Document and Entity Information
Document and Entity Information - USD ($) $ in Billions | 12 Months Ended | ||
Dec. 31, 2022 | Feb. 28, 2023 | Jun. 30, 2022 | |
Cover [Abstract] | |||
Document Type | 10-K | ||
Amendment Flag | false | ||
Document Period End Date | Dec. 31, 2022 | ||
Document Fiscal Year Focus | 2022 | ||
Document Fiscal Period Focus | FY | ||
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 | ||
ICFR Auditor Attestation Flag | true | ||
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 Annual Report | true | ||
Document Transition Report | false | ||
Entity Common Stock, Shares Outstanding | 91,314,616 | ||
Entity Public Float | $ 6 | ||
Entity Well-known Seasoned Issuer | Yes | ||
Entity Voluntary Filers | No | ||
Auditor Name | Ernst & Young LLP | ||
Auditor Location | Nashville, Tennessee | ||
Auditor Firm ID | 42 | ||
Documents Incorporated by Reference | Portions of the registrant’s definitive proxy statement for its 2023 annual meeting of stockholders to be held on May 18, 2023 are incorporated by reference into Part III of this Form 10-K. |
Consolidated Balance Sheets
Consolidated Balance Sheets - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 |
Current assets: | ||
Cash and cash equivalents | $ 97,649 | $ 133,813 |
Accounts receivable, net | 322,439 | 281,332 |
Other current assets | 86,037 | 79,886 |
Total current assets | 506,125 | 495,031 |
Property and equipment, net | 1,952,045 | 1,771,159 |
Goodwill | 2,222,805 | 2,199,937 |
Intangible assets, net | 76,041 | 70,145 |
Deferred tax assets | 2,950 | 3,080 |
Operating lease right-of-use assets | 135,238 | 133,761 |
Other assets | 92,697 | 94,965 |
Total assets | 4,987,901 | 4,768,078 |
Current liabilities: | ||
Current portion of long-term debt | 21,250 | 18,594 |
Accounts payable | 104,723 | 98,575 |
Accrued salaries and benefits | 125,298 | 137,845 |
Current portion of operating lease liabilities | 26,463 | 23,348 |
Other accrued liabilities | 110,592 | 126,499 |
Total current liabilities | 388,326 | 404,861 |
Long-term debt | 1,364,541 | 1,478,626 |
Deferred tax liabilities | 92,588 | 74,368 |
Operating lease liabilities | 116,429 | 116,841 |
Other liabilities | 125,033 | 110,505 |
Total liabilities | 2,086,917 | 2,185,201 |
Redeemable noncontrolling interests | 88,257 | 65,388 |
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; 89,913,659 and 89,028,158 issued and outstanding as of December 31, 2022 and 2021, respectively | 899 | 890 |
Additional paid-in capital | 2,658,440 | 2,636,350 |
Retained earnings (accumulated deficit) | 153,388 | (119,751) |
Total equity | 2,812,727 | 2,517,489 |
Total liabilities and equity | $ 4,987,901 | $ 4,768,078 |
Consolidated Balance Sheets (Pa
Consolidated Balance Sheets (Parenthetical) - $ / shares | Dec. 31, 2022 | Dec. 31, 2021 |
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 | 89,913,659 | 89,028,158 |
Common stock, shares outstanding | 89,913,659 | 89,028,158 |
Consolidated Statements of Oper
Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Income Statement [Abstract] | |||
Revenue | $ 2,610,399 | $ 2,314,394 | $ 2,089,929 |
Salaries, wages and benefits (including equity-based compensation expense of $29,635, $37,530 and $22,504, respectively) | 1,393,434 | 1,243,804 | 1,154,522 |
Professional fees | 158,013 | 136,739 | 120,489 |
Supplies | 100,200 | 90,702 | 87,241 |
Rents and leases | 45,462 | 38,519 | 37,362 |
Other operating expenses | 349,277 | 301,339 | 262,272 |
Income from provider relief fund | (21,451) | (17,900) | (32,819) |
Depreciation and amortization | 117,769 | 106,717 | 95,256 |
Interest expense, net | 69,760 | 76,993 | 158,105 |
Debt extinguishment costs | 24,650 | 7,233 | |
Loss on impairment | 24,293 | 4,751 | |
Transaction-related expenses | 23,792 | 12,778 | 11,720 |
Total expenses | 2,236,256 | 2,038,634 | 1,906,132 |
Income from continuing operations before income taxes | 374,143 | 275,760 | 183,797 |
Provision for income taxes | 94,110 | 67,557 | 40,606 |
Income from continuing operations | 280,033 | 208,203 | 143,191 |
Loss from discontinued operations, net of taxes | (12,641) | (812,390) | |
Net income (loss) | 280,033 | 195,562 | (669,199) |
Net income attributable to noncontrolling interests | (6,894) | (4,927) | (2,933) |
Net income (loss) attributable to Acadia Healthcare Company, Inc. | $ 273,139 | $ 190,635 | $ (672,132) |
Basic earnings (loss) per share attributable to Acadia Healthcare Company, Inc. stockholders: | |||
Income from continuing operations attributable to Acadia Healthcare Company, Inc. | $ 3.05 | $ 2.29 | $ 1.60 |
Loss from discontinued operations | (0.14) | (9.25) | |
Net income (loss) attributable to Acadia Healthcare Company, Inc. | 3.05 | 2.15 | (7.65) |
Diluted earnings (loss) per share attributable to Acadia Healthcare Company, Inc. stockholders: | |||
Income from continuing operations attributable to Acadia Healthcare Company, Inc. | 2.98 | 2.24 | 1.58 |
Loss from discontinued operations | (0.14) | (9.17) | |
Net income (loss) attributable to Acadia Healthcare Company, Inc. | $ 2.98 | $ 2.10 | $ (7.59) |
Weighted-average shares outstanding: | |||
Basic | 89,680 | 88,769 | 87,875 |
Diluted | 91,555 | 90,793 | 88,595 |
Consolidated Statements of Op_2
Consolidated Statements of Operations (Parenthetical) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Income Statement [Abstract] | |||
Equity-based compensation expense | $ 29,635 | $ 37,530 | $ 22,504 |
Consolidated Statements of Comp
Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Statement Of Income And Comprehensive Income [Abstract] | |||
Net income (loss) | $ 280,033 | $ 195,562 | $ (669,199) |
Other comprehensive income (loss): | |||
Foreign currency translation (loss) gain | (4,260) | 61,247 | |
Gain (loss) on derivative instruments, net of tax of $0.0 million, $0.1 million and $(3.9) million, respectively | 19 | (11,272) | |
Pension liability adjustment, net of tax of $0.0 million, $0.0 million and $(0.8) million, respectively | (6,456) | ||
U.K. Sale | 375,606 | ||
Other comprehensive income | 371,365 | 43,519 | |
Comprehensive income (loss) | 280,033 | 566,927 | (625,680) |
Comprehensive income attributable to noncontrolling interests | (6,894) | (4,927) | (2,933) |
Comprehensive income (loss) attributable to Acadia Healthcare Company, Inc. | $ 273,139 | $ 562,000 | $ (628,613) |
Consolidated Statements of Co_2
Consolidated Statements of Comprehensive Income (Loss) (Parenthetical) - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Statement Of Income And Comprehensive Income [Abstract] | |||
Gain (loss) on derivative instruments, tax | $ 0 | $ 0.1 | $ (3.9) |
Pension liability adjustment, tax | $ 0 | $ 0 | $ (0.8) |
Consolidated Statements of Equi
Consolidated Statements of Equity - USD ($) $ in Thousands | Total | Common Stock [Member] | Additional Paid-in Capital [Member] | Accumulated Other Comprehensive Loss [Member] | (Accumulated Deficit) Retained Earnings [Member] |
Balance at Dec. 31, 2019 | $ 2,505,381 | $ 877 | $ 2,557,642 | $ (414,884) | $ 361,746 |
Balance, shares at Dec. 31, 2019 | 87,715,000 | ||||
Common stock issued under stock incentive plans | $ 2,027 | $ 3 | 2,024 | ||
Common stock issued under stock incentive plans, shares | 68,700 | 309,000 | |||
Repurchase of shares for payroll tax witholdings, net of proceeds from stock option exercises | $ (1,843) | (1,843) | |||
Equity-based compensation expense | 22,504 | 22,504 | |||
Other comprehensive income | 43,519 | 43,519 | |||
Net income (Loss) attributable to Acadia Healthcare Company, Inc. stockholders | (672,132) | (672,132) | |||
Balance at Dec. 31, 2020 | 1,899,456 | $ 880 | 2,580,327 | (371,365) | (310,386) |
Balance, shares at Dec. 31, 2020 | 88,024,000 | ||||
Common stock issued under stock incentive plans | $ 22,029 | $ 10 | 22,019 | ||
Common stock issued under stock incentive plans, shares | 558,322 | 1,004,000 | |||
Repurchase of shares for payroll tax witholdings, net of proceeds from stock option exercises | $ (5,734) | (5,734) | |||
Equity-based compensation expense | 37,530 | 37,530 | |||
Other comprehensive income | 371,365 | $ 371,365 | |||
Other | 2,208 | 2,208 | |||
Net income (Loss) attributable to Acadia Healthcare Company, Inc. stockholders | 190,635 | 190,635 | |||
Balance at Dec. 31, 2021 | $ 2,517,489 | $ 890 | 2,636,350 | (119,751) | |
Balance, shares at Dec. 31, 2021 | 89,028,158 | 89,028,000 | |||
Common stock issued under stock incentive plans | $ 11,613 | $ 9 | 11,604 | ||
Common stock issued under stock incentive plans, shares | 285,577 | 886,000 | |||
Repurchase of shares for payroll tax witholdings, net of proceeds from stock option exercises | $ (17,792) | (17,792) | |||
Equity-based compensation expense | 29,635 | 29,635 | |||
Other | (1,357) | (1,357) | |||
Net income (Loss) attributable to Acadia Healthcare Company, Inc. stockholders | 273,139 | 273,139 | |||
Balance at Dec. 31, 2022 | $ 2,812,727 | $ 899 | $ 2,658,440 | $ 153,388 | |
Balance, shares at Dec. 31, 2022 | 89,913,659 | 89,914,000 |
Consolidated Statements of Cash
Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Operating activities: | |||
Net income (loss) | $ 280,033 | $ 195,562 | $ (669,199) |
Adjustments to reconcile net income (loss) to net cash provided by continuing operating activities: | |||
Depreciation and amortization | 117,769 | 106,717 | 95,256 |
Amortization of debt issuance costs | 3,261 | 4,071 | 12,636 |
Equity-based compensation expense | 29,635 | 37,530 | 22,504 |
Deferred income taxes | 16,545 | 11,772 | 53,108 |
Loss from discontinued operations, net of taxes | 12,641 | 812,390 | |
Debt extinguishment costs | 24,650 | 7,233 | |
Loss on impairment | 24,293 | 4,751 | |
Other | 2,680 | 491 | 1,041 |
Change in operating assets and liabilities, net of effect of acquisitions: | |||
Accounts receivable, net | (41,978) | 2,448 | 15,340 |
Other current assets | (17,626) | 1,968 | 9,675 |
Other assets | 2,252 | (10,770) | 1,519 |
Accounts payable and other accrued liabilities | 5,174 | 6,164 | 41,910 |
Accrued salaries and benefits | 6,804 | 9,755 | (10,001) |
Other liabilities | 15,090 | (14,940) | 18,082 |
Government relief funds | (39,070) | (38,128) | 86,599 |
Net cash provided by continuing operating activities | 380,569 | 374,224 | 502,844 |
Net cash provided by discontinued operating activities | 253 | 155,963 | |
Net cash provided by operating activities | 380,569 | 374,477 | 658,807 |
Investing activities: | |||
Cash paid for acquisitions, net of cash acquired | (9,507) | (139,015) | |
Cash paid for capital expenditures | (296,149) | (244,811) | (224,964) |
Proceeds from U.K. Sale | 1,511,020 | ||
Settlement of foreign currency derivatives | (84,795) | ||
Proceeds from sale of property and equipment | 7,074 | 3,493 | 92 |
Cash paid for purchase of finance lease | (31,401) | ||
Other | (7,248) | (1,394) | (13,365) |
Net cash (used in) provided by continuing investing activities | (305,830) | 1,013,097 | (238,237) |
Net cash used in discontinued investing activities | (43,602) | ||
Net cash (used in) provided by investing activities | (305,830) | 1,013,097 | (281,839) |
Financing activities: | |||
Borrowings on long-term debt | 425,000 | 925,000 | |
Borrowings on revolving credit facility | 500,000 | 100,000 | |
Principal payments on revolving credit facility | (95,000) | (330,000) | (100,000) |
Principal payments on long-term debt | (18,594) | (7,969) | (41,291) |
Repayment of long-term debt | (2,227,935) | (909,785) | |
Payment of debt issuance costs | (7,964) | (18,295) | |
Repurchase of shares for payroll tax withholding, net of proceeds from stock option exercises | (6,179) | 16,295 | 184 |
Contributions from noncontrolling partners in joint ventures | 15,362 | 4,536 | |
Distributions to noncontrolling partners in joint ventures | (1,004) | (1,588) | (916) |
Acquisition of ownership interests from noncontrolling partners | (5,540) | ||
Other | 52 | (6,900) | (3,146) |
Net cash used in continuing financing activities | (110,903) | (1,636,525) | (48,249) |
Net cash used in discontinued financing activities | (3,250) | ||
Net cash used in financing activities | (110,903) | (1,636,525) | (51,499) |
Effect of exchange rate changes on cash | 4,067 | 4,087 | |
Net (decrease) increase in cash and cash equivalents, including cash classified within current assets held for sale | (36,164) | (244,884) | 329,556 |
Less: cash classified within current assets held for sale | (75,051) | ||
Net (decrease) increase in cash and cash equivalents | (36,164) | (244,884) | 254,505 |
Cash and cash equivalents at beginning of the period | 133,813 | 378,697 | 124,192 |
Cash and cash equivalents at end of the period | 97,649 | 133,813 | 378,697 |
Supplemental Cash Flow Information: | |||
Cash paid for interest | 65,687 | 93,669 | 137,578 |
Cash paid (received) for income taxes | 86,195 | 79,304 | (16,486) |
Effect of acquisitions: | |||
Assets acquired, excluding cash | 10,756 | 176,365 | 20,200 |
Liabilities assumed | (1,249) | (37,350) | (53) |
Redeemable noncontrolling interest resulting from an acquisition | $ (20,147) | ||
Cash paid for acquisitions, net of cash acquired | $ 9,507 | $ 139,015 |
Description of Business and Bas
Description of Business and Basis of Presentation | 12 Months Ended |
Dec. 31, 2022 | |
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 (the “U.S.”) and Puerto Rico. At December 31, 2022, the Company operated 250 behavioral healthcare facilities with approximately 11,000 beds in 39 states and Puerto Rico. On January 19, 2021, the Company completed the sale of its operations in the United Kingdom (the “U.K.”) to RemedcoUK Limited, a company organized under the laws of England and Wales and owned by funds managed or advised by Waterland Private Equity Fund VII (the “U.K. Sale”). The U.K. Sale allowed the Company to reduce its indebtedness and focus on its U.S. operations. As a result of the U.K. Sale, the Company reported, for all periods presented, results of operations and cash flows of the U.K. operations as discontinued operations in the accompanying financial statements. See Note 9 – U.K. Sale. 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”). 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. The majority of the Company’s expenses are “cost of revenue” items. Costs that could be classified as general and administrative expenses include the Company’s corporate office costs, which were $124.3 million, $108.2 million and $97.8 million for the years ended December 31, 2022, 2021 and 2020, respectively. Certain reclassifications have been made to prior years to conform to the current year presentation. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2022 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | 2. Summary of Significant Accounting Policies Cash and Cash Equivalents The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents. At times, cash and cash equivalent balances may exceed federally insured limits. Management believes that the Company mitigates any risks by depositing cash and investing in cash equivalents with major financial institutions. Insurance The Company is subject to medical malpractice and other lawsuits due to the nature of the services the Company provides. A portion of the Company’s professional liability risks are insured through a wholly-owned insurance subsidiary providing coverage for up to $10.0 million per claim through August 31, 2022 and $5.0 million and $10.0 million for certain other claims thereafter. The Company has obtained reinsurance coverage from a third party to cover claims in excess of those limits. The reinsurance policy has a coverage limit of $75.0 million or $70.0 million for certain other claims 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. The reserve for professional and general liability risks was estimated based on historical claims, prior settlements and judgments, demographic factors, industry trends, severity factors, and other actuarial assumptions. The estimated accrual for professional and general liabilities could be significantly affected should current and future occurrences differ from historical claim trends and expectations. While claims are monitored closely when estimating professional and general liability accruals, the complexity of the claims and wide range of potential outcomes often hampers timely adjustments to the assumptions used in these estimates. The Company recorded an unfavorable adjustment of $5.9 million to its estimated liability for self-insured professional and general liability claims during the year ended December 31, 2022, relating to the settlement or expected settlement of certain prior year claims relating primarily to the 2017 to 2018 period. The professional and general liability reserve was $103.6 million at December 31, 2022, of which $12.1 million was included in other accrued liabilities and $91.5 million was included in other long-term liabilities. The professional and general liability reserve was $87.8 million at December 31, 2021 , of which $ 11.9 million was included in other accrued liabilities and $ 75.9 million was included in other long-term liabilities. The Company estimates receivables for the portion of professional and general liability reserves that are recoverable under the Company’s insurance policies. Such receivable was $ 37.8 million a t December 31, 2022 , of which $ 10.2 million was included in other current assets and $ 27.6 million was included in other assets, and such receivable was $ 37.9 million a t December 31, 2021 , of which $ 10.8 million was included in other current assets and $ 27.1 million was included in other assets. The Company’s statutory workers’ compensation program is fully insured with a $0.5 million deductible per accident. The workers’ compensation liability was $24.2 million at December 31, 2022, of which $12.0 million was included in accrued salaries and benefits and $12.2 million was included in other long-term liabilities, and such liability was $23.6 million at December 31, 2021, of which $12.0 million was included in accrued salaries and benefits and $11.6 million was included in other long-term liabilities. The reserve for workers compensation claims was based upon independent actuarial estimates of future amounts that will be paid to claimants. Management believes that adequate provisions have been made for workers’ compensation and professional and general liability risk exposures. Property and Equipment and Other Long-Lived Assets Property and equipment are recorded at cost. Depreciation is calculated on the straight-line basis over the estimated useful lives of the assets, which typically range from 10 to 50 years for buildings and improvements, three to seven years for equipment and the shorter of the lease term or estimated useful lives for leasehold improvements. When assets are sold or retired, the corresponding cost and accumulated depreciation are removed from the related accounts and any gain or loss is recorded in the period of sale or retirement. Repair and maintenance costs are expensed as incurred. Depreciation expense was $117.8 million, $106.7 million and $95.3 million for the years ended December 31, 2022, 2021 and 2020, respectively. The carrying values of long-lived assets are reviewed for possible impairment whenever events, circumstances or operating results indicate that the carrying amount of an asset may not be recoverable. If this review indicates that the asset will not be recoverable, as determined based upon the undiscounted cash flows of the operating asset over the remaining useful life, the carrying value of the asset will be reduced to its estimated fair value. Fair value estimates are based on independent appraisals, market values of comparable assets or internal evaluations of future net cash flows. During the second quarter of 2021, the Company opened a 260-bed replacement facility in Pennsylvania and recorded a non-cash property impairment charge of $23.2 million for the existing facility. Additionally, during the third quarter of 2021, the Company recorded a $1.1 million non-cash property impairment charge for one facility in Louisiana resulting from hurricane damage. The Company performed an impairment review of long-lived assets in the fourth quarter of 2022 and 2021 and recorded no impairment. The impairment review of long-lived assets in the fourth quarter of 2020 indicated the carrying amounts of certain of the Company’s long-lived assets may not be recoverable. This created a non-cash impairment of $4.2 million for the year ended December 31, 2020, which was recorded in loss on impairment on the Company’s consolidated statements of operations. Goodwill and Indefinite-Lived Intangible Assets The Company’s goodwill and other indefinite-lived intangible assets, which consist of licenses and accreditations, trade names and certificates of need intangible assets that are not amortized, are evaluated for impairment annually during the fourth quarter or more frequently if events indicate the carrying value of a reporting unit may not be recoverable. As of the Company’s annual impairment tests on October 1, 2022 and October 1, 2021, the Company had one reporting unit, behavioral health services. The fair value of the Company’s behavioral health services reporting unit substantially exceeded its carrying value, and therefore no impairment was recorded. During the second quarter of 2021, the Company sold one outpatient facility for $4.3 million and recorded a write down of $1.8 million of goodwill and $0.2 million of intangible assets related to the disposition. During the fourth quarter of 2021, the Company sold one outpatient facility for $1.5 million and recorded a write down of $0.7 million of goodwill and $0.1 million of intangibles related to the disposition. As of the Company’s annual impairment test on October 1, 2020, the Company had two operating segments for segment reporting purposes, U.S. facilities and U.K. facilities, each of which represented a reporting unit for purposes of the Company’s goodwill impairment test. Other Current Assets Other current assets consisted of the following (in thousands): December 31, 2022 2021 Prepaid expenses $ 27,052 $ 22,292 Other receivables 15,371 10,786 Workers’ compensation deposits – current portion 12,000 12,000 Insurance receivable – current portion 10,158 10,807 Assets held for sale 8,347 15,808 Income taxes receivable 5,767 1,523 Inventory 5,087 4,786 Other 2,255 1,884 Other current assets $ 86,037 $ 79,886 Other Accrued Liabilities Other accrued liabilities consisted of the following (in thousands): December 31, 2022 2021 Accrued expenses $ 26,699 $ 26,791 Accrued interest 17,596 17,418 Cost report payable 13,738 6,487 Insurance liability – current portion 12,128 11,923 Accrued property taxes 9,009 8,375 Government relief funds 8,975 8,550 Contract liabilities 6,653 30,371 Income taxes payable 1,338 5,540 Finance lease liabilities 990 990 Other 13,466 10,054 Other accrued liabilities $ 110,592 $ 126,499 Stock Compensation The Company measures and recognizes the cost of employee services received in exchange for awards of equity instruments based on the grant-date fair value in accordance with the Financial Accounting Standards Board (the “FASB”) Accounting Standards Codification (“ASC”) 718, “ Compensation—Stock Compensation Earnings Per Share Basic and diluted earnings per share are calculated in accordance with FASB ASC 260, “ Earnings Per Share Income Taxes The Company uses the asset and liability method of accounting for income taxes. Under this method, deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes and net operating loss and tax credit carryforwards. The amount of deferred taxes on these temporary differences is determined using the tax rates that are expected to apply in the period when the asset is realized or the liability is settled, as applicable, based on tax rates and laws in the respective tax jurisdiction enacted as of the balance sheet date. The Company reviews its deferred tax assets for recoverability and establishes a valuation allowance based on historical taxable income, projected future taxable income, applicable tax strategies, and the expected timing of the reversals of existing temporary differences. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax assets will not be realized. The Company records a liability for unrecognized tax benefits resulting from uncertain tax positions taken or expected to be taken in a tax return. The Company recognizes interest and penalties, if any, related to unrecognized tax benefits in income tax expense. The Company established accruals for taxes and associated interest that may become payable in future years as a result of audits by tax authorities. The Company accrues for tax contingencies when it is more likely than not that a liability to a taxing authority has been incurred and the amount of the contingency can be reasonably estimated. Management believes that the positions taken on previously filed tax returns are reasonable and has not established tax and interest reserves in recognition that various taxing authorities may challenge the positions taken by the Company resulting in additional liabilities for taxes and interest. These amounts are reviewed as circumstances warrant and adjusted as events occur that affect the Company’s potential liability for additional taxes, such as lapsing of applicable statutes of limitations, conclusion of tax audits, additional exposure based on current calculations, identification of new issues, release of administrative guidance, or rendering of a court decision affecting a particular tax issue. Recent Accounting Pronouncements In November 2021, the FASB issued Accounting Standards Update (“ASU”) 2021-10, “ Government Assistance (Topic 832) Not-for-Profit Entities In March 2020, the FASB issued ASU 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting |
Revenue
Revenue | 12 Months Ended |
Dec. 31, 2022 | |
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. Services ordered by a healthcare provider in an episode of care are not separately identifiable and therefore have been combined into a single performance obligation for each contract. The Company recognizes revenue as its performance obligations are completed. The performance obligation is satisfied over time as the customer simultaneously receives and consumes the benefits of As the Company’s performance obligations relate to contracts with a duration of one year or less, the Company elected the optional exemption in 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 the Company’s patients typically are under no obligation to remain admitted in the Company’s facilities. At December 31, 2022 and 2021, estimated implicit price concessions of $61.4 million and $49.7 million, respectively, had been recorded as reductions to the Company’s the Company the Company The Company disaggregates revenue from contracts with customers by service type and by payor. The Company’s facilities and services provided by the facilities can generally be classified into the following categories: acute inpatient psychiatric facilities; specialty treatment facilities; comprehensive treatment centers (“CTCs”); and residential treatment centers. 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 and eating disorder facilities. 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. Comprehensive treatment centers. CTCs specialize in providing medication-assisted treatment in an outpatient setting to individuals addicted to opioids such as opioid analgesics (prescription pain medications). 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. The table below presents total revenue from continuing operations attributed to each category (in thousands): Year Ended December 31, 2022 2021 2020 Acute inpatient psychiatric facilities $ 1,330,757 $ 1,126,872 $ 984,609 Specialty treatment facilities 564,671 510,929 452,805 Comprehensive treatment centers 419,940 385,635 349,217 Residential treatment centers 295,031 283,169 281,158 Other — 7,789 22,140 Revenue $ 2,610,399 $ 2,314,394 $ 2,089,929 The Company receives payments from the following sources for services rendered in its 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 the Company’s The Company derives a significant portion of its revenue from Medicare, Medicaid and other payors that receive discounts from established billing rates. The Medicare and Medicaid regulations and various managed care contracts under which these discounts must be estimated are complex, subject to interpretation and adjustment, and may include multiple reimbursement mechanisms for different types of services provided in the Company’s facilities and cost settlement provisions. Management estimates the transaction price on a payor-specific basis given its interpretation of the applicable regulations or contract terms. The services authorized and provided and related reimbursement are often subject to interpretation that could result in payments that differ from the Company’s estimates. Additionally, updated regulations and contract renegotiations occur frequently, necessitating regular review and assessment of the estimation process by management. Settlements under cost reimbursement agreements with third-party payors are estimated and recorded in the period in which the related services are rendered and are adjusted in future periods as final settlements are determined. Final determination of amounts earned under the Medicare and Medicaid programs often occurs in subsequent years because of audits by such programs, rights of appeal and the application of numerous technical provisions. In the opinion of management, adequate provision has been made for any adjustments and final settlements. However, there can be no assurance that any such adjustments and final settlements will not have a material effect on the Company’s financial condition or results of operations. The Company’s cost report payables were $13.7 million and $6.5 million as of December 31, 2022 and 2021, respectively, and were included in other current liabilities on the consolidated balance sheet. The net adjustments to estimated cost report settlements resulted in an increase to revenue of $0.1 million for the year ended December 31, 2022, compared to decreases to revenue of $5.4 million and $1.3 million for the years ended December 31, 2021 and 2020, respectively. The Company provides care without charge to patients who are financially unable to pay for the healthcare services they receive based on Company policies and federal and state poverty thresholds. Such amounts determined to qualify as charity care are not reported as revenue. The cost of providing charity care services were $6.4 million, $3.8 million and $4.4 million for the years ended December 31, 2022, 2021 and 2020, respectively. The estimated cost of charity care services was determined using a ratio of cost to gross charges determined from the Company’s The following table presents revenue by payor type and as a percentage of revenue for continuing operations for the years ended December 31, 2022, 2021 and 2020 (in thousands): Year Ended December 31, 2022 2021 2020 Amount % Amount % Amount % Commercial $ 788,895 30.2 % $ 684,292 29.6 % $ 596,698 28.5 % Medicare 394,227 15.1 % 364,598 15.8 % 330,070 15.8 % Medicaid 1,319,600 50.6 % 1,147,884 49.6 % 1,037,852 49.7 % Self-Pay 76,050 2.9 % 93,425 4.0 % 98,302 4.7 % Other 31,627 1.2 % 24,195 1.0 % 27,007 1.3 % Revenue $ 2,610,399 100.0 % $ 2,314,394 100.0 % $ 2,089,929 100.0 % Contract liabilities primarily consisted of advances from payors and unearned revenue from CMS’ Accelerated and Advance Payment Program. In April 2020, the Company received approximately $45.2 million from CMS’ Accelerated and Advance Payment Program for Medicare providers. Of the $45.2 million of advance payments received in 2020, the Company repaid approximately $25.1 million of advance payments during 2021 and made additional payments of approximately $20.1 million during the year ended December 31, 2022. Contract liabilities of $6.7 million and $30.4 million are included in other accrued liabilities at December 31, 2022 and 2021, respectively, on the consolidated balance sheet. A summary of the activity in contract liabilities is as follows (in thousands): Balance at December 31, 2020 $ 47,196 Payments received 11,739 Revenue recognized (3,463 ) Medicare advance repayments (25,101 ) Balance at December 31, 2021 $ 30,371 Payments received 22,914 Revenue recognized (26,497 ) Medicare advance repayments (20,135 ) Balance at December 31, 2022 $ 6,653 |
Earnings Per Share
Earnings Per Share | 12 Months Ended |
Dec. 31, 2022 | |
Earnings Per Share [Abstract] | |
Earnings Per Share | 4. Earnings Per Share The following table sets forth the computation of basic and diluted earnings (loss) per share for the years ended December 31, 2022, 2021 and 2020 (in thousands, except per share amounts): Year Ended December 31, 2022 2021 2020 Numerator: Income from continuing operations attributable to Acadia Healthcare Company, Inc. $ 273,139 $ 203,276 $ 140,258 Loss from discontinued operations — (12,641 ) (812,390 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 273,139 $ 190,635 $ (672,132 ) Denominator: Weighted average shares outstanding for basic earnings per share 89,680 88,769 87,875 Effects of dilutive instruments 1,875 2,024 720 Shares used in computing diluted earnings per common share 91,555 90,793 88,595 Basic earnings (loss) per share attributable to Acadia Healthcare Company, Inc. stockholders: Income from continuing operations attributable to Acadia Healthcare Company, Inc. $ 3.05 $ 2.29 $ 1.60 Loss from discontinued operations — (0.14 ) (9.25 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 3.05 $ 2.15 $ (7.65 ) Diluted earnings (loss) per share attributable to Acadia Healthcare Company, Inc. stockholders: Income from continuing operations attributable to Acadia Healthcare Company, Inc. $ 2.98 $ 2.24 $ 1.58 Loss from discontinued operations — (0.14 ) (9.17 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 2.98 $ 2.10 $ (7.59 ) Approximately 0.1 million, 0.3 million and 1.9 million shares of common stock issuable upon exercise of outstanding stock options were excluded from the calculation of diluted earnings per share for the years ended December 31, 2022, 2021 and 2020, respectively, because their effect would have been anti-dilutive. |
Acquisitions
Acquisitions | 12 Months Ended |
Dec. 31, 2022 | |
Business Combinations [Abstract] | |
Acquisitions | 5. Acquisitions 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 November 7, 2022, the Company acquired four CTCs located in Georgia from Brand New Start Treatment Centers. On December 31, 2021, the Company acquired the equity of CenterPointe Behavioral Health System, LLC and certain related entities (“CenterPointe”) for cash consideration of approximately $140 million. The acquisition was funded through a combination of cash on hand and a $70.0 million draw on the Revolving Facility. At the time of the acquisition, CenterPointe operated four acute inpatient hospitals with 306 beds and ten outpatient locations primarily in Missouri. The fair values of assets acquired and liabilities assumed in the CenterPointe acquisition were as follows (in thousands): Cash $ 5,640 Accounts receivable, net 9,358 Other current assets 1,981 Property and equipment 35,227 Goodwill 105,883 Intangible assets 825 Deferred tax assets 1,573 Operating lease right-of-use assets 29,245 Total assets acquired 189,732 Accounts payable 3,820 Accrued salaries and benefits 3,585 Current portion of operating lease liabilities 2,820 Other accrued liabilities 4,326 Deferred tax liability 1,805 Operating lease liabilities 27,850 Total liabilities assumed 44,206 Net assets acquired $ 145,526 The qualitative factors comprising the goodwill acquired in the CenterPointe acquisition include the value of the business and efficiencies derived through synergies expected by the elimination of certain redundant corporate functions and expenses, coordination of services provided across the combined network of facilities, achievement of operating efficiencies by benchmarking performance and applying best practices. Goodwill The following table summarizes changes in goodwill for the years ended December 31, 2022 and 2021 (in thousands): Balance at January 1, 2021 $ 2,105,264 Increase from acquisitions 97,122 2021 dispositions (2,449 ) Balance at December 31, 2021 2,199,937 Increase from acquisitions 9,488 Adjustments related to 2021 acquisitions 8,761 Increase from contributions of redeemable noncontrolling interests 4,619 Balance at December 31, 2022 $ 2,222,805 Of the increases to goodwill from acquisitions in 2022 and 2021, the Company expects $9.5 million and $56.1 million to be tax-deductible for the years ended December 31, 2022 and 2021, respectively. Transaction-related expenses Transaction-related expenses represent costs primarily related to legal, accounting, termination, restructuring, management transition, acquisition and other similar costs. Transaction-related expenses comprised the following costs for the years ended December 31, 2022, 2021 and 2020 (in thousands): Year Ended December 31, 2022 2021 2020 Management transition costs $ 11,575 $ — $ — Termination and restructuring costs 6,476 5,343 3,468 Legal, accounting and other acquisition-related costs 5,741 7,435 8,252 $ 23,792 $ 12,778 $ 11,720 |
Property and Equipment
Property and Equipment | 12 Months Ended |
Dec. 31, 2022 | |
Property Plant And Equipment [Abstract] | |
Property and Equipment | 6. Property and Equipment Property and equipment consisted of the following at December 31, 2022 and 2021 (in thousands): December 31, 2022 2021 Land $ 169,137 $ 154,376 Building and improvements 1,797,809 1,683,560 Equipment 292,200 253,100 Construction in progress 349,473 221,249 2,608,619 2,312,285 Less: accumulated depreciation (656,574 ) (541,126 ) Property and equipment, net $ 1,952,045 $ 1,771,159 During the year ended December 31, 2021, the Company recorded non-cash impairment charges of $24.3 million related primarily to the closure of certain facilities. During the second quarter of 2021, the Company opened a 260-bed replacement facility in Pennsylvania and recorded a non-cash property impairment charge of $23.2 million for the existing facility. Additionally, during the third quarter 2021, the Company recorded a $1.1 million non-cash property impairment charge for one facility in Louisiana resulting from hurricane damage. The Company has recorded assets held for sale within other current assets on the consolidated balance sheets for closed properties actively marketed of $8.3 million and $15.8 million at December 31, 2022 and 2021, respectively. |
Other Intangible Assets
Other Intangible Assets | 12 Months Ended |
Dec. 31, 2022 | |
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 December 31, 2022 and 2021 (in thousands): Gross Carrying Amount Accumulated Amortization December 31, 2022 December 31, 2021 December 31, 2022 December 31, 2021 Intangible assets subject to amortization: Non-compete agreements $ 1,131 $ 1,131 $ (1,131 ) $ (1,131 ) Intangible assets not subject to amortization: Licenses and accreditations 11,512 11,600 — — Trade names 45,935 40,435 — — Certificates of need 18,594 18,110 — — 76,041 70,145 — — Total $ 77,172 $ 71,276 $ (1,131 ) $ (1,131 ) All 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. During the second quarter of 2021, the Company sold one outpatient facility for $4.3 million and recorded a write down of $1.8 million of goodwill and $0.2 million of intangible assets related to the disposition. During the fourth quarter of 2021, the Company sold one outpatient facility for $1.5 million and recorded a write down of $0.7 million of goodwill and $0.1 million of intangibles related to the disposition. These dispositions are reflected in other investing activities in the consolidated statement of cash flows. |
Leases
Leases | 12 Months Ended |
Dec. 31, 2022 | |
Leases [Abstract] | |
Leases | 8. Leases 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 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 consolidated balance sheets. Non-lease components, which are not significant overall, are combined with lease components. Operating lease liabilities are recorded at 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 were calculated based on information available at the lease commencement date. The Company reviews service agreements for embedded leases and records right-of-use assets and liabilities as necessary. Lease Position The Company recorded the following at December 31, 2022 and 2021 on the consolidated balance sheets (in thousands): Right-of-Use Assets Balance Sheet Classification December 31, 2022 December 31, 2021 Finance lease right-of-use assets Property and equipment, net $ 8,250 $ 8,627 Operating lease right-of-use assets Operating lease right-of-use assets 135,238 133,761 Total $ 143,488 $ 142,388 Lease Liabilities Balance Sheet Classification December 31, 2022 December 31, 2021 Current: Finance lease liabilities Other accrued liabilities $ 990 $ 990 Operating lease liabilities Current portion of operating lease liabilities 26,463 23,348 Noncurrent: Finance lease liabilities Other liabilities 10,858 10,807 Operating lease liabilities Operating lease liabilities 116,429 116,841 Total $ 154,740 $ 151,986 Weighted-average remaining lease terms and discount rates were as follows at December 31, 2022 and 2021: December 31, 2022 2021 Weighted-average remaining lease term (in years): Finance 21.9 22.9 Operating 8.4 9.1 Weighted-average discount rate: Finance 5.1 % 5.1 % Operating 5.0 % 5.1 % Lease Costs The Company recorded the following lease costs for the years ended December 31, 2022, 2021 and 2020 (in thousands): Year Ended December 31, 2022 2021 2020 Finance lease costs: Depreciation of leased assets 378 378 868 Interest of lease liabilities 1,041 2,174 3,214 Total finance lease costs $ 1,419 $ 2,552 $ 4,082 Operating lease costs 34,349 28,233 27,050 Variable lease costs 3,129 2,488 2,501 Short term lease costs 2,605 3,257 3,558 Other lease costs 5,379 4,541 4,253 Total rents and leases $ 45,462 $ 38,519 $ 37,362 Total lease costs $ 46,881 $ 41,071 $ 41,444 Other Undiscounted future cash flows for finance and operating leases recorded on the consolidated balance sheet were as follows at December 31, 2022 (in thousands): Finance Leases Operating Leases 2023 $ 990 $ 32,818 2024 1,007 29,568 2025 1,089 25,146 2026 1,180 19,251 2027 1,089 12,380 Thereafter 21,821 62,653 Total minimum lease payments 27,176 181,816 Less: amount of lease payments representing interest 15,328 38,924 Present value of future minimum lease payments 11,848 142,892 Less: Current portion of lease liabilities 990 26,463 Noncurrent lease liabilities $ 10,858 $ 116,429 Supplemental data for the years ended December 31, 2022, 2021 and 2020 were as follows (in thousands): Year Ended December 31, 2022 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 33,836 $ 27,508 $ 26,810 Operating cash flows for finance leases $ 1,041 $ 2,174 $ 3,214 Financing cash flows for finance leases $ (51 ) $ 31,136 $ 551 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 31,294 $ 63,279 $ 21,285 Finance leases $ — $ — $ — |
U.K. Sale
U.K. Sale | 12 Months Ended |
Dec. 31, 2022 | |
Discontinued Operations And Disposal Groups [Abstract] | |
U.K. Sale | 9. U.K. Sale On January 19, 2021, the Company completed the U.K. Sale pursuant to a Share Purchase Agreement in which it sold all of the securities of AHC-WW Jersey Limited, a private limited liability company incorporated in Jersey and a subsidiary of the Company, which constituted the entirety of the Company’s U.K. operations. The Company used the net proceeds of approximately $1,425 million (excluding cash retained by the buyer) along with cash on the balance sheet to reduce debt by $1,640 million during the first quarter of 2021 as described in Note 11 – Long-Term Debt. As a result of the U.K. Sale, the Company reported, for all periods presented, results of operations and cash flows of the U.K. operations as discontinued operations in the accompanying financial statements. In December 2020, the Company’s U.K. operations met the criteria to be classified as assets held for sale. The carrying value of the U.K. operations was written down to fair value less costs to sell in the consolidated balance sheet at December 31, 2020. This resulted in a loss on sale of $867.3 million, which includes approximately $356.2 million of non-cash goodwill impairment, recorded within discontinued operations in the consolidated statement of operations. During the first quarter of 2021, an additional $14.3 million was recorded as a loss on sale primarily resulting from an increase in the U.K. operations carrying value. For the years ended December 31, 2021 and 2020, results of operations of the U.K. operations were as follows (in thousands): Year Ended December 31, 2021 2020 Revenue $ 62,520 $ 1,119,768 Salaries, wages and benefits 35,937 632,134 Professional fees 6,815 127,291 Supplies 2,217 38,285 Rents and leases 2,509 47,748 Other operating expenses 6,682 113,534 Depreciation and amortization — 74,935 Interest expense, net 10 (417 ) Loss on sale 13,490 867,324 Loss on impairment — 20,239 Transaction-related expenses 6,265 8,719 Total expenses 73,925 1,929,792 Loss from discontinued operations before income taxes (11,405 ) (810,024 ) Provision for income taxes 1,236 2,366 Loss from discontinued operations $ (12,641 ) $ (812,390 ) The consolidated cash flows for the year ended December 31, 2020 related to the discontinued U.K. operations includes cash paid for capital expenditures of $48.4 million. |
The CARES Act
The CARES Act | 12 Months Ended |
Dec. 31, 2022 | |
Extraordinary And Unusual Items [Abstract] | |
The CARES Act | 10. The CARES Act As part of the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”), the U.S. government announced it would offer $100 billion of relief to eligible healthcare providers. On April 24, 2020, then President Trump signed into law the Paycheck Protection Program and Health Care Enhancement Act (the “PPP Act”). Among other things, the PPP Act allocates $75 billion to eligible healthcare providers to help offset COVID-19 related losses and expenses. The $75 billion allocated under the PPP Act is in addition to the $100 billion allocated to healthcare providers for the same purposes in the CARES Act and has been disbursed to providers under terms and conditions similar to the CARES Act funds. The Company accounts for government grants by analogizing to the grant model in accordance with International Accounting Standard ("IAS") 20, Accounting for Government Grants and Disclosure of Government Assistance During 2020, the Company participated in certain relief programs offered through the CARES Act, including receipt of approximately $34.9 million relating to the Public Health and Social Services Emergency Fund (“PHSSE Fund”), also known as the Provider Relief Fund. During the fourth quarter of 2020, the Company recorded approximately $32.8 million of income from provider relief fund related to PHSSE Fund funds received in 2020. In 2021, the Company received $24.2 million of additional funds from the PHSSE Fund. During the fourth quarter of 2021, the Company recorded $17.9 million of income from provider relief fund related to the funds received. During the year ended December 31, 2022, the Company received $7.7 million of additional funds from the PHSSE Fund and $14.2 million from the American Rescue Plan (“ARP”) Rural Payments for Hospitals. During the year ended December 31, 2022, the Company recorded $21.5 million of income from provider relief fund related to PHSSE Fund and ARP funds received. The remaining unrecognized funds of $9.0 million are included in other accrued liabilities on the consolidated balance sheet at December 31, 2022. The Company continues to evaluate its compliance with the terms and conditions to, and the financial impact of, the additional funds received, including potential repayment of the remaining balance. Healthcare providers were required to sign an attestation confirming receipt of the Provider Relief Fund funds and agree to the terms and conditions of payment. Under the terms and conditions for receipt of the payment, the Company was allowed to use the funds to cover lost revenues and healthcare costs related to COVID-19, and the Company was required to properly and fully document the use of these funds to the U.S. Department of Health and Human Services (“HHS”). The reporting of the funds is subject to future audit for compliance with the terms and conditions. The Company recognized Provider Relief Fund funds to the extent it had qualifying COVID-19 expenses or lost revenues as permitted under the terms and conditions. The grant income associated with the COVID-19 expenses and lost revenues incurred during the years ended December 31, 2022, 2021 and 2020 is reflected as income from provider relief fund in the Company’s consolidated statements of operations. During 2020, the Company applied for and received approximately $45.2 million of payments from the CMS Accelerated and Advance Payment Program. Of the $45.2 million of advance payments received in 2020, the Company repaid approximately $25.1 million of advance payments during 2021 and made additional repayments of approximately $20.1 million during the year ended December 31, 2022. In addition, the Company received a 2% increase in facilities’ Medicare reimbursement rate as a result of the temporary suspension of Medicare sequestration from May 1, 2020, to March 31, 2022, which was reduced to 1% on April 1, 2022 and was eliminated effective July 1, 2022. The CARES Act also provides for certain federal income and other tax changes. The Company received a cash benefit of approximately $39.3 million for 2020 relating to the delay of payment of the employer portion of Social Security payroll taxes. The Company repaid half of the $39.3 million of payroll tax deferrals during the third quarter of 2021 and repaid the remaining portion in the third quarter 2022 to eliminate the liability. The payroll tax deferral at December 31, 2021 was included in accrued salaries and benefits on the consolidated balance sheet. |
Long-Term Debt
Long-Term Debt | 12 Months Ended |
Dec. 31, 2022 | |
Debt Disclosure [Abstract] | |
Long-Term Debt | 11. Long-Term Debt Long-term debt consisted of the following (in thousands): December 31, 2022 2021 Credit Facility: Term Loan A $ 398,438 $ 417,031 Revolving Line of Credit 75,000 170,000 5.500% Senior Notes due 2028 450,000 450,000 5.000% Senior Notes due 2029 475,000 475,000 Less: unamortized debt issuance costs, discount and premium (12,647 ) (14,811 ) 1,385,791 1,497,220 Less: current portion (21,250 ) (18,594 ) Long-term debt $ 1,364,541 $ 1,478,626 New Credit Facility The Company entered into a credit agreement establishing a new senior credit facility (the “New Credit Facility”) on March 17, 2021. The New Credit Facility provides for a $600.0 million senior secured revolving credit facility (the “Revolving Facility”) and a $425.0 million senior secured term loan facility (the “Term Loan Facility” and, together with the Revolving Facility, the “Senior Facilities”), each maturing on March 17, 2026 unless extended in accordance with the terms of the New Credit Facility. The Revolving Facility further provides for (i) up to $20.0 million to be utilized for the issuance of letters of credit and (ii) the availability of a swingline facility under which the Company may borrow up to $20.0 million. As a part of the closing of the New Credit Facility on March 17, 2021, the Company (i) refinanced and terminated the Company’s prior credit facilities under an amended and restated credit agreement, dated as of December 31, 2012 (the “Prior Credit Facility”) and (ii) financed the redemption of all of the Company’s outstanding 5.625% Senior Notes due 2023 (the “5.625% Senior Notes”). The Company had $521.6 million of availability under the Revolving Facility and had standby letters of credit outstanding of $3.4 million related to security for the payment of claims required by its workers’ compensation insurance program at December 31, 2022. During the year ended December 31, 2022, the Company repaid $95.0 million of the balance outstanding on the Revolving Facility. During the third quarter of 2021, the Company repaid $60.0 million of the initial $160.0 million balance outstanding on the Revolving Facility. During the fourth quarter of 2021, the Company had a draw of $70.0 million on the Revolving Facility related to the CenterPointe acquisition. The New Credit Facility requires quarterly principal repayments for the Term Loan Facility of $5.3 million for March 31, 2023 to March 31, 2024, $8.0 million for June 30, 2024 to March 31, 2025, $10.6 million for June 30, 2025 to December 31, 2025, with the remaining principal balance of the Term Loan Facility due on the maturity date of March 17, 2026. The Company has the ability to increase the amount of the Senior Facilities, which may take the form of increases to the Revolving Facility or the Term Loan Facility or the issuance of one or more incremental term loan facilities (collectively, the “Incremental Facilities”), upon obtaining additional commitments from new or existing lenders and the satisfaction of customary conditions precedent for such Incremental Facilities. Such Incremental Facilities may not exceed the sum of (i) the greater of $480.0 million and an amount equal to 100% of the Consolidated EBITDA (as defined in the New Credit Facility) of the Company and its Restricted Subsidiaries (as defined in the New Credit Facility) (as determined for the four fiscal quarter period most recently ended for which financial statements are available), and (ii) additional amounts so long as, after giving effect thereto, the Consolidated Senior Secured Net Leverage Ratio (as defined in the New Credit Facility) does not exceed 3.5 to 1.0. Subject to certain exceptions, substantially all of the Company’s existing and subsequently acquired or organized direct or indirect wholly-owned U.S. subsidiaries are required to guarantee the repayment of the Company’s obligations under the New Credit Facility. Borrowings under the Senior Facilities bear interest at a floating rate, which will initially be, at the Company’s option, either (i) adjusted LIBOR plus 1.75% or (ii) an alternative base rate plus 0.75% (in each case, subject to adjustment based on the Company’s consolidated total net leverage ratio). An unused fee initially set at 0.25% per annum (subject to adjustment based on the Company’s consolidated total net leverage ratio) is payable quarterly in arrears based on the actual daily undrawn portion of the commitments in respect of the Revolving Facility. The New Credit Facility contains customary representations and affirmative and negative covenants, including limitations on the Company’s and its subsidiaries’ ability to incur additional debt, grant or permit additional liens, make investments and acquisitions, merge or consolidate with others, dispose of assets, pay dividends and distributions, pay junior indebtedness and enter into affiliate transactions, in each case, subject to customary exceptions. In addition, the New Credit Facility contains financial covenants requiring the Company on a consolidated basis to maintain, as of the last day of any consecutive four fiscal quarter period, a consolidated total net leverage ratio of not more than 5.0 to 1.0 and an interest coverage ratio of at least 3.0 to 1.0. The New Credit Facility also includes events of default customary for facilities of this type and upon the occurrence of such events of default, among other things, all outstanding loans under the Senior Facilities may be accelerated and/or the lenders’ commitments terminated. At December 31, 2022, the Company was in compliance with such covenants. Prior Credit Facility The Company entered into a credit agreement establishing 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 establishing the Prior Credit Facility, which amended and restated the Senior Secured Credit Facility. The Company amended the Prior Credit Facility from time to time as described in the Company’s prior filings with the SEC. On April 21, 2020, the Company entered into the Thirteenth Amendment (the “Thirteenth Amendment”) to the Prior Credit Facility. The Thirteenth Amendment amended the Consolidated Leverage Ratio in the prior covenant to increase such leverage ratio for the rest of 2020. On November 13, 2020, the Company entered into the Fourth Repricing Facilities Amendment (the “Fourth Repricing Facilities Amendment”) to the Prior Credit Facility. The Fourth Repricing Facilities Amendment extended the maturity date of each of the prior revolving line of credit and the Term Loan A Facility of the Prior Credit Facility (“TLA Facility”) from November 30, 2021 to November 30, 2022. The Fourth Repricing Facilities Amendment also (1) replaced the revolving line of credit in an aggregate committed amount of $500.0 million with an aggregate committed amount of approximately $459.0 million and (2) replaced the TLA Facility aggregate outstanding principal amount of approximately $352.4 million with an aggregate principal amount of approximately $318.9 million. The interest rate margin applicable to both facilities remained unchanged from the prior facilities, and the commitment fee applicable to the new revolving line of credit also remained unchanged from the prior revolving line of credit. In connection with the Fourth Repricing Facilities Amendment, the Company recorded a debt extinguishment charge of $ 1.0 million, including the write-off of discount and deferred financing costs, which was recorded in debt extinguishment costs in the consolidated statement of operations for the year ended December 31, 2020. On January 5, 2021, the Company made a voluntary payment of $105.0 million on the Term Loan B Facility Tranche B-4 of the Prior Credit Facility (“Tranche B-4 Facility”). On January 19, 2021, the Company used a portion of the net proceeds from the U.K. Sale to repay the outstanding balances of $311.7 million of the TLA Facility and $767.9 million of the Tranche B-4 Facility Senior Notes 5.500% Senior Notes due 2028 On June 24, 2020, the Company issued $450.0 million of 5.500% Senior Notes due 2028 (the “5.500% Senior Notes”). The 5.500% Senior Notes mature on July 1, 2028 and bear interest at a rate of 5.500% per annum, payable semi-annually in arrears on January 1 and July 1 of each year, commencing on January 1, 2021. 5.000% Senior Notes due 2029 On October 14, 2020, the Company issued $475.0 million of 5.000% Senior Notes due 2029 (the “5.000% Senior Notes”). The 5.000% Senior Notes mature on April 15, 2029 and bear interest at a rate of 5.000% per annum, payable semi-annually in arrears on April 15 and October 15 of each year, commencing on April 15, 2021. The Company used the net proceeds of the 5.000% Senior Notes to prepay approximately $453.3 million of the outstanding borrowings on the Company’s The indentures governing the 5.500% Senior Notes and the 5.000% 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 New 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. 5.625% Senior Notes due 2023 On February 11, 2015, the Company issued $375.0 million of 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 had outstanding an aggregate of $650.0 million of 5.625% Senior Notes. The 5.625% Senior Notes were to 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. On March 17, 2021, the Company redeemed the 5.625% Senior Notes. 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 were to 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. On March 1, 2021, the Company redeemed the 6.500% Senior Notes. Redemption of 5.625% Senior Notes and 6.500% Senior Notes On January 29, 2021, the Company issued conditional notices of full redemption providing for the redemption in full of $650 million of 5.625% Senior Notes and $390 million of 6.500% Senior Notes to the holders of such notes. On March 1, 2021 , the Company satisfied and discharged the indentures governing the 6.500% Senior Notes. In connection with the redemption of the 6.500% Senior Notes, the Company recorded debt extinguishment costs of $ 10.5 million, including $ 6.3 million cash paid for breakage costs and the write-off of deferred financing costs of $ 4.2 million in the consolidated statement of operations. On March 17, 2021, the Company satisfied and discharged the indentures governing the 5.625% Senior Notes. In connection with the redemption of the 5.625% Senior Notes, the Company recorded debt extinguishment costs of $3.3 million, including the write-off of deferred financing and premiums costs in the consolidated statement of operations. 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 were to 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. On June 24, 2020, the Company redeemed the 6.125% Senior Notes. 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 were to 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. On Redemption of 6.125% Senior Notes and 5.125% Senior Notes On June 10, 2020, the Company issued conditional notices of full redemption providing for the redemption in full of the 6.125% Senior Notes and 5.125% Senior Notes on July 10, 2020 (the “Redemption Date”), in each case at a redemption price equal to 100.0% of the principal amount thereof, plus accrued and unpaid interest, if any, to, but not including the Redemption Date (the “Redemption Price”). On June 24, 2020, the Company satisfied and discharged the indentures governing the 6.125% Senior Notes and the 5.125% Senior Notes by irrevocably depositing with a trustee sufficient funds equal to the Redemption Price for the 6.125% Senior Notes and the 5.125% Senior Notes and otherwise complying with the terms in the indentures relating to the satisfaction and discharge of the 6.125% Senior Notes and the 5.125% Senior Notes. In connection with the redemption of the 6.125% Senior Notes and the 5.125% Senior Notes, the Company recorded a debt extinguishment charge of $3.3 million, including the write-off of the deferred financing and other costs in the consolidated statement of operations for the year ended December 31, 2020. Other long-term debt During the year ended December 31, 2021, the Company repaid other long-term debt of $3.3 million, which is reflected in repayment of long-term debt within financing activities in the consolidated statement of cash flows. Debt Issuance Costs Debt issuance costs are deferred and amortized to interest expense over the term of the related debt. Debt issuance costs at December 31, 2022 were $12.6 million, net of accumulated amortization of $4.6 million. Debt issuance costs at December 31, 2021 were $14.8 million, net of accumulated amortization of $2.4 million. Amortization expense related to debt issuance costs, which is included in interest expense on the consolidated statements of operations, was $2.2 million, $2.8 million and $9.8 million, respectively, for the years ended December 31, 2022, 2021 and 2020. Other The aggregate maturities of long-term debt at December 31, 2022 were as follows (in thousands): 2023 $ 21,250 2024 29,219 2025 39,844 2026 383,125 2027 — Thereafter 925,000 Total $ 1,398,438 |
Noncontrolling Interests
Noncontrolling Interests | 12 Months Ended |
Dec. 31, 2022 | |
Noncontrolling Interest [Abstract] | |
Noncontrolling Interests | 12. 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 December 31, 2022, the Company operated eight facilities through non-wholly owned subsidiaries. The Company owns between approximately 65% and 86% of the equity interests of these entities and noncontrolling partners own the remaining equity interests. The initial value of the noncontrolling interests is based on the fair value of contributions. The Company consolidates the operations of each facility based on its status as primary beneficiary, as further discussed in Note 13 – Variable Interest Entities. The noncontrolling interests are reflected as redeemable noncontrolling interests on the accompanying 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 January 1, 2021 $ 55,315 Contributions from noncontrolling partners in joint ventures 6,734 Net income attributable to noncontrolling interests 4,927 Distributions to noncontrolling partners in joint ventures (1,588 ) Balance at December 31, 2021 65,388 Contributions from noncontrolling partners in joint ventures 21,162 Net income attributable to noncontrolling interests 6,894 Acquisition of ownership interests from noncontrolling partners (4,183 ) Distributions to noncontrolling partners in joint ventures (1,004 ) Balance at December 31, 2022 $ 88,257 |
Variable Interest Entities
Variable Interest Entities | 12 Months Ended |
Dec. 31, 2022 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Variable Interest Entities | 13. Variable Interest Entities For legal entities where the Company has a financial relationship, the Company evaluates whether it has a variable interest and determines if the entity is considered a variable interest entity (“VIE”). If the Company concludes an entity is a VIE and the Company is the primary beneficiary, the entity is consolidated. The primary beneficiary analysis is a qualitative analysis based on power and benefits. A reporting entity has a controlling financial interest in a VIE and must consolidate the VIE if it has both power and benefits. It must have the power to direct the activities that most significantly impact the VIE’s economic performance and the obligation to absorb losses of the VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE. At December 31, 2022, the Company operated eight facilities through non-wholly owned subsidiaries. The Company owns between approximately 65% and 86% of the equity interests of these entities, and noncontrolling partners own the remaining equity interests. The Company manages each of these facilities, is responsible for the day to day operations and, therefore, has the obligation to absorb losses or receive benefits from the VIE that could potentially be significant to the VIE. These activities include, but are not limited to, behavioral healthcare services, human resource and employment-related decisions, marketing and finance. The terms of the agreements governing each of the Company’s VIEs prohibit the Company from using the assets of each VIE to satisfy the obligations of other entities. The consolidated VIEs assets and liabilities in the Company’s consolidated balance sheets are shown below (in thousands): December 31, 2022 2021 Cash and cash equivalents $ 32,478 $ 26,360 Accounts receivable, net 23,789 20,144 Other current assets 2,561 1,304 Total current assets 58,828 47,808 Property and equipment, net 313,358 220,793 Goodwill 39,564 34,945 Intangible assets, net 16,139 10,490 Operating lease right-of-use assets 6,284 6,603 Total assets $ 434,173 $ 320,639 Accounts payable $ 4,650 $ 3,690 Accrued salaries and benefits 6,866 5,656 Current portion of operating lease liabilities 233 197 Other accrued liabilities 6,179 6,818 Total current liabilities 17,928 16,361 Operating lease liabilities 6,433 6,666 Other liabilities — 1,083 Total liabilities $ 24,361 $ 24,110 |
Accumulated Other Comprehensive
Accumulated Other Comprehensive Loss | 12 Months Ended |
Dec. 31, 2022 | |
Equity [Abstract] | |
Accumulated Other Comprehensive Loss | 14. 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 January 1, 2020 $ (434,633 ) $ 24,958 $ (5,209 ) $ (414,884 ) Foreign currency translation gain (loss) 61,532 — (285 ) 61,247 Loss on derivative instruments, net of tax of $(3.9) million — (11,272 ) — (11,272 ) Pension liability adjustment, net of tax of $(0.8) million — — (6,456 ) (6,456 ) Balance at December 31, 2020 (373,101 ) 13,686 (11,950 ) (371,365 ) Foreign currency translation gain (loss) (4,293 ) — 33 (4,260 ) Gain on derivative instruments, net of tax of $0.1 million — 19 — 19 U.K. Sale 377,394 (13,705 ) 11,917 375,606 Balance at December 31, 2021 $ — $ — $ — $ — |
Equity
Equity | 12 Months Ended |
Dec. 31, 2022 | |
Equity [Abstract] | |
Equity | 15. Equity Preferred Stock The Company’s amended and restated certificate of incorporation provides that up to 10,000,000 shares of preferred stock may be issued. The board of directors has the authority to issue preferred stock in one or more series and to fix for each series the voting powers (full, limited or none), and the designations, preferences and relative participating, optional or other special rights and qualifications, limitations or restrictions on the stock and the number of shares constituting any series and the designations of this series, without any further vote or action by the stockholders. Common Stock The Company’s amended and restated certificate of incorporation provides that up to 180,000,000 shares of common stock may be issued. Holders of the Company’s common stock are entitled to one vote for each share held of record on all matters on which stockholders may vote. There are no preemptive, conversion, redemption or sinking fund provisions applicable to shares of the Company’s common stock. In the event of liquidation, dissolution or winding up, holders of the Company’s common stock are entitled to share ratably in the assets available for distribution, subject to any prior rights of any holders of preferred stock then outstanding. Delaware law prohibits the Company from paying any dividends unless it has capital surplus or net profits available for this purpose. In addition, the New Credit Facility imposes restrictions on the Company’s ability to pay dividends. |
Equity-Based Compensation
Equity-Based Compensation | 12 Months Ended |
Dec. 31, 2022 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Equity-Based Compensation | 16. 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 December 31, 2022, a maximum of 12,700,000 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 3,133,811 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 closing price of the Company’s common stock on the most recent trading date prior to the date of grant. The Company recognized $29.6 million, $37.5 million and $22.5 million in equity-based compensation expense for the years ended December 31, 2022, 2021 and 2020, respectively. Stock compensation expense for the years ended December 31, 2022, 2021 and 2020 is impacted by forfeiture adjustments and restricted stock unit adjustments based on actual performance compared to vesting targets. At December 31, 2022, there was $61.9 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 1.4 years. At December 31, 2022, there were no warrants outstanding. The Company recognized a deferred income tax benefit of $8.0 million, $9.6 million and $5.5 million for the years ended December 31, 2022, 2021 and 2020, respectively, related to equity-based compensation expense. Stock Options Stock option activity during 2020, 2021 and 2022 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, 2020 1,360,068 $ 39.40 Options granted 507,600 33.13 Options exercised (68,700 ) 29.15 Options cancelled (288,662 ) 39.67 Options outstanding at December 31, 2020 1,510,306 37.56 Options granted 324,320 57.53 Options exercised (558,322 ) 39.45 Options cancelled (170,235 ) 40.08 Options outstanding at December 31, 2021 1,106,069 42.07 Options granted 334,260 55.73 Options exercised (285,577 ) 40.66 Options cancelled (175,475 ) 46.98 Options outstanding at December 31, 2022 979,277 $ 46.27 7.44 $ 35,303 Options exercisable at December 31, 2022 301,827 $ 41.43 5.69 $ 12,341 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 years ended December 31, 2022, 2021 and 2020: Year Ended December 31, 2022 2021 2020 Weighted average grant-date fair value of options $ 20.72 $ 20.64 $ 12.37 Risk-free interest rate 2.0 % 0.9 % 1.6 % Expected volatility 39 % 40 % 41 % Expected life (in years) 5.0 5.0 5.0 The Company’s estimate of expected volatility for stock options is based upon the volatility of its 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 2020, 2021 and 2022 was as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2020 805,136 $ 34.14 Granted 637,312 25.82 Cancelled (129,683 ) 34.56 Vested (289,769 ) 35.88 Unvested at December 31, 2020 1,022,996 $ 28.41 Granted 352,430 58.32 Cancelled (82,751 ) 39.63 Vested (366,048 ) 30.81 Unvested at December 31, 2021 926,627 $ 37.84 Granted 650,396 64.65 Cancelled (145,205 ) 49.03 Vested (386,616 ) 32.64 Unvested at December 31, 2022 1,045,202 $ 54.89 Restricted stock unit activity during 2020, 2021 and 2022 was as follows: Number of Units Weighted Average Grant-Date Fair Value Unvested at January 1, 2020 447,357 $ 38.89 Granted 583,680 10.60 Performance adjustment 117,772 13.50 Cancelled (63,056 ) 43.35 Vested (12,691 ) 42.09 Unvested at December 31, 2020 1,073,062 $ 20.15 Granted 149,416 61.52 Performance adjustment 465,993 25.49 Cancelled — — Vested (184,051 ) 42.30 Unvested at December 31, 2021 1,504,420 $ 23.20 Granted 105,311 73.96 Performance adjustment 182,543 33.05 Cancelled — — Vested (518,474 ) 43.16 Unvested at December 31, 2022 1,273,800 $ 20.69 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. In addition to Company performance, these performance-based restricted stock units are subject to the continuing service of the employee during the 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. |
Income Taxes
Income Taxes | 12 Months Ended |
Dec. 31, 2022 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | 17. Income Taxes Provision for income taxes from continuing operations consists of the following for the periods presented (in thousands): Year Ended December 31, 2022 2021 2020 Current: Federal $ 63,041 $ 48,292 $ (18,215 ) State 13,769 6,715 4,981 Foreign 755 778 732 Total current 77,565 55,785 (12,502 ) Deferred: Federal 9,808 13,339 46,442 State 6,377 (1,892 ) 564 Foreign 360 325 6,102 Total deferred provision 16,545 11,772 53,108 Provision for income taxes $ 94,110 $ 67,557 $ 40,606 A reconciliation of the U.S. federal statutory rate to the effective tax rate is as follows for the periods presented: Year Ended December 31, 2022 2021 2020 U.S. federal statutory rate on income before income taxes 21.0 % 21.0 % 21.0 % Impact of foreign operations (0.1 ) 1.7 (0.5 ) Effects of statutory rate change — — 3.2 State income taxes, net of federal tax effect 4.7 3.9 5.1 Permanent differences 0.1 1.7 1.5 Change in valuation allowance 0.2 (2.8 ) 127.4 Unrecognized tax benefit release — (0.9 ) (0.4 ) Federal tax credits (0.6 ) (0.8 ) (1.0 ) Basis recognition related to foreign divestiture — — (129.9 ) CARES Act impacts to net operating losses — — (4.5 ) Other (0.1 ) 0.7 0.2 Effective income tax rate 25.2 % 24.5 % 22.1 % For the year ended December 31, 2022, the provision for income taxes was $94.1 million, reflecting an effective tax rate of 25.2%, compared to $67.6 million, reflecting an effective tax rate of 24.5%, for the year ended December 31, 2021. The domestic and foreign components of income from continuing operations before income taxes for continuing operations are as follows (in thousands): Year Ended December 31, 2022 2021 2020 Foreign $ 5,420 $ 5,596 $ 9,904 Domestic 368,723 270,164 173,893 Income from continuing operations before income taxes $ 374,143 $ 275,760 $ 183,797 The tax effects of temporary differences that give rise to significant portions of the deferred tax assets and liabilities of the Company at December 31, 2022 and December 31, 2021 were as follows (in thousands): December 31, 2022 2021 Deferred tax assets: Net operating losses and tax credit carryforwards – federal and state $ 7,333 $ 9,354 Capital loss carryovers 215,745 215,367 Bad debt allowance 1,148 1,083 Accrued compensation and severance 18,784 18,241 Insurance reserves 20,924 18,847 Leases 862 896 Accrued expenses — 5,768 Interest carryforwards 2,639 3,396 Lease right-of-use liabilities 26,277 26,154 Fixed asset basis difference 2,128 — Other assets 8,987 8,066 Total gross deferred tax assets 304,827 307,172 Less: valuation allowance (217,705 ) (217,325 ) Deferred tax assets 87,122 89,847 Deferred tax liabilities: Fixed asset basis difference — (2,456 ) Prepaid items (3,714 ) (2,882 ) Accrued expenses (5,713 ) — Intangible assets (139,843 ) (126,446 ) Lease right-of-use assets (24,960 ) (24,660 ) Investment in foreign subsidiary (2,530 ) (4,691 ) Total deferred tax liabilities (176,760 ) (161,135 ) Total net deferred tax liability $ (89,638 ) $ (71,288 ) The Company records a valuation allowance to reduce its net deferred tax assets to the amount that is more likely than not to be realized. At December 31, 2022 and 2021, the Company carried a valuation allowance against deferred tax assets of $217.7 million and $217.3 million, respectively. These amounts are primarily related to deferred tax assets related to the Company’s capital loss carryforward resulting from the U.K. Sale and certain state net operating losses. If the capital loss carryforward is not utilized, it will begin to expire in 2026. As of December 31, 2022 and 2021, the Company had no federal net operating loss carryforwards. The foreign net operating loss carryforwards at December 31, 2022 and 2021 are approximately $0.1 million and $0.1 million, respectively, and have no expiration. The Company has state net operating loss carryforwards at December 31, 2022 and 2021 of approximately $191.5 million and $227.3 million, respectively. These net operating loss carryforwards, if not used to offset future taxable income, will expire from 2023 to 2036. In addition, the Company has certain state tax credits of $0.2 million which will begin to expire in 2030 if not utilized. Income taxes receivable was $28.9 million and $24.6 million at December 31, 2022 and 2021, respectively. At December 31, 2022 and 2021, $23.1 million of income taxes receivable has been included in other assets due to anticipated delays in receipt of income tax refunds associated with amended tax return filings. The remaining $5.8 million and $1.5 million of income taxes receivable is included in other current assets in the December 31, 2022 and 2021 consolidated balance sheet, respectively. Income taxes payable of $1.3 million and $5.5 million at December 31, 2022 and 2021, respectively, was included in other accrued liabilities in the consolidated balance sheets. The Company did not record any amounts related to unrecognized tax benefits at December 31, 2022 or 2021. The Company’s accounting policy is to record any interest and penalties as a component of income tax expense, when applicable. A reconciliation of the beginning and ending amount of unrecognized income tax benefits, exclusive of any interest and penalties, net of the federal benefit, is as follows (in thousands): 2021 Balance at January 1 $ 2,060 Additions based on tax positions related to the current year — Reductions as a result of the lapse of applicable statutes of limitations and settlements with tax authorities (2,060 ) Balance at December 31 $ — The Company and its subsidiaries file income tax returns in federal and in many state and local jurisdictions as well as foreign jurisdictions. The Company may be subject to examination by the Internal Revenue Service (“IRS”) for calendar years 2019 through 2021. Additionally, any net operating losses that were generated in prior years and utilized in these years may also be subject to examination by the IRS. While no foreign jurisdictions are presently under examination, the Company may be subject to examination for calendar years 2018 through 2021. Generally, for state tax purposes, the Company’s 2017 through 2021 tax years remain open for examination by the tax authorities. At the date of this report, there were no audits or inquires that had progressed sufficiently to predict their ultimate outcome. |
Derivatives
Derivatives | 12 Months Ended |
Dec. 31, 2022 | |
Derivative Instruments And Hedging Activities Disclosure [Abstract] | |
Derivatives | 18. Derivatives The Company entered into foreign currency forward contracts during the year ended December 31, 2020 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 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 received semi-annual interest payments in USD from the counterparties at fixed interest rates, and the Company made semi-annual interest payments in GBP to the counterparties at fixed interest rates. The interest payments under the cross-currency swap agreements resulted in £25.4 million of annual cash flows from the Company’s U.K. business being converted to $35.8 million. In conjunction with the U.K. Sale in January 2021, the Company settled its cross currency swap liability and outstanding forward contracts as shown in investing activities on the consolidated statement of cash flows. |
Fair Value Measurements
Fair Value Measurements | 12 Months Ended |
Dec. 31, 2022 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | 19. 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 New Credit Facility, 5.500% Senior Notes and 5.000% Senior Notes at December 31, 2022 and 2021 were as follows (in thousands): Carrying Amount Fair Value December 31, December 31, 2022 2021 2022 2021 New Credit Facility $ 471,489 $ 584,418 $ 471,489 $ 584,418 5.500% Senior Notes due 2028 $ 444,694 $ 443,894 $ 422,459 $ 466,577 5.000% Senior Notes due 2029 $ 469,609 $ 468,907 $ 433,214 $ 481,802 The Company’s New Credit Facility, 5.500% Senior Notes and 5.000% Senior Notes 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. |
Commitments and Contingencies
Commitments and Contingencies | 12 Months Ended |
Dec. 31, 2022 | |
Commitments And Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 20. Commitments and Contingencies 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 Pfenning v. Jacobs, et al., Solak v. Jacobs, et al In the fall of 2017, the Office of Inspector General (“OIG”) 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 OIG 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. |
Employee Benefit Plans
Employee Benefit Plans | 12 Months Ended |
Dec. 31, 2022 | |
Compensation And Retirement Disclosure [Abstract] | |
Employee Benefit Plans | 21. Employee Benefit Plans The Company maintains a qualified defined contribution 401(k) plan covering substantially all of its employees in the U.S. The Company may, at its discretion, make contributions to the plan. The Company recorded expense of $6.6 million, $2.8 million and $3.8 million related to the 401(k) plan for the years ended December 31, 2022, 2021 and 2020, respectively. |
Financial Information Combined
Financial Information Combined Wholly-Owned Subsidiaries | 12 Months Ended |
Dec. 31, 2022 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Financial Information Combined Wholly-Owned Subsidiaries | 22. Financial Information Combined Wholly-Owned Subsidiaries The Company conducts substantially all of its business through its subsidiaries. The 5.500% Senior Notes and the 5.000% 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 New Credit Facility. Summarized financial information presented below is consistent with the consolidated financial statements of the Company, except transactions between combining entities have been eliminated. Financial information for the combined non-guarantor entities has been excluded. Presented below is financial information for the combined wholly-owned subsidiary guarantors at December 31, 2022 and 2021, and for the year ended December 31, 2022. The summarized balance sheet information at December 31, 2021, has been adjusted to reclassify certain wholly-owned subsidiaries as non-guarantor entities. Summarized balance sheet information (in thousands): December 31, 2022 2021 Current assets $ 396,553 $ 349,250 Property and equipment, net 1,517,893 1,166,409 Goodwill 2,105,227 2,086,978 Total noncurrent assets 3,921,336 3,527,700 Current liabilities 345,606 340,514 Long-term debt 1,364,541 1,478,626 Total noncurrent liabilities 1,629,750 1,688,326 Redeemable noncontrolling interests — — Total equity 2,342,533 1,848,110 Summarized operating results information (in thousands): For the Year Ended December 31, 2022 Revenue $ 2,299,562 Income from continuing operations before income taxes 325,309 Net income 244,148 Net income attributable to Acadia Healthcare Company, Inc. 244,148 |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2022 | |
Accounting Policies [Abstract] | |
Cash and Cash Equivalents | Cash and Cash Equivalents The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents. At times, cash and cash equivalent balances may exceed federally insured limits. Management believes that the Company mitigates any risks by depositing cash and investing in cash equivalents with major financial institutions. |
Insurance | Insurance The Company is subject to medical malpractice and other lawsuits due to the nature of the services the Company provides. A portion of the Company’s professional liability risks are insured through a wholly-owned insurance subsidiary providing coverage for up to $10.0 million per claim through August 31, 2022 and $5.0 million and $10.0 million for certain other claims thereafter. The Company has obtained reinsurance coverage from a third party to cover claims in excess of those limits. The reinsurance policy has a coverage limit of $75.0 million or $70.0 million for certain other claims 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. The reserve for professional and general liability risks was estimated based on historical claims, prior settlements and judgments, demographic factors, industry trends, severity factors, and other actuarial assumptions. The estimated accrual for professional and general liabilities could be significantly affected should current and future occurrences differ from historical claim trends and expectations. While claims are monitored closely when estimating professional and general liability accruals, the complexity of the claims and wide range of potential outcomes often hampers timely adjustments to the assumptions used in these estimates. The Company recorded an unfavorable adjustment of $5.9 million to its estimated liability for self-insured professional and general liability claims during the year ended December 31, 2022, relating to the settlement or expected settlement of certain prior year claims relating primarily to the 2017 to 2018 period. The professional and general liability reserve was $103.6 million at December 31, 2022, of which $12.1 million was included in other accrued liabilities and $91.5 million was included in other long-term liabilities. The professional and general liability reserve was $87.8 million at December 31, 2021 , of which $ 11.9 million was included in other accrued liabilities and $ 75.9 million was included in other long-term liabilities. The Company estimates receivables for the portion of professional and general liability reserves that are recoverable under the Company’s insurance policies. Such receivable was $ 37.8 million a t December 31, 2022 , of which $ 10.2 million was included in other current assets and $ 27.6 million was included in other assets, and such receivable was $ 37.9 million a t December 31, 2021 , of which $ 10.8 million was included in other current assets and $ 27.1 million was included in other assets. The Company’s statutory workers’ compensation program is fully insured with a $0.5 million deductible per accident. The workers’ compensation liability was $24.2 million at December 31, 2022, of which $12.0 million was included in accrued salaries and benefits and $12.2 million was included in other long-term liabilities, and such liability was $23.6 million at December 31, 2021, of which $12.0 million was included in accrued salaries and benefits and $11.6 million was included in other long-term liabilities. The reserve for workers compensation claims was based upon independent actuarial estimates of future amounts that will be paid to claimants. Management believes that adequate provisions have been made for workers’ compensation and professional and general liability risk exposures. |
Property and Equipment and Other Long-Lived Assets | Property and Equipment and Other Long-Lived Assets Property and equipment are recorded at cost. Depreciation is calculated on the straight-line basis over the estimated useful lives of the assets, which typically range from 10 to 50 years for buildings and improvements, three to seven years for equipment and the shorter of the lease term or estimated useful lives for leasehold improvements. When assets are sold or retired, the corresponding cost and accumulated depreciation are removed from the related accounts and any gain or loss is recorded in the period of sale or retirement. Repair and maintenance costs are expensed as incurred. Depreciation expense was $117.8 million, $106.7 million and $95.3 million for the years ended December 31, 2022, 2021 and 2020, respectively. The carrying values of long-lived assets are reviewed for possible impairment whenever events, circumstances or operating results indicate that the carrying amount of an asset may not be recoverable. If this review indicates that the asset will not be recoverable, as determined based upon the undiscounted cash flows of the operating asset over the remaining useful life, the carrying value of the asset will be reduced to its estimated fair value. Fair value estimates are based on independent appraisals, market values of comparable assets or internal evaluations of future net cash flows. During the second quarter of 2021, the Company opened a 260-bed replacement facility in Pennsylvania and recorded a non-cash property impairment charge of $23.2 million for the existing facility. Additionally, during the third quarter of 2021, the Company recorded a $1.1 million non-cash property impairment charge for one facility in Louisiana resulting from hurricane damage. The Company performed an impairment review of long-lived assets in the fourth quarter of 2022 and 2021 and recorded no impairment. The impairment review of long-lived assets in the fourth quarter of 2020 indicated the carrying amounts of certain of the Company’s long-lived assets may not be recoverable. This created a non-cash impairment of $4.2 million for the year ended December 31, 2020, which was recorded in loss on impairment on the Company’s consolidated statements of operations. |
Goodwill and Indefinite-Lived Intangible Assets | Goodwill and Indefinite-Lived Intangible Assets The Company’s goodwill and other indefinite-lived intangible assets, which consist of licenses and accreditations, trade names and certificates of need intangible assets that are not amortized, are evaluated for impairment annually during the fourth quarter or more frequently if events indicate the carrying value of a reporting unit may not be recoverable. As of the Company’s annual impairment tests on October 1, 2022 and October 1, 2021, the Company had one reporting unit, behavioral health services. The fair value of the Company’s behavioral health services reporting unit substantially exceeded its carrying value, and therefore no impairment was recorded. During the second quarter of 2021, the Company sold one outpatient facility for $4.3 million and recorded a write down of $1.8 million of goodwill and $0.2 million of intangible assets related to the disposition. During the fourth quarter of 2021, the Company sold one outpatient facility for $1.5 million and recorded a write down of $0.7 million of goodwill and $0.1 million of intangibles related to the disposition. As of the Company’s annual impairment test on October 1, 2020, the Company had two operating segments for segment reporting purposes, U.S. facilities and U.K. facilities, each of which represented a reporting unit for purposes of the Company’s goodwill impairment test. |
Other Current Assets | Other Current Assets Other current assets consisted of the following (in thousands): December 31, 2022 2021 Prepaid expenses $ 27,052 $ 22,292 Other receivables 15,371 10,786 Workers’ compensation deposits – current portion 12,000 12,000 Insurance receivable – current portion 10,158 10,807 Assets held for sale 8,347 15,808 Income taxes receivable 5,767 1,523 Inventory 5,087 4,786 Other 2,255 1,884 Other current assets $ 86,037 $ 79,886 |
Other Accrued Liabilities | Other Accrued Liabilities Other accrued liabilities consisted of the following (in thousands): December 31, 2022 2021 Accrued expenses $ 26,699 $ 26,791 Accrued interest 17,596 17,418 Cost report payable 13,738 6,487 Insurance liability – current portion 12,128 11,923 Accrued property taxes 9,009 8,375 Government relief funds 8,975 8,550 Contract liabilities 6,653 30,371 Income taxes payable 1,338 5,540 Finance lease liabilities 990 990 Other 13,466 10,054 Other accrued liabilities $ 110,592 $ 126,499 |
Stock Compensation | Stock Compensation The Company measures and recognizes the cost of employee services received in exchange for awards of equity instruments based on the grant-date fair value in accordance with the Financial Accounting Standards Board (the “FASB”) Accounting Standards Codification (“ASC”) 718, “ Compensation—Stock Compensation |
Earnings Per Share | Earnings Per Share Basic and diluted earnings per share are calculated in accordance with FASB ASC 260, “ Earnings Per Share |
Income Taxes | Income Taxes The Company uses the asset and liability method of accounting for income taxes. Under this method, deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes and net operating loss and tax credit carryforwards. The amount of deferred taxes on these temporary differences is determined using the tax rates that are expected to apply in the period when the asset is realized or the liability is settled, as applicable, based on tax rates and laws in the respective tax jurisdiction enacted as of the balance sheet date. The Company reviews its deferred tax assets for recoverability and establishes a valuation allowance based on historical taxable income, projected future taxable income, applicable tax strategies, and the expected timing of the reversals of existing temporary differences. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax assets will not be realized. The Company records a liability for unrecognized tax benefits resulting from uncertain tax positions taken or expected to be taken in a tax return. The Company recognizes interest and penalties, if any, related to unrecognized tax benefits in income tax expense. The Company established accruals for taxes and associated interest that may become payable in future years as a result of audits by tax authorities. The Company accrues for tax contingencies when it is more likely than not that a liability to a taxing authority has been incurred and the amount of the contingency can be reasonably estimated. Management believes that the positions taken on previously filed tax returns are reasonable and has not established tax and interest reserves in recognition that various taxing authorities may challenge the positions taken by the Company resulting in additional liabilities for taxes and interest. These amounts are reviewed as circumstances warrant and adjusted as events occur that affect the Company’s potential liability for additional taxes, such as lapsing of applicable statutes of limitations, conclusion of tax audits, additional exposure based on current calculations, identification of new issues, release of administrative guidance, or rendering of a court decision affecting a particular tax issue. |
Recent Accounting Pronouncements | Recent Accounting Pronouncements In November 2021, the FASB issued Accounting Standards Update (“ASU”) 2021-10, “ Government Assistance (Topic 832) Not-for-Profit Entities In March 2020, the FASB issued ASU 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting |
Summary of Significant Accoun_3
Summary of Significant Accounting Policies (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Accounting Policies [Abstract] | |
Other Current Assets | Other current assets consisted of the following (in thousands): December 31, 2022 2021 Prepaid expenses $ 27,052 $ 22,292 Other receivables 15,371 10,786 Workers’ compensation deposits – current portion 12,000 12,000 Insurance receivable – current portion 10,158 10,807 Assets held for sale 8,347 15,808 Income taxes receivable 5,767 1,523 Inventory 5,087 4,786 Other 2,255 1,884 Other current assets $ 86,037 $ 79,886 |
Summary of Other Accrued Liabilities | Other accrued liabilities consisted of the following (in thousands): December 31, 2022 2021 Accrued expenses $ 26,699 $ 26,791 Accrued interest 17,596 17,418 Cost report payable 13,738 6,487 Insurance liability – current portion 12,128 11,923 Accrued property taxes 9,009 8,375 Government relief funds 8,975 8,550 Contract liabilities 6,653 30,371 Income taxes payable 1,338 5,540 Finance lease liabilities 990 990 Other 13,466 10,054 Other accrued liabilities $ 110,592 $ 126,499 |
Revenue (Tables)
Revenue (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Revenue From Contract With Customer [Abstract] | |
Schedule of Revenue Attributed to Each Category | The table below presents total revenue from continuing operations attributed to each category (in thousands): Year Ended December 31, 2022 2021 2020 Acute inpatient psychiatric facilities $ 1,330,757 $ 1,126,872 $ 984,609 Specialty treatment facilities 564,671 510,929 452,805 Comprehensive treatment centers 419,940 385,635 349,217 Residential treatment centers 295,031 283,169 281,158 Other — 7,789 22,140 Revenue $ 2,610,399 $ 2,314,394 $ 2,089,929 |
Schedule of Revenue and Percentage Generated by Each Payor Type in U.S Facilities | The following table presents revenue by payor type and as a percentage of revenue for continuing operations for the years ended December 31, 2022, 2021 and 2020 (in thousands): Year Ended December 31, 2022 2021 2020 Amount % Amount % Amount % Commercial $ 788,895 30.2 % $ 684,292 29.6 % $ 596,698 28.5 % Medicare 394,227 15.1 % 364,598 15.8 % 330,070 15.8 % Medicaid 1,319,600 50.6 % 1,147,884 49.6 % 1,037,852 49.7 % Self-Pay 76,050 2.9 % 93,425 4.0 % 98,302 4.7 % Other 31,627 1.2 % 24,195 1.0 % 27,007 1.3 % Revenue $ 2,610,399 100.0 % $ 2,314,394 100.0 % $ 2,089,929 100.0 % |
Summary of the Activity in Unearned Revenue in U.S. Facilities | A summary of the activity in contract liabilities is as follows (in thousands): Balance at December 31, 2020 $ 47,196 Payments received 11,739 Revenue recognized (3,463 ) Medicare advance repayments (25,101 ) Balance at December 31, 2021 $ 30,371 Payments received 22,914 Revenue recognized (26,497 ) Medicare advance repayments (20,135 ) Balance at December 31, 2022 $ 6,653 |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Earnings Per Share [Abstract] | |
Computation of Basic and Diluted Earnings Per Share | The following table sets forth the computation of basic and diluted earnings (loss) per share for the years ended December 31, 2022, 2021 and 2020 (in thousands, except per share amounts): Year Ended December 31, 2022 2021 2020 Numerator: Income from continuing operations attributable to Acadia Healthcare Company, Inc. $ 273,139 $ 203,276 $ 140,258 Loss from discontinued operations — (12,641 ) (812,390 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 273,139 $ 190,635 $ (672,132 ) Denominator: Weighted average shares outstanding for basic earnings per share 89,680 88,769 87,875 Effects of dilutive instruments 1,875 2,024 720 Shares used in computing diluted earnings per common share 91,555 90,793 88,595 Basic earnings (loss) per share attributable to Acadia Healthcare Company, Inc. stockholders: Income from continuing operations attributable to Acadia Healthcare Company, Inc. $ 3.05 $ 2.29 $ 1.60 Loss from discontinued operations — (0.14 ) (9.25 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 3.05 $ 2.15 $ (7.65 ) Diluted earnings (loss) per share attributable to Acadia Healthcare Company, Inc. stockholders: Income from continuing operations attributable to Acadia Healthcare Company, Inc. $ 2.98 $ 2.24 $ 1.58 Loss from discontinued operations — (0.14 ) (9.17 ) Net income (loss) attributable to Acadia Healthcare Company, Inc. $ 2.98 $ 2.10 $ (7.59 ) |
Acquisitions (Tables)
Acquisitions (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Business Combinations [Abstract] | |
Summary of Preliminary Fair Values of Assets Acquired and Liabilities Assumed | The fair values of assets acquired and liabilities assumed in the CenterPointe acquisition were as follows (in thousands): Cash $ 5,640 Accounts receivable, net 9,358 Other current assets 1,981 Property and equipment 35,227 Goodwill 105,883 Intangible assets 825 Deferred tax assets 1,573 Operating lease right-of-use assets 29,245 Total assets acquired 189,732 Accounts payable 3,820 Accrued salaries and benefits 3,585 Current portion of operating lease liabilities 2,820 Other accrued liabilities 4,326 Deferred tax liability 1,805 Operating lease liabilities 27,850 Total liabilities assumed 44,206 Net assets acquired $ 145,526 |
Summary of Changes in Goodwill | The following table summarizes changes in goodwill for the years ended December 31, 2022 and 2021 (in thousands): Balance at January 1, 2021 $ 2,105,264 Increase from acquisitions 97,122 2021 dispositions (2,449 ) Balance at December 31, 2021 2,199,937 Increase from acquisitions 9,488 Adjustments related to 2021 acquisitions 8,761 Increase from contributions of redeemable noncontrolling interests 4,619 Balance at December 31, 2022 $ 2,222,805 |
Transaction Related Expenses as Incurred | Transaction-related expenses represent costs primarily related to legal, accounting, termination, restructuring, management transition, acquisition and other similar costs. Transaction-related expenses comprised the following costs for the years ended December 31, 2022, 2021 and 2020 (in thousands): Year Ended December 31, 2022 2021 2020 Management transition costs $ 11,575 $ — $ — Termination and restructuring costs 6,476 5,343 3,468 Legal, accounting and other acquisition-related costs 5,741 7,435 8,252 $ 23,792 $ 12,778 $ 11,720 |
Property and Equipment (Tables)
Property and Equipment (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Property Plant And Equipment [Abstract] | |
Summary of Property and Equipment | Property and equipment consisted of the following at December 31, 2022 and 2021 (in thousands): December 31, 2022 2021 Land $ 169,137 $ 154,376 Building and improvements 1,797,809 1,683,560 Equipment 292,200 253,100 Construction in progress 349,473 221,249 2,608,619 2,312,285 Less: accumulated depreciation (656,574 ) (541,126 ) Property and equipment, net $ 1,952,045 $ 1,771,159 |
Other Intangible Assets (Tables
Other Intangible Assets (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
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 December 31, 2022 and 2021 (in thousands): Gross Carrying Amount Accumulated Amortization December 31, 2022 December 31, 2021 December 31, 2022 December 31, 2021 Intangible assets subject to amortization: Non-compete agreements $ 1,131 $ 1,131 $ (1,131 ) $ (1,131 ) Intangible assets not subject to amortization: Licenses and accreditations 11,512 11,600 — — Trade names 45,935 40,435 — — Certificates of need 18,594 18,110 — — 76,041 70,145 — — Total $ 77,172 $ 71,276 $ (1,131 ) $ (1,131 ) |
Leases (Tables)
Leases (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Leases [Abstract] | |
Schedule of Leases on Consolidated Balance Sheet | The Company recorded the following at December 31, 2022 and 2021 on the consolidated balance sheets (in thousands): Right-of-Use Assets Balance Sheet Classification December 31, 2022 December 31, 2021 Finance lease right-of-use assets Property and equipment, net $ 8,250 $ 8,627 Operating lease right-of-use assets Operating lease right-of-use assets 135,238 133,761 Total $ 143,488 $ 142,388 Lease Liabilities Balance Sheet Classification December 31, 2022 December 31, 2021 Current: Finance lease liabilities Other accrued liabilities $ 990 $ 990 Operating lease liabilities Current portion of operating lease liabilities 26,463 23,348 Noncurrent: Finance lease liabilities Other liabilities 10,858 10,807 Operating lease liabilities Operating lease liabilities 116,429 116,841 Total $ 154,740 $ 151,986 |
Schedule of Weighted-average Remaining Lease Terms and Discount Rates | Weighted-average remaining lease terms and discount rates were as follows at December 31, 2022 and 2021: December 31, 2022 2021 Weighted-average remaining lease term (in years): Finance 21.9 22.9 Operating 8.4 9.1 Weighted-average discount rate: Finance 5.1 % 5.1 % Operating 5.0 % 5.1 % |
Schedule of Lease Cost | The Company recorded the following lease costs for the years ended December 31, 2022, 2021 and 2020 (in thousands): Year Ended December 31, 2022 2021 2020 Finance lease costs: Depreciation of leased assets 378 378 868 Interest of lease liabilities 1,041 2,174 3,214 Total finance lease costs $ 1,419 $ 2,552 $ 4,082 Operating lease costs 34,349 28,233 27,050 Variable lease costs 3,129 2,488 2,501 Short term lease costs 2,605 3,257 3,558 Other lease costs 5,379 4,541 4,253 Total rents and leases $ 45,462 $ 38,519 $ 37,362 Total lease costs $ 46,881 $ 41,071 $ 41,444 |
Schedule of Undiscounted Cash Flows for Finance and Operating Leases | Undiscounted future cash flows for finance and operating leases recorded on the consolidated balance sheet were as follows at December 31, 2022 (in thousands): Finance Leases Operating Leases 2023 $ 990 $ 32,818 2024 1,007 29,568 2025 1,089 25,146 2026 1,180 19,251 2027 1,089 12,380 Thereafter 21,821 62,653 Total minimum lease payments 27,176 181,816 Less: amount of lease payments representing interest 15,328 38,924 Present value of future minimum lease payments 11,848 142,892 Less: Current portion of lease liabilities 990 26,463 Noncurrent lease liabilities $ 10,858 $ 116,429 |
Schedule of Supplemental Data | Supplemental data for the years ended December 31, 2022, 2021 and 2020 were as follows (in thousands): Year Ended December 31, 2022 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 33,836 $ 27,508 $ 26,810 Operating cash flows for finance leases $ 1,041 $ 2,174 $ 3,214 Financing cash flows for finance leases $ (51 ) $ 31,136 $ 551 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 31,294 $ 63,279 $ 21,285 Finance leases $ — $ — $ — |
U.K. Sale (Tables)
U.K. Sale (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Discontinued Operations And Disposal Groups [Abstract] | |
Schedule of Financial Condition, Results of Operations and Cash Flows of U.K. Operations as Discontinued Operations | For the years ended December 31, 2021 and 2020, results of operations of the U.K. operations were as follows (in thousands): Year Ended December 31, 2021 2020 Revenue $ 62,520 $ 1,119,768 Salaries, wages and benefits 35,937 632,134 Professional fees 6,815 127,291 Supplies 2,217 38,285 Rents and leases 2,509 47,748 Other operating expenses 6,682 113,534 Depreciation and amortization — 74,935 Interest expense, net 10 (417 ) Loss on sale 13,490 867,324 Loss on impairment — 20,239 Transaction-related expenses 6,265 8,719 Total expenses 73,925 1,929,792 Loss from discontinued operations before income taxes (11,405 ) (810,024 ) Provision for income taxes 1,236 2,366 Loss from discontinued operations $ (12,641 ) $ (812,390 ) |
Long-Term Debt (Tables)
Long-Term Debt (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Debt Disclosure [Abstract] | |
Components of Long-Term Debt | Long-term debt consisted of the following (in thousands): December 31, 2022 2021 Credit Facility: Term Loan A $ 398,438 $ 417,031 Revolving Line of Credit 75,000 170,000 5.500% Senior Notes due 2028 450,000 450,000 5.000% Senior Notes due 2029 475,000 475,000 Less: unamortized debt issuance costs, discount and premium (12,647 ) (14,811 ) 1,385,791 1,497,220 Less: current portion (21,250 ) (18,594 ) Long-term debt $ 1,364,541 $ 1,478,626 |
Summary of Aggregate Maturities of Long-Term Debt | The aggregate maturities of long-term debt at December 31, 2022 were as follows (in thousands): 2023 $ 21,250 2024 29,219 2025 39,844 2026 383,125 2027 — Thereafter 925,000 Total $ 1,398,438 |
Noncontrolling Interests (Table
Noncontrolling Interests (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Noncontrolling Interest [Abstract] | |
Summary of Redeemable Noncontrolling Interests | The components of redeemable noncontrolling interests are as follows (in thousands): Balance at January 1, 2021 $ 55,315 Contributions from noncontrolling partners in joint ventures 6,734 Net income attributable to noncontrolling interests 4,927 Distributions to noncontrolling partners in joint ventures (1,588 ) Balance at December 31, 2021 65,388 Contributions from noncontrolling partners in joint ventures 21,162 Net income attributable to noncontrolling interests 6,894 Acquisition of ownership interests from noncontrolling partners (4,183 ) Distributions to noncontrolling partners in joint ventures (1,004 ) Balance at December 31, 2022 $ 88,257 |
Variable Interest Entities (Tab
Variable Interest Entities (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Schedule of Consolidated VIEs Assets and Liabilities | The consolidated VIEs assets and liabilities in the Company’s consolidated balance sheets are shown below (in thousands): December 31, 2022 2021 Cash and cash equivalents $ 32,478 $ 26,360 Accounts receivable, net 23,789 20,144 Other current assets 2,561 1,304 Total current assets 58,828 47,808 Property and equipment, net 313,358 220,793 Goodwill 39,564 34,945 Intangible assets, net 16,139 10,490 Operating lease right-of-use assets 6,284 6,603 Total assets $ 434,173 $ 320,639 Accounts payable $ 4,650 $ 3,690 Accrued salaries and benefits 6,866 5,656 Current portion of operating lease liabilities 233 197 Other accrued liabilities 6,179 6,818 Total current liabilities 17,928 16,361 Operating lease liabilities 6,433 6,666 Other liabilities — 1,083 Total liabilities $ 24,361 $ 24,110 |
Accumulated Other Comprehensi_2
Accumulated Other Comprehensive Loss (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
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 January 1, 2020 $ (434,633 ) $ 24,958 $ (5,209 ) $ (414,884 ) Foreign currency translation gain (loss) 61,532 — (285 ) 61,247 Loss on derivative instruments, net of tax of $(3.9) million — (11,272 ) — (11,272 ) Pension liability adjustment, net of tax of $(0.8) million — — (6,456 ) (6,456 ) Balance at December 31, 2020 (373,101 ) 13,686 (11,950 ) (371,365 ) Foreign currency translation gain (loss) (4,293 ) — 33 (4,260 ) Gain on derivative instruments, net of tax of $0.1 million — 19 — 19 U.K. Sale 377,394 (13,705 ) 11,917 375,606 Balance at December 31, 2021 $ — $ — $ — $ — |
Equity-Based Compensation (Tabl
Equity-Based Compensation (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Stock Option Activity | Stock option activity during 2020, 2021 and 2022 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, 2020 1,360,068 $ 39.40 Options granted 507,600 33.13 Options exercised (68,700 ) 29.15 Options cancelled (288,662 ) 39.67 Options outstanding at December 31, 2020 1,510,306 37.56 Options granted 324,320 57.53 Options exercised (558,322 ) 39.45 Options cancelled (170,235 ) 40.08 Options outstanding at December 31, 2021 1,106,069 42.07 Options granted 334,260 55.73 Options exercised (285,577 ) 40.66 Options cancelled (175,475 ) 46.98 Options outstanding at December 31, 2022 979,277 $ 46.27 7.44 $ 35,303 Options exercisable at December 31, 2022 301,827 $ 41.43 5.69 $ 12,341 |
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 years ended December 31, 2022, 2021 and 2020: Year Ended December 31, 2022 2021 2020 Weighted average grant-date fair value of options $ 20.72 $ 20.64 $ 12.37 Risk-free interest rate 2.0 % 0.9 % 1.6 % Expected volatility 39 % 40 % 41 % Expected life (in years) 5.0 5.0 5.0 |
Restricted Stock Activity | Restricted stock activity during 2020, 2021 and 2022 was as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2020 805,136 $ 34.14 Granted 637,312 25.82 Cancelled (129,683 ) 34.56 Vested (289,769 ) 35.88 Unvested at December 31, 2020 1,022,996 $ 28.41 Granted 352,430 58.32 Cancelled (82,751 ) 39.63 Vested (366,048 ) 30.81 Unvested at December 31, 2021 926,627 $ 37.84 Granted 650,396 64.65 Cancelled (145,205 ) 49.03 Vested (386,616 ) 32.64 Unvested at December 31, 2022 1,045,202 $ 54.89 |
Restricted Stock Unit Activity | Restricted stock unit activity during 2020, 2021 and 2022 was as follows: Number of Units Weighted Average Grant-Date Fair Value Unvested at January 1, 2020 447,357 $ 38.89 Granted 583,680 10.60 Performance adjustment 117,772 13.50 Cancelled (63,056 ) 43.35 Vested (12,691 ) 42.09 Unvested at December 31, 2020 1,073,062 $ 20.15 Granted 149,416 61.52 Performance adjustment 465,993 25.49 Cancelled — — Vested (184,051 ) 42.30 Unvested at December 31, 2021 1,504,420 $ 23.20 Granted 105,311 73.96 Performance adjustment 182,543 33.05 Cancelled — — Vested (518,474 ) 43.16 Unvested at December 31, 2022 1,273,800 $ 20.69 |
Income Taxes (Tables)
Income Taxes (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Income Tax Disclosure [Abstract] | |
Components of Provision for Income Taxes | Provision for income taxes from continuing operations consists of the following for the periods presented (in thousands): Year Ended December 31, 2022 2021 2020 Current: Federal $ 63,041 $ 48,292 $ (18,215 ) State 13,769 6,715 4,981 Foreign 755 778 732 Total current 77,565 55,785 (12,502 ) Deferred: Federal 9,808 13,339 46,442 State 6,377 (1,892 ) 564 Foreign 360 325 6,102 Total deferred provision 16,545 11,772 53,108 Provision for income taxes $ 94,110 $ 67,557 $ 40,606 |
Effective Income Tax Rate | A reconciliation of the U.S. federal statutory rate to the effective tax rate is as follows for the periods presented: Year Ended December 31, 2022 2021 2020 U.S. federal statutory rate on income before income taxes 21.0 % 21.0 % 21.0 % Impact of foreign operations (0.1 ) 1.7 (0.5 ) Effects of statutory rate change — — 3.2 State income taxes, net of federal tax effect 4.7 3.9 5.1 Permanent differences 0.1 1.7 1.5 Change in valuation allowance 0.2 (2.8 ) 127.4 Unrecognized tax benefit release — (0.9 ) (0.4 ) Federal tax credits (0.6 ) (0.8 ) (1.0 ) Basis recognition related to foreign divestiture — — (129.9 ) CARES Act impacts to net operating losses — — (4.5 ) Other (0.1 ) 0.7 0.2 Effective income tax rate 25.2 % 24.5 % 22.1 % |
Summary of Domestic and Foreign Components of Income from Continuing Operations before Income Taxes | The domestic and foreign components of income from continuing operations before income taxes for continuing operations are as follows (in thousands): Year Ended December 31, 2022 2021 2020 Foreign $ 5,420 $ 5,596 $ 9,904 Domestic 368,723 270,164 173,893 Income from continuing operations before income taxes $ 374,143 $ 275,760 $ 183,797 |
Deferred Tax Assets and Liabilities | The tax effects of temporary differences that give rise to significant portions of the deferred tax assets and liabilities of the Company at December 31, 2022 and December 31, 2021 were as follows (in thousands): December 31, 2022 2021 Deferred tax assets: Net operating losses and tax credit carryforwards – federal and state $ 7,333 $ 9,354 Capital loss carryovers 215,745 215,367 Bad debt allowance 1,148 1,083 Accrued compensation and severance 18,784 18,241 Insurance reserves 20,924 18,847 Leases 862 896 Accrued expenses — 5,768 Interest carryforwards 2,639 3,396 Lease right-of-use liabilities 26,277 26,154 Fixed asset basis difference 2,128 — Other assets 8,987 8,066 Total gross deferred tax assets 304,827 307,172 Less: valuation allowance (217,705 ) (217,325 ) Deferred tax assets 87,122 89,847 Deferred tax liabilities: Fixed asset basis difference — (2,456 ) Prepaid items (3,714 ) (2,882 ) Accrued expenses (5,713 ) — Intangible assets (139,843 ) (126,446 ) Lease right-of-use assets (24,960 ) (24,660 ) Investment in foreign subsidiary (2,530 ) (4,691 ) Total deferred tax liabilities (176,760 ) (161,135 ) Total net deferred tax liability $ (89,638 ) $ (71,288 ) |
Unrecognized Income Tax Benefits Net of Federal Benefit | A reconciliation of the beginning and ending amount of unrecognized income tax benefits, exclusive of any interest and penalties, net of the federal benefit, is as follows (in thousands): 2021 Balance at January 1 $ 2,060 Additions based on tax positions related to the current year — Reductions as a result of the lapse of applicable statutes of limitations and settlements with tax authorities (2,060 ) Balance at December 31 $ — |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Fair Value Disclosures [Abstract] | |
Carrying Amounts and Fair Values of Company's Credit Facilities and Contingent Consideration Liabilities | The carrying amounts and fair values of the Company’s New Credit Facility, 5.500% Senior Notes and 5.000% Senior Notes at December 31, 2022 and 2021 were as follows (in thousands): Carrying Amount Fair Value December 31, December 31, 2022 2021 2022 2021 New Credit Facility $ 471,489 $ 584,418 $ 471,489 $ 584,418 5.500% Senior Notes due 2028 $ 444,694 $ 443,894 $ 422,459 $ 466,577 5.000% Senior Notes due 2029 $ 469,609 $ 468,907 $ 433,214 $ 481,802 |
Financial Information Combine_2
Financial Information Combined Wholly-Owned Subsidiaries (Tables) | 12 Months Ended |
Dec. 31, 2022 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Summarized Balance Sheet | Summarized balance sheet information (in thousands): December 31, 2022 2021 Current assets $ 396,553 $ 349,250 Property and equipment, net 1,517,893 1,166,409 Goodwill 2,105,227 2,086,978 Total noncurrent assets 3,921,336 3,527,700 Current liabilities 345,606 340,514 Long-term debt 1,364,541 1,478,626 Total noncurrent liabilities 1,629,750 1,688,326 Redeemable noncontrolling interests — — Total equity 2,342,533 1,848,110 |
Summarized Statements of Income (Loss) | Summarized operating results information (in thousands): For the Year Ended December 31, 2022 Revenue $ 2,299,562 Income from continuing operations before income taxes 325,309 Net income 244,148 Net income attributable to Acadia Healthcare Company, Inc. 244,148 |
Description of Business and B_2
Description of Business and Basis of Presentation - Additional Information (Detail) $ in Millions | 12 Months Ended | ||
Dec. 31, 2022 USD ($) Facility Bed State | Dec. 31, 2021 USD ($) | Dec. 31, 2020 USD ($) | |
Accounting Policies [Abstract] | |||
Number of facilities | Facility | 250 | ||
Number of beds | Bed | 11,000 | ||
Number of operating states | State | 39 | ||
General and administrative expenses | $ | $ 124.3 | $ 108.2 | $ 97.8 |
Summary of Significant Accoun_4
Summary of Significant Accounting Policies - Additional Information (Detail) | 1 Months Ended | 3 Months Ended | 12 Months Ended | ||||||||
Oct. 01, 2022 USD ($) Segment | Oct. 01, 2021 USD ($) Segment | Jan. 19, 2021 USD ($) | Aug. 31, 2022 USD ($) | Dec. 31, 2022 USD ($) | Dec. 31, 2021 USD ($) Facility | Sep. 30, 2021 USD ($) | Jun. 30, 2021 USD ($) Facility Bed | Dec. 31, 2022 USD ($) | Dec. 31, 2021 USD ($) | Dec. 31, 2020 USD ($) | |
Significant Accounting Policies [Line Items] | |||||||||||
Unfavorable adjustment for professional and general liability claims | $ 5,900,000 | ||||||||||
Professional and general liability reserve | $ 103,600,000 | $ 87,800,000 | 103,600,000 | $ 87,800,000 | |||||||
Professional and general liability reserve current | 12,100,000 | 11,900,000 | 12,100,000 | 11,900,000 | |||||||
Professional and general liability reserve noncurrent | 91,500,000 | 75,900,000 | 91,500,000 | 75,900,000 | |||||||
Insurance receivable | 37,800,000 | 37,900,000 | 37,800,000 | 37,900,000 | |||||||
Insurance receivable - current portion | 10,158,000 | 10,807,000 | 10,158,000 | 10,807,000 | |||||||
Insurance receivable noncurrent | 27,600,000 | 27,100,000 | 27,600,000 | 27,100,000 | |||||||
Workers compensation insurance claims deductible per accident | 500,000 | ||||||||||
Reserve for workers compensation liability | 24,200,000 | 23,600,000 | |||||||||
Accrued salaries and benefits | 12,000,000 | 12,000,000 | 12,000,000 | 12,000,000 | |||||||
Other long-term liabilities | 12,200,000 | 11,600,000 | 12,200,000 | 11,600,000 | |||||||
Depreciation expense | $ 117,800,000 | 106,700,000 | $ 95,300,000 | ||||||||
Number of beds, replacement facility | Bed | 260 | ||||||||||
Non-cash property impairment charge relating to existing facility | $ 1,100,000 | $ 23,200,000 | 24,300,000 | ||||||||
Impairment of long-lived assets | $ 0 | $ 0 | $ 0 | $ 0 | $ 4,200,000 | ||||||
Impairment, Long-Lived Asset, Held-for-Use, Statement of Income or Comprehensive Income [Extensible Enumeration] | Other operating expenses | Other operating expenses | Other operating expenses | Other operating expenses | Other operating expenses | ||||||
Number of reporting units | Segment | 1 | 1 | |||||||||
Number of outpatient | Facility | 1 | 1 | |||||||||
Proceeds from U.K. Sale | $ 1,500,000 | $ 4,300,000 | 1,511,020,000 | ||||||||
Goodwill write down | 700,000 | 1,800,000 | $ 2,449,000 | ||||||||
Intangible assets for the disposition | $ 100,000 | $ 200,000 | |||||||||
ASU 2021-10 [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Change in Accounting Principle, Accounting Standards Update, Adopted [true false] | true | true | |||||||||
Change in Accounting Principle, Accounting Standards Update, Adoption Date | Dec. 31, 2022 | Dec. 31, 2022 | |||||||||
U.S. Facilities [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Goodwill impairment loss | $ 0 | ||||||||||
Discontinued Operations [Member] | U.K. Facilities [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Proceeds from U.K. Sale | $ 1,525,000,000 | ||||||||||
Goodwill impairment loss | 356,200,000 | $ 356,200,000 | |||||||||
Closed Facilities [Member] | U.S. Facilities [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Non-cash impairment charge related to indefinite-lived assets | $ 600,000 | ||||||||||
Maximum [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Maximum self insured professional liability limit per claim | $ 10,000,000 | 5,000,000 | |||||||||
Maximum professional liability aggregate policy limit | $ 75,000,000 | ||||||||||
Maximum [Member] | Building and Improvements [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Property plant and equipment estimated useful life | 50 years | ||||||||||
Maximum [Member] | Equipment [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Property plant and equipment estimated useful life | 7 years | ||||||||||
Minimum [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Maximum professional liability retention limit | $ 10,000,000 | ||||||||||
Maximum professional liability aggregate policy limit | $ 70,000,000 | ||||||||||
Minimum [Member] | Building and Improvements [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Property plant and equipment estimated useful life | 10 years | ||||||||||
Minimum [Member] | Equipment [Member] | |||||||||||
Significant Accounting Policies [Line Items] | |||||||||||
Property plant and equipment estimated useful life | 3 years |
Summary of Significant Accoun_5
Summary of Significant Accounting Policies - Other Current Assets (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 |
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract] | ||
Prepaid expenses | $ 27,052 | $ 22,292 |
Other receivables | 15,371 | 10,786 |
Workers’ compensation deposits – current portion | 12,000 | 12,000 |
Insurance receivable - current portion | 10,158 | 10,807 |
Assets held for sale | 8,347 | 15,808 |
Income taxes receivable | 5,767 | 1,523 |
Inventory | 5,087 | 4,786 |
Other | 2,255 | 1,884 |
Other current assets | $ 86,037 | $ 79,886 |
Summary of Significant Accoun_6
Summary of Significant Accounting Policies - Summary of Other Accrued Liabilities (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 |
Accounts Payable And Accrued Liabilities Current [Abstract] | ||
Accrued expenses | $ 26,699 | $ 26,791 |
Accrued interest | 17,596 | 17,418 |
Cost report payable | 13,738 | 6,487 |
Insurance liability – current portion | 12,128 | 11,923 |
Accrued property taxes | 9,009 | 8,375 |
Government relief funds | 8,975 | 8,550 |
Contract liabilities | 6,653 | 30,371 |
Income taxes payable | 1,338 | 5,540 |
Finance lease liabilities | $ 990 | $ 990 |
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration] | Other accrued liabilities | Other accrued liabilities |
Other | $ 13,466 | $ 10,054 |
Other accrued liabilities | $ 110,592 | $ 126,499 |
Revenue - Additional Informatio
Revenue - Additional Information (Detail) - USD ($) $ in Thousands | 1 Months Ended | 12 Months Ended | ||
Apr. 30, 2020 | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Disaggregation of Revenue [Line Items] | ||||
Accounts receivable, net | $ (41,978) | $ 2,448 | $ 15,340 | |
Cost report payables | 13,700 | 6,500 | ||
Net adjustments to estimated cost report settlements resulted in (decreases) increases to revenue | 100 | (5,400) | (1,300) | |
Costs of providing charity care services | 6,400 | 3,800 | $ 4,400 | |
CARES Act [Member] | Medicare [Member] | ||||
Disaggregation of Revenue [Line Items] | ||||
Repayment of advanced payments | 25,100 | |||
CARES Act [Member] | CMS' Accelerated and Advance Payment Program [Member] | Medicare [Member] | ||||
Disaggregation of Revenue [Line Items] | ||||
Amount of advance payment received | $ 45,200 | |||
Repayment of advanced payments | 20,100 | 25,100 | ||
Repayment of advanced payments description | In April 2020, the Company received approximately $45.2 million from CMS’ Accelerated and Advance Payment Program for Medicare providers. Of the $45.2 million of advance payments received in 2020, the Company repaid approximately $25.1 million of advance payments during 2021 and made additional payments of approximately $20.1 million during the year ended December 31, 2022. | |||
CARES Act [Member] | CMS' Accelerated and Advance Payment Program [Member] | Medicare [Member] | Other Accrued Liabilities [Member] | ||||
Disaggregation of Revenue [Line Items] | ||||
Contract liabilities | 6,700 | 30,400 | ||
Accounting Standards Update 2014-09 | ||||
Disaggregation of Revenue [Line Items] | ||||
Accounts receivable, net | $ 61,400 | $ 49,700 |
Revenue - Schedule of U.S. Reve
Revenue - Schedule of U.S. Revenue Attributed to Each Category (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Disaggregation of Revenue [Line Items] | |||
Revenue | $ 2,610,399 | $ 2,314,394 | $ 2,089,929 |
U.S. Facilities [Member] | |||
Disaggregation of Revenue [Line Items] | |||
Revenue | 2,610,399 | 2,314,394 | 2,089,929 |
U.S. Facilities [Member] | Acute Inpatient Psychiatric Facilities [Member] | |||
Disaggregation of Revenue [Line Items] | |||
Revenue | 1,330,757 | 1,126,872 | 984,609 |
U.S. Facilities [Member] | Specialty Treatment Facilities [Member] | |||
Disaggregation of Revenue [Line Items] | |||
Revenue | 564,671 | 510,929 | 452,805 |
U.S. Facilities [Member] | Comprehensive Treatment Centers [Member] | |||
Disaggregation of Revenue [Line Items] | |||
Revenue | 419,940 | 385,635 | 349,217 |
U.S. Facilities [Member] | Residential Treatment Centers [Member] | |||
Disaggregation of Revenue [Line Items] | |||
Revenue | $ 295,031 | 283,169 | 281,158 |
U.S. Facilities [Member] | Other [Member] | |||
Disaggregation of Revenue [Line Items] | |||
Revenue | $ 7,789 | $ 22,140 |
Revenue - Schedule of Revenue a
Revenue - Schedule of Revenue and Percentage Generated by Each Payor Type in U.S Facilities (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | |||
Revenue | $ 2,610,399 | $ 2,314,394 | $ 2,089,929 |
U.S. Facilities [Member] | |||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | |||
Revenue | $ 2,610,399 | $ 2,314,394 | $ 2,089,929 |
Revenue, Percentage | 100% | 100% | 100% |
U.S. Facilities [Member] | Commercial [Member] | |||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | |||
Revenue | $ 788,895 | $ 684,292 | $ 596,698 |
Revenue, Percentage | 30.20% | 29.60% | 28.50% |
U.S. Facilities [Member] | Medicare [Member] | |||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | |||
Revenue | $ 394,227 | $ 364,598 | $ 330,070 |
Revenue, Percentage | 15.10% | 15.80% | 15.80% |
U.S. Facilities [Member] | Medicaid [Member] | |||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | |||
Revenue | $ 1,319,600 | $ 1,147,884 | $ 1,037,852 |
Revenue, Percentage | 50.60% | 49.60% | 49.70% |
U.S. Facilities [Member] | Self-Pay [Member] | |||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | |||
Revenue | $ 76,050 | $ 93,425 | $ 98,302 |
Revenue, Percentage | 2.90% | 4% | 4.70% |
U.S. Facilities [Member] | Other [Member] | |||
Health Care Organization, Receivable and Revenue Disclosures [Line Items] | |||
Revenue | $ 31,627 | $ 24,195 | $ 27,007 |
Revenue, Percentage | 1.20% | 1% | 1.30% |
Revenue - Summary of the Activi
Revenue - Summary of the Activity in Unearned Revenue in U.S. Facilities (Detail) - U.S. Facilities [Member] - Unearned Revenue [Member] - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2022 | Dec. 31, 2021 | |
Disaggregation of Revenue [Line Items] | ||
Beginning Balance | $ 30,371 | $ 47,196 |
Payments received | 22,914 | 11,739 |
Revenue recognized | (26,497) | (3,463) |
Ending Balance | 6,653 | 30,371 |
Medicare [Member] | ||
Disaggregation of Revenue [Line Items] | ||
Medicare advance repayments | $ (20,135) | $ (25,101) |
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 | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Numerator: | |||
Income from continuing operations attributable to Acadia Healthcare Company, Inc. | $ 273,139 | $ 203,276 | $ 140,258 |
Loss from discontinued operations | (12,641) | (812,390) | |
Net income (loss) attributable to Acadia Healthcare Company, Inc. | $ 273,139 | $ 190,635 | $ (672,132) |
Denominator: | |||
Weighted average shares outstanding for basic earnings per share | 89,680 | 88,769 | 87,875 |
Effects of dilutive instruments | 1,875 | 2,024 | 720 |
Shares used in computing diluted earnings per common share | 91,555 | 90,793 | 88,595 |
Basic earnings (loss) per share attributable to Acadia Healthcare Company, Inc. stockholders: | |||
Income from continuing operations attributable to Acadia Healthcare Company, Inc. | $ 3.05 | $ 2.29 | $ 1.60 |
Loss from discontinued operations | (0.14) | (9.25) | |
Net income (loss) attributable to Acadia Healthcare Company, Inc. | 3.05 | 2.15 | (7.65) |
Diluted earnings (loss) per share attributable to Acadia Healthcare Company, Inc. stockholders: | |||
Income from continuing operations attributable to Acadia Healthcare Company, Inc. | 2.98 | 2.24 | 1.58 |
Loss from discontinued operations | (0.14) | (9.17) | |
Net income (loss) attributable to Acadia Healthcare Company, Inc. | $ 2.98 | $ 2.10 | $ (7.59) |
Earnings Per Share - Additional
Earnings Per Share - Additional Information (Detail) - shares shares in Millions | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Earnings Per Share [Abstract] | |||
Excluded common stock for computation of diluted earnings per share | 0.1 | 0.3 | 1.9 |
Acquisitions - Additional Infor
Acquisitions - Additional Information (Detail) $ in Millions | 12 Months Ended | ||
Dec. 31, 2021 USD ($) Bed Hospital Location | Dec. 31, 2022 USD ($) Bed | Dec. 31, 2021 USD ($) Bed | |
Business Acquisition [Line Items] | |||
Number of beds | Bed | 11,000 | ||
Tax deductible | $ 9.5 | $ 56.1 | |
CenterPointe Behavioral Health System, LLC [Member] | |||
Business Acquisition [Line Items] | |||
Business acquisition cash consideration | $ 140 | ||
Revolving Facility | $ 70 | $ 70 | |
Number of acute inpatient hospitals | Hospital | 4 | ||
Number of beds | Bed | 306 | 306 | |
Number of outpatient locations | Location | 10 |
Acquisitions - Summary of Preli
Acquisitions - Summary of Preliminary Fair Values of Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 |
Business Acquisition [Line Items] | |||
Goodwill | $ 2,222,805 | $ 2,199,937 | $ 2,105,264 |
CenterPointe Behavioral Health System, LLC [Member] | |||
Business Acquisition [Line Items] | |||
Cash | 5,640 | ||
Accounts receivable, net | 9,358 | ||
Other current assets | 1,981 | ||
Property and equipment | 35,227 | ||
Goodwill | 105,883 | ||
Intangible assets | 825 | ||
Deferred tax assets | 1,573 | ||
Operating lease right-of-use assets | 29,245 | ||
Total assets acquired | 189,732 | ||
Accounts payable | 3,820 | ||
Accrued salaries and benefits | 3,585 | ||
Current portion of operating lease liabilities | 2,820 | ||
Other accrued liabilities | 4,326 | ||
Deferred tax liability | 1,805 | ||
Operating lease liabilities | 27,850 | ||
Total liabilities assumed | 44,206 | ||
Net assets acquired | $ 145,526 |
Acquisitions - Summary of Chang
Acquisitions - Summary of Changes in Goodwill (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | ||
Dec. 31, 2021 | Jun. 30, 2021 | Dec. 31, 2022 | Dec. 31, 2021 | |
Business Combinations [Abstract] | ||||
Goodwill balance | $ 2,199,937 | $ 2,105,264 | ||
Increase from acquisitions | 9,488 | 97,122 | ||
2021 dispositions | $ (700) | $ (1,800) | (2,449) | |
Adjustments related to 2021 acquisitions | 8,761 | |||
Increase from contributions of redeemable noncontrolling interests | 4,619 | |||
Goodwill balance | $ 2,199,937 | $ 2,222,805 | $ 2,199,937 |
Acquisitions - Transaction Rela
Acquisitions - Transaction Related Expenses as Incurred (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Business Combinations [Abstract] | |||
Management transition costs | $ 11,575 | ||
Termination and restructuring costs | 6,476 | $ 5,343 | $ 3,468 |
Legal, accounting and other acquisition-related costs | 5,741 | 7,435 | 8,252 |
Transaction-related expenses | $ 23,792 | $ 12,778 | $ 11,720 |
Property and Equipment - Summar
Property and Equipment - Summary of Property and Equipment (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 |
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | $ 2,608,619 | $ 2,312,285 |
Less: accumulated depreciation | (656,574) | (541,126) |
Property and equipment, net | 1,952,045 | 1,771,159 |
Land [Member] | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 169,137 | 154,376 |
Building and Improvements [Member] | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 1,797,809 | 1,683,560 |
Equipment [Member] | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 292,200 | 253,100 |
Construction in Progress [Member] | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | $ 349,473 | $ 221,249 |
Property and Equipment - Additi
Property and Equipment - Additional information (Detail) $ in Millions | 3 Months Ended | 12 Months Ended | ||
Sep. 30, 2021 USD ($) | Jun. 30, 2021 USD ($) Bed | Dec. 31, 2021 USD ($) | Dec. 31, 2022 USD ($) | |
Property Plant And Equipment [Line Items] | ||||
Loss on impairment | $ 1.1 | $ 23.2 | $ 24.3 | |
Number of beds, replacement facility | Bed | 260 | |||
Other Assets [Member] | ||||
Property Plant And Equipment [Line Items] | ||||
Assets held for sale | $ 15.8 | $ 8.3 |
Other Intangible Assets - Other
Other Intangible Assets - Other Identifiable Intangible Assets and Related Accumulated Amortization (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 |
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items] | ||
Intangible assets not subject to amortization, Gross Carrying Amount | $ 76,041 | $ 70,145 |
Total | 77,172 | 71,276 |
Intangible assets not subject to amortization, Accumulated Amortization | 0 | 0 |
Total | (1,131) | (1,131) |
Licenses and Accreditations [Member] | ||
Schedule Of Finite and Indefinite Lived Other Intangible Assets [Line Items] | ||
Intangible assets not subject to amortization, Gross Carrying Amount | 11,512 | 11,600 |
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 | 45,935 | 40,435 |
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 | 18,594 | 18,110 |
Intangible assets not subject to amortization, Accumulated Amortization | 0 | 0 |
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) |
Other Intangible Assets - Addit
Other Intangible Assets - Additional Information (Detail) $ in Thousands | 3 Months Ended | 12 Months Ended | |
Dec. 31, 2021 USD ($) Facility | Jun. 30, 2021 USD ($) Facility | Dec. 31, 2021 USD ($) | |
Goodwill And Intangible Assets Disclosure [Abstract] | |||
Number of outpatient | Facility | 1 | 1 | |
Gross proceeds from sale of business | $ 1,500 | $ 4,300 | $ 1,511,020 |
Goodwill write down | 700 | 1,800 | $ 2,449 |
Intangible assets for the disposition | $ 100 | $ 200 |
Leases - Additional Information
Leases - Additional Information (Detail) | 12 Months Ended |
Dec. 31, 2022 | |
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 Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 |
Leases [Abstract] | ||
Finance lease right-of-use assets | $ 8,250 | $ 8,627 |
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration] | Property and equipment, net | Property and equipment, net |
Operating lease right-of-use assets | $ 135,238 | $ 133,761 |
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration] | Operating lease right-of-use assets | Operating lease right-of-use assets |
Total | $ 143,488 | $ 142,388 |
Finance lease liabilities | $ 990 | $ 990 |
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration] | Other accrued liabilities | Other accrued liabilities |
Operating lease liabilities | $ 26,463 | $ 23,348 |
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration] | Operating lease liabilities | Operating lease liabilities |
Finance lease liabilities | $ 10,858 | $ 10,807 |
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration] | Other liabilities | Other liabilities |
Operating lease liabilities | $ 116,429 | $ 116,841 |
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration] | Operating lease liabilities | Operating lease liabilities |
Total | $ 154,740 | $ 151,986 |
Leases - Schedule of Weighted-a
Leases - Schedule of Weighted-average Remaining Lease Terms and Discount Rates (Detail) | Dec. 31, 2022 | Dec. 31, 2021 |
Leases [Abstract] | ||
Finance lease, weighted average remaining lease term (years) | 21 years 10 months 24 days | 22 years 10 months 24 days |
Operating lease, weighted average remaining term (years) | 8 years 4 months 24 days | 9 years 1 month 6 days |
Finance lease, weighted average discount rate percent | 5.10% | 5.10% |
Operating lease, weighted average discount rate percent | 5% | 5.10% |
Leases - Schedule of Lease Cost
Leases - Schedule of Lease Cost (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Finance lease costs: | |||
Depreciation of leased assets | $ 378 | $ 378 | $ 868 |
Interest of lease liabilities | 1,041 | 2,174 | 3,214 |
Total finance lease costs | 1,419 | 2,552 | 4,082 |
Operating lease costs | 34,349 | 28,233 | 27,050 |
Variable lease costs | 3,129 | 2,488 | 2,501 |
Short term lease costs | 2,605 | 3,257 | 3,558 |
Other lease costs | 5,379 | 4,541 | 4,253 |
Total rents and leases | 45,462 | 38,519 | 37,362 |
Total lease costs | $ 46,881 | $ 41,071 | $ 41,444 |
Leases - Schedule of Undiscount
Leases - Schedule of Undiscounted Future Cash Flows for Finance and Operating Leases (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 |
Finance Leases | ||
2023 | $ 990 | |
2024 | 1,007 | |
2025 | 1,089 | |
2026 | 1,180 | |
2027 | 1,089 | |
Thereafter | 21,821 | |
Total minimum lease payments | 27,176 | |
Less: amount of lease payments representing interest | 15,328 | |
Present value of future minimum lease payments | 11,848 | |
Less: Current portion of lease liabilities | 990 | $ 990 |
Noncurrent lease liabilities | 10,858 | 10,807 |
Operating Leases | ||
2023 | 32,818 | |
2024 | 29,568 | |
2025 | 25,146 | |
2026 | 19,251 | |
2027 | 12,380 | |
Thereafter | 62,653 | |
Total minimum lease payments | 181,816 | |
Less: amount of lease payments representing interest | 38,924 | |
Present value of future minimum lease payments | 142,892 | |
Current portion of operating lease liabilities | 26,463 | 23,348 |
Operating lease liabilities | $ 116,429 | $ 116,841 |
Leases - Schedule of Supplement
Leases - Schedule of Supplemental Data (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Cash paid for amounts included in the measurement of lease liabilities: | |||
Operating cash flows for operating leases | $ 33,836 | $ 27,508 | $ 26,810 |
Operating cash flows for finance leases | 1,041 | 2,174 | 3,214 |
Financing cash flows for finance leases | (51) | 31,136 | 551 |
Right-of-use assets obtained in exchange for lease obligations: | |||
Operating leases | $ 31,294 | $ 63,279 | $ 21,285 |
U.K. Sale - Additional Informat
U.K. Sale - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | |||||
Jan. 19, 2021 | Dec. 31, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Gross proceeds from sale of business | $ 1,500 | $ 4,300 | $ 1,511,020 | ||||
Loss on sale | $ 14,300 | $ 867,300 | |||||
Discontinued Operation, Gain (Loss) on Disposal, Statement of Income or Comprehensive Income [Extensible Enumeration] | Debt extinguishment costs | Debt extinguishment costs | |||||
Discontinued Operations [Member] | U.K. Sales [Member] | |||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Gross proceeds from sale of business | $ 1,525,000 | ||||||
Settlement of existing foreign currency hedging liabilities | 85,000 | ||||||
Net proceeds from sale of business | $ 1,425,000 | ||||||
Cash from the balance sheet to reduce debt, amount | $ 1,640,000 | ||||||
Goodwill impairment loss | $ 356,200 | $ 356,200 | |||||
Cash paid for capital expenditures | $ 48,400 |
U.K. Sale - Result of Operation
U.K. Sale - Result of Operation (Detail) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2021 | Dec. 31, 2020 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||
Loss from discontinued operations | $ (12,641) | $ (812,390) |
Discontinued Operations [Member] | U.K. Sales [Member] | ||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||
Revenue | 62,520 | 1,119,768 |
Salaries, wages and benefits | 35,937 | 632,134 |
Professional fees | 6,815 | 127,291 |
Supplies | 2,217 | 38,285 |
Rents and leases | 2,509 | 47,748 |
Other operating expenses | 6,682 | 113,534 |
Depreciation and amortization | 74,935 | |
Interest expense, net | 10 | (417) |
Loss on sale | 13,490 | 867,324 |
Loss on impairment | 20,239 | |
Transaction-related expenses | 6,265 | 8,719 |
Total expenses | 73,925 | 1,929,792 |
Loss from discontinued operations before income taxes | (11,405) | (810,024) |
Provision for income taxes | 1,236 | 2,366 |
Loss from discontinued operations | $ (12,641) | $ (812,390) |
The CARES Act - Additional Info
The CARES Act - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | |||
Apr. 24, 2020 | Sep. 30, 2021 | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
CARES Act [Line Items] | |||||
Income from relief fund | $ 21,451 | $ 17,900 | $ 32,819 | ||
Expected repay of payroll tax deferrals | $ 39,300 | ||||
CARES Act [Member] | |||||
CARES Act [Line Items] | |||||
Offer of eligible relief amount | 100,000,000 | ||||
Additional offer of eligible relief amount | $ 75,000,000 | ||||
Cash benefit relating to delay of payment of social security payroll taxes | $ 39,300 | ||||
CARES Act [Member] | Medicare [Member] | |||||
CARES Act [Line Items] | |||||
Percentage of increase in medicare reimbursement rate | 2% | ||||
Repayment of advanced payments | 25,100 | ||||
Percentage of reduced in medicare reimbursement rate | 1% | ||||
CARES Act [Member] | Public Health and Social Services Emergency Fund [Member] | |||||
CARES Act [Line Items] | |||||
Receipt of CARES Act of 2020 aid amount | $ 34,900 | ||||
Income from relief fund | $ 21,500 | 17,900 | |||
Receipt of additional CARES Act of 2020 aid amount | 7,700 | $ 24,200 | |||
CARES Act [Member] | Public Health and Social Services Emergency Fund [Member] | American Rescue Plan | |||||
CARES Act [Line Items] | |||||
Receipt of additional CARES Act of 2020 aid amount | 14,200 | ||||
CARES Act [Member] | CMS' Accelerated and Advance Payment Program [Member] | Medicare [Member] | |||||
CARES Act [Line Items] | |||||
Amount of advance payment received | $ 45,200 | ||||
Repayments of medicare advance payments | $ 20,100 |
Long-Term Debt - Components of
Long-Term Debt - Components of Long-Term Debt (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 | Nov. 13, 2020 |
Debt Instrument [Line Items] | |||
Less: unamortized debt issuance costs, discount and premium | $ (12,647) | $ (14,811) | |
Long-term debt | 1,385,791 | 1,497,220 | |
Less: current portion | (21,250) | (18,594) | |
Long-term debt | 1,364,541 | 1,478,626 | |
Term Loan A Facility [Member] | |||
Debt Instrument [Line Items] | |||
Revolving Facility | $ 352,400 | ||
Credit Facility [Member] | Term Loan A Facility [Member] | |||
Debt Instrument [Line Items] | |||
Revolving Facility | 398,438 | 417,031 | |
Credit Facility [Member] | Senior Secured Revolving Line of Credit [Member] | |||
Debt Instrument [Line Items] | |||
Revolving Facility | 75,000 | 170,000 | |
5.500% Senior Notes due 2028 [Member] | |||
Debt Instrument [Line Items] | |||
Senior Notes | 450,000 | 450,000 | |
5.000% Senior Notes due 2029 [Member] | |||
Debt Instrument [Line Items] | |||
Senior Notes | $ 475,000 | $ 475,000 |
Long-Term Debt - Components o_2
Long-Term Debt - Components of Long-Term Debt (Parenthetical) (Detail) | 12 Months Ended | |||
Dec. 31, 2022 | Dec. 31, 2021 | Oct. 14, 2020 | Jun. 24, 2020 | |
5.500% Senior Notes due 2028 [Member] | ||||
Debt Instrument [Line Items] | ||||
Debt instrument interest rate | 5.50% | 5.50% | 5.50% | |
Senior notes maturity year | 2028 | 2028 | ||
5.000% Senior Notes due 2029 [Member] | ||||
Debt Instrument [Line Items] | ||||
Debt instrument interest rate | 5% | 5% | 5% | |
Senior notes maturity year | 2029 | 2029 |
Long-Term Debt (New Credit Faci
Long-Term Debt (New Credit Facility) - Additional Information (Detail) - USD ($) | 3 Months Ended | 12 Months Ended | |||||
Mar. 17, 2021 | Dec. 31, 2021 | Sep. 30, 2021 | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | Nov. 13, 2020 | |
Debt Instrument [Line Items] | |||||||
Date entered into a credit agreement | Mar. 17, 2021 | ||||||
Repayments of revolving facility | $ 95,000,000 | $ 330,000,000 | $ 100,000,000 | ||||
Term Loan A- Facility [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Line of credit outstanding principal amount | $ 352,400,000 | ||||||
New Credit Facility [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Date entered into a credit agreement | Mar. 17, 2021 | ||||||
Repayments of revolving facility | $ 60,000,000 | $ 95,000,000 | |||||
Proceeds from revolving facility | $ 70,000,000 | ||||||
Term loan remaining balance due date | Mar. 17, 2026 | ||||||
Maximum incremental debt amount | $ 480,000,000 | ||||||
Incremental debt amount maximum percentage of consolidated EBITDA | 100% | ||||||
Consolidated senior secured net leverage ratio | 350% | ||||||
Maximum consolidated net leverage ratio | 500% | ||||||
Minimum interest coverage ratio | 300% | ||||||
New Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Basis spread on variable rate | 1.75% | ||||||
New Credit Facility [Member] | Base Rate Loans [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Basis spread on variable rate | 0.75% | ||||||
New Credit Facility [Member] | March 31, 2023 to March 31, 2024 [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Term loan principal repayments | $ 5,300,000 | ||||||
New Credit Facility [Member] | June 30, 2024 to March 31, 2025 [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Term loan principal repayments | 8,000,000 | ||||||
New Credit Facility [Member] | June 30, 2025 to December 31, 2025 [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Term loan principal repayments | 10,600,000 | ||||||
New Credit Facility [Member] | Term Loan A- Facility [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Line of credit outstanding principal amount | $ 425,000,000 | ||||||
Debt instrument maturity date | Mar. 17, 2026 | ||||||
New Credit Facility [Member] | Letters of Credit [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Line of credit outstanding principal amount | $ 20,000,000 | ||||||
New Credit Facility [Member] | Swingline Facility [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Line of credit outstanding principal amount | 20,000,000 | ||||||
New Credit Facility [Member] | Standby Letters of Credit [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Line of credit outstanding principal amount | 3,400,000 | ||||||
New Credit Facility [Member] | Senior Secured Revolving Line of Credit [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Line of credit outstanding principal amount | $ 600,000,000 | $ 160,000,000 | |||||
Debt instrument maturity date | Mar. 17, 2026 | ||||||
Amount available under revolving line of credit | $ 521,600,000 | ||||||
Unused fee payable percentage | 0.25% | ||||||
Amended and Restated Credit Agreement [Member] | |||||||
Debt Instrument [Line Items] | |||||||
Agreement termination date | Mar. 17, 2021 |
Long-Term Debt (Prior Credit Fa
Long-Term Debt (Prior Credit Facility) - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | ||||||||||
Mar. 17, 2021 | Jan. 19, 2021 | Jan. 05, 2021 | Nov. 13, 2020 | Apr. 21, 2020 | Dec. 15, 2015 | Dec. 31, 2012 | Apr. 01, 2011 | Mar. 31, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | Mar. 29, 2018 | |
Debt Instrument [Line Items] | ||||||||||||
Date entered into a credit agreement | Mar. 17, 2021 | |||||||||||
Debt extinguishment costs | $ (24,650) | $ (7,233) | ||||||||||
Tranche B-4 Facility [Member] | ||||||||||||
Debt Instrument [Line Items] | ||||||||||||
Repayments of credit facility | $ 767,900 | $ 105,000 | ||||||||||
Term Loan A- Facility [Member] | ||||||||||||
Debt Instrument [Line Items] | ||||||||||||
Line of credit outstanding principal amount | $ 352,400 | |||||||||||
Repayments of credit facility | $ 311,700 | |||||||||||
Prior Credit Facility [Member] | ||||||||||||
Debt Instrument [Line Items] | ||||||||||||
Date entered into a credit agreement | Dec. 31, 2012 | Apr. 01, 2011 | ||||||||||
Debt instrument maturity date | Nov. 30, 2021 | |||||||||||
Debt extinguishment costs | $ 10,900 | |||||||||||
Prior Credit Facility [Member] | Repricing Facilities Amendments [Member] | ||||||||||||
Debt Instrument [Line Items] | ||||||||||||
Debt instrument maturity date | Nov. 30, 2022 | |||||||||||
Debt extinguishment costs | $ 1,000 | |||||||||||
Prior Credit Facility [Member] | Senior Secured Revolving Line of Credit [Member] | Repricing Facilities Amendments [Member] | ||||||||||||
Debt Instrument [Line Items] | ||||||||||||
Line of credit | 459,000 | $ 500,000 | ||||||||||
Prior Credit Facility [Member] | Term Loan A- Facility [Member] | Repricing Facilities Amendments [Member] | ||||||||||||
Debt Instrument [Line Items] | ||||||||||||
Line of credit outstanding principal amount | $ 318,900 | |||||||||||
Thirteenth Amendment [Member] | ||||||||||||
Debt Instrument [Line Items] | ||||||||||||
Date entered into a credit agreement | Apr. 21, 2020 |
Long-Term Debt (5.500% Senior N
Long-Term Debt (5.500% Senior Notes due 2028) - Additional Information (Detail) - 5.500% Senior Notes due 2028 [Member] - USD ($) | 12 Months Ended | ||
Jun. 24, 2020 | Dec. 31, 2022 | Dec. 31, 2021 | |
Debt Instrument [Line Items] | |||
Issued Senior Notes | $ 450,000,000 | ||
Debt instrument interest rate | 5.50% | 5.50% | 5.50% |
Debt instrument maturity date | Jul. 01, 2028 | ||
Interest on the notes | payable semi-annually in arrears on January 1 and July 1 of each year, commencing on January 1, 2021 |
Long-Term Debt (5.000% Senior N
Long-Term Debt (5.000% Senior Notes due 2029) - Additional Information (Detail) - USD ($) $ in Thousands | 12 Months Ended | |||
Oct. 14, 2020 | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Debt Instrument [Line Items] | ||||
Debt extinguishment costs | $ (24,650) | $ (7,233) | ||
5.000% Senior Notes due 2029 [Member] | ||||
Debt Instrument [Line Items] | ||||
Issued Senior Notes | $ 475,000 | |||
Debt instrument interest rate | 5% | 5% | 5% | |
Debt instrument maturity date | Apr. 15, 2029 | |||
Interest on the notes | payable semi-annually in arrears on April 15 and October 15 of each year, commencing on April 15, 2021 | |||
Tranche B-3 Facility [Member] | ||||
Debt Instrument [Line Items] | ||||
Debt extinguishment charge | $ 453,300 | |||
Debt extinguishment costs | $ 2,900 |
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 ($) | 12 Months Ended | ||
Dec. 31, 2022 | 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% | |
Senior Notes | $ 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 | ||
Term loan remaining balance due date | Mar. 17, 2021 |
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 ($) | 12 Months Ended | |
Feb. 16, 2016 | Dec. 31, 2022 | |
Debt Instrument [Line Items] | ||
Issued Senior Notes | $ 390,000,000 | |
Debt instrument interest rate | 6.50% | |
Debt instrument maturity date | Mar. 01, 2024 | |
Interest on the notes | per annum, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2016 | |
Term loan remaining balance due date | Mar. 01, 2021 |
Long-Term Debt (Redemption of 5
Long-Term Debt (Redemption of 5.265% Senior Notes and 6.500% Senior Notes) - Additional Information (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||||
Mar. 17, 2021 | Mar. 01, 2021 | Jan. 29, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | |
Debt Instrument [Line Items] | |||||
Debt extinguishment costs | $ (24,650) | $ (7,233) | |||
Redemption of 5.265% Senior Notes [Member] | |||||
Debt Instrument [Line Items] | |||||
Senior Notes | $ 650,000 | ||||
Debt instrument interest rate | 5.625% | ||||
Debt extinguishment costs | $ 3,300 | ||||
Redemption of 6.500% Senior Notes [Member] | |||||
Debt Instrument [Line Items] | |||||
Senior Notes | $ 390,000 | ||||
Debt instrument interest rate | 6.50% | ||||
Debt extinguishment costs | $ 10,500 | ||||
Cash paid for breakage costs | 6,300 | ||||
Write off of deferred financing costs | $ 4,200 | ||||
Redemption of 5.265% Senior Notes and 6.500% Senior Notes [Member] | |||||
Debt Instrument [Line Items] | |||||
Term loan remaining balance due date | Jan. 29, 2021 |
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 ($) | 12 Months Ended | |
Mar. 12, 2013 | Dec. 31, 2022 | |
Debt Instrument [Line Items] | ||
Issued Senior Notes | $ 150,000,000 | |
Debt instrument interest rate | 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 | |
Term loan remaining balance due date | Jun. 24, 2020 |
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 ($) | 12 Months Ended | |
Jul. 01, 2014 | Dec. 31, 2022 | |
Debt Instrument [Line Items] | ||
Issued Senior Notes | $ 300,000,000 | |
Debt instrument interest rate | 5.125% | 5.125% |
Debt instrument maturity date | Jul. 01, 2022 | |
Interest on the notes | payable semi-annually in arrears on January 1 and July 1 of each year | |
Term loan remaining balance due date | Jun. 24, 2020 |
Long-Term Debt (Redemption of 6
Long-Term Debt (Redemption of 6.125% Senior Notes and 5.125% Senior Notes) - Additional Information (Detail) - USD ($) $ in Millions | 12 Months Ended | ||||
Jun. 10, 2020 | Dec. 31, 2022 | Dec. 31, 2020 | 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% | |||
Term loan remaining balance due date | Jun. 24, 2020 | ||||
Debt instrument, redemption price percentage of principal amount | 100% | ||||
5.125% Senior Notes Due 2022 [Member] | |||||
Debt Instrument [Line Items] | |||||
Debt instrument interest rate | 5.125% | 5.125% | |||
Term loan remaining balance due date | Jun. 24, 2020 | ||||
Debt instrument, redemption price percentage of principal amount | 100% | ||||
6.125% Senior Notes Due 2021 and 5.125% Senior Notes Due 2022 [Member] | |||||
Debt Instrument [Line Items] | |||||
Debt extinguishment charge | $ 3.3 |
Long-Term Debt (Other Long-term
Long-Term Debt (Other Long-term Debt) - Additional Information (Detail) $ in Millions | 12 Months Ended |
Dec. 31, 2021 USD ($) | |
Debt Disclosure [Abstract] | |
Repayments of other long-term debt | $ 3.3 |
Long-Term Debt (Debt Issuance C
Long-Term Debt (Debt Issuance Costs) - Additional Information (Detail) - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Debt Disclosure [Abstract] | |||
Debt issuance costs | $ 12.6 | $ 14.8 | |
Accumulated amortization | 4.6 | 2.4 | |
Amortization expenses reported as interest expense | $ 2.2 | $ 2.8 | $ 9.8 |
Long-Term Debt (Other) - Summar
Long-Term Debt (Other) - Summary of Aggregate Maturities of Long-Term Debt (Detail) $ in Thousands | Dec. 31, 2022 USD ($) |
Debt Disclosure [Abstract] | |
2023 | $ 21,250 |
2024 | 29,219 |
2025 | 39,844 |
2026 | 383,125 |
Thereafter | 925,000 |
Total | $ 1,398,438 |
Noncontrolling Interests - Addi
Noncontrolling Interests - Additional Information (Detail) | 12 Months Ended |
Dec. 31, 2022 Facility | |
Noncontrolling Interest [Line Items] | |
Number of facilities operated by non-wholly owned subsidiaries | 8 |
Non-Wholly Owned Subsidiaries [Member] | Minimum [Member] | |
Noncontrolling Interest [Line Items] | |
Equity ownership interests percentage in the facility | 65% |
Non-Wholly Owned Subsidiaries [Member] | Maximum [Member] | |
Noncontrolling Interest [Line Items] | |
Equity ownership interests percentage in the facility | 86% |
Noncontrolling Interests - Summ
Noncontrolling Interests - Summary of Redeemable Noncontrolling Interests (Detail) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2022 | Dec. 31, 2021 | |
Noncontrolling Interest [Abstract] | ||
Beginning Balance | $ 65,388 | $ 55,315 |
Contributions from noncontrolling partners in joint ventures | 21,162 | 6,734 |
Net income attributable to noncontrolling interests | 6,894 | 4,927 |
Acquisition of ownership interests from noncontrolling partners | (4,183) | |
Distributions to noncontrolling partners in joint ventures | (1,004) | (1,588) |
Ending Balance | $ 88,257 | $ 65,388 |
Variable Interest Entities - Ad
Variable Interest Entities - Additional Information (Detail) $ in Thousands | 12 Months Ended | |
Dec. 31, 2022 USD ($) Facility | Dec. 31, 2021 USD ($) | |
Variable Interest Entity [Line Items] | ||
Consolidated assets | $ 4,987,901 | $ 4,768,078 |
Consolidated liabilities | $ 2,086,917 | 2,185,201 |
Variable Interest Entity, Primary Beneficiary [Member] | ||
Variable Interest Entity [Line Items] | ||
Number of facilities operated through non-wholly owned subsidiaries | Facility | 8 | |
Consolidated assets | $ 434,173 | 320,639 |
Consolidated liabilities | $ 24,361 | $ 24,110 |
Variable Interest Entity, Primary Beneficiary [Member] | Minimum [Member] | ||
Variable Interest Entity [Line Items] | ||
Variable interest entity, ownership percentage | 65% | |
Variable Interest Entity, Primary Beneficiary [Member] | Maximum [Member] | ||
Variable Interest Entity [Line Items] | ||
Variable interest entity, ownership percentage | 86% |
Variable Interest Entities - Sc
Variable Interest Entities - Schedule of Consolidated VIEs Assets and Liabilities (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 |
Variable Interest Entity [Line Items] | |||
Cash and cash equivalents | $ 97,649 | $ 133,813 | |
Accounts receivable, net | 322,439 | 281,332 | |
Other current assets | 86,037 | 79,886 | |
Total current assets | 506,125 | 495,031 | |
Property and equipment, net | 1,952,045 | 1,771,159 | |
Goodwill | 2,222,805 | 2,199,937 | $ 2,105,264 |
Intangible assets, net | 76,041 | 70,145 | |
Operating lease right-of-use assets | 135,238 | 133,761 | |
Total assets | 4,987,901 | 4,768,078 | |
Accounts payable | 104,723 | 98,575 | |
Accrued salaries and benefits | 125,298 | 137,845 | |
Current portion of operating lease liabilities | 26,463 | 23,348 | |
Other accrued liabilities | 110,592 | 126,499 | |
Total current liabilities | 388,326 | 404,861 | |
Operating lease liabilities | 116,429 | 116,841 | |
Other liabilities | 125,033 | 110,505 | |
Total liabilities | 2,086,917 | 2,185,201 | |
Variable Interest Entity, Primary Beneficiary [Member] | |||
Variable Interest Entity [Line Items] | |||
Cash and cash equivalents | 32,478 | 26,360 | |
Accounts receivable, net | 23,789 | 20,144 | |
Other current assets | 2,561 | 1,304 | |
Total current assets | 58,828 | 47,808 | |
Property and equipment, net | 313,358 | 220,793 | |
Goodwill | 39,564 | 34,945 | |
Intangible assets, net | 16,139 | 10,490 | |
Operating lease right-of-use assets | 6,284 | 6,603 | |
Total assets | 434,173 | 320,639 | |
Accounts payable | 4,650 | 3,690 | |
Accrued salaries and benefits | 6,866 | 5,656 | |
Current portion of operating lease liabilities | 233 | 197 | |
Other accrued liabilities | 6,179 | 6,818 | |
Total current liabilities | 17,928 | 16,361 | |
Operating lease liabilities | 6,433 | 6,666 | |
Other liabilities | 1,083 | ||
Total liabilities | $ 24,361 | $ 24,110 |
Accumulated Other Comprehensi_3
Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2021 | Dec. 31, 2020 | |
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | $ 1,899,456 | $ 2,505,381 |
Foreign currency translation gain (loss) | (4,260) | 61,247 |
Gain (loss) on derivative instruments, net of tax of $0.0 million, $0.1 million and $(3.9) million, respectively | 19 | (11,272) |
Pension liability adjustment, net of tax of $0.0 million, $0.0 million and $(0.8) million, respectively | (6,456) | |
U.K. Sale | 375,606 | |
Balance | 2,517,489 | 1,899,456 |
Foreign Currency Translation Adjustments [Member] | ||
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | (373,101) | (434,633) |
Foreign currency translation gain (loss) | (4,293) | 61,532 |
U.K. Sale | 377,394 | |
Balance | (373,101) | |
Change in Fair Value of Derivative Instruments [Member] | ||
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | 13,686 | 24,958 |
Gain (loss) on derivative instruments, net of tax of $0.0 million, $0.1 million and $(3.9) million, respectively | 19 | (11,272) |
U.K. Sale | (13,705) | |
Balance | 13,686 | |
Pension Plan [Member] | ||
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | (11,950) | (5,209) |
Foreign currency translation gain (loss) | 33 | (285) |
Pension liability adjustment, net of tax of $0.0 million, $0.0 million and $(0.8) million, respectively | (6,456) | |
U.K. Sale | 11,917 | |
Balance | (11,950) | |
Other Comprehensive Loss [Member] | ||
Accumulated Other Comprehensive Income (Loss) [Line Items] | ||
Balance | $ (371,365) | (414,884) |
Balance | $ (371,365) |
Accumulated Other Comprehensi_4
Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Accumulated Other Comprehensive Income Loss Net Of Tax [Abstract] | |||
Gain (Loss) on derivative instruments, tax | $ 0 | $ 0.1 | $ (3.9) |
Pension liability adjustment, tax | $ 0 | $ 0 | $ (0.8) |
Equity - Additional Information
Equity - Additional Information (Detail) - shares | 12 Months Ended | |
Dec. 31, 2022 | Dec. 31, 2021 | |
Equity [Line Items] | ||
Preferred stock, number of shares proposed to be issued | 10,000,000 | 10,000,000 |
Common stock, number of shares proposed to be issued | 180,000,000 | 180,000,000 |
Common stock voting rights | one vote for each share | |
Maximum [Member] | ||
Equity [Line Items] | ||
Preferred stock, number of shares proposed to be issued | 10,000,000 | |
Common stock, number of shares proposed to be issued | 180,000,000 |
Equity-Based Compensation - Add
Equity-Based Compensation - Additional Information (Detail) - USD ($) | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Authorized common stock | 12,700,000 | ||
Equity incentive plan available for future grant | 3,133,811 | ||
Annual increments in employee grants | 25% | ||
Stock options, contractual term | 10 years | ||
Equity-based compensation expense | $ 29,635,000 | $ 37,530,000 | $ 22,504,000 |
Unrecognized compensation expense related to unvested options | $ 61,900,000 | ||
Vesting period | 1 year 4 months 24 days | ||
Warrant outstanding | $ 0 | ||
Deferred income tax benefit | 16,545,000 | 11,772,000 | 53,108,000 |
Stock Compensation Plan [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Deferred income tax benefit | $ 8,000,000 | $ 9,600,000 | $ 5,500,000 |
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] | |||
Number of shares issuable at the end of the vesting period, percentage | 0% | ||
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% |
Equity-Based Compensation - Sto
Equity-Based Compensation - Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |||
Options outstanding, Beginning balance | 1,106,069 | 1,510,306 | 1,360,068 |
Options granted | 334,260 | 324,320 | 507,600 |
Options exercised | (285,577) | (558,322) | (68,700) |
Options cancelled | (175,475) | (170,235) | (288,662) |
Options outstanding, Ending balance | 979,277 | 1,106,069 | 1,510,306 |
Options exercisable, Ending balance | 301,827 | ||
Options outstanding, Weighted Average Exercise Price, Beginning balance | $ 42.07 | $ 37.56 | $ 39.40 |
Options granted, Weighted Average Exercise Price | 55.73 | 57.53 | 33.13 |
Options exercised, Weighted Average Exercise Price | 40.66 | 39.45 | 29.15 |
Options cancelled, Weighted Average Exercise Price | 46.98 | 40.08 | 39.67 |
Options outstanding, Weighted Average Exercise Price, Ending balance | 46.27 | $ 42.07 | $ 37.56 |
Options exercisable, Weighted Average Exercise Price, Ending balance | $ 41.43 | ||
Options outstanding, Weighted Average Remaining Contractual Term | 7 years 5 months 8 days | ||
Options exercisable, Weighted Average Remaining Contractual Term, Ending balance | 5 years 8 months 8 days | ||
Options outstanding, Aggregate Intrinsic Value | $ 35,303 | ||
Options exercisable, Aggregate Intrinsic Value, Ending balance | $ 12,341 |
Equity-Based Compensation - Sch
Equity-Based Compensation - Schedule of Stock Options Valuation Assumptions (Detail) - $ / shares | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |||
Weighted average grant-date fair value of options | $ 20.72 | $ 20.64 | $ 12.37 |
Risk-free interest rate | 2% | 0.90% | 1.60% |
Expected volatility | 39% | 40% | 41% |
Expected life (in years) | 5 years | 5 years | 5 years |
Equity-Based Compensation - Res
Equity-Based Compensation - Restricted Stock Activity (Detail) - Restricted Stock Award [Member] - $ / shares | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Unvested, Number of Shares/Units, Beginning balance | 926,627 | 1,022,996 | 805,136 |
Granted, Number of Shares | 650,396 | 352,430 | 637,312 |
Cancelled, Number of Shares | (145,205) | (82,751) | (129,683) |
Vested, Number of Shares | (386,616) | (366,048) | (289,769) |
Unvested, Number of Shares/Units, Ending balance | 1,045,202 | 926,627 | 1,022,996 |
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance | $ 37.84 | $ 28.41 | $ 34.14 |
Granted, Weighted Average Grant-Date Fair Value | 64.65 | 58.32 | 25.82 |
Cancelled, Weighted Average Grant-Date Fair Value | 49.03 | 39.63 | 34.56 |
Vested, Weighted Average Grant-Date Fair Value | 32.64 | 30.81 | 35.88 |
Unvested, Weighted Average Grant-Date Fair Value, Ending balance | $ 54.89 | $ 37.84 | $ 28.41 |
Equity-Based Compensation - R_2
Equity-Based Compensation - Restricted Stock Unit Activity (Detail) - Restricted Stock Units [Member] - $ / shares | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Unvested, Number of Shares/Units, Beginning balance | 1,504,420 | 1,073,062 | 447,357 |
Granted, Number of Units | 105,311 | 149,416 | 583,680 |
Performance adjustment, Number of Units | 182,543 | 465,993 | 117,772 |
Cancelled, Number of Units | (63,056) | ||
Vested, Number of Units | (518,474) | (184,051) | (12,691) |
Unvested, Number of Shares/Units, Ending balance | 1,273,800 | 1,504,420 | 1,073,062 |
Unvested, Weighted Average Grant-Date Fair Value, Beginning balance | $ 23.20 | $ 20.15 | $ 38.89 |
Granted, Weighted Average Grant-Date Fair Value | 73.96 | 61.52 | 10.60 |
Performance adjustment, Weighted Average Grant-Date Fair Value | 33.05 | 25.49 | 13.50 |
Cancelled, Weighted Average Grant-Date Fair Value | 43.35 | ||
Vested, Weighted Average Grant-Date Fair Value | 43.16 | 42.30 | 42.09 |
Unvested, Weighted Average Grant-Date Fair Value, Ending balance | $ 20.69 | $ 23.20 | $ 20.15 |
Income Taxes - Components of Pr
Income Taxes - Components of Provision for Income Taxes From Continuing operations (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Current: | |||
Federal | $ 63,041 | $ 48,292 | $ (18,215) |
State | 13,769 | 6,715 | 4,981 |
Foreign | 755 | 778 | 732 |
Total current | 77,565 | 55,785 | (12,502) |
Deferred: | |||
Federal | 9,808 | 13,339 | 46,442 |
State | 6,377 | (1,892) | 564 |
Foreign | 360 | 325 | 6,102 |
Total deferred provision | 16,545 | 11,772 | 53,108 |
Provision for income taxes | $ 94,110 | $ 67,557 | $ 40,606 |
Income Taxes - Effective Income
Income Taxes - Effective Income Tax Rate (Detail) | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Income Tax Disclosure [Abstract] | |||
U.S. federal statutory rate on income before income taxes | 21% | 21% | 21% |
Impact of foreign operations | (0.10%) | 1.70% | (0.50%) |
Effects of statutory rate change | 3.20% | ||
State income taxes, net of federal tax effect | 4.70% | 3.90% | 5.10% |
Permanent differences | 0.10% | 1.70% | 1.50% |
Change in valuation allowance | 0.20% | (2.80%) | 127.40% |
Unrecognized tax benefit release | (0.90%) | (0.40%) | |
Federal tax credits | (0.60%) | (0.80%) | (1.00%) |
Basis recognition related to foreign divestiture | (129.90%) | ||
CARES Act impacts to net operating losses | (4.50%) | ||
Other | (0.10%) | 0.70% | 0.20% |
Effective income tax rate | 25.20% | 24.50% | 22.10% |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Income Tax Examination [Line Items] | |||
Provision for income taxes | $ 94,110 | $ 67,557 | $ 40,606 |
Effective tax rates | 25.20% | 24.50% | 22.10% |
Valuation allowance against deferred tax assets | $ 217,705 | $ 217,325 | |
Operating loss carryforwards expiration end year | 2036 | ||
Federal net operating loss carryforwards | $ 0 | 0 | |
Foreign net operating loss carryforwards | 100 | 100 | |
State net operating loss carry forwards | $ 191,500 | 227,300 | |
Operating loss carryforwards expiration start year | 2023 | ||
Expiration of State tax credits | 2030 | ||
State tax credits | $ 200 | ||
Income taxes receivable | 28,900 | 24,600 | |
Income tax payable included in other accrued liabilities | 1,338 | 5,540 | |
Unrecognized tax benefits | $ 0 | 0 | $ 2,060 |
Earliest Tax Year [Member] | Internal Revenue Service (IRS) [Member] | |||
Income Tax Examination [Line Items] | |||
Period of examination by internal revenue service | 2019 | ||
Latest Tax Year [Member] | Internal Revenue Service (IRS) [Member] | |||
Income Tax Examination [Line Items] | |||
Period of examination by internal revenue service | 2021 | ||
Other Assets [Member] | |||
Income Tax Examination [Line Items] | |||
Income taxes receivable | $ 23,100 | 23,100 | |
Other Current Assets [Member] | |||
Income Tax Examination [Line Items] | |||
Income taxes receivable | $ 5,800 | $ 1,500 | |
Foreign Tax Authority [Member] | |||
Income Tax Examination [Line Items] | |||
Operating loss carryforwards expiration end year | 2026 | ||
Period of examination by internal revenue service minimum | 2018 | ||
Period of examination by internal revenue service maximum | 2021 | ||
State and Local Jurisdiction [Member] | |||
Income Tax Examination [Line Items] | |||
Period of examination by internal revenue service minimum | 2017 | ||
Period of examination by internal revenue service maximum | 2021 |
Income Taxes - Summary of Domes
Income Taxes - Summary of Domestic and Foreign Components of Income from Continuing Operations before Income Taxes (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Income Taxes [Line Items] | |||
Income from continuing operations before income taxes | $ 374,143 | $ 275,760 | $ 183,797 |
Foreign Tax Authority [Member] | |||
Income Taxes [Line Items] | |||
Income from continuing operations before income taxes | 5,420 | 5,596 | 9,904 |
Domestic Tax Authority [Member] | |||
Income Taxes [Line Items] | |||
Income from continuing operations before income taxes | $ 368,723 | $ 270,164 | $ 173,893 |
Income Taxes - Deferred Tax Ass
Income Taxes - Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 |
Deferred tax assets: | ||
Net operating losses and tax credit carryforwards - federal and state | $ 7,333 | $ 9,354 |
Capital loss carryovers | 215,745 | 215,367 |
Bad debt allowance | 1,148 | 1,083 |
Accrued compensation and severance | 18,784 | 18,241 |
Insurance reserves | 20,924 | 18,847 |
Leases | 862 | 896 |
Accrued expenses | 5,768 | |
Interest carryforwards | 2,639 | 3,396 |
Lease right-of-use liabilities | 26,277 | 26,154 |
Fixed asset basis difference | 2,128 | |
Other assets | 8,987 | 8,066 |
Total gross deferred tax assets | 304,827 | 307,172 |
Less: valuation allowance | (217,705) | (217,325) |
Deferred tax assets | 87,122 | 89,847 |
Deferred tax liabilities: | ||
Fixed asset basis difference | (2,456) | |
Prepaid items | (3,714) | (2,882) |
Accrued expenses | (5,713) | |
Intangible assets | (139,843) | (126,446) |
Lease right-of-use assets | (24,960) | (24,660) |
Investment in foreign subsidiary | (2,530) | (4,691) |
Total deferred tax liabilities | (176,760) | (161,135) |
Total net deferred tax liability | $ (89,638) | $ (71,288) |
Income Taxes - Unrecognized Inc
Income Taxes - Unrecognized Income Tax Benefits Net of Federal Benefit (Detail) $ in Thousands | 12 Months Ended |
Dec. 31, 2021 USD ($) | |
Income Tax Disclosure [Abstract] | |
Balance at January 1 | $ 2,060 |
Reductions as a result of the lapse of applicable statutes of limitations and settlements with tax authorities | (2,060) |
Balance at December 31 | $ 0 |
Derivatives - Additional Inform
Derivatives - Additional Information (Detail) - 1 months ended Aug. 31, 2019 - Cross Currency Swap Assets [Member] | USD ($) | GBP (£) | GBP (£) |
Derivative [Line Items] | |||
Notional amount | $ 650,000,000 | £ 538,100,000 | |
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 Credit Facilities and Contingent Consideration Liabilities (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 |
Carrying Amount [Member] | New Credit Facility [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Revolving Facility | $ 471,489 | $ 584,418 |
Carrying Amount [Member] | 5.500% Senior Notes due 2028 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 444,694 | 443,894 |
Carrying Amount [Member] | 5.000% Senior Notes due 2029 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 469,609 | 468,907 |
Fair Value [Member] | New Credit Facility [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Secured | 471,489 | 584,418 |
Fair Value [Member] | 5.500% Senior Notes due 2028 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | 422,459 | 466,577 |
Fair Value [Member] | 5.000% Senior Notes due 2029 [Member] | ||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||
Senior Notes | $ 433,214 | $ 481,802 |
Fair Value Measurements - Addit
Fair Value Measurements - Additional Information (Detail) | Dec. 31, 2022 | Dec. 31, 2021 | Oct. 14, 2020 | Jun. 24, 2020 |
5.500% Senior Notes due 2028 [Member] | ||||
Debt Instrument [Line Items] | ||||
Debt instrument interest rate | 5.50% | 5.50% | 5.50% | |
5.000% Senior Notes due 2029 [Member] | ||||
Debt Instrument [Line Items] | ||||
Debt instrument interest rate | 5% | 5% | 5% |
Employee Benefit Plans - Additi
Employee Benefit Plans - Additional Information (Detail) - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Defined Contribution Plan [Member] | 401(k) [Member] | |||
Defined Benefit Plan Disclosure [Line Items] | |||
Defined contribution expense | $ 6.6 | $ 2.8 | $ 3.8 |
Financial Information Combine_3
Financial Information Combined Wholly-Owned Subsidiaries - Additional Information (Detail) | Dec. 31, 2022 | Dec. 31, 2021 | Oct. 14, 2020 | Jun. 24, 2020 |
5.500% Senior Notes due 2028 [Member] | ||||
Line of Credit Facility [Line Items] | ||||
Debt instrument interest rate | 5.50% | 5.50% | 5.50% | |
5.000% Senior Notes due 2029 [Member] | ||||
Line of Credit Facility [Line Items] | ||||
Debt instrument interest rate | 5% | 5% | 5% |
Financial Information Combine_4
Financial Information Combined Wholly-Owned Subsidiaries - Summarized Balance Sheet (Detail) - USD ($) $ in Thousands | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 |
Condensed Financial Statements, Captions [Line Items] | ||||
Current assets | $ 506,125 | $ 495,031 | ||
Property and equipment, net | 1,952,045 | 1,771,159 | ||
Goodwill | 2,222,805 | 2,199,937 | $ 2,105,264 | |
Current liabilities | 388,326 | 404,861 | ||
Long-term debt | 1,364,541 | 1,478,626 | ||
Redeemable noncontrolling interests | 88,257 | 65,388 | 55,315 | |
Total equity | 2,812,727 | 2,517,489 | $ 1,899,456 | $ 2,505,381 |
Parent [Member] | ||||
Condensed Financial Statements, Captions [Line Items] | ||||
Current assets | 396,553 | 349,250 | ||
Property and equipment, net | 1,517,893 | 1,166,409 | ||
Goodwill | 2,105,227 | 2,086,978 | ||
Total noncurrent assets | 3,921,336 | 3,527,700 | ||
Current liabilities | 345,606 | 340,514 | ||
Long-term debt | 1,364,541 | 1,478,626 | ||
Total noncurrent liabilities | 1,629,750 | 1,688,326 | ||
Total equity | $ 2,342,533 | $ 1,848,110 |
Financial Information Combine_5
Financial Information Combined Wholly-Owned Subsidiaries - Summarized Statements of Income (Loss) (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | |
Condensed Financial Statements, Captions [Line Items] | |||
Revenue | $ 2,610,399 | $ 2,314,394 | $ 2,089,929 |
Income from continuing operations before income taxes | 374,143 | 275,760 | 183,797 |
Net income | 280,033 | 195,562 | (669,199) |
Net income attributable to Acadia Healthcare Company, Inc. | 273,139 | $ 190,635 | $ (672,132) |
Parent [Member] | |||
Condensed Financial Statements, Captions [Line Items] | |||
Revenue | 2,299,562 | ||
Income from continuing operations before income taxes | 325,309 | ||
Net income | 244,148 | ||
Net income attributable to Acadia Healthcare Company, Inc. | $ 244,148 |