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Acadia Healthcare Company, Inc.: Form 10-Q for the period ended Mar 31, 2024

Filed with the SEC on May 2, 2024 and accepted by EDGAR at May 2, 2024, 20:05 ET.

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Management's discussion and analysis

As filed, 34,329 characters, with its headings, lists and tables. Extracted from the main document; charts and exhibits are in the original on sec.gov.

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 competition for staffing, labor shortages and higher turnover rates on our labor costs and profitability;
  • the impact of inflation and interest rate volatility;
  • compliance with laws and government regulations;
  • our indebtedness, our ability to meet our debt obligations, and our ability to incur substantially more debt;
  • the impact of payments received from the government and third-party payors on our revenue and results of operations;
  • the impact of volatility in the global capital and credit markets, as well as significant developments in macroeconomic and

political conditions that are out of our control;

  • the impact of general economic and employment conditions, including increased construction and other costs due to inflation, on our business and future 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 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;

  • 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 outcome of pending litigation;
  • the impact of carrying a large self-insured retention, the possibilities of being responsible for significant amounts not covered by insurance, premium increases and insurance not being available on acceptable terms because of our claims experience;
  • the impact of governmental investigations, regulatory actions and whistleblower lawsuits;
  • any failure to comply with the terms of our corporate integrity agreement with the OIG;
  • the impact of healthcare reform in the U.S.;
  • 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 ability to implement our business strategies;
  • the impact of Medicaid eligibility determinations associated with the end of COVID-19 related Medicaid continuing coverage requirements;
  • the impact of disruptions on our inpatient and outpatient volumes caused by pandemics, epidemics or outbreaks of

infectious diseases, such as the COVID-19 pandemic;

  • our dependence on key management personnel, key executives and local facility management personnel, and the impact of any disruptions from the recent transition of various executives;
  • our restrictive covenants, which may restrict our business and financing activities;
  • the impact of adverse weather conditions and climate change, including the effects of hurricanes, wildfires and other natural

disasters, and any resulting outmigration;

  • the risk of a cyber-security incident and any resulting adverse impact on our operations or violation of laws and regulations regarding information privacy;
  • the impact on our business if our information systems fail or our databases are destroyed or damaged;
  • our future cash flow and earnings;
  • the impact of our highly competitive industry on patient volumes;
  • our ability to cultivate and maintain relationships with referral sources;
  • 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;
  • 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;
  • 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; 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 become the indispensable behavioral healthcare provider for the high-acuity and complex needs patient population. We are committed to providing the communities we serve with high-quality, cost-effective behavioral healthcare services, while growing our business, increasing profitability and creating long-term value for our stockholders. This strategy includes five growth pathways: expansions of existing facilities, joint venture partnerships, de novo facilities, acquisitions and expansion across our continuum of care. At March 31, 2024, we operated 258 behavioral healthcare facilities with approximately 11,300 beds in 38 states and Puerto Rico. During the three months ended March 31, 2024, we added 47 beds, consisting of 27 beds to existing facilities and 20 beds added through the opening of a wholly-owned facility. For the year ending December 31, 2024, we expect to add approximately 1,200 total beds and open up to 14 CTCs, excluding acquisitions.

We are the leading publicly traded pure-play provider of behavioral healthcare services in the U.S. 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.

Results of Operations

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

Three Months Ended March 31, 2024 Amount% 2023 Amount%
Revenue $768,051 100.0% $704,267 100.0%
Salaries, wages and benefits 417,523 54.4% 391,177 55.6%
Professional fees 45,688 5.9% 41,125 5.8%
Supplies 26,652 3.5% 26,021 3.7%
Rents and leases 11,863 1.5% 11,424 1.6%
Other operating expenses 101,073 13.2% 90,838 12.9%
Depreciation and amortization 36,347 4.7% 31,569 4.5%
Interest expense, net 27,214 3.5% 19,999 2.8%
Transaction, legal and other costs 2,847 0.4% 6,471 0.9%
Total expenses 669,207 87.1% 618,624 87.8%
Income before income taxes 98,844 12.9% 85,643 12.2%
Provision for income taxes 20,074 2.6% 19,085 2.7%
Net income 78,770 10.3% 66,558 9.5%
Net income attributable to noncontrolling interests (2,387) -0.4% (543) -0.1%
Net income attributable to Acadia Healthcare Company, Inc. $76,383 9.9% $66,015 9.4%

We believe that we are well positioned to help meet the growing demand for behavioral healthcare services and recorded revenue growth of 9.1% for the three months ended March 31, 2024 compared to the three months ended March 31, 2023. Similar with many other healthcare providers and other industries across the country, we continue to navigate a tight labor market. While we experienced higher wage inflation recently compared to long-term historical averages, we have seen stability in our labor costs and our proactive focus helps us manage through this environment. We remain focused on ensuring that we have the level of staff to meet the demand in our markets across 38 states and Puerto Rico.

The following table sets forth percent changes in same facility operating data for the three months ended March 31, 2024 compared to the same period in 2023:

Same Facility Results (a)
Revenue growth 9.2%
Patient days growth 2.2%
Admissions growth -1.7%
Average length of stay change (b) 4.0%
Revenue per patient day growth 6.9%
Adjusted EBITDA margin change (c) 120 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.

(c) Adjusted EBITDA is defined as income before provision for income taxes, equity-based compensation expense, transaction, legal and other costs, 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. Adjusted EBITDA margin is defined as Adjusted EBITDA divided by revenue.

Three months ended March 31, 2024 compared to the three months ended March 31, 2023

Revenue. Revenue increased $63.8 million, or 9.1%, to $768.1 million for the three months ended March 31, 2024 from $704.3 million for the three months ended March 31, 2023. Same facility revenue increased $63.8 million, or 9.2%, for the three months ended March 31, 2024 compared to the three months ended March 31, 2023, resulting from an increase in same facility revenue per day of 6.9% and same facility growth in patient days of 2.2%. Consistent with same facility revenue growth in 2023, the growth in same facility patient days for the three months ended March 31, 2024 compared to the three months ended March 31, 2023 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 $417.5 million for the three months ended March 31, 2024 compared to $391.2 million for the three months ended March 31, 2023, an increase of $26.3 million. SWB expense included $8.7 million and $7.6 million of equity-based compensation expense for the three months ended March 31, 2024 and 2023, respectively. Excluding equity-based compensation expense, SWB expense was $408.8 million, or 53.2% of revenue, for the three months ended March 31, 2024, compared to $383.6 million, or 54.5% of revenue, for the three months ended March 31, 2023. Same facility SWB expense was $368.7 million for the three months ended March 31, 2024, or 48.7% of revenue, compared to $344.1 million for the three months ended March 31, 2023, or 49.7% of revenue.

Professional fees. Professional fees were $45.7 million for the three months ended March 31, 2024, or 5.9% of revenue, compared to $41.1 million for the three months ended March 31, 2023, or 5.8% of revenue. Same facility professional fees were $39.9 million for the three months ended March 31, 2024, or 5.3% of revenue, compared to $37.1 million for the three months ended March 31, 2023, or 5.4% of revenue.

Supplies. Supplies expense was $26.7 million for the three months ended March 31, 2024, or 3.5% of revenue, compared to $26.0 million for the three months ended March 31, 2023, or 3.7% of revenue. Same facility supplies expense was $26.0 million for the three months ended March 31, 2024, or 3.4% of revenue, compared to $25.4 million for the three months ended March 31, 2023, or 3.7% of revenue.

Rents and leases. Rents and leases were $11.9 million for the three months ended March 31, 2024, or 1.5% of revenue, compared to $11.4 million for the three months ended March 31, 2023, or 1.6% of revenue. Same facility rents and leases were $10.8 million for the three months ended March 31, 2024, or 1.4% of revenue, compared to $10.5 million for the three months ended March 31, 2023, or 1.5% 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 $101.1 million for the three months ended March 31, 2024, or

13.2% of revenue, compared to $90.8 million for the three months ended March 31, 2023, or 12.9% of revenue. Same facility other operating expenses were $93.9 million for the three months ended March 31, 2024, or 12.4% of revenue, compared to $84.9 million for the three months ended March 31, 2023, or 12.3% of revenue.

Depreciation and amortization. Depreciation and amortization expense was $36.3 million for the three months ended March 31, 2024, or 4.7% of revenue, compared to $31.6 million for the three months ended March 31, 2023, or 4.5% of revenue.

Interest expense. Interest expense was $27.2 million for the three months ended March 31, 2024 compared to $20.0 million for the three months ended March 31, 2023. The increase in interest expense was primarily the result of borrowings under the Credit Facility during the first quarter of 2024.

Transaction, legal and other costs. Transaction, legal and other costs were $2.8 million for the three months ended March 31, 2024, compared to $6.5 million for the three months ended March 31, 2023. Transaction, legal and other costs represent legal, accounting, termination, restructuring, management transition, acquisition and other similar costs incurred in the respective period, as summarized below (in thousands).

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

Provision for income taxes. For the three months ended March 31, 2024, the provision for income taxes was $20.1 million, reflecting an effective tax rate of 20.3%, compared to $19.1 million, reflecting an effective tax rate of 22.3%, for the three months ended March 31, 2023.

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 other programs; 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.

The following table presents revenue by payor type and as a percentage of revenue for the three months ended March 31, 2024 and 2023 (dollars in thousands):

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

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The following tables present a summary of our aging of accounts receivable at March 31, 2024 and December 31, 2023:

March 31, 2024

Current 30-90 90-150 >150 Total
Commercial 19.1% 4.7% 2.8% 9.1% 35.7%
Medicare 8.8% 1.8% 0.5% 0.8% 11.9%
Medicaid 34.3% 5.2% 2.1% 4.3% 45.9%
Self-Pay 1.3% 1.6% 1.1% 2.3% 6.3%
Other 0.0% 0.1% 0.0% 0.1% 0.2%
Total 63.5% 13.4% 6.5% 16.6% 100.0%

December 31, 2023

Current 30-90 90-150 >150 Total
Commercial 17.3% 5.4% 3.1% 9.5% 35.3%
Medicare 9.3% 1.4% 0.5% 1.1% 12.3%
Medicaid 33.4% 5.4% 2.5% 4.7% 46.0%
Self-Pay 1.4% 1.3% 1.2% 2.5% 6.4%
Other 0.0% 0.0% 0.0% 0.0% 0.0%
Total 61.4% 13.5% 7.3% 17.8% 100.0%

Liquidity and Capital Resources

Cash used in operating activities for the three months ended March 31, 2024 was $321.3 million compared to cash provided by operating activities of $44.4 million for the three months ended March 31, 2023. Days sales outstanding at March 31, 2024 was 46 days compared to 45 days at December 31, 2023.

Cash used in investing activities for the three months ended March 31, 2024 was $184.6 million compared to $66.9 million for the three months ended March 31, 2023. Cash used in investing activities for the three months ended March 31, 2024 primarily consisted of $142.4 million of cash paid for capital expenditures, $50.4 million of cash paid for acquisitions and $0.9 million of other, offset by $9.1 million of proceeds from sales of property and equipment. Cash paid for capital expenditures for the three months ended March 31, 2024 was $142.4 million, consisting of routine or maintenance capital expenditures of $22.3 million and expansion capital expenditures of $120.1 million. We define expansion capital expenditures as those that increase the capacity of our facilities or otherwise enhance revenue. Routine or maintenance capital expenditures, including information technology capital expenditures, were approximately 3% of revenue for the three months ended March 31, 2024. Cash used in investing activities for the three months ended March 31, 2023 primarily consisted of $66.5 million of cash paid for capital expenditures and $0.8 million of other, offset by $0.4 million of proceeds from sales of property and equipment. Cash paid for capital expenditures for the three months ended March 31, 2023 was $66.5 million, consisting of routine or maintenance capital expenditures of $18.0 million and expansion capital expenditures of $48.5 million.

Cash provided by financing activities for the three months ended March 31, 2024 was $483.1 million compared to cash used in financing activities of $11.3 million for the three months ended March 31, 2023. Cash provided by financing activities for the three months ended March 31, 2024 consisted of borrowings on long-term debt of $350.0 million, borrowings on revolving credit facility of $160.0 million and contributions from noncontrolling partners in joint ventures of $2.3 million, offset by principal payments on revolving credit facility of $15.0 million, principal payments on long-term debt of $10.2 million, payment of debt issuance costs of $1.5 million, distributions to noncontrolling partners in joint ventures of $1.0 million, repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises of $1.0 million and $0.4 million of other. Cash used in financing activities for the three months ended March 31, 2023 consisted of repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises of $47.7 million and principal payments on long-term debt of $5.3 million, offset by borrowings on revolving credit facility of $40.0 million and contributions from noncontrolling partners in joint ventures of $1.7 million.

We had total available cash and cash equivalents of $77.3 million and $100.1 million at March 31, 2024 and December 31, 2023, respectively, of which approximately $13.5 million and $11.3 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.

Desert Hills Litigation

As described in more detail in Note 10 – Commitments and Contingencies in the accompanying notes to our consolidated financial statements, on October 30, 2023, we entered into settlement agreements in connection with the Cases. The settlement agreements were approved by the District Court in December 2023 and fully resolve each of the Cases with no admission of liability or wrongdoing by us. On January 19, 2024, pursuant to the terms of the settlement agreements, we paid an aggregate amount of

$400.0 million in exchange for the release and discharge of all claims arising from, relating to, concerning or with respect to all harm, injuries or damages asserted or that may be asserted in the future.

Credit Facility

On March 17, 2021, we entered into the Credit Facility, which provides for a $600.0 million Revolving Facility and a Term Loan Facility in an initial principal amount of $425.0 million, each maturing on March 17, 2026. The Revolving Facility further provides for a $20.0 million subfacility for the issuance of letters of credit.

As a part of the closing of the Credit Facility on March 17, 2021, we (i) refinanced and terminated our prior credit facilities under an amended and restated credit agreement, dated as of December 31, 2012 and (ii) financed the redemption of all of our outstanding 5.625% Senior Notes due 2023.

On March 30, 2023, we entered into the First Amendment, which replaced LIBOR as the reference rate applicable to borrowings under the Credit Facility with Adjusted Term SOFR. After giving effect to the First Amendment, borrowings under the Credit Facility bear interest at a rate equal to, at our option, either (i) Adjusted Term SOFR plus a margin ranging from 1.375% to 2.250% or (ii) a base rate plus a margin ranging from 0.375% to 1.250%, in each case, depending on our consolidated total net leverage ratio. In addition, an unused fee that varies according to our consolidated total net leverage ratio ranging from 0.200% to 0.350% is payable quarterly in arrears based on the average daily undrawn portion of the commitments in respect of the Revolving Facility.

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

Pricing Tier Consolidated Total Net Leverage Ratio SOFR Loans Base Rate 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%

On January 18, 2024, we entered into the Second Amendment, which provides for the incurrence of $350.0 million of Incremental Term Loans. Such Incremental Term Loans are structured as an increase of the Term Loan Facility. The maturity date, the leverage-based pricing grid, mandatory prepayment events and other terms applicable to the Incremental Term Loans are substantially identical to those applicable to the initial $425.0 million term loans incurred under the Term Loan Facility. After giving effect to the Incremental Term Loans, the Credit Facility requires quarterly principal repayments for the Term Loan Facility of approximately $15.4 million for each quarter ending from June 30, 2024 to March 31, 2025 and $20.5 million for each quarter ending from June 30, 2025 to December 31, 2025. The remaining outstanding principal balance of the Term Loan Facility is due on the maturity date of March 17, 2026.

We have the ability to increase the amount of the Credit Facility, which may take the form of increases to the Revolving Facility or the Term Loan Facility or the issuance of one or more Incremental 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 Incremental Fixed Basket, and (ii) the Incremental Ratio Basket. The Incremental Term Loans were incurred in reliance on the Incremental Ratio Basket, leaving the full amount of the Incremental Fixed Basket available for any future Incremental Facilities.

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

The Credit Facility contains customary representations and affirmative and negative covenants, including limitations on our ability and our subsidiaries’ ability to incur additional debt, grant or permit additional liens, make investments and acquisitions, merge or consolidate with others, dispose of assets, pay dividends and distributions, pay junior indebtedness and enter into affiliate transactions, in each case, subject to customary exceptions. In addition, the Credit Facility contains financial covenants requiring us on a consolidated basis to maintain, as of the last day of any consecutive four fiscal quarter period, a consolidated total net leverage ratio of not more than 4.5 to 1.0 (which may be increased to 5.0 to 1.0 for a period of up to four consecutive fiscal quarters following the consummation of certain material acquisitions) and an interest coverage ratio of at least 3.0 to 1.0. The Credit Facility also includes events of default customary for facilities of this type and upon the occurrence of such events of default, among other things, all outstanding loans under the Credit Facility may be accelerated, the lenders’ commitments terminated, and/or the lenders may exercise collateral remedies. At March 31, 2024, we were in compliance with all financial covenants.

During the three months ended March 31, 2024, we borrowed $160.0 million on the Revolving Facility and repaid $15.0 million of the balance outstanding. During the three months ended March 31, 2023, we borrowed $40.0 million on the Revolving Facility. We had $371.5 million of availability under the Revolving Facility and had standby letters of credit outstanding of $3.5 million related to security for the payment of claims required by our workers’ compensation insurance program at March 31, 2024.

Senior Notes

5.500% Senior Notes due 2028

On June 24, 2020, we issued $450.0 million of 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, 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.

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 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.

Supplemental Guarantor Financial Information

We conduct substantially all of our business through our subsidiaries. The Senior Notes are jointly and severally guaranteed on an unsecured senior basis by all of our subsidiaries that guarantee our obligations under the Credit Facility. The summarized financial information presented below is consistent with our condensed consolidated financial statements, except transactions between combining entities have been eliminated. Financial information for our combined non-guarantor entities has been excluded pursuant to SEC Regulation S-X Rule 13-01. Presented below is condensed financial information for our combined wholly-owned subsidiary guarantors at March 31, 2024 and December 31, 2023, and for the three months ended March 31, 2024.

Summarized balance sheet information (in thousands):

March 31, 2024 December 31, 2023
Current assets $484,365 $442,813
Property and equipment, net 1,681,224 1,656,941
Goodwill 2,140,627 2,105,563
Total noncurrent assets 4,097,017 4,043,891
Current liabilities 461,731 827,648
Long-term debt 1,794,296 1,342,548
Total noncurrent liabilities 1,978,103 1,503,345
Redeemable noncontrolling interests — —
Total equity 2,141,548 2,155,711

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Summarized operating results information (in thousands):

Three Months Ended March 31, 2024
Revenue $652,725
Income before income taxes 79,905
Net income 64,400
Net income attributable to Acadia Healthcare Company, Inc. 64,400

Contractual Obligations

The following table presents a summary of contractual obligations at March 31, 2024 (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) $173,317 $1,025,775 $528,438 $504,688 $2,232,218
Operating lease liabilities (b) 33,644 49,235 27,314 72,074 182,267
Finance lease liabilities 1,031 2,178 2,178 20,460 25,847
Total obligations and commitments $207,992 $1,077,188 $557,930 $597,222 $2,440,332

(a) Amounts include required principal and interest payments. The projected interest payments reflect the interest rates in place on our variable-rate debt at March 31, 2024.

(b) Amounts exclude variable components of lease payments.

Critical Accounting Policies

There have been no material changes in our critical accounting policies at March 31, 2024 from those described in our Annual Report on Form 10-K for the year ended December 31, 2023.

Market risk

As filed, 477 characters, with its headings, lists and tables. Extracted from the main document; charts and exhibits are in the original on sec.gov.

Interest Rate Risk

Our interest expense is sensitive to changes in market interest rates. Our long-term debt outstanding at March 31, 2024 was composed of $916.3 million of fixed-rate debt and $939.5 million of variable-rate debt with interest based on Adjusted Term SOFR plus an applicable margin. Based on our borrowing level at March 31, 2024, a hypothetical 1% increase in interest rates would decrease our pretax income on an annual basis by approximately $9.4 million.

Controls and procedures

As filed, 1,257 characters, with its headings, lists and tables. Extracted from the main document; charts and exhibits are in the original on sec.gov.

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 March 31, 2024 that have materially affected or are reasonably likely to materially affect our internal control over financial reporting.

Risk factors

As filed, 615 characters, with its headings, lists and tables. Extracted from the main document; charts and exhibits are in the original on sec.gov.

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, 2023. The risks described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023, 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.

Figures reported in this filing

Standardized line items from the XBRL in this filing, for the period ended 2024-03-31. Comparative periods it repeats are left out.

Figures reported in this filing
Line itemPeriodValueXBRL concept
Revenue3 months2024-01-01 to 2024-03-31$768.1mus-gaap:RevenueFromContractWithCustomerExcludingAssessedTax
Income tax3 months2024-01-01 to 2024-03-31$20.1mus-gaap:IncomeTaxExpenseBenefit
Net income3 months2024-01-01 to 2024-03-31$76.4mus-gaap:NetIncomeLoss
Diluted EPS3 months2024-01-01 to 2024-03-31$0.83us-gaap:EarningsPerShareDiluted
Basic EPS3 months2024-01-01 to 2024-03-31$0.84us-gaap:EarningsPerShareBasic
Diluted shares (weighted)3 months2024-01-01 to 2024-03-3192,010,000 sharesus-gaap:WeightedAverageNumberOfDilutedSharesOutstanding
Operating cash flow3 months2024-01-01 to 2024-03-31−$321.3mus-gaap:NetCashProvidedByUsedInOperatingActivities
Capital expenditure3 months2024-01-01 to 2024-03-31$142.4mus-gaap:PaymentsToAcquirePropertyPlantAndEquipment
Cash and equivalentsAt period end2024-03-31$77.3mus-gaap:CashAndCashEquivalentsAtCarryingValue
Current assetsAt period end2024-03-31$610.8mus-gaap:AssetsCurrent
Total assetsAt period end2024-03-31$5.52bnus-gaap:Assets
Current liabilitiesAt period end2024-03-31$482.3mus-gaap:LiabilitiesCurrent
Total liabilitiesAt period end2024-03-31$2.54bnus-gaap:Liabilities
Long-term debtAt period end2024-03-31$1.79bnus-gaap:LongTermDebtNoncurrent
Current portion of debtAt period end2024-03-31$61.5mus-gaap:LongTermDebtCurrent
Shareholders' equityAt period end2024-03-31$2.87bnus-gaap:StockholdersEquity

Source: SEC EDGAR, the filing index for accession 0000950170-24-052085. Last ingested by Listed: Oct 24, 2026, 15:13 ET. Listed shows no prices and gives no investment advice.