Document and Entity Information
Document and Entity Information - shares | 3 Months Ended | |
Mar. 31, 2020 | May 05, 2020 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Mar. 31, 2020 | |
Document Fiscal Year Focus | 2020 | |
Document Fiscal Period Focus | Q1 | |
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, $.01 par value | |
Security Exchange Name | NASDAQ | |
Entity File Number | 001-35331 | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 45-2492228 | |
Entity Address, Address Line One | 6100 Tower Circle | |
Entity Address, Address Line Two | Suite 1000 | |
Entity Address, City or Town | Franklin | |
Entity Address, State or Province | TN | |
Entity Address, Postal Zip Code | 37067 | |
City Area Code | 615 | |
Local Phone Number | 861-6000 | |
Document Quarterly Report | true | |
Document Transition Report | false | |
Entity Common Stock, Shares Outstanding | 88,942,499 |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Current assets: | ||
Cash and cash equivalents | $ 81,004 | $ 124,192 |
Accounts receivable, net | 339,505 | 339,775 |
Other current assets | 82,443 | 78,244 |
Total current assets | 502,952 | 542,211 |
Property and equipment, net | 3,151,739 | 3,224,034 |
Goodwill | 2,426,700 | 2,449,131 |
Intangible assets, net | 89,052 | 90,357 |
Deferred tax assets | 3,307 | 3,339 |
Operating lease right-of-use assets | 476,028 | 501,837 |
Other assets | 68,217 | 68,233 |
Total assets | 6,717,995 | 6,879,142 |
Current liabilities: | ||
Current portion of long-term debt | 196,072 | 43,679 |
Accounts payable | 134,693 | 127,045 |
Accrued salaries and benefits | 114,790 | 122,552 |
Current portion of operating lease liabilities | 29,671 | 29,140 |
Other accrued liabilities | 104,358 | 141,160 |
Total current liabilities | 579,584 | 463,576 |
Long-term debt | 2,944,820 | 3,105,420 |
Deferred tax liabilities | 85,405 | 71,860 |
Operating lease liabilities | 474,746 | 502,252 |
Derivative instrument liabilities | 9,015 | 68,915 |
Other liabilities | 126,767 | 128,587 |
Total liabilities | 4,220,337 | 4,340,610 |
Redeemable noncontrolling interests | 33,491 | 33,151 |
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; 87,842,302 and 87,715,591 issued and outstanding at March 31, 2020 and December 31, 2019, respectively | 878 | 877 |
Additional paid-in capital | 2,561,218 | 2,557,642 |
Accumulated other comprehensive loss | (493,138) | (414,884) |
Retained earnings | 395,209 | 361,746 |
Total equity | 2,464,167 | 2,505,381 |
Total liabilities and equity | $ 6,717,995 | $ 6,879,142 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares | Mar. 31, 2020 | Dec. 31, 2019 |
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 | 87,842,302 | 87,715,591 |
Common stock, shares outstanding | 87,842,302 | 87,715,591 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | ||||
Mar. 31, 2020 | Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | |
Income Statement [Abstract] | |||||
Revenue | $ 782,810 | $ 760,617 | |||
Salaries, wages and benefits (including equity-based compensation expense of $4,979 and $6,101, respectively) | 440,316 | 429,579 | |||
Professional fees | 63,300 | 57,007 | |||
Supplies | 31,971 | 29,957 | |||
Rents and leases | 20,824 | 20,307 | |||
Other operating expenses | 98,529 | 93,865 | |||
Depreciation and amortization | 41,680 | 40,580 | |||
Interest expense, net | 42,785 | 48,130 | |||
Transaction-related expenses | 3,549 | 4,321 | |||
Total expenses | 742,954 | 723,746 | |||
Income before income taxes | 39,856 | 36,871 | |||
Provision for income taxes | 5,789 | 7,360 | |||
Net income | 34,067 | 29,511 | |||
Net income attributable to noncontrolling interests | (604) | (40) | |||
Net income attributable to Acadia Healthcare Company, Inc. | $ 33,463 | $ (11,254) | $ 42,566 | $ 48,140 | $ 29,471 |
Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders: | |||||
Basic | $ 0.38 | $ 0.34 | |||
Diluted | $ 0.38 | $ 0.34 | |||
Weighted-average shares outstanding: | |||||
Basic | 87,765 | 87,505 | |||
Diluted | 87,971 | 87,694 |
Condensed Consolidated Statem_2
Condensed Consolidated Statements of Income (Unaudited) (Parenthetical) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Income Statement [Abstract] | ||
Equity-based compensation expense | $ 4,979 | $ 6,101 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Comprehensive (Loss) Income (Unaudited) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Statement Of Income And Comprehensive Income [Abstract] | ||
Net income | $ 34,067 | $ 29,511 |
Other comprehensive loss: | ||
Foreign currency translation (loss) gain | (122,000) | 44,481 |
Gain (loss) on derivative instruments, net of tax of $16.3 million and $(3.5) million, respectively | 43,746 | (8,690) |
Other comprehensive (loss) income | (78,254) | 35,791 |
Comprehensive (loss) income | (44,187) | 65,302 |
Comprehensive income attributable to noncontrolling interests | (604) | (40) |
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc. | $ (44,791) | $ 65,262 |
Condensed Consolidated Statem_4
Condensed Consolidated Statements of Comprehensive (Loss) Income (Unaudited) (Parenthetical) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Statement Of Income And Comprehensive Income [Abstract] | ||
Gain (loss) on derivative instruments, tax | $ 16.3 | $ (3.5) |
Condensed Consolidated Statem_5
Condensed Consolidated Statements of Equity (Unaudited) - USD ($) $ in Thousands | Total | Common Stock [Member] | Additional Paid-in Capital [Member] | Accumulated Other Comprehensive Loss [Member] | Earnings (Accumulated Deficit) [Member] |
Balance at Dec. 31, 2018 | $ 2,333,307 | $ 874 | $ 2,541,987 | $ (462,377) | $ 252,823 |
Balance, shares at Dec. 31, 2018 | 87,444,000 | ||||
Common stock issued under stock incentive plans | 293 | $ 2 | 291 | ||
Common stock issued under stock incentive plans, shares | 149,000 | ||||
Common stock withheld for minimum statutory taxes | (1,620) | (1,620) | |||
Equity-based compensation expense | 6,101 | 6,101 | |||
Other comprehensive income (loss) | 35,791 | 35,791 | |||
Net income (loss) attributable to Acadia Healthcare Company, Inc. | 29,471 | 29,471 | |||
Balance at Mar. 31, 2019 | 2,403,343 | $ 876 | 2,546,759 | (426,586) | 282,294 |
Balance, shares at Mar. 31, 2019 | 87,593,000 | ||||
Balance at Dec. 31, 2018 | $ 2,333,307 | $ 874 | 2,541,987 | (462,377) | 252,823 |
Balance, shares at Dec. 31, 2018 | 87,444,000 | ||||
Common stock issued under stock incentive plans, shares | 55,671 | ||||
Balance at Dec. 31, 2019 | $ 2,505,381 | $ 877 | 2,557,642 | (414,884) | 361,746 |
Balance, shares at Dec. 31, 2019 | 87,715,591 | 87,715,000 | |||
Balance at Mar. 31, 2019 | $ 2,403,343 | $ 876 | 2,546,759 | (426,586) | 282,294 |
Balance, shares at Mar. 31, 2019 | 87,593,000 | ||||
Common stock issued under stock incentive plans | 68 | 68 | |||
Common stock issued under stock incentive plans, shares | 52,000 | ||||
Common stock withheld for minimum statutory taxes | (356) | (356) | |||
Equity-based compensation expense | 4,182 | 4,182 | |||
Other comprehensive income (loss) | (33,031) | (33,031) | |||
Net income (loss) attributable to Acadia Healthcare Company, Inc. | 48,140 | 48,140 | |||
Balance at Jun. 30, 2019 | 2,422,346 | $ 876 | 2,550,653 | (459,617) | 330,434 |
Balance, shares at Jun. 30, 2019 | 87,645,000 | ||||
Common stock issued under stock incentive plans | 154 | $ 1 | 153 | ||
Common stock issued under stock incentive plans, shares | 10,000 | ||||
Common stock withheld for minimum statutory taxes | (37) | (37) | |||
Equity-based compensation expense | 4,039 | 4,039 | |||
Other comprehensive income (loss) | (48,377) | (48,377) | |||
Net income (loss) attributable to Acadia Healthcare Company, Inc. | 42,566 | 42,566 | |||
Balance at Sep. 30, 2019 | 2,420,691 | $ 877 | 2,554,808 | (507,994) | 373,000 |
Balance, shares at Sep. 30, 2019 | 87,655,000 | ||||
Common stock issued under stock incentive plans | 54 | 54 | |||
Common stock issued under stock incentive plans, shares | 60,000 | ||||
Common stock withheld for minimum statutory taxes | (205) | (205) | |||
Equity-based compensation expense | 2,985 | 2,985 | |||
Other comprehensive income (loss) | 93,110 | 93,110 | |||
Net income (loss) attributable to Acadia Healthcare Company, Inc. | (11,254) | (11,254) | |||
Balance at Dec. 31, 2019 | $ 2,505,381 | $ 877 | 2,557,642 | (414,884) | 361,746 |
Balance, shares at Dec. 31, 2019 | 87,715,591 | 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 | 87,842,302 | 87,842 |
Condensed Consolidated Statem_6
Condensed Consolidated Statements of Cash Flows (Unaudited) $ in Thousands | 3 Months Ended |
Mar. 31, 2019USD ($) | |
Operating activities: | |
Net income | $ 29,511 |
Adjustments to reconcile net income to net cash provided by operating activities: | |
Depreciation and amortization | 40,580 |
Amortization of debt issuance costs | 2,888 |
Equity-based compensation expense | 6,101 |
Deferred income taxes | (666) |
Other | 2,187 |
Change in operating assets and liabilities: | |
Accounts receivable, net | (11,980) |
Other current assets | (5,875) |
Other assets | 295 |
Accounts payable and other accrued liabilities | (15,701) |
Accrued salaries and benefits | (5,849) |
Other liabilities | 2,182 |
Net cash provided by operating activities | 43,673 |
Investing activities: | |
Cash paid for acquisitions, net of cash acquired | (40,400) |
Cash paid for capital expenditures | (69,248) |
Cash paid for real estate acquisitions | (1,066) |
Proceeds from sale of property and equipment | 928 |
Other | (315) |
Net cash used in investing activities | (110,101) |
Financing activities: | |
Borrowings on revolving credit facility | 71,573 |
Principal payments on long-term debt | (8,246) |
Common stock withheld for minimum statutory taxes, net | (1,327) |
Other | (3,497) |
Net cash (used in) provided by financing activities | 58,503 |
Effect of exchange rate changes on cash | 1,099 |
Net decrease in cash and cash equivalents | (6,826) |
Cash and cash equivalents at beginning of the period | 50,510 |
Cash and cash equivalents at end of the period | 43,684 |
Effect of acquisitions: | |
Assets acquired, excluding cash | 44,028 |
Liabilities assumed | (3,628) |
Cash paid for acquisitions, net of cash acquired | $ 40,400 |
Description of Business and Bas
Description of Business and Basis of Presentation | 3 Months Ended |
Mar. 31, 2020 | |
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.”), the United Kingdom (“U.K.”) and Puerto Rico. At March 31, 2020, the Company operated 588 behavioral healthcare facilities with approximately 18,200 beds in 40 states, the U.K. and Puerto Rico. During 2019, the Company commenced a review of strategic alternatives including those related to its U.K. operations and a potential sale of such operations. In January 2020, the Company launched a formal process regarding the sale of its U.K. business. Consistent with market practice for U.K. transactions of this nature, and in conjunction with its advisors, the Company solicited and has received initial, non-binding offers to acquire its U.K. business from multiple bidders. During the first quarter of 2020, the Company began the second phase of the sale process, during which interested bidders would receive proposed transaction documents and complete their confirmatory due diligence. While the interest from potential buyers has been strong, given evolving market dynamics related to the novel coronavirus (“COVID-19”) pandemic, the Company temporarily suspended the sale process in mid-March 2020 until market conditions recover. 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, 2019 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, 2019 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on February 28, 2020. 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 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 a limited number of 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 is adversely impacting the Company’s business and likely will have an impact on its financial results that the Company is not currently able to quantify. Continued 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. |
Recently Issued Accounting Stan
Recently Issued Accounting Standards | 3 Months Ended |
Mar. 31, 2020 | |
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 In August 2018, the FASB issued ASU 2018-15, “ Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract In June 2016, the FASB issued ASU 2016-13, “ Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments . |
Revenue
Revenue | 3 Months Ended |
Mar. 31, 2020 | |
Revenue From Contract With Customer [Abstract] | |
Revenue | 3. 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 within each of the Company’s segments. U.S. Facilities The Company’s facilities in the United States (the “U.S. Facilities”) and services provided by the U.S. 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 U.S. revenue attributed to each category (in thousands): Three Months Ended March 31, 2020 2019 Acute inpatient psychiatric facilities $ 239,414 $ 216,597 Specialty treatment facilities 193,611 193,035 Residential treatment centers 70,434 73,224 Outpatient community-based facilities 5,758 5,104 Revenue $ 509,217 $ 487,960 The Company receives payments from the following sources for services rendered in our U.S. 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 U.S. 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 consolidating statements of income. Bad debt expense for the three months ended March 31, 2020 and 2019 was not significant. The following table presents revenue by payor type and as a percentage of revenue in our U.S. Facilities (in thousands): Three Months Ended March 31, 2020 2019 Amount % Amount % Commercial $ 143,142 28.1 % $ 139,427 28.6 % Medicare 72,271 14.2 % 72,616 14.9 % Medicaid 260,044 51.1 % 239,191 49.0 % Self-Pay 27,034 5.3 % 31,732 6.5 % Other 6,726 1.3 % 4,994 1.0 % Revenue $ 509,217 100.0 % $ 487,960 100.0 % U.K. Facilities The Company’s facilities located in the United Kingdom (the “U.K. Facilities”) and services provided by the U.K. Facilities can generally be classified into the following categories: healthcare facilities; education and children’s services; and adult care facilities. Healthcare facilities . Healthcare facilities provide psychiatric treatment and nursing for sufferers of mental disorders, including for patients whose risk of harm to others and risk of escape from hospitals cannot be managed safely within other mental health settings. In order to manage the risks involved with treating patients, the facility is managed through the application of a range of security measures depending on the level of dependency and risk exhibited by the patient. Education and children’s services. Education and children’s services provide specialist education for children and young people with special educational needs, including autism, Asperger’s Syndrome, social, emotional and mental health, and specific learning difficulties, such as dyslexia. The division also offers standalone children’s homes for children that require 52-week residential care to support complex and challenging behavior and fostering services. Adult care facilities . Adult care focuses on care of individuals with a variety of learning difficulties, mental health illnesses and adult autism spectrum disorders. It also includes long-term, short-term and respite nursing care to high-dependency elderly individuals who are physically frail or suffering from dementia. Care is provided in a number of settings, including in residential care homes and through supported living. The table below presents total U.K. revenue attributed to each category (in thousands): Three Months Ended March 31, 2020 2019 Healthcare facilities $ 148,137 $ 151,708 Education and Children’s Services 46,666 46,122 Adult Care facilities 78,790 74,827 Revenue $ 273,593 $ 272,657 On an annual basis, the Company receives payments from approximately 500 public funded sources in the U.K. (including the National Health Service (“NHS”), Clinical Commissioning Groups (“CCGs”) and local authorities in England, Scotland and Wales) and individual patients and clients. The Company determines the transaction price based on established billing rates by payor reduced by implicit price concessions. Implicit price concessions are insignificant in the U.K. Facilities. The following table presents revenue by payor type and as a percentage of revenue in our U.K. Facilities (in thousands): Three Months Ended March 31, 2020 2019 Amount % Amount % U.K. public funded sources $ 246,136 90.0 % $ 245,413 90.0 % Self-Pay 26,915 9.8 % 26,814 9.8 % Other 542 0.2 % 430 0.2 % Revenue $ 273,593 100.0 % $ 272,657 100.0 % The Company’s contract liabilities primarily consist of unearned revenue in our U.K. Facilities due to the timing of payments received mainly in our education and children’s services and healthcare facilities. Contract liabilities are included in other accrued liabilities on the condensed consolidated balance sheets. A summary of the activity in unearned revenue in the U.K. Facilities is as follows (in thousands): Balance at December 31, 2019 $ 36,579 Payments received 38,152 Revenue recognized (42,787 ) Foreign currency translation loss (1,891 ) Balance at March 31, 2020 $ 30,053 |
Earnings Per Share
Earnings Per Share | 3 Months Ended |
Mar. 31, 2020 | |
Earnings Per Share [Abstract] | |
Earnings Per Share | 4 . The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2020 and 2019 (in thousands, except per share amounts): Three Months Ended March 31, 2020 2019 Numerator: Net income attributable to Acadia Healthcare Company, Inc. $ 33,463 $ 29,471 Denominator: Weighted average shares outstanding for basic earnings per share 87,765 87,505 Effect of dilutive instruments 206 189 Shares used in computing diluted earnings per common share 87,971 87,694 Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders: Basic $ 0.38 $ 0.34 Diluted $ 0.38 $ 0.34 Approximately 2.9 million and 2.6 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 March 31, 2020 and 2019, respectively, because their effect would have been anti-dilutive. |
Acquisitions
Acquisitions | 3 Months Ended |
Mar. 31, 2020 | |
Business Combinations [Abstract] | |
Acquisitions | 5 . The Company’s strategy is to acquire and develop behavioral healthcare facilities and improve operating results within its facilities and its other behavioral healthcare operations. On April 1, 2019, the Company completed the acquisition of Bradford Recovery Center (“Bradford”), a specialty treatment facility with 46 beds located in Millerton, Pennsylvania, for cash consideration of approximately $4.5 million. On February 15, 2019, the Company completed the acquisition of Whittier Pavilion (“Whittier”), an inpatient psychiatric facility with 71 beds located in Haverhill, Massachusetts, for cash consideration of approximately $17.9 million. Also on February 15, 2019, the Company completed the acquisition of Mission Treatment (“Mission Treatment”) for cash consideration of approximately $22.5 million. Mission Treatment operates nine comprehensive treatment centers in California, Nevada, Arizona and Oklahoma. Transaction-related expenses Transaction-related expenses primarily relate to termination, restructuring, U.K. sale, strategic review, management transition and other similar costs. Transaction-related expenses for the three months ended March 31, 2020 and 2019 were as follows (in thousands): Three Months Ended March 31, 2020 2019 Termination, restructuring, sale and strategic review costs $ 2,221 $ 2,282 Legal, accounting and other acquisition-related costs 1,328 796 Management transition costs — 1,243 $ 3,549 $ 4,321 |
Property and Equipment
Property and Equipment | 3 Months Ended |
Mar. 31, 2020 | |
Property Plant And Equipment [Abstract] | |
Property and Equipment | 6 . Property and Equipment Property and equipment consisted of the following at March 31, 2020 and December 31, 2019 (in thousands): March 31, 2020 December 31, 2019 Land $ 429,601 $ 448,716 Building and improvements 2,738,302 2,746,111 Equipment 502,246 516,769 Construction in progress 229,058 254,213 3,899,207 3,965,809 Less: accumulated depreciation (747,468 ) (741,775 ) Property and equipment, net $ 3,151,739 $ 3,224,034 The Company has recorded assets held for sale within other assets on the condensed consolidated balance sheets for closed properties being actively marketed of $30.3 million and $31.1 million at March 31, 2020 and December 31, 2019, respectively. |
Other Intangible Assets
Other Intangible Assets | 3 Months Ended |
Mar. 31, 2020 | |
Goodwill And Intangible Assets Disclosure [Abstract] | |
Other Intangible Assets | 7 . Other Intangible Assets Other identifiable intangible assets and related accumulated amortization consisted of the following at March 31, 2020 and December 31, 2019 (in thousands): Gross Carrying Amount Accumulated Amortization March 31, 2020 December 31, 2019 March 31, 2020 December 31, 2019 Intangible assets subject to amortization: Contract intangible assets $ 2,100 $ 2,100 $ (2,100 ) $ (2,100 ) Non-compete agreements 1,131 1,131 (1,131 ) (1,131 ) 3,231 3,231 (3,231 ) (3,231 ) Intangible assets not subject to amortization: Licenses and accreditations 12,429 12,455 — — Trade names 59,532 60,831 — — Certificates of need 17,091 17,071 — — 89,052 90,357 — — Total $ 92,283 $ 93,588 $ (3,231 ) $ (3,231 ) 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. |
Leases
Leases | 3 Months Ended |
Mar. 31, 2020 | |
Leases [Abstract] | |
Leases | 8 . The Company’s lease portfolio primarily consists of finance and operating real estate leases integral for facility operations. The original terms of the leases typically range from five to 30 years with optional renewal periods. A minimal portion of the Company’s lease portfolio consists of non-real estate leases, including copiers and equipment, which generally have lease terms of one to three years and have insignificant lease obligations. The Company has elected the accounting policy practical expedients by class of underlying asset in ASC 842 “Leases” to: (i) combine associated lease and non-lease components into a single lease component; and (ii) exclude recording short-term leases as right-of-use assets and liabilities on the condensed consolidated balance sheets. Non-lease components, which are not significant overall, are combined with lease components. Operating lease liabilities are recorded as the present value of remaining lease payments not yet paid for the lease term discounted using the incremental borrowing rate associated with each lease. Operating lease right-of-use assets represent operating lease liabilities adjusted for prepayments, accrued lease payments, lease incentives and initial direct costs. Certain of the Company’s leases include renewal or termination options. Calculation of operating lease right-of-use assets and liabilities include the initial lease term unless it is reasonably certain a renewal or termination option will be exercised. Variable components of lease payments fluctuating with a future index or rate, as well as those related to common area maintenance costs, are not included in determining lease payments and are expensed as incurred. Most of the Company’s leases do not contain implicit borrowing rates, and therefore, incremental borrowing rates a re calculated based on information available at the lease commencement date. Incremental borrowing rates reflect the Company’s estimated interest rates for collateralized borrowings over similar lease terms. Additionally, the Company reviews service agreements for embedded lease and right-of-use assets and liabilities as necessary. Lease Position The Company recorded the following at March 31, 2020 and December 31, 2019 on the condensed consolidated balance sheets (in thousands): Right-of-Use Assets Balance Sheet Classification March 31, 2020 December 31, 2019 Finance lease right-of-use assets Property and equipment, net $ 43,760 $ 44,370 Operating lease right-of-use assets Operating lease right-of-use assets 476,028 501,837 Total $ 519,788 $ 546,207 Lease Liabilities Balance Sheet Classification March 31, 2020 December 31, 2019 Current: Finance lease liabilities Other accrued liabilities $ 6,637 $ 6,819 Operating lease liabilities Current portion of operating lease liabilities 29,671 29,140 Noncurrent: Finance lease liabilities Other liabilities 43,295 43,662 Operating lease liabilities Operating lease liabilities 474,746 502,252 Total $ 554,349 $ 581,873 Weighted-average remaining lease terms and discount rates were as follows at March 31, 2020 and December 31, 2019: March 31, 2020 December 31, 2019 Weighted-average remaining lease term (in years): Finance 6.7 6.9 Operating 19.0 19.4 Weighted-average discount rate: Finance 6.4 % 6.4 % Operating 6.3 % 6.3 % Lease Costs The Company recorded the following lease costs for the three months ended March 31, 2020 and 2019 (in thousands): Three Months Ended March 31, 2020 2019 Finance lease costs: Depreciation of leased assets 1,137 1,123 Interest of lease liabilities 997 997 Total finance lease costs $ 2,134 $ 2,120 Operating lease costs 16,481 16,529 Variable lease costs 1,310 886 Short term lease costs 1,147 1,447 Other lease costs 1,886 1,445 Total rents and leases $ 20,824 $ 20,307 Total lease costs $ 22,958 $ 22,427 Other Undiscounted cash flows for finance and operating leases recorded on the condensed consolidated balance sheets were as follows at March 31, 2020 (in thousands): Finance Leases Operating Leases For the nine months ending December 31, 2020 $ 5,549 $ 45,846 2021 35,726 58,023 2022 2,845 52,956 2023 1,620 48,544 2024 1,027 46,312 Thereafter 25,088 650,931 Total minimum lease payments 71,855 902,612 Less: amount of lease payments representing interest 21,923 398,195 Present value of future minimum lease payments 49,932 504,417 Less: Current portion of lease liabilities 6,637 29,671 Noncurrent lease liabilities $ 43,295 $ 474,746 Supplemental data for the three months ended March 31, 2020 and 2019 was as follows (in thousands): Three Months Ended March 31, 2020 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 15,836 $ 15,809 Operating cash flows for finance leases $ 997 $ 997 Financing cash flows for finance leases $ 878 $ 846 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 6,082 $ 3,662 Finance leases $ 953 $ 1,027 |
Long-Term Debt
Long-Term Debt | 3 Months Ended |
Mar. 31, 2020 | |
Debt Disclosure [Abstract] | |
Long-Term Debt | 9. Long-Term Debt Long-term debt consisted of the following (in thousands): March 31, 2020 December 31, 2019 Amended and Restated Senior Credit Facility: Senior Secured Term A Loan $ 339,625 $ 346,750 Senior Secured Term B Loans 1,335,432 1,338,928 Senior Secured Revolving Line of Credit — — 6.125% Senior Notes due 2021 150,000 150,000 5.125% Senior Notes due 2022 300,000 300,000 5.625% Senior Notes due 2023 650,000 650,000 6.500% Senior Notes due 2024 390,000 390,000 Other long-term debt 4,533 4,821 Less: unamortized debt issuance costs, discount and premium (28,698 ) (31,400 ) 3,140,892 3,149,099 Less: current portion (196,072 ) (43,679 ) Long-term debt $ 2,944,820 $ 3,105,420 Amended and Restated Senior 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 an Amended and Restated Credit Agreement (the “Amended and Restated Credit Agreement”) which amended and restated the Senior Secured Credit Facility (the “Amended and Restated Senior Credit Facility”). The Company has amended the Amended and Restated Credit Agreement from time to time as described in the Company’s prior filings with the SEC. On February 6, 2019, the Company entered into the Eleventh Amendment (the “Eleventh Amendment”) to the Amended and Restated Credit Agreement. The Eleventh Amendment, among other things, amended the definition of “Consolidated EBITDA” to remove the cap on non-cash charges, losses and expenses related to the impairment of goodwill, which in turn provided increased flexibility to the Company in terms of the Company’s financial covenants. On February 27, 2019, the Company entered into the Twelfth Amendment (the “Twelfth Amendment”) to the Amended and Restated Credit Agreement. The Twelfth Amendment, among other things, modified certain definitions, including “Consolidated EBITDA”, and increased our permitted Maximum Consolidated Leverage Ratio, thereby providing increased flexibility to the Company in terms of the Company’s financial covenants. On April 21, 2020, the Company entered into the Thirteenth Amendment (the “Thirteenth Amendment”) to the Amended and Restated Credit Agreement. The Thirteenth Amendment amended the Consolidated Leverage Ratio in the existing covenant to increase the leverage ratio for the rest of 2020. The Company had $485.0 million of availability under the revolving line of credit and had standby letters of credit outstanding of $15.0 million related to security for the payment of claims required by its workers’ compensation insurance program at March 31, 2020. In early April 2020, the Company borrowed $100.0 million on the revolving line of credit to enhance its cash position in response to the potential impact of COVID-19 on the Company’s future liquidity. Borrowings under the revolving line of credit are subject to customary conditions precedent to borrowing. The Amended and Restated Credit Agreement requires quarterly term loan principal repayments of our Term Loan A facility (“TLA Facility”) of $7.1 million for June 30, 2020 to December 31, 2020, and $9.5 million for March 31, 2021 to September 30, 2021, with the remaining principal balance of the TLA Facility due on the maturity date of November 30, 2021. The Company is required to repay the Term Loan B facility Tranche B-3 (the “Tranche B-3 Facility”) in equal quarterly installments of $1.2 million on the last business day of each March, June, September and December, with the outstanding principal balance of the Tranche B-3 Facility of $447.3 million due on February 11, 2022. The Company is required to repay the Term Loan B facility Tranche B-4 (the “Tranche B-4 Facility”) in equal quarterly installments of approximately $2.3 million on the last business day of each March, June, September and December, with the outstanding principal balance of the Tranche B-4 Facility of $854.4 million due on February 16, 2023. Borrowings under the Amended and Restated Senior Credit Facility are guaranteed by each of the Company’s wholly-owned domestic subsidiaries (other than certain excluded subsidiaries) and are secured by a lien on substantially all of the assets of the Company and such subsidiaries. Borrowings with respect to the TLA Facility and the Company’s revolving credit facility (collectively, “Pro Rata Facilities”) under the Amended and Restated Credit Agreement bear interest at a rate tied to Acadia’s Consolidated Leverage Ratio (defined as consolidated funded debt net of up to $50.0 million of unrestricted and unencumbered cash to consolidated EBITDA, in each case as defined in the Amended and Restated Credit Agreement). The Applicable Rate (as defined in the Amended and Restated Credit Agreement) for the Pro Rata Facilities was 2.50% for Eurodollar Rate Loans (as defined in the Amended and Restated Credit Agreement) and 1.50% for Base Rate Loans (as defined in the Amended and Restated Credit Agreement) at March 31, 2020. Eurodollar Rate Loans with respect to the Pro Rata Facilities bear interest at the Applicable Rate plus the Eurodollar Rate (as defined in the Amended and Restated Credit Agreement) (based upon the LIBOR Rate (as defined in the Amended and Restated Credit Agreement) prior to commencement of the interest rate period). Base Rate Loans with respect to the Pro Rata Facilities bear interest at the Applicable Rate plus the highest of (i) the federal funds rate plus 0.50%, (ii) the prime rate and (iii) the Eurodollar Rate plus 1.00%. At March 31, 2020, the Pro Rata Facilities bore interest at a rate of LIBOR plus 2.50%. In addition, the Company is required to pay a commitment fee on undrawn amounts under the revolving line of credit. Eurodollar Rate Loans with respect to the Tranche B-3 Facility bear interest at the Tranche B-3 Facility Applicable Rate (as defined below) plus the Eurodollar Rate (subject to a floor of 0.75% and based upon the LIBOR Rate prior to commencement of the interest rate period). Base Rate Loans bear interest at the Tranche B-3 Facility Applicable Rate plus the highest of (i) the federal funds rate plus 0.50%, (ii) the prime rate and (iii) the Eurodollar Rate plus 1.0%. As used herein, the term “Tranche B-3 Facility Applicable Rate” means, with respect to Eurodollar Rate Loans, 2.50%, and with respect to Base Rate Loans, 1.50%. The Tranche B-4 Facility bears interest as follows: Eurodollar Rate Loans bear interest at the Applicable Rate (as defined in the Amended and Restated Credit Agreement) plus the Eurodollar Rate (subject to a floor of 0.75% and based upon the LIBOR Rate prior to commencement of the interest rate period) and Base Rate Loans bear interest at the Applicable Rate plus the highest of (i) the federal funds rate plus 0.50 %, (ii) the prime rate and (iii) the Eurodollar Rate plus 1.0 %. As used herein, the term “Applicable Rate” means, with respect to Eurodollar Rate Loans, 2.50 %, and with respect to Base Rate Loans, 1.50 %. The Amended and Restated Credit Agreement requires the Company and its subsidiaries to comply with customary affirmative, negative and financial covenants, including a fixed charge coverage ratio, consolidated leverage ratio and senior secured leverage ratio. The Company may be required to pay all of its indebtedness immediately if it defaults on any of the numerous financial or other restrictive covenants contained in any of its material debt agreements. At March 31, 2020, the Company was in compliance with such covenants. Senior Notes 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 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. At March 31, 2020, the 6.125% Senior Notes are included in current portion of debt on the condensed consolidated balance sheet. 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 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. 5.625% Senior Notes due 2023 On February 11, 2015, the Company issued $375.0 million of 5.625% Senior Notes due 2023 (the “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 has outstanding an aggregate of $650.0 million of 5.625% Senior Notes. The 5.625% Senior Notes 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. 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 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. The indentures governing the 6.125% Senior Notes, 5.125% Senior Notes, 5.625% Senior Notes and 6.500% 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 Amended and Restated Senior 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. |
Equity-Based Compensation
Equity-Based Compensation | 3 Months Ended |
Mar. 31, 2020 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Equity-Based Compensation | 10 . 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 March 31, 2020, a maximum of 8,200,000 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 1,024,052 were available for future grant. Stock options may be granted for terms of up to ten 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 $5.0 million and $6.1 million in equity-based compensation expense for the three months ended March 31, 2020 and 2019, respectively. At March 31, 2020, there was $50.8 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 1.5 years. At March 31, 2020, there were no warrants outstanding and exercisable. The Company recognized a deferred income tax benefit of $1.3 million and $1.6 million for the three months ended March 31, 2020 and 2019, respectively, related to equity-based compensation expense. Stock Options Stock option activity during 2019 and 2020 was as follows (aggregate intrinsic value in thousands): Number of Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term (in years) Aggregate Intrinsic Value Options outstanding at January 1, 2019 1,199,540 $ 44.64 7.26 $ 2,717 Options granted 605,200 28.50 9.21 1,343 Options exercised (55,671 ) 19.05 N/A 658 Options cancelled (389,001 ) 40.84 N/A N/A Options outstanding at December 31, 2019 1,360,068 39.40 7.57 1,650 Options granted 443,200 33.72 9.91 — Options exercised — — N/A — Options cancelled (105,462 ) 41.00 N/A N/A Options outstanding at March 31, 2020 1,697,806 $ 37.81 7.97 $ 659 Options exercisable at December 31, 2019 513,290 $ 48.08 5.88 $ 512 Options exercisable at March 31, 2020 702,956 $ 44.08 6.36 $ 479 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 three months ended March 31, 2020 and year ended December 31, 2019: March 31, 2020 December 31, 2019 Weighted average grant-date fair value of options $ 12.29 $ 17.59 Risk-free interest rate 1.6 % 2.4 % Expected volatility 39 % 38 % 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 2019 and 2020 was as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2019 805,057 $ 42.40 Granted 700,937 28.77 Cancelled (389,684 ) 33.50 Vested (311,174 ) 44.23 Unvested at December 31, 2019 805,136 $ 34.14 Granted 511,006 25.37 Cancelled (57,782 ) 35.55 Vested (160,398 ) 36.73 Unvested at March 31, 2020 1,097,962 $ 29.61 Restricted stock unit activity during 2019 and 2020 was as follows: Number of Units Weighted Average Grant-Date Fair Value Unvested at January 1, 2019 484,111 $ 44.52 Granted 234,408 34.54 Cancelled (271,162 ) 45.17 Vested — — Unvested at December 31, 2019 447,357 $ 38.89 Granted 583,680 10.60 Cancelled (10,123 ) 42.09 Vested (12,691 ) 42.09 Unvested at March 31, 2020 1,008,223 $ 22.44 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 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. |
Income Taxes
Income Taxes | 3 Months Ended |
Mar. 31, 2020 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | 11 . Income Taxes The provision for income taxes for the three months ended March 31, 2020 and 2019 reflects effective tax rates of 14.5% and 20.0%, respectively. The decrease in the effective tax rate for the three months ended March 31, 2020 was primarily attributable to the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”). The Company recorded a discrete benefit during the three months ended March 31, 2020 resulting from a change in the Company’s valuation allowance related to a decrease in the deferred tax asset on carried forward interest . As we continue to monitor tax implications of the CARES Act and other state, federal and foreign stimulus and tax legislation, we may make adjustments to our estimates and record additional amounts for tax assets and liabilities. Additionally, market disruption due to COVID-19 may affect the Company’s ability to realize our deferred tax assets. 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. |
Derivatives
Derivatives | 3 Months Ended |
Mar. 31, 2020 | |
Derivative Instruments And Hedging Activities Disclosure [Abstract] | |
Derivatives | 12 . Derivatives The Company periodically enters into foreign currency forward contracts 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 U.S. Dollars (“USD”) and British Pounds (“GBP”) associated with cash transfers. In May 2016, the Company 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 thereafter, to fixed-rate GBP-denominated debt of £449.3 million. In August 2019, the Company terminated its existing net investment cross currency swap derivatives of $105.0 million. Cash received from the termination of the cross currency swap derivatives was included in investing activities in the condensed consolidated statement of cash flows. The related gain from this termination was included in accumulated other comprehensive loss in accordance with ASC 815-30-40-1. 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 will receive semi-annual interest payments in USD from the counterparties at fixed interest rates, and the Company will make semi-annual interest payments in GBP to the counterparties at fixed interest rates. The interest payments under the cross-currency swap agreements result in £25.4 million of annual cash flows from the Company’s U.K. business being converted to $35.8 million. The Company has designated the cross currency swap agreements and forward contracts entered into during 2019 and the three months ended March 31, 2020 as qualifying hedging instruments and is accounting for these derivatives as net investment hedges. The fair values of these derivatives at March 31, 2020 and December 31, 2019 of $(9.0) million and $(68.9) million, respectively, are recorded as derivative instrument liabilities on the condensed consolidated balance sheets. During the three months ended March 31, 2020, the Company elected the spot method for recording its net investment hedges. Gains and losses resulting from the settlement of the excluded components are recorded in interest expense on the condensed consolidated statements of income. Gains and losses resulting from fair value adjustments to the cross currency swap agreements are recorded in accumulated other comprehensive loss as the swaps are effective in hedging the designated risk. Cash flows related to the cross currency swap derivatives are included in operating activities in the condensed consolidated statements of cash flows. |
Fair Value Measurements
Fair Value Measurements | 3 Months Ended |
Mar. 31, 2020 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | 13 . 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 Amended and Restated Senior Credit Facility, 6.125% Senior Notes, 5.125% Senior Notes, 5.625% Senior Notes, 6.500% Senior Notes, other long-term debt and derivative instruments at March 31, 2020 and December 31, 2019 were as follows (in thousands): Carrying Amount Fair Value March 31, 2020 December 31, 2019 March 31, 2020 December 31, 2019 Amended and Restated Senior Credit Facility $ 1,659,098 $ 1,668,062 $ 1,659,098 $ 1,668,062 6.125% Senior Notes due 2021 $ 149,409 $ 149,254 $ 144,927 $ 149,441 5.125% Senior Notes due 2022 $ 297,973 $ 297,761 $ 283,998 $ 299,994 5.625% Senior Notes due 2023 $ 645,156 $ 644,771 $ 607,995 $ 655,249 6.500% Senior Notes due 2024 $ 384,723 $ 384,430 $ 374,143 $ 398,366 Other long-term debt $ 4,533 $ 4,821 $ 4,533 $ 4,821 Derivative instrument liabilities $ (9,015 ) $ (68,915 ) $ (9,015 ) $ (68,915 ) The Company’s Amended and Restated Senior Credit Facility, 6.125% Senior Notes, 5.125% Senior Notes, 5.625% Senior Notes, 6.500% 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. |
Commitments and Contingencies
Commitments and Contingencies | 3 Months Ended |
Mar. 31, 2020 | |
Commitments And Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 14 . 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 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. 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. Beard v. Jacobs, et al. Davydov Beard St. Clair County v. Acadia Healthcare On April 25, 2018, plaintiff filed Pence v. Sober Living By the Sea, Inc Pence v. Sober Living by the Sea, Inc.; Acadia Healthcare Company, Inc. (3) failure to provide meal periods; (4) failure to provide rest periods; (5); failure to pay wages due at termination; (6) failure to provi de accurate wage statements; (7) violations of California Business and Professions Code section 17200; and (8) civil penalties under California Labor Code section 2699 (PAGA). At this time, we are unable to quantify any potential liability in connection with this litigation because the cases are in their early stages. In the fall of 2017, the Office of Inspector General 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 Office of Inspector General 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. |
Noncontrolling Interests
Noncontrolling Interests | 3 Months Ended |
Mar. 31, 2020 | |
Noncontrolling Interest [Abstract] | |
Noncontrolling Interests | 15 . 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 March 31, 2020, the Company operated five facilities through non-wholly owned subsidiaries and owns between 60% and 86% of the equity interests, 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, 2019 $ 33,151 Net income attributable to noncontrolling interests 604 Dividend payments to noncontrolling interests (264 ) Balance at March 31, 2020 $ 33,491 |
Other Current Assets
Other Current Assets | 3 Months Ended |
Mar. 31, 2020 | |
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract] | |
Other Current Assets | 16 . Other Current Assets Other current assets consisted of the following (in thousands): March 31, 2020 December 31, 2019 Prepaid expenses $ 22,161 $ 23,708 Cost report receivable 14,402 13,723 Other receivables 14,257 16,097 Workers’ compensation deposits – current portion 10,000 10,000 Income taxes receivable 9,358 5,579 Insurance receivable – current portion 5,739 3,030 Inventory 4,882 4,759 Other 1,644 1,348 Other current assets $ 82,443 $ 78,244 |
Other Accrued Liabilities
Other Accrued Liabilities | 3 Months Ended |
Mar. 31, 2020 | |
Other Liabilities Disclosure [Abstract] | |
Other Accrued Liabilities | 17 . Other Accrued Liabilities Other accrued liabilities consisted of the following (in thousands): March 31, 2020 December 31, 2019 Accrued expenses $ 41,131 $ 50,614 Unearned income 31,631 38,475 Accrued interest 11,660 33,323 Finance lease liabilities 6,637 6,819 Insurance liability – current portion 4,731 4,731 Accrued property taxes 4,222 4,755 Other 4,346 2,443 Other accrued liabilities $ 104,358 $ 141,160 |
Segment Information
Segment Information | 3 Months Ended |
Mar. 31, 2020 | |
Segment Reporting [Abstract] | |
Segment Information | 1 8 . Segment Information The Company operates in one line of business, which is operating acute inpatient psychiatric facilities, specialty treatment facilities, residential treatment centers and facilities providing outpatient behavioral healthcare services. As management reviews the operating results of its U.S. Facilities and its U.K. Facilities separately to assess performance and make decisions, the Company’s operating segments include our U.S. Facilities and U.K. Facilities. At March 31, 2020, the U.S. Facilities segment included 228 behavioral healthcare facilities with approximately 9,600 beds in 40 states and Puerto Rico, and the U.K. Facilities segment included 360 behavioral healthcare facilities with approximately 8,700 beds in the U.K. The following tables set forth the financial information by operating segment, including a reconciliation of Segment EBITDA to income before income taxes (in thousands): Three Months Ended March 31, 2020 2019 Revenue: U.S. Facilities $ 509,217 $ 487,960 U.K. Facilities 273,593 272,657 Corporate and Other — — $ 782,810 $ 760,617 Segment EBITDA (1): U.S. Facilities $ 120,074 $ 119,008 U.K. Facilities 36,168 40,056 Corporate and Other (23,393 ) (23,061 ) $ 132,849 $ 136,003 Three Months Ended March 31, 2020 2019 Segment EBITDA (1) $ 132,849 $ 136,003 Less: Equity-based compensation expense (4,979 ) (6,101 ) Transaction-related expenses (3,549 ) (4,321 ) Interest expense, net (42,785 ) (48,130 ) Depreciation and amortization (41,680 ) (40,580 ) Income before income taxes $ 39,856 $ 36,871 U.S. Facilities U.K. Facilities Corporate and Other Consolidated Goodwill: Balance at January 1, 2020 Goodwill $ 2,085,104 $ 689,902 $ — $ 2,775,006 Accumulated impairment loss — (325,875 ) — (325,875 ) Net goodwill at January 1, 2020 2,085,104 364,027 — 2,449,131 Prior period purchase price adjustments (13 ) — — (13 ) Foreign currency translation gain — (22,418 ) — (22,418 ) Balance at March 31, 2020 Goodwill 2,085,091 667,484 — 2,752,575 Accumulated impairment loss — (325,875 ) — (325,875 ) Net goodwill at March 31, 2020 $ 2,085,091 $ 341,609 $ — $ 2,426,700 March 31, 2020 December 31, 2019 Assets (2): U.S. Facilities $ 4,083,825 $ 4,037,968 U.K. Facilities 2,443,498 2,610,357 Corporate and Other 190,672 230,817 $ 6,717,995 $ 6,879,142 (1) Segment EBITDA is defined as income before provision for income taxes, equity-based compensation expense, transaction-related expenses, interest expense and depreciation and amortization. The Company uses Segment EBITDA as an analytical indicator to measure the performance of the Company’s segments and to develop strategic objectives and operating plans for those segments. Segment 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. Segment EBITDA should not be considered as a measure of financial performance under GAAP, and the items excluded from Segment EBITDA are significant components in understanding and assessing financial performance. Because Segment EBITDA is not a measurement determined in accordance with GAAP and is thus susceptible to varying calculations, Segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. (2) Assets include property and equipment for the U.S. Facilities of $1.5 billion, U.K. Facilities of $1.6 billion and corporate and other of $57.3 million at March 31, 2020. Assets include property and equipment for the U.S. Facilities of $1.4 billion, U.K. Facilities of $1.7 billion and corporate and other of $50.9 million at December 31, 2019. |
Accumulated Other Comprehensive
Accumulated Other Comprehensive Loss | 3 Months Ended |
Mar. 31, 2020 | |
Equity [Abstract] | |
Accumulated Other Comprehensive Loss | 1 9 . 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, 2019 $ (434,633 ) $ 24,958 $ (5,209 ) $ (414,884 ) Foreign currency translation (loss) gain (122,321 ) — 321 (122,000 ) Gain on derivative instruments, net of tax of $16.3 million — 43,746 — 43,746 Balance at March 31, 2020 $ (556,954 ) $ 68,704 $ (4,888 ) $ (493,138 ) |
Financial Information for the C
Financial Information for the Company and Its Subsidiaries | 3 Months Ended |
Mar. 31, 2020 | |
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 6.125% Senior Notes, 5.125% Senior Notes, 5.625% Senior Notes and 6.500% 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 Amended and Restated Senior Credit Facility. Presented below is condensed consolidating financial information for the Company and its subsidiaries at March 31, 2020 and December 31, 2019, and for the three months ended March 31, 2020 and 2019. The information segregates the parent company (Acadia Healthcare Company, Inc.), the combined wholly-owned subsidiary guarantors, the combined non-guarantor subsidiaries and eliminations. Acadia Healthcare Company, Inc. Condensed Consolidating Balance Sheets March 31, 2020 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Current assets: Cash and cash equivalents $ — $ 51,340 $ 29,664 $ — $ 81,004 Accounts receivable, net — 272,098 67,407 — 339,505 Other current assets — 65,346 17,097 — 82,443 Total current assets — 388,784 114,168 — 502,952 Property and equipment, net — 1,348,045 1,803,694 — 3,151,739 Goodwill — 1,992,332 434,368 — 2,426,700 Intangible assets, net — 58,312 30,740 — 89,052 Deferred tax assets 1,303 — 3,307 (1,303 ) 3,307 Investment in subsidiaries 5,390,417 — — (5,390,417 ) — Operating lease right-of-use assets — 98,166 377,862 — 476,028 Other assets 234,014 48,597 12,214 (226,608 ) 68,217 Total assets $ 5,625,734 $ 3,934,236 $ 2,776,353 $ (5,618,328 ) $ 6,717,995 Current liabilities: Current portion of long-term debt $ 196,072 $ — $ — $ — $ 196,072 Accounts payable — 97,196 37,497 — 134,693 Accrued salaries and benefits — 82,072 32,718 — 114,790 Current portion of operating lease liabilities — 18,571 11,100 — 29,671 Other accrued liabilities 11,660 26,021 66,677 — 104,358 Total current liabilities 207,732 223,860 147,992 — 579,584 Long-term debt 2,944,820 — 226,608 (226,608 ) 2,944,820 Deferred tax liabilities — 41,087 45,621 (1,303 ) 85,405 Operating lease liabilities — 85,577 389,169 — 474,746 Derivative instrument liabilities 9,015 — — — 9,015 Other liabilities — 110,923 15,844 — 126,767 Total liabilities 3,161,567 461,447 825,234 (227,911 ) 4,220,337 Redeemable noncontrolling interests — — 33,491 — 33,491 Total equity 2,464,167 3,472,789 1,917,628 (5,390,417 ) 2,464,167 Total liabilities and equity $ 5,625,734 $ 3,934,236 $ 2,776,353 $ (5,618,328 ) $ 6,717,995 Acadia Healthcare Company, Inc. Condensed Consolidating Balance Sheets December 31, 2019 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Current assets: Cash and cash equivalents $ — $ 98,943 $ 25,249 $ — $ 124,192 Accounts receivable, net — 266,864 72,911 — 339,775 Other current assets — 61,508 16,736 — 78,244 Total current assets — 427,315 114,896 — 542,211 Property and equipment, net — 1,313,830 1,910,204 — 3,224,034 Goodwill — 1,992,344 456,787 — 2,449,131 Intangible assets, net — 58,291 32,066 — 90,357 Deferred tax assets – noncurrent 1,403 — 3,339 (1,403 ) 3,339 Operating lease right-of-use assets — 97,396 404,441 — 501,837 Investment in subsidiaries 5,521,340 — — (5,521,340 ) — Other assets 233,975 48,949 13,127 (227,818 ) 68,233 Total assets $ 5,756,718 $ 3,938,125 $ 2,934,860 $ (5,750,561 ) $ 6,879,142 Current liabilities: Current portion of long-term debt $ 43,679 $ — $ — $ — $ 43,679 Accounts payable — 87,165 39,880 — 127,045 Accrued salaries and benefits — 89,483 33,069 — 122,552 Current portion of operating lease liabilities — 17,967 11,173 — 29,140 Other accrued liabilities 33,323 22,672 85,165 — 141,160 Total current liabilities 77,002 217,287 169,287 — 463,576 Long-term debt 3,105,420 — 227,818 (227,818 ) 3,105,420 Deferred tax liabilities – noncurrent — 21,858 51,405 (1,403 ) 71,860 Operating lease liabilities — 85,365 416,887 — 502,252 Derivative instrument liabilities 68,915 — — — 68,915 Other liabilities — 110,445 18,142 — 128,587 Total liabilities 3,251,337 434,955 883,539 (229,221 ) 4,340,610 Redeemable noncontrolling interests — — 33,151 — 33,151 Total equity 2,505,381 3,503,170 2,018,170 (5,521,340 ) 2,505,381 Total liabilities and equity $ 5,756,718 $ 3,938,125 $ 2,934,860 $ (5,750,561 ) $ 6,879,142 Acadia Healthcare Company, Inc. Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended March 31, 2020 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Revenue $ — $ 474,612 $ 308,198 $ — $ 782,810 Salaries, wages and benefits 4,979 261,603 173,734 — 440,316 Professional fees — 28,558 34,742 — 63,300 Supplies — 20,859 11,112 — 31,971 Rents and leases — 8,883 11,941 — 20,824 Other operating expenses — 63,819 34,710 — 98,529 Depreciation and amortization — 21,046 20,634 — 41,680 Interest expense, net 14,460 24,159 4,166 — 42,785 Transaction-related expenses — 1,525 2,024 — 3,549 Total expenses 19,439 430,452 293,063 — 742,954 (Loss) income before income taxes (19,439 ) 44,160 15,135 — 39,856 Equity in earnings of subsidiaries 48,353 — — (48,353 ) — (Benefit from) provision for income taxes (5,153 ) 11,712 (770 ) — 5,789 Net income (loss) 34,067 32,448 15,905 (48,353 ) 34,067 Net income attributable to noncontrolling interests — — (604 ) — (604 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 34,067 $ 32,448 $ 15,301 $ (48,353 ) $ 33,463 Other comprehensive income: Foreign currency translation gain — — (122,000 ) — (122,000 ) Loss on derivative instruments 43,746 — — — 43,746 Other comprehensive income (loss) 43,746 — (122,000 ) — (78,254 ) Comprehensive income (loss) attributable to Acadia Healthcare Company, Inc. $ 77,813 $ 32,448 $ (106,699 ) $ (48,353 ) $ (44,791 ) Acadia Healthcare Company, Inc. Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended March 31, 2019 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Revenue $ — $ 459,818 $ 300,799 $ — $ 760,617 Salaries, wages and benefits 6,101 254,942 168,536 — 429,579 Professional fees — 25,368 31,639 — 57,007 Supplies — 19,384 10,573 — 29,957 Rents and leases — 8,403 11,904 — 20,307 Other operating expenses — 59,390 34,475 — 93,865 Depreciation and amortization — 19,605 20,975 — 40,580 Interest expense, net 19,578 23,018 5,534 — 48,130 Transaction-related expenses — 3,218 1,103 — 4,321 Total expenses 25,679 413,328 284,739 — 723,746 (Loss) income before income taxes (25,679 ) 46,490 16,060 — 36,871 Equity in earnings of subsidiaries 48,157 — — (48,157 ) — (Benefit from) provision for income taxes (7,033 ) 17,065 (2,672 ) — 7,360 Net income (loss) 29,511 29,425 18,732 (48,157 ) 29,511 Net income attributable to noncontrolling interests — — (40 ) — (40 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 29,511 $ 29,425 $ 18,692 $ (48,157 ) $ 29,471 Other comprehensive income: Foreign currency translation gain — — 44,481 — 44,481 Loss on derivative instruments (8,690 ) — — — (8,690 ) Other comprehensive income (loss) (8,690 ) — 44,481 — 35,791 Comprehensive income (loss) attributable to Acadia Healthcare Company, Inc. $ 20,821 $ 29,425 $ 63,173 $ (48,157 ) $ 65,262 Acadia Healthcare Company, Inc. Condensed Consolidating Statement of Cash Flows Three Months Ended March 31, 2020 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Operating activities: Net income (loss) $ 34,067 $ 32,448 $ 15,905 $ (48,353 ) $ 34,067 Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: Equity in earnings of subsidiaries (48,353 ) — — 48,353 — Depreciation and amortization — 21,046 20,634 — 41,680 Amortization of debt issuance costs 3,050 — — — 3,050 Equity-based compensation expense 4,979 — — — 4,979 Deferred income taxes 101 11,044 141 — 11,286 Other (101 ) (9 ) 3 — (107 ) Change in operating assets and liabilities: Accounts receivable, net — (5,234 ) 2,406 — (2,828 ) Other current assets — (17,887 ) (1,244 ) — (19,131 ) Other assets 82 (1,593 ) 497 (82 ) (1,096 ) Accounts payable and other accrued liabilities — 17,726 (39,481 ) — (21,755 ) Accrued salaries and benefits — (7,411 ) 1,381 — (6,030 ) Other liabilities — 2,803 (1,372 ) — 1,431 Net cash (used in) provided by operating activities (6,175 ) 52,933 (1,130 ) (82 ) 45,546 Investing activities: Cash paid for capital expenditures — (48,264 ) (21,283 ) — (69,547 ) Cash paid for real estate acquisitions — (3,149 ) — — (3,149 ) Proceeds from sale of property and equipment — 207 — — 207 Other — (1,672 ) — — (1,672 ) Net cash used in investing activities — (52,878 ) (21,283 ) — (74,161 ) Financing activities: Principal payments on long-term debt (10,621 ) — (82 ) 82 (10,621 ) Common stock withheld for minimum statutory taxes, net (1,402 ) — — — (1,402 ) Distributions to noncontrolling interests — — (264 ) — (264 ) Other — (423 ) (720 ) — (1,143 ) Cash provided by (used in) intercompany activity 18,198 (47,235 ) 29,037 — — Net cash provided by (used in) in financing activities 6,175 (47,658 ) 27,971 82 (13,430 ) Effect of exchange rate changes on cash — — (1,143 ) — (1,143 ) Net (decrease) increase in cash and cash equivalents — (47,603 ) 4,415 — (43,188 ) Cash and cash equivalents at beginning of the period — 98,943 25,249 — 124,192 Cash and cash equivalents at end of the period $ — $ 51,340 $ 29,664 $ — $ 81,004 Acadia Healthcare Company, Inc. Condensed Consolidating Statement of Cash Flows Three Months Ended March 31, 2019 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Operating activities: Net income (loss) $ 29,511 $ 29,425 $ 18,732 $ (48,157 ) $ 29,511 Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: Equity in earnings of subsidiaries (48,157 ) — — 48,157 — Depreciation and amortization — 19,605 20,975 — 40,580 Amortization of debt issuance costs 2,888 — — — 2,888 Equity-based compensation expense 6,101 — — — 6,101 Deferred income taxes (254 ) (678 ) 266 — (666 ) Other 1,993 253 (59 ) — 2,187 Change in operating assets and liabilities: Accounts receivable, net — (15,693 ) 3,713 — (11,980 ) Other current assets — (5,484 ) (391 ) — (5,875 ) Other assets 2,665 (353 ) 648 (2,665 ) 295 Accounts payable and other accrued liabilities — (7,100 ) (8,601 ) — (15,701 ) Accrued salaries and benefits — (7,872 ) 2,023 — (5,849 ) Other liabilities — 3,317 (1,135 ) — 2,182 Net cash (used in) provided by operating activities (5,253 ) 15,420 36,171 (2,665 ) 43,673 Investing activities: Cash paid for acquisitions, net of cash acquired — (40,400 ) — — (40,400 ) Cash paid for capital expenditures — (45,231 ) (24,017 ) — (69,248 ) Cash paid for real estate acquisitions — (1,066 ) — — (1,066 ) Proceeds from sale of property and equipment — 836 92 — 928 Other — (315 ) — — (315 ) Net cash used in investing activities — (86,176 ) (23,925 ) — (110,101 ) Financing activities: Borrowings on revolving credit facility 71,573 — — — 71,573 Principal payments on long-term debt (8,246 ) — (2,665 ) 2,665 (8,246 ) Common stock withheld for minimum statutory taxes, net (1,327 ) — — — (1,327 ) Other (2,375 ) (442 ) (680 ) — (3,497 ) Cash (used in) provided by intercompany activity (54,372 ) 56,570 (2,198 ) — — Net cash provided by (used in) in financing activities 5,253 56,128 (5,543 ) 2,665 58,503 Effect of exchange rate changes on cash — — 1,099 — 1,099 Net (decrease) increase in cash and cash equivalents — (14,628 ) 7,802 — (6,826 ) Cash and cash equivalents at beginning of the period — 32,471 18,039 — 50,510 Cash and cash equivalents at end of the period $ — $ 17,843 $ 25,841 $ — $ 43,684 |
Subsequent Events
Subsequent Events | 3 Months Ended |
Mar. 31, 2020 | |
Subsequent Events [Abstract] | |
Subsequent Events | 21. Subsequent Events On April 21, 2020, the Company entered into the Thirteenth Amendment to the Amended and Restated Credit Agreement. The Thirteenth Amendment amended the Consolidated Leverage Ratio in the existing covenant, to increase the leverage ratio for the rest of 2020. Additionally, in early April 2020, the Company borrowed $100.0 million on its revolving line of credit to enhance its cash position in response to the potential impact of COVID-19 on the Company’s future liquidity. As part of the CARES Act, the U.S. government announced it would offer $100 billion of relief to eligible healthcare providers. The Company received approximately $20 million of the initial funds distributed in April 2020. The Company is evaluating the terms and conditions and financial impact of any funds received under the CARES Act and other government relief programs. Using existing authority and certain expanded authority under the CARES Act, the U.S. Department of Health and Human Services (“HHS”) has 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, our facilities may request up to 100% of their Medicare payment amount for a three-month three-month |
Revenue (Tables)
Revenue (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Summary of the Activity in Unearned Revenue in the U.K. Facilities | A summary of the activity in unearned revenue in the U.K. Facilities is as follows (in thousands): Balance at December 31, 2019 $ 36,579 Payments received 38,152 Revenue recognized (42,787 ) Foreign currency translation loss (1,891 ) Balance at March 31, 2020 $ 30,053 |
U.S. Facilities [Member] | |
Schedule of Revenue Attributed to Each Category | The table below presents total U.S. revenue attributed to each category (in thousands): Three Months Ended March 31, 2020 2019 Acute inpatient psychiatric facilities $ 239,414 $ 216,597 Specialty treatment facilities 193,611 193,035 Residential treatment centers 70,434 73,224 Outpatient community-based facilities 5,758 5,104 Revenue $ 509,217 $ 487,960 |
Schedule of Revenue and Percentage Generated by Each Payor Type | The following table presents revenue by payor type and as a percentage of revenue in our U.S. Facilities (in thousands): Three Months Ended March 31, 2020 2019 Amount % Amount % Commercial $ 143,142 28.1 % $ 139,427 28.6 % Medicare 72,271 14.2 % 72,616 14.9 % Medicaid 260,044 51.1 % 239,191 49.0 % Self-Pay 27,034 5.3 % 31,732 6.5 % Other 6,726 1.3 % 4,994 1.0 % Revenue $ 509,217 100.0 % $ 487,960 100.0 % |
U.K. Facilities [Member] | |
Schedule of Revenue Attributed to Each Category | The table below presents total U.K. revenue attributed to each category (in thousands): Three Months Ended March 31, 2020 2019 Healthcare facilities $ 148,137 $ 151,708 Education and Children’s Services 46,666 46,122 Adult Care facilities 78,790 74,827 Revenue $ 273,593 $ 272,657 |
Schedule of Revenue and Percentage Generated by Each Payor Type | The following table presents revenue by payor type and as a percentage of revenue in our U.K. Facilities (in thousands): Three Months Ended March 31, 2020 2019 Amount % Amount % U.K. public funded sources $ 246,136 90.0 % $ 245,413 90.0 % Self-Pay 26,915 9.8 % 26,814 9.8 % Other 542 0.2 % 430 0.2 % Revenue $ 273,593 100.0 % $ 272,657 100.0 % |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
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 months ended March 31, 2020 and 2019 (in thousands, except per share amounts): Three Months Ended March 31, 2020 2019 Numerator: Net income attributable to Acadia Healthcare Company, Inc. $ 33,463 $ 29,471 Denominator: Weighted average shares outstanding for basic earnings per share 87,765 87,505 Effect of dilutive instruments 206 189 Shares used in computing diluted earnings per common share 87,971 87,694 Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders: Basic $ 0.38 $ 0.34 Diluted $ 0.38 $ 0.34 |
Acquisitions (Tables)
Acquisitions (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Business Combinations [Abstract] | |
Transaction Related Expenses as Incurred | Transaction-related expenses primarily relate to termination, restructuring, U.K. sale, strategic review, management transition and other similar costs. Transaction-related expenses for the three months ended March 31, 2020 and 2019 were as follows (in thousands): Three Months Ended March 31, 2020 2019 Termination, restructuring, sale and strategic review costs $ 2,221 $ 2,282 Legal, accounting and other acquisition-related costs 1,328 796 Management transition costs — 1,243 $ 3,549 $ 4,321 |
Property and Equipment (Tables)
Property and Equipment (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Property Plant And Equipment [Abstract] | |
Summary of Property and Equipment | Property and equipment consisted of the following at March 31, 2020 and December 31, 2019 (in thousands): March 31, 2020 December 31, 2019 Land $ 429,601 $ 448,716 Building and improvements 2,738,302 2,746,111 Equipment 502,246 516,769 Construction in progress 229,058 254,213 3,899,207 3,965,809 Less: accumulated depreciation (747,468 ) (741,775 ) Property and equipment, net $ 3,151,739 $ 3,224,034 |
Other Intangible Assets (Tables
Other Intangible Assets (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
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 March 31, 2020 and December 31, 2019 (in thousands): Gross Carrying Amount Accumulated Amortization March 31, 2020 December 31, 2019 March 31, 2020 December 31, 2019 Intangible assets subject to amortization: Contract intangible assets $ 2,100 $ 2,100 $ (2,100 ) $ (2,100 ) Non-compete agreements 1,131 1,131 (1,131 ) (1,131 ) 3,231 3,231 (3,231 ) (3,231 ) Intangible assets not subject to amortization: Licenses and accreditations 12,429 12,455 — — Trade names 59,532 60,831 — — Certificates of need 17,091 17,071 — — 89,052 90,357 — — Total $ 92,283 $ 93,588 $ (3,231 ) $ (3,231 ) |
Leases (Tables)
Leases (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Leases [Abstract] | |
Schedule of Leases on Condensed Consolidated Balance Sheet | The Company recorded the following at March 31, 2020 and December 31, 2019 on the condensed consolidated balance sheets (in thousands): Right-of-Use Assets Balance Sheet Classification March 31, 2020 December 31, 2019 Finance lease right-of-use assets Property and equipment, net $ 43,760 $ 44,370 Operating lease right-of-use assets Operating lease right-of-use assets 476,028 501,837 Total $ 519,788 $ 546,207 Lease Liabilities Balance Sheet Classification March 31, 2020 December 31, 2019 Current: Finance lease liabilities Other accrued liabilities $ 6,637 $ 6,819 Operating lease liabilities Current portion of operating lease liabilities 29,671 29,140 Noncurrent: Finance lease liabilities Other liabilities 43,295 43,662 Operating lease liabilities Operating lease liabilities 474,746 502,252 Total $ 554,349 $ 581,873 |
Schedule of Weighted-average Remaining Lease Terms and Discount Rates | Weighted-average remaining lease terms and discount rates were as follows at March 31, 2020 and December 31, 2019: March 31, 2020 December 31, 2019 Weighted-average remaining lease term (in years): Finance 6.7 6.9 Operating 19.0 19.4 Weighted-average discount rate: Finance 6.4 % 6.4 % Operating 6.3 % 6.3 % |
Schedule of Lease Cost | The Company recorded the following lease costs for the three months ended March 31, 2020 and 2019 (in thousands): Three Months Ended March 31, 2020 2019 Finance lease costs: Depreciation of leased assets 1,137 1,123 Interest of lease liabilities 997 997 Total finance lease costs $ 2,134 $ 2,120 Operating lease costs 16,481 16,529 Variable lease costs 1,310 886 Short term lease costs 1,147 1,447 Other lease costs 1,886 1,445 Total rents and leases $ 20,824 $ 20,307 Total lease costs $ 22,958 $ 22,427 |
Schedule of Undiscounted Cash Flows for Finance and Operating Leases | Undiscounted cash flows for finance and operating leases recorded on the condensed consolidated balance sheets were as follows at March 31, 2020 (in thousands): Finance Leases Operating Leases For the nine months ending December 31, 2020 $ 5,549 $ 45,846 2021 35,726 58,023 2022 2,845 52,956 2023 1,620 48,544 2024 1,027 46,312 Thereafter 25,088 650,931 Total minimum lease payments 71,855 902,612 Less: amount of lease payments representing interest 21,923 398,195 Present value of future minimum lease payments 49,932 504,417 Less: Current portion of lease liabilities 6,637 29,671 Noncurrent lease liabilities $ 43,295 $ 474,746 |
Schedule of Supplemental Data | Supplemental data for the three months ended March 31, 2020 and 2019 was as follows (in thousands): Three Months Ended March 31, 2020 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 15,836 $ 15,809 Operating cash flows for finance leases $ 997 $ 997 Financing cash flows for finance leases $ 878 $ 846 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 6,082 $ 3,662 Finance leases $ 953 $ 1,027 |
Long-Term Debt (Tables)
Long-Term Debt (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Debt Disclosure [Abstract] | |
Components of Long-Term Debt | Long-term debt consisted of the following (in thousands): March 31, 2020 December 31, 2019 Amended and Restated Senior Credit Facility: Senior Secured Term A Loan $ 339,625 $ 346,750 Senior Secured Term B Loans 1,335,432 1,338,928 Senior Secured Revolving Line of Credit — — 6.125% Senior Notes due 2021 150,000 150,000 5.125% Senior Notes due 2022 300,000 300,000 5.625% Senior Notes due 2023 650,000 650,000 6.500% Senior Notes due 2024 390,000 390,000 Other long-term debt 4,533 4,821 Less: unamortized debt issuance costs, discount and premium (28,698 ) (31,400 ) 3,140,892 3,149,099 Less: current portion (196,072 ) (43,679 ) Long-term debt $ 2,944,820 $ 3,105,420 |
Equity-Based Compensation (Tabl
Equity-Based Compensation (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Stock Option Activity | Stock option activity during 2019 and 2020 was as follows (aggregate intrinsic value in thousands): Number of Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term (in years) Aggregate Intrinsic Value Options outstanding at January 1, 2019 1,199,540 $ 44.64 7.26 $ 2,717 Options granted 605,200 28.50 9.21 1,343 Options exercised (55,671 ) 19.05 N/A 658 Options cancelled (389,001 ) 40.84 N/A N/A Options outstanding at December 31, 2019 1,360,068 39.40 7.57 1,650 Options granted 443,200 33.72 9.91 — Options exercised — — N/A — Options cancelled (105,462 ) 41.00 N/A N/A Options outstanding at March 31, 2020 1,697,806 $ 37.81 7.97 $ 659 Options exercisable at December 31, 2019 513,290 $ 48.08 5.88 $ 512 Options exercisable at March 31, 2020 702,956 $ 44.08 6.36 $ 479 |
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 three months ended March 31, 2020 and year ended December 31, 2019: March 31, 2020 December 31, 2019 Weighted average grant-date fair value of options $ 12.29 $ 17.59 Risk-free interest rate 1.6 % 2.4 % Expected volatility 39 % 38 % Expected life (in years) 5.0 5.0 |
Restricted Stock Activity | Restricted stock activity during 2019 and 2020 was as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2019 805,057 $ 42.40 Granted 700,937 28.77 Cancelled (389,684 ) 33.50 Vested (311,174 ) 44.23 Unvested at December 31, 2019 805,136 $ 34.14 Granted 511,006 25.37 Cancelled (57,782 ) 35.55 Vested (160,398 ) 36.73 Unvested at March 31, 2020 1,097,962 $ 29.61 |
Restricted Stock Unit Activity | Restricted stock unit activity during 2019 and 2020 was as follows: Number of Units Weighted Average Grant-Date Fair Value Unvested at January 1, 2019 484,111 $ 44.52 Granted 234,408 34.54 Cancelled (271,162 ) 45.17 Vested — — Unvested at December 31, 2019 447,357 $ 38.89 Granted 583,680 10.60 Cancelled (10,123 ) 42.09 Vested (12,691 ) 42.09 Unvested at March 31, 2020 1,008,223 $ 22.44 |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Fair Value Disclosures [Abstract] | |
Carrying Amounts and Fair Values of Company's Amended and Restated Senior Credit Facilities and Contingent Consideration Liabilities | The carrying amounts and fair values of the Company’s Amended and Restated Senior Credit Facility, 6.125% Senior Notes, 5.125% Senior Notes, 5.625% Senior Notes, 6.500% Senior Notes, other long-term debt and derivative instruments at March 31, 2020 and December 31, 2019 were as follows (in thousands): Carrying Amount Fair Value March 31, 2020 December 31, 2019 March 31, 2020 December 31, 2019 Amended and Restated Senior Credit Facility $ 1,659,098 $ 1,668,062 $ 1,659,098 $ 1,668,062 6.125% Senior Notes due 2021 $ 149,409 $ 149,254 $ 144,927 $ 149,441 5.125% Senior Notes due 2022 $ 297,973 $ 297,761 $ 283,998 $ 299,994 5.625% Senior Notes due 2023 $ 645,156 $ 644,771 $ 607,995 $ 655,249 6.500% Senior Notes due 2024 $ 384,723 $ 384,430 $ 374,143 $ 398,366 Other long-term debt $ 4,533 $ 4,821 $ 4,533 $ 4,821 Derivative instrument liabilities $ (9,015 ) $ (68,915 ) $ (9,015 ) $ (68,915 ) |
Noncontrolling Interests (Table
Noncontrolling Interests (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Noncontrolling Interest [Abstract] | |
Summary of Redeemable Noncontrolling Interests | The components of redeemable noncontrolling interests are as follows (in thousands): Balance at December 31, 2019 $ 33,151 Net income attributable to noncontrolling interests 604 Dividend payments to noncontrolling interests (264 ) Balance at March 31, 2020 $ 33,491 |
Other Current Assets (Tables)
Other Current Assets (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract] | |
Other Current Assets | Other current assets consisted of the following (in thousands): March 31, 2020 December 31, 2019 Prepaid expenses $ 22,161 $ 23,708 Cost report receivable 14,402 13,723 Other receivables 14,257 16,097 Workers’ compensation deposits – current portion 10,000 10,000 Income taxes receivable 9,358 5,579 Insurance receivable – current portion 5,739 3,030 Inventory 4,882 4,759 Other 1,644 1,348 Other current assets $ 82,443 $ 78,244 |
Other Accrued Liabilities (Tabl
Other Accrued Liabilities (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Other Liabilities Disclosure [Abstract] | |
Summary of Other Accrued Liabilities | Other accrued liabilities consisted of the following (in thousands): March 31, 2020 December 31, 2019 Accrued expenses $ 41,131 $ 50,614 Unearned income 31,631 38,475 Accrued interest 11,660 33,323 Finance lease liabilities 6,637 6,819 Insurance liability – current portion 4,731 4,731 Accrued property taxes 4,222 4,755 Other 4,346 2,443 Other accrued liabilities $ 104,358 $ 141,160 |
Segment Information (Tables)
Segment Information (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Summary of Reconciliation of Segment EBITDA to Income before Income Taxes | The following tables set forth the financial information by operating segment, including a reconciliation of Segment EBITDA to income before income taxes (in thousands): Three Months Ended March 31, 2020 2019 Revenue: U.S. Facilities $ 509,217 $ 487,960 U.K. Facilities 273,593 272,657 Corporate and Other — — $ 782,810 $ 760,617 Segment EBITDA (1): U.S. Facilities $ 120,074 $ 119,008 U.K. Facilities 36,168 40,056 Corporate and Other (23,393 ) (23,061 ) $ 132,849 $ 136,003 Three Months Ended March 31, 2020 2019 Segment EBITDA (1) $ 132,849 $ 136,003 Less: Equity-based compensation expense (4,979 ) (6,101 ) Transaction-related expenses (3,549 ) (4,321 ) Interest expense, net (42,785 ) (48,130 ) Depreciation and amortization (41,680 ) (40,580 ) Income before income taxes $ 39,856 $ 36,871 |
Summary of Assets by Operating Segment | March 31, 2020 December 31, 2019 Assets (2): U.S. Facilities $ 4,083,825 $ 4,037,968 U.K. Facilities 2,443,498 2,610,357 Corporate and Other 190,672 230,817 $ 6,717,995 $ 6,879,142 (1) Segment EBITDA is defined as income before provision for income taxes, equity-based compensation expense, transaction-related expenses, interest expense and depreciation and amortization. The Company uses Segment EBITDA as an analytical indicator to measure the performance of the Company’s segments and to develop strategic objectives and operating plans for those segments. Segment 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. Segment EBITDA should not be considered as a measure of financial performance under GAAP, and the items excluded from Segment EBITDA are significant components in understanding and assessing financial performance. Because Segment EBITDA is not a measurement determined in accordance with GAAP and is thus susceptible to varying calculations, Segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. (2) Assets include property and equipment for the U.S. Facilities of $1.5 billion, U.K. Facilities of $1.6 billion and corporate and other of $57.3 million at March 31, 2020. Assets include property and equipment for the U.S. Facilities of $1.4 billion, U.K. Facilities of $1.7 billion and corporate and other of $50.9 million at December 31, 2019. |
Goodwill [Member] | |
Summary of Assets by Operating Segment | U.S. Facilities U.K. Facilities Corporate and Other Consolidated Goodwill: Balance at January 1, 2020 Goodwill $ 2,085,104 $ 689,902 $ — $ 2,775,006 Accumulated impairment loss — (325,875 ) — (325,875 ) Net goodwill at January 1, 2020 2,085,104 364,027 — 2,449,131 Prior period purchase price adjustments (13 ) — — (13 ) Foreign currency translation gain — (22,418 ) — (22,418 ) Balance at March 31, 2020 Goodwill 2,085,091 667,484 — 2,752,575 Accumulated impairment loss — (325,875 ) — (325,875 ) Net goodwill at March 31, 2020 $ 2,085,091 $ 341,609 $ — $ 2,426,700 |
Accumulated Other Comprehensi_2
Accumulated Other Comprehensive Loss (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
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, 2019 $ (434,633 ) $ 24,958 $ (5,209 ) $ (414,884 ) Foreign currency translation (loss) gain (122,321 ) — 321 (122,000 ) Gain on derivative instruments, net of tax of $16.3 million — 43,746 — 43,746 Balance at March 31, 2020 $ (556,954 ) $ 68,704 $ (4,888 ) $ (493,138 ) |
Financial Information for the_2
Financial Information for the Company and Its Subsidiaries (Tables) | 3 Months Ended |
Mar. 31, 2020 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Summary of Condensed Consolidating Balance Sheets | Acadia Healthcare Company, Inc. Condensed Consolidating Balance Sheets March 31, 2020 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Current assets: Cash and cash equivalents $ — $ 51,340 $ 29,664 $ — $ 81,004 Accounts receivable, net — 272,098 67,407 — 339,505 Other current assets — 65,346 17,097 — 82,443 Total current assets — 388,784 114,168 — 502,952 Property and equipment, net — 1,348,045 1,803,694 — 3,151,739 Goodwill — 1,992,332 434,368 — 2,426,700 Intangible assets, net — 58,312 30,740 — 89,052 Deferred tax assets 1,303 — 3,307 (1,303 ) 3,307 Investment in subsidiaries 5,390,417 — — (5,390,417 ) — Operating lease right-of-use assets — 98,166 377,862 — 476,028 Other assets 234,014 48,597 12,214 (226,608 ) 68,217 Total assets $ 5,625,734 $ 3,934,236 $ 2,776,353 $ (5,618,328 ) $ 6,717,995 Current liabilities: Current portion of long-term debt $ 196,072 $ — $ — $ — $ 196,072 Accounts payable — 97,196 37,497 — 134,693 Accrued salaries and benefits — 82,072 32,718 — 114,790 Current portion of operating lease liabilities — 18,571 11,100 — 29,671 Other accrued liabilities 11,660 26,021 66,677 — 104,358 Total current liabilities 207,732 223,860 147,992 — 579,584 Long-term debt 2,944,820 — 226,608 (226,608 ) 2,944,820 Deferred tax liabilities — 41,087 45,621 (1,303 ) 85,405 Operating lease liabilities — 85,577 389,169 — 474,746 Derivative instrument liabilities 9,015 — — — 9,015 Other liabilities — 110,923 15,844 — 126,767 Total liabilities 3,161,567 461,447 825,234 (227,911 ) 4,220,337 Redeemable noncontrolling interests — — 33,491 — 33,491 Total equity 2,464,167 3,472,789 1,917,628 (5,390,417 ) 2,464,167 Total liabilities and equity $ 5,625,734 $ 3,934,236 $ 2,776,353 $ (5,618,328 ) $ 6,717,995 Acadia Healthcare Company, Inc. Condensed Consolidating Balance Sheets December 31, 2019 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Current assets: Cash and cash equivalents $ — $ 98,943 $ 25,249 $ — $ 124,192 Accounts receivable, net — 266,864 72,911 — 339,775 Other current assets — 61,508 16,736 — 78,244 Total current assets — 427,315 114,896 — 542,211 Property and equipment, net — 1,313,830 1,910,204 — 3,224,034 Goodwill — 1,992,344 456,787 — 2,449,131 Intangible assets, net — 58,291 32,066 — 90,357 Deferred tax assets – noncurrent 1,403 — 3,339 (1,403 ) 3,339 Operating lease right-of-use assets — 97,396 404,441 — 501,837 Investment in subsidiaries 5,521,340 — — (5,521,340 ) — Other assets 233,975 48,949 13,127 (227,818 ) 68,233 Total assets $ 5,756,718 $ 3,938,125 $ 2,934,860 $ (5,750,561 ) $ 6,879,142 Current liabilities: Current portion of long-term debt $ 43,679 $ — $ — $ — $ 43,679 Accounts payable — 87,165 39,880 — 127,045 Accrued salaries and benefits — 89,483 33,069 — 122,552 Current portion of operating lease liabilities — 17,967 11,173 — 29,140 Other accrued liabilities 33,323 22,672 85,165 — 141,160 Total current liabilities 77,002 217,287 169,287 — 463,576 Long-term debt 3,105,420 — 227,818 (227,818 ) 3,105,420 Deferred tax liabilities – noncurrent — 21,858 51,405 (1,403 ) 71,860 Operating lease liabilities — 85,365 416,887 — 502,252 Derivative instrument liabilities 68,915 — — — 68,915 Other liabilities — 110,445 18,142 — 128,587 Total liabilities 3,251,337 434,955 883,539 (229,221 ) 4,340,610 Redeemable noncontrolling interests — — 33,151 — 33,151 Total equity 2,505,381 3,503,170 2,018,170 (5,521,340 ) 2,505,381 Total liabilities and equity $ 5,756,718 $ 3,938,125 $ 2,934,860 $ (5,750,561 ) $ 6,879,142 |
Summary of Condensed Consolidating Statement of Comprehensive Income (Loss) | Acadia Healthcare Company, Inc. Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended March 31, 2020 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Revenue $ — $ 474,612 $ 308,198 $ — $ 782,810 Salaries, wages and benefits 4,979 261,603 173,734 — 440,316 Professional fees — 28,558 34,742 — 63,300 Supplies — 20,859 11,112 — 31,971 Rents and leases — 8,883 11,941 — 20,824 Other operating expenses — 63,819 34,710 — 98,529 Depreciation and amortization — 21,046 20,634 — 41,680 Interest expense, net 14,460 24,159 4,166 — 42,785 Transaction-related expenses — 1,525 2,024 — 3,549 Total expenses 19,439 430,452 293,063 — 742,954 (Loss) income before income taxes (19,439 ) 44,160 15,135 — 39,856 Equity in earnings of subsidiaries 48,353 — — (48,353 ) — (Benefit from) provision for income taxes (5,153 ) 11,712 (770 ) — 5,789 Net income (loss) 34,067 32,448 15,905 (48,353 ) 34,067 Net income attributable to noncontrolling interests — — (604 ) — (604 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 34,067 $ 32,448 $ 15,301 $ (48,353 ) $ 33,463 Other comprehensive income: Foreign currency translation gain — — (122,000 ) — (122,000 ) Loss on derivative instruments 43,746 — — — 43,746 Other comprehensive income (loss) 43,746 — (122,000 ) — (78,254 ) Comprehensive income (loss) attributable to Acadia Healthcare Company, Inc. $ 77,813 $ 32,448 $ (106,699 ) $ (48,353 ) $ (44,791 ) Acadia Healthcare Company, Inc. Condensed Consolidating Statement of Comprehensive Income (Loss) Three Months Ended March 31, 2019 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Revenue $ — $ 459,818 $ 300,799 $ — $ 760,617 Salaries, wages and benefits 6,101 254,942 168,536 — 429,579 Professional fees — 25,368 31,639 — 57,007 Supplies — 19,384 10,573 — 29,957 Rents and leases — 8,403 11,904 — 20,307 Other operating expenses — 59,390 34,475 — 93,865 Depreciation and amortization — 19,605 20,975 — 40,580 Interest expense, net 19,578 23,018 5,534 — 48,130 Transaction-related expenses — 3,218 1,103 — 4,321 Total expenses 25,679 413,328 284,739 — 723,746 (Loss) income before income taxes (25,679 ) 46,490 16,060 — 36,871 Equity in earnings of subsidiaries 48,157 — — (48,157 ) — (Benefit from) provision for income taxes (7,033 ) 17,065 (2,672 ) — 7,360 Net income (loss) 29,511 29,425 18,732 (48,157 ) 29,511 Net income attributable to noncontrolling interests — — (40 ) — (40 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 29,511 $ 29,425 $ 18,692 $ (48,157 ) $ 29,471 Other comprehensive income: Foreign currency translation gain — — 44,481 — 44,481 Loss on derivative instruments (8,690 ) — — — (8,690 ) Other comprehensive income (loss) (8,690 ) — 44,481 — 35,791 Comprehensive income (loss) attributable to Acadia Healthcare Company, Inc. $ 20,821 $ 29,425 $ 63,173 $ (48,157 ) $ 65,262 |
Summary of Condensed Consolidating Statement of Cash Flows | Acadia Healthcare Company, Inc. Condensed Consolidating Statement of Cash Flows Three Months Ended March 31, 2020 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Operating activities: Net income (loss) $ 34,067 $ 32,448 $ 15,905 $ (48,353 ) $ 34,067 Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: Equity in earnings of subsidiaries (48,353 ) — — 48,353 — Depreciation and amortization — 21,046 20,634 — 41,680 Amortization of debt issuance costs 3,050 — — — 3,050 Equity-based compensation expense 4,979 — — — 4,979 Deferred income taxes 101 11,044 141 — 11,286 Other (101 ) (9 ) 3 — (107 ) Change in operating assets and liabilities: Accounts receivable, net — (5,234 ) 2,406 — (2,828 ) Other current assets — (17,887 ) (1,244 ) — (19,131 ) Other assets 82 (1,593 ) 497 (82 ) (1,096 ) Accounts payable and other accrued liabilities — 17,726 (39,481 ) — (21,755 ) Accrued salaries and benefits — (7,411 ) 1,381 — (6,030 ) Other liabilities — 2,803 (1,372 ) — 1,431 Net cash (used in) provided by operating activities (6,175 ) 52,933 (1,130 ) (82 ) 45,546 Investing activities: Cash paid for capital expenditures — (48,264 ) (21,283 ) — (69,547 ) Cash paid for real estate acquisitions — (3,149 ) — — (3,149 ) Proceeds from sale of property and equipment — 207 — — 207 Other — (1,672 ) — — (1,672 ) Net cash used in investing activities — (52,878 ) (21,283 ) — (74,161 ) Financing activities: Principal payments on long-term debt (10,621 ) — (82 ) 82 (10,621 ) Common stock withheld for minimum statutory taxes, net (1,402 ) — — — (1,402 ) Distributions to noncontrolling interests — — (264 ) — (264 ) Other — (423 ) (720 ) — (1,143 ) Cash provided by (used in) intercompany activity 18,198 (47,235 ) 29,037 — — Net cash provided by (used in) in financing activities 6,175 (47,658 ) 27,971 82 (13,430 ) Effect of exchange rate changes on cash — — (1,143 ) — (1,143 ) Net (decrease) increase in cash and cash equivalents — (47,603 ) 4,415 — (43,188 ) Cash and cash equivalents at beginning of the period — 98,943 25,249 — 124,192 Cash and cash equivalents at end of the period $ — $ 51,340 $ 29,664 $ — $ 81,004 Acadia Healthcare Company, Inc. Condensed Consolidating Statement of Cash Flows Three Months Ended March 31, 2019 (In thousands) Parent Combined Subsidiary Guarantors Combined Non- Guarantors Consolidating Adjustments Total Consolidated Amounts Operating activities: Net income (loss) $ 29,511 $ 29,425 $ 18,732 $ (48,157 ) $ 29,511 Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: Equity in earnings of subsidiaries (48,157 ) — — 48,157 — Depreciation and amortization — 19,605 20,975 — 40,580 Amortization of debt issuance costs 2,888 — — — 2,888 Equity-based compensation expense 6,101 — — — 6,101 Deferred income taxes (254 ) (678 ) 266 — (666 ) Other 1,993 253 (59 ) — 2,187 Change in operating assets and liabilities: Accounts receivable, net — (15,693 ) 3,713 — (11,980 ) Other current assets — (5,484 ) (391 ) — (5,875 ) Other assets 2,665 (353 ) 648 (2,665 ) 295 Accounts payable and other accrued liabilities — (7,100 ) (8,601 ) — (15,701 ) Accrued salaries and benefits — (7,872 ) 2,023 — (5,849 ) Other liabilities — 3,317 (1,135 ) — 2,182 Net cash (used in) provided by operating activities (5,253 ) 15,420 36,171 (2,665 ) 43,673 Investing activities: Cash paid for acquisitions, net of cash acquired — (40,400 ) — — (40,400 ) Cash paid for capital expenditures — (45,231 ) (24,017 ) — (69,248 ) Cash paid for real estate acquisitions — (1,066 ) — — (1,066 ) Proceeds from sale of property and equipment — 836 92 — 928 Other — (315 ) — — (315 ) Net cash used in investing activities — (86,176 ) (23,925 ) — (110,101 ) Financing activities: Borrowings on revolving credit facility 71,573 — — — 71,573 Principal payments on long-term debt (8,246 ) — (2,665 ) 2,665 (8,246 ) Common stock withheld for minimum statutory taxes, net (1,327 ) — — — (1,327 ) Other (2,375 ) (442 ) (680 ) — (3,497 ) Cash (used in) provided by intercompany activity (54,372 ) 56,570 (2,198 ) — — Net cash provided by (used in) in financing activities 5,253 56,128 (5,543 ) 2,665 58,503 Effect of exchange rate changes on cash — — 1,099 — 1,099 Net (decrease) increase in cash and cash equivalents — (14,628 ) 7,802 — (6,826 ) Cash and cash equivalents at beginning of the period — 32,471 18,039 — 50,510 Cash and cash equivalents at end of the period $ — $ 17,843 $ 25,841 $ — $ 43,684 |
Description of Business and B_2
Description of Business and Basis of Presentation - Additional Information (Detail) | 3 Months Ended |
Mar. 31, 2020FacilityBedState | |
Accounting Policies [Abstract] | |
Number of facilities | Facility | 588 |
Number of beds | Bed | 18,200 |
Number of operating states | State | 40 |
Revenue - Schedule of U.S. Reve
Revenue - Schedule of U.S. Revenue Attributed to Each Category (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Disaggregation of Revenue [Line Items] | ||
Revenue | $ 782,810 | $ 760,617 |
U.S. Facilities [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 509,217 | 487,960 |
U.S. Facilities [Member] | Acute Inpatient Psychiatric Facilities [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 239,414 | 216,597 |
U.S. Facilities [Member] | Specialty Treatment Facilities [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 193,611 | 193,035 |
U.S. Facilities [Member] | Residential Treatment Centers [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 70,434 | 73,224 |
U.S. Facilities [Member] | Outpatient Community-Based Facilities [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | $ 5,758 | $ 5,104 |
Revenue - Schedule of U.S. Re_2
Revenue - Schedule of U.S. Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 782,810 | $ 760,617 |
U.S. Facilities [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 509,217 | $ 487,960 |
Revenue, Percentage | 100.00% | 100.00% |
U.S. Facilities [Member] | Commercial [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 143,142 | $ 139,427 |
Revenue, Percentage | 28.10% | 28.60% |
U.S. Facilities [Member] | Medicare [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 72,271 | $ 72,616 |
Revenue, Percentage | 14.20% | 14.90% |
U.S. Facilities [Member] | Medicaid [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 260,044 | $ 239,191 |
Revenue, Percentage | 51.10% | 49.00% |
U.S. Facilities [Member] | Self-Pay [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 27,034 | $ 31,732 |
Revenue, Percentage | 5.30% | 6.50% |
U.S. Facilities [Member] | Other [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 6,726 | $ 4,994 |
Revenue, Percentage | 1.30% | 1.00% |
Revenue - Schedule of U.K. Reve
Revenue - Schedule of U.K. Revenue Attributed to Each Category (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Disaggregation of Revenue [Line Items] | ||
Revenue | $ 782,810 | $ 760,617 |
U.K. Facilities [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 273,593 | 272,657 |
U.K. Facilities [Member] | Health Care Facilities [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 148,137 | 151,708 |
U.K. Facilities [Member] | Education and Children's Services [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 46,666 | 46,122 |
U.K. Facilities [Member] | Adult Care Facilities [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | $ 78,790 | $ 74,827 |
Revenue - Schedule of U.K. Re_2
Revenue - Schedule of U.K. Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 782,810 | $ 760,617 |
U.K. Facilities [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 273,593 | $ 272,657 |
Revenue, Percentage | 100.00% | 100.00% |
U.K. Facilities [Member] | U.K. Public Funded Sources [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 246,136 | $ 245,413 |
Revenue, Percentage | 90.00% | 90.00% |
U.K. Facilities [Member] | Self-Pay [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 26,915 | $ 26,814 |
Revenue, Percentage | 9.80% | 9.80% |
U.K. Facilities [Member] | Other [Member] | ||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | ||
Revenue | $ 542 | $ 430 |
Revenue, Percentage | 0.20% | 0.20% |
Revenue - Summary of the Activi
Revenue - Summary of the Activity in Unearned Revenue (Detail) - U.K. Facilities [Member] - Unearned Revenue [Member] $ in Thousands | 3 Months Ended |
Mar. 31, 2020USD ($) | |
Disaggregation of Revenue [Line Items] | |
Beginning Balance | $ 36,579 |
Payments received | 38,152 |
Revenue recognized | (42,787) |
Foreign currency translation loss | (1,891) |
Ending Balance | $ 30,053 |
Earnings Per Share - Computatio
Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | ||||
Mar. 31, 2020 | Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | |
Numerator: | |||||
Net income attributable to Acadia Healthcare Company, Inc. | $ 33,463 | $ (11,254) | $ 42,566 | $ 48,140 | $ 29,471 |
Denominator: | |||||
Weighted average shares outstanding for basic earnings per share | 87,765 | 87,505 | |||
Effect of dilutive instruments | 206 | 189 | |||
Shares used in computing diluted earnings per common share | 87,971 | 87,694 | |||
Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders: | |||||
Basic | $ 0.38 | $ 0.34 | |||
Diluted | $ 0.38 | $ 0.34 |
Earnings Per Share - Additional
Earnings Per Share - Additional Information (Detail) - shares shares in Millions | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Earnings Per Share [Abstract] | ||
Excluded common stock for computation of diluted earnings per share | 2.9 | 2.6 |
Acquisitions - Additional Infor
Acquisitions - Additional Information (Detail) $ in Millions | Apr. 01, 2019USD ($)Bed | Feb. 15, 2019USD ($)BedCenter | Mar. 31, 2020Bed |
Business Acquisition [Line Items] | |||
Number of beds | Bed | 18,200 | ||
Bradford [Member] | |||
Business Acquisition [Line Items] | |||
Number of beds | Bed | 46 | ||
Business acquisition cash consideration | $ | $ 4.5 | ||
Whittier Pavilion [Member] | Massachusetts [Member] | |||
Business Acquisition [Line Items] | |||
Number of beds | Bed | 71 | ||
Business acquisition cash consideration | $ | $ 17.9 | ||
Mission Treatment [Member] | California, Nevada, Arizona and Oklahoma [Member] | |||
Business Acquisition [Line Items] | |||
Business acquisition cash consideration | $ | $ 22.5 | ||
Number of comprehensive treatment centers operates | Center | 9 |
Acquisitions - Transaction Rela
Acquisitions - Transaction Related Expenses as Incurred (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Business Combinations [Abstract] | ||
Termination, restructuring, sale and strategic review costs | $ 2,221 | $ 2,282 |
Legal, accounting and other acquisition-related costs | 1,328 | 796 |
Management transition costs | 1,243 | |
Transaction-related expenses | $ 3,549 | $ 4,321 |
Property and Equipment - Summar
Property and Equipment - Summary of Property and Equipment (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | $ 3,899,207 | $ 3,965,809 |
Less: accumulated depreciation | (747,468) | (741,775) |
Property and equipment, net | 3,151,739 | 3,224,034 |
Land [Member] | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 429,601 | 448,716 |
Building and Improvements [Member] | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 2,738,302 | 2,746,111 |
Equipment [Member] | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 502,246 | 516,769 |
Construction in Progress [Member] | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | $ 229,058 | $ 254,213 |
Property and Equipment - Additi
Property and Equipment - Additional Information (Detail) - USD ($) $ in Millions | Mar. 31, 2020 | Dec. 31, 2019 |
Other Assets [Member] | ||
Property Plant And Equipment [Line Items] | ||
Assets held for sale | $ 30.3 | $ 31.1 |
Other Intangible Assets - Other
Other Intangible Assets - Other Identifiable Intangible Assets and Related Accumulated Amortization (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items] | ||
Intangible assets subject to amortization, Gross Carrying Amount | $ 3,231 | $ 3,231 |
Intangible assets not subject to amortization, Gross Carrying Amount | 89,052 | 90,357 |
Total | 92,283 | 93,588 |
Intangible assets subject to amortization, Accumulated Amortization | (3,231) | (3,231) |
Intangible assets not subject to amortization, Accumulated Amortization | 0 | 0 |
Total | (3,231) | (3,231) |
Licenses and Accreditations [Member] | ||
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items] | ||
Intangible assets not subject to amortization, Gross Carrying Amount | 12,429 | 12,455 |
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 | 59,532 | 60,831 |
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 | 17,091 | 17,071 |
Intangible assets not subject to amortization, Accumulated Amortization | 0 | 0 |
Contract Intangible Assets [Member] | ||
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items] | ||
Intangible assets subject to amortization, Gross Carrying Amount | 2,100 | 2,100 |
Intangible assets subject to amortization, Accumulated Amortization | (2,100) | (2,100) |
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) |
Leases - Additional Information
Leases - Additional Information (Detail) | 3 Months Ended |
Mar. 31, 2020 | |
Minimum [Member] | |
Lessee Lease Description [Line Items] | |
Lessee operating and finance lease term of contract | 5 years |
Maximum [Member] | |
Lessee Lease Description [Line Items] | |
Lessee operating and finance lease term of contract | 30 years |
Copiers and Equipment [Member] | Minimum [Member] | |
Lessee Lease Description [Line Items] | |
Lessee operating and finance lease term of contract | 1 year |
Copiers and Equipment [Member] | Maximum [Member] | |
Lessee Lease Description [Line Items] | |
Lessee operating and finance lease term of contract | 3 years |
Leases - Schedule of Leases on
Leases - Schedule of Leases on Condensed Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Lessee Lease Description [Line Items] | ||
Operating lease right-of-use assets | $ 476,028 | $ 501,837 |
Total | 519,788 | 546,207 |
Finance lease liabilities | 6,637 | 6,819 |
Operating lease liabilities | 29,671 | 29,140 |
Finance lease liabilities | 43,295 | |
Operating lease liabilities | 474,746 | 502,252 |
Total | 554,349 | 581,873 |
Property and Equipment, Net [Member] | ||
Lessee Lease Description [Line Items] | ||
Finance lease right-of-use assets | 43,760 | 44,370 |
Operating Lease Right-of-use Assets [Member] | ||
Lessee Lease Description [Line Items] | ||
Operating lease right-of-use assets | 476,028 | 501,837 |
Other Accrued Liabilities [Member] | ||
Lessee Lease Description [Line Items] | ||
Finance lease liabilities | 6,637 | 6,819 |
Current Portion of Operating Lease Liabilities [Member] | ||
Lessee Lease Description [Line Items] | ||
Operating lease liabilities | 29,671 | 29,140 |
Other Liabilities [Member] | ||
Lessee Lease Description [Line Items] | ||
Finance lease liabilities | 43,295 | 43,662 |
Operating Lease Liabilities [Member] | ||
Lessee Lease Description [Line Items] | ||
Operating lease liabilities | $ 474,746 | $ 502,252 |
Leases - Schedule of Weighted-a
Leases - Schedule of Weighted-average Remaining Lease Terms and Discount Rates (Detail) | Mar. 31, 2020 | Dec. 31, 2019 |
Leases [Abstract] | ||
Finance lease, weighted average remaining lease term (years) | 6 years 8 months 12 days | 6 years 10 months 24 days |
Operating lease, weighted average remaining term (years) | 19 years | 19 years 4 months 24 days |
Finance lease, weighted average discount rate percent | 6.40% | 6.40% |
Operating lease, weighted average discount rate percent | 6.30% | 6.30% |
Leases - Schedule of Lease Cost
Leases - Schedule of Lease Cost (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Finance lease costs: | ||
Depreciation of leased assets | $ 1,137 | $ 1,123 |
Interest of lease liabilities | 997 | 997 |
Total finance lease costs | 2,134 | 2,120 |
Operating lease costs | 16,481 | 16,529 |
Variable lease costs | 1,310 | 886 |
Short term lease costs | 1,147 | 1,447 |
Other lease costs | 1,886 | 1,445 |
Total rents and leases | 20,824 | 20,307 |
Total lease costs | $ 22,958 | $ 22,427 |
Leases - Schedule of Undiscount
Leases - Schedule of Undiscounted Cash Flows for Finance and Operating Leases (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Finance Leases | ||
For the nine months ending December 31, 2020 | $ 5,549 | |
2021 | 35,726 | |
2022 | 2,845 | |
2023 | 1,620 | |
2024 | 1,027 | |
Thereafter | 25,088 | |
Total minimum lease payments | 71,855 | |
Less: amount of lease payments representing interest | 21,923 | |
Present value of future minimum lease payments | 49,932 | |
Less: Current portion of lease liabilities | 6,637 | $ 6,819 |
Noncurrent lease liabilities | 43,295 | |
Operating Leases | ||
For the nine months ending December 31, 2020 | 45,846 | |
2021 | 58,023 | |
2022 | 52,956 | |
2023 | 48,544 | |
2024 | 46,312 | |
Thereafter | 650,931 | |
Total minimum lease payments | 902,612 | |
Less: amount of lease payments representing interest | 398,195 | |
Present value of future minimum lease payments | 504,417 | |
Current portion of operating lease liabilities | 29,671 | 29,140 |
Operating lease liabilities | $ 474,746 | $ 502,252 |
Leases - Schedule of Supplement
Leases - Schedule of Supplemental Data (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Cash paid for amounts included in the measurement of lease liabilities: | ||
Operating cash flows for operating leases | $ 15,836 | $ 15,809 |
Operating cash flows for finance leases | 997 | 997 |
Financing cash flows for finance leases | 878 | 846 |
Right-of-use assets obtained in exchange for lease obligations: | ||
Operating leases | 6,082 | 3,662 |
Finance leases | $ 953 | $ 1,027 |
Long-Term Debt - Components of
Long-Term Debt - Components of Long-Term Debt (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 | Sep. 21, 2015 |
Debt Instrument [Line Items] | |||
Other long-term debt | $ 4,533 | $ 4,821 | |
Less: unamortized debt issuance costs, discount and premium | (28,698) | (31,400) | |
Long-term debt | 3,140,892 | 3,149,099 | |
Less: current portion | (196,072) | (43,679) | |
Long-term debt | 2,944,820 | 3,105,420 | |
Amended and Restated Senior Credit Facility [Member] | Senior Secured Term A Loan [Member] | |||
Debt Instrument [Line Items] | |||
Senior Secured | 339,625 | 346,750 | |
Amended and Restated Senior Credit Facility [Member] | Senior Secured Term B Loans [Member] | |||
Debt Instrument [Line Items] | |||
Senior Secured | 1,335,432 | 1,338,928 | |
6.125% Senior Notes Due 2021 [Member] | |||
Debt Instrument [Line Items] | |||
Senior Notes | 150,000 | 150,000 | |
5.125% Senior Notes Due 2022 [Member] | |||
Debt Instrument [Line Items] | |||
Senior Notes | 300,000 | 300,000 | |
5.625% Senior Notes Due 2023 [Member] | |||
Debt Instrument [Line Items] | |||
Senior Notes | 650,000 | 650,000 | $ 650,000 |
6.500% Senior Notes Due 2024 [Member] | |||
Debt Instrument [Line Items] | |||
Senior Notes | $ 390,000 | $ 390,000 |
Long-Term Debt - Components o_2
Long-Term Debt - Components of Long-Term Debt (Parenthetical) (Detail) | 3 Months Ended | 12 Months Ended | |||||
Mar. 31, 2020 | Dec. 31, 2019 | Feb. 16, 2016 | Sep. 21, 2015 | Feb. 11, 2015 | 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% | 6.125% | ||||
Senior notes maturity year | 2021 | 2021 | |||||
5.125% Senior Notes Due 2022 [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Debt instrument interest rate | 5.125% | 5.125% | 5.125% | ||||
Senior notes maturity year | 2022 | 2022 | |||||
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 |
Long-Term Debt (Amended and Res
Long-Term Debt (Amended and Restated Senior Credit Facility) - Additional Information (Detail) - USD ($) $ in Thousands | Apr. 21, 2020 | Feb. 27, 2019 | Feb. 06, 2019 | Dec. 15, 2015 | Dec. 31, 2012 | Apr. 01, 2011 | Apr. 30, 2020 | Mar. 31, 2020 | Mar. 31, 2019 | Dec. 31, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Mar. 31, 2016 | Dec. 31, 2017 | Dec. 15, 2014 |
Debt Instrument [Line Items] | |||||||||||||||
Borrowings on revolving credit facility | $ 71,573 | ||||||||||||||
Consolidated funded debt, unrestricted and unencumbered cash to consolidated EBITDA | $ 50,000 | ||||||||||||||
Eurodollar [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Interest on borrowings | 2.50% | ||||||||||||||
Base Rate Loans [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Interest on borrowings | 1.50% | ||||||||||||||
Tranche B-3 Facility [Member] | Eurodollar [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Interest on borrowings | 2.50% | ||||||||||||||
Basis spread on variable rate | 1.00% | ||||||||||||||
Tranche B-3 Facility [Member] | Base Rate Loans [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Interest on borrowings | 1.50% | ||||||||||||||
Basis spread on variable rate | 0.50% | ||||||||||||||
Tranche B-3 Facility [Member] | London Interbank Offered Rate (LIBOR) [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Interest on borrowings | 0.75% | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Date entered into an agreement | Dec. 31, 2012 | Apr. 1, 2011 | |||||||||||||
Amount available under revolving line of credit | $ 485,000 | ||||||||||||||
Debt instrument maturity date | Nov. 30, 2021 | Feb. 11, 2022 | |||||||||||||
Term loan repayments | $ 1,200 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | Eurodollar [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Basis spread on variable rate | 1.00% | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | Base Rate Loans [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Basis spread on variable rate | 0.50% | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Interest on borrowings | 2.50% | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | Tranche B-3 Facility [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Term loan repayments | $ 447,300 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | Tranche B-4 Facilities [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Debt instrument maturity date | Feb. 16, 2023 | ||||||||||||||
Term loan repayments | $ 854,400 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | Tranche B-4 Facilities [Member] | Eurodollar [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Interest on borrowings | 2.50% | ||||||||||||||
Basis spread on variable rate | 1.00% | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | Tranche B-4 Facilities [Member] | Base Rate Loans [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Interest on borrowings | 1.50% | ||||||||||||||
Basis spread on variable rate | 0.50% | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | Tranche B-4 Facilities [Member] | London Interbank Offered Rate (LIBOR) [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Interest on borrowings | 0.75% | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | June 30, 2020 to December 31, 2020 [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Term loan principal repayments | $ 7,100 | ||||||||||||||
Term loan repayments | $ 1,200 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | March 31, 2021 to September 30, 2021 [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Term loan principal repayments | $ 9,500 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | March 31, 2019 to December 31, 2019 [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Term loan repayments | $ 1,200 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | September 30, 2015 to December 31, 2015 [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Term loan repayments | $ 1,200 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | Standby Letters Of Credit [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Standby letters of credit outstanding | $ 15,000 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | TLB Facility Due on February 16, 2023 [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Term loan repayments | $ 2,300 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | TLB Facility Due on February 16, 2023 [Member] | June 30, 2020 to December 31, 2020 [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Term loan repayments | $ 2,300 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | TLB Facility Due on February 16, 2023 [Member] | March 31, 2019 to December 31, 2019 [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Term loan repayments | $ 2,300 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | TLB Facility Due on February 16, 2023 [Member] | September 30, 2015 to December 31, 2015 [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Term loan repayments | $ 2,300 | ||||||||||||||
Amended and Restated Senior Credit Facility [Member] | Subsequent Event [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Borrowings on revolving credit facility | $ 100,000 | ||||||||||||||
Eleventh Amendment [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Date entered into an agreement | Feb. 6, 2019 | ||||||||||||||
Twelfth Amendment [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Date entered into an agreement | Feb. 27, 2019 | ||||||||||||||
Thirteenth Amendment [Member] | Subsequent Event [Member] | |||||||||||||||
Debt Instrument [Line Items] | |||||||||||||||
Date entered into an agreement | Apr. 21, 2020 |
Long-Term Debt (6.125% Senior N
Long-Term Debt (6.125% Senior Notes due 2021) - Additional Information (Detail) - 6.125% Senior Notes Due 2021 [Member] - USD ($) | Mar. 12, 2013 | Mar. 31, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | |||
Issued Senior Notes | $ 150,000,000 | ||
Debt instrument interest rate | 6.125% | 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 |
Long-Term Debt (5.125% Senior N
Long-Term Debt (5.125% Senior Notes due 2022) - Additional Information (Detail) - 5.125% Senior Notes Due 2022 [Member] - USD ($) | Jul. 01, 2014 | Mar. 31, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | |||
Issued Senior Notes | $ 300,000,000 | ||
Debt instrument interest rate | 5.125% | 5.125% | 5.125% |
Debt instrument maturity date | Jul. 1, 2022 | ||
Interest on the notes | payable semi-annually in arrears on January 1 and July 1 of each year |
Long-Term Debt (5.625% Senior N
Long-Term Debt (5.625% Senior Notes due 2023) - Additional Information (Detail) - 5.625% Senior Notes Due 2023 [Member] - USD ($) | 3 Months Ended | |||
Mar. 31, 2020 | Dec. 31, 2019 | Sep. 21, 2015 | Feb. 11, 2015 | |
Debt Instrument [Line Items] | ||||
Issued Senior Notes | $ 275,000,000 | $ 375,000,000 | ||
Debt instrument interest rate | 5.625% | 5.625% | 5.625% | 5.625% |
Senior Notes | $ 650,000,000 | $ 650,000,000 | $ 650,000,000 | |
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 |
Long-Term Debt (6.500% Senior N
Long-Term Debt (6.500% Senior Notes due 2024) - Additional Information (Detail) - 6.500% Senior Notes Due 2024 [Member] - USD ($) | Feb. 16, 2016 | Mar. 31, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | |||
Issued Senior Notes | $ 390,000,000 | ||
Debt instrument interest rate | 6.50% | 6.50% | 6.50% |
Debt instrument maturity date | Mar. 1, 2024 | ||
Interest on the notes | payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2016 |
Equity-Based Compensation - Add
Equity-Based Compensation - Additional Information (Detail) - USD ($) | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Authorized common stock | 8,200,000 | |
Annual increments in employee grants | 25.00% | |
Equity incentive plan available for future grant | 1,024,052 | |
Stock options, contractual term | 10 years | |
Equity-based compensation expense | $ 4,979,000 | $ 6,101,000 |
Unrecognized compensation expense related to unvested options | $ 50,800,000 | |
Vesting period | 1 year 6 months | |
Warrant outstanding | $ 0 | |
Deferred income tax benefit | 11,286,000 | (666,000) |
Stock Compensation Plan [Member] | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Deferred income tax benefit | $ 1,300,000 | $ 1,600,000 |
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% |
Equity-Based Compensation - Sto
Equity-Based Compensation - Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |||
Options outstanding, Beginning balance | 1,360,068 | 1,199,540 | |
Options granted | 443,200 | 605,200 | |
Options exercised | (55,671) | ||
Options cancelled | (105,462) | (389,001) | |
Options outstanding, Ending balance | 1,697,806 | 1,360,068 | 1,199,540 |
Options exercisable, Ending balance | 702,956 | 513,290 | |
Options outstanding, Weighted Average Exercise Price, Beginning balance | $ 39.40 | $ 44.64 | |
Options granted, Weighted Average Exercise Price | 33.72 | 28.50 | |
Options exercised, Weighted Average Exercise Price | 19.05 | ||
Options cancelled, Weighted Average Exercise Price | 41 | 40.84 | |
Options outstanding, Weighted Average Exercise Price, Ending balance | 37.81 | 39.40 | $ 44.64 |
Options exercisable, Weighted Average Exercise Price, Ending balance | $ 44.08 | $ 48.08 | |
Options outstanding, Weighted Average Remaining Contractual Term | 7 years 11 months 19 days | 7 years 6 months 25 days | 7 years 3 months 3 days |
Options granted, Weighted Average Remaining Contractual Term | 9 years 10 months 28 days | 9 years 2 months 15 days | |
Options exercisable, Weighted Average Remaining Contractual Term, Ending balance | 6 years 4 months 9 days | 5 years 10 months 17 days | |
Options outstanding, Aggregate Intrinsic Value | $ 659 | $ 1,650 | $ 2,717 |
Options granted, Aggregate Intrinsic Value | 1,343 | ||
Options exercised, Aggregate Intrinsic Value | 658 | ||
Options cancelled, Aggregate Intrinsic Value | 0 | 0 | |
Options exercisable, Aggregate Intrinsic Value, Ending balance | $ 479 | $ 512 |
Equity-Based Compensation - Sch
Equity-Based Compensation - Schedule of Stock Options Valuation Assumptions (Detail) - $ / shares | 3 Months Ended | 12 Months Ended |
Mar. 31, 2020 | Dec. 31, 2019 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | ||
Weighted average grant-date fair value of options | $ 12.29 | $ 17.59 |
Risk-free interest rate | 1.60% | 2.40% |
Expected volatility | 39.00% | 38.00% |
Expected life (in years) | 5 years | 5 years |
Equity-Based Compensation - Res
Equity-Based Compensation - Restricted Stock Activity (Detail) - Restricted Stock Award [Member] - $ / shares | 3 Months Ended | 12 Months Ended |
Mar. 31, 2020 | Dec. 31, 2019 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Unvested, Number of Shares/Units, Beginning balance | 805,136 | 805,057 |
Granted, Number of Shares | 511,006 | 700,937 |
Cancelled, Number of Shares | (57,782) | (389,684) |
Vested, Number of Shares | (160,398) | (311,174) |
Unvested, Number of Shares/Units, Ending balance | 1,097,962 | 805,136 |
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance | $ 34.14 | $ 42.40 |
Granted, Weighted Average Grant-Date Fair Value | 25.37 | 28.77 |
Cancelled, Weighted Average Grant-Date Fair Value | 35.55 | 33.50 |
Vested, Weighted Average Grant-Date Fair Value | 36.73 | 44.23 |
Unvested, Weighted Average Grant-Date Fair Value, Ending balance | $ 29.61 | $ 34.14 |
Equity-Based Compensation - R_2
Equity-Based Compensation - Restricted Stock Unit Activity (Detail) - Restricted Stock Units [Member] - $ / shares | 3 Months Ended | 12 Months Ended |
Mar. 31, 2020 | Dec. 31, 2019 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Unvested, Number of Shares/Units, Beginning balance | 447,357 | 484,111 |
Granted, Number of Units | 583,680 | 234,408 |
Cancelled, Number of Units | (10,123) | (271,162) |
Vested, Number of Units | (12,691) | |
Unvested, Number of Shares/Units, Ending balance | 1,008,223 | 447,357 |
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance | $ 38.89 | $ 44.52 |
Granted, Weighted Average Grant-Date Fair Value | 10.60 | 34.54 |
Cancelled, Weighted Average Grant-Date Fair Value | 42.09 | 45.17 |
Vested, Weighted Average Grant-Date Fair Value | 42.09 | |
Unvested, Weighted Average Grant-Date Fair Value, Ending balance | $ 22.44 | $ 38.89 |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Income Tax Disclosure [Abstract] | ||
Effective tax rates | 14.50% | 20.00% |
Derivatives - Additional Inform
Derivatives - Additional Information (Detail) | 1 Months Ended | ||||||
Aug. 31, 2019USD ($) | Aug. 31, 2019GBP (£) | Mar. 31, 2020USD ($) | Dec. 31, 2019USD ($) | Aug. 31, 2019GBP (£) | May 31, 2016USD ($) | May 31, 2016GBP (£) | |
Derivative [Line Items] | |||||||
Cross currency swap liabilities | $ (9,000,000) | $ (68,900,000) | |||||
Cross Currency Swap Assets [Member] | |||||||
Derivative [Line Items] | |||||||
Notional amount | $ 650,000,000 | £ 538,100,000 | $ 650,000,000 | £ 449,300,000 | |||
Terminated cross currency swap derivatives | 105,000,000 | ||||||
Cross currency swap agreement cash flow due to interest payment | $ 35,800,000 | £ 25,400,000 |
Fair Value Measurements - Carry
Fair Value Measurements - Carrying Amounts and Fair Values of Company's Amended and Restated Senior Credit Facilities and Contingent Consideration Liabilities (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Other long-term debt | $ 4,533 | $ 4,821 |
Carrying Amount [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Other long-term debt | 4,533 | 4,821 |
Derivative instrument liabilities | (9,015) | (68,915) |
Carrying Amount [Member] | Amended and Restated Senior Credit Facility [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Secured | 1,659,098 | 1,668,062 |
Carrying Amount [Member] | 6.125% Senior Notes Due 2021 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 149,409 | 149,254 |
Carrying Amount [Member] | 5.125% Senior Notes Due 2022 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 297,973 | 297,761 |
Carrying Amount [Member] | 5.625% Senior Notes Due 2023 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 645,156 | 644,771 |
Carrying Amount [Member] | 6.500% Senior Notes due 2024 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 384,723 | 384,430 |
Fair Value [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Other long-term debt | 4,533 | 4,821 |
Derivative instrument liabilities | (9,015) | (68,915) |
Fair Value [Member] | Amended and Restated Senior Credit Facility [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Amended and Restated Senior Credit Facility | 1,659,098 | 1,668,062 |
Fair Value [Member] | 6.125% Senior Notes Due 2021 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 144,927 | 149,441 |
Fair Value [Member] | 5.125% Senior Notes Due 2022 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 283,998 | 299,994 |
Fair Value [Member] | 5.625% Senior Notes Due 2023 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 607,995 | 655,249 |
Fair Value [Member] | 6.500% Senior Notes due 2024 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | $ 374,143 | $ 398,366 |
Fair Value Measurements - Addit
Fair Value Measurements - Additional Information (Detail) | Mar. 31, 2020 | Dec. 31, 2019 | Feb. 16, 2016 | Sep. 21, 2015 | Feb. 11, 2015 | 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% | 6.125% | ||||
5.125% Senior Notes Due 2022 [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Debt instrument interest rate | 5.125% | 5.125% | 5.125% | ||||
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% |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Detail) | 3 Months Ended |
Mar. 31, 2020USD ($) | |
Loss Contingencies [Line Items] | |
Maximum professional liability aggregate policy limit | $ 75,000,000 |
Maximum [Member] | |
Loss Contingencies [Line Items] | |
Maximum self insured professional liability limit per claim | 3,000,000 |
Minimum [Member] | |
Loss Contingencies [Line Items] | |
Maximum professional liability retention limit | $ 3,000,000 |
Noncontrolling Interests - Addi
Noncontrolling Interests - Additional Information (Detail) | 3 Months Ended |
Mar. 31, 2020Facility | |
Noncontrolling Interest [Line Items] | |
Number of facilities operated by non-wholly owned subsidiaries | 5 |
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% |
Noncontrolling Interests - Summ
Noncontrolling Interests - Summary of Redeemable Noncontrolling Interests (Detail) $ in Thousands | 3 Months Ended |
Mar. 31, 2020USD ($) | |
Noncontrolling Interest [Abstract] | |
Beginning Balance | $ 33,151 |
Net income attributable to noncontrolling interests | 604 |
Dividend payments to noncontrolling interests | (264) |
Ending Balance | $ 33,491 |
Other Current Assets - Other Cu
Other Current Assets - Other Current Assets (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract] | ||
Prepaid expenses | $ 22,161 | $ 23,708 |
Cost report receivable | 14,402 | 13,723 |
Other receivables | 14,257 | 16,097 |
Workers’ compensation deposits – current portion | 10,000 | 10,000 |
Income taxes receivable | 9,358 | 5,579 |
Insurance receivable – current portion | 5,739 | 3,030 |
Inventory | 4,882 | 4,759 |
Other | 1,644 | 1,348 |
Other current assets | $ 82,443 | $ 78,244 |
Other Accrued Liabilities - Sum
Other Accrued Liabilities - Summary of Other Accrued Liabilities (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Accounts Payable And Accrued Liabilities Current [Abstract] | ||
Accrued expenses | $ 41,131 | $ 50,614 |
Unearned income | 31,631 | 38,475 |
Accrued interest | 11,660 | 33,323 |
Finance lease liabilities | 6,637 | 6,819 |
Insurance liability – current portion | 4,731 | 4,731 |
Accrued property taxes | 4,222 | 4,755 |
Other | 4,346 | 2,443 |
Other accrued liabilities | $ 104,358 | $ 141,160 |
Segment Information - Additiona
Segment Information - Additional Information (Detail) | 3 Months Ended |
Mar. 31, 2020FacilityBedState | |
Segment Reporting Information [Line Items] | |
Number of facilities | Facility | 588 |
Number of beds | Bed | 18,200 |
Number of operating states | State | 40 |
U.S. Facilities [Member] | |
Segment Reporting Information [Line Items] | |
Number of facilities | Facility | 228 |
Number of beds | Bed | 9,600 |
Number of operating states | State | 40 |
U.K. Facilities [Member] | |
Segment Reporting Information [Line Items] | |
Number of facilities | Facility | 360 |
Number of beds | Bed | 8,700 |
Segment Information - Summary o
Segment Information - Summary of Reconciliation of Segment EBITDA to Income before Income Taxes (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Segment Reporting Information [Line Items] | ||
Revenue | $ 782,810 | $ 760,617 |
Segment EBITDA | 132,849 | 136,003 |
Equity-based compensation expense | (4,979) | (6,101) |
Transaction-related expenses | (3,549) | (4,321) |
Interest expense, net | (42,785) | (48,130) |
Depreciation and amortization | (41,680) | (40,580) |
Income before income taxes | 39,856 | 36,871 |
U.S. Facilities [Member] | ||
Segment Reporting Information [Line Items] | ||
Revenue | 509,217 | 487,960 |
U.S. Facilities [Member] | Operating Segment [Member] | ||
Segment Reporting Information [Line Items] | ||
Revenue | 509,217 | 487,960 |
Segment EBITDA | 120,074 | 119,008 |
U.K. Facilities [Member] | ||
Segment Reporting Information [Line Items] | ||
Revenue | 273,593 | 272,657 |
U.K. Facilities [Member] | Operating Segment [Member] | ||
Segment Reporting Information [Line Items] | ||
Revenue | 273,593 | 272,657 |
Segment EBITDA | 36,168 | 40,056 |
Corporate and Other [Member] | Corporate Reconciling Items and Eliminations [Member] | ||
Segment Reporting Information [Line Items] | ||
Segment EBITDA | $ (23,393) | $ (23,061) |
Segment Information - Summary_2
Segment Information - Summary of Financial Information by Operating Segment, Goodwill (Detail) $ in Thousands | 3 Months Ended |
Mar. 31, 2020USD ($) | |
Goodwill: | |
Goodwill | $ 2,775,006 |
Accumulated impairment loss | (325,875) |
Net goodwill, beginning balance | 2,449,131 |
Prior period purchase price adjustments | (13) |
Foreign currency translation gain | (22,418) |
Goodwill | 2,752,575 |
Accumulated impairment loss | (325,875) |
Net goodwill, ending balance | 2,426,700 |
U.S. Facilities [Member] | Operating Segment [Member] | |
Goodwill: | |
Goodwill | 2,085,104 |
Net goodwill, beginning balance | 2,085,104 |
Prior period purchase price adjustments | (13) |
Goodwill | 2,085,091 |
Net goodwill, ending balance | 2,085,091 |
U.K. Facilities [Member] | Operating Segment [Member] | |
Goodwill: | |
Goodwill | 689,902 |
Accumulated impairment loss | (325,875) |
Net goodwill, beginning balance | 364,027 |
Foreign currency translation gain | (22,418) |
Goodwill | 667,484 |
Accumulated impairment loss | (325,875) |
Net goodwill, ending balance | $ 341,609 |
Segment Information - Summary_3
Segment Information - Summary of Financial Information by Operating Segment, Assets (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Assets: | ||
Assets | $ 6,717,995 | $ 6,879,142 |
U.S. Facilities [Member] | Operating Segment [Member] | ||
Assets: | ||
Assets | 4,083,825 | 4,037,968 |
U.K. Facilities [Member] | Operating Segment [Member] | ||
Assets: | ||
Assets | 2,443,498 | 2,610,357 |
Corporate and Other [Member] | Corporate Reconciling Items and Eliminations [Member] | ||
Assets: | ||
Assets | $ 190,672 | $ 230,817 |
Segment Information - Summary_4
Segment Information - Summary of Financial Information by Operating Segment, Assets (Parenthetical) (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 |
Segment Reporting, Asset Reconciling Item [Line Items] | ||
Property and equipment, net | $ 3,151,739 | $ 3,224,034 |
Operating Segment [Member] | U.S. Facilities [Member] | ||
Segment Reporting, Asset Reconciling Item [Line Items] | ||
Property and equipment, net | 1,500,000 | 1,400,000 |
Operating Segment [Member] | U.K. Facilities [Member] | ||
Segment Reporting, Asset Reconciling Item [Line Items] | ||
Property and equipment, net | 1,600,000 | 1,700,000 |
Corporate Reconciling Items and Eliminations [Member] | Corporate and Other [Member] | ||
Segment Reporting, Asset Reconciling Item [Line Items] | ||
Property and equipment, net | $ 57,300 | $ 50,900 |
Accumulated Other Comprehensi_3
Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | $ 2,505,381 | $ 2,333,307 |
Foreign currency translation (loss) gain | (122,000) | 44,481 |
Gain on derivative instruments, net of tax of $16.3 million | 43,746 | (8,690) |
Balance | 2,464,167 | 2,403,343 |
Foreign Currency Translation Adjustments [Member] | ||
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | (434,633) | |
Foreign currency translation (loss) gain | (122,321) | |
Balance | (556,954) | |
Change in Fair Value of Derivative Instruments [Member] | ||
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | 24,958 | |
Gain on derivative instruments, net of tax of $16.3 million | 43,746 | |
Balance | 68,704 | |
Pension Plan [Member] | ||
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | (5,209) | |
Foreign currency translation (loss) gain | 321 | |
Balance | (4,888) | |
Other Comprehensive Loss [Member] | ||
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | (414,884) | (462,377) |
Balance | $ (493,138) | $ (426,586) |
Accumulated Other Comprehensi_4
Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Accumulated Other Comprehensive Income Loss Net Of Tax [Abstract] | ||
Gain on derivative instruments, tax | $ 16.3 | $ (3.5) |
Financial Information for the_3
Financial Information for the Company and Its Subsidiaries - Additional Information (Detail) | Mar. 31, 2020 | Dec. 31, 2019 | Feb. 16, 2016 | Sep. 21, 2015 | Feb. 11, 2015 | Jul. 01, 2014 | Mar. 12, 2013 |
6.125% Senior Notes Due 2021 [Member] | |||||||
Line of Credit Facility [Line Items] | |||||||
Debt instrument interest rate | 6.125% | 6.125% | 6.125% | ||||
5.125% Senior Notes Due 2022 [Member] | |||||||
Line of Credit Facility [Line Items] | |||||||
Debt instrument interest rate | 5.125% | 5.125% | 5.125% | ||||
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% |
Financial Information for the_4
Financial Information for the Company and Its Subsidiaries - Summary of Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands | Mar. 31, 2020 | Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Dec. 31, 2018 |
Current assets: | ||||||
Cash and cash equivalents | $ 81,004 | $ 124,192 | ||||
Accounts receivable, net | 339,505 | 339,775 | ||||
Other current assets | 82,443 | 78,244 | ||||
Total current assets | 502,952 | 542,211 | ||||
Property and equipment, net | 3,151,739 | 3,224,034 | ||||
Goodwill | 2,426,700 | 2,449,131 | ||||
Intangible assets, net | 89,052 | 90,357 | ||||
Deferred tax assets | 3,307 | 3,339 | ||||
Operating lease right-of-use assets | 476,028 | 501,837 | ||||
Other assets | 68,217 | 68,233 | ||||
Total assets | 6,717,995 | 6,879,142 | ||||
Current liabilities: | ||||||
Current portion of long-term debt | 196,072 | 43,679 | ||||
Accounts payable | 134,693 | 127,045 | ||||
Accrued salaries and benefits | 114,790 | 122,552 | ||||
Current portion of operating lease liabilities | 29,671 | 29,140 | ||||
Other accrued liabilities | 104,358 | 141,160 | ||||
Total current liabilities | 579,584 | 463,576 | ||||
Long-term debt | 2,944,820 | 3,105,420 | ||||
Deferred tax liabilities | 85,405 | 71,860 | ||||
Operating lease liabilities | 474,746 | 502,252 | ||||
Derivative instrument liabilities | 9,015 | 68,915 | ||||
Other liabilities | 126,767 | 128,587 | ||||
Total liabilities | 4,220,337 | 4,340,610 | ||||
Redeemable noncontrolling interests | 33,491 | 33,151 | ||||
Total equity | 2,464,167 | 2,505,381 | $ 2,420,691 | $ 2,422,346 | $ 2,403,343 | $ 2,333,307 |
Total liabilities and equity | 6,717,995 | 6,879,142 | ||||
Parent [Member] | ||||||
Current assets: | ||||||
Deferred tax assets | 1,303 | 1,403 | ||||
Investment in subsidiaries | 5,390,417 | 5,521,340 | ||||
Other assets | 234,014 | 233,975 | ||||
Total assets | 5,625,734 | 5,756,718 | ||||
Current liabilities: | ||||||
Current portion of long-term debt | 196,072 | 43,679 | ||||
Other accrued liabilities | 11,660 | 33,323 | ||||
Total current liabilities | 207,732 | 77,002 | ||||
Long-term debt | 2,944,820 | 3,105,420 | ||||
Derivative instrument liabilities | 9,015 | 68,915 | ||||
Total liabilities | 3,161,567 | 3,251,337 | ||||
Total equity | 2,464,167 | 2,505,381 | ||||
Total liabilities and equity | 5,625,734 | 5,756,718 | ||||
Combined Subsidiary Guarantors [Member] | ||||||
Current assets: | ||||||
Cash and cash equivalents | 51,340 | 98,943 | ||||
Accounts receivable, net | 272,098 | 266,864 | ||||
Other current assets | 65,346 | 61,508 | ||||
Total current assets | 388,784 | 427,315 | ||||
Property and equipment, net | 1,348,045 | 1,313,830 | ||||
Goodwill | 1,992,332 | 1,992,344 | ||||
Intangible assets, net | 58,312 | 58,291 | ||||
Operating lease right-of-use assets | 98,166 | 97,396 | ||||
Other assets | 48,597 | 48,949 | ||||
Total assets | 3,934,236 | 3,938,125 | ||||
Current liabilities: | ||||||
Accounts payable | 97,196 | 87,165 | ||||
Accrued salaries and benefits | 82,072 | 89,483 | ||||
Current portion of operating lease liabilities | 18,571 | 17,967 | ||||
Other accrued liabilities | 26,021 | 22,672 | ||||
Total current liabilities | 223,860 | 217,287 | ||||
Deferred tax liabilities | 41,087 | 21,858 | ||||
Operating lease liabilities | 85,577 | 85,365 | ||||
Other liabilities | 110,923 | 110,445 | ||||
Total liabilities | 461,447 | 434,955 | ||||
Total equity | 3,472,789 | 3,503,170 | ||||
Total liabilities and equity | 3,934,236 | 3,938,125 | ||||
Combined Non-Guarantors [Member] | ||||||
Current assets: | ||||||
Cash and cash equivalents | 29,664 | 25,249 | ||||
Accounts receivable, net | 67,407 | 72,911 | ||||
Other current assets | 17,097 | 16,736 | ||||
Total current assets | 114,168 | 114,896 | ||||
Property and equipment, net | 1,803,694 | 1,910,204 | ||||
Goodwill | 434,368 | 456,787 | ||||
Intangible assets, net | 30,740 | 32,066 | ||||
Deferred tax assets | 3,307 | 3,339 | ||||
Operating lease right-of-use assets | 377,862 | 404,441 | ||||
Other assets | 12,214 | 13,127 | ||||
Total assets | 2,776,353 | 2,934,860 | ||||
Current liabilities: | ||||||
Accounts payable | 37,497 | 39,880 | ||||
Accrued salaries and benefits | 32,718 | 33,069 | ||||
Current portion of operating lease liabilities | 11,100 | 11,173 | ||||
Other accrued liabilities | 66,677 | 85,165 | ||||
Total current liabilities | 147,992 | 169,287 | ||||
Long-term debt | 226,608 | 227,818 | ||||
Deferred tax liabilities | 45,621 | 51,405 | ||||
Operating lease liabilities | 389,169 | 416,887 | ||||
Other liabilities | 15,844 | 18,142 | ||||
Total liabilities | 825,234 | 883,539 | ||||
Redeemable noncontrolling interests | 33,491 | 33,151 | ||||
Total equity | 1,917,628 | 2,018,170 | ||||
Total liabilities and equity | 2,776,353 | 2,934,860 | ||||
Consolidating Adjustments [Member] | ||||||
Current assets: | ||||||
Deferred tax assets | (1,303) | (1,403) | ||||
Investment in subsidiaries | (5,390,417) | (5,521,340) | ||||
Other assets | (226,608) | (227,818) | ||||
Total assets | (5,618,328) | (5,750,561) | ||||
Current liabilities: | ||||||
Long-term debt | (226,608) | (227,818) | ||||
Deferred tax liabilities | (1,303) | (1,403) | ||||
Total liabilities | (227,911) | (229,221) | ||||
Total equity | (5,390,417) | (5,521,340) | ||||
Total liabilities and equity | $ (5,618,328) | $ (5,750,561) |
Financial Information for the_5
Financial Information for the Company and Its Subsidiaries - Summary of Condensed Consolidating Statement of Comprehensive Income (Loss) (Detail) - USD ($) $ in Thousands | 3 Months Ended | ||||
Mar. 31, 2020 | Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | |
Condensed Financial Statements, Captions [Line Items] | |||||
Revenue | $ 782,810 | $ 760,617 | |||
Salaries, wages and benefits | 440,316 | 429,579 | |||
Professional fees | 63,300 | 57,007 | |||
Supplies | 31,971 | 29,957 | |||
Rents and leases | 20,824 | 20,307 | |||
Other operating expenses | 98,529 | 93,865 | |||
Depreciation and amortization | 41,680 | 40,580 | |||
Interest expense, net | 42,785 | 48,130 | |||
Transaction-related expenses | 3,549 | 4,321 | |||
Total expenses | 742,954 | 723,746 | |||
(Loss) income before income taxes | 39,856 | 36,871 | |||
(Benefit from) provision for income taxes | 5,789 | 7,360 | |||
Net income | 34,067 | 29,511 | |||
Net income attributable to noncontrolling interests | (604) | (40) | |||
Net income attributable to Acadia Healthcare Company, Inc. | 33,463 | $ (11,254) | $ 42,566 | $ 48,140 | 29,471 |
Other comprehensive income: | |||||
Foreign currency translation (loss) gain | (122,000) | 44,481 | |||
Loss on derivative instruments | 43,746 | (8,690) | |||
Other comprehensive (loss) income | (78,254) | $ 93,110 | $ (48,377) | $ (33,031) | 35,791 |
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc. | (44,791) | 65,262 | |||
Parent [Member] | |||||
Condensed Financial Statements, Captions [Line Items] | |||||
Salaries, wages and benefits | 4,979 | 6,101 | |||
Interest expense, net | 14,460 | 19,578 | |||
Total expenses | 19,439 | 25,679 | |||
(Loss) income before income taxes | (19,439) | (25,679) | |||
Equity in earnings of subsidiaries | 48,353 | 48,157 | |||
(Benefit from) provision for income taxes | (5,153) | (7,033) | |||
Net income | 34,067 | 29,511 | |||
Net income attributable to Acadia Healthcare Company, Inc. | 34,067 | 29,511 | |||
Other comprehensive income: | |||||
Loss on derivative instruments | 43,746 | (8,690) | |||
Other comprehensive (loss) income | 43,746 | (8,690) | |||
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc. | 77,813 | 20,821 | |||
Combined Subsidiary Guarantors [Member] | |||||
Condensed Financial Statements, Captions [Line Items] | |||||
Revenue | 474,612 | 459,818 | |||
Salaries, wages and benefits | 261,603 | 254,942 | |||
Professional fees | 28,558 | 25,368 | |||
Supplies | 20,859 | 19,384 | |||
Rents and leases | 8,883 | 8,403 | |||
Other operating expenses | 63,819 | 59,390 | |||
Depreciation and amortization | 21,046 | 19,605 | |||
Interest expense, net | 24,159 | 23,018 | |||
Transaction-related expenses | 1,525 | 3,218 | |||
Total expenses | 430,452 | 413,328 | |||
(Loss) income before income taxes | 44,160 | 46,490 | |||
(Benefit from) provision for income taxes | 11,712 | 17,065 | |||
Net income | 32,448 | 29,425 | |||
Net income attributable to Acadia Healthcare Company, Inc. | 32,448 | 29,425 | |||
Other comprehensive income: | |||||
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc. | 32,448 | 29,425 | |||
Combined Non-Guarantors [Member] | |||||
Condensed Financial Statements, Captions [Line Items] | |||||
Revenue | 308,198 | 300,799 | |||
Salaries, wages and benefits | 173,734 | 168,536 | |||
Professional fees | 34,742 | 31,639 | |||
Supplies | 11,112 | 10,573 | |||
Rents and leases | 11,941 | 11,904 | |||
Other operating expenses | 34,710 | 34,475 | |||
Depreciation and amortization | 20,634 | 20,975 | |||
Interest expense, net | 4,166 | 5,534 | |||
Transaction-related expenses | 2,024 | 1,103 | |||
Total expenses | 293,063 | 284,739 | |||
(Loss) income before income taxes | 15,135 | 16,060 | |||
(Benefit from) provision for income taxes | (770) | (2,672) | |||
Net income | 15,905 | 18,732 | |||
Net income attributable to noncontrolling interests | (604) | (40) | |||
Net income attributable to Acadia Healthcare Company, Inc. | 15,301 | 18,692 | |||
Other comprehensive income: | |||||
Foreign currency translation (loss) gain | (122,000) | 44,481 | |||
Other comprehensive (loss) income | (122,000) | 44,481 | |||
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc. | (106,699) | 63,173 | |||
Consolidating Adjustments [Member] | |||||
Condensed Financial Statements, Captions [Line Items] | |||||
Equity in earnings of subsidiaries | (48,353) | (48,157) | |||
Net income | (48,353) | (48,157) | |||
Net income attributable to Acadia Healthcare Company, Inc. | (48,353) | (48,157) | |||
Other comprehensive income: | |||||
Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc. | $ (48,353) | $ (48,157) |
Financial Information for the_6
Financial Information for the Company and Its Subsidiaries - Summary of Condensed Consolidating Statement of Cash Flows (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2020 | Mar. 31, 2019 | |
Operating activities: | ||
Net income (loss) | $ 34,067 | $ 29,511 |
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: | ||
Depreciation and amortization | 41,680 | 40,580 |
Amortization of debt issuance costs | 3,050 | 2,888 |
Equity-based compensation expense | 4,979 | 6,101 |
Deferred income taxes | 11,286 | (666) |
Other | (107) | 2,187 |
Change in operating assets and liabilities: | ||
Accounts receivable, net | (2,828) | (11,980) |
Other current assets | (19,131) | (5,875) |
Other assets | (1,096) | 295 |
Accounts payable and other accrued liabilities | (21,755) | (15,701) |
Accrued salaries and benefits | (6,030) | (5,849) |
Other liabilities | 1,431 | 2,182 |
Net cash provided by operating activities | 45,546 | 43,673 |
Investing activities: | ||
Cash paid for acquisitions, net of cash acquired | (40,400) | |
Cash paid for capital expenditures | (69,547) | (69,248) |
Cash paid for real estate acquisitions | (3,149) | (1,066) |
Proceeds from sale of property and equipment | 207 | 928 |
Other | (1,672) | (315) |
Net cash used in investing activities | (74,161) | (110,101) |
Financing activities: | ||
Borrowings on revolving credit facility | 71,573 | |
Principal payments on long-term debt | (10,621) | (8,246) |
Common stock withheld for minimum statutory taxes, net | (1,402) | (1,327) |
Distributions to noncontrolling interests | (264) | |
Other | (1,143) | (3,497) |
Net cash (used in) provided by financing activities | (13,430) | 58,503 |
Effect of exchange rate changes on cash | (1,143) | 1,099 |
Net decrease in cash and cash equivalents | (43,188) | (6,826) |
Cash and cash equivalents at beginning of the period | 124,192 | 50,510 |
Cash and cash equivalents at end of the period | 81,004 | 43,684 |
Parent [Member] | ||
Operating activities: | ||
Net income (loss) | 34,067 | 29,511 |
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: | ||
Equity in earnings of subsidiaries | (48,353) | (48,157) |
Amortization of debt issuance costs | 3,050 | 2,888 |
Equity-based compensation expense | 4,979 | 6,101 |
Deferred income taxes | 101 | (254) |
Other | (101) | 1,993 |
Change in operating assets and liabilities: | ||
Other assets | 82 | 2,665 |
Net cash provided by operating activities | (6,175) | (5,253) |
Financing activities: | ||
Borrowings on revolving credit facility | 71,573 | |
Principal payments on long-term debt | (10,621) | (8,246) |
Common stock withheld for minimum statutory taxes, net | (1,402) | (1,327) |
Other | (2,375) | |
Cash provided by (used in) intercompany activity | 18,198 | (54,372) |
Net cash (used in) provided by financing activities | 6,175 | 5,253 |
Combined Subsidiary Guarantors [Member] | ||
Operating activities: | ||
Net income (loss) | 32,448 | 29,425 |
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: | ||
Depreciation and amortization | 21,046 | 19,605 |
Deferred income taxes | 11,044 | (678) |
Other | (9) | 253 |
Change in operating assets and liabilities: | ||
Accounts receivable, net | (5,234) | (15,693) |
Other current assets | (17,887) | (5,484) |
Other assets | (1,593) | (353) |
Accounts payable and other accrued liabilities | 17,726 | (7,100) |
Accrued salaries and benefits | (7,411) | (7,872) |
Other liabilities | 2,803 | 3,317 |
Net cash provided by operating activities | 52,933 | 15,420 |
Investing activities: | ||
Cash paid for acquisitions, net of cash acquired | (40,400) | |
Cash paid for capital expenditures | (48,264) | (45,231) |
Cash paid for real estate acquisitions | (3,149) | (1,066) |
Proceeds from sale of property and equipment | 207 | 836 |
Other | (1,672) | (315) |
Net cash used in investing activities | (52,878) | (86,176) |
Financing activities: | ||
Other | (423) | (442) |
Cash provided by (used in) intercompany activity | (47,235) | 56,570 |
Net cash (used in) provided by financing activities | (47,658) | 56,128 |
Net decrease in cash and cash equivalents | (47,603) | (14,628) |
Cash and cash equivalents at beginning of the period | 98,943 | 32,471 |
Cash and cash equivalents at end of the period | 51,340 | 17,843 |
Combined Non-Guarantors [Member] | ||
Operating activities: | ||
Net income (loss) | 15,905 | 18,732 |
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: | ||
Depreciation and amortization | 20,634 | 20,975 |
Deferred income taxes | 141 | 266 |
Other | 3 | (59) |
Change in operating assets and liabilities: | ||
Accounts receivable, net | 2,406 | 3,713 |
Other current assets | (1,244) | (391) |
Other assets | 497 | 648 |
Accounts payable and other accrued liabilities | (39,481) | (8,601) |
Accrued salaries and benefits | 1,381 | 2,023 |
Other liabilities | (1,372) | (1,135) |
Net cash provided by operating activities | (1,130) | 36,171 |
Investing activities: | ||
Cash paid for capital expenditures | (21,283) | (24,017) |
Proceeds from sale of property and equipment | 92 | |
Net cash used in investing activities | (21,283) | (23,925) |
Financing activities: | ||
Principal payments on long-term debt | (82) | (2,665) |
Distributions to noncontrolling interests | (264) | |
Other | (720) | (680) |
Cash provided by (used in) intercompany activity | 29,037 | (2,198) |
Net cash (used in) provided by financing activities | 27,971 | (5,543) |
Effect of exchange rate changes on cash | (1,143) | 1,099 |
Net decrease in cash and cash equivalents | 4,415 | 7,802 |
Cash and cash equivalents at beginning of the period | 25,249 | 18,039 |
Cash and cash equivalents at end of the period | 29,664 | 25,841 |
Consolidating Adjustments [Member] | ||
Operating activities: | ||
Net income (loss) | (48,353) | (48,157) |
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: | ||
Equity in earnings of subsidiaries | 48,353 | 48,157 |
Change in operating assets and liabilities: | ||
Other assets | (82) | (2,665) |
Net cash provided by operating activities | (82) | (2,665) |
Financing activities: | ||
Principal payments on long-term debt | 82 | 2,665 |
Net cash (used in) provided by financing activities | $ 82 | $ 2,665 |
Subsequent Events - Additional
Subsequent Events - Additional Information (Detail) - USD ($) $ in Thousands | Apr. 21, 2020 | Dec. 31, 2012 | Apr. 01, 2011 | Apr. 30, 2020 | Mar. 31, 2019 |
Subsequent Event [Line Items] | |||||
Borrowings on revolving credit facility | $ 71,573 | ||||
Subsequent Event [Member] | CARES Act [Member] | |||||
Subsequent Event [Line Items] | |||||
Offer of eligible relief amount | $ 100,000,000 | ||||
Received relief amount | $ 20,000 | ||||
Subsequent Event [Member] | CARES Act [Member] | CMS’ Accelerated and Advance Payment Program [Member] | Medicare [Member] | |||||
Subsequent Event [Line Items] | |||||
Period of amount payable in advance | 3 months | ||||
Repayment of advanced payments description | The repayment of these accelerated/advanced payments does not begin until 120 days after the date of the issuance of the payment. Once the repayment period starts, the amounts previously advanced to the provider or supplier will be recouped from the provider’s or supplier’s new Medicare claims. Facilities will generally have 210 days from the date the accelerated or advance payment was made to repay the amounts that they owe. The Company applied for and received approximately $45 million in April 2020 from this program, which the Company expects to repay over a three-month period from August to November 2020. | ||||
Amount of advance payment received | $ 45,000 | ||||
Expected repayment period | 3 months | ||||
Subsequent Event [Member] | CARES Act [Member] | CMS’ Accelerated and Advance Payment Program [Member] | Medicare [Member] | Maximum [Member] | |||||
Subsequent Event [Line Items] | |||||
Percentage of amount payable in advance | 100.00% | ||||
Amended and Restated Senior Credit Facility [Member] | |||||
Subsequent Event [Line Items] | |||||
Date entered into an agreement | Dec. 31, 2012 | Apr. 1, 2011 | |||
Amended and Restated Senior Credit Facility [Member] | Subsequent Event [Member] | |||||
Subsequent Event [Line Items] | |||||
Borrowings on revolving credit facility | $ 100,000 | ||||
Thirteenth Amendment [Member] | Subsequent Event [Member] | |||||
Subsequent Event [Line Items] | |||||
Date entered into an agreement | Apr. 21, 2020 |