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Acadia Healthcare Company, Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 25 February 2026: press release. Guidance figures: 23 new. The quarter’s numbers.

Key takeaways

  • Fourth quarter revenue rose 6.1%: Quarterly revenue was $821.5 million. Full-year revenue of $3,312.8 million, up 5.0%, was above the previously issued guidance range. Source
  • Quarterly Adjusted EBITDA fell 35%: Adjusted EBITDA was $99.8 million, down from $153.1 million. The fourth-quarter figure includes a $52.7 million adjustment to PLGL reserves. Source
  • Acute psychiatric revenue grew 10%: Acute inpatient psychiatric revenue was $451 million, up 10%, driven by expanded capacity from new and existing facilities. Source
  • PLGL reserve adjustment drove other costs: Other operating expenses were $176 million, up $58 million, including the $52.7 million PLGL adjustment. Full-year PLGL expenses were $115 million, against $54 million. Source
  • Goodwill impairment of $996.2 million: The fourth-quarter impairment loss of $1,006 million included a non-cash goodwill charge of $996.2 million. Year-end goodwill was $1,296 million, against $2,265 million. Source
  • Osteen named chief executive: Debbie Osteen joined Acadia as Chief Executive Officer, announced alongside the fourth-quarter results. Source

“Our results for the fourth quarter reflect improved volume growth with year-over-year revenue growth of 6%”

Debbie Osteen, Chief Executive Officer of Acadia

Guidance

AreaPeriodFigureAgainst last quarter
Revenue SourceFull year 2026$3.37 to $3.45 billionNew
Adjusted EBITDA SourceFull year 2026$575 to $610 millionNew
Adjusted earnings per diluted share SourceFull year 2026$1.30 to $1.55New
Capital expenditures SourceFull year 2026$255 to $280 millionNew
Expansion capital expenditures SourceFull year 2026$140 to $155 millionNew
Maintenance and IT capital expenditures SourceFull year 2026$115 to $125 millionNew
Operating cash flow SourceFull year 2026$280 to $320 millionNew
Stock compensation expense SourceFull year 2026$40 to $45 millionNew
Depreciation and amortization SourceFull year 2026$198 to $203 millionNew
Interest expense SourceFull year 2026$157 to $162 millionNew
Tax rate SourceFull year 2026approximately 26%New
Total bed additions SourceFull year 2026400 to 600 bedsNew
Same-facility volume growth SourceFull year 20260% to 1%New
Same-facility revenue per patient day growth SourceFull year 20262% to 3%New
Startup losses SourceFull year 2026$47 to $53 millionNew
Pennsylvania specialty facility volume headwind SourceFull year 2026approximately 350 basis pointsNew
New York Medicaid policy effect on adjusted EBITDA SourceFull year 2026 versus prior-year period$25 to $30 million negative impactNew
Existing Medicaid supplemental payments, net of provider taxes SourceFull year 2026$15 to $20 million decreaseNew
Potential new or expanded Medicaid supplemental programs SourceAnnual run rate, if approved; not in guidanceat least $22 millionNew
Revenue SourceFirst quarter 2026$820 to $830 millionNew
Adjusted EBITDA SourceFirst quarter 2026$130 to $137 millionNew
Adjusted earnings per diluted share SourceFirst quarter 2026$0.25 to $0.30New
Startup losses SourceFirst quarter 2026approximately $14 millionNew

What changed from last quarter

  • New guidance: Full-year and first-quarter 2026 guidance was provided in this release. Source
  • New: Debbie Osteen joined the company as Chief Executive Officer. Source

Fourth quarter and full-year results

  • Fourth quarter revenue rose 6.1%: Quarterly revenue was $821.5 million. Full-year revenue of $3,312.8 million, up 5.0%, was above the previously issued guidance range. Source
  • Quarterly Adjusted EBITDA fell 35%: Adjusted EBITDA was $99.8 million, down from $153.1 million. The fourth-quarter figure includes a $52.7 million adjustment to PLGL reserves. Source
  • Full-year Adjusted EBITDA declined: Full-year 2025 Adjusted EBITDA was $608.9 million, compared with $709.0 million in 2024. Source
  • GAAP diluted EPS turned to a loss: Fourth-quarter GAAP diluted loss was $(13.02) per share, against $0.35 a year earlier. Full-year GAAP diluted loss was $(12.16), against $2.78. Source
  • Adjusted EPS fell to $0.07: Fourth-quarter adjusted diluted EPS was $0.07, against $0.64. Full-year adjusted diluted EPS was $2.00, against $3.30. Source

Segment revenue by business line

  • Acute psychiatric revenue grew 10%: Acute inpatient psychiatric revenue was $451 million, up 10%, driven by expanded capacity from new and existing facilities. Source
  • Specialty revenue fell on closures: Specialty treatment revenue was $136 million, down 4%. Closed specialty facilities were a 7% headwind to segment growth in the fourth quarter. Source
  • CTC and residential revenue grew: CTC revenue was $144 million, up 5%. Residential treatment center revenue was $90 million, up 3%. Source
  • Closed facilities cut reported growth: Facilities closed in the last twelve months reduced reported fourth-quarter revenue growth by 2 percentage points. Source

“I have great confidence in our teams and in the long-term strategic direction of the Company”

Debbie Osteen, Chief Executive Officer of Acadia

Volumes and revenue drivers

  • Acute volumes rose 6%: Acute inpatient volumes rose 6%. Total facility admissions were 52,170, up 7.2%, in the fourth quarter. Source
  • Volume growth lifted quarterly revenue: Revenue exceeded the high end of the implied fourth-quarter guidance range, which management attributed mainly to improved volume growth during the quarter. Source
  • Full-year patient days grew 2.1%: Full-year same-facility patient days grew 2.1% and revenue per patient day rose 2.8%. Source

Operating costs and reserves

  • Operating expenses rose 15%: Operating expenses were $728 million. Excluding the $52.7 million PLGL adjustment and a $5 million rise in provider taxes, they rose 6%. Source
  • PLGL reserve adjustment drove other costs: Other operating expenses were $176 million, up $58 million, including the $52.7 million PLGL adjustment. Full-year PLGL expenses were $115 million, against $54 million. Source
  • Salaries rose with new openings: Salaries, wages and benefits rose 8%, mainly from new facility openings, which run net losses as occupancy builds. Per patient day the increase was 4%. Source
  • Tennessee supplemental payment benefit in 2025: Full-year 2025 net supplemental payments included about $28.5 million of out-of-period benefit to adjusted EBITDA from Tennessee. Source

Impairment and legal charges

  • Goodwill impairment of $996.2 million: The fourth-quarter impairment loss of $1,006 million included a non-cash goodwill charge of $996.2 million. Year-end goodwill was $1,296 million, against $2,265 million. Source
  • Securities litigation settlement recorded: Legal settlements expense of $147 million mainly covers the 2019 securities litigation settlement, net of expected insurance recoveries. Source
  • Transaction and legal costs eased: Transaction, legal and other costs were $25 million, against $30 million a year earlier. Source

Development and bed additions

  • 181 beds added in quarter: The company added 181 licensed beds in the quarter, 37 at existing facilities and 144 at new facilities. Full-year additions were 1,089 beds. Source
  • ECU Health joint venture hospital opened: In December, the 144-bed joint venture hospital in Greenville, North Carolina began operations, offering inpatient and intensive outpatient programs. Source
  • One new CTC added: One CTC was added in the quarter, bringing 2025 CTC additions to 15. Source

Cash, liquidity and shareholder returns

  • Year-end cash and revolver availability: Year-end cash was $133.2 million, and $595 million was available under the $1.0 billion revolving credit facility. Source
  • Operating cash flow and capital spending: Full-year 2025 operating cash flow was $131.9 million. Cash paid for capital expenditures was $571.8 million. Source
  • Share repurchases and debt repayment: Full-year 2025 common stock repurchases totaled $50.0 million, and $670.9 million of long-term debt was repaid. Source
  • Interest expense rose on borrowing: Fourth-quarter interest expense was $38 million, up from $30 million, primarily from increased borrowings. Source

Leadership change and priorities

  • Osteen named chief executive: Debbie Osteen joined Acadia as Chief Executive Officer, announced alongside the fourth-quarter results. Source
  • Three priorities named for the CEO role: The CEO named steady leadership, operational discipline and positioning the company for long-term success as her priorities. Source
  • Commitment to next phase: The CEO stated full commitment to supporting the company through the next phase of execution and operational improvement. Source

Coming up, as management said on 25 February 2026

  • Fiscal 2025 supplemental payments in first quarter: First-quarter 2026 guidance assumes recognition of $11 million of supplemental payments related to fiscal 2025. Source
  • Pending CMS approvals excluded from guidance: Guidance excludes new or expanded supplemental programs that still need CMS approval, which management is monitoring. Source
  • Future deals excluded from guidance: Adjusted EBITDA and EPS guidance excludes future acquisitions, divestitures, transaction, legal and other costs, and non-recurring legal settlements. Source

Figures management reported

FigureReported
Same-facility revenue (fourth quarter) Source$792.7 million, up 4.4%
Same-facility revenue (full year) Source$3,231.4 million, up 4.9%
Same-facility patient days (fourth quarter) Source787,174, up 3.1%
Same-facility admissions (fourth quarter) Source49,003, up 2.5%
Same-facility average length of stay (fourth quarter) Source16.1 days, up 0.6%
Same-facility revenue per patient day (fourth quarter) Source$1,007, up 1.3%
Patients served daily (network) Sourcemore than 84,000
Patients treated daily (CTCs) Sourceapproximately 76,000

Risks management discussed

  • Operational: Management referred to ongoing challenges affecting the business and said it is working to address them. Source
  • Regulatory: Government investigation costs were $12 million in the fourth quarter, within transaction, legal and other costs. Source
  • Financial: Net leverage was 4.0 times adjusted EBITDA at December 31, 2025. Source

Earlier plans management reported on

  • Ahead: Management said full-year 2025 revenue was above the previously issued guidance range. Source
  • Ahead: Fourth-quarter revenue exceeded the high end of the implied guidance range. Source
  • Met: Fourth-quarter Adjusted EBITDA was at the upper end of the implied guidance range. Source
  • Not stated: The $52.7 million PLGL adjustment had been previewed before the release. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.