10-Q

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

(Mark One)

☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended September 30, 2021

or

☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                      to                     

Commission File Number: 001-35331

Acadia Healthcare Company, Inc.

(Exact name of registrant as specified in its charter)

Delaware	45-2492228
(State or other jurisdiction of incorporation or organization)	(I.R.S. Employer Identification No.)

6100 Tower Circle, Suite 1000

Franklin, Tennessee 37067

(Address, including zip code, of registrant’s principal executive offices)

(615) 861-6000

(Registrant’s telephone number, including area code)

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  ☒    No  ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  ☒    No  ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer	☒	Accelerated filer	☐  Non-accelerated filer	☐
Smaller reporting company	☐	Emerging growth company	☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ☐    No  ☒

Securities registered pursuant to Section 12(b) of the Act:

Title of each class	Trading Symbol	Name of each exchange on which registered
Common Stock, $.01 par value	ACHC	NASDAQ Global Select Market

At October 29, 2021, there were 89,935,616 shares of the registrant’s common stock outstanding.

ACADIA HEALTHCARE COMPANY, INC.

QUARTERLY REPORT ON FORM 10-Q

TABLE OF CONTENTS

PART I – FINANCIAL INFORMATION
Item 1.	Financial Statements	1
	Condensed Consolidated Balance Sheets (Unaudited)	1
	Condensed Consolidated Statements of Operations (Unaudited)	2
	Condensed Consolidated Statements of Comprehensive Income (Unaudited)	3
	Condensed Consolidated Statements of Equity (Unaudited)	4
	Condensed Consolidated Statements of Cash Flows (Unaudited)	5
	Notes to Condensed Consolidated Financial Statements (Unaudited)	6
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	23
Item 3.	Quantitative and Qualitative Disclosures About Market Risk	35
Item 4.	Controls and Procedures	36
PART II – OTHER INFORMATION
Item 1.	Legal Proceedings	37
Item 1A.	Risk Factors	37
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	37
Item 6.	Exhibits	38
SIGNATURES		39

PART I – FINANCIAL INFORMATION

Item 1. Financial Statements

Acadia Healthcare Company, Inc.

Condensed Consolidated Balance Sheets

(Unaudited)

	September 30, 2021			December 31, 2020
	(In thousands, except share and per share amounts)
ASSETS
Current assets:
Cash and cash equivalents	$	196,313		$	378,697
Accounts receivable, net		282,161			273,551
Other current assets		88,685			61,332
Current assets held for sale		—			1,809,815
Total current assets		567,159			2,523,395
Property and equipment, net		1,665,025			1,622,896
Goodwill		2,103,503			2,105,264
Intangible assets, net		69,366			68,535
Deferred tax assets		3,112			3,209
Operating lease right-of-use assets		103,162			96,937
Other assets		83,400			79,126
Total assets	$	4,594,727		$	6,499,362
LIABILITIES AND EQUITY
Current liabilities:
Current portion of long-term debt	$	15,938		$	153,478
Accounts payable		85,924			87,815
Accrued salaries and benefits		124,164			124,912
Current portion of operating lease liabilities		20,062			18,916
Other accrued liabilities		157,204			178,453
Derivative instrument liabilities		—			84,584
Current liabilities held for sale		—			660,027
Total current liabilities		403,292			1,308,185
Long-term debt		1,413,407			2,968,948
Deferred tax liabilities		73,673			50,017
Operating lease liabilities		89,952			84,029
Other liabilities		117,883			133,412
Total liabilities		2,098,207			4,544,591
Redeemable noncontrolling interests		62,074			55,315
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; 89,006,713    and 88,024,395 issued and outstanding at September 30, 2021 and    December 31, 2020, respectively		890			880
Additional paid-in capital		2,623,585			2,580,327
Accumulated other comprehensive loss		—			(371,365	)
Accumulated deficit		(190,029	)		(310,386	)
Total equity		2,434,446			1,899,456
Total liabilities and equity	$	4,594,727		$	6,499,362

See accompanying notes.

1

Acadia Healthcare Company, Inc.

Condensed Consolidated Statements of Operations

(Unaudited)

	Three Months Ended September 30,						Nine Months Ended September 30,
	2021			2020			2021			2020
	(In thousands, except per share amounts)
Revenue	$	587,559		$	547,961		$	1,720,914		$	1,548,653
Salaries, wages and benefits (including equity-based compensation      expense of $8,923, $5,471, $24,988 and $16,258, respectively)		309,118			290,619			922,684			852,864
Professional fees		35,602			29,372			101,915			91,009
Supplies		23,743			21,773			67,698			65,028
Rents and leases		9,658			9,365			28,690			27,975
Other operating expenses		76,502			68,213			222,263			202,540
Other income		—			18,070			—			—
Depreciation and amortization		27,805			24,132			78,349			70,298
Interest expense, net		15,706			37,315			61,420			118,398
Debt extinguishment costs		—			—			24,650			3,271
Loss on impairment		1,079			—			24,293			—
Transaction-related expenses		3,035			3,024			9,320			9,558
Total expenses		502,248			501,883			1,541,282			1,440,941
Income from continuing operations before income taxes		85,311			46,078			179,632			107,712
Provision for income taxes		17,411			9,191			42,948			24,174
Income from continuing operations		67,900			36,887			136,684			83,538
Income (loss) from discontinued operations, net of taxes		—			674			(12,641	)		29,804
Net income		67,900			37,561			124,043			113,342
Net income attributable to noncontrolling interests		(1,774	)		(563	)		(3,686	)		(1,802	)
Net income attributable to Acadia Healthcare Company, Inc.	$	66,126		$	36,998		$	120,357		$	111,540
Basic earnings per share attributable to Acadia Healthcare     Company, Inc. stockholders:
Income from continuing operations attributable to Acadia     Healthcare Company, Inc.	$	0.74		$	0.41		$	1.50		$	0.93
Income (loss) from discontinued operations		—			0.01			(0.14	)		0.34
Net income attributable to Acadia Healthcare Company, Inc.	$	0.74		$	0.42		$	1.36		$	1.27
Diluted earnings per share attributable to Acadia Healthcare     Company, Inc. stockholders:
Income from continuing operations attributable to Acadia     Healthcare Company, Inc.	$	0.73		$	0.41		$	1.47		$	0.92
Income (loss) from discontinued operations		—			0.01			(0.14	)		0.34
Net income attributable to Acadia Healthcare Company, Inc.	$	0.73		$	0.42		$	1.33		$	1.26
Weighted-average shares outstanding:
Basic		88,962			87,911			88,684			87,849
Diluted		90,889			88,856			90,604			88,449

See accompanying notes.

2

Acadia Healthcare Company, Inc.

Condensed Consolidated Statements of Comprehensive Income

(Unaudited)

	Three Months Ended September 30,						Nine Months Ended September 30,
	2021			2020			2021			2020
	(In thousands)
Net income	$	67,900		$	37,561		$	124,043		$	113,342
Other comprehensive income (loss):
Foreign currency translation gain (loss)		—			82,332			(4,260	)		(46,851	)
(Loss) gain on derivative instruments, net of tax of $0.0 million,    $(8.0) million, $0.1 million and $8.0 million, respectively		—			(21,566	)		19			21,622
U.K. Sale		—			—			375,606			—
Other comprehensive income (loss)		—			60,766			371,365			(25,229	)
Comprehensive income		67,900			98,327			495,408			88,113
Comprehensive income attributable to noncontrolling interests		(1,774	)		(563	)		(3,686	)		(1,802	)
Comprehensive income attributable to Acadia Healthcare      Company, Inc.	$	66,126		$	97,764		$	491,722		$	86,311

See accompanying notes.

3

Acadia Healthcare Company, Inc.

Condensed Consolidated Statements of Equity

(Unaudited)

(In thousands)

	Common Stock				Additional Paid-in			Accumulated Other Comprehensive			Retained Earnings (Accumulated
	Shares		Amount		Capital			(Loss)			Deficit)			Total
Balance at December 31, 2019		87,715	$	877	$	2,557,642		$	(414,884	)	$	361,746		$	2,505,381
Common stock issued under stock incentive plans		127		1		(1	)		—			—			—
Common stock withheld for minimum statutory taxes		—		—		(1,402	)		—			—			(1,402	)
Equity-based compensation expense		—		—		4,979			—			—			4,979
Other comprehensive loss		—		—		—			(78,254	)		—			(78,254	)
Net income attributable to Acadia Healthcare    Company, Inc.		—		—		—			—			33,463			33,463
Balance at March 31, 2020		87,842		878		2,561,218			(493,138	)		395,209			2,464,167
Common stock issued under stock incentive plans		56		1		169			—			—			170
Common stock withheld for minimum statutory taxes		—		—		(145	)		—			—			(145	)
Equity-based compensation expense		—		—		5,808			—			—			5,808
Other comprehensive loss		—		—		—			(7,741	)		—			(7,741	)
Net income attributable to Acadia Healthcare    Company, Inc.		—		—		—			—			41,079			41,079
Balance at June 30, 2020		87,898		879		2,567,050			(500,879	)		436,288			2,503,338
Common stock issued under stock incentive plans		22		—		180			—			—			180
Common stock withheld for minimum statutory taxes		—		—		(114	)		—			—			(114	)
Equity-based compensation expense		—		—		5,471			—			—			5,471
Other comprehensive income		—		—		—			60,766			—			60,766
Net income attributable to Acadia Healthcare    Company, Inc.		—		—		—			—			36,998			36,998
Balance at September 30, 2020		87,920		879		2,572,587			(440,113	)		473,286			2,606,639
Common stock issued under stock incentive plans		104		1		1,676			—			—			1,677
Common stock withheld for minimum statutory taxes		—		—		(182	)		—			—			(182	)
Equity-based compensation expense		—		—		6,246			—			—			6,246
Other comprehensive income		—		—		—			68,748			—			68,748
Net loss attributable to Acadia Healthcare    Company, Inc.		—		—		—			—			(783,672	)		(783,672	)
Balance at December 31, 2020		88,024		880		2,580,327			(371,365	)		(310,386	)		1,899,456
Common stock issued under stock incentive plans		705		7		12,733			—			—			12,740
Common stock withheld for minimum statutory taxes		—		—		(4,521	)		—			—			(4,521	)
Equity-based compensation expense		—		—		7,034			—			—			7,034
Other		—		—		2,208			—			—			2,208
Other comprehensive income		—		—		—			371,365			—			371,365
Net income attributable to Acadia Healthcare    Company, Inc.		—		—		—			—			9,717			9,717
Balance at March 31, 2021		88,729		887		2,597,781			—			(300,669	)		2,297,999
Common stock issued under stock incentive plans		188		2		5,620			—			—			5,622
Common stock withheld for minimum statutory taxes		—		—		(580	)		—			—			(580	)
Equity-based compensation expense		—		—		9,031			—			—			9,031
Net income attributable to Acadia Healthcare    Company, Inc.		—		—		—			—			44,514			44,514
Balance at June 30, 2021		88,917		889		2,611,852			—			(256,155	)		2,356,586
Common stock issued under stock incentive plans		89		1		3,254			—			—			3,255
Common stock withheld for minimum statutory taxes		—		—		(444	)		—			—			(444	)
Equity-based compensation expense		—		—		8,923			—			—			8,923
Net income attributable to Acadia Healthcare    Company, Inc.		—		—		—			—			66,126			66,126
Balance at September 30, 2021		89,006	$	890	$	2,623,585		$	—		$	(190,029	)	$	2,434,446

See accompanying notes.

4

Acadia Healthcare Company, Inc.

Condensed Consolidated Statements of Cash Flows

(Unaudited)

	Nine Months Ended September 30,
	2021			2020
	(In thousands)
Operating activities:
Net income	$	124,043		$	113,342
Adjustments to reconcile net income to net cash provided by continuing operating     activities:
Depreciation and amortization		78,349			70,298
Amortization of debt issuance costs		3,265			9,696
Equity-based compensation expense		24,988			16,258
Deferred income taxes		8,995			45,105
Loss (income) from discontinued operations, net of taxes		12,641			(29,804	)
Debt extinguishment costs		24,650			3,271
Loss on impairment		24,293			—
Other		881			1,024
Change in operating assets and liabilities:
Accounts receivable, net		(8,610	)		7,364
Other current assets		(2,758	)		(4,942	)
Other assets		(15,846	)		(880	)
Accounts payable and other accrued liabilities		6,358			19,854
Accrued salaries and benefits		18,820			14,150
Other liabilities		(11,633	)		(2,256	)
Government relief funds		(12,058	)		103,908
Net cash provided by continuing operating activities		276,378			366,388
Net cash provided by discontinued operating activities		253			105,852
Net cash provided by operating activities		276,631			472,240
Investing activities:
Cash paid for capital expenditures		(156,624	)		(168,804	)
Proceeds from U.K. Sale		1,511,020			—
Settlement of foreign currency derivatives		(84,795	)		—
Proceeds from sale of property and equipment		1,792			72
Cash paid for purchase of finance lease		(31,401	)		—
Other		4,906			(10,734	)
Net cash provided by (used in) continuing investing activities		1,244,898			(179,466	)
Net cash used in discontinued investing activities		—			(30,188	)
Net cash provided by (used in) investing activities		1,244,898			(209,654	)
Financing activities:
Borrowings on long-term debt		425,000			450,000
Borrowings on revolving credit facility		430,000			100,000
Principal payments on revolving credit facility		(330,000	)		(100,000	)
Principal payments on long-term debt		(5,313	)		(31,863	)
Repayment of long-term debt		(2,227,935	)		(450,000	)
Payment of debt issuance costs		(7,964	)		(11,220	)
Common stock withheld for minimum statutory taxes, net		16,072			(1,311	)
Distributions to noncontrolling interests		(926	)		(653	)
Other		(6,914	)		(1,291	)
Net cash used in continuing financing activities		(1,707,980	)		(46,338	)
Net cash used in discontinued financing activities		—			(2,226	)
Net cash used in financing activities		(1,707,980	)		(48,564	)
Effect of exchange rate changes on cash		4,067			488
Net (decrease) increase in cash and cash equivalents, including cash classified within     current assets held for sale		(182,384	)		214,510
Less: cash classified within current assets held for sale		—			(50,568	)
Net (decrease) increase in cash and cash equivalents		(182,384	)		163,942
Cash and cash equivalents at beginning of the period		378,697			124,192
Cash and cash equivalents at end of the period	$	196,313		$	288,134

See accompanying notes.

5

Acadia Healthcare Company, Inc.

Notes to Condensed Consolidated Financial Statements

September 30, 2021

(Unaudited)

1. Description of Business and Basis of Presentation

Description of Business

Acadia Healthcare Company, Inc. (the “Company”) develops and operates inpatient psychiatric facilities, residential treatment centers, group homes, substance abuse facilities and facilities providing outpatient behavioral healthcare services to serve the behavioral health and recovery needs of communities throughout the United States (“U.S.”) and Puerto Rico. At September 30, 2021, the Company operated 230 behavioral healthcare facilities with approximately 10,200 beds in 40 states and Puerto Rico.

On January 19, 2021, the Company completed the sale of its United Kingdom (“U.K.”) operations to RemedcoUK Limited, a company organized under the laws of England and Wales and owned by funds managed or advised by Waterland Private Equity Fund VII (the “U.K. Sale”). The U.K. Sale allowed us to reduce our indebtedness and focus on our U.S. operations. As a result of the U.K. Sale, the Company reported, for all periods presented, results of operations and cash flows of the U.K. operations as discontinued operations in the accompanying financial statements. See Note 3 – U.K. Sale.

Basis of Presentation

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

The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) 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 our 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, 2020 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, 2020 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on February 26, 2021. 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.

During March 2020, the global pandemic of the novel coronavirus known as COVID-19 (“COVID-19”) began to affect the Company’s facilities, employees, patients, communities, business operations and financial performance, as well as the broader U.S. and U.K. economies and financial markets. At many of the Company’s facilities, employees and/or patients have tested positive for COVID-19. The Company is committed to protecting the health of our communities and has been responding to the evolving COVID-19 situation while taking steps to provide quality care and protect the health and safety of patients and employees. All of the Company’s facilities are closely following infectious disease protocols, as well as recommendations by the Centers for Disease Control and Prevention (“CDC”) and local health officials. The Company has established an internal COVID-19 taskforce, taken steps to secure its supply chain, expanded telehealth capabilities and implemented emergency planning in directly impacted markets. Nevertheless, COVID-19 may adversely impact the Company’s business and have an impact on its financial results that management is not currently able to quantify. Disruptions to the Company’s business as a result of the COVID-19 pandemic could have a material adverse effect on its results of operations, financial condition, cash flows and ability to service its indebtedness and may affect the amounts reported in the consolidated financial statements including those related to collectability of accounts receivable as well as professional and general liability reserves, tax assets and liabilities and may result in a potential impairment of goodwill and long-lived assets.

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

2. Recently Issued Accounting Standards

In March 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) ASU 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting” (“ASU 2020-04”). ASU 2020-04 provides optional guidance for a limited period of time to ease the potential burden in accounting for or

6

recognizing the effects of reference rate reform on financial reporting and applies only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. ASU 2020-04 is effective as of March 12, 2020 through December 31, 2022. Entities may adopt ASU 2020-04 as of any date from the beginning of an interim period that includes or is subsequent to March 12, 2020 or prospectively from a date within an interim period that includes or is subsequent to March 12, 2020, up to the date that the financial statements are available to be issued. Management is evaluating the impact of ASU 2020-04 on the Company’s consolidated financial statements.

In December 2019, FASB issued ASU 2019-12, “Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes” (“ASU 2019-12”). ASU 2019-12 simplifies the accounting for income taxes by eliminating certain exceptions to the guidance in Topic 740 related to the approach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period and the recognition of deferred tax liabilities for outside basis differences. The new guidance also simplifies aspects of the accounting for franchise taxes and enacted changes in tax laws or rates and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill and allocating consolidated income taxes to separate financial statements of entities not subject to income tax. ASU 2019-12 is effective for fiscal years beginning after December 15, 2020. Upon adoption, the Company must apply certain aspects of this standard retrospectively for all periods presented while other aspects are applied on a modified retrospective basis through a cumulative-effect adjustment to retained earnings as of the beginning of the fiscal year of adoption. The Company adopted ASU 2019-12 on January 1, 2021. There is no significant impact to the Company’s consolidated financial statements.

3. U.K. Sale

On January 19, 2021, the Company completed the U.K. Sale pursuant to a Share Purchase Agreement in which it sold all of the securities of AHC-WW Jersey Limited, a private limited liability company incorporated in Jersey and a subsidiary of the Company, which constituted the entirety of the Company’s U.K. business operations. The U.K. Sale resulted in approximately $1,525 million of gross proceeds before deducting the settlement of existing foreign currency hedging liabilities of $85 million based on the current British Pounds (“GBP”) to U.S. Dollars (“USD”) exchange rate, cash retained by the buyer and transaction costs. The Company used the net proceeds of approximately $1,425 million (excluding cash retained by the buyer) along with cash from the balance sheet to reduce debt by $1,640 million during the first quarter of 2021 as described in Note 11 – Long-Term Debt.

As a result of the U.K. Sale, the Company reported, for all periods presented, results of operations and cash flows of the U.K. operations as discontinued operations in the accompanying financial statements. In December 2020, the Company’s U.K. operations met the criteria to be classified as assets held for sale. The carrying value of the U.K. operations was written down to fair value less costs to sell in the condensed consolidated balance sheet at December 31, 2020. This resulted in a loss on sale of $867.3 million, which includes approximately $356.2 million of non-cash goodwill impairment, within discontinued operations in the consolidated statement of operations for the year ended December 31, 2020. During the first quarter of 2021, an additional $14.3 million was recorded as loss on sale primarily resulting from an increase in the U.K. operations carrying value.

For the three and nine months ended September 30, 2021 and 2020, results of operations of the U.K. operations were as follows (in thousands):

	Three Months Ended September 30,					Nine Months Ended September 30,
	2021		2020			2021			2020
Revenue	$	—	$	285,343		$	62,520		$	817,772
Salaries, wages and benefits		—		159,840			35,937			465,514
Professional fees		—		31,987			6,815			92,264
Supplies		—		9,434			2,217			28,274
Rents and leases		—		11,817			2,509			34,858
Other operating expenses		—		28,880			6,682			85,682
Depreciation and amortization		—		18,780			—			55,739
Interest expense, net		—		238			10			666
Loss on sale		—		—			14,254			—
Loss on impairment		—		20,239			—			20,239
Transaction-related expenses		—		5,479			6,265			7,735
Total expenses		—		286,694			74,689			790,971
(Loss) income from discontinued operations      before income taxes		—		(1,351	)		(12,169	)		26,801
(Benefit from) provision for income taxes		—		(2,025	)		472			(3,003	)
Income (loss) from discontinued operations, net      of taxes	$	—	$	674		$	(12,641	)	$	29,804

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The major classes of assets and liabilities for the U.K. operations as of December 31, 2020 are shown below (in thousands):

Cash and cash equivalents	$	75,051
Accounts receivable, net		52,196
Other current assets		13,361
Current assets of discontinued operations		140,608
Property and equipment, net		1,297,923
Goodwill		—
Intangible assets, net		22,289
Operating lease right-of-use assets		341,289
Other assets		7,706
Total assets of discontinued operations	$	1,809,815
Current liabilities:
Accounts payable	$	44,929
Current portion of operating lease liabilities		11,141
Other current liabilities		136,895
Current liabilities of discontinued operations		192,965
Operating lease liabilities		387,607
Deferred tax liabilities		57,230
Other liabilities		22,225
Total liabilities of discontinued operations	$	660,027

4. 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.

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

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

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

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

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

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

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

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

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021		2020
Acute inpatient psychiatric facilities	$	284,143	$	259,353	$	832,692	$	723,611
Specialty treatment facilities		230,753		211,796		669,552		597,886
Residential treatment centers		71,006		71,153		211,377		210,432
Outpatient community-based facilities		1,657		5,659		7,293		16,724
Revenue	$	587,559	$	547,961	$	1,720,914	$	1,548,653

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

The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients and implicit price concessions. Contractual adjustments and discounts are based on contractual agreements, discount policies and historical experience. Implicit price concessions are based on historical collection experience. Most of our facilities have contracts containing variable consideration. However, it is unlikely a significant reversal of revenue will occur when the uncertainty is resolved, and therefore, the Company has included the variable consideration in the estimated transaction price. Subsequent changes resulting from a patient’s ability to pay are recorded as bad debt expense, which is included as a component of other operating expenses in the condensed consolidated statements of operations. Bad debt expense for the three and nine months ended September 30, 2021 and 2020 was not significant.

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

	Three Months Ended September 30,										Nine Months Ended September 30,
	2021					2020					2021					2020
	Amount		%			Amount		%			Amount		%			Amount		%
Commercial	$	170,427		29.0	%	$	156,741		28.6	%	$	511,975		29.8	%	$	439,911		28.4	%
Medicare		97,529		16.6	%		96,536		17.6	%		274,208		15.9	%		244,721		15.9	%
Medicaid		288,092		49.0	%		261,341		47.7	%		845,128		49.1	%		767,075		49.4	%
Self-Pay		25,998		4.4	%		26,060		4.8	%		71,875		4.2	%		75,570		4.9	%
Other		5,513		1.0	%		7,283		1.3	%		17,728		1.0	%		21,376		1.4	%
Revenue	$	587,559		100.0	%	$	547,961		100.0	%	$	1,720,914		100.0	%	$	1,548,653		100.0	%

Contract liabilities primarily consisted of unearned revenue from CMS’ Accelerated and Advance Payment Program. In April 2020, the Company received approximately $45 million from CMS’ Accelerated and Advance Payment Program for Medicare providers. The Company repaid approximately $7 million and $10 million of the $45 million of advance payments during the second and third quarters of 2021, respectively, via recoupment from the Company’s new Medicare claims and will continue to repay the remaining balance on a monthly basis through September 2022. Contract liabilities of $32.9 million are included in other accrued liabilities at September 30, 2021 and, at December 31, 2020, $35.9 million was included in other accrued liabilities and $11.3 million in other liabilities on the condensed consolidated balance sheets. A summary of the activity in contract liabilities is as follows (in thousands):

Balance at December 31, 2020	$	47,196
Payments received		5,385
Revenue recognized		(2,724	)
Medicare advance repayments		(16,931	)
Balance at September 30, 2021	$	32,926

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5. Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2021 and 2020 (in thousands, except per share amounts):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021			2020
Numerator:
Income from continuing operations attributable to    Acadia Healthcare Company, Inc.	$	66,126	$	36,324	$	132,998		$	81,736
Income (loss) from discontinued operations		—		674		(12,641	)		29,804
Net income attributable to Acadia Healthcare     Company, Inc.	$	66,126	$	36,998	$	120,357		$	111,540
Denominator:
Weighted average shares outstanding for basic    earnings per share		88,962		87,911		88,684			87,849
Effects of dilutive instruments		1,927		945		1,920			600
Shares used in computing diluted earnings per    common share		90,889		88,856		90,604			88,449
Basic earnings per share attributable to Acadia    Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to     Acadia Healthcare Company, Inc.	$	0.74	$	0.41	$	1.50		$	0.93
Income (loss) from discontinued operations		—		0.01		(0.14	)		0.34
Net income attributable to Acadia Healthcare     Company, Inc.	$	0.74	$	0.42	$	1.36		$	1.27
Diluted earnings per share attributable to Acadia    Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to     Acadia Healthcare Company, Inc.	$	0.73	$	0.41	$	1.47		$	0.92
Income (loss) from discontinued operations		—		0.01		(0.14	)		0.34
Net income attributable to Acadia Healthcare     Company, Inc.	$	0.73	$	0.42	$	1.33		$	1.26

Approximately 0.3 million and 2.0 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 September 30, 2021 and 2020, respectively, because their effect would have been anti-dilutive. Approximately 0.4 million and 2.1 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 nine months ended September 30, 2021 and 2020, respectively, because their effect would have been anti-dilutive.

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6. Other Current Assets

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

	September 30, 2021		December 31, 2020
Prepaid expenses	$	28,664	$	19,480
Assets held for sale		17,566		—
Workers’ compensation deposits – current portion		12,000		12,000
Other receivables		8,530		10,025
Income taxes receivable		7,952		897
Insurance receivable – current portion		6,792		6,792
Inventory		4,322		4,851
Cost report receivable		—		5,818
Other		2,859		1,469
Other current assets	$	88,685	$	61,332

7. Property and Equipment

Property and equipment consisted of the following at September 30, 2021 and December 31, 2020 (in thousands):

	September 30, 2021			December 31, 2020
Land	$	149,759		$	144,221
Building and improvements		1,640,951			1,490,149
Equipment		244,484			220,690
Construction in progress		143,766			217,479
		2,178,960			2,072,539
Less: accumulated depreciation		(513,935	)		(449,643	)
Property and equipment, net	$	1,665,025		$	1,622,896

During the three months ended June 30, 2021, the Company opened a 260-bed replacement facility in Pennsylvania and recorded a non-cash property impairment charge of $23.2 million for the existing facility. Additionally, during the three months ended September 30, 2021, the Company recorded a $1.1 million non-cash property impairment charge for one facility in Louisiana resulting from hurricane damage.

8. Goodwill and Other Intangible Assets

Other identifiable intangible assets and related accumulated amortization consisted of the following at September 30, 2021 and December 31, 2020 (in thousands):

	Gross Carrying Amount				Accumulated Amortization
	September 30, 2021		December 31, 2020		September 30, 2021			December 31, 2020
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		11,663		11,873		—			—
Trade names		40,435		39,526		—			—
Certificates of need		17,268		17,136		—			—
		69,366		68,535		—			—
Total	$	70,497	$	69,666	$	(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 certificate of need intangible assets have indefinite lives and are, therefore, not subject to amortization.

During the second quarter of 2021, the Company sold one outpatient facility for $4.3 million and recorded a write down of $1.8 million of goodwill and $0.2 million of intangible assets related to the disposition. This disposition is reflected in other investing

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activities in the condensed consolidated statement of cash flows.

9. The CARES Act

As part of the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”), the U.S. government announced it would offer $100 billion of relief to eligible healthcare providers. On April 24, 2020, then President Trump signed into law the Paycheck Protection Program and Health Care Enhancement Act (the “PPP Act”). Among other things, the PPP Act allocated $75 billion to eligible healthcare providers to help offset COVID-19 related losses and expenses. The $75 billion allocated under the PPP Act is in addition to the $100 billion allocated to healthcare providers for the same purposes in the CARES Act and has been disbursed to providers under terms and conditions similar to the CARES Act funds. During the three months ended June 30, 2020, the Company participated in certain relief programs offered through the CARES Act, including receipt of approximately $19.7 million relating to the initial portions of the Public Health and Social Services Emergency Fund (the “PHSSE Fund”), also known as the Provider Relief Fund, and approximately $45 million of payments from the CMS Accelerated and Advance Payment Program. In August 2020, the Company received approximately $12.8 million of additional funds from the PHSSE Fund. The Company repaid approximately $7 million and $10 million of the $45 million of advance payments during the second and third quarters of 2021, respectively, via recoupment from the Company’s new Medicare claims and will continue to repay the remaining balance on a monthly basis through September 2022. In addition, the Company received a 2% increase in facilities’ Medicare reimbursement rate as a result of the temporary suspension of Medicare sequestration from May 1, 2020, to December 31, 2021. In April 2021, the Company received $24.2 million of additional funds from the PHSSE Fund, which is included in other accrued liabilities on the condensed consolidated balance sheet at September 30, 2021.

The CARES Act also provides for certain federal income and other tax changes, including an increase in the interest expense tax deduction limitation and bonus depreciation of qualified improvement property. Furthermore, under the CARES Act, (i) for taxable years beginning before 2021, net operating loss (“NOL”) carryforwards and carrybacks may offset 100% of taxable income and (ii) NOLs arising in 2018, 2019 and 2020 taxable years may be carried back to each of the preceding five years to generate a refund. As a result, in 2019 and 2020 the Company received a benefit, in the form of refunds and lower future tax payments, of $51.6 million, consisting of $22.8 million related to interest expense, $20.5 million related to qualified improvement property legislation and an $8.3 million permanent benefit due to loss being able to be carried back at a 35% tax rate to offset income in tax years prior to 2018 (21% for tax years after 2017). The Company also received a cash benefit of approximately $39 million for 2020 relating to the delay of payment of the employer portion of Social Security payroll taxes, as enacted by the CARES Act. The Company repaid half of the $39 million of payroll tax deferrals during the three months ended September 30, 2021 and expects to repay the remaining portion by December 31, 2022.

During the three months ended June 30, 2020, the Company recorded $18.1 million of other income in the condensed consolidated statement of operations related to $19.7 million received from the PHSSE Fund during the quarter. This was subsequently reversed during the third quarter of 2020. During the fourth quarter of 2020, the Company recorded $32.8 million of other income in the consolidated statement of operations related to $34.9 million received from the PHSSE Fund from April through December 2020. The Company’s recognition of this income was based on revised guidance in the Consolidated Appropriations Act, 2021 enacted in December 2020. The Company continues to evaluate its compliance with the terms and conditions to, and the financial impact of, funds received under the CARES Act and other government relief programs.

10. Other Accrued Liabilities

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

	September 30, 2021		December 31, 2020
Accrued expenses	$	38,386	$	28,452
Contract liabilities		32,926		35,946
Government relief funds		28,310		5,495
Accrued interest		17,158		40,479
Income taxes payable		9,921		16,345
Insurance liability – current portion		9,700		9,700
Accrued property taxes		9,054		6,763
Cost report payable		4,210		—
Finance lease liabilities		990		32,188
Other		6,549		3,085
Other accrued liabilities	$	157,204	$	178,453

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During the three months ended September 30, 2021, the Company purchased a leased property for approximately $31.4 million, which was recorded as a finance lease liability within other accrued liabilities on the condensed consolidated balance sheet at December 31, 2020.

11.Long-Term Debt

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

	September 30, 2021			December 31, 2020
New Credit Facility:
Term Loan A	$	419,687		$	—
Revolving Line of Credit		100,000			—
Prior Credit Facility:
Senior Secured Term A Loan		—			311,733
Senior Secured Term B Loans		—			872,870
Senior Secured Revolving Line of Credit		—			—
5.625% Senior Notes due 2023		—			650,000
6.500% Senior Notes due 2024		—			390,000
5.500% Senior Notes due 2028		450,000			450,000
5.000% Senior Notes due 2029		475,000			475,000
Other long-term debt		—			3,625
Less: unamortized debt issuance costs, discount and    premium		(15,342	)		(30,802	)
		1,429,345			3,122,426
Less: current portion		(15,938	)		(153,478	)
Long-term debt	$	1,413,407		$	2,968,948

New Credit Facility

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

As a part of the closing of the New Credit Facility on March 17, 2021, the Company (i) refinanced and terminated the Company’s prior credit facilities under the Amended and Restated Credit Agreement, dated as of December 31, 2012 (the “Prior Credit Facility”) and (ii) financed the redemption of all of the Company’s outstanding 5.625% Senior Notes due 2023 (the “5.625% Senior Notes”).

The Company had $496.6 million of availability under the Revolving Facility and had standby letters of credit outstanding of $3.4 million related to security for the payment of claims required by its workers’ compensation insurance program at September 30, 2021.

During the nine months ended September 30, 2021, the Company repaid $60.0 million of the balance outstanding on the Revolving Facility.

The New Credit Facility requires quarterly term loan principal repayments for the Term Loan Facility of $2.7 million for December 31, 2021 to March 31, 2022, $5.3 million for June 30, 2022 to March 31, 2024, $8.0 million for June 30, 2024 to March 31, 2025, $10.6 million for June 30, 2025 to December 31, 2025, with the remaining principal balance of the Term Loan Facility due on the maturity date of March 17, 2026.

The Company has the ability to increase the amount of the Senior Facilities, which may take the form of increases to the Revolving Facility or the Term Loan Facility or the issuance of one or more incremental term loan facilities (collectively, the “Incremental Facilities”), upon obtaining additional commitments from new or existing lenders and the satisfaction of customary conditions precedent for such Incremental Facilities. Such Incremental Facilities may not exceed the sum of (i) the greater of $480.0 million and an amount equal to 100% of Consolidated EBITDA (as defined in the New Credit Facility) of the Company and its Restricted Subsidiaries (as defined in the New Credit Facility) (as determined for the four fiscal quarter period most recently ended for which financial statements are available), and (ii) additional amounts so long as, after giving effect thereto, the Consolidated Senior Secured Net Leverage Ratio (as defined in the New Credit Facility) does not exceed 3.5 to 1.0.

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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 New Credit Facility. Borrowings under the Senior Facilities bear interest at a floating rate, which will initially be, at the Company’s option, either (i) adjusted LIBOR plus 1.75% or (ii) an alternative base rate plus 0.75% (in each case, subject to adjustment based on the Company’s consolidated total net leverage ratio). An unused fee initially set at 0.25% per annum (subject to adjustment based on the Company’s consolidated total net leverage ratio) is payable quarterly in arrears based on the actual daily undrawn portion of the commitments in respect of the Revolving Facility.

The New 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 New Credit Facility contains financial covenants requiring the Company on a consolidated basis to maintain, as of the last day of any consecutive four fiscal quarter period, a consolidated total net leverage ratio of not more than 5.0 to 1.0 and an interest coverage ratio of at least 3.0 to 1.0. The New 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 Senior Facilities may be accelerated and/or the lenders’ commitments terminated. At September 30, 2021, the Company was in compliance with such covenants.

Prior Credit Facility

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

On April 21, 2020, the Company entered into the Thirteenth Amendment (the “Thirteenth Amendment”) to the Prior Credit Facility. The Thirteenth Amendment amended the Consolidated Leverage Ratio in the prior covenant to increase such leverage ratio for the rest of 2020.

On November 13, 2020, the Company entered into the Fourth Repricing Facilities Amendment (the “Fourth Repricing Facilities Amendment”) to the Prior Credit Facility. The Fourth Repricing Facilities Amendment extended the maturity date of each of the prior revolving line of credit and the prior Term Loan A Facility (“TLA Facility”) from November 30, 2021 to November 30, 2022. The Fourth Repricing Facilities Amendment also (1) replaced the revolving line of credit in an aggregate committed amount of $500.0 million with an aggregate committed amount of approximately $459.0 million and (2) replaced the TLA Facility aggregate outstanding principal amount of approximately $352.4 million with an aggregate principal amount of approximately $318.9 million. The interest rate margin applicable to both facilities remained unchanged from the prior facilities, and the commitment fee applicable to the new revolving line of credit also remained unchanged from the prior revolving line of credit. In connection with the Fourth Repricing Facilities Amendment, the Company recorded a debt extinguishment charge of $1.0 million, including the write-off of discount and deferred financing costs, which was recorded in debt extinguishment costs in the consolidated statement of operations for the year ended December 31, 2020.

On January 5, 2021, the Company made a voluntary payment of $105.0 million on the Term Loan B Facility Tranche B-4 (“Tranche B-4 Facility”). On January 19, 2021, the Company used a portion of the net proceeds from the U.K. Sale to repay the outstanding balances of $311.7 million of its TLA Facility and $767.9 million of its Tranche B-4 Facility of the Prior Credit Facility. At March 31, 2021, in connection with the termination of the Prior Credit Facility, the Company recorded a debt extinguishment charge of $10.9 million, including the write-off of discount and deferred financing costs, which was recorded in debt extinguishment costs in the condensed consolidated statement of operations.

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 Company used the net proceeds of the 5.000% Senior Notes to prepay approximately $453.3 million of the outstanding borrowings on our existing Term Loan B Facility Tranche B-3 (“Tranche B-3 Facility”) and used the remaining net proceeds for general corporate purposes and to pay related fees and expenses in

14

connection with the offering. In connection with the 5.000% Senior Notes, the Company recorded a debt extinguishment charge of $2.9 million, including the write-off of discount and deferred financing costs of the Tranche B-3 Facility, which was recorded in debt extinguishment costs in the consolidated statement of operations for the year ended December 31, 2020.

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 New 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.

5.625% Senior Notes due 2023

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

6.500% Senior Notes due 2024

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

Redemption of 5.625% Senior Notes and 6.500% Senior Notes

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

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

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

6.125% Senior Notes due 2021

On March 12, 2013, the Company issued $150.0 million of 6.125% Senior Notes due 2021 (the “6.125% Senior Notes”). The 6.125% Senior Notes were to mature on March 15, 2021 and bear interest at a rate of 6.125% per annum, payable semi-annually in arrears on March 15 and September 15 of each year. On June 24, 2020, the Company redeemed the 6.125% Senior Notes.

5.125% Senior Notes due 2022

On July 1, 2014, the Company issued $300.0 million of 5.125% Senior Notes due 2022 (the “5.125% Senior Notes”). The 5.125% Senior Notes were to mature on July 1, 2022 and bear interest at a rate of 5.125% per annum, payable semi-annually in arrears on January 1 and July 1 of each year. On June 24, 2020, the Company redeemed the 5.125% Senior Notes.

Redemption of 6.125% Senior Notes and 5.125% Senior Notes

On June 10, 2020, the Company issued conditional notices of full redemption providing for the redemption in full of the 6.125% Senior Notes and 5.125% Senior Notes on July 10, 2020 (the “Redemption Date”), in each case at a redemption price equal to 100.0% of the principal amount thereof, plus accrued and unpaid interest, if any, to, but not including the Redemption Date (the “Redemption Price”). On June 24, 2020, the Company satisfied and discharged the indentures governing the 6.125% Senior Notes and the 5.125% Senior Notes by irrevocably depositing with a trustee sufficient funds equal to the Redemption Price for the 6.125% Senior Notes and

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the 5.125% Senior Notes and otherwise complying with the terms in the indentures relating to the satisfaction and discharge of the 6.125% Senior Notes and the 5.125% Senior Notes. In connection with the redemption of the 6.125% Senior Notes and the 5.125% Senior Notes, the Company recorded a debt extinguishment charge of $3.3 million, including the write-off of the deferred financing and other costs in the consolidated statement of operations for the year ended December 31, 2020.

Other long-term debt

During the nine months ended September 30, 2021, the Company repaid other long-term debt of $3.3 million, which is reflected in repayment of long-term debt within financing activities in the condensed consolidated statement of cash flows.

12. Noncontrolling Interests

Noncontrolling interests in the consolidated financial statements represents the portion of equity held by noncontrolling partners in the Company’s non-wholly owned subsidiaries. At September 30, 2021, the Company operated six facilities through non-wholly owned subsidiaries. The Company owns between 60% and 86% 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, and the Company consolidates the operations of each facility based on its equity ownership and its control of the entity. The noncontrolling interests are reflected as redeemable noncontrolling interests on the accompanying 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 December 31, 2020	$	55,315
Contribution of redeemable noncontrolling interests		3,999
Net income attributable to noncontrolling interests		3,686
Dividend payments to noncontrolling interests		(926	)
Balance at September 30, 2021	$	62,074

13. Variable Interest Entities

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

At September 30, 2021, the Company operated six facilities through non-wholly owned subsidiaries. The Company owns between 60% and 86% 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 our VIEs prohibit us from using the assets of each VIE to satisfy the obligations of other entities. Consolidated assets at September 30, 2021 and December 31, 2020 include total assets of variable interest entities of $298.9 million and $261.7 million, respectively, which cannot be used to settle the obligations of other entities. Consolidated liabilities at September 30, 2021 and December 31, 2020 include total liabilities of variable interest entities of $24.4 million and $26.1 million, respectively.

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

	September 30, 2021		December 31, 2020
Cash and cash equivalents	$	25,028	$	15,151
Accounts receivable, net		20,673		18,507
Other current assets		2,029		1,461
Total current assets		47,730		35,119
Property and equipment, net		199,078		175,103
Goodwill		34,945		34,945
Intangible assets, net		10,490		9,581
Operating lease right-of-use assets		6,681		6,909
Total assets	$	298,924	$	261,657
Accounts payable	$	3,102	$	4,143
Accrued salaries and benefits		5,735		4,357
Current portion of operating lease liabilities		188		164
Other accrued liabilities		7,604		8,366
Total current liabilities		16,629		17,030
Operating lease liabilities		6,718		6,863
Other liabilities		1,083		2,166
Total liabilities	$	24,430	$	26,059

14. Accumulated Other Comprehensive Loss

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

	Foreign Currency Translation Adjustments			Change in Fair Value of Derivative Instruments			Pension Plan			Total
Balance at December 31, 2020	$	(373,101	)	$	13,686		$	(11,950	)	$	(371,365	)
Foreign currency translation (loss) gain		(4,293	)		—			33			(4,260	)
Gain on derivative instruments, net of tax of $0.1    million		—			19			—			19
U.K. Sale		377,394			(13,705	)		11,917			375,606
Balance at September 30, 2021	$	—		$	—		$	—		$	—

15. Equity-Based Compensation

Equity Incentive Plans

The Company issues stock-based awards, including stock options, restricted stock and restricted stock units, to certain officers, employees and non-employee directors under the Acadia Healthcare Company, Inc. Incentive Compensation Plan (the “Equity Incentive Plan”). At September 30, 2021, a maximum of 12,700,000 shares of the Company’s common stock were authorized for issuance as stock options, restricted stock and restricted stock units or other share-based compensation under the Equity Incentive Plan, of which 4,484,084 were available for future grant. Stock options may be granted for terms of up to 10 years. The Company recognizes expense on all share-based awards on a straight-line basis over the requisite service period of the entire award. Grants to employees generally vest in annual increments of 25% each year, commencing one year after the date of grant. The exercise prices of stock options are equal to the most recent closing price of the Company’s common stock on the most recent trading date prior to the date of grant.

The Company recognized $8.9 million and $5.5 million in equity-based compensation expense for the three months ended September 30, 2021 and 2020, respectively, and $25.0 million and $16.3 million for the nine months ended September 30, 2021 and 2020, respectively. At September 30, 2021, there was $48.5 million of unrecognized compensation expense related to unvested

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options, restricted stock and restricted stock units, which is expected to be recognized over the remaining weighted average vesting period of 1.2 years.

The Company recognized a deferred income tax benefit of $2.3 million and $1.4 million for the three months ended September 30, 2021 and 2020, respectively, related to equity-based compensation expense. The Company recognized a deferred income tax benefit of $6.4 million and $4.2 million for the nine months ended September 30, 2021 and 2020, respectively, related to equity-based compensation expense.

Stock Options

Stock option activity during 2020 and 2021 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, 2020		1,360,068		$	39.40		7.57	$	1,650
Options granted		507,600			33.13		9.18		157
Options exercised		(68,700	)		29.15	N/A			854
Options cancelled		(288,662	)		39.67	N/A		N/A
Options outstanding at December 31, 2020		1,510,306			37.56		7.35		1,414
Options granted		306,520			57.58		7.66		823
Options exercised		(547,522	)		39.48	N/A			10,846
Options cancelled		(143,165	)		39.97	N/A		N/A
Options outstanding at September 30, 2021		1,126,139		$	41.77		7.39	$	20,808
Options exercisable at December 31, 2020		596,606		$	45.37		5.55	$	543
Options exercisable at September 30, 2021		332,934		$	43.20		6.00	$	5,767

Fair values are estimated using the Black-Scholes option pricing model. The following table summarizes the grant-date fair value of options and the assumptions used to develop the fair value estimates for options granted during the nine months ended September 30, 2021 and year ended December 31, 2020:

	September 30, 2021			December 31, 2020
Weighted average grant-date fair value of options	$	20.67		$	12.37
Risk-free interest rate		0.9	%		1.6	%
Expected volatility		40	%		41	%
Expected life (in years)		5.0			5.0

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

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Other Stock-Based Awards

Restricted stock activity during 2020 and 2021 was as follows:

	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2020		805,136		$	34.14
Granted		637,312			25.82
Cancelled		(129,683	)		34.56
Vested		(289,769	)		35.88
Unvested at December 31, 2020		1,022,996		$	28.41
Granted		324,530			58.48
Cancelled		(66,801	)		38.56
Vested		(352,184	)		30.63
Unvested at September 30, 2021		928,541		$	37.35

Restricted stock unit activity during 2020 and 2021 was as follows:

	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2020		447,357		$	38.89
Granted		583,680			10.60
Performance adjustment		117,772			13.50
Cancelled		(63,056	)		43.35
Vested		(12,691	)		42.09
Unvested at December 31, 2020		1,073,062		$	20.15
Granted		149,416			61.52
Performance adjustment		345,731			24.10
Cancelled		—			—
Vested		(184,051	)		42.30
Unvested at September 30, 2021		1,384,158		$	22.66

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

Restricted stock units are granted to employees and are subject to Company performance compared to pre-established targets and Company performance compared to peers. In addition to Company performance, these performance-based restricted stock units are subject to the continuing service of the employee during the two- or three-year period covered by the awards. The performance condition for the restricted stock units is based on the Company’s achievement of annually established targets for diluted earnings per share. Additionally, the number of shares issuable pursuant to restricted stock units granted during 2020 are subject to adjustment based on the Company’s three-year annualized total stockholder return relative to a peer group consisting of S&P 1500 companies within the Healthcare Providers & Services 6 digit GICS industry group and selected other companies deemed to be peers. The number of shares issuable at the end of the applicable vesting period of restricted stock units ranges from 0% to 200% of the targeted units based on the Company’s actual performance compared to the targets and, for 2021 and 2020 awards, performance compared to peers.

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

16. Income Taxes

The provision for income taxes for the three months ended September 30, 2021 and 2020 reflects effective tax rates of 20.4% and 19.9%, respectively, and 23.9% and 22.4% for the nine months ended September 30, 2021 and 2020, respectively. The increase in

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the effective tax rate for the three and nine months ended September 30, 2021 was primarily attributable to the Company’s disallowance of certain compensation-related deductions and the impact of U.S. and U.K. tax legislation changes in the 2020 year.

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

17. Fair Value Measurements

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

The carrying amounts and fair values of the Company’s New Credit Facility, Prior Credit Facility, 5.625% Senior Notes, 6.500% Senior Notes, 5.500% Senior Notes, 5.000% Senior Notes, other long-term debt and derivative instruments at September 30, 2021 and December 31, 2020 were as follows (in thousands):

	Carrying Amount				Fair Value
	September 30, 2021		December 31, 2020		September 30, 2021		December 31, 2020
New Credit Facility	$	516,905	$	—	$	516,905	$	—
Prior Credit Facility	$	—	$	1,175,437	$	—	$	1,175,437
5.625% Senior Notes due 2023	$	—	$	646,344	$	—	$	647,960
6.500% Senior Notes due 2024	$	—	$	385,636	$	—	$	393,850
5.500% Senior Notes due 2028	$	443,703	$	443,139	$	466,421	$	475,931
5.000% Senior Notes due 2029	$	468,737	$	468,245	$	488,096	$	499,852
Other long-term debt	$	—	$	3,625	$	—	$	3,625
Derivative instrument liabilities	$	—	$	84,584	$	—	$	84,584

The Company’s New Credit Facility, Prior Credit Facility, 5.625% Senior Notes, 6.500% Senior Notes, 5.500% Senior Notes, 5.000% Senior Notes and other long-term debt were categorized as Level 2 in the GAAP fair value hierarchy. Fair values were based on trading activity among the Company’s lenders and the average bid and ask price as determined using published rates.

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

18.Commitments and Contingencies

Professional and General Liability

A portion of the Company’s professional liability risks are insured through a wholly-owned insurance subsidiary. The Company is self-insured for professional liability claims up to $3.0 million per claim through August 31, 2021 and $10.0 million thereafter, and has obtained reinsurance coverage from a third party to cover claims in excess of the retention limit. The reinsurance policy has a coverage limit of $75.0 million in the aggregate. The Company’s reinsurance receivables are recognized consistent with the related liabilities and include known claims and any incurred but not reported claims that are covered by current insurance policies in place.

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 False Claims Act can result in substantial monetary penalties and fines, the imposition of a corporate integrity agreement and exclusion from participation in governmental health programs. In addition, the federal False Claims Act permits private parties to bring qui tam, or “whistleblower,” suits against companies that submit false claims for payments to, or improperly retain overpayments from, the government. Some states have adopted similar state whistleblower and false claims provisions.

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 purports to be brought on behalf of a class consisting of all persons (other than defendants) who purchased securities of the Company between April 30, 2014 and

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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. At this time, we are not able to quantify any potential liability in connection with this litigation because the case is in its early stages.  

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. Joey A. 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 16, 2021, the parties filed a stipulation 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-JRS, 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. At this time, we are not able to quantify any potential liability in connection with this litigation because the cases are in their early stages.  

On April 25, 2018, plaintiff filed Pence v. Sober Living By the Sea, Inc. - 30-2018-00988742-CU-OE-CXC, Orange County Superior Court (Pence I). On July 13, 2018, plaintiff next filed Pence v. Sober Living by the Sea, Inc.; Acadia Healthcare Company, Inc. - 30-2018-01005317-CU-OE-CJC, Orange County Superior Court (Pence II). These cases have now been consolidated before the same judge in the Complex Litigation Department of the Orange County Superior Court. The complaints allege various wage and hour violations under California law on behalf of a putative class of all non-exempt California employees of Acadia and various subsidiaries, going back to April 25, 2014, and on behalf of purportedly aggrieved non-exempt employees under California’s Private Attorney General Act (“PAGA”). The claims include (1) failure to provide overtime wages; (2); failure to provide minimum wages; (3) failure to provide meal periods; (4) failure to provide rest periods; (5); failure to pay wages due at termination; (6) failure to provide accurate wage statements; (7) violations of California Business and Professions Code section 17200; and (8) civil penalties under California Labor Code section 2699 (PAGA). During the second quarter of 2020, the Company recorded approximately $4.0 million to transaction-related expenses in the condensed consolidated statements of operations based on the Company’s expected settlement and legal fees. The court granted final approval of the settlement in September 2021, and the Company made the settlement payment in October 2021.  

In the fall of 2017, the Office of Inspector General (“OIG”) issued subpoenas to three of the Company’s facilities requesting certain documents from January 2013 to the date of the subpoenas. The U.S. Attorney’s Office for the Middle District of Florida issued a civil investigative demand to one of the Company’s facilities in December 2017 requesting certain documents from November 2012 to the date of the demand. In April 2019, the OIG issued subpoenas relating to six additional facilities requesting certain documents and information from January 2013 to the date of the subpoenas. The government’s investigation of each of these facilities is focused on claims not eligible for payment because of alleged violations of certain regulatory requirements relating to, among other things, medical necessity, admission eligibility, discharge decisions, length of stay and patient care issues. The Company is cooperating with the government’s investigation but is not able to quantify any potential liability in connection with these investigations.  

19. Derivatives

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

In August 2019, the Company also entered into multiple cross currency swap agreements with an aggregate notional amount of $650.0 million to manage foreign currency risk by effectively converting a portion of its fixed-rate USD-denominated senior notes, including the semi-annual interest payments thereunder, to fixed-rate GBP-denominated debt of £538.1 million. During the term of the swap agreements, the Company received semi-annual interest payments in USD from the counterparties at fixed interest rates, and the Company made semi-annual interest payments in GBP to the counterparties at fixed interest rates. The interest payments under the cross-currency swap agreements resulted in £25.4 million of annual cash flows from the Company’s U.K. business being converted to $35.8 million.

In conjunction with the U.K. Sale in January 2021, the Company settled its cross currency swap liability and outstanding forward contracts. Cash paid from the settlement of the cross currency swap derivatives and forward contracts outstanding at December 31, 2020 are included in investing activities as part of the net proceeds received from the U.K. Sale in the condensed consolidated statement of cash flows.

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The Company designated the cross currency swap agreements and forward contracts entered into during 2020 as qualifying hedging instruments and accounted for these derivatives as net investment hedges. The fair value of these derivatives at December 31, 2020 of $84.6 million is recorded as derivative instrument liabilities in the condensed consolidated balance sheet. During 2019, the Company elected the spot method for recording its net investment hedges. Gains and losses resulting from the settlement of the excluded components were recorded in interest expense on the condensed consolidated statement of operations. Gains and losses resulting from fair value adjustments to the cross currency swap agreements were recorded in accumulated other comprehensive loss as the swaps are effective in hedging the designated risk. These gains and losses were considered in the carrying value of the U.K. operations and included in the loss on the U.K. Sale recorded in December 31, 2020 and January 2021. Prior to the U.K. Sale, cash flows related to the cross currency swap derivatives are included in operating activities in the condensed consolidated statement of cash flows.

20. Financial Information for the Company and Its Subsidiaries

The Company conducts substantially all of its business through its subsidiaries. The 5.500% Senior Notes and 5.000% Senior Notes are jointly and severally guaranteed on an unsecured senior basis by all of the Company’s subsidiaries that guarantee the Company’s obligations under the New Credit Facility. The 5.625% Senior Notes, 6.500% Senior Notes, 5.500% Senior Notes and 5.000% Senior Notes were jointly and severally guaranteed on an unsecured senior basis by all of the Company’s subsidiaries that guarantee the Company’s obligations under the Prior Credit Facility. Summarized financial information is presented below is consistent with the condensed consolidated financial statements of the Company, except transactions between combining entities have been eliminated. Financial information for the combined non-guarantor entities has been excluded. Presented below is condensed financial information for Acadia Healthcare Company, Inc. and the combined wholly-owned subsidiary guarantors at September 30, 2021 and December 31, 2020, and for the nine months ended September 30, 2021.

Summarized balance sheet information (in thousands):

	September 30, 2021		December 31, 2020
Current assets	$	496,397	$	654,735
Property and equipment, net		1,440,846		1,421,875
Goodwill		1,990,544		1,992,305
Total noncurrent assets		3,668,848		3,640,809
Current liabilities		381,950		626,419
Long-term debt		1,392,041		2,786,125
Total noncurrent liabilities		1,661,072		3,045,981
Redeemable noncontrolling interests		—		—
Total equity		2,122,223		623,144

Summarized operating results information (in thousands):

	Nine Months Ended September 30, 2021
Revenue	$	1,585,837
Income before income taxes		158,117
Net income		119,785
Net income attributable to Acadia Healthcare Company, Inc.		119,785

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations.

This Quarterly Report on Form 10-Q contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include any statements that address future results or occurrences. In some cases you can identify forward-looking statements by terminology such as “may,” “might,” “will,” “would,” “should,” “could” or the negative thereof. Generally, the words “anticipate,” “believe,” “continue,” “expect,” “intend,” “estimate,” “project,” “plan” and similar expressions identify forward-looking statements. In particular, statements about our expectations, beliefs, plans, objectives, assumptions or future events or performance are forward-looking statements.

We have based these forward-looking statements on our current expectations, assumptions, estimates and projections. While we believe these expectations, assumptions, estimates and projections are reasonable, such forward-looking statements are only predictions and involve known and unknown risks, uncertainties and other factors, many of which are outside of our control, which could cause our actual results, performance or achievements to differ materially from any results, performance or achievements expressed or implied by such forward-looking statements. These risks, uncertainties and other factors include, but are not limited to:

• the impact of the COVID-19 pandemic on our inpatient and outpatient volumes, or disruptions caused by other pandemics, epidemics or outbreaks of infectious diseases;

• the impact of vaccine and other pandemic-related mandates imposed by local, state and federal authorities on our business;

• costs of providing care to our patients, including increased staffing, equipment and supply expenses resulting from the COVID-19 pandemic;

• our ability to identify and integrate a new chief executive officer;

• our significant indebtedness, our ability to meet our debt obligations, and our ability to incur substantially more debt;

• our ability to implement our business strategies, especially in light of the COVID-19 pandemic;

• the impact of payments received from the government and third-party payors on our revenue and results of operations;

• difficulties in successfully integrating the operations of acquired facilities or realizing the potential benefits and synergies of our acquisitions and joint ventures;

• our ability to recruit and retain quality psychiatrists and other physicians, nurses, counselors and other medical support personnel;

• the impact of competition for staffing on our labor costs and profitability;

• the impact of increases to our labor costs;

• the impact of the U.S. economic and employment conditions on our business and future results of operations;

• the occurrence of patient incidents, which could result in negative media coverage, adversely affect the price of our securities and result in incremental regulatory burdens and governmental investigations;

• our future cash flow and earnings;

• our restrictive covenants, which may restrict our business and financing activities;

• the impact of the economic and employment conditions on our business and future results of operations;

• the impact of adverse weather conditions, including the effects of hurricanes and wildfires;

• compliance with laws and government regulations;

• the impact of claims brought against us or our facilities including claims for damages for personal injuries, medical malpractice, overpayments, breach of contract, securities law violations, tort and employee related claims;

• the impact of governmental investigations, regulatory actions and whistleblower lawsuits;

• any failure to comply with the terms of the Company’s corporate integrity agreement with the OIG;

• the impact of healthcare reform in the U.S. and abroad, including the potential repeal, replacement or modification of the Patient Protection and Affordable Care Act;

• the risk of a cyber-security incident and any resulting adverse impact on our operations or violation of laws and regulations regarding information privacy;

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• the impact of our highly competitive industry on patient volumes;

• our dependence on key management personnel, key executives and local facility management personnel;

• our acquisition, joint venture and wholly-owned de novo strategies, which expose us to a variety of operational and financial risks, as well as legal and regulatory risks;

• the impact of state efforts to regulate the construction or expansion of healthcare facilities on our ability to operate and expand our operations;

• our potential inability to extend leases at expiration;

• the impact of controls designed to reduce inpatient services on our revenue;

• the impact of different interpretations of accounting principles on our results of operations or financial condition;

• the impact of environmental, health and safety laws and regulations, especially in locations where we have concentrated operations;

• the impact of laws and regulations relating to privacy and security of patient health information and standards for electronic transactions;

• our ability to cultivate and maintain relationships with referral sources;

• the impact of a change in the mix of our earnings, adverse changes in our effective tax rate and adverse developments in tax laws generally;

• changes in interpretations, assumptions and expectations regarding recent tax legislation, including provisions of the CARES Act and additional guidance that may be issued by federal and state taxing authorities;

• failure to maintain effective internal control over financial reporting;

• the impact of fluctuations in our operating results, quarter to quarter earnings and other factors on the price of our securities;

• the impact of the trend for insurance companies and managed care organizations to enter into sole source contracts on our ability to obtain patients;

• the impact of value-based purchasing programs on our revenue; and

• those risks and uncertainties described from time to time in our filings with the SEC.

Given these risks and uncertainties, you are cautioned not to place undue reliance on such forward-looking statements. These risks and uncertainties may cause our actual future results to be materially different than those expressed in our forward-looking statements. These forward-looking statements are made only as of the date of this Quarterly Report on Form 10-Q. We do not undertake and specifically decline any obligation to update any such statements or to publicly announce the results of any revisions to any such statements to reflect future events or developments.

Overview

Our business strategy is to acquire and develop behavioral healthcare facilities and improve our operating results within our facilities and our other behavioral healthcare operations. We strive to improve the operating results of our facilities by providing high-quality services, expanding referral networks and marketing initiatives while meeting the increased demand for behavioral healthcare services through expansion of our current locations as well as developing new services within existing locations. At September 30, 2021, we operated 230 behavioral healthcare facilities with approximately 10,200 beds in 40 states and Puerto Rico. During the nine months ended September 30, 2021, we added 362 beds, consisting of 282 beds to existing facilities and 80 through the opening of one wholly-owned facility and five comprehensive treatment centers (“CTCs”). For the year ending December 31, 2021, we expect to add approximately 300 beds to existing facilities, 80 beds through the opening of one wholly-owned facility and 11 CTCs.

We are the leading publicly traded pure-play provider of behavioral healthcare services in the United States. Management believes that we are positioned as a leading platform in a highly fragmented industry under the direction of an experienced management team that has significant industry expertise. Management expects to take advantage of several strategies that are more accessible as a result of our increased size and geographic scale, including continuing a national marketing strategy to attract new patients and referral sources, increasing our volume of out-of-state referrals, providing a broader range of services to new and existing patients and clients and selectively pursuing opportunities to expand our facility and bed count in the U.S. through acquisitions, wholly-owned de novo facilities, joint ventures and bed additions in existing facilities.

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On January 19, 2021, we completed the U.K. Sale pursuant to a Share Purchase Agreement in which we sold all of the securities of AHC-WW Jersey Limited, a private limited liability company incorporated in Jersey and a subsidiary of the Company, which constituted the entirety of our U.K. business operations. The U.K. Sale resulted in approximately $1,525 million of gross proceeds before deducting the settlement of existing foreign currency hedging liabilities of $85 million based on the current GBP to USD exchange rate, cash retained by the buyer and transaction costs. We used the net proceeds of approximately $1,425 million (excluding cash retained by the buyer) along with cash from the balance sheet to reduce debt by $1,640 million during the first quarter of 2021. As a result of the U.K. Sale, we reported, for all periods presented, results of operations and cash flows of the U.K. operations as discontinued operations in the accompanying financial statements.

COVID-19

During March 2020, the global pandemic of COVID-19 began to affect our facilities, employees, patients, communities, business operations and financial performance, as well as the broader U.S. and U.K. economies and financial markets. At many of our facilities, employees and/or patients have tested positive for COVID-19. We are committed to protecting the health of our communities and have been responding to the evolving COVID-19 situation while taking steps to provide quality care and protect the health and safety of our patients and employees. All of our facilities are closely following infectious disease protocols, as well as recommendations by the CDC and local health officials.

We have taken numerous steps to help minimize the impact of the virus on our patients and employees. For example, we:

• established an internal COVID-19 taskforce;

• instituted social distancing practices and protective measures throughout our facilities, which includes restricting or suspending visitor access, screening patients and staff who enter our facilities based on criteria established by the CDC and local health officials, and testing and isolating patients when warranted;

• have taken steps to secure our supply chain;

• expanded telehealth capabilities;

• implemented emergency planning in directly impacted markets; and

• limited all non-essential business travel and suspended in-person trainings and conferences.

We have developed additional supply chain management processes, which includes extensive tracking and delivery of key personal protective equipment (“PPE”) and supplies and sharing resources across all facilities. We could experience supply chain disruptions and significant price increases in equipment, pharmaceuticals and medical supplies, particularly PPE. Pandemic-related staffing difficulties and equipment, pharmaceutical and medical supplies shortages may impact our ability to treat patients at our facilities. Such shortages could lead to us paying higher prices for supplies, equipment and labor and an increase in overtime hours paid to our employees.

CARES Act and Other Regulatory Developments

On March 27, 2020, the CARES Act was signed into law. The CARES Act is intended to provide over $2 trillion in stimulus benefits for the U.S. economy. Among other things, the CARES Act includes additional support for small businesses, expands unemployment benefits, makes forgivable loans available to small businesses, provides for certain federal income tax changes, and provides $500 billion for loans, loan guarantees, and other investments for or in U.S. businesses.

In addition, the CARES Act contains a number of provisions that are intended to assist healthcare providers as they combat the effects of the COVID-19 pandemic. Those provisions include, among others:

• an appropriation to the PHSSE Fund to reimburse, through grants or other mechanisms, eligible healthcare providers and other approved entities for COVID-19-related expenses or lost revenue;

• the expansion of CMS’ Accelerated and Advance Payment Program;

• the temporary suspension of Medicare sequestration from May 1, 2020, to December 31, 2021; and

• waivers or temporary suspension of certain regulatory requirements.

The U.S. government initially announced it would offer $100 billion of relief to eligible healthcare providers through the PHSSE Fund. On April 24, 2020, then President Trump signed into law the PPP Act. Among other things, the PPP Act allocated $75 billion to eligible healthcare providers to help offset COVID-19 related losses and expenses. The $75 billion allocated under the PPP Act is in addition to the $100 billion allocated to healthcare providers for the same purposes in the CARES Act and has been disbursed

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to providers under terms and conditions similar to the CARES Act funds. We received approximately $19.7 million of the initial funds distributed from the PHSSE Fund in April 2020. We received an additional $12.8 million from the PHSSE Fund in August 2020. In April 2021, we received $24.2 million of additional funds from the PHSSE Fund, which is included in other accrued liabilities on the condensed consolidated balance sheet at September 30, 2021. We continue to evaluate our compliance with the terms and conditions to, and the financial impact of, these additional funds received.

During the three months ended June 30, 2020, we recorded $18.1 million of other income in the condensed consolidated statement of operations related to $19.7 million received from the PHSSE Fund during the quarter. This was subsequently reversed during the third quarter of 2020. During the fourth quarter of 2020, we recorded $32.8 million of other income in the consolidated statement of operations related to $34.9 million received from the PHSSE Fund from April through December 2020. Our recognition of this income was based on revised guidance in the Consolidated Appropriations Act, 2021 enacted in December 2020.

Using existing authority and certain expanded authority under the CARES Act, HHS expanded CMS’ Accelerated and Advance Payment Program to a broader group of Medicare Part A and Part B providers for the duration of the COVID-19 pandemic. Under the program, certain of our facilities were eligible to request up to 100% of their Medicare payment amount for a three-month period. Under the original terms of the program, the repayment of these accelerated/advanced payments would have begun 120 days after the date of the issuance of the payment and the amounts advanced to our facilities would have been recouped from new Medicare claims as a 100% offset. Our facilities would have had 210 days from the date the accelerated or advance payment was made to repay the amounts that they owe.

On October 1, 2020, Congress amended the terms of the Accelerated and Advance Payment Program to extend the term of the loan and adjust the repayment process. Under the new terms of the program, all providers will have 29 months from the date of their first program payment to repay the full amount of the accelerated or advance payments they have received. The revised terms extend the period before repayment begins from 210 days to one year from the date that payment under the program was received. Once the repayment period begins, the offset is limited to 25% of new claims during the first 11 months of repayment and 50% of new claims during the final 6 months. The revised program terms also lower the interest rate on outstanding amounts due at the end of the repayment period from 10% to 4%. We applied for and received approximately $45 million in April 2020 from this program. We repaid approximately $7 million and $10 million of the $45 million of advance payments during the second and third quarters of 2021, respectively, via recoupment from our new Medicare claims and will continue to repay the remaining balance on a monthly basis through September 2022.

Under the CARES Act, we also received a 2% increase in our facilities’ Medicare reimbursement rate as a result of the temporary suspension of Medicare sequestration from May 1, 2020 to December 31, 2021.

The CARES Act also provides for certain federal income and other tax changes, including an increase in the interest expense tax deduction limitation and bonus depreciation of qualified improvement property. Furthermore, under the CARES Act, (i) for taxable years beginning before 2021, NOL carryforwards and carrybacks may offset 100% of taxable income and (ii) NOLs arising in 2018, 2019 and 2020 taxable years may be carried back to each of the preceding five years to generate a refund. As a result, in 2019 and 2020 we received a benefit, in the form of refunds and lower future tax payments, of $51.6 million, consisting of $22.8 million related to interest expense, $20.5 million related to qualified improvement property legislation, and an $8.3 million permanent benefit due to the loss being able to be carried back at a 35% tax rate to offset income in tax years prior to 2018 (21% for tax years after 2017). We also received a cash benefit of approximately $39 million for 2020 relating to the delay of payment of the employer portion of Social Security payroll taxes, as enacted by the CARES Act. Additionally, we repaid half of the $39 million of payroll tax deferrals during the three months ended September 30, 2021 and expect to repay the remaining portion in by December 31, 2022.

In addition to the financial and other relief that has been provided by the federal government through the CARES Act and other legislation passed by Congress, CMS and many state governments have also issued waivers and temporary suspensions of healthcare facility licensure, certification, and reimbursement requirements in order to provide hospitals, physicians, and other healthcare providers with increased flexibility to meet the challenges presented by the COVID-19 pandemic. For example, CMS and many state governments have temporarily eased regulatory requirements and burdens for delivering and being reimbursed for healthcare services provided remotely through telemedicine. CMS has also temporarily waived many provisions of the Stark law, including many of the provisions affecting our relationships with physicians. Many states have also suspended the enforcement of certain regulatory requirements to ensure that healthcare providers have sufficient capacity to treat COVID-19 patients. These regulatory changes are temporary, with most slated to expire at the end of the declared COVID-19 public health emergency.  

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

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Results of Operations

The following table illustrates our consolidated results of operations for the respective periods shown (dollars in thousands):

	Three Months Ended September 30,												Nine Months Ended September 30,
	2021						2020						2021						2020
	Amount			%			Amount			%			Amount			%			Amount			%
Revenue	$	587,559			100.0	%	$	547,961			100.0	%	$	1,720,914			100.0	%	$	1,548,653			100.0	%
Salaries, wages and benefits		309,118			52.6	%		290,619			53.0	%		922,684			53.6	%		852,864			55.1	%
Professional fees		35,602			6.1	%		29,372			5.4	%		101,915			5.9	%		91,009			5.9	%
Supplies		23,743			4.0	%		21,773			4.0	%		67,698			3.9	%		65,028			4.2	%
Rents and leases		9,658			1.6	%		9,365			1.7	%		28,690			1.7	%		27,975			1.8	%
Other operating expenses		76,502			13.0	%		68,213			12.4	%		222,263			12.9	%		202,540			13.1	%
Other income		—			0.0	%		18,070			3.3	%		—			0.0	%		—			0.0	%
Depreciation and amortization		27,805			4.7	%		24,132			4.4	%		78,349			4.6	%		70,298			4.5	%
Interest expense		15,706			2.7	%		37,315			6.8	%		61,420			3.6	%		118,398			7.6	%
Debt extinguishment costs		—			0.0	%		—			0.0	%		24,650			1.4	%		3,271			0.2	%
Loss on impairment		1,079			0.2	%		—			0.0	%		24,293			1.4	%		—			0.0	%
Transaction-related expenses		3,035			0.5	%		3,024			0.6	%		9,320			0.5	%		9,558			0.6	%
Total expenses		502,248			85.4	%		501,883			91.6	%		1,541,282			89.5	%		1,440,941			93.0	%
Income from continuing operations before       income taxes		85,311			14.6	%		46,078			8.4	%		179,632			10.5	%		107,712			7.0	%
Provision for income taxes		17,411			3.0	%		9,191			1.7	%		42,948			2.5	%		24,174			1.6	%
Income from continuing operations		67,900			11.6	%		36,887			6.7	%		136,684			8.0	%		83,538			5.4	%
Income (loss) from discontinued operations, net       of taxes		—			0.0	%		674			0.1	%		(12,641	)		-0.8	%		29,804			1.9	%
Net income		67,900			11.6	%		37,561			6.8	%		124,043			7.2	%		113,342			7.3	%
Net income attributable to noncontrolling       interests		(1,774	)		-0.3	%		(563	)		-0.1	%		(3,686	)		-0.2	%		(1,802	)		-0.1	%
Net income attributable to Acadia Healthcare       Company, Inc.	$	66,126			11.3	%	$	36,998			6.7	%	$	120,357			7.0	%	$	111,540			7.2	%

At September 30, 2021, we operated 230 behavioral healthcare facilities with approximately 10,200 beds in 40 states and Puerto Rico. For all periods presented, results of operations and cash flows of the U.K. operations are reported as discontinued operations in the accompanying financial statements.

We are encouraged by the favorable trends in our business and believe we are well positioned to capitalize on the expected growth in demand for behavioral health services.  As with many other healthcare providers and other industries across the country, we are currently dealing with a tight labor market.  However, we believe the diversity of our markets and service lines and our proactive focus helps us manage through this environment. Generally, the challenges that we have faced are temporary and market specific.  We remain focused on ensuring that we have the level of staff to meet the demand in our markets across our 40 states.

The following table sets forth percent changes in same facility operating data for our U.S. Facilities for the three and nine months ended September 30, 2021 compared to the same periods in 2020:

	Three Months Ended	Nine Months Ended
U.S. Same Facility Results (a)
Revenue growth	7.9%	10.9%
Patient days growth	2.2%	4.8%
Admissions growth	0.6%	4.8%
Average length of stay change (b)	1.5%	0.1%
Revenue per patient day growth	5.6%	5.8%
Adjusted EBITDA margin change (c)	360 bps	280 bps

(a) Results for the periods presented include facilities we have operated more than one year and exclude certain closed services.

(b) Average length of stay is defined as patient days divided by admissions.

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

Three months ended September 30, 2021 compared to the three months ended September 30, 2020

Revenue. Revenue increased $39.6 million, or 7.2%, to $587.6 million for the three months ended September 30, 2021 from $548.0 million for the three months ended September 30, 2020. Same facility revenue increased $43.0 million, or 7.9%, for the three months ended September 30, 2021 compared to the three months ended September 30, 2020, resulting from same facility growth in patient days of 2.2% and an increase in same facility revenue per day of 5.6%. Consistent with same facility growth in 2020, the growth in same facility patient days for the three months ended September 30, 2021 compared to the three months ended September 30, 2020 resulted from the addition of beds to our existing facilities and ongoing demand for our services.

Salaries, wages and benefits. Salaries, wages and benefits (“SWB”) expense was $309.1 million for the three months ended September 30, 2021 compared to $290.6 million for the three months ended September 30, 2020, an increase of $18.5 million. SWB expense included $8.9 million and $5.5 million of equity-based compensation expense for the three months ended September 30, 2021 and 2020, respectively. Excluding equity-based compensation expense, SWB expense was $300.2 million, or 51.1% of revenue, for the three months ended September 30, 2021, compared to $285.1 million, or 52.0% of revenue, for the three months ended September 30, 2020. Same facility SWB expense was $279.1 million for the three months ended September 30, 2021, or 47.6% of revenue, compared to $264.3 million for the three months ended September 30, 2020, or 48.6% of revenue.

Professional fees. Professional fees were $35.6 million for the three months ended September 30, 2021, or 6.1% of revenue, compared to $29.4 million for the three months ended September 30, 2020, or 5.4% of revenue. Same facility professional fees were $32.5 million for the three months ended September 30, 2021, or 5.5% of revenue, compared to $26.4 million, for the three months ended September 30, 2020, or 4.9% of revenue.

Supplies. Supplies expense was $23.7 million for the three months ended September 30, 2021, or 4.0% of revenue, compared to $21.8 million for the three months ended September 30, 2020, or 4.0% of revenue. Same facility supplies expense was $23.5 million for the three months ended September 30, 2021, or 4.0% of revenue, compared to $21.6 million for the three months ended September 30, 2020, or 4.0% of revenue.

Rents and leases. Rents and leases were $9.7 million for the three months ended September 30, 2021, or 1.6% of revenue, compared to $9.4 million for the three months ended September 30, 2020, or 1.7% of revenue. Same facility rents and leases were $8.7 million for the three months ended September 30, 2021, or 1.5% of revenue, compared to $8.5 million for the three months ended September 30, 2020, or 1.6% of revenue.

Other operating expenses. Other operating expenses consisted primarily of purchased services, utilities, insurance, travel and repairs and maintenance expenses. Other operating expenses were $76.5 million for the three months ended September 30, 2021, or 13.0% of revenue, compared to $68.2 million for the three months ended September 30, 2020, or 12.4% of revenue. Same facility other operating expenses were $72.4 million for the three months ended September 30, 2021, or 12.3% of revenue, compared to $66.7 million for the three months ended September 30, 2020, or 12.3% of revenue.

Other income. For the three months ended September 30, 2020, we reversed the $18.1 million of other income recorded during the second quarter of 2020 related to $19.7 million received from the PHSSE Fund. During the fourth quarter of 2020, we recorded $32.8 million of other income in the consolidated statement of operations related to $34.9 million received from the PHSSE Fund from April through December 2020. Our recognition of this income was based on revised guidance in the Consolidated Appropriations Act, 2021 enacted in December 2020.

Depreciation and amortization. Depreciation and amortization expense was $27.8 million for the three months ended September 30, 2021, or 4.7% of revenue, compared to $24.1 million for the three months ended September 30, 2020, or 4.4% of revenue.

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Interest expense. Interest expense was $15.7 million for the three months ended September 30, 2021 compared to $37.3 million for the three months ended September 30, 2020. The decrease in interest expense was primarily due to debt repayments in connection with the U.K. Sale.

Loss on impairment. During the three months ended September 30, 2021, we recorded a $1.1 million non-cash property impairment charge for one facility in Louisiana resulting from hurricane damage.

Transaction-related expenses. Transaction-related expenses were $3.0 million for both the three months ended September 30, 2021 and 2020. Transaction-related expenses represent termination, restructuring, strategic review, acquisition and other similar costs.

Provision for income taxes. For the three months ended September 30, 2021, the provision for income taxes was $17.4 million, reflecting an effective tax rate of 20.4%, compared to $9.2 million, reflecting an effective tax rate of 19.9%, for the three months ended September 30, 2020. The increase in the effective tax rate for the three months ended September 30, 2021 was primarily attributable to the disallowance of certain compensation-related deductions and the impact of U.S. and U.K. tax legislation changes in the 2020 year.

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

Nine months ended September 30, 2021 compared to the nine months ended September 30, 2020

Revenue. Revenue increased $172.3 million, or 11.1%, to $1,720.9 million for the nine months ended September 30, 2021 from $1,548.7 million for the nine months ended September 30, 2020. Same facility revenue increased $168.5 million, or 10.9%, for the nine months ended September 30, 2021 compared to the nine months ended September 30, 2020, resulting from same facility growth in patient days of 4.8% and an increase in same facility revenue per day of 5.8%. Consistent with same facility growth in 2020, the growth in same facility patient days for the nine months ended September 30, 2021 compared to the nine months ended September 30, 2020 resulted from the addition of beds to our existing facilities and ongoing demand for our services.

Salaries, wages and benefits. SWB expense was $922.7 million for the nine months ended September 30, 2021 compared to $852.9 million for the nine months ended September 30, 2020, an increase of $69.8 million. SWB expense included $25.0 million and $16.3 million of equity-based compensation expense for the nine months ended September 30, 2021 and 2020, respectively. Excluding equity-based compensation expense, SWB expense was $897.7 million, or 52.2% of revenue, for the nine months ended September 30, 2021, compared to $836.6 million, or 54.0% of revenue, for the nine months ended September 30, 2020. Same facility SWB expense was $829.6 million for the nine months ended September 30, 2021, or 48.6% of revenue, compared to $776.8 million for the nine months ended September 30, 2020, or 50.4% of revenue.

Professional fees. Professional fees were $101.9 million for the nine months ended September 30, 2021, or 5.9% of revenue, compared to $91.0 million for the nine months ended September 30, 2020, or 5.9% of revenue. Same facility professional fees were $91.3 million for the nine months ended September 30, 2021, or 5.3% of revenue, compared to $81.5 million, for the nine months ended September 30, 2020, or 5.3% of revenue.

Supplies. Supplies expense was $67.7 million for the nine months ended September 30, 2021, or 3.9% of revenue, compared to $65.0 million for the nine months ended September 30, 2020, or 4.2% of revenue. Same facility supplies expense was $66.8 million for the nine months ended September 30, 2021, or 3.9% of revenue, compared to $64.6 million for the nine months ended September 30, 2020, or 4.2% of revenue.

Rents and leases. Rents and leases were $28.7 million for the nine months ended September 30, 2021, or 1.7% of revenue, compared to $28.0 million for the nine months ended September 30, 2020, or 1.8% of revenue. Same facility rents and leases were $25.7 million for the nine months ended September 30, 2021, or 1.5% of revenue, compared to $25.6 million for the nine months ended September 30, 2020, or 1.7% of revenue.

Other operating expenses. Other operating expenses consisted primarily of purchased services, utilities, insurance, travel and repairs and maintenance expenses. Other operating expenses were $222.3 million for the nine months ended September 30, 2021, or 12.9% of revenue, compared to $202.5 million for the nine months ended September 30, 2020, or 13.1% of revenue. Same facility other operating expenses were $211.1 million for the nine months ended September 30, 2021, or 12.4% of revenue, compared to $198.9 million for the nine months ended September 30, 2020, or 12.9% of revenue.

Other income. For the nine months ended September 30, 2020, we reversed the $18.1 million of other income recorded during the second quarter of 2020 related $19.7 million received from the PHSSE Fund. During the fourth quarter of 2020, we recorded $32.8

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million of other income in the consolidated statement of operations related to $34.9 million received from the PHSSE Fund from April through December 2020. Our recognition of this income was based on revised guidance in the Consolidated Appropriations Act, 2021 enacted in December 2020.

Depreciation and amortization. Depreciation and amortization expense was $78.3 million for the nine months ended September 30, 2021, or 4.6% of revenue, compared to $70.3 million for the nine months ended September 30, 2020, or 4.5% of revenue.

Interest expense. Interest expense was $61.4 million for the nine months ended September 30, 2021 compared to $118.4 million for the nine months ended September 30, 2020. The decrease in interest expense was primarily due to debt repayments in connection with the U.K. Sale.

Debt extinguishment costs. Debt extinguishment costs were $24.7 million for the nine months ended September 30, 2021 and represented $6.3 million of cash charges and $18.4 million of non-cash charges in connection with the redemption of the 5.625% Senior Notes and 6.500% Senior Notes and the termination of the Prior Credit Facility. Debt extinguishment costs were $3.3 million for the nine months ended September 30, 2020 and represented $1.0 million of cash charges and $2.3 million of non-cash charges in connection with the redemption of the 6.125% Senior Notes and 5.125% Senior Notes.

Loss on impairment. Loss on impairment was $24.3 million for the nine months ended September 30, 2021. During the three months ended June 30, 2021 we opened a 260-bed replacement facility in Pennsylvania and recorded a non-cash property impairment charge of $23.2 million for the existing facility. Additionally, during the three months ended September 30, 2021, we recorded a $1.1 million non-cash property impairment charge for one facility in Louisiana resulting from hurricane damage.

Transaction-related expenses. Transaction-related expenses were $9.3 million for the nine months ended September 30, 2021 compared to $9.6 million for the nine months ended September 30, 2020. Transaction-related expenses represent termination, restructuring, strategic review, acquisition and other similar costs.

Provision for income taxes. For the nine months ended September 30, 2021, the provision for income taxes was $42.9 million, reflecting an effective tax rate of 23.9%, compared to $24.2 million, reflecting an effective tax rate of 22.4%, for the nine months ended September 30, 2020. The increase in the effective tax rate for the nine months ended September 30, 2021 was primarily attributable to the disallowance of certain compensation-related deductions and the impact of U.S. and U.K. tax legislation changes in the 2020 year.

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

Revenue

Our revenue is primarily derived from services rendered to patients for inpatient psychiatric and substance abuse care, outpatient psychiatric care and adolescent residential treatment. We receive payments from the following sources for services rendered in our facilities: (i) state governments under their respective Medicaid and other programs; (ii) commercial insurers; (iii) the federal government under the Medicare program administered by CMS; and (iv) individual patients and clients. We determine 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.

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The following table presents revenue by payor type and as a percentage of revenue for the three and nine months ended September 30, 2021 and 2020 (dollars in thousands):

	Three Months Ended September 30,										Nine Months Ended September 30,
	2021					2020					2021					2020
	Amount		%			Amount		%			Amount		%			Amount		%
Commercial	$	170,427		29.0	%	$	156,741		28.6	%	$	511,975		29.8	%	$	439,911		28.4	%
Medicare		97,529		16.6	%		96,536		17.6	%		274,208		15.9	%		244,721		15.9	%
Medicaid		288,092		49.0	%		261,341		47.7	%		845,128		49.1	%		767,075		49.4	%
Self-Pay		25,998		4.4	%		26,060		4.8	%		71,875		4.2	%		75,570		4.9	%
Other		5,513		1.0	%		7,283		1.3	%		17,728		1.0	%		21,376		1.4	%
Revenue	$	587,559		100.0	%	$	547,961		100.0	%	$	1,720,914		100.0	%	$	1,548,653		100.0	%

The following tables present a summary of our aging of accounts receivable at September 30, 2021 and December 31, 2020:

September 30, 2021

	Current			30-90			90-150			>150			Total
Commercial		21.5	%		4.2	%		2.9	%		8.0	%		36.6	%
Medicare		11.0	%		2.3	%		0.9	%		2.0	%		16.2	%
Medicaid		29.3	%		3.1	%		2.0	%		5.7	%		40.1	%
Self-Pay		1.3	%		1.5	%		1.4	%		2.6	%		6.8	%
Other		0.1	%		0.1	%		0.0	%		0.1	%		0.3	%
Total		63.2	%		11.2	%		7.2	%		18.4	%		100.0	%

December 31, 2020

	Current			30-90			90-150			>150			Total
Commercial		19.8	%		5.6	%		2.2	%		6.3	%		33.9	%
Medicare		12.0	%		1.2	%		0.6	%		1.5	%		15.3	%
Medicaid		27.4	%		4.7	%		2.7	%		8.6	%		43.4	%
Self-Pay		1.5	%		1.4	%		1.3	%		2.5	%		6.7	%
Other		0.0	%		0.3	%		0.1	%		0.3	%		0.7	%
Total		60.7	%		13.2	%		6.9	%		19.2	%		100.0	%

Liquidity and Capital Resources

Cash provided by continuing operating activities for the nine months ended September 30, 2021 was $276.4 million compared to $366.4 million for the nine months ended September 30, 2020. Operating cash flows for the nine months ended September 30, 2021 included net government relief funds paid of approximately $12.1 million, which consisted of $19.4 million of payroll tax deferral payments and repayment of $16.9 million of Medicare advance payments offset by receipt of $24.2 million of PHSSE Fund payments. Operating cash flows for the nine months ended September 30, 2020 included government relief funds received of approximately $103.9 million, which consisted of Medicare advance payments of $45.2 million, $32.5 million of PHSSE Fund payments and payroll tax deferrals of $26.2 million. Operating cash flows were impacted by an increase in earnings, a reduction in cash paid for interest and an increase in tax payments during the nine months ended September 30, 2021. Days sales outstanding were 44 days at September 30, 2021 compared to 47 days at December 31, 2020.

Cash provided by continuing investing activities for the nine months ended September 30, 2021 was $1,244.9 million compared to cash used in continuing investing activities of $179.5 million for the nine months ended September 30, 2020. Cash provided by investing activities for the nine months ended September 30, 2021 primarily consisted of $1,511.0 million of proceeds from U.K. Sale, $4.9 million of other and $1.8 million of proceeds from the sale of property and equipment offset by $84.8 million of settlement of foreign currency derivatives, $31.4 million of cash paid for purchase of finance lease and $156.6 million of cash paid for capital expenditures. Cash paid for capital expenditures for the nine months ended September 30, 2021 consisted of $31.0 million of routine capital expenditures and $125.6 million of expansion capital expenditures. We define expansion capital expenditures as those that increase the capacity of our facilities or otherwise enhance revenue. Routine or maintenance capital expenditures were 1.8% of revenue for the nine months ended September 30, 2021. Cash used in continuing investing activities for the nine months ended September 30, 2020 primarily consisted of $168.8 million of cash paid for capital expenditures and other of $10.7 million. Cash paid for capital expenditures for the nine months ended September 30, 2020 consisted of $30.1 million of cash paid for routine capital expenditures and $138.7 million of expansion capital expenditures.

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Cash used in continuing financing activities for the nine months ended September 30, 2021 was $1,708.0 million compared to $46.3 million for the nine months ended September 30, 2020. Cash used in continuing financing activities for the nine months ended September 30, 2021 consisted of repayment of long-term debt of $2,227.9 million, principal payments on revolving credit facility of $330.0 million, payment of debt issuance costs of $8.0 million, principal payments on long-term debt of $5.3 million, distributions to noncontrolling interests of $0.9 million and other of $6.9 million offset by common stock withheld for minimum statutory taxes of $16.1 million, borrowings of long-term debt of $425.0 million and borrowings on revolving credit facility of $430.0 million. Cash used in continuing financing activities for the nine months ended September 30, 2020 primarily consisted of principal payments of long-term debt of $31.9 million, repayment of long-term debt of $450.0 million, payment of debt issuance costs of $11.2 million, principal payments on revolving credit facility of $100.0 million, common stock withheld for minimum statutory taxes of $1.3 million, $0.7 million of distributions to noncontrolling interest and other of $1.3 million offset by borrowings on long-term debt of $450.0 million and borrowings on revolving credit facility of $100.0 million.

We had total available cash and cash equivalents of $196.3 million and $378.7 million at September 30, 2021 and December 31, 2020, respectively, of which approximately $18.0 million and $17.0 million was held by our foreign subsidiaries, respectively. Our strategic plan does not require the repatriation of foreign cash in order to fund our operations in the U.S., and it is our current intention to permanently reinvest our foreign cash and cash equivalents outside of the U.S.

We believe existing cash on hand, cash flows from operations, the availability under our revolving line of credit and cash from additional financing will be sufficient to meet our expected liquidity needs during the next 12 months.

New Credit Facility

We entered into a New Credit Facility on March 17, 2021. The New Credit Facility provides for a $600.0 million Revolving Facility and a $425.0 million Term Loan Facility with each maturing on March 17, 2026 unless extended in accordance with the terms of the New Credit Facility. The Revolving Facility further provides for (i) up to $20.0 million to be utilized for the issuance of letters of credit and (ii) the availability of a swingline facility under which we may borrow up to $20.0 million.  

As a part of the closing of the New Credit Facility on March 17, 2021, we (i) refinanced and terminated our Prior Credit Facility and (ii) financed the redemption of all of our outstanding 5.625% Senior Notes.

We had $496.6 million of availability under the Revolving Facility and had standby letters of credit outstanding of $3.4 million related to security for the payment of claims required by our workers’ compensation insurance program at September 30, 2021.

During the nine months ended September 30, 2021, we repaid $60.0 million of the balance outstanding on the Revolving Facility.

The New Credit Facility requires quarterly term loan principal repayments for our Term Loan Facility of $2.7 million for December 31, 2021 to March 31, 2022, $5.3 million for June 30, 2022 to March 31, 2024, $8.0 million for June 30, 2024 to March 31, 2025, $10.6 million for June 30, 2025 to December 31, 2025, with the remaining principal balance of the Term Loan Facility due on the maturity date of March 17, 2026.

We have the ability to increase the amount of the Senior Facilities, which may take the form of increases to the Revolving Facility or the Term Loan Facility or the issuance of one or more Incremental 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 our Consolidated EBITDA (as defined in the New Credit Facility) and its Restricted Subsidiaries (as defined in the New Credit Facility) (as determined for the four fiscal quarter period most recently ended for which financial statements are available), and (ii) additional amounts so long as, after giving effect thereto, the Consolidated Senior Secured Net Leverage Ratio (as defined in the New Credit Facility) does not exceed 3.5 to 1.0.

Subject to certain exceptions, substantially all of our existing and subsequently acquired or organized direct or indirect wholly-owned U.S. subsidiaries are required to guarantee the repayment of its obligations under the New Credit Facility. Borrowings under the Senior Facilities bear interest at a floating rate, which will initially be, at our option, either (i) adjusted LIBOR plus 1.50% or (ii) an alternative base rate plus 0.50% (in each case, subject to adjustment based on the Company’s consolidated total net leverage ratio). An unused fee initially set at 0.20% per annum (subject to adjustment based on the Company’s consolidated total net leverage ratio) is payable quarterly in arrears based on the actual daily undrawn portion of the commitments in respect of the Revolving Facility.

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The interest rates and the unused line fee on unused commitments related to the Senior Facilities are based upon the following pricing tiers:

Pricing Tier	Consolidated Total Net Leverage Ratio	Eurodollar Rate Loans and Letter of Credit Fees			Base Rate and Swing Line Loans			Commitment Fee
1	≥ 4.50:1.0		2.250	%		1.250	%		0.350	%
2	<4.50:1.0 but ≥ 3.75:1.0		2.000	%		1.000	%		0.300	%
3	<3.75:1.0 but ≥ 3.00:1.0		1.750	%		0.750	%		0.250	%
4	<3.00:1.0 but ≥ 2.25:1.0		1.500	%		0.500	%		0.200	%
5	<2.25:1.0		1.375	%		0.375	%		0.200	%

The New 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 New Credit Facility contains financial covenants requiring the Company on a consolidated basis to maintain, as of the last day of any consecutive four fiscal quarter period, a consolidated total net leverage ratio of not more than 5.0 to 1.0  and an interest coverage ratio of at least 3.0 to 1.0. The New 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 Senior Facilities may be accelerated and/or the lenders’ commitments terminated. At September 30, 2021, the Company was in compliance with such covenants.

Prior Credit Facility

We entered into the Senior Secured Credit Facility on April 1, 2011. On December 31, 2012, we entered into the Prior Credit Facility which amended and restated the Senior Secured Credit Facility. We amended the Prior Credit Facility from time to time as described in our prior filings with the SEC.

On April 21, 2020, we entered into the Thirteenth Amendment to the Prior Credit Facility. The Thirteenth Amendment amended the Consolidated Leverage Ratio in the prior covenant to increase such leverage ratio for the rest of 2020.

On November 13, 2020, we entered into the Fourth Repricing Facilities Amendment to the Prior Credit Facility. The Fourth Repricing Facilities Amendment extended the maturity date of each of the prior revolving line of credit and the prior TLA Facility from November 30, 2021 to November 30, 2022. The Fourth Repricing Facilities Amendment also (1) replaced the revolving line of credit in an aggregate committed amount of $500.0 million with an aggregate committed amount of approximately $459.0 million and (2) replaced the TLA Facility aggregate outstanding principal amount of approximately $352.4 million with an aggregate principal amount of approximately $318.9 million. The interest rate margin applicable to both facilities remained unchanged from the prior facilities, and the commitment fee applicable to the new revolving line of credit also remained unchanged from the prior revolving line of credit. In connection with the Fourth Repricing Facilities Amendment, we recorded a debt extinguishment charge of $1.0 million, including the write-off of discount and deferred financing costs, which was recorded in debt extinguishment costs in the consolidated statement of operations at December 31, 2020.

On January 5, 2021, we made a voluntary payment of $105.0 million on the Tranche B-4 Facility. On January 19, 2021, we used a portion of the net proceeds from the U.K. Sale to repay the outstanding balances of $311.7 million of its TLA Facility and $767.9 million of its Tranche B-4 Facility of the Prior Credit Facility. At March 31, 2021, in connection with the termination of the Prior Credit Facility, we recorded a debt extinguishment charge of $10.9 million, including the write-off of discount and deferred financing costs, which was recorded in debt extinguishment costs in the condensed consolidated statement of operations.

Senior Notes

5.500% Senior Notes due 2028

On June 24, 2020, we issued $450.0 million of 5.500% Senior Notes due 2028. 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.

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5.000% Senior Notes due 2029

On October 14, 2020, we issued $475.0 million of 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. We used the net proceeds of the 5.000% Senior Notes to prepay approximately $453.3 million of the outstanding borrowings on our existing Tranche B-3 Facility and used the remaining net proceeds for general corporate purposes and to pay related fees and expenses in connection with the offering. In connection with the 5.000% Senior Notes, we recorded a debt extinguishment charge of $2.9 million, including the write-off of discount and deferred financing costs of the Tranche B-3 Facility, which was recorded in debt extinguishment costs in the consolidated statement of operations for the year ended December 31, 2020.

The indentures governing the Senior Notes contain covenants that, among other things, limit our ability and the ability of our 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 our assets; and (vii) create liens on assets.

The Senior Notes issued by us are guaranteed by each of our subsidiaries that guaranteed our obligations under the New Credit Facility. The guarantees are full and unconditional and joint and several.

We may redeem the Senior Notes at our option, in whole or part, at the dates and amounts set forth in the indentures.

5.625% Senior Notes due 2023

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

6.500% Senior Notes due 2024

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

Redemption of 5.625% Senior Notes and 6.500% Senior Notes

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

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

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

6.125% Senior Notes Due 2021

On March 12, 2013, we issued $150.0 million of 6.125% Senior Notes due 2021. The 6.125% Senior Notes were to mature on March 15, 2021 and bear interest at a rate of 6.125% per annum, payable semi-annually in arrears on March 15 and September 15 of each year. On June 24, 2020, we redeemed the 6.125% Senior Notes.

5.125% Senior Notes due 2022

On July 1, 2014, we issued $300.0 million of 5.125% Senior Notes due 2022. The 5.125% Senior Notes were to mature on July 1, 2022 and bear interest at a rate of 5.125% per annum, payable semi-annually in arrears on January 1 and July 1 of each year. On June 24, 2020, we redeemed the 5.125% Senior Notes.

Redemption of 6.125% Senior Notes and 5.125% Senior Notes

On June 10, 2020, we issued conditional notices of full redemption providing for the redemption in full of the 6.125% Senior Notes and 5.125% Senior Notes on Redemption Date, in each case at the Redemption Price. On June 24, 2020, we satisfied and

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discharged the indentures governing the 6.125% Senior Notes and the 5.125% Senior Notes by irrevocably depositing with a trustee sufficient funds equal to the Redemption Price for the 6.125% Senior Notes and the 5.125% Senior Notes and otherwise complying with the terms in the indentures relating to the satisfaction and discharge of the 6.125% Senior Notes and the 5.125% Senior Notes. In connection with the redemption of the 6.125% Senior Notes and the 5.125% Senior Notes, we recorded a debt extinguishment charge of $3.3 million, including the write-off of the deferred financing and other costs in the consolidated statement of operations for the year ended December 31, 2020.

Other long-term debt

During the nine months ended September 30, 2021, the Company repaid other long-term debt of $3.3 million, which is reflected in financing activities in the condensed consolidated statement of cash flows.

Contractual Obligations

The following table presents a summary of contractual obligations at September 30, 2021 (in thousands):

	Payments Due by Period
	Less Than 1 Year		1-3 Years		3-5 Years		More Than 5 Years		Total
Long-term debt (a)	$	73,536	$	161,991	$	563,331	$	1,033,625	$	1,832,483
Operating lease liabilities (b)		25,771		41,162		27,941		52,511		147,385
Finance lease liabilities		990		1,980		2,170		23,183		28,323
Total obligations and commitments	$	100,297	$	205,133	$	593,442	$	1,109,319	$	2,008,191

(a) Amounts include required principal and interest payments. The projected interest payments reflect the interest rates in place on our variable-rate debt at September 30, 2021.

(b) Amounts exclude variable components of lease payments.

Critical Accounting Policies

Our goodwill and other indefinite-lived intangible assets, which consist of licenses and accreditations, trade names and certificates of need intangible assets that are not amortized, are evaluated for impairment annually during the fourth quarter or more frequently if events indicate the carrying value of a reporting unit may not be recoverable. As of our most recent impairment test on October 1, 2020, we had two operating segments for segment reporting purposes, U.S. Facilities and facilities in the U.K. (“U.K. Facilities”), each of which represented a reporting unit for purposes of our goodwill impairment test.

Our annual goodwill impairment and other indefinite-lived intangible assets test performed as of October 1, 2020 considered recent financial performance, including the impacts of COVID-19 on certain portions of the U.K. business. The 2020 impairment test of the U.K. Facilities indicated carrying value of the reporting unit exceeded the estimated fair value and resulted in a non-cash loss on impairment of the remaining goodwill of the U.K. Facilities of $356.2 million. As of our impairment test on October 1, 2020, the fair value of our U.S. Facilities reporting unit substantially exceeded its carrying value, and therefore no impairment was recorded.

Due to the classification of the U.K. Facilities in discontinued operations, we have one operating segment, behavioral healthcare services, for segment reporting purposes. The behavioral healthcare services operating segment represents one reporting unit for future goodwill impairment tests.

There have been no material changes in our critical accounting policies at September 30, 2021 from those described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020.

Item 3. Quantitative and Qualitative Disclosures About Market Risk

Interest Rate Risk

Our interest expense is sensitive to changes in market interest rates. Our long-term debt outstanding at September 30, 2021 was composed of $912.4 million of fixed-rate debt and $516.9 million of variable-rate debt with interest based on LIBOR plus an applicable margin. A hypothetical 10% increase in interest rates (which would equate to a 0.16% higher rate on our variable rate debt) would decrease our net income and cash flows by $0.6 million on an annual basis based upon our borrowing level at September 30, 2021.

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Item 4. Controls and Procedures

Evaluation of Disclosure Controls and Procedures

As of the end of the period covered by this report, our management conducted an evaluation, with the participation of our chief executive officer and chief financial officer, of the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act). Based on this evaluation, our chief executive officer and chief financial officer have concluded that our disclosure controls and procedures are effective to ensure that information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms and that such information is accumulated and communicated to management, including our chief executive officer and chief financial officer, as appropriate to allow timely decisions regarding required disclosure.

Changes in Internal Control Over Financial Reporting

There have been no changes in our internal control over financial reporting during the three months ended September 30, 2021 that have materially affected or are reasonably likely to materially affect our internal control over financial reporting.

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PART II – OTHER INFORMATION

Item 1. Legal Proceedings

Information with respect to this item may be found in Note 18 – Commitments and Contingencies in the accompanying notes to our consolidated financial statements of this Quarterly Report on Form 10-Q, which information is incorporated herein by reference.

Item 1A. Risk Factors

In addition to the other information set forth in this report, an investor should carefully consider the factors discussed in Part I, “Item 1A. Risk Factors” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020. The risks described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, are not the only risks facing the Company. Additional risks and uncertainties not currently known to management or that management currently deems immaterial also may materially, adversely affect the Company’s business, financial condition, operating results or cash flows.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

During the three months ended September 30, 2021, the Company withheld shares of Company common stock to satisfy employee minimum statutory tax withholding obligations payable upon the vesting of restricted stock, as follows:

Period	Total Number of Shares Purchased		Average Price Paid per Share		Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs		Maximum Number of Shares that May Yet Be Purchased Under the Plans or Programs
July –  July 31		5,410	$	61.47		—		—
August 1 – August 31		1,494		61.98		—		—
September 1 –  September 30		—		—		—		—
Total		6,904

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Item 6. Exhibits

Exhibit No.	Exhibit Description
3.1	Amended and Restated Certificate of Incorporation, as amended. (1)
3.2	Amended and Restated Bylaws of the Company, as amended. (1)
22	List of Subsidiary Guarantors and Issuers of Guaranteed Securities. (2)
31.1*	Certification of the Chief Executive Officer of the Company pursuant to Rule 13a-14(a) of the Securities Exchange Act of 1934, as amended, as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
31.2*	Certification of the Chief Financial Officer of the Company pursuant to Rule 13a-14(a) of the Securities Exchange Act of 1934, as amended, as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
32*	Certification of Chief Executive Officer and Chief Financial Officer of the Company pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
101.INS**	Inline XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the inline XBRL document.
101.SCH**	Inline XBRL Taxonomy Extension Schema Document.
101.CAL**	Inline XBRL Taxonomy Calculation Linkbase Document.
101.DEF**	Inline XBRL Taxonomy Extension Definition Linkbase Document.
101.LAB**	Inline XBRL Taxonomy Label Linkbase Document.
101.PRE**	Inline XBRL Taxonomy Presentation Linkbase Document.
104	The cover page from the Company’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2021, has been formatted in Inline XBRL.

(1) Incorporated by reference to exhibits filed with the Company’s Current Report on Form 8-K filed May 25, 2017 (File No. 001-35331).

(2) Incorporated by reference to exhibits filed with the Company’s Quarterly Report on Form 10-Q for the three months ended March 31, 2021 (File No. 001-35331).

* Filed herewith.

**     The XBRL related information in Exhibit 101 to this quarterly report on Form 10-Q shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to liability of that section and shall not be incorporated by reference into any filing or other document pursuant to the Securities Act of 1933, as amended, except as shall be expressly set forth by specific reference in such filing or document.

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SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

Acadia Healthcare Company, Inc.
By:	/s/ David M. Duckworth
	David M. Duckworth
	Chief Financial Officer

Dated: October 29, 2021

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EX-31.1

Exhibit 31.1

CERTIFICATION OF CEO PURSUANT TO

RULE 13a-14(a)/15d-14(a), AS ADOPTED PURSUANT TO

SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Debra K. Osteen, certify that:

1. I have reviewed this Quarterly Report on Form 10-Q of Acadia Healthcare Company, Inc.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with U.S. generally accepted accounting principles;

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: October 29, 2021

/s/ Debra K. Osteen

Debra K. Osteen

Chief Executive Officer and Director

EX-31.2

Exhibit 31.2

CERTIFICATION OF CFO PURSUANT TO

RULE 13a-14(a)/15d-14(a), AS ADOPTED PURSUANT TO

SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, David M. Duckworth, certify that:

1. I have reviewed this Quarterly Report on Form 10-Q of Acadia Healthcare Company, Inc.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with U.S. generally accepted accounting principles;

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: October 29, 2021

/s/ David M. Duckworth

David M. Duckworth

Chief Financial Officer

EX-32

Exhibit 32

CERTIFICATIONS OF CEO AND CFO PURSUANT TO

18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report on Form 10-Q of Acadia Healthcare Company, Inc. (the “Company”) for the quarterly period ended September 30, 2021, as filed with the Securities and Exchange Commission on the date hereof (the “Report”), I, Debra K. Osteen, Chief Executive Officer of the Company, and I, David M. Duckworth, Chief Financial Officer of the Company, each certify, for the purpose of complying with 18 U.S.C. Section 1350 and Rule 13a-14(b) or Rule 15d-14(b) of the Securities Exchange Act of 1934 (the “Exchange Act”), as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

(1) The Report fully complies with the requirements of Section 13(a) or 15(d) of the Exchange Act; and

(2) The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

A signed original of this written statement required by Section 906 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.

Date: October 29, 2021

/s/ Debra K. Osteen

Debra K. Osteen

Chief Executive Officer and Director

/s/ David M. Duckworth

David M. Duckworth

Chief Financial Officer

XML

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2021	Oct. 29, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Trading Symbol	ACHC
Entity Registrant Name	Acadia Healthcare Company, Inc.
Entity Central Index Key	0001520697
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common Stock, $.01 par value
Security Exchange Name	NASDAQ
Entity File Number	001-35331
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	45-2492228
Entity Address, Address Line One	6100 Tower Circle
Entity Address, Address Line Two	Suite 1000
Entity Address, City or Town	Franklin
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37067
City Area Code	615
Local Phone Number	861-6000
Document Quarterly Report	true
Document Transition Report	false
Entity Common Stock, Shares Outstanding		89,935,616

XML

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 196,313	$ 378,697
Accounts receivable, net	282,161	273,551
Other current assets	88,685	61,332
Current assets held for sale		1,809,815
Total current assets	567,159	2,523,395
Property and equipment, net	1,665,025	1,622,896
Goodwill	2,103,503	2,105,264
Intangible assets, net	69,366	68,535
Deferred tax assets	3,112	3,209
Operating lease right-of-use assets	103,162	96,937
Other assets	83,400	79,126
Total assets	4,594,727	6,499,362
Current liabilities:
Current portion of long-term debt	15,938	153,478
Accounts payable	85,924	87,815
Accrued salaries and benefits	124,164	124,912
Current portion of operating lease liabilities	20,062	18,916
Other accrued liabilities	157,204	178,453
Derivative instrument liabilities		84,584
Current liabilities held for sale		660,027
Total current liabilities	403,292	1,308,185
Long-term debt	1,413,407	2,968,948
Deferred tax liabilities	73,673	50,017
Operating lease liabilities	89,952	84,029
Other liabilities	117,883	133,412
Total liabilities	2,098,207	4,544,591
Redeemable noncontrolling interests	62,074	55,315
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; 89,006,713 and 88,024,395 issued and outstanding at September 30, 2021 and December 31, 2020, respectively	890	880
Additional paid-in capital	2,623,585	2,580,327
Accumulated other comprehensive loss		(371,365)
Accumulated deficit	(190,029)	(310,386)
Total equity	2,434,446	1,899,456
Total liabilities and equity	$ 4,594,727	$ 6,499,362

XML

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2021	Dec. 31, 2020
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	89,006,713	88,024,395
Common stock, shares outstanding	89,006,713	88,024,395

XML

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement [Abstract]
Revenue	$ 587,559	$ 547,961	$ 1,720,914	$ 1,548,653
Salaries, wages and benefits (including equity-based compensation expense of $8,923, $5,471, $24,988 and $16,258, respectively)	309,118	290,619	922,684	852,864
Professional fees	35,602	29,372	101,915	91,009
Supplies	23,743	21,773	67,698	65,028
Rents and leases	9,658	9,365	28,690	27,975
Other operating expenses	76,502	68,213	222,263	202,540
Other income		18,070
Depreciation and amortization	27,805	24,132	78,349	70,298
Interest expense, net	15,706	37,315	61,420	118,398
Debt extinguishment costs			24,650	3,271
Loss on impairment	1,079		24,293
Transaction-related expenses	3,035	3,024	9,320	9,558
Total expenses	502,248	501,883	1,541,282	1,440,941
Income from continuing operations before income taxes	85,311	46,078	179,632	107,712
Provision for income taxes	17,411	9,191	42,948	24,174
Income from continuing operations	67,900	36,887	136,684	83,538
Income (loss) from discontinued operations, net of taxes		674	(12,641)	29,804
Net income	67,900	37,561	124,043	113,342
Net income attributable to noncontrolling interests	(1,774)	(563)	(3,686)	(1,802)
Net income attributable to Acadia Healthcare Company, Inc.	$ 66,126	$ 36,998	$ 120,357	$ 111,540
Basic earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to Acadia Healthcare Company, Inc.	$ 0.74	$ 0.41	$ 1.50	$ 0.93
Income (loss) from discontinued operations		0.01	(0.14)	0.34
Net income attributable to Acadia Healthcare Company, Inc.	0.74	0.42	1.36	1.27
Diluted earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to Acadia Healthcare Company, Inc.	0.73	0.41	1.47	0.92
Income (loss) from discontinued operations		0.01	(0.14)	0.34
Net income attributable to Acadia Healthcare Company, Inc.	$ 0.73	$ 0.42	$ 1.33	$ 1.26
Weighted-average shares outstanding:
Basic	88,962	87,911	88,684	87,849
Diluted	90,889	88,856	90,604	88,449

XML

Condensed Consolidated Statements of Operations (Unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement [Abstract]
Equity-based compensation expense	$ 8,923	$ 5,471	$ 24,988	$ 16,258

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Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 67,900	$ 37,561	$ 124,043	$ 113,342
Other comprehensive income (loss):
Foreign currency translation gain (loss)		82,332	(4,260)	(46,851)
(Loss) gain on derivative instruments, net of tax of $0.0 million, $(8.0) million, $0.1 million and $8.0 million, respectively		(21,566)	19	21,622
U.K. Sale			375,606
Other comprehensive income (loss)		60,766	371,365	(25,229)
Comprehensive income	67,900	98,327	495,408	88,113
Comprehensive income attributable to noncontrolling interests	(1,774)	(563)	(3,686)	(1,802)
Comprehensive income attributable to Acadia Healthcare Company, Inc.	$ 66,126	$ 97,764	$ 491,722	$ 86,311

XML

Condensed Consolidated Statements of Comprehensive Income (Unaudited) (Parenthetical) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement Of Income And Comprehensive Income [Abstract]
Gain (loss) on derivative instruments, tax	$ 0.0	$ (8.0)	$ 0.1	$ 8.0

XML

Condensed Consolidated Statements of Equity (Unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive (Loss) [Member]	Retained Earnings (Accumulated Deficit) [Member]
Balance at Dec. 31, 2019	$ 2,505,381	$ 877	$ 2,557,642	$ (414,884)	$ 361,746
Balance, shares at Dec. 31, 2019		87,715,000
Common stock issued under stock incentive plans		$ 1	(1)
Common stock issued under stock incentive plans, shares		127,000
Common stock withheld for minimum statutory taxes	(1,402)		(1,402)
Equity-based compensation expense	4,979		4,979
Other comprehensive income (loss)	(78,254)			(78,254)
Net income (loss) attributable to Acadia Healthcare Company, Inc.	33,463				33,463
Balance at Mar. 31, 2020	2,464,167	$ 878	2,561,218	(493,138)	395,209
Balance, shares at Mar. 31, 2020		87,842,000
Balance at Dec. 31, 2019	2,505,381	$ 877	2,557,642	(414,884)	361,746
Balance, shares at Dec. 31, 2019		87,715,000
Other comprehensive income (loss)	(25,229)
Net income (loss) attributable to Acadia Healthcare Company, Inc.	111,540
Balance at Sep. 30, 2020	2,606,639	$ 879	2,572,587	(440,113)	473,286
Balance, shares at Sep. 30, 2020		87,920,000
Balance at Dec. 31, 2019	$ 2,505,381	$ 877	2,557,642	(414,884)	361,746
Balance, shares at Dec. 31, 2019		87,715,000
Common stock issued under stock incentive plans, shares	68,700
Balance at Dec. 31, 2020	$ 1,899,456	$ 880	2,580,327	(371,365)	(310,386)
Balance, shares at Dec. 31, 2020	88,024,395	88,024,000
Balance at Mar. 31, 2020	$ 2,464,167	$ 878	2,561,218	(493,138)	395,209
Balance, shares at Mar. 31, 2020		87,842,000
Common stock issued under stock incentive plans	170	$ 1	169
Common stock issued under stock incentive plans, shares		56,000
Common stock withheld for minimum statutory taxes	(145)		(145)
Equity-based compensation expense	5,808		5,808
Other comprehensive income (loss)	(7,741)			(7,741)
Net income (loss) attributable to Acadia Healthcare Company, Inc.	41,079				41,079
Balance at Jun. 30, 2020	2,503,338	$ 879	2,567,050	(500,879)	436,288
Balance, shares at Jun. 30, 2020		87,898,000
Common stock issued under stock incentive plans	180		180
Common stock issued under stock incentive plans, shares		22,000
Common stock withheld for minimum statutory taxes	(114)		(114)
Equity-based compensation expense	5,471		5,471
Other comprehensive income (loss)	60,766			60,766
Net income (loss) attributable to Acadia Healthcare Company, Inc.	36,998				36,998
Balance at Sep. 30, 2020	2,606,639	$ 879	2,572,587	(440,113)	473,286
Balance, shares at Sep. 30, 2020		87,920,000
Common stock issued under stock incentive plans	1,677	$ 1	1,676
Common stock issued under stock incentive plans, shares		104,000
Common stock withheld for minimum statutory taxes	(182)		(182)
Equity-based compensation expense	6,246		6,246
Other comprehensive income (loss)	68,748			68,748
Net income (loss) attributable to Acadia Healthcare Company, Inc.	(783,672)				(783,672)
Balance at Dec. 31, 2020	$ 1,899,456	$ 880	2,580,327	(371,365)	(310,386)
Balance, shares at Dec. 31, 2020	88,024,395	88,024,000
Common stock issued under stock incentive plans	$ 12,740	$ 7	12,733
Common stock issued under stock incentive plans, shares		705,000
Common stock withheld for minimum statutory taxes	(4,521)		(4,521)
Equity-based compensation expense	7,034		7,034
Other	2,208		2,208
Other comprehensive income (loss)	371,365			371,365
Net income (loss) attributable to Acadia Healthcare Company, Inc.	9,717				9,717
Balance at Mar. 31, 2021	2,297,999	$ 887	2,597,781		(300,669)
Balance, shares at Mar. 31, 2021		88,729
Balance at Dec. 31, 2020	$ 1,899,456	$ 880	2,580,327	$ (371,365)	(310,386)
Balance, shares at Dec. 31, 2020	88,024,395	88,024,000
Common stock issued under stock incentive plans, shares	547,522
Other comprehensive income (loss)	$ 371,365
Net income (loss) attributable to Acadia Healthcare Company, Inc.	120,357
Balance at Sep. 30, 2021	$ 2,434,446	$ 890	2,623,585		(190,029)
Balance, shares at Sep. 30, 2021	89,006,713	89,006
Balance at Mar. 31, 2021	$ 2,297,999	$ 887	2,597,781		(300,669)
Balance, shares at Mar. 31, 2021		88,729
Common stock issued under stock incentive plans	5,622	$ 2	5,620
Common stock issued under stock incentive plans, shares		188,000
Common stock withheld for minimum statutory taxes	(580)		(580)
Equity-based compensation expense	9,031		9,031
Net income (loss) attributable to Acadia Healthcare Company, Inc.	44,514				44,514
Balance at Jun. 30, 2021	2,356,586	$ 889	2,611,852		(256,155)
Balance, shares at Jun. 30, 2021		88,917
Common stock issued under stock incentive plans	3,255	$ 1	3,254
Common stock issued under stock incentive plans, shares		89
Common stock withheld for minimum statutory taxes	(444)		(444)
Equity-based compensation expense	8,923		8,923
Net income (loss) attributable to Acadia Healthcare Company, Inc.	66,126				66,126
Balance at Sep. 30, 2021	$ 2,434,446	$ 890	$ 2,623,585		$ (190,029)
Balance, shares at Sep. 30, 2021	89,006,713	89,006

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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Operating activities:
Net income	$ 124,043	$ 113,342
Adjustments to reconcile net income to net cash provided by continuing operating activities:
Depreciation and amortization	78,349	70,298
Amortization of debt issuance costs	3,265	9,696
Equity-based compensation expense	24,988	16,258
Deferred income taxes	8,995	45,105
Loss (income) from discontinued operations, net of taxes	12,641	(29,804)
Debt extinguishment costs	24,650	3,271
Loss on impairment	24,293
Other	881	1,024
Change in operating assets and liabilities:
Accounts receivable, net	(8,610)	7,364
Other current assets	(2,758)	(4,942)
Other assets	(15,846)	(880)
Accounts payable and other accrued liabilities	6,358	19,854
Accrued salaries and benefits	18,820	14,150
Other liabilities	(11,633)	(2,256)
Government relief funds	(12,058)	103,908
Net cash provided by continuing operating activities	276,378	366,388
Net cash provided by discontinued operating activities	253	105,852
Net cash provided by operating activities	276,631	472,240
Investing activities:
Cash paid for capital expenditures	(156,624)	(168,804)
Proceeds from U.K. Sale	1,511,020
Settlement of foreign currency derivatives	(84,795)
Proceeds from sale of property and equipment	1,792	72
Cash paid for purchase of finance lease	(31,401)
Other	4,906	(10,734)
Net cash provided by (used in) continuing investing activities	1,244,898	(179,466)
Net cash used in discontinued investing activities		(30,188)
Net cash provided by (used in) investing activities	1,244,898	(209,654)
Financing activities:
Borrowings on long-term debt	425,000	450,000
Borrowings on revolving credit facility	430,000	100,000
Principal payments on revolving credit facility	(330,000)	(100,000)
Principal payments on long-term debt	(5,313)	(31,863)
Repayment of long-term debt	(2,227,935)	(450,000)
Payment of debt issuance costs	(7,964)	(11,220)
Common stock withheld for minimum statutory taxes, net	16,072	(1,311)
Distributions to noncontrolling interests	(926)	(653)
Other	(6,914)	(1,291)
Net cash used in continuing financing activities	(1,707,980)	(46,338)
Net cash used in discontinued financing activities		(2,226)
Net cash used in financing activities	(1,707,980)	(48,564)
Effect of exchange rate changes on cash	4,067	488
Net (decrease) increase in cash and cash equivalents, including cash classified within current assets held for sale	(182,384)	214,510
Less: cash classified within current assets held for sale		(50,568)
Net (decrease) increase in cash and cash equivalents	(182,384)	163,942
Cash and cash equivalents at beginning of the period	378,697	124,192
Cash and cash equivalents at end of the period	$ 196,313	$ 288,134

XML

Description of Business and Basis of Presentation

9 Months Ended

Sep. 30, 2021

Accounting Policies [Abstract]

Description of Business and Basis of Presentation

1. Description of Business and Basis of Presentation

Description of Business

Acadia Healthcare Company, Inc. (the “Company”) develops and operates inpatient psychiatric facilities, residential treatment centers, group homes, substance abuse facilities and facilities providing outpatient behavioral healthcare services to serve the behavioral health and recovery needs of communities throughout the United States (“U.S.”) and Puerto Rico. At September 30, 2021, the Company operated 230 behavioral healthcare facilities with approximately 10,200 beds in 40 states and Puerto Rico.

On January 19, 2021, the Company completed the sale of its United Kingdom (“U.K.”) operations to RemedcoUK Limited, a company organized under the laws of England and Wales and owned by funds managed or advised by Waterland Private Equity Fund VII (the “U.K. Sale”). The U.K. Sale allowed us to reduce our indebtedness and focus on our U.S. operations. As a result of the U.K. Sale, the Company reported, for all periods presented, results of operations and cash flows of the U.K. operations as discontinued operations in the accompanying financial statements. See Note 3 – U.K. Sale.

Basis of Presentation

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

The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) 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 our 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, 2020 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, 2020 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on February 26, 2021. 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.

During March 2020, the global pandemic of the novel coronavirus known as COVID-19 (“COVID-19”) began to affect the Company’s facilities, employees, patients, communities, business operations and financial performance, as well as the broader U.S. and U.K. economies and financial markets. At many of the Company’s facilities, employees and/or patients have tested positive for COVID-19. The Company is committed to protecting the health of our communities and has been responding to the evolving COVID-19 situation while taking steps to provide quality care and protect the health and safety of patients and employees. All of the Company’s facilities are closely following infectious disease protocols, as well as recommendations by the Centers for Disease Control and Prevention (“CDC”) and local health officials. The Company has established an internal COVID-19 taskforce, taken steps to secure its supply chain, expanded telehealth capabilities and implemented emergency planning in directly impacted markets. Nevertheless, COVID-19 may adversely impact the Company’s business and have an impact on its financial results that management is not currently able to quantify. Disruptions to the Company’s business as a result of the COVID-19 pandemic could have a material adverse effect on its results of operations, financial condition, cash flows and ability to service its indebtedness and may affect the amounts reported in the consolidated financial statements including those related to collectability of accounts receivable as well as professional and general liability reserves, tax assets and liabilities and may result in a potential impairment of goodwill and long-lived assets.

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

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Recently Issued Accounting Standards

9 Months Ended

Sep. 30, 2021

Accounting Changes And Error Corrections [Abstract]

Recently Issued Accounting Standards

2. Recently Issued Accounting Standards

In March 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) ASU 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting” (“ASU 2020-04”). ASU 2020-04 provides optional guidance for a limited period of time to ease the potential burden in accounting for or

recognizing the effects of reference rate reform on financial reporting and applies only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. ASU 2020-04 is effective as of March 12, 2020 through December 31, 2022. Entities may adopt ASU 2020-04 as of any date from the beginning of an interim period that includes or is subsequent to March 12, 2020 or prospectively from a date within an interim period that includes or is subsequent to March 12, 2020, up to the date that the financial statements are available to be issued. Management is evaluating the impact of ASU 2020-04 on the Company’s consolidated financial statements.

In December 2019, FASB issued ASU 2019-12, “Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes” (“ASU 2019-12”). ASU 2019-12 simplifies the accounting for income taxes by eliminating certain exceptions to the guidance in Topic 740 related to the approach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period and the recognition of deferred tax liabilities for outside basis differences. The new guidance also simplifies aspects of the accounting for franchise taxes and enacted changes in tax laws or rates and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill and allocating consolidated income taxes to separate financial statements of entities not subject to income tax. ASU 2019-12 is effective for fiscal years beginning after December 15, 2020. Upon adoption, the Company must apply certain aspects of this standard retrospectively for all periods presented while other aspects are applied on a modified retrospective basis through a cumulative-effect adjustment to retained earnings as of the beginning of the fiscal year of adoption. The Company adopted ASU 2019-12 on January 1, 2021. There is no significant impact to the Company’s consolidated financial statements.

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U.K. Sale

9 Months Ended

Sep. 30, 2021

Discontinued Operations And Disposal Groups [Abstract]

U.K. Sale

3. U.K. Sale

On January 19, 2021, the Company completed the U.K. Sale pursuant to a Share Purchase Agreement in which it sold all of the securities of AHC-WW Jersey Limited, a private limited liability company incorporated in Jersey and a subsidiary of the Company, which constituted the entirety of the Company’s U.K. business operations. The U.K. Sale resulted in approximately $1,525 million of gross proceeds before deducting the settlement of existing foreign currency hedging liabilities of $85 million based on the current British Pounds (“GBP”) to U.S. Dollars (“USD”) exchange rate, cash retained by the buyer and transaction costs. The Company used the net proceeds of approximately $1,425 million (excluding cash retained by the buyer) along with cash from the balance sheet to reduce debt by $1,640 million during the first quarter of 2021 as described in Note 11 – Long-Term Debt.

As a result of the U.K. Sale, the Company reported, for all periods presented, results of operations and cash flows of the U.K. operations as discontinued operations in the accompanying financial statements. In December 2020, the Company’s U.K. operations met the criteria to be classified as assets held for sale. The carrying value of the U.K. operations was written down to fair value less costs to sell in the condensed consolidated balance sheet at December 31, 2020. This resulted in a loss on sale of $867.3 million, which includes approximately $356.2 million of non-cash goodwill impairment, within discontinued operations in the consolidated statement of operations for the year ended December 31, 2020. During the first quarter of 2021, an additional $14.3 million was recorded as loss on sale primarily resulting from an increase in the U.K. operations carrying value.

For the three and nine months ended September 30, 2021 and 2020, results of operations of the U.K. operations were as follows (in thousands):

	Three Months Ended September 30,					Nine Months Ended September 30,
	2021		2020			2021			2020
Revenue	$	—	$	285,343		$	62,520		$	817,772
Salaries, wages and benefits		—		159,840			35,937			465,514
Professional fees		—		31,987			6,815			92,264
Supplies		—		9,434			2,217			28,274
Rents and leases		—		11,817			2,509			34,858
Other operating expenses		—		28,880			6,682			85,682
Depreciation and amortization		—		18,780			—			55,739
Interest expense, net		—		238			10			666
Loss on sale		—		—			14,254			—
Loss on impairment		—		20,239			—			20,239
Transaction-related expenses		—		5,479			6,265			7,735
Total expenses		—		286,694			74,689			790,971
(Loss) income from discontinued operations      before income taxes		—		(1,351	)		(12,169	)		26,801
(Benefit from) provision for income taxes		—		(2,025	)		472			(3,003	)
Income (loss) from discontinued operations, net      of taxes	$	—	$	674		$	(12,641	)	$	29,804

The major classes of assets and liabilities for the U.K. operations as of December 31, 2020 are shown below (in thousands):

Cash and cash equivalents	$	75,051
Accounts receivable, net		52,196
Other current assets		13,361
Current assets of discontinued operations		140,608
Property and equipment, net		1,297,923
Goodwill		—
Intangible assets, net		22,289
Operating lease right-of-use assets		341,289
Other assets		7,706
Total assets of discontinued operations	$	1,809,815
Current liabilities:
Accounts payable	$	44,929
Current portion of operating lease liabilities		11,141
Other current liabilities		136,895
Current liabilities of discontinued operations		192,965
Operating lease liabilities		387,607
Deferred tax liabilities		57,230
Other liabilities		22,225
Total liabilities of discontinued operations	$	660,027

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Revenue

9 Months Ended

Sep. 30, 2021

Revenue From Contract With Customer [Abstract]

Revenue

4. 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.

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

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

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

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

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

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

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

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

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021		2020
Acute inpatient psychiatric facilities	$	284,143	$	259,353	$	832,692	$	723,611
Specialty treatment facilities		230,753		211,796		669,552		597,886
Residential treatment centers		71,006		71,153		211,377		210,432
Outpatient community-based facilities		1,657		5,659		7,293		16,724
Revenue	$	587,559	$	547,961	$	1,720,914	$	1,548,653

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

The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients and implicit price concessions. Contractual adjustments and discounts are based on contractual agreements, discount policies and historical experience. Implicit price concessions are based on historical collection experience. Most of our facilities have contracts containing variable consideration. However, it is unlikely a significant reversal of revenue will occur when the uncertainty is resolved, and therefore, the Company has included the variable consideration in the estimated transaction price. Subsequent changes resulting from a patient’s ability to pay are recorded as bad debt expense, which is included as a component of other operating expenses in the condensed consolidated statements of operations. Bad debt expense for the three and nine months ended September 30, 2021 and 2020 was not significant.

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

	Three Months Ended September 30,										Nine Months Ended September 30,
	2021					2020					2021					2020
	Amount		%			Amount		%			Amount		%			Amount		%
Commercial	$	170,427		29.0	%	$	156,741		28.6	%	$	511,975		29.8	%	$	439,911		28.4	%
Medicare		97,529		16.6	%		96,536		17.6	%		274,208		15.9	%		244,721		15.9	%
Medicaid		288,092		49.0	%		261,341		47.7	%		845,128		49.1	%		767,075		49.4	%
Self-Pay		25,998		4.4	%		26,060		4.8	%		71,875		4.2	%		75,570		4.9	%
Other		5,513		1.0	%		7,283		1.3	%		17,728		1.0	%		21,376		1.4	%
Revenue	$	587,559		100.0	%	$	547,961		100.0	%	$	1,720,914		100.0	%	$	1,548,653		100.0	%

Contract liabilities primarily consisted of unearned revenue from CMS’ Accelerated and Advance Payment Program. In April 2020, the Company received approximately $45 million from CMS’ Accelerated and Advance Payment Program for Medicare providers. The Company repaid approximately $7 million and $10 million of the $45 million of advance payments during the second and third quarters of 2021, respectively, via recoupment from the Company’s new Medicare claims and will continue to repay the remaining balance on a monthly basis through September 2022. Contract liabilities of $32.9 million are included in other accrued liabilities at September 30, 2021 and, at December 31, 2020, $35.9 million was included in other accrued liabilities and $11.3 million in other liabilities on the condensed consolidated balance sheets. A summary of the activity in contract liabilities is as follows (in thousands):

Balance at December 31, 2020	$	47,196
Payments received		5,385
Revenue recognized		(2,724	)
Medicare advance repayments		(16,931	)
Balance at September 30, 2021	$	32,926

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Earnings Per Share

9 Months Ended

Sep. 30, 2021

Earnings Per Share [Abstract]

Earnings Per Share

5. Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2021 and 2020 (in thousands, except per share amounts):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021			2020
Numerator:
Income from continuing operations attributable to    Acadia Healthcare Company, Inc.	$	66,126	$	36,324	$	132,998		$	81,736
Income (loss) from discontinued operations		—		674		(12,641	)		29,804
Net income attributable to Acadia Healthcare     Company, Inc.	$	66,126	$	36,998	$	120,357		$	111,540
Denominator:
Weighted average shares outstanding for basic    earnings per share		88,962		87,911		88,684			87,849
Effects of dilutive instruments		1,927		945		1,920			600
Shares used in computing diluted earnings per    common share		90,889		88,856		90,604			88,449
Basic earnings per share attributable to Acadia    Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to     Acadia Healthcare Company, Inc.	$	0.74	$	0.41	$	1.50		$	0.93
Income (loss) from discontinued operations		—		0.01		(0.14	)		0.34
Net income attributable to Acadia Healthcare     Company, Inc.	$	0.74	$	0.42	$	1.36		$	1.27
Diluted earnings per share attributable to Acadia    Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to     Acadia Healthcare Company, Inc.	$	0.73	$	0.41	$	1.47		$	0.92
Income (loss) from discontinued operations		—		0.01		(0.14	)		0.34
Net income attributable to Acadia Healthcare     Company, Inc.	$	0.73	$	0.42	$	1.33		$	1.26

Approximately 0.3 million and 2.0 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 September 30, 2021 and 2020, respectively, because their effect would have been anti-dilutive. Approximately 0.4 million and 2.1 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 nine months ended September 30, 2021 and 2020, respectively, because their effect would have been anti-dilutive.

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Other Current Assets

9 Months Ended

Sep. 30, 2021

Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]

Other Current Assets

6. Other Current Assets

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

	September 30, 2021		December 31, 2020
Prepaid expenses	$	28,664	$	19,480
Assets held for sale		17,566		—
Workers’ compensation deposits – current portion		12,000		12,000
Other receivables		8,530		10,025
Income taxes receivable		7,952		897
Insurance receivable – current portion		6,792		6,792
Inventory		4,322		4,851
Cost report receivable		—		5,818
Other		2,859		1,469
Other current assets	$	88,685	$	61,332

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Property and Equipment

9 Months Ended

Sep. 30, 2021

Property Plant And Equipment [Abstract]

Property and Equipment

7. Property and Equipment

Property and equipment consisted of the following at September 30, 2021 and December 31, 2020 (in thousands):

	September 30, 2021			December 31, 2020
Land	$	149,759		$	144,221
Building and improvements		1,640,951			1,490,149
Equipment		244,484			220,690
Construction in progress		143,766			217,479
		2,178,960			2,072,539
Less: accumulated depreciation		(513,935	)		(449,643	)
Property and equipment, net	$	1,665,025		$	1,622,896

During the three months ended June 30, 2021, the Company opened a 260-bed replacement facility in Pennsylvania and recorded a non-cash property impairment charge of $23.2 million for the existing facility. Additionally, during the three months ended September 30, 2021, the Company recorded a $1.1 million non-cash property impairment charge for one facility in Louisiana resulting from hurricane damage.

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Goodwill and Other Intangible Assets

9 Months Ended

Sep. 30, 2021

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Other Intangible Assets

8. Goodwill and Other Intangible Assets

Other identifiable intangible assets and related accumulated amortization consisted of the following at September 30, 2021 and December 31, 2020 (in thousands):

	Gross Carrying Amount				Accumulated Amortization
	September 30, 2021		December 31, 2020		September 30, 2021			December 31, 2020
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		11,663		11,873		—			—
Trade names		40,435		39,526		—			—
Certificates of need		17,268		17,136		—			—
		69,366		68,535		—			—
Total	$	70,497	$	69,666	$	(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 certificate of need intangible assets have indefinite lives and are, therefore, not subject to amortization.

During the second quarter of 2021, the Company sold one outpatient facility for $4.3 million and recorded a write down of $1.8 million of goodwill and $0.2 million of intangible assets related to the disposition. This disposition is reflected in other investing

activities in the condensed consolidated statement of cash flows.

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The CARES Act

9 Months Ended

Sep. 30, 2021

Extraordinary And Unusual Items [Abstract]

The CARES Act

9. The CARES Act

As part of the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”), the U.S. government announced it would offer $100 billion of relief to eligible healthcare providers. On April 24, 2020, then President Trump signed into law the Paycheck Protection Program and Health Care Enhancement Act (the “PPP Act”). Among other things, the PPP Act allocated $75 billion to eligible healthcare providers to help offset COVID-19 related losses and expenses. The $75 billion allocated under the PPP Act is in addition to the $100 billion allocated to healthcare providers for the same purposes in the CARES Act and has been disbursed to providers under terms and conditions similar to the CARES Act funds. During the three months ended June 30, 2020, the Company participated in certain relief programs offered through the CARES Act, including receipt of approximately $19.7 million relating to the initial portions of the Public Health and Social Services Emergency Fund (the “PHSSE Fund”), also known as the Provider Relief Fund, and approximately $45 million of payments from the CMS Accelerated and Advance Payment Program. In August 2020, the Company received approximately $12.8 million of additional funds from the PHSSE Fund. The Company repaid approximately $7 million and $10 million of the $45 million of advance payments during the second and third quarters of 2021, respectively, via recoupment from the Company’s new Medicare claims and will continue to repay the remaining balance on a monthly basis through September 2022. In addition, the Company received a 2% increase in facilities’ Medicare reimbursement rate as a result of the temporary suspension of Medicare sequestration from May 1, 2020, to December 31, 2021. In April 2021, the Company received $24.2 million of additional funds from the PHSSE Fund, which is included in other accrued liabilities on the condensed consolidated balance sheet at September 30, 2021.

The CARES Act also provides for certain federal income and other tax changes, including an increase in the interest expense tax deduction limitation and bonus depreciation of qualified improvement property. Furthermore, under the CARES Act, (i) for taxable years beginning before 2021, net operating loss (“NOL”) carryforwards and carrybacks may offset 100% of taxable income and (ii) NOLs arising in 2018, 2019 and 2020 taxable years may be carried back to each of the preceding five years to generate a refund. As a result, in 2019 and 2020 the Company received a benefit, in the form of refunds and lower future tax payments, of $51.6 million, consisting of $22.8 million related to interest expense, $20.5 million related to qualified improvement property legislation and an $8.3 million permanent benefit due to loss being able to be carried back at a 35% tax rate to offset income in tax years prior to 2018 (21% for tax years after 2017). The Company also received a cash benefit of approximately $39 million for 2020 relating to the delay of payment of the employer portion of Social Security payroll taxes, as enacted by the CARES Act. The Company repaid half of the $39 million of payroll tax deferrals during the three months ended September 30, 2021 and expects to repay the remaining portion by December 31, 2022.

During the three months ended June 30, 2020, the Company recorded $18.1 million of other income in the condensed consolidated statement of operations related to $19.7 million received from the PHSSE Fund during the quarter. This was subsequently reversed during the third quarter of 2020. During the fourth quarter of 2020, the Company recorded $32.8 million of other income in the consolidated statement of operations related to $34.9 million received from the PHSSE Fund from April through December 2020. The Company’s recognition of this income was based on revised guidance in the Consolidated Appropriations Act, 2021 enacted in December 2020. The Company continues to evaluate its compliance with the terms and conditions to, and the financial impact of, funds received under the CARES Act and other government relief programs.

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Other Accrued Liabilities

9 Months Ended

Sep. 30, 2021

Other Liabilities Disclosure [Abstract]

Other Accrued Liabilities

10. Other Accrued Liabilities

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

	September 30, 2021		December 31, 2020
Accrued expenses	$	38,386	$	28,452
Contract liabilities		32,926		35,946
Government relief funds		28,310		5,495
Accrued interest		17,158		40,479
Income taxes payable		9,921		16,345
Insurance liability – current portion		9,700		9,700
Accrued property taxes		9,054		6,763
Cost report payable		4,210		—
Finance lease liabilities		990		32,188
Other		6,549		3,085
Other accrued liabilities	$	157,204	$	178,453

During the three months ended September 30, 2021, the Company purchased a leased property for approximately $31.4 million, which was recorded as a finance lease liability within other accrued liabilities on the condensed consolidated balance sheet at December 31, 2020.

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Long-Term Debt

9 Months Ended

Sep. 30, 2021

Debt Disclosure [Abstract]

Long-Term Debt

11.Long-Term Debt

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

	September 30, 2021			December 31, 2020
New Credit Facility:
Term Loan A	$	419,687		$	—
Revolving Line of Credit		100,000			—
Prior Credit Facility:
Senior Secured Term A Loan		—			311,733
Senior Secured Term B Loans		—			872,870
Senior Secured Revolving Line of Credit		—			—
5.625% Senior Notes due 2023		—			650,000
6.500% Senior Notes due 2024		—			390,000
5.500% Senior Notes due 2028		450,000			450,000
5.000% Senior Notes due 2029		475,000			475,000
Other long-term debt		—			3,625
Less: unamortized debt issuance costs, discount and    premium		(15,342	)		(30,802	)
		1,429,345			3,122,426
Less: current portion		(15,938	)		(153,478	)
Long-term debt	$	1,413,407		$	2,968,948

New Credit Facility

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

As a part of the closing of the New Credit Facility on March 17, 2021, the Company (i) refinanced and terminated the Company’s prior credit facilities under the Amended and Restated Credit Agreement, dated as of December 31, 2012 (the “Prior Credit Facility”) and (ii) financed the redemption of all of the Company’s outstanding 5.625% Senior Notes due 2023 (the “5.625% Senior Notes”).

The Company had $496.6 million of availability under the Revolving Facility and had standby letters of credit outstanding of $3.4 million related to security for the payment of claims required by its workers’ compensation insurance program at September 30, 2021.

During the nine months ended September 30, 2021, the Company repaid $60.0 million of the balance outstanding on the Revolving Facility.

The New Credit Facility requires quarterly term loan principal repayments for the Term Loan Facility of $2.7 million for December 31, 2021 to March 31, 2022, $5.3 million for June 30, 2022 to March 31, 2024, $8.0 million for June 30, 2024 to March 31, 2025, $10.6 million for June 30, 2025 to December 31, 2025, with the remaining principal balance of the Term Loan Facility due on the maturity date of March 17, 2026.

The Company has the ability to increase the amount of the Senior Facilities, which may take the form of increases to the Revolving Facility or the Term Loan Facility or the issuance of one or more incremental term loan facilities (collectively, the “Incremental Facilities”), upon obtaining additional commitments from new or existing lenders and the satisfaction of customary conditions precedent for such Incremental Facilities. Such Incremental Facilities may not exceed the sum of (i) the greater of $480.0 million and an amount equal to 100% of Consolidated EBITDA (as defined in the New Credit Facility) of the Company and its Restricted Subsidiaries (as defined in the New Credit Facility) (as determined for the four fiscal quarter period most recently ended for which financial statements are available), and (ii) additional amounts so long as, after giving effect thereto, the Consolidated Senior Secured Net Leverage Ratio (as defined in the New Credit Facility) does not exceed 3.5 to 1.0.

Subject to certain exceptions, substantially all of the Company’s existing and subsequently acquired or organized direct or indirect wholly-owned U.S. subsidiaries are required to guarantee the repayment of the Company’s obligations under the New Credit Facility. Borrowings under the Senior Facilities bear interest at a floating rate, which will initially be, at the Company’s option, either (i) adjusted LIBOR plus 1.75% or (ii) an alternative base rate plus 0.75% (in each case, subject to adjustment based on the Company’s consolidated total net leverage ratio). An unused fee initially set at 0.25% per annum (subject to adjustment based on the Company’s consolidated total net leverage ratio) is payable quarterly in arrears based on the actual daily undrawn portion of the commitments in respect of the Revolving Facility.

The New 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 New Credit Facility contains financial covenants requiring the Company on a consolidated basis to maintain, as of the last day of any consecutive four fiscal quarter period, a consolidated total net leverage ratio of not more than 5.0 to 1.0 and an interest coverage ratio of at least 3.0 to 1.0. The New 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 Senior Facilities may be accelerated and/or the lenders’ commitments terminated. At September 30, 2021, the Company was in compliance with such covenants.

Prior Credit Facility

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

On April 21, 2020, the Company entered into the Thirteenth Amendment (the “Thirteenth Amendment”) to the Prior Credit Facility. The Thirteenth Amendment amended the Consolidated Leverage Ratio in the prior covenant to increase such leverage ratio for the rest of 2020.

On November 13, 2020, the Company entered into the Fourth Repricing Facilities Amendment (the “Fourth Repricing Facilities Amendment”) to the Prior Credit Facility. The Fourth Repricing Facilities Amendment extended the maturity date of each of the prior revolving line of credit and the prior Term Loan A Facility (“TLA Facility”) from November 30, 2021 to November 30, 2022. The Fourth Repricing Facilities Amendment also (1) replaced the revolving line of credit in an aggregate committed amount of $500.0 million with an aggregate committed amount of approximately $459.0 million and (2) replaced the TLA Facility aggregate outstanding principal amount of approximately $352.4 million with an aggregate principal amount of approximately $318.9 million. The interest rate margin applicable to both facilities remained unchanged from the prior facilities, and the commitment fee applicable to the new revolving line of credit also remained unchanged from the prior revolving line of credit. In connection with the Fourth Repricing Facilities Amendment, the Company recorded a debt extinguishment charge of $1.0 million, including the write-off of discount and deferred financing costs, which was recorded in debt extinguishment costs in the consolidated statement of operations for the year ended December 31, 2020.

On January 5, 2021, the Company made a voluntary payment of $105.0 million on the Term Loan B Facility Tranche B-4 (“Tranche B-4 Facility”). On January 19, 2021, the Company used a portion of the net proceeds from the U.K. Sale to repay the outstanding balances of $311.7 million of its TLA Facility and $767.9 million of its Tranche B-4 Facility of the Prior Credit Facility. At March 31, 2021, in connection with the termination of the Prior Credit Facility, the Company recorded a debt extinguishment charge of $10.9 million, including the write-off of discount and deferred financing costs, which was recorded in debt extinguishment costs in the condensed consolidated statement of operations.

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 Company used the net proceeds of the 5.000% Senior Notes to prepay approximately $453.3 million of the outstanding borrowings on our existing Term Loan B Facility Tranche B-3 (“Tranche B-3 Facility”) and used the remaining net proceeds for general corporate purposes and to pay related fees and expenses in

connection with the offering. In connection with the 5.000% Senior Notes, the Company recorded a debt extinguishment charge of $2.9 million, including the write-off of discount and deferred financing costs of the Tranche B-3 Facility, which was recorded in debt extinguishment costs in the consolidated statement of operations for the year ended December 31, 2020.

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 New 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.

5.625% Senior Notes due 2023

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

6.500% Senior Notes due 2024

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

Redemption of 5.625% Senior Notes and 6.500% Senior Notes

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

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

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

6.125% Senior Notes due 2021

On March 12, 2013, the Company issued $150.0 million of 6.125% Senior Notes due 2021 (the “6.125% Senior Notes”). The 6.125% Senior Notes were to mature on March 15, 2021 and bear interest at a rate of 6.125% per annum, payable semi-annually in arrears on March 15 and September 15 of each year. On June 24, 2020, the Company redeemed the 6.125% Senior Notes.

5.125% Senior Notes due 2022

On July 1, 2014, the Company issued $300.0 million of 5.125% Senior Notes due 2022 (the “5.125% Senior Notes”). The 5.125% Senior Notes were to mature on July 1, 2022 and bear interest at a rate of 5.125% per annum, payable semi-annually in arrears on January 1 and July 1 of each year. On June 24, 2020, the Company redeemed the 5.125% Senior Notes.

Redemption of 6.125% Senior Notes and 5.125% Senior Notes

On June 10, 2020, the Company issued conditional notices of full redemption providing for the redemption in full of the 6.125% Senior Notes and 5.125% Senior Notes on July 10, 2020 (the “Redemption Date”), in each case at a redemption price equal to 100.0% of the principal amount thereof, plus accrued and unpaid interest, if any, to, but not including the Redemption Date (the “Redemption Price”). On June 24, 2020, the Company satisfied and discharged the indentures governing the 6.125% Senior Notes and the 5.125% Senior Notes by irrevocably depositing with a trustee sufficient funds equal to the Redemption Price for the 6.125% Senior Notes and

the 5.125% Senior Notes and otherwise complying with the terms in the indentures relating to the satisfaction and discharge of the 6.125% Senior Notes and the 5.125% Senior Notes. In connection with the redemption of the 6.125% Senior Notes and the 5.125% Senior Notes, the Company recorded a debt extinguishment charge of $3.3 million, including the write-off of the deferred financing and other costs in the consolidated statement of operations for the year ended December 31, 2020.

Other long-term debt

During the nine months ended September 30, 2021, the Company repaid other long-term debt of $3.3 million, which is reflected in repayment of long-term debt within financing activities in the condensed consolidated statement of cash flows.

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Noncontrolling Interests

9 Months Ended

Sep. 30, 2021

Noncontrolling Interest [Abstract]

Noncontrolling Interests

12. Noncontrolling Interests

Noncontrolling interests in the consolidated financial statements represents the portion of equity held by noncontrolling partners in the Company’s non-wholly owned subsidiaries. At September 30, 2021, the Company operated six facilities through non-wholly owned subsidiaries. The Company owns between 60% and 86% 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, and the Company consolidates the operations of each facility based on its equity ownership and its control of the entity. The noncontrolling interests are reflected as redeemable noncontrolling interests on the accompanying 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 December 31, 2020	$	55,315
Contribution of redeemable noncontrolling interests		3,999
Net income attributable to noncontrolling interests		3,686
Dividend payments to noncontrolling interests		(926	)
Balance at September 30, 2021	$	62,074

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Variable Interest Entities

9 Months Ended

Sep. 30, 2021

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Variable Interest Entities

13. Variable Interest Entities

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

At September 30, 2021, the Company operated six facilities through non-wholly owned subsidiaries. The Company owns between 60% and 86% 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 our VIEs prohibit us from using the assets of each VIE to satisfy the obligations of other entities. Consolidated assets at September 30, 2021 and December 31, 2020 include total assets of variable interest entities of $298.9 million and $261.7 million, respectively, which cannot be used to settle the obligations of other entities. Consolidated liabilities at September 30, 2021 and December 31, 2020 include total liabilities of variable interest entities of $24.4 million and $26.1 million, respectively.

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

	September 30, 2021		December 31, 2020
Cash and cash equivalents	$	25,028	$	15,151
Accounts receivable, net		20,673		18,507
Other current assets		2,029		1,461
Total current assets		47,730		35,119
Property and equipment, net		199,078		175,103
Goodwill		34,945		34,945
Intangible assets, net		10,490		9,581
Operating lease right-of-use assets		6,681		6,909
Total assets	$	298,924	$	261,657
Accounts payable	$	3,102	$	4,143
Accrued salaries and benefits		5,735		4,357
Current portion of operating lease liabilities		188		164
Other accrued liabilities		7,604		8,366
Total current liabilities		16,629		17,030
Operating lease liabilities		6,718		6,863
Other liabilities		1,083		2,166
Total liabilities	$	24,430	$	26,059

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Accumulated Other Comprehensive Loss

9 Months Ended

Sep. 30, 2021

Equity [Abstract]

Accumulated Other Comprehensive Loss

14. Accumulated Other Comprehensive Loss

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

	Foreign Currency Translation Adjustments			Change in Fair Value of Derivative Instruments			Pension Plan			Total
Balance at December 31, 2020	$	(373,101	)	$	13,686		$	(11,950	)	$	(371,365	)
Foreign currency translation (loss) gain		(4,293	)		—			33			(4,260	)
Gain on derivative instruments, net of tax of $0.1    million		—			19			—			19
U.K. Sale		377,394			(13,705	)		11,917			375,606
Balance at September 30, 2021	$	—		$	—		$	—		$	—

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Equity-Based Compensation

9 Months Ended

Sep. 30, 2021

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 and restricted stock units, to certain officers, employees and non-employee directors under the Acadia Healthcare Company, Inc. Incentive Compensation Plan (the “Equity Incentive Plan”). At September 30, 2021, a maximum of 12,700,000 shares of the Company’s common stock were authorized for issuance as stock options, restricted stock and restricted stock units or other share-based compensation under the Equity Incentive Plan, of which 4,484,084 were available for future grant. Stock options may be granted for terms of up to 10 years. The Company recognizes expense on all share-based awards on a straight-line basis over the requisite service period of the entire award. Grants to employees generally vest in annual increments of 25% each year, commencing one year after the date of grant. The exercise prices of stock options are equal to the most recent closing price of the Company’s common stock on the most recent trading date prior to the date of grant.

The Company recognized $8.9 million and $5.5 million in equity-based compensation expense for the three months ended September 30, 2021 and 2020, respectively, and $25.0 million and $16.3 million for the nine months ended September 30, 2021 and 2020, respectively. At September 30, 2021, there was $48.5 million of unrecognized compensation expense related to unvested

options, restricted stock and restricted stock units, which is expected to be recognized over the remaining weighted average vesting period of 1.2 years.

The Company recognized a deferred income tax benefit of $2.3 million and $1.4 million for the three months ended September 30, 2021 and 2020, respectively, related to equity-based compensation expense. The Company recognized a deferred income tax benefit of $6.4 million and $4.2 million for the nine months ended September 30, 2021 and 2020, respectively, related to equity-based compensation expense.

Stock Options

Stock option activity during 2020 and 2021 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, 2020		1,360,068		$	39.40		7.57	$	1,650
Options granted		507,600			33.13		9.18		157
Options exercised		(68,700	)		29.15	N/A			854
Options cancelled		(288,662	)		39.67	N/A		N/A
Options outstanding at December 31, 2020		1,510,306			37.56		7.35		1,414
Options granted		306,520			57.58		7.66		823
Options exercised		(547,522	)		39.48	N/A			10,846
Options cancelled		(143,165	)		39.97	N/A		N/A
Options outstanding at September 30, 2021		1,126,139		$	41.77		7.39	$	20,808
Options exercisable at December 31, 2020		596,606		$	45.37		5.55	$	543
Options exercisable at September 30, 2021		332,934		$	43.20		6.00	$	5,767

Fair values are estimated using the Black-Scholes option pricing model. The following table summarizes the grant-date fair value of options and the assumptions used to develop the fair value estimates for options granted during the nine months ended September 30, 2021 and year ended December 31, 2020:

	September 30, 2021			December 31, 2020
Weighted average grant-date fair value of options	$	20.67		$	12.37
Risk-free interest rate		0.9	%		1.6	%
Expected volatility		40	%		41	%
Expected life (in years)		5.0			5.0

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

Other Stock-Based Awards

Restricted stock activity during 2020 and 2021 was as follows:

	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2020		805,136		$	34.14
Granted		637,312			25.82
Cancelled		(129,683	)		34.56
Vested		(289,769	)		35.88
Unvested at December 31, 2020		1,022,996		$	28.41
Granted		324,530			58.48
Cancelled		(66,801	)		38.56
Vested		(352,184	)		30.63
Unvested at September 30, 2021		928,541		$	37.35

Restricted stock unit activity during 2020 and 2021 was as follows:

	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2020		447,357		$	38.89
Granted		583,680			10.60
Performance adjustment		117,772			13.50
Cancelled		(63,056	)		43.35
Vested		(12,691	)		42.09
Unvested at December 31, 2020		1,073,062		$	20.15
Granted		149,416			61.52
Performance adjustment		345,731			24.10
Cancelled		—			—
Vested		(184,051	)		42.30
Unvested at September 30, 2021		1,384,158		$	22.66

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

Restricted stock units are granted to employees and are subject to Company performance compared to pre-established targets and Company performance compared to peers. In addition to Company performance, these performance-based restricted stock units are subject to the continuing service of the employee during the two- or three-year period covered by the awards. The performance condition for the restricted stock units is based on the Company’s achievement of annually established targets for diluted earnings per share. Additionally, the number of shares issuable pursuant to restricted stock units granted during 2020 are subject to adjustment based on the Company’s three-year annualized total stockholder return relative to a peer group consisting of S&P 1500 companies within the Healthcare Providers & Services 6 digit GICS industry group and selected other companies deemed to be peers. The number of shares issuable at the end of the applicable vesting period of restricted stock units ranges from 0% to 200% of the targeted units based on the Company’s actual performance compared to the targets and, for 2021 and 2020 awards, performance compared to peers.

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

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Income Taxes

9 Months Ended

Sep. 30, 2021

Income Tax Disclosure [Abstract]

Income Taxes

16. Income Taxes

The provision for income taxes for the three months ended September 30, 2021 and 2020 reflects effective tax rates of 20.4% and 19.9%, respectively, and 23.9% and 22.4% for the nine months ended September 30, 2021 and 2020, respectively. The increase in

the effective tax rate for the three and nine months ended September 30, 2021 was primarily attributable to the Company’s disallowance of certain compensation-related deductions and the impact of U.S. and U.K. tax legislation changes in the 2020 year.

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

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Fair Value Measurements

9 Months Ended

Sep. 30, 2021

Fair Value Disclosures [Abstract]

Fair Value Measurements

17. Fair Value Measurements

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

The carrying amounts and fair values of the Company’s New Credit Facility, Prior Credit Facility, 5.625% Senior Notes, 6.500% Senior Notes, 5.500% Senior Notes, 5.000% Senior Notes, other long-term debt and derivative instruments at September 30, 2021 and December 31, 2020 were as follows (in thousands):

	Carrying Amount				Fair Value
	September 30, 2021		December 31, 2020		September 30, 2021		December 31, 2020
New Credit Facility	$	516,905	$	—	$	516,905	$	—
Prior Credit Facility	$	—	$	1,175,437	$	—	$	1,175,437
5.625% Senior Notes due 2023	$	—	$	646,344	$	—	$	647,960
6.500% Senior Notes due 2024	$	—	$	385,636	$	—	$	393,850
5.500% Senior Notes due 2028	$	443,703	$	443,139	$	466,421	$	475,931
5.000% Senior Notes due 2029	$	468,737	$	468,245	$	488,096	$	499,852
Other long-term debt	$	—	$	3,625	$	—	$	3,625
Derivative instrument liabilities	$	—	$	84,584	$	—	$	84,584

The Company’s New Credit Facility, Prior Credit Facility, 5.625% Senior Notes, 6.500% Senior Notes, 5.500% Senior Notes, 5.000% Senior Notes and other long-term debt were categorized as Level 2 in the GAAP fair value hierarchy. Fair values were based on trading activity among the Company’s lenders and the average bid and ask price as determined using published rates.

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

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Commitments and Contingencies

9 Months Ended

Sep. 30, 2021

Commitments And Contingencies Disclosure [Abstract]

Commitments and Contingencies

18.Commitments and Contingencies

Professional and General Liability

A portion of the Company’s professional liability risks are insured through a wholly-owned insurance subsidiary. The Company is self-insured for professional liability claims up to $3.0 million per claim through August 31, 2021 and $10.0 million thereafter, and has obtained reinsurance coverage from a third party to cover claims in excess of the retention limit. The reinsurance policy has a coverage limit of $75.0 million in the aggregate. The Company’s reinsurance receivables are recognized consistent with the related liabilities and include known claims and any incurred but not reported claims that are covered by current insurance policies in place.

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 False Claims Act can result in substantial monetary penalties and fines, the imposition of a corporate integrity agreement and exclusion from participation in governmental health programs. In addition, the federal False Claims Act permits private parties to bring qui tam, or “whistleblower,” suits against companies that submit false claims for payments to, or improperly retain overpayments from, the government. Some states have adopted similar state whistleblower and false claims provisions.

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 purports to be 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. At this time, we are not able to quantify any potential liability in connection with this litigation because the case is in its early stages.  

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. Joey A. 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 16, 2021, the parties filed a stipulation 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-JRS, 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. At this time, we are not able to quantify any potential liability in connection with this litigation because the cases are in their early stages.  

On April 25, 2018, plaintiff filed Pence v. Sober Living By the Sea, Inc. - 30-2018-00988742-CU-OE-CXC, Orange County Superior Court (Pence I). On July 13, 2018, plaintiff next filed Pence v. Sober Living by the Sea, Inc.; Acadia Healthcare Company, Inc. - 30-2018-01005317-CU-OE-CJC, Orange County Superior Court (Pence II). These cases have now been consolidated before the same judge in the Complex Litigation Department of the Orange County Superior Court. The complaints allege various wage and hour violations under California law on behalf of a putative class of all non-exempt California employees of Acadia and various subsidiaries, going back to April 25, 2014, and on behalf of purportedly aggrieved non-exempt employees under California’s Private Attorney General Act (“PAGA”). The claims include (1) failure to provide overtime wages; (2); failure to provide minimum wages; (3) failure to provide meal periods; (4) failure to provide rest periods; (5); failure to pay wages due at termination; (6) failure to provide accurate wage statements; (7) violations of California Business and Professions Code section 17200; and (8) civil penalties under California Labor Code section 2699 (PAGA). During the second quarter of 2020, the Company recorded approximately $4.0 million to transaction-related expenses in the condensed consolidated statements of operations based on the Company’s expected settlement and legal fees. The court granted final approval of the settlement in September 2021, and the Company made the settlement payment in October 2021.  

In the fall of 2017, the Office of Inspector General (“OIG”) issued subpoenas to three of the Company’s facilities requesting certain documents from January 2013 to the date of the subpoenas. The U.S. Attorney’s Office for the Middle District of Florida issued a civil investigative demand to one of the Company’s facilities in December 2017 requesting certain documents from November 2012 to the date of the demand. In April 2019, the OIG issued subpoenas relating to six additional facilities requesting certain documents and information from January 2013 to the date of the subpoenas. The government’s investigation of each of these facilities is focused on claims not eligible for payment because of alleged violations of certain regulatory requirements relating to, among other things, medical necessity, admission eligibility, discharge decisions, length of stay and patient care issues. The Company is cooperating with the government’s investigation but is not able to quantify any potential liability in connection with these investigations.  

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Derivatives

9 Months Ended

Sep. 30, 2021

Derivative Instruments And Hedging Activities Disclosure [Abstract]

Derivatives

19. Derivatives

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

In August 2019, the Company also entered into multiple cross currency swap agreements with an aggregate notional amount of $650.0 million to manage foreign currency risk by effectively converting a portion of its fixed-rate USD-denominated senior notes, including the semi-annual interest payments thereunder, to fixed-rate GBP-denominated debt of £538.1 million. During the term of the swap agreements, the Company received semi-annual interest payments in USD from the counterparties at fixed interest rates, and the Company made semi-annual interest payments in GBP to the counterparties at fixed interest rates. The interest payments under the cross-currency swap agreements resulted in £25.4 million of annual cash flows from the Company’s U.K. business being converted to $35.8 million.

In conjunction with the U.K. Sale in January 2021, the Company settled its cross currency swap liability and outstanding forward contracts. Cash paid from the settlement of the cross currency swap derivatives and forward contracts outstanding at December 31, 2020 are included in investing activities as part of the net proceeds received from the U.K. Sale in the condensed consolidated statement of cash flows.

The Company designated the cross currency swap agreements and forward contracts entered into during 2020 as qualifying hedging instruments and accounted for these derivatives as net investment hedges. The fair value of these derivatives at December 31, 2020 of $84.6 million is recorded as derivative instrument liabilities in the condensed consolidated balance sheet. During 2019, the Company elected the spot method for recording its net investment hedges. Gains and losses resulting from the settlement of the excluded components were recorded in interest expense on the condensed consolidated statement of operations. Gains and losses resulting from fair value adjustments to the cross currency swap agreements were recorded in accumulated other comprehensive loss as the swaps are effective in hedging the designated risk. These gains and losses were considered in the carrying value of the U.K. operations and included in the loss on the U.K. Sale recorded in December 31, 2020 and January 2021. Prior to the U.K. Sale, cash flows related to the cross currency swap derivatives are included in operating activities in the condensed consolidated statement of cash flows.

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Financial Information for the Company and Its Subsidiaries

9 Months Ended

Sep. 30, 2021

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Financial Information for the Company and Its Subsidiaries

20. Financial Information for the Company and Its Subsidiaries

The Company conducts substantially all of its business through its subsidiaries. The 5.500% Senior Notes and 5.000% Senior Notes are jointly and severally guaranteed on an unsecured senior basis by all of the Company’s subsidiaries that guarantee the Company’s obligations under the New Credit Facility. The 5.625% Senior Notes, 6.500% Senior Notes, 5.500% Senior Notes and 5.000% Senior Notes were jointly and severally guaranteed on an unsecured senior basis by all of the Company’s subsidiaries that guarantee the Company’s obligations under the Prior Credit Facility. Summarized financial information is presented below is consistent with the condensed consolidated financial statements of the Company, except transactions between combining entities have been eliminated. Financial information for the combined non-guarantor entities has been excluded. Presented below is condensed financial information for Acadia Healthcare Company, Inc. and the combined wholly-owned subsidiary guarantors at September 30, 2021 and December 31, 2020, and for the nine months ended September 30, 2021.

Summarized balance sheet information (in thousands):

	September 30, 2021		December 31, 2020
Current assets	$	496,397	$	654,735
Property and equipment, net		1,440,846		1,421,875
Goodwill		1,990,544		1,992,305
Total noncurrent assets		3,668,848		3,640,809
Current liabilities		381,950		626,419
Long-term debt		1,392,041		2,786,125
Total noncurrent liabilities		1,661,072		3,045,981
Redeemable noncontrolling interests		—		—
Total equity		2,122,223		623,144

Summarized operating results information (in thousands):

	Nine Months Ended September 30, 2021
Revenue	$	1,585,837
Income before income taxes		158,117
Net income		119,785
Net income attributable to Acadia Healthcare Company, Inc.		119,785

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U.K. Sale (Tables)

9 Months Ended

Sep. 30, 2021

Discontinued Operations And Disposal Groups [Abstract]

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

For the three and nine months ended September 30, 2021 and 2020, results of operations of the U.K. operations were as follows (in thousands):

	Three Months Ended September 30,					Nine Months Ended September 30,
	2021		2020			2021			2020
Revenue	$	—	$	285,343		$	62,520		$	817,772
Salaries, wages and benefits		—		159,840			35,937			465,514
Professional fees		—		31,987			6,815			92,264
Supplies		—		9,434			2,217			28,274
Rents and leases		—		11,817			2,509			34,858
Other operating expenses		—		28,880			6,682			85,682
Depreciation and amortization		—		18,780			—			55,739
Interest expense, net		—		238			10			666
Loss on sale		—		—			14,254			—
Loss on impairment		—		20,239			—			20,239
Transaction-related expenses		—		5,479			6,265			7,735
Total expenses		—		286,694			74,689			790,971
(Loss) income from discontinued operations      before income taxes		—		(1,351	)		(12,169	)		26,801
(Benefit from) provision for income taxes		—		(2,025	)		472			(3,003	)
Income (loss) from discontinued operations, net      of taxes	$	—	$	674		$	(12,641	)	$	29,804

The major classes of assets and liabilities for the U.K. operations as of December 31, 2020 are shown below (in thousands):

Cash and cash equivalents	$	75,051
Accounts receivable, net		52,196
Other current assets		13,361
Current assets of discontinued operations		140,608
Property and equipment, net		1,297,923
Goodwill		—
Intangible assets, net		22,289
Operating lease right-of-use assets		341,289
Other assets		7,706
Total assets of discontinued operations	$	1,809,815
Current liabilities:
Accounts payable	$	44,929
Current portion of operating lease liabilities		11,141
Other current liabilities		136,895
Current liabilities of discontinued operations		192,965
Operating lease liabilities		387,607
Deferred tax liabilities		57,230
Other liabilities		22,225
Total liabilities of discontinued operations	$	660,027

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

9 Months Ended

Sep. 30, 2021

Schedule of Revenue Attributed to Each Category

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

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021		2020
Acute inpatient psychiatric facilities	$	284,143	$	259,353	$	832,692	$	723,611
Specialty treatment facilities		230,753		211,796		669,552		597,886
Residential treatment centers		71,006		71,153		211,377		210,432
Outpatient community-based facilities		1,657		5,659		7,293		16,724
Revenue	$	587,559	$	547,961	$	1,720,914	$	1,548,653

Schedule of Revenue and Percentage Generated by Each Payor Type

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

	Three Months Ended September 30,										Nine Months Ended September 30,
	2021					2020					2021					2020
	Amount		%			Amount		%			Amount		%			Amount		%
Commercial	$	170,427		29.0	%	$	156,741		28.6	%	$	511,975		29.8	%	$	439,911		28.4	%
Medicare		97,529		16.6	%		96,536		17.6	%		274,208		15.9	%		244,721		15.9	%
Medicaid		288,092		49.0	%		261,341		47.7	%		845,128		49.1	%		767,075		49.4	%
Self-Pay		25,998		4.4	%		26,060		4.8	%		71,875		4.2	%		75,570		4.9	%
Other		5,513		1.0	%		7,283		1.3	%		17,728		1.0	%		21,376		1.4	%
Revenue	$	587,559		100.0	%	$	547,961		100.0	%	$	1,720,914		100.0	%	$	1,548,653		100.0	%

Summary of the Activity in Contract Liabilities

A summary of the activity in contract liabilities is as follows (in thousands):

Balance at December 31, 2020	$	47,196
Payments received		5,385
Revenue recognized		(2,724	)
Medicare advance repayments		(16,931	)
Balance at September 30, 2021	$	32,926

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Earnings Per Share (Tables)

9 Months Ended

Sep. 30, 2021

Earnings Per Share [Abstract]

Computation of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2021 and 2020 (in thousands, except per share amounts):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021			2020
Numerator:
Income from continuing operations attributable to    Acadia Healthcare Company, Inc.	$	66,126	$	36,324	$	132,998		$	81,736
Income (loss) from discontinued operations		—		674		(12,641	)		29,804
Net income attributable to Acadia Healthcare     Company, Inc.	$	66,126	$	36,998	$	120,357		$	111,540
Denominator:
Weighted average shares outstanding for basic    earnings per share		88,962		87,911		88,684			87,849
Effects of dilutive instruments		1,927		945		1,920			600
Shares used in computing diluted earnings per    common share		90,889		88,856		90,604			88,449
Basic earnings per share attributable to Acadia    Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to     Acadia Healthcare Company, Inc.	$	0.74	$	0.41	$	1.50		$	0.93
Income (loss) from discontinued operations		—		0.01		(0.14	)		0.34
Net income attributable to Acadia Healthcare     Company, Inc.	$	0.74	$	0.42	$	1.36		$	1.27
Diluted earnings per share attributable to Acadia    Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to     Acadia Healthcare Company, Inc.	$	0.73	$	0.41	$	1.47		$	0.92
Income (loss) from discontinued operations		—		0.01		(0.14	)		0.34
Net income attributable to Acadia Healthcare     Company, Inc.	$	0.73	$	0.42	$	1.33		$	1.26

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Other Current Assets (Tables)

9 Months Ended

Sep. 30, 2021

Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]

Other Current Assets

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

	September 30, 2021		December 31, 2020
Prepaid expenses	$	28,664	$	19,480
Assets held for sale		17,566		—
Workers’ compensation deposits – current portion		12,000		12,000
Other receivables		8,530		10,025
Income taxes receivable		7,952		897
Insurance receivable – current portion		6,792		6,792
Inventory		4,322		4,851
Cost report receivable		—		5,818
Other		2,859		1,469
Other current assets	$	88,685	$	61,332

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Property and Equipment (Tables)

9 Months Ended

Sep. 30, 2021

Property Plant And Equipment [Abstract]

Summary of Property and Equipment

Property and equipment consisted of the following at September 30, 2021 and December 31, 2020 (in thousands):

	September 30, 2021			December 31, 2020
Land	$	149,759		$	144,221
Building and improvements		1,640,951			1,490,149
Equipment		244,484			220,690
Construction in progress		143,766			217,479
		2,178,960			2,072,539
Less: accumulated depreciation		(513,935	)		(449,643	)
Property and equipment, net	$	1,665,025		$	1,622,896

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Goodwill and Other Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2021

Goodwill And Intangible Assets Disclosure [Abstract]

Other Identifiable Intangible Assets and Related Accumulated Amortization

Other identifiable intangible assets and related accumulated amortization consisted of the following at September 30, 2021 and December 31, 2020 (in thousands):

	Gross Carrying Amount				Accumulated Amortization
	September 30, 2021		December 31, 2020		September 30, 2021			December 31, 2020
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		11,663		11,873		—			—
Trade names		40,435		39,526		—			—
Certificates of need		17,268		17,136		—			—
		69,366		68,535		—			—
Total	$	70,497	$	69,666	$	(1,131	)	$	(1,131	)

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Other Accrued Liabilities (Tables)

9 Months Ended

Sep. 30, 2021

Other Liabilities Disclosure [Abstract]

Summary of Other Accrued Liabilities

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

	September 30, 2021		December 31, 2020
Accrued expenses	$	38,386	$	28,452
Contract liabilities		32,926		35,946
Government relief funds		28,310		5,495
Accrued interest		17,158		40,479
Income taxes payable		9,921		16,345
Insurance liability – current portion		9,700		9,700
Accrued property taxes		9,054		6,763
Cost report payable		4,210		—
Finance lease liabilities		990		32,188
Other		6,549		3,085
Other accrued liabilities	$	157,204	$	178,453

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Long-Term Debt (Tables)

9 Months Ended

Sep. 30, 2021

Debt Disclosure [Abstract]

Components of Long-Term Debt

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

	September 30, 2021			December 31, 2020
New Credit Facility:
Term Loan A	$	419,687		$	—
Revolving Line of Credit		100,000			—
Prior Credit Facility:
Senior Secured Term A Loan		—			311,733
Senior Secured Term B Loans		—			872,870
Senior Secured Revolving Line of Credit		—			—
5.625% Senior Notes due 2023		—			650,000
6.500% Senior Notes due 2024		—			390,000
5.500% Senior Notes due 2028		450,000			450,000
5.000% Senior Notes due 2029		475,000			475,000
Other long-term debt		—			3,625
Less: unamortized debt issuance costs, discount and    premium		(15,342	)		(30,802	)
		1,429,345			3,122,426
Less: current portion		(15,938	)		(153,478	)
Long-term debt	$	1,413,407		$	2,968,948

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Noncontrolling Interests (Tables)

9 Months Ended

Sep. 30, 2021

Noncontrolling Interest [Abstract]

Summary of Redeemable Noncontrolling Interests

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

Balance at December 31, 2020	$	55,315
Contribution of redeemable noncontrolling interests		3,999
Net income attributable to noncontrolling interests		3,686
Dividend payments to noncontrolling interests		(926	)
Balance at September 30, 2021	$	62,074

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Variable Interest Entities (Tables)

9 Months Ended

Sep. 30, 2021

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Schedule of Consolidated VIEs Assets and Liabilities

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

	September 30, 2021		December 31, 2020
Cash and cash equivalents	$	25,028	$	15,151
Accounts receivable, net		20,673		18,507
Other current assets		2,029		1,461
Total current assets		47,730		35,119
Property and equipment, net		199,078		175,103
Goodwill		34,945		34,945
Intangible assets, net		10,490		9,581
Operating lease right-of-use assets		6,681		6,909
Total assets	$	298,924	$	261,657
Accounts payable	$	3,102	$	4,143
Accrued salaries and benefits		5,735		4,357
Current portion of operating lease liabilities		188		164
Other accrued liabilities		7,604		8,366
Total current liabilities		16,629		17,030
Operating lease liabilities		6,718		6,863
Other liabilities		1,083		2,166
Total liabilities	$	24,430	$	26,059

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Accumulated Other Comprehensive Loss (Tables)

9 Months Ended

Sep. 30, 2021

Equity [Abstract]

Components of Accumulated Other Comprehensive Loss

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

	Foreign Currency Translation Adjustments			Change in Fair Value of Derivative Instruments			Pension Plan			Total
Balance at December 31, 2020	$	(373,101	)	$	13,686		$	(11,950	)	$	(371,365	)
Foreign currency translation (loss) gain		(4,293	)		—			33			(4,260	)
Gain on derivative instruments, net of tax of $0.1    million		—			19			—			19
U.K. Sale		377,394			(13,705	)		11,917			375,606
Balance at September 30, 2021	$	—		$	—		$	—		$	—

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Equity-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2021

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock Option Activity

Stock option activity during 2020 and 2021 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, 2020		1,360,068		$	39.40		7.57	$	1,650
Options granted		507,600			33.13		9.18		157
Options exercised		(68,700	)		29.15	N/A			854
Options cancelled		(288,662	)		39.67	N/A		N/A
Options outstanding at December 31, 2020		1,510,306			37.56		7.35		1,414
Options granted		306,520			57.58		7.66		823
Options exercised		(547,522	)		39.48	N/A			10,846
Options cancelled		(143,165	)		39.97	N/A		N/A
Options outstanding at September 30, 2021		1,126,139		$	41.77		7.39	$	20,808
Options exercisable at December 31, 2020		596,606		$	45.37		5.55	$	543
Options exercisable at September 30, 2021		332,934		$	43.20		6.00	$	5,767

Schedule of Stock Options Valuation Assumptions

The following table summarizes the grant-date fair value of options and the assumptions used to develop the fair value estimates for options granted during the nine months ended September 30, 2021 and year ended December 31, 2020:

	September 30, 2021			December 31, 2020
Weighted average grant-date fair value of options	$	20.67		$	12.37
Risk-free interest rate		0.9	%		1.6	%
Expected volatility		40	%		41	%
Expected life (in years)		5.0			5.0

Restricted Stock Activity

Restricted stock activity during 2020 and 2021 was as follows:

	Number of Shares			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2020		805,136		$	34.14
Granted		637,312			25.82
Cancelled		(129,683	)		34.56
Vested		(289,769	)		35.88
Unvested at December 31, 2020		1,022,996		$	28.41
Granted		324,530			58.48
Cancelled		(66,801	)		38.56
Vested		(352,184	)		30.63
Unvested at September 30, 2021		928,541		$	37.35

Restricted Stock Unit Activity

Restricted stock unit activity during 2020 and 2021 was as follows:

	Number of Units			Weighted Average Grant-Date Fair Value
Unvested at January 1, 2020		447,357		$	38.89
Granted		583,680			10.60
Performance adjustment		117,772			13.50
Cancelled		(63,056	)		43.35
Vested		(12,691	)		42.09
Unvested at December 31, 2020		1,073,062		$	20.15
Granted		149,416			61.52
Performance adjustment		345,731			24.10
Cancelled		—			—
Vested		(184,051	)		42.30
Unvested at September 30, 2021		1,384,158		$	22.66

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Fair Value Measurements (Tables)

9 Months Ended

Sep. 30, 2021

Fair Value Disclosures [Abstract]

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

The carrying amounts and fair values of the Company’s New Credit Facility, Prior Credit Facility, 5.625% Senior Notes, 6.500% Senior Notes, 5.500% Senior Notes, 5.000% Senior Notes, other long-term debt and derivative instruments at September 30, 2021 and December 31, 2020 were as follows (in thousands):

	Carrying Amount				Fair Value
	September 30, 2021		December 31, 2020		September 30, 2021		December 31, 2020
New Credit Facility	$	516,905	$	—	$	516,905	$	—
Prior Credit Facility	$	—	$	1,175,437	$	—	$	1,175,437
5.625% Senior Notes due 2023	$	—	$	646,344	$	—	$	647,960
6.500% Senior Notes due 2024	$	—	$	385,636	$	—	$	393,850
5.500% Senior Notes due 2028	$	443,703	$	443,139	$	466,421	$	475,931
5.000% Senior Notes due 2029	$	468,737	$	468,245	$	488,096	$	499,852
Other long-term debt	$	—	$	3,625	$	—	$	3,625
Derivative instrument liabilities	$	—	$	84,584	$	—	$	84,584

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Financial Information for the Company and Its Subsidiaries (Tables)

9 Months Ended

Sep. 30, 2021

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Summarized Balance Sheet

Summarized balance sheet information (in thousands):

	September 30, 2021		December 31, 2020
Current assets	$	496,397	$	654,735
Property and equipment, net		1,440,846		1,421,875
Goodwill		1,990,544		1,992,305
Total noncurrent assets		3,668,848		3,640,809
Current liabilities		381,950		626,419
Long-term debt		1,392,041		2,786,125
Total noncurrent liabilities		1,661,072		3,045,981
Redeemable noncontrolling interests		—		—
Total equity		2,122,223		623,144

Summarized Statements of Income (Loss)

Summarized operating results information (in thousands):

	Nine Months Ended September 30, 2021
Revenue	$	1,585,837
Income before income taxes		158,117
Net income		119,785
Net income attributable to Acadia Healthcare Company, Inc.		119,785

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Description of Business and Basis of Presentation - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2021 Facility Bed State
Accounting Policies [Abstract]
Number of facilities | Facility	230
Number of beds | Bed	10,200
Number of operating states | State	40

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Recently Issued Accounting Standards - Additional Information (Detail) - ASU 2019-12	Sep. 30, 2021
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Change in accounting principle, accounting standards update, adopted [true false]	true
Change in accounting principle, accounting standards update, adoption date	Jan. 01, 2021
Change in accounting principle, accounting standards update, immaterial effect [true false]	true

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U.K. Sale - Additional Information (Detail) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended	12 Months Ended
	Jan. 19, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2021	Dec. 31, 2020
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from U.K. Sale		$ 4,300		$ 1,511,020
Discontinued Operations [Member] | U.K. Sales [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from U.K. Sale	$ 1,525,000
Settlement of existing foreign currency hedging liabilities	85,000
Net proceeds from sale of business	$ 1,425,000
Cash from the balance sheet to reduce debt, amount			$ 1,640,000
Loss on sale			$ 14,300		$ 867,300
Goodwill impairment loss					$ 356,200

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U.K. Sale - Result of Operation (Detail) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income (loss) from discontinued operations, net of taxes	$ 674	$ (12,641)	$ 29,804
Discontinued Operations [Member] | U.K. Sales [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	285,343	62,520	817,772
Salaries, wages and benefits	159,840	35,937	465,514
Professional fees	31,987	6,815	92,264
Supplies	9,434	2,217	28,274
Rents and leases	11,817	2,509	34,858
Other operating expenses	28,880	6,682	85,682
Depreciation and amortization	18,780		55,739
Interest expense, net	238	10	666
Loss on sale		14,254
Loss on impairment	20,239		20,239
Transaction-related expenses	5,479	6,265	7,735
Total expenses	286,694	74,689	790,971
(Loss) income from discontinued operations before income taxes	(1,351)	(12,169)	26,801
(Benefit from) provision for income taxes	(2,025)	472	(3,003)
Income (loss) from discontinued operations, net of taxes	$ 674	$ (12,641)	$ 29,804

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U.K. Sale - Major Classes of Assets and Liabilities (Detail) $ in Thousands	Dec. 31, 2020 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Current assets of discontinued operations	$ 1,809,815
Current liabilities:
Current liabilities of discontinued operations	660,027
Discontinued Operations [Member] | U.K. Sales [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash and cash equivalents	75,051
Accounts receivable, net	52,196
Other current assets	13,361
Current assets of discontinued operations	140,608
Property and equipment, net	1,297,923
Intangible assets, net	22,289
Operating lease right-of-use assets	341,289
Other assets	7,706
Total assets of discontinued operations	1,809,815
Current liabilities:
Accounts payable	44,929
Current portion of operating lease liabilities	11,141
Other current liabilities	136,895
Current liabilities of discontinued operations	192,965
Operating lease liabilities	387,607
Deferred tax liabilities	57,230
Other liabilities	22,225
Total liabilities of discontinued operations	$ 660,027

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Revenue - Schedule of Revenue Attributed to Each Category (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disaggregation of Revenue [Line Items]
Revenue	$ 587,559	$ 547,961	$ 1,720,914	$ 1,548,653
U.S. Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	587,559	547,961	1,720,914	1,548,653
U.S. Facilities [Member] | Acute Inpatient Psychiatric Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	284,143	259,353	832,692	723,611
U.S. Facilities [Member] | Specialty Treatment Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	230,753	211,796	669,552	597,886
U.S. Facilities [Member] | Residential Treatment Centers [Member]
Disaggregation of Revenue [Line Items]
Revenue	71,006	71,153	211,377	210,432
U.S. Facilities [Member] | Outpatient Community-Based Facilities [Member]
Disaggregation of Revenue [Line Items]
Revenue	$ 1,657	$ 5,659	$ 7,293	$ 16,724

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Revenue - Schedule of Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 587,559	$ 547,961	$ 1,720,914	$ 1,548,653
U.S. Facilities [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 587,559	$ 547,961	$ 1,720,914	$ 1,548,653
Revenue, Percentage	100.00%	100.00%	100.00%	100.00%
U.S. Facilities [Member] | Commercial [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 170,427	$ 156,741	$ 511,975	$ 439,911
Revenue, Percentage	29.00%	28.60%	29.80%	28.40%
U.S. Facilities [Member] | Medicare [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 97,529	$ 96,536	$ 274,208	$ 244,721
Revenue, Percentage	16.60%	17.60%	15.90%	15.90%
U.S. Facilities [Member] | Medicaid [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 288,092	$ 261,341	$ 845,128	$ 767,075
Revenue, Percentage	49.00%	47.70%	49.10%	49.40%
U.S. Facilities [Member] | Self-Pay [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 25,998	$ 26,060	$ 71,875	$ 75,570
Revenue, Percentage	4.40%	4.80%	4.20%	4.90%
U.S. Facilities [Member] | Other [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 5,513	$ 7,283	$ 17,728	$ 21,376
Revenue, Percentage	1.00%	1.30%	1.00%	1.40%

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Revenue - Additional Information (Detail) - CARES Act [Member] - Medicare [Member] - USD ($) $ in Millions	1 Months Ended	3 Months Ended
	Apr. 30, 2020	Sep. 30, 2021	Jun. 30, 2021	Dec. 31, 2020
Disaggregation of Revenue [Line Items]
Repayment of advanced payments period	2022-09
Repayment of advanced payments		$ 10.0	$ 7.0
CMS' Accelerated and Advance Payment Program [Member]
Disaggregation of Revenue [Line Items]
Amount of advance payment received	$ 45.0
Repayment of advanced payments description	In April 2020, the Company received approximately $45 million from CMS’ Accelerated and Advance Payment Program for Medicare providers. The Company repaid approximately $7 million and $10 million of the $45 million of advance payments during the second and third quarters of 2021, respectively, via recoupment from the Company’s new Medicare claims and will continue to repay the remaining balance on a monthly basis through September 2022.
Repayment of advanced payments period	2022-09
Repayment of advanced payments		10.0	$ 7.0
CMS' Accelerated and Advance Payment Program [Member] | Other Accrued Liabilities [Member]
Disaggregation of Revenue [Line Items]
Contract liabilities		$ 32.9		$ 35.9
CMS' Accelerated and Advance Payment Program [Member] | Other Liabilities [Member]
Disaggregation of Revenue [Line Items]
Contract liabilities				$ 11.3

XML

Revenue - Summary of the Activity in Contract Liabilities (Detail) - Unearned Revenue [Member] $ in Thousands	9 Months Ended
	Sep. 30, 2021 USD ($)
Disaggregation of Revenue [Line Items]
Beginning Balance	$ 47,196
Payments received	5,385
Revenue recognized	(2,724)
Medicare advance repayments	(16,931)
Ending Balance	$ 32,926

XML

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended							9 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020
Numerator:
Income from continuing operations attributable to Acadia Healthcare Company, Inc.	$ 66,126				$ 36,324			$ 132,998	$ 81,736
Income (loss) from discontinued operations					674			(12,641)	29,804
Net income attributable to Acadia Healthcare Company, Inc.	$ 66,126	$ 44,514	$ 9,717	$ (783,672)	$ 36,998	$ 41,079	$ 33,463	$ 120,357	$ 111,540
Denominator:
Weighted average shares outstanding for basic earnings per share	88,962				87,911			88,684	87,849
Effects of dilutive instruments	1,927				945			1,920	600
Shares used in computing diluted earnings per common share	90,889				88,856			90,604	88,449
Basic earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to Acadia Healthcare Company, Inc.	$ 0.74				$ 0.41			$ 1.50	$ 0.93
Income (loss) from discontinued operations					0.01			(0.14)	0.34
Net income attributable to Acadia Healthcare Company, Inc.	0.74				0.42			1.36	1.27
Diluted earnings per share attributable to Acadia Healthcare Company, Inc. stockholders:
Income from continuing operations attributable to Acadia Healthcare Company, Inc.	0.73				0.41			1.47	0.92
Income (loss) from discontinued operations					0.01			(0.14)	0.34
Net income attributable to Acadia Healthcare Company, Inc.	$ 0.73				$ 0.42			$ 1.33	$ 1.26

XML

Earnings Per Share - Additional Information (Detail) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Earnings Per Share [Abstract]
Excluded common stock for computation of diluted earnings per share	0.3	2.0	0.4	2.1

XML

Other Current Assets - Other Current Assets (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Prepaid expenses	$ 28,664	$ 19,480
Assets held for sale	17,566
Workers’ compensation deposits – current portion	12,000	12,000
Other receivables	8,530	10,025
Income taxes receivable	7,952	897
Insurance receivable – current portion	6,792	6,792
Inventory	4,322	4,851
Cost report receivable		5,818
Other	2,859	1,469
Other current assets	$ 88,685	$ 61,332

XML

Property and Equipment - Summary of Property and Equipment (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 2,178,960	$ 2,072,539
Less: accumulated depreciation	(513,935)	(449,643)
Property and equipment, net	1,665,025	1,622,896
Land [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	149,759	144,221
Building and Improvements [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	1,640,951	1,490,149
Equipment [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	244,484	220,690
Construction in Progress [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 143,766	$ 217,479

XML

Property and Equipment - Additional Information (Detail) $ in Millions	3 Months Ended
	Sep. 30, 2021 USD ($)	Jun. 30, 2021 USD ($) Bed
Property Plant And Equipment [Abstract]
Number of beds, replacement facility | Bed		260
Non-cash property impairment charge relating to existing facility | $	$ 1.1	$ 23.2

XML

Goodwill and Other Intangible Assets - Other Identifiable Intangible Assets and Related Accumulated Amortization (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	$ 69,366	$ 68,535
Total	70,497	69,666
Intangible assets not subject to amortization, Accumulated Amortization	0	0
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	11,663	11,873
Intangible assets not subject to amortization, Accumulated Amortization	0	0
Trade Names [Member]
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	40,435	39,526
Intangible assets not subject to amortization, Accumulated Amortization	0	0
Certificates of Need [Member]
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items]
Intangible assets not subject to amortization, Gross Carrying Amount	17,268	17,136
Intangible assets not subject to amortization, Accumulated Amortization	$ 0	$ 0

XML

Goodwill and Other Intangible Assets - Additional Information (Detail) $ in Thousands	3 Months Ended	9 Months Ended
	Jun. 30, 2021 USD ($) Facility	Sep. 30, 2021 USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
Number of outpatient | Facility	1
Sale of outpatient facility	$ 4,300	$ 1,511,020
Goodwill write down	1,800
Intangible assets for the disposition	$ 200

XML

The CARES Act - Additional Information (Detail) - USD ($) $ in Thousands		1 Months Ended			3 Months Ended					9 Months Ended		12 Months Ended
	Apr. 24, 2020	Apr. 30, 2021	Aug. 31, 2020	Apr. 30, 2020	Sep. 30, 2021	Jun. 30, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Sep. 30, 2021	Dec. 31, 2020	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2017
CARES Act [Line Items]
Received benefit in form of refunds and lower future tax payments												$ 51,600	$ 51,600
Received benefit related to interest expense												22,800	22,800
Received benefit related to qualified improvement property legislation												20,500	20,500
Expected permanent cash benefit due to loss												$ 8,300	$ 8,300
Effective income tax rate reconciliation at federal statutory income tax rate												21.00%		35.00%
Expected repay of payroll tax deferrals					$ 39,000
Other income								$ 18,070
CARES Act [Member]
CARES Act [Line Items]
Offer of eligible relief amount									$ 100,000,000
Additional offer of eligible relief amount	$ 75,000,000
Net operating loss carryforwards and carrybacks offset percentage of taxable income										100.00%
Net operating loss carried back period										5 years
Cash benefit relating to delay of payment of social security payroll taxes												$ 39,000
CARES Act [Member] | Medicare [Member]
CARES Act [Line Items]
Repayment of advanced payments					$ 10,000	$ 7,000
Percentage of increase in medicare reimbursement rate									2.00%
Repayment of advanced payments period				2022-09
CARES Act [Member] | Public Health and Social Services Emergency Fund [Member]
CARES Act [Line Items]
Receipt of CARES Act of 2020 aid amount									$ 19,700		$ 34,900
Receipt of additional CARES Act of 2020 aid amount		$ 24,200	$ 12,800
Other income							$ 32,800		18,100
CARES Act [Member] | CMS' Accelerated and Advance Payment Program [Member] | Medicare [Member]
CARES Act [Line Items]
Amount of advance payment received									$ 45,000

XML

Other Accrued Liabilities - Summary of Other Accrued Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Accounts Payable And Accrued Liabilities Current [Abstract]
Accrued expenses	$ 38,386	$ 28,452
Contract liabilities	32,926	35,946
Government relief funds	28,310	5,495
Accrued interest	17,158	40,479
Income taxes payable	9,921	16,345
Insurance liability – current portion	9,700	9,700
Accrued property taxes	9,054	6,763
Cost report payable	4,210
Finance lease liabilities	990	32,188
Other	6,549	3,085
Other accrued liabilities	$ 157,204	$ 178,453

XML

Other Accrued Liabilities - Additional Information (Detail) $ in Millions	3 Months Ended
	Sep. 30, 2021 USD ($)
Accounts Payable And Accrued Liabilities Current [Abstract]
Purchase of leased property	$ 31.4

XML

Long-Term Debt - Components of Long-Term Debt (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Mar. 17, 2021	Dec. 31, 2020	Nov. 13, 2020	Sep. 21, 2015
Debt Instrument [Line Items]
Other long-term debt			$ 3,625
Less: unamortized debt issuance costs, discount and premium	$ (15,342)		(30,802)
Long-term debt	1,429,345		3,122,426
Less: current portion	(15,938)		(153,478)
Long-term debt	1,413,407		2,968,948
Term Loan A [Member]
Debt Instrument [Line Items]
Senior Secured				$ 352,400
New Credit Facility [Member] | Term Loan A [Member]
Debt Instrument [Line Items]
Senior Secured	419,687	$ 425,000
New Credit Facility [Member] | Senior Secured Revolving Line of Credit [Member]
Debt Instrument [Line Items]
Senior Secured	100,000	$ 600,000
Prior Credit Facility [Member] | Senior Secured Term A Loan [Member]
Debt Instrument [Line Items]
Senior Secured			311,733
Prior Credit Facility [Member] | Senior Secured Term B Loans [Member]
Debt Instrument [Line Items]
Senior Secured			872,870
5.625% Senior Notes Due 2023 [Member]
Debt Instrument [Line Items]
Senior Notes			650,000		$ 650,000
6.500% Senior Notes Due 2024 [Member]
Debt Instrument [Line Items]
Senior Notes			390,000
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

XML

Long-Term Debt - Components of Long-Term Debt (Parenthetical) (Detail)	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2020	Oct. 14, 2020	Jun. 24, 2020	Feb. 16, 2016	Sep. 21, 2015	Feb. 11, 2015
5.625% Senior Notes Due 2023 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.625%	5.625%				5.625%	5.625%
Senior notes maturity year	2023	2023
6.500% Senior Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	6.50%	6.50%			6.50%
Senior notes maturity year	2024	2024
5.000% Senior Notes due 2029 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.00%	5.00%	5.00%
Senior notes maturity year	2029	2029
5.500% Senior Notes due 2028 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.50%	5.50%		5.50%
Senior notes maturity year	2028	2028

XML

Long-Term Debt (New Credit Facility) - Additional Information (Detail) - USD ($)		9 Months Ended
	Mar. 17, 2021	Sep. 30, 2021	Sep. 30, 2020	Nov. 13, 2020
Debt Instrument [Line Items]
Repayments of revolving facility		$ 330,000,000	$ 100,000,000
Term Loan A- Facility [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount				$ 352,400,000
New Credit Facility [Member]
Debt Instrument [Line Items]
Date entered into an agreement	Mar. 17, 2021
Repayments of revolving facility		$ 60,000,000.0
Term loan remaining balance due date		Mar. 17, 2026
Maximum incremental debt amount		$ 480,000,000.0
Incremental debt amount maximum percentage of consolidated EBITDA		100.00%
Consolidated senior secured net leverage ratio		350.00%
Maximum consolidated net leverage ratio		500.00%
Minimum interest coverage ratio		300.00%
New Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument [Line Items]
Basis spread on variable rate		1.75%
New Credit Facility [Member] | Base Rate Loans [Member]
Debt Instrument [Line Items]
Basis spread on variable rate		0.75%
New Credit Facility [Member] | December 31, 2021 to March 31, 2022 [Member]
Debt Instrument [Line Items]
Term loan principal repayments		$ 2,700,000
New Credit Facility [Member] | June 30, 2022 to March 31, 2024 [Member]
Debt Instrument [Line Items]
Term loan principal repayments		5,300,000
New Credit Facility [Member] | June 30, 2024 to March 31, 2025 [Member]
Debt Instrument [Line Items]
Term loan principal repayments		8,000,000.0
New Credit Facility [Member] | June 30, 2025 to December 31, 2025 [Member]
Debt Instrument [Line Items]
Term loan principal repayments		10,600,000
New Credit Facility [Member] | Senior Secured Revolving Line of Credit [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount	$ 600,000,000.0	100,000,000
Debt instrument maturity date	Mar. 17, 2026
Amount available under revolving line of credit		$ 496,600,000
Unused fee payable percentage		0.25%
New Credit Facility [Member] | Term Loan A- Facility [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount	$ 425,000,000.0	$ 419,687,000
Debt instrument maturity date	Mar. 17, 2026
New Credit Facility [Member] | Letters of Credit [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount	$ 20,000,000.0
New Credit Facility [Member] | Swingline Facility [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount	$ 20,000,000.0
New Credit Facility [Member] | Standby Letters of Credit [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount		$ 3,400,000
Amended and Restated Credit Agreement [Member]
Debt Instrument [Line Items]
Agreement termination date	Mar. 17, 2021

XML

Long-Term Debt (Prior Credit Facility) - Additional Information (Detail) - USD ($) $ in Thousands								3 Months Ended	9 Months Ended
	Jan. 19, 2021	Jan. 05, 2021	Nov. 13, 2020	Apr. 21, 2020	Dec. 15, 2015	Dec. 31, 2012	Apr. 01, 2011	Mar. 31, 2021	Sep. 30, 2021	Sep. 30, 2020	Mar. 29, 2018
Debt Instrument [Line Items]
Debt extinguishment costs									$ (24,650)	$ (3,271)
Tranche B-4 Facilities [Member]
Debt Instrument [Line Items]
Repayments of credit facility	$ 767,900	$ 105,000
Term Loan A- Facility [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount			$ 352,400
Repayments of credit facility	$ 311,700
Prior Credit Facility [Member]
Debt Instrument [Line Items]
Date entered into an agreement						Dec. 31, 2012	Apr. 01, 2011
Debt instrument maturity date					Nov. 30, 2021
Debt extinguishment costs								$ 10,900
Prior Credit Facility [Member] | Repricing Facilities Amendments [Member]
Debt Instrument [Line Items]
Debt instrument maturity date			Nov. 30, 2022
Debt extinguishment costs			$ 1,000
Prior Credit Facility [Member] | Senior Secured Revolving Line of Credit [Member] | Repricing Facilities Amendments [Member]
Debt Instrument [Line Items]
Line of credit			459,000								$ 500,000
Prior Credit Facility [Member] | Term Loan A- Facility [Member] | Repricing Facilities Amendments [Member]
Debt Instrument [Line Items]
Line of credit outstanding principal amount			$ 318,900
Thirteenth Amendment [Member]
Debt Instrument [Line Items]
Date entered into an agreement				Apr. 21, 2020

XML

Long-Term Debt (5.500% Senior Notes due 2028) - Additional Information (Detail) - 5.500% Senior Notes due 2028 [Member] - USD ($) $ in Millions		9 Months Ended
	Jun. 24, 2020	Sep. 30, 2021	Dec. 31, 2020
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

XML

Long-Term Debt (5.000% Senior Notes due 2029) - Additional Information (Detail) - USD ($) $ in Thousands		9 Months Ended
	Oct. 14, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Debt Instrument [Line Items]
Debt extinguishment costs		$ (24,650)	$ (3,271)
5.000% Senior Notes due 2029 [Member]
Debt Instrument [Line Items]
Issued Senior Notes	$ 475,000
Debt instrument interest rate	5.00%	5.00%		5.00%
Debt instrument maturity date	Apr. 15, 2029
Interest on the notes		payable semi-annually in arrears on April 15 and October 15 of each year, commencing on April 15, 2021.
Tranche B-3 Facility [Member]
Debt Instrument [Line Items]
Debt extinguishment charge	$ 453,300
Debt extinguishment costs	$ 2,900

XML

Long-Term Debt (5.625% Senior Notes due 2023) - Additional Information (Detail) - 5.625% Senior Notes Due 2023 [Member] - USD ($)	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020	Sep. 21, 2015	Feb. 11, 2015
Debt Instrument [Line Items]
Issued Senior Notes			$ 275,000,000.0	$ 375,000,000.0
Debt instrument interest rate	5.625%	5.625%	5.625%	5.625%
Senior Notes		$ 650,000,000	$ 650,000,000.0
Debt instrument maturity date	Feb. 15, 2023
Interest on the notes	payable semi-annually in arrears on February 15 and August 15 of each year
Debt instrument, redemption date	Mar. 17, 2021

XML

Long-Term Debt (6.500% Senior Notes due 2024) - Additional Information (Detail) - 6.500% Senior Notes Due 2024 [Member] - USD ($)		9 Months Ended
	Feb. 16, 2016	Sep. 30, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Issued Senior Notes	$ 390,000,000.0
Debt instrument interest rate	6.50%	6.50%	6.50%
Debt instrument maturity date	Mar. 01, 2024
Interest on the notes		payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2016
Debt instrument, redemption date		Mar. 01, 2021

XML

Long-Term Debt (Redemption of 5.625% Senior Notes and 6.500% Senior Notes) - Additional Information (Detail) - USD ($) $ in Thousands				9 Months Ended
	Mar. 17, 2021	Mar. 01, 2021	Jan. 29, 2021	Sep. 30, 2021	Sep. 30, 2020
Debt Instrument [Line Items]
Debt extinguishment costs				$ (24,650)	$ (3,271)
Redemption of 5.625% Senior Notes [Member]
Debt Instrument [Line Items]
Senior Notes			$ 650,000
Debt instrument interest rate			5.625%
Debt extinguishment costs	$ 3,300
Redemption of 6.500% Senior Notes [Member]
Debt Instrument [Line Items]
Senior Notes			$ 390,000
Debt instrument interest rate			6.50%
Debt extinguishment costs		$ 10,500
Cash paid for breakage costs		6,300
Write off of deferred financing costs		$ 4,200
Redemption of 5.625% Senior Notes and 6.500% Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument, redemption date			Jan. 29, 2021

XML

Long-Term Debt (6.125% Senior Notes due 2021) - Additional Information (Detail) - 6.125% Senior Notes Due 2021 [Member] - USD ($)		9 Months Ended
	Mar. 12, 2013	Sep. 30, 2021
Debt Instrument [Line Items]
Issued Senior Notes	$ 150,000,000.0
Debt instrument interest rate	6.125%	6.125%
Debt instrument maturity date	Mar. 15, 2021
Interest on the notes		payable semi-annually in arrears on March 15 and September 15 of each year
Debt instrument, redemption date		Jun. 24, 2020

XML

Long-Term Debt (5.125% Senior Notes due 2022) - Additional Information (Detail) - 5.125% Senior Notes Due 2022 [Member] - USD ($)		9 Months Ended
	Jul. 01, 2014	Sep. 30, 2021
Debt Instrument [Line Items]
Issued Senior Notes	$ 300,000,000.0
Debt instrument interest rate	5.125%	5.125%
Debt instrument maturity date	Jul. 01, 2022
Interest on the notes		payable semi-annually in arrears on January 1 and July 1 of each year
Debt instrument, redemption date		Jun. 24, 2020

XML

Long-Term Debt (Redemption of 6.125% Senior Notes and 5.125% Senior Notes) - Additional Information (Detail) - USD ($) $ in Millions		9 Months Ended	12 Months Ended
	Jun. 10, 2020	Sep. 30, 2021	Dec. 31, 2020	Jul. 01, 2014	Mar. 12, 2013
6.125% Senior Notes Due 2021 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate		6.125%			6.125%
Debt instrument, redemption date		Jun. 24, 2020
Debt instrument, redemption price percentage of principal amount	100.00%
5.125% Senior Notes Due 2022 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate		5.125%		5.125%
Debt instrument, redemption date		Jun. 24, 2020
Debt instrument, redemption price percentage of principal amount	100.00%
6.125% Senior Notes Due 2021 and 5.125% Senior Notes Due 2022 [Member]
Debt Instrument [Line Items]
Debt extinguishment charge			$ 3.3

XML

Long-Term Debt (Other Long-term Debt) - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2021 USD ($)
Debt Disclosure [Abstract]
Repayments of other long-term debt	$ 3.3

XML

Noncontrolling Interests - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2021 Facility
Noncontrolling Interest [Line Items]
Number of facilities operated by non-wholly owned subsidiaries	6
Non-Wholly Owned Subsidiaries [Member] | Minimum [Member]
Noncontrolling Interest [Line Items]
Equity ownership interests percentage in the facility	60.00%
Non-Wholly Owned Subsidiaries [Member] | Maximum [Member]
Noncontrolling Interest [Line Items]
Equity ownership interests percentage in the facility	86.00%

XML

Noncontrolling Interests - Summary of Redeemable Noncontrolling Interests (Detail) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Noncontrolling Interest [Abstract]
Beginning Balance	$ 55,315
Contribution of redeemable noncontrolling interests	3,999
Net income attributable to noncontrolling interests	3,686
Dividend payments to noncontrolling interests	(926)	$ (653)
Ending Balance	$ 62,074

XML

Variable Interest Entities - Additional Information (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2021 USD ($) Facility	Dec. 31, 2020 USD ($)
Variable Interest Entity [Line Items]
Consolidated assets	$ 4,594,727	$ 6,499,362
Consolidated liabilities	$ 2,098,207	4,544,591
Variable Interest Entity, Primary Beneficiary [Member]
Variable Interest Entity [Line Items]
Number of facilities operated through non-wholly owned subsidiaries | Facility	6
Consolidated assets	$ 298,924	261,657
Consolidated liabilities	$ 24,430	$ 26,059
Variable Interest Entity, Primary Beneficiary [Member] | Minimum [Member]
Variable Interest Entity [Line Items]
Variable interest entity, ownership percentage	60.00%
Variable Interest Entity, Primary Beneficiary [Member] | Maximum [Member]
Variable Interest Entity [Line Items]
Variable interest entity, ownership percentage	86.00%

XML

Variable Interest Entities - Schedule of Consolidated VIEs Assets and Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Variable Interest Entity [Line Items]
Cash and cash equivalents	$ 196,313	$ 378,697
Accounts receivable, net	282,161	273,551
Other current assets	88,685	61,332
Total current assets	567,159	2,523,395
Property and equipment, net	1,665,025	1,622,896
Goodwill	2,103,503	2,105,264
Intangible assets, net	69,366	68,535
Operating lease right-of-use assets	103,162	96,937
Total assets	4,594,727	6,499,362
Accounts payable	85,924	87,815
Accrued salaries and benefits	124,164	124,912
Current portion of operating lease liabilities	20,062	18,916
Other accrued liabilities	157,204	178,453
Total current liabilities	403,292	1,308,185
Operating lease liabilities	89,952	84,029
Other liabilities	117,883	133,412
Total liabilities	2,098,207	4,544,591
Variable Interest Entity, Primary Beneficiary [Member]
Variable Interest Entity [Line Items]
Cash and cash equivalents	25,028	15,151
Accounts receivable, net	20,673	18,507
Other current assets	2,029	1,461
Total current assets	47,730	35,119
Property and equipment, net	199,078	175,103
Goodwill	34,945	34,945
Intangible assets, net	10,490	9,581
Operating lease right-of-use assets	6,681	6,909
Total assets	298,924	261,657
Accounts payable	3,102	4,143
Accrued salaries and benefits	5,735	4,357
Current portion of operating lease liabilities	188	164
Other accrued liabilities	7,604	8,366
Total current liabilities	16,629	17,030
Operating lease liabilities	6,718	6,863
Other liabilities	1,083	2,166
Total liabilities	$ 24,430	$ 26,059

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Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	$ 2,503,338	$ 1,899,456	$ 2,505,381
Foreign currency translation (loss) gain	82,332	(4,260)	(46,851)
Gain on derivative instruments, net of tax of $0.1 million	(21,566)	19	21,622
U.K. Sale		375,606
Balance	2,606,639	2,434,446	2,606,639
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance		(373,101)
Foreign currency translation (loss) gain		(4,293)
U.K. Sale		377,394
Change in Fair Value of Derivative Instruments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance		13,686
Gain on derivative instruments, net of tax of $0.1 million		19
U.K. Sale		(13,705)
Pension Plan [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance		(11,950)
Foreign currency translation (loss) gain		33
U.K. Sale		11,917
Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(500,879)	$ (371,365)	(414,884)
Balance	$ (440,113)		$ (440,113)

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Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Accumulated Other Comprehensive Income Loss Net Of Tax [Abstract]
Gain on derivative instruments, tax	$ 0.0	$ (8.0)	$ 0.1	$ 8.0

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Equity-Based Compensation - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized common stock	12,700,000		12,700,000
Annual increments in employee grants			25.00%
Equity incentive plan available for future grant	4,484,084		4,484,084
Stock options, contractual term			10 years
Equity-based compensation expense	$ 8,923	$ 5,471	$ 24,988	$ 16,258
Unrecognized compensation expense related to unvested options			$ 48,500
Vesting period			1 year 2 months 12 days
Deferred income tax benefit			$ 8,995	45,105
Stock Compensation Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Deferred income tax benefit	$ 2,300	$ 1,400	$ 6,400	$ 4,200
Restricted Stock Award [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			3 years
Restricted Stock Award [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			4 years
Restricted Stock Units [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			2 years
Number of shares issuable at the end of the vesting period, percentage			0.00%
Restricted Stock Units [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			3 years
Number of shares issuable at the end of the vesting period, percentage			200.00%

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Equity-Based Compensation - Stock Option Activity (Detail) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2021 USD ($) $ / shares shares	Dec. 31, 2020 USD ($) $ / shares shares	Dec. 31, 2019 USD ($) $ / shares shares
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Options outstanding, Beginning balance | shares	1,510,306	1,360,068
Options granted | shares	306,520	507,600
Options exercised | shares	(547,522)	(68,700)
Options cancelled | shares	(143,165)	(288,662)
Options outstanding, Ending balance | shares	1,126,139	1,510,306	1,360,068
Options exercisable, Ending balance | shares	332,934	596,606
Options outstanding, Weighted Average Exercise Price, Beginning balance | $ / shares	$ 37.56	$ 39.40
Options granted, Weighted Average Exercise Price | $ / shares	57.58	33.13
Options exercised, Weighted Average Exercise Price | $ / shares	39.48	29.15
Options cancelled, Weighted Average Exercise Price | $ / shares	39.97	39.67
Options outstanding, Weighted Average Exercise Price, Ending balance | $ / shares	41.77	37.56	$ 39.40
Options exercisable, Weighted Average Exercise Price, Ending balance | $ / shares	$ 43.20	$ 45.37
Options outstanding, Weighted Average Remaining Contractual Term	7 years 4 months 20 days	7 years 4 months 6 days	7 years 6 months 25 days
Options granted, Weighted Average Remaining Contractual Term	7 years 7 months 28 days	9 years 2 months 4 days
Options exercisable, Weighted Average Remaining Contractual Term, Ending balance	6 years	5 years 6 months 18 days
Options outstanding, Aggregate Intrinsic Value | $	$ 20,808	$ 1,414	$ 1,650
Options granted, Aggregate Intrinsic Value | $	823	157
Options exercised, Aggregate Intrinsic Value | $	10,846	854
Options exercisable, Aggregate Intrinsic Value, Ending balance | $	$ 5,767	$ 543

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Equity-Based Compensation - Schedule of Stock Options Valuation Assumptions (Detail) - $ / shares	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Weighted average grant-date fair value of options	$ 20.67	$ 12.37
Risk-free interest rate	0.90%	1.60%
Expected volatility	40.00%	41.00%
Expected life (in years)	5 years	5 years

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Equity-Based Compensation - Restricted Stock Activity (Detail) - Restricted Stock Award [Member] - $ / shares	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	1,022,996	805,136
Granted, Number of Shares	324,530	637,312
Cancelled, Number of Shares	(66,801)	(129,683)
Vested, Number of Shares	(352,184)	(289,769)
Unvested, Number of Shares/Units, Ending balance	928,541	1,022,996
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 28.41	$ 34.14
Granted, Weighted Average Grant-Date Fair Value	58.48	25.82
Cancelled, Weighted Average Grant-Date Fair Value	38.56	34.56
Vested, Weighted Average Grant-Date Fair Value	30.63	35.88
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 37.35	$ 28.41

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Equity-Based Compensation - Restricted Stock Unit Activity (Detail) - Restricted Stock Units [Member] - $ / shares	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested, Number of Shares/Units, Beginning balance	1,073,062	447,357
Granted, Number of Units	149,416	583,680
Performance adjustment, Number of Units	345,731	117,772
Cancelled, Number of Units		(63,056)
Vested, Number of Units	(184,051)	(12,691)
Unvested, Number of Shares/Units, Ending balance	1,384,158	1,073,062
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance	$ 20.15	$ 38.89
Granted, Weighted Average Grant-Date Fair Value	61.52	10.60
Performance adjustment, Weighted Average Grant-Date Fair Value	24.10	13.50
Cancelled, Weighted Average Grant-Date Fair Value		43.35
Vested, Weighted Average Grant-Date Fair Value	42.30	42.09
Unvested, Weighted Average Grant-Date Fair Value, Ending balance	$ 22.66	$ 20.15

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Income Taxes - Additional Information (Detail)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Effective tax rates	20.40%	19.90%	23.90%	22.40%

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Fair Value Measurements - Carrying Amounts and Fair Values of Company's Credit Facilities and Contingent Consideration Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Other long-term debt		$ 3,625
Carrying Amount [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Other long-term debt		3,625
Derivative instrument liabilities		84,584
Carrying Amount [Member] | New Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Secured	$ 516,905
Carrying Amount [Member] | Prior Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Secured		1,175,437
Carrying Amount [Member] | 5.625% Senior Notes Due 2023 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes		646,344
Carrying Amount [Member] | 6.500% Senior Notes due 2024 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes		385,636
Carrying Amount [Member] | 5.500% Senior Notes due 2028 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	443,703	443,139
Carrying Amount [Member] | 5.000% Senior Notes due 2029 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	468,737	468,245
Fair Value [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Other long-term debt		3,625
Derivative instrument liabilities		84,584
Fair Value [Member] | New Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Secured	516,905
Fair Value [Member] | Prior Credit Facility [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Secured		1,175,437
Fair Value [Member] | 5.625% Senior Notes Due 2023 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes		647,960
Fair Value [Member] | 6.500% Senior Notes due 2024 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes		393,850
Fair Value [Member] | 5.500% Senior Notes due 2028 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	466,421	475,931
Fair Value [Member] | 5.000% Senior Notes due 2029 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Senior Notes	$ 488,096	$ 499,852

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Fair Value Measurements - Additional Information (Detail)	Sep. 30, 2021	Dec. 31, 2020	Oct. 14, 2020	Jun. 24, 2020	Feb. 16, 2016	Sep. 21, 2015	Feb. 11, 2015
5.625% Senior Notes Due 2023 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.625%	5.625%				5.625%	5.625%
6.500% Senior Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	6.50%	6.50%			6.50%
5.000% Senior Notes due 2029 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.00%	5.00%	5.00%
5.500% Senior Notes due 2028 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate	5.50%	5.50%		5.50%

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Commitments and Contingencies - Additional Information (Detail) - USD ($)	1 Months Ended		3 Months Ended	9 Months Ended
	Sep. 30, 2021	Aug. 31, 2021	Jun. 30, 2020	Sep. 30, 2021
Loss Contingencies [Line Items]
Maximum self insured professional liability limit per claim	$ 10,000,000.0
Maximum professional liability aggregate policy limit				$ 75,000,000.0
Transaction-related expenses			$ 4,000,000.0
Maximum [Member]
Loss Contingencies [Line Items]
Maximum self insured professional liability limit per claim		$ 3,000,000.0
Minimum [Member]
Loss Contingencies [Line Items]
Maximum professional liability retention limit				$ 3,000,000.0

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Derivatives - Additional Information (Detail)	1 Months Ended
	Aug. 31, 2019 USD ($)	Aug. 31, 2019 GBP (£)	Dec. 31, 2020 USD ($)	Aug. 31, 2019 GBP (£)
Derivative [Line Items]
Cross currency swap liabilities			$ 84,600,000
Cross Currency Swap Assets [Member]
Derivative [Line Items]
Notional amount	$ 650,000,000.0			£ 538,100,000
Cross currency swap agreement cash flow due to interest payment	$ 35,800,000	£ 25,400,000

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Financial Information for the Company and Its Subsidiaries - Additional Information (Detail)	Sep. 30, 2021	Dec. 31, 2020	Feb. 16, 2016	Sep. 21, 2015	Feb. 11, 2015
5.500% Senior Notes Due 2028 [Member]
Line of Credit Facility [Line Items]
Debt instrument interest rate	5.50%
5.000% Senior Notes Due 2029 [Member]
Line of Credit Facility [Line Items]
Debt instrument interest rate	5.00%
5.625% Senior Notes Due 2023 [Member]
Line of Credit Facility [Line Items]
Debt instrument interest rate	5.625%	5.625%		5.625%	5.625%
6.500% Senior Notes Due 2024 [Member]
Line of Credit Facility [Line Items]
Debt instrument interest rate	6.50%	6.50%	6.50%

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Financial Information for the Company and Its Subsidiaries - Summarized Balance Sheet (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019
Condensed Financial Statements, Captions [Line Items]
Current assets	$ 567,159			$ 2,523,395
Property and equipment, net	1,665,025			1,622,896
Goodwill	2,103,503			2,105,264
Current liabilities	403,292			1,308,185
Long-term debt	1,413,407			2,968,948
Redeemable noncontrolling interests	62,074			55,315
Total equity	2,434,446	$ 2,356,586	$ 2,297,999	1,899,456	$ 2,606,639	$ 2,503,338	$ 2,464,167	$ 2,505,381
Parent [Member]
Condensed Financial Statements, Captions [Line Items]
Current assets	496,397			654,735
Property and equipment, net	1,440,846			1,421,875
Goodwill	1,990,544			1,992,305
Total noncurrent assets	3,668,848			3,640,809
Current liabilities	381,950			626,419
Long-term debt	1,392,041			2,786,125
Total noncurrent liabilities	1,661,072			3,045,981
Total equity	$ 2,122,223			$ 623,144

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Financial Information for the Company and Its Subsidiaries - Summarized Statements of Income (Loss) (Detail) - USD ($) $ in Thousands	3 Months Ended							9 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020
Condensed Financial Statements, Captions [Line Items]
Revenue	$ 587,559				$ 547,961			$ 1,720,914	$ 1,548,653
Income before income taxes	85,311				46,078			179,632	107,712
Net income	67,900				37,561			124,043	113,342
Net income (loss) attributable to Acadia Healthcare Company, Inc.	$ 66,126	$ 44,514	$ 9,717	$ (783,672)	$ 36,998	$ 41,079	$ 33,463	120,357	$ 111,540
Parent [Member]
Condensed Financial Statements, Captions [Line Items]
Revenue								1,585,837
Income before income taxes								158,117
Net income								119,785
Net income (loss) attributable to Acadia Healthcare Company, Inc.								$ 119,785