Costs

16.

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 three months ended March 31, 2024 and 2023 (in thousands):


	Three Months Ended March 31,
	2024			2023
Legal, accounting and other acquisition-related costs	$	5,238		$	1,640
Management transition costs		1,009			4,800
Termination and restructuring		(3,400	)		31
	$	2,847		$	6,471

Noncontrolling Interests

3 Months Ended

Mar. 31, 2024

Noncontrolling Interest [Abstract]

Noncontrolling Interests

13.

Noncontrolling Interests

Noncontrolling interests in the consolidated financial statements represent the portion of equity held by noncontrolling partners in the Company’s non-wholly owned subsidiaries. At March 31, 2024, the Company operated ten facilities through non-wholly owned subsidiaries. The Company owns between approximately 65% and 87% of the equity interests of these entities, and noncontrolling

partners own the remaining equity interests. The initial value of the noncontrolling interests is based on the fair value of contributions. The Company consolidates the operations of each facility based on its status as primary beneficiary, as further discussed in Note 14 – Variable Interest Entities. The noncontrolling interests are reflected as redeemable noncontrolling interests on the accompanying condensed consolidated balance sheets based on put rights that could require the Company to purchase the noncontrolling interests upon the occurrence of a change in control.

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


Balance at January 1, 2023	$	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
Contributions from noncontrolling partners in joint ventures		2,280
Net income attributable to noncontrolling interests		2,387
Distributions to noncontrolling partners in joint ventures		(1,020	)
Balance at March 31, 2024	$	109,333

Equity-Based Compensation - Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Options outstanding, Beginning balance	936,545	979,277
Options granted	1,000	296,340
Options exercised	(90,178)	(198,527)
Options cancelled	(22,888)	(140,545)
Options outstanding, Ending balance	824,479	936,545
Options exercisable, Ending balance	448,934
Options outstanding, Weighted Average Exercise Price, Beginning balance	$ 56.21	$ 46.27
Options granted, Weighted Average Exercise Price	84.18	78.94
Options exercised, Weighted Average Exercise Price	45.49	41.29
Options cancelled, Weighted Average Exercise Price	62.76	55.95
Options outstanding, Weighted Average Exercise Price, Ending balance	57.24	$ 56.21
Options exercisable, Weighted Average Exercise Price, Ending balance	$ 47.76
Options outstanding, Weighted Average Remaining Contractual Term	7 years 1 month 6 days
Options exercisable, Weighted Average Remaining Contractual Term, Ending balance	6 years 7 days
Options outstanding, Aggregate Intrinsic Value	$ 18,435
Options exercisable, Aggregate Intrinsic Value, Ending balance	$ 14,197

Earnings Per Share

3 Months Ended

Mar. 31, 2024

Earnings Per Share [Abstract]

Earnings Per Share

4. Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2024 and 2023 (in thousands, except per share amounts):


	Three Months Ended March 31,
	2024		2023
Numerator:
Net income attributable to Acadia Healthcare Company, Inc.	$	76,383	$	66,015
Denominator:
Weighted average shares outstanding for basic earnings per share		91,363		90,101
Effects of dilutive instruments		647		1,290
Shares used in computing diluted earnings per common share		92,010		91,391

Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Basic	$	0.84	$	0.73
Diluted	$	0.83	$	0.72

Approximately 0.3 million and 0.5 million shares of common stock issuable upon exercise of outstanding stock option awards were excluded from the calculation of diluted earnings per share for the three months ended March 31, 2024 and 2023, respectively, because their effect would have been anti-dilutive.

Income Taxes - Additional Information (Detail)	3 Months Ended
Income Taxes - Additional Information (Detail)	Mar. 31, 2024	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Effective tax rates	20.30%	22.30%

Commitments and Contingencies - Additional Information (Detail) - USD ($)			1 Months Ended	3 Months Ended
	Jan. 19, 2024	Jul. 07, 2023	Aug. 31, 2023	Mar. 31, 2024
Loss Contingencies [Line Items]
Aggregate amount on settlement agreements	$ 400,000,000
Anticipated financial impact value				$ 19,900,000
Inman Litigation [Member] \| Compensatory Damages [Member]
Loss Contingencies [Line Items]
Awarded plaintiff damages amount		$ 80,000,000
Inman Litigation [Member] \| Punitive Damages [Member]
Loss Contingencies [Line Items]
Awarded plaintiff damages amount		$ 405,000,000
Maximum [Member]
Loss Contingencies [Line Items]
Maximum coverage limit per claim			$ 5,000,000	7,000,000
Reinsurance policy aggregate policy limit			75,000,000	78,000,000
Minimum [Member]
Loss Contingencies [Line Items]
Maximum professional liability for certain other claims thereafter			10,000,000	10,000,000
Reinsurance policy aggregate policy limit			$ 70,000,000	$ 75,000,000

Revenue - Schedule of Revenue Attributed to Each Category (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Disaggregation of Revenue [Line Items]
Revenue	$ 768,051	$ 704,267
U.S. Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	768,051	704,267
U.S. Facilities [Member] \| Acute Inpatient Psychiatric Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	406,422	361,811
U.S. Facilities [Member] \| Specialty Treatment Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	143,832	147,303
U.S. Facilities [Member] \| Comprehensive Treatment Centers [Member]
Disaggregation of Revenue [Line Items]
Revenue	132,167	115,501
U.S. Facilities [Member] \| Residential Treatment Centers [Member]
Disaggregation of Revenue [Line Items]
Revenue	$ 85,630	$ 79,652

- 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 Intangible Assets (Tables)

3 Months Ended

Mar. 31, 2024

Goodwill And Intangible Assets Disclosure [Abstract]

Other Identifiable Intangible Assets and Related Accumulated Amortization

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


	Gross Carrying Amount				Accumulated Amortization
	March 31, 2024		December 31, 2023		March 31, 2024			December 31, 2023
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		11,721		11,681		—			—
Trade names		42,588		42,588		—			—
Certificates of need		19,043		19,009		—			—
		73,352		73,278		—			—
Total	$	74,483	$	74,409	$	(1,131	)	$	(1,131	)

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 76,383	$ 57,729	$ (217,710)	$ 72,299	$ 66,015

- Definition

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

+ References

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

Recently Issued Accounting Standards	3 Months Ended
Recently Issued Accounting Standards	Mar. 31, 2024
Accounting Changes And Error Corrections [Abstract]
Recently Issued Accounting Standards	2. Recently Issued Accounting Standards In December 2023, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) 2023-09 Income Taxes (Topic 740) “Improvements to Income Tax Disclosures”. 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.

- Definition

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

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+ Details

Condensed Consolidated Statements of Equity (Unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]
Balance at Dec. 31, 2022	$ 2,812,727	$ 899	$ 2,658,440	$ 153,388
Balance, shares at Dec. 31, 2022		89,914,000
Common stock issued under stock incentive plans	1,203	$ 11	1,192
Common stock issued under stock incentive plans, shares		1,039,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(48,874)		(48,874)
Equity-based compensation expense	7,629		7,629
Other	902		902
Net Income (Loss)	66,015			66,015
Balance at Mar. 31, 2023	2,839,602	$ 910	2,619,289	219,403
Balance, shares at Mar. 31, 2023		90,953,000
Balance at Dec. 31, 2022	$ 2,812,727	$ 899	2,658,440	153,388
Balance, shares at Dec. 31, 2022		89,914,000
Common stock issued under stock incentive plans, shares	198,527
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
Balance at Mar. 31, 2023	$ 2,839,602	$ 910	2,619,289	219,403
Balance, shares at Mar. 31, 2023		90,953,000
Common stock issued under stock incentive plans	3,784	$ 1	3,783
Common stock issued under stock incentive plans, shares		176,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(2,017)		(2,017)
Equity-based compensation expense	7,348		7,348
Net Income (Loss)	72,299			72,299
Balance at Jun. 30, 2023	2,921,016	$ 911	2,628,403	291,702
Balance, shares at Jun. 30, 2023		91,129,000
Common stock issued under stock incentive plans	1,554	$ 1	1,553
Common stock issued under stock incentive plans, shares		76,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(843)		(843)
Equity-based compensation expense	8,163		8,163
Other	382		382
Net Income (Loss)	(217,710)			(217,710)
Balance at Sep. 30, 2023	2,712,562	$ 912	2,637,658	73,992
Balance, shares at Sep. 30, 2023		91,205,000
Common stock issued under stock incentive plans	1,656	$ 1	1,655
Common stock issued under stock incentive plans, shares		59,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	(798)		(798)
Equity-based compensation expense	9,149		9,149
Other	1,676		1,676
Net Income (Loss)	57,729			57,729
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
Common stock issued under stock incentive plans	$ 4,102	$ 3	4,099
Common stock issued under stock incentive plans, shares	90,178	310,000
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises	$ (5,115)		(5,115)
Equity-based compensation expense	8,678		8,678
Net Income (Loss)	76,383			76,383
Balance at Mar. 31, 2024	$ 2,866,022	$ 916	$ 2,657,002	$ 208,104
Balance, shares at Mar. 31, 2024	91,573,596	91,574,000

- Definition

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

+ References

+ Details

- Definition

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

+ References

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

Fair Value Measurements

3 Months Ended

Mar. 31, 2024

Fair Value Disclosures [Abstract]

Fair Value Measurements

18.

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 March 31, 2024 and December 31, 2023 were as follows (in thousands):


	Carrying Amount				Fair Value
	March 31, 2024		December 31, 2023		March 31, 2024		December 31, 2023
Credit Facility	$	939,450	$	455,880	$	939,450	$	455,880
5.500% Senior Notes due 2028	$	445,760	$	445,539	$	433,502	$	436,628
5.000% Senior Notes due 2029	$	470,538	$	470,348	$	444,658	$	451,534

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

Commitments and Contingencies

3 Months Ended

Mar. 31, 2024

Commitments And Contingencies Disclosure [Abstract]

Commitments and Contingencies

10.

Commitments and Contingencies

Professional and General Liability

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.

Legal Proceedings

The Company is, from time to time, subject to various claims, lawsuits, governmental investigations and regulatory actions, including claims for damages for personal injuries, medical malpractice, overpayments, breach of contract, securities law violations, tort and employment related claims. In these actions, plaintiffs request a variety of damages, including, in some instances, punitive and other types of damages that may not be covered by insurance. In addition, healthcare companies are subject to numerous investigations by various governmental agencies. Certain of the Company’s individual facilities have received, and from time to time, 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 two 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 for the two cases 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 for the Cases 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 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 resolution is $19.9 million and has been recorded within other accrued liabilities on the condensed consolidated balance sheets at March 31, 2024 and December 31, 2023, respectively.

Noncontrolling Interests (Tables)

3 Months Ended

Mar. 31, 2024

Noncontrolling Interest [Abstract]

Summary of Redeemable Noncontrolling Interests

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


Balance at January 1, 2023	$	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
Contributions from noncontrolling partners in joint ventures		2,280
Net income attributable to noncontrolling interests		2,387
Distributions to noncontrolling partners in joint ventures		(1,020	)
Balance at March 31, 2024	$	109,333

Transaction, Legal and Other Costs (Tables)

3 Months Ended

Mar. 31, 2024

Transaction, Legal and Other Costs [Abstract]

Transaction, Legal and Other Costs as Incurred

Transaction, legal and other costs comprised the following costs for the three months ended March 31, 2024 and 2023 (in thousands):


	Three Months Ended March 31,
	2024			2023
Legal, accounting and other acquisition-related costs	$	5,238		$	1,640
Management transition costs		1,009			4,800
Termination and restructuring		(3,400	)		31
	$	2,847		$	6,471

Condensed Consolidated Statements of Income (Unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Equity-based compensation expense	$ 8,678	$ 7,629

Other Current Assets (Tables)

3 Months Ended

Mar. 31, 2024

Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]

Other Current Assets

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


	March 31, 2024		December 31, 2023
Income taxes receivable	$	38,427	$	12,416
Prepaid expenses		30,190		36,085
Insurance receivable – current portion		23,586		33,579
Other receivables		22,867		22,084
Assets held for sale		12,865		11,496
Workers’ compensation deposits – current portion		12,000		12,000
Inventory		5,745		5,300
Other		1,632		1,516
Other current assets	$	147,312	$	134,476

Other Intangible Assets

3 Months Ended

Mar. 31, 2024

Goodwill And Intangible Assets Disclosure [Abstract]

Other Intangible Assets

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


	Gross Carrying Amount				Accumulated Amortization
	March 31, 2024		December 31, 2023		March 31, 2024			December 31, 2023
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		11,721		11,681		—			—
Trade names		42,588		42,588		—			—
Certificates of need		19,043		19,009		—			—
		73,352		73,278		—			—
Total	$	74,483	$	74,409	$	(1,131	)	$	(1,131	)

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

Variable Interest Entities - Schedule of Consolidated VIEs Assets and Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Variable Interest Entity [Line Items]
Cash and cash equivalents	$ 77,303	$ 100,073
Accounts receivable, net	386,191	361,451
Other current assets	147,312	134,476
Total current assets	610,806	596,000
Property and equipment, net	2,376,059	2,266,610
Goodwill	2,261,026	2,225,962	$ 2,222,805
Intangible assets, net	73,352	73,278
Operating lease right-of-use assets	121,346	117,780
Total assets	5,517,247	5,358,841
Accounts payable	156,130	156,132
Accrued salaries and benefits	118,005	141,901
Current portion of operating lease liabilities	26,815	26,268
Other accrued liabilities	119,911	532,261
Total current liabilities	482,313	885,781
Operating lease liabilities	103,352	100,808
Other liabilities	146,404	140,113
Total liabilities	2,541,892	2,471,181
Variable Interest Entity, Primary Beneficiary [Member]
Variable Interest Entity [Line Items]
Cash and cash equivalents	63,571	55,149
Accounts receivable, net	36,746	34,910
Other current assets	2,739	2,193
Total current assets	103,056	92,252
Property and equipment, net	476,150	438,965
Goodwill	42,384	42,384
Intangible assets, net	18,313	18,295
Operating lease right-of-use assets	10,231	5,948
Total assets	650,134	597,844
Accounts payable	8,611	8,235
Accrued salaries and benefits	6,714	9,909
Current portion of operating lease liabilities	554	273
Other accrued liabilities	3,097	2,385
Total current liabilities	18,976	20,802
Operating lease liabilities	10,208	6,160
Total liabilities	$ 29,184	$ 26,962

Variable Interest Entities - Additional Information (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2024 USD ($) Facility	Dec. 31, 2023 USD ($)
Variable Interest Entity [Line Items]
Consolidated assets	$ 5,517,247	$ 5,358,841
Consolidated liabilities	$ 2,541,892	2,471,181
Variable Interest Entity, Primary Beneficiary [Member]
Variable Interest Entity [Line Items]
Number of facilities operated through non-wholly owned subsidiaries \| Facility	10
Consolidated assets	$ 650,134	597,844
Consolidated liabilities	$ 29,184	$ 26,962
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.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 810
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
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Revenue - Schedule of Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 768,051	$ 704,267
U.S. Facilities [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 768,051	$ 704,267
Revenue, Percentage	100.00%	100.00%
U.S. Facilities [Member] \| Commercial [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 196,017	$ 203,619
Revenue, Percentage	25.50%	28.90%
U.S. Facilities [Member] \| Medicare [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 109,388	$ 108,640
Revenue, Percentage	14.20%	15.40%
U.S. Facilities [Member] \| Medicaid [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 436,422	$ 364,306
Revenue, Percentage	56.90%	51.80%
U.S. Facilities [Member] \| Self-Pay [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 16,427	$ 20,698
Revenue, Percentage	2.10%	2.90%
U.S. Facilities [Member] \| Other [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 9,797	$ 7,004
Revenue, Percentage	1.30%	1.00%

- Definition

+ References

+ Details

Description of Business and Basis of Presentation

3 Months Ended

Mar. 31, 2024

Accounting Policies [Abstract]

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 (“U.S.”) and Puerto Rico. At March 31, 2024, the Company operated 258 behavioral healthcare facilities with approximately 11,300 beds in 38 states and Puerto Rico.

Basis of Presentation

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

The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for fair presentation of the Company’s financial position and results of operations have been included. The Company’s fiscal year ends on December 31 and interim results are not necessarily indicative of results for a full year or any other interim period. The condensed consolidated balance sheet at December 31, 2023 has been derived from the audited financial statements as of that date. The information contained in these condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements and notes thereto for the fiscal year ended December 31, 2023 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on February 28, 2024. The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates.

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

Income Taxes

3 Months Ended

Mar. 31, 2024

Income Tax Disclosure [Abstract]

Income Taxes

17.

Income Taxes

The provision for income taxes for the three months ended March 31, 2024 and 2023 reflects effective tax rates of 20.3% and 22.3%, respectively.

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

- Definition

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

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+ Details

Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2024	May 02, 2024
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Trading Symbol	ACHC
Entity Registrant Name	Acadia Healthcare Company, Inc.
Entity Central Index Key	0001520697
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common Stock, $.01 par value
Security Exchange Name	NASDAQ
Entity File Number	001-35331
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	45-2492228
Entity Address, Address Line One	6100 Tower Circle
Entity Address, Address Line Two	Suite 1000
Entity Address, City or Town	Franklin
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37067
City Area Code	615
Local Phone Number	861-6000
Document Quarterly Report	true
Document Transition Report	false
Entity Common Stock, Shares Outstanding		92,774,604

Property and Equipment - Additional Information (Detail) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Other Assets [Member]
Property Plant And Equipment [Line Items]
Assets held for sale	$ 12.9	$ 11.5

Financial Information for the Company and Its Subsidiaries - Summarized Balance Sheet (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Dec. 31, 2022
Condensed Financial Statements, Captions [Line Items]
Current assets	$ 610,806	$ 596,000
Property and equipment, net	2,376,059	2,266,610
Goodwill	2,261,026	2,225,962				$ 2,222,805
Current liabilities	482,313	885,781
Long-term debt	1,794,296	1,342,548
Redeemable noncontrolling interests	109,333	105,686				88,257
Total equity	$ 2,866,022	$ 2,781,974	$ 2,712,562	$ 2,921,016	$ 2,839,602	$ 2,812,727

- Definition

Sum of the carrying amounts as of the balance sheet date of all assets that are expected to be realized in cash, sold, or consumed within one year (or the normal operating cycle, if longer). Assets are probable future economic benefits obtained or controlled by an entity as a result of past transactions or events.

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-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.21)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480566/210-10-S99-1

+ Details

- Definition

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

+ References

+ Details

Other Intangible Assets - Other Identifiable Intangible Assets and Related Accumulated Amortization (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	$ 73,352	$ 73,278
Total	74,483	74,409
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	11,721	11,681
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	42,588
Certificates of Need [Member]
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	$ 19,043	$ 19,009

Long-Term Debt - Components of Long-Term Debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Mar. 17, 2021
Debt Instrument [Line Items]
Less: unamortized debt issuance costs, discount and premium	$ (11,197)	$ (10,421)
Long-term debt	1,855,748	1,371,767
Less: current portion	(61,452)	(29,219)
Long-term debt	1,794,296	1,342,548
Credit Facility [Member] \| Term Loan A [Member]
Debt Instrument [Line Items]
Revolving Facility	716,945	377,188
Credit Facility [Member] \| Senior Secured Revolving Line of Credit [Member]
Debt Instrument [Line Items]
Revolving Facility	225,000	80,000	$ 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

Property and Equipment - Summary of Property and Equipment (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 3,172,768	$ 3,033,956
Less: accumulated depreciation	(796,709)	(767,346)
Property and equipment, net	2,376,059	2,266,610
Land [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	195,216	183,347
Building and Improvements [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	2,088,489	2,064,353
Equipment [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	383,053	365,826
Construction in Progress [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 506,010	$ 420,430

Fair Value Measurements - Additional Information (Detail)	Mar. 31, 2024	Dec. 31, 2023	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

Earnings Per Share - Additional Information (Detail) - shares shares in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Earnings Per Share [Abstract]
Excluded common stock for computation of diluted earnings per share	0.3	0.5

Long-Term Debt (Tables)

3 Months Ended

Mar. 31, 2024

Debt Disclosure [Abstract]

Components of Long-Term Debt

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


	March 31, 2024			December 31, 2023
Credit Facility:
Term Loan A	$	716,945		$	377,188
Revolving Line of Credit		225,000			80,000
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		(11,197	)		(10,421	)
		1,855,748			1,371,767
Less: current portion		(61,452	)		(29,219	)
Long-term debt	$	1,794,296		$	1,342,548

- Definition

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

+ References

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

The CARES Act - Additional Information (Detail) - CARES Act [Member] - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
CARES Act [Line Items]
Offer of eligible relief amount	$ 100.0
American Rescue Plan
CARES Act [Line Items]
Income from relief fund		$ 6.4

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 77,303	$ 100,073
Accounts receivable, net	386,191	361,451
Other current assets	147,312	134,476
Total current assets	610,806	596,000
Property and equipment, net	2,376,059	2,266,610
Goodwill	2,261,026	2,225,962
Intangible assets, net	73,352	73,278
Deferred tax assets	2,777	6,658
Operating lease right-of-use assets	121,346	117,780
Other assets	71,881	72,553
Total assets	5,517,247	5,358,841
Current liabilities:
Current portion of long-term debt	61,452	29,219
Accounts payable	156,130	156,132
Accrued salaries and benefits	118,005	141,901
Current portion of operating lease liabilities	26,815	26,268
Other accrued liabilities	119,911	532,261
Total current liabilities	482,313	885,781
Long-term debt	1,794,296	1,342,548
Deferred tax liabilities	15,527	1,931
Operating lease liabilities	103,352	100,808
Other liabilities	146,404	140,113
Total liabilities	2,541,892	2,471,181
Redeemable noncontrolling interests	109,333	105,686
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; 91,573,596 and 91,263,989 issued and outstanding at March 31, 2024 and December 31, 2023, respectively	916	913
Additional paid-in capital	2,657,002	2,649,340
Retained earnings	208,104	131,721
Total equity	2,866,022	2,781,974
Total liabilities and equity	$ 5,517,247	$ 5,358,841