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Acadia Healthcare Company, Inc.: Q1 FY2026 earnings call

What management said about Q1 FY2026, from the documents filed with the SEC on 29 April 2026: press release. Guidance figures: 3 raised, 6 new, 2 kept. The quarter’s numbers.

Key takeaways

  • Revenue grew 7.6% year over year: Revenue was $828.8 million, up 7.6% from the first quarter of 2025, which the company reported at $770.5 million. Source
  • Same-facility revenue rose 7.3%: Same-facility revenue growth came from a 1.6% rise in patient days and a 5.6% rise in revenue per patient day. Source
  • Adjusted EBITDA rose to $144.2 million: Growth was attributed to volume growth in Acute and RTC facilities and disciplined cost controls, against $134.2 million a year earlier. Source
  • Acute inpatient revenue up 14%: Acute inpatient revenue was $470.7 million, up 14%. Acute volumes rose 6.2%, driven mainly by added capacity at new and existing facilities. Source
  • Specialty revenue fell 6.5%: Specialty revenue was $128.1 million. Management tied the decline to Pennsylvania specialty facilities and to specialty closures after the first quarter of 2025. Source
  • PLGL reserve and provider taxes added cost: Expenses included a $10.3 million increase in the PLGL reserve, in line with 2026 guidance, and a $6.0 million rise in provider taxes on state Medicaid supplemental payment programs. Source
  • Prior-year Tennessee payments drive guidance: Management gave second-quarter guidance because of substantial out-of-period Tennessee supplemental payments received in the second quarter of 2025. Source
  • Net leverage at 3.9x Adjusted EBITDA: Net leverage was 3.9x at March 31, 2026, against 4.0x at December 31, 2025 as reported in the February release. Source

“The good start to the year reflects disciplined execution throughout Acadia as we provide quality care for individuals seeking treatment for mental health and substance abuse issues,”

Debbie Osteen, Chief Executive Officer of Acadia

Guidance

AreaPeriodFigureAgainst last quarter
Revenue Sourcesecond quarter of 2026$835 to $850 millionNew
Adjusted EBITDA Sourcesecond quarter of 2026$142 to $152 millionNew
Adjusted earnings per diluted share Sourcesecond quarter of 2026$0.30 to $0.40New
Startup losses Sourcesecond quarter of 2026approximately $15 millionNew
Net leverage Sourceend of second quarter of 20264.4x-4.5x Adjusted EBITDANew
Net leverage Sourceyear-end 20263.9x to 4.2xNew
Revenue Sourcefull year 2026$3.37 to $3.45 billionKept
Adjusted EBITDA Sourcefull year 2026$580 to $615 millionRaised from $575 to $610 million
Adjusted earnings per diluted share Sourcefull year 2026$1.35 to $1.60Raised from $1.30 to $1.55
Operating cash flow Sourcefull year 2026$285 to $325 millionRaised from $280 to $320 million
Capital expenditures Sourcefull year 2026$255 to $280 millionKept

What changed from last quarter

  • Guidance raised: Full-year 2026 Adjusted EBITDA and Adjusted EPS ranges were raised from the February ranges. Source
  • Guidance raised: Full-year 2026 operating cash flow range was raised from $280 to $320 million to $285 to $325 million. Source
  • New guidance: Second quarter 2026 guidance was given for the first time, which management said it does not typically provide. Source
  • Guidance kept: Full-year 2026 revenue and capital expenditure ranges were kept at the February levels. Source
  • New: Debbie Osteen was announced in February as joining Acadia as Chief Executive Officer; the first-quarter release describes her as CEO.

Results and growth drivers

  • Revenue grew 7.6% year over year: Revenue was $828.8 million, up 7.6% from the first quarter of 2025, which the company reported at $770.5 million. Source
  • Same-facility revenue rose 7.3%: Same-facility revenue growth came from a 1.6% rise in patient days and a 5.6% rise in revenue per patient day. Source
  • Adjusted EBITDA rose to $144.2 million: Growth was attributed to volume growth in Acute and RTC facilities and disciplined cost controls, against $134.2 million a year earlier. Source
  • Adjusted EPS fell to $0.37: Adjusted EPS was $0.37 against $0.40 a year earlier. Reported diluted EPS was $0.05, against $0.09 in the prior-year quarter. Source

Segments and facility types

  • Acute inpatient revenue up 14%: Acute inpatient revenue was $470.7 million, up 14%. Acute volumes rose 6.2%, driven mainly by added capacity at new and existing facilities. Source
  • Specialty revenue fell 6.5%: Specialty revenue was $128.1 million. Management tied the decline to Pennsylvania specialty facilities and to specialty closures after the first quarter of 2025. Source
  • CTC revenue up 2.5%: CTC revenue was $140.4 million, up 2.5% from the prior-year first quarter. Source
  • RTC revenue up 6.3%: RTC revenue was $89.6 million, up 6.3% from the prior-year first quarter. Source

“I am very pleased with how the team has responded in my first few months back as CEO”

Debbie Osteen, Chief Executive Officer of Acadia

Patient volumes and admissions

  • Same-facility admissions up 6.5%: Same-facility admissions rose 6.5% compared with the prior-year quarter. Source
  • Average length of stay shortened: Same-facility average length of stay fell 4.6%, to 14.9 days from 15.6 days, while same-facility patient days rose 1.6%. Source
  • Closed facilities cut revenue growth: Facilities closed over the last twelve months reduced reported revenue growth by 1.5 percentage points in the first quarter. Source

Costs and reserves

  • Operating expenses up 7.6%: Total operating expenses were $684.6 million, up $48.3 million, or 7.6%, from the prior-year first quarter. Source
  • PLGL reserve and provider taxes added cost: Expenses included a $10.3 million increase in the PLGL reserve, in line with 2026 guidance, and a $6.0 million rise in provider taxes on state Medicaid supplemental payment programs. Source
  • Salaries rose on new facility openings: Salaries, wages and benefits rose 4.9%. Per patient day they rose 3.3%, and same-facility per patient day costs rose 2.0%. Source

Supplemental payments and guidance assumptions

  • Supplemental payments lifted revenue per day: Part of the 5.6% rise in revenue per patient day came from Tennessee and Ohio supplemental payments not in the prior-year quarter, which were contemplated in February guidance. Source
  • Prior-year Tennessee payments drive guidance: Management gave second-quarter guidance because of substantial out-of-period Tennessee supplemental payments received in the second quarter of 2025. Source
  • Guidance excludes deals and legal items: Guidance excludes future acquisitions, divestitures, transaction, legal and other costs, and non-recurring legal settlement expense. Source

Capital, cash and leverage

  • Net leverage at 3.9x Adjusted EBITDA: Net leverage was 3.9x at March 31, 2026, against 4.0x at December 31, 2025 as reported in the February release. Source
  • Cash and revolver availability: Cash was $158.5 million, and $564.8 million was available under the $1.0 billion revolving credit facility. Source
  • No common stock repurchases this quarter: No common stock was repurchased in the first quarter of 2026, against $46.9 million in the first quarter of 2025. Source

Development and bed additions

  • 82 licensed beds added: The company added 42 beds to existing facilities and 40 beds from newly constructed facilities, including the joint venture with Tufts Medicine. Source
  • Network count reduced to 275 facilities: At March 31, 2026 the network had 275 facilities and about 12,400 beds, against 277 facilities and over 12,500 beds at December 31, 2025. Source

Legal and transaction costs

  • Transaction and legal costs fell to $22 million: Transaction, legal and other costs were $22 million, against $31 million in the first quarter of 2025. Source
  • Sandoval settlement cost $13.8 million: Legal settlements expense was $13.8 million, against $3.5 million a year earlier, and is excluded from Adjusted EBITDA. Source
  • Former CEO severance in transition costs: Management transition costs of $3.9 million consisted mainly of severance tied to the departure of former CEO Christopher H. Hunter. Source

Coming up, as management said on 29 April 2026

  • Benefit expense reversal in second half: Management said $3.2 million of lower benefit expense in the first quarter is expected to reverse in the second half of 2026. Source

Risks management discussed

  • Financial: Interest expense rose to $38 million from $29 million, which management attributed to increased borrowings. Source
  • Operational: Management expects specialty revenue and EBITDA to rise against February guidance, offset by modestly higher bad debts and denials. Source
  • Regulatory: Government investigation costs were $12.4 million in the first quarter, against $31.0 million a year earlier, and are included in transaction, legal and other costs. Source
  • Financial: Net leverage is expected to rise to 4.4x-4.5x at the end of the second quarter, because of the prior-year Tennessee out-of-period benefit. Source

Earlier plans management reported on

  • Ahead: Management said the first-quarter Adjusted EBITDA of $144.2 million exceeded the high end of the February first-quarter guidance. Source
  • Not stated: In February, the CEO described her priorities as steady leadership, operational discipline and long-term success for the company.

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.