Acadia Healthcare Announces First Quarter 2026 Results
04.29.2026
Company Increases Full Year 2026 Adjusted EBITDA and Adjusted EPS Guidance
First Quarter 2026 Results
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Revenue totaled
$828.8 million , a 7.6% increase compared with the first quarter of 2025 - Same-facility revenue increased 7.3% compared with the first quarter of 2025, including an increase in revenue per patient day of 5.6% and an increase in patient days of 1.6%
-
Net income attributable to Acadia totaled
$0.05 per diluted share, compared with$0.09 per diluted share in the prior-year period -
Adjusted net income attributable to Acadia totaled
$33.3 million , or$0.37 per diluted share, compared with$36.9 million , or$0.40 per diluted share, in the prior-year period -
Adjusted EBITDA was
$144.2 million , compared with$134.2 million in the prior-year period - Added 82 newly licensed beds during the first quarter, including 42 beds to existing facilities and 40 beds from newly constructed facilities
Adjusted net income attributable to Acadia, Adjusted EBITDA and Adjusted earnings per diluted share are non-GAAP financial measures. A reconciliation of all non-GAAP financial measures in this press release begins on page 10.
“The good start to the year reflects disciplined execution throughout Acadia as we provide quality care for individuals seeking treatment for mental health and substance abuse issues,” said
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First Quarter Financial Summary |
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(dollars in millions, except per share amounts) |
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2026 |
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2025 |
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Change (%) |
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Acute Inpatient Psychiatric Facilities |
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|
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14% |
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Specialty Treatment Facilities |
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(7%) |
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Comprehensive Treatment Facilities |
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2% |
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Residential Treatment Facilities |
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6% |
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Total Revenue |
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8% |
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Reported Net Income |
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(56%) |
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Adjusted EBITDA |
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7% |
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Reported EPS |
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(44%) |
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Adjusted EPS |
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(8%) |
Discussion of First Quarter Results
Acadia reported first quarter revenue of
Acute inpatient psychiatric facility revenue was
Specialty treatment facility revenue was
Comprehensive treatment facility (“CTC”) revenue was
Total operating expenses were
Salaries, wages and benefits increased by 4.9% primarily due to new facility openings, which generally run net loss positions as occupancy builds, as well as routine annual wage increases. On a per-patient-day basis, total salaries, wages and benefits increased by 3.3%. Same-facility salaries, wages and benefits increased by 3.7%. On a per-patient-day basis, same-facility salaries, wages and benefits increased by 2.0%.
Adjusted EBITDA for the quarter was
Interest expense was
Transaction, legal and other costs were
Development Activity
The Company added 42 beds to existing facilities in the first quarter and added 40 beds from newly constructed facilities, including the Company’s joint venture with Tufts Medicine.
Cash and Liquidity
As of
Q2 and Full Year 2026 Financial Guidance
While Acadia does not typically provide financial guidance for the second quarter, given the substantial out-of-period supplemental payments received from the state of
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Second Quarter 2026 |
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Revenue |
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Adjusted EBITDA |
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Adjusted earnings per diluted share |
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The Company’s second quarter guidance includes the following assumptions:
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Startup losses of approximately
$15 million - No incremental new supplemental payments
-
Net leverage at the end of the second quarter is expected at 4.4x-4.5x Adjusted EBITDA (calculated in accordance with the Credit Agreement) because of the significant out-of-period benefit from
Tennessee supplemental payments in Q2 of 2025. The Company expects net leverage at year-end 2026 to be in the range of 3.9x to 4.2x.
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Full Year 2026
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Full Year 2026
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Revenue |
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Adjusted EBITDA |
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Adjusted earnings per diluted share |
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Operating Cash Flow |
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Capital expenditures |
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The Company expects its Specialty revenue and contribution to Adjusted EBITDA to increase relative to its guidance provided in February; however, the increase in Specialty is expected to be off-set by modestly higher bad debts and denials.
The Company’s guidance does not include the impact of any future acquisitions, divestitures, transaction, legal and other costs or non-recurring legal settlements expense.
Conference Call
Acadia will hold a conference call to discuss its first quarter financial results at
About Acadia
Acadia is a leading provider of behavioral healthcare services across
Description of Business
Unless the context otherwise requires, all references herein to “Acadia,” “the Company,” “we,” “us” or “our” mean
Forward-Looking Information
This press release contains “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), including statements related to our strategy, growth and anticipated operating results for future periods. Generally, words such as “may,” “will,” “should,” “could,” “anticipate,” “expect,” “intend,” “estimate,” “plan,” “continue” and “believe” or the negative of or other variation on these and other similar expressions identify forward-looking statements. These forward-looking statements are made only as of the date of this press release. We do not undertake to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. Forward-looking statements are based on current expectations and involve risks and uncertainties, and our future results could differ significantly from those expressed or implied by our forward-looking statements. Factors that may cause actual results to differ materially include, without limitation, (i) potential difficulties in successfully integrating the operations of acquired facilities or realizing the expected benefits and synergies of facility expansions, acquisitions, joint ventures and de novo transactions; (ii) Acadia’s ability to add beds, expand services, enhance marketing programs and improve efficiencies at its facilities; (iii) potential reductions in payments received by Acadia from government and commercial payors, including because of the significant changes to Medicaid financing mechanisms introduced by the One Big Beautiful Bill Act (the “OBBBA”) enacted on
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||||||||
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Condensed Consolidated Statements of Income |
||||||||
|
(Unaudited) |
||||||||
| Three Months Ended |
||||||||
|
|
2026 |
|
|
2025 |
|
|||
| (In thousands, except per share amounts) | ||||||||
| Revenue |
$ |
828,802 |
|
$ |
770,505 |
|
||
| Salaries, wages and benefits (including equity-based compensation expense of |
|
467,040 |
|
|
445,271 |
|
||
| Professional fees |
|
53,197 |
|
|
45,707 |
|
||
| Supplies |
|
29,491 |
|
|
28,342 |
|
||
| Rents and leases |
|
11,733 |
|
|
11,656 |
|
||
| Other operating expenses |
|
131,079 |
|
|
114,002 |
|
||
| Depreciation and amortization |
|
52,426 |
|
|
47,032 |
|
||
| Interest expense, net |
|
38,330 |
|
|
29,182 |
|
||
| Debt extinguishment costs |
|
— |
|
|
1,269 |
|
||
| Legal settlements expense |
|
13,751 |
|
|
3,504 |
|
||
| Gain on sale of property, net |
|
(1,222 |
) |
|
— |
|
||
| Transaction, legal and other costs |
|
22,013 |
|
|
31,072 |
|
||
| Total expenses |
|
817,838 |
|
|
757,037 |
|
||
| Income before income taxes |
|
10,964 |
|
|
13,468 |
|
||
| Provision for income taxes |
|
6,500 |
|
|
4,404 |
|
||
| Net income |
|
4,464 |
|
|
9,064 |
|
||
| Net income attributable to noncontrolling interests |
|
(359 |
) |
|
(690 |
) |
||
| Net income attributable to |
$ |
4,105 |
|
$ |
8,374 |
|
||
| Earnings per share attributable to |
||||||||
| Basic |
$ |
0.05 |
|
$ |
0.09 |
|
||
| Diluted |
$ |
0.05 |
|
$ |
0.09 |
|
||
| Weighted-average shares outstanding: | ||||||||
| Basic |
|
90,530 |
|
|
91,654 |
|||
| Diluted |
90,859 |
92,038 |
||||||
|
|
||||||||
| Condensed Consolidated Balance Sheets | ||||||||
| (Unaudited) | ||||||||
|
|
2026 |
|
|
2025 |
|
|||
| (In thousands) | ||||||||
| ASSETS | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents |
$ |
158,472 |
|
$ |
133,242 |
|
||
| Accounts receivable, net |
|
471,752 |
|
|
440,604 |
|
||
| Other current assets |
|
206,974 |
|
|
240,293 |
|
||
| Total current assets |
|
837,198 |
|
|
814,139 |
|
||
| Property and equipment, net |
|
3,106,635 |
|
|
3,111,212 |
|
||
|
|
1,301,412 |
|
|
1,296,342 |
|
|||
| Intangible assets, net |
|
98,585 |
|
|
96,672 |
|
||
| Deferred tax assets |
|
2,493 |
|
|
2,528 |
|
||
| Operating lease right-of-use assets |
|
132,159 |
|
|
134,005 |
|
||
| Other assets |
|
67,969 |
|
|
72,550 |
|
||
| Total assets |
$ |
5,546,451 |
|
$ |
5,527,448 |
|
||
| LIABILITIES AND EQUITY | ||||||||
| Current liabilities: | ||||||||
| Current portion of long-term debt |
$ |
32,500 |
|
$ |
28,438 |
|
||
| Accounts payable |
|
142,201 |
|
|
150,403 |
|
||
| Accrued salaries and benefits |
|
157,057 |
|
|
188,638 |
|
||
| Current portion of operating lease liabilities |
|
20,735 |
|
|
21,160 |
|
||
| Other accrued liabilities |
|
136,863 |
|
|
136,555 |
|
||
| Total current liabilities |
|
489,356 |
|
|
525,194 |
|
||
| Long-term debt |
|
2,494,293 |
|
|
2,471,529 |
|
||
| Deferred tax liabilities |
|
76,909 |
|
|
66,605 |
|
||
| Operating lease liabilities |
|
121,362 |
|
|
121,961 |
|
||
| Other liabilities |
|
196,271 |
|
|
201,607 |
|
||
| Total liabilities |
|
3,378,191 |
|
|
3,386,896 |
|
||
| Redeemable noncontrolling interests |
|
209,983 |
|
|
191,592 |
|
||
| Equity: | ||||||||
| Common stock |
|
908 |
|
|
905 |
|
||
| Additional paid-in capital |
|
2,719,105 |
|
|
2,713,896 |
|
||
| Accumulated deficit |
|
(761,736 |
) |
|
(765,841 |
) |
||
| Total equity |
|
1,958,277 |
|
|
1,948,960 |
|
||
| Total liabilities and equity |
$ |
5,546,451 |
|
$ |
5,527,448 |
|
||
| Condensed Consolidated Statements of Cash Flows | ||||||||
| (Unaudited) | ||||||||
| Three Months Ended |
||||||||
|
|
2026 |
|
|
2025 |
|
|||
| (In thousands) | ||||||||
| Operating activities: | ||||||||
| Net income |
$ |
4,464 |
|
$ |
9,064 |
|
||
| Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
| Depreciation and amortization |
|
52,426 |
|
|
47,032 |
|
||
| Amortization of debt issuance costs |
|
1,253 |
|
|
1,056 |
|
||
| Equity-based compensation expense |
|
7,956 |
|
|
8,677 |
|
||
| Deferred income taxes |
|
10,340 |
|
|
(5,621 |
) |
||
| Debt extinguishment costs |
|
— |
|
|
1,269 |
|
||
| Non-cash legal settlements expense |
|
— |
|
|
3,504 |
|
||
| Gain on sale of property, net |
|
(1,222 |
) |
|
— |
|
||
| Other |
|
401 |
|
|
73 |
|
||
| Change in operating assets and liabilities, net of effect of acquisitions: | ||||||||
| Accounts receivable, net |
|
(31,148 |
) |
|
(30,993 |
) |
||
| Other current assets |
|
27,501 |
|
|
(9,019 |
) |
||
| Other assets |
|
(542 |
) |
|
(1,214 |
) |
||
| Accounts payable and other accrued liabilities |
|
24,402 |
|
|
(9,242 |
) |
||
| Accrued salaries and benefits |
|
(34,570 |
) |
|
(19,801 |
) |
||
| Other liabilities |
|
270 |
|
|
16,692 |
|
||
| Net cash provided by operating activities |
|
61,531 |
|
|
11,477 |
|
||
| Investing activities: | ||||||||
| Cash paid for acquisitions, net of cash acquired |
|
— |
|
|
(8,594 |
) |
||
| Cash paid for capital expenditures |
|
(76,564 |
) |
|
(174,631 |
) |
||
| Proceeds from sale of property and equipment |
|
16,383 |
|
|
43 |
|
||
| Other |
|
(30 |
) |
|
(56 |
) |
||
| Net cash used in investing activities |
|
(60,211 |
) |
|
(183,238 |
) |
||
| Financing activities: | ||||||||
| Borrowings on long-term debt |
|
— |
|
|
1,200,000 |
|
||
| Borrowings on revolving credit facility |
|
85,000 |
|
|
760,000 |
|
||
| Principal payments on revolving credit facility |
|
(55,000 |
) |
|
(1,035,000 |
) |
||
| Principal payments on long-term debt |
|
(4,063 |
) |
|
— |
|
||
| Repayment of long-term debt |
|
— |
|
|
(670,856 |
) |
||
| Payment of debt issuance costs |
|
— |
|
|
(18,615 |
) |
||
| Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises |
|
(2,744 |
) |
|
(1,936 |
) |
||
| Repurchase of common stock |
|
— |
|
|
(46,880 |
) |
||
| Contributions from noncontrolling partners in joint ventures |
|
743 |
|
|
— |
|
||
| Other |
|
(26 |
) |
|
(21 |
) |
||
| Net cash provided by financing activities |
|
23,910 |
|
|
186,692 |
|
||
| Net increase in cash and cash equivalents |
|
25,230 |
|
|
14,931 |
|
||
| Cash and cash equivalents at beginning of the period |
|
133,242 |
|
|
76,305 |
|
||
| Cash and cash equivalents at end of the period |
$ |
158,472 |
|
$ |
91,236 |
|
||
| Effect of acquisitions: | ||||||||
| Assets acquired, excluding cash |
$ |
17,290 |
|
$ |
19,768 |
|
||
| Liabilities assumed |
|
— |
|
|
(300 |
) |
||
| Redeemable noncontrolling interest resulting from an acquisition |
|
(17,290 |
) |
|
(10,874 |
) |
||
| Cash paid for acquisitions, net of cash acquired |
$ |
— |
|
$ |
8,594 |
|
||
| Operating Statistics (1) | |||||||||
| (Unaudited, $ in thousands except per |
|||||||||
| Three Months Ended |
|||||||||
|
|
2026 |
|
2025 |
% Change | |||||
| Same Facility Results (2) | |||||||||
| Revenue |
$ |
813,384 |
$ |
758,346 |
7.3 |
% |
|||
|
|
772,858 |
|
760,664 |
1.6 |
% |
||||
| Admissions |
|
51,959 |
|
48,776 |
6.5 |
% |
|||
| Average Length of Stay (3) |
|
14.9 |
|
15.6 |
-4.6 |
% |
|||
| Revenue per |
$ |
1,052 |
$ |
997 |
5.6 |
% |
|||
| Adjusted EBITDA |
$ |
199,490 |
$ |
178,449 |
11.8 |
% |
|||
| Total Facility Results | |||||||||
| Revenue |
$ |
828,802 |
$ |
770,505 |
7.6 |
% |
|||
|
|
786,780 |
|
774,933 |
1.5 |
% |
||||
| Admissions |
|
53,558 |
|
49,683 |
7.8 |
% |
|||
| Average Length of Stay (3) |
|
14.7 |
|
15.6 |
-5.8 |
% |
|||
| Revenue per |
$ |
1,053 |
$ |
994 |
5.9 |
% |
|||
| Adjusted EBITDA |
$ |
185,489 |
$ |
172,361 |
7.6 |
% |
|||
| (1) Total facility and same facility results may not be indicative of the overall performance of our business and should not be considered as alternatives for net income or any other performance measures in accordance with GAAP (as defined herein). | |||||||||
| (2) Same facility results for the periods presented include facilities we have operated for more than one year and exclude certain closed services. | |||||||||
| (3) Average length of stay is defined as patient days divided by admissions. | |||||||||
| Reconciliation of Net Income Attributable to Same Facility Adjusted EBITDA |
||||||||
| (Unaudited) | ||||||||
| Three Months Ended |
||||||||
|
|
2026 |
|
|
2025 |
|
|||
| (in thousands) | ||||||||
| Net income attributable to |
$ |
4,105 |
|
$ |
8,374 |
|
||
| Net income attributable to noncontrolling interests |
|
359 |
|
|
690 |
|
||
| Provision for income taxes |
|
6,500 |
|
|
4,404 |
|
||
| Interest expense, net |
|
38,330 |
|
|
29,182 |
|
||
| Depreciation and amortization |
|
52,426 |
|
|
47,032 |
|
||
| EBITDA |
|
101,720 |
|
|
89,682 |
|
||
| Adjustments: | ||||||||
| Equity-based compensation expense (a) |
|
7,956 |
|
|
8,677 |
|
||
| Transaction, legal and other costs (b) |
|
22,013 |
|
|
31,072 |
|
||
| Debt extinguishment costs (c) |
|
— |
|
|
1,269 |
|
||
| Legal settlements expense (d) |
|
13,751 |
|
|
3,504 |
|
||
| Gain on sale of property, net (e) |
|
(1,222 |
) |
|
— |
|
||
| Adjusted EBITDA |
$ |
144,218 |
|
$ |
134,204 |
|
||
| Corporate general and administrative costs (f) |
|
(41,271 |
) |
|
(38,157 |
) |
||
| Total Facility Adjusted EBITDA |
|
185,489 |
|
|
172,361 |
|
||
| De novos, acquisitions, and closed facilities (g) |
|
(14,001 |
) |
|
(6,088 |
) |
||
| Same Facility Adjusted EBITDA |
$ |
199,490 |
|
$ |
178,449 |
|
||
| See footnotes on pages 12-13. |
|
|||||||
| Reconciliation of Net Income Attributable to |
|||||||
| Adjusted Income Attributable to |
|||||||
| (Unaudited) | |||||||
| Three Months Ended |
|||||||
|
|
2026 |
|
|
2025 |
|||
| (in thousands, except per share amounts) | |||||||
| Net income attributable to |
$ |
4,105 |
|
$ |
8,374 |
||
| Adjustments to income: | |||||||
| Transaction, legal and other costs (b) |
|
22,013 |
|
|
31,072 |
||
| Debt extinguishment costs (c) |
|
— |
|
|
1,269 |
||
| Legal settlements expense (d) |
|
13,751 |
|
|
3,504 |
||
| Gain on sale of property, net (e) |
|
(1,222 |
) |
|
— |
||
| Provision for income taxes |
|
6,500 |
|
|
4,404 |
||
| Adjusted income before income taxes attributable to |
|
45,147 |
|
|
48,623 |
||
| Income tax effect of adjustments to income (h) |
|
11,824 |
|
|
11,694 |
||
| Adjusted income attributable to |
|
33,323 |
|
|
36,929 |
||
| Weighted-average shares outstanding - diluted |
|
90,859 |
|
|
92,038 |
||
| Adjusted income attributable to |
$ |
0.37 |
|
$ |
0.40 |
||
| See footnotes on pages 12-13. | |||||||
| Footnotes | ||||||||
| We have included certain financial measures in this press release, including those listed below, which are “non-GAAP financial measures” as defined under the rules and regulations promulgated by the |
||||||||
| • EBITDA: net income attributable to |
||||||||
| • Adjusted EBITDA: EBITDA adjusted for equity-based compensation expense, transaction, legal and other costs, debt extinguishment costs, legal settlements expense, and gain on sale of property, net. | ||||||||
| • Adjusted income before income taxes attributable to |
||||||||
| • Adjusted income attributable to |
||||||||
| • Total facility adjusted EBITDA: Adjusted EBITDA adjusted for general and administrative costs related to our corporate functions. General and administrative costs directly related to the facilities are included in total facility results. | ||||||||
| • Same facility adjusted EBITDA: Adjusted EBITDA for facilities and services to those facilities operated in both the current and prior year. These metrics exclude the operating results associated with facilities under operation for less than one year and facilities acquired, divested or removed from service during the current or prior year. | ||||||||
| The non-GAAP financial measures presented herein are supplemental measures of our performance and are not required by, or presented in accordance with, generally accepted accounting principles in |
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| Total facility results include operating results for all of our facilities and services but exclude general and administrative costs related to our corporate functions. Such costs related to our corporate functions include, amongst others, costs for accounting and finance, information systems, human resources, legal and operational and executive leadership. General and administrative costs directly related to the facilities are included in facility results. Such costs directly related to our facilities include, amongst others, labor at the facility level, insurance, including property, professional, legal and general liability insurance, hospital supplies, including medication, utilities and food service, and general maintenance costs for the facility. We determine which general and administrative costs to exclude and include in total facility results by ensuring those costs directly associated with facility operations are captured at the facility level for reporting. Note that total facility costs include those related to new facilities and the cost of closure and run-out costs related to facilities we have closed. We believe that providing results on a total facility basis is helpful to our investors as a measure of our financial and operating performance because it neutralizes the impact of corporate-level items that do not arise out of our core operations at our facilities. | ||||||||
| Same facility results include operating results only for facilities and services operated in both the current and prior year. These metrics exclude the operating results associated with facilities under operation for less than one year and facilities acquired during the current or prior year, as well as facilities divested or removed from service. We believe that providing results on a same facility basis is helpful to investors because it neutralizes the impact of new facilities that are in early stages of operation and facilities that we no longer operate, each of which may distort investors’ understanding of the Company’s underlying performance at our existing and continuing facilities. Further, we believe that providing same facility information is helpful to our investors as a measure of the financial and operating performance of our existing and continuing facilities on a comparable basis, and same facility results provide investors with information useful in understanding underlying organic growth in such facilities. For these reasons, we believe that same facility results are particularly useful during periods of significant expansion or contraction. | ||||||||
| Total facility results reflect adjustments that are intended to provide the specific presentation described above, and same facility results reflect adjustments that may be irregular in timing from period to period related to newly opened or acquired facilities or facilities that we no longer operate, and may omit certain results that investors may view as important. Total facility and same facility results may therefore not be indicative of the overall performance of our business and should be not be considered as alternatives for net income or any other performance measures derived in accordance with GAAP. | ||||||||
| The Company is not able to provide a reconciliation of projected Adjusted EBITDA and adjusted earnings per diluted share, where provided, to expected results due to the unknown effect, timing and potential significance of transaction-related expenses and the tax effect of such expenses. | ||||||||
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Investor Contact:
investorrelations@acadiahealthcare.com
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