Acadia Healthcare Reports Third Quarter 2025 Results

Third Quarter 2025 Results

• Revenue totaled $851.6 million, an increase of 4.4% over the third quarter of 2024
• Same facility revenue increased 3.7% compared with the third quarter of 2024, including an increase in revenue per patient day of 2.3% and an increase in patient days of 1.3%
• Same facility admissions grew 3.3% compared to the third quarter of 2024
• Net income attributable to Acadia totaled $36.2 million, or $0.40 per diluted share, vs $0.74 per diluted share in the prior-year period
• Adjusted income attributable to Acadia totaled $64.8 million, or $0.72 per diluted share, vs $0.91 per diluted share in the prior-year period
• Adjusted EBITDA was $173.0 million, compared with $194.3 million in the prior-year period
• Added 83 newly licensed beds to existing facilities and 346 beds to new facilities in the third quarter

Full Year Financial Guidance

• Lowering revenue guidance to $3.28 billion to $3.30 billion from the prior range of $3.30 billion to $3.35 billion
• Lowering Adjusted EBITDA guidance to $650 million to $660 million from the prior range of $675 million to $700 million
• Lowering Adjusted earnings per share guidance to $2.35 to $2.45 from the prior range of $2.45 to $2.65
• See table below for a full summary of revised guidance

Revenue Performance by Service Type

• Acute inpatient psychiatric facilities: Revenue totaled $471.5 million, an increase of 7.2% over the third quarter of 2024
• Specialty treatment facilities: Revenue totaled $148.1 million, a decrease of 4.9% over the third quarter of 2024, reflecting certain facilities closed over the last twelve months
• Comprehensive treatment centers: Revenue totaled $144.5 million, an increase of 7.7% over the third quarter of 2024
• Residential treatment centers: Revenue totaled $87.5 million, an increase of 1.8% over the third quarter of 2024

Adjusted income attributable to Acadia and Adjusted EBITDA are non-GAAP financial measures. A reconciliation of all non-GAAP financial measures in this press release begins on page 11.

“Acadia delivered solid revenue performance in the third quarter despite a challenging operating environment,” said Chris Hunter, Chief Executive Officer of Acadia. “While we are lowering our full-year EBITDA guidance to reflect incremental volume and rate pressures, we remain encouraged by patient demand and the progress we’re making across key initiatives. In light of these ongoing headwinds, we are taking decisive steps to improve performance and position the business for the future — including targeted efforts to drive volume recovery, a reduction in capital expenditures to accelerate free cash flow generation, and portfolio rationalization to ensure we are focused on the highest-performing markets and service lines. We are executing a focused strategy centered on disciplined growth to expand access to high-quality behavioral healthcare, improve clinical outcomes and drive operational efficiency across our national network.”

Discussion of Results and Updated Guidance

Acadia reported third quarter revenue of $851.6 million, reflecting a 4.4% increase year-over-year. Same-facility revenue grew 3.7%, driven by a 2.3% increase in revenue per patient day and a 1.3% rise in patient days. Same-facility admissions increased 3.3% compared to the prior-year period, underscoring early momentum from targeted referral initiatives. However, patient day growth fell short of expectations due to persistent softness in acute care Medicaid volumes and heightened payor scrutiny around authorizations. In addition, revenue was negatively impacted by elevated levels of bad debt and denials, which are expected to remain a headwind in the fourth quarter.

Adjusted EBITDA for the quarter was $173.0 million, down from $194.3 million in the prior-year period, reflecting the impact of lower volumes, increased startup losses from newly opened facilities, and higher professional and general liability (“PLGL”) expenses. Startup losses from newly opened facilities totaled $13.3 million in the quarter, up from $7.3 million in the third quarter of 2024 due to the significant number of new beds opened in the last 12 months.

In response to these dynamics, Acadia is lowering its full-year 2025 guidance ranges for revenue, adjusted EBITDA, and adjusted earnings per share. The revised outlook incorporates an incremental assumption on PLGL charges of $4.0 million to $6.0 million that are now expected in the fourth quarter, as well as rate pressure stemming from evolving macroeconomic and policy conditions.

While the reimbursement environment remains challenging, Acadia’s investments in quality infrastructure and clinical outcomes position the Company favorably in discussions with payor partners. Several Medicaid supplemental payment programs are currently under review by CMS. However, due to uncertainty surrounding the timing of approvals amid the ongoing government shutdown, these potential contributions of up to $22.0 million in adjusted EBITDA from new supplemental payment programs are not reflected in the updated guidance.

Development Activity

Acadia added 429 new beds during the third quarter, with a total of 908 beds added in the first nine months of 2025:

• The Company added 83 beds to existing facilities in the third quarter, bringing the total to 274 beds added to existing facilities for the first nine months of 2025.
• The Company added 346 beds to newly constructed facilities in the third quarter, with a total of 634 added in the first nine months of 2025.

The 429 beds added during the third quarter are attributable to the Company’s commencement of operations at three previously announced joint venture hospitals: a 96-bed hospital in Danville, Pennsylvania, its second joint venture hospital with Geisinger Health; a 106-bed expansion of a hospital in Austin, Texas, through a joint venture with Ascension Seton; and a 144-bed hospital in St. Paul, Minnesota, through a joint venture with Fairview Health Services.

Joint ventures continue to be an important part of our growth strategy as we partner with marquee healthcare systems to provide critical behavioral care to our patients and communities.

In addition, Acadia added three new comprehensive treatment centers (“CTCs”), extending the Company’s market reach to 177 CTCs across 33 states, treating over 74,000 patients daily in this critical area of care.

Taking Decisive Action to Drive Improved Performance

Acadia is taking decisive steps to strengthen performance and position the Company for long-term success. As announced in September, the Company is reducing its 2026 capital expenditures by at least $300 million compared to 2025 levels, following a comprehensive facility-by-facility review of its development pipeline. This disciplined approach to capital deployment reflects a sharpened focus on high-performing markets and service lines with the most favorable end-market dynamics and is expected to accelerate Acadia’s path to generating positive free cash flow for the full year 2026.

At the same time, Acadia is intensifying efforts to optimize the performance of its expanded footprint. With over 1,700 beds added across 2024 and 2025, and an additional 500 to 700 beds expected in 2026, the Company is executing targeted initiatives to drive volume growth. These efforts include referral source–level action plans at underperforming facilities, enhanced data-driven planning, and dedicated resources to support execution. These initiatives are already yielding results, with same-facility admissions growing 3.3% in the third quarter and referral volumes accelerating meaningfully in the second half of the year.

Acadia’s investments in quality and technology continue to differentiate the Company in a sector historically marked by underinvestment. The Company’s integrated quality dashboard tracks more than 50 key performance indicators in real time, enabling consistent delivery of evidence-based care and supporting constructive engagement with payor partners. These capabilities are increasingly critical in an environment where demonstrated clinical outcomes are becoming a key determinant of reimbursement and access.

Moreover, Acadia’s commitment to quality has helped attract and retain talent, with labor turnover improving for six consecutive quarters and base wage growth stabilizing. As referral volumes rise, these labor trends position the Company to convert demand into admissions more effectively, further supporting its growth trajectory.

Cash and Liquidity

As of September 30, 2025, the Company had $118.7 million in cash and cash equivalents and $786.7 million available under its $1.0 billion revolving credit facility.

2025 Financial Guidance

Acadia today updated its previously announced financial guidance for 2025, as follows:

The Company’s full-year guidance includes the following assumptions:

• Same-facility volume growth is expected at the low end of the prior range of two to three percent.
• Same-facility revenue per patient day growth in the low single digits.
• Startup losses are expected in the range of $60 to $65 million.
• A net increase in existing Medicaid supplemental payments at the high end of the prior range of $30 to $40 million.

The Company’s guidance does not include the impact of any future acquisitions, divestitures, transaction, legal and other costs or non-recurring legal settlements expense.

Chief Operating Officer Transition

The Company also announced that Dr. Nasser Khan resigned from his role as Chief Operating Officer, effective November 3, 2025. Dr. Khan will continue to serve as an executive advisor through December 31, 2025. The Company has initiated a search for his replacement, and in the interim, Dr. Khan’s responsibilities are being assumed by other members of executive management.

Conference Call

Acadia will hold a conference call to discuss its third quarter financial results at 8:00 a.m. Central Time/9:00 a.m. Eastern Time on Thursday, November 6, 2025. A live webcast of the conference call will be available at www.acadiahealthcare.com in the “Investors” section of the website. The webcast of the conference call will be available for 30 days.

About Acadia

Acadia is a leading provider of behavioral healthcare services across the United States. As of September 30, 2025, Acadia operated a network of 278 behavioral healthcare facilities with approximately 12,500 beds in 40 states and Puerto Rico. With approximately 25,500 employees serving more than 82,000 patients daily, Acadia is the largest stand-alone behavioral healthcare company in the U.S. Acadia provides behavioral healthcare services to its patients in a variety of settings, including inpatient psychiatric hospitals, specialty treatment facilities, residential treatment centers and outpatient clinics.

Forward-Looking Information

This press release contains “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), including statements related to our strategy, growth, anticipated operating results for future periods and our share repurchase program. Generally, words such as “may,” “will,” “should,” “could,” “anticipate,” “expect,” “intend,” “estimate,” “plan,” “continue,” and “believe” or the negative of or other variation on these and other similar expressions identify forward-looking statements. These forward-looking statements are made only as of the date of this press release. We do not undertake to update or revise the forward-looking statements, whether as a result of new information, future events or otherwise. Forward-looking statements are based on current expectations and involve risks and uncertainties and our future results could differ significantly from those expressed or implied by our forward-looking statements. Factors that may cause actual results to differ materially include, without limitation, (i) potential difficulties in successfully integrating the operations of acquired facilities or realizing the expected benefits and synergies of our facility expansions, acquisitions, joint ventures and de novo transactions; (ii) Acadia’s ability to add beds, expand services, enhance marketing programs and improve efficiencies at its facilities; (iii) potential reductions in payments received by Acadia from government and commercial payors, including because of the significant changes to Medicaid financing mechanisms introduced by the One Big Beautiful Bill Act (“OBBBA”) enacted on July 4, 2025; (iv) the occurrence of patient incidents, governmental investigations, litigation and adverse regulatory actions, which could adversely affect the price of our common stock and result in substantial payments and incremental regulatory burdens; (v) the risk that Acadia may not generate sufficient cash from operations to service its debt and meet its working capital and capital expenditure requirements; (vi) potential disruptions to our information technology systems or a cybersecurity incident; and (vii) potential operating difficulties, including, without limitation, disruption to the U.S. economy and financial markets, and any effects of the ongoing U.S. government shutdown; reduced admissions and patient volumes, including, without limitation, due to OBBBA’s introduction of work or community engagement requirements in the Medicaid expansion population; increased costs relating to labor, supply chain and other expenditures; changes in competition and client preferences; and general economic or industry conditions that may prevent Acadia from realizing the expected benefits of its business strategies. These factors and others are more fully described in Acadia’s periodic reports and other filings with the SEC.

Share Repurchase Authorization Disclaimer

Acadia’s share repurchase program permits the Company to make repurchases on a discretionary basis as determined by management, subject to market conditions, applicable legal requirements, available liquidity, compliance with the Company's debt agreements, and other appropriate factors. Repurchases under the share repurchase program are to be made through open market or privately negotiated transactions and may be made pursuant to plans entered into in accordance with Rule 10b5-1 and/or Rule 10b-18 of the Exchange Act. The share repurchase program does not have a termination date, does not obligate Acadia to acquire any particular amount of common stock, and may be modified, extended, suspended, or discontinued by the Company’s Board of Directors at any time without prior notice. No assurance can be given that any particular amount of common stock will be repurchased.