AAC (AACH) 10-Q 4 May 17 2017 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2017	Apr. 28, 2017
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q1
Trading Symbol	AAC
Entity Registrant Name	AAC Holdings, Inc.
Entity Central Index Key	1,606,180
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		24,071,969

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Revenues
Client related revenue	$ 71,219	$ 62,706
Non-client related revenue	1,820	2,642
Total revenues	73,039	65,348
Operating expenses
Salaries, wages and benefits	36,772	31,971
Client related services	6,378	4,919
Provision for doubtful accounts	6,587	5,483
Advertising and marketing	3,775	4,397
Professional fees	2,642	4,307
Other operating expenses	8,789	6,654
Rentals and leases	1,885	1,532
Depreciation and amortization	5,469	3,915
Acquisition-related expenses	183	764
Total operating expenses	72,480	63,942
Income from operations	559	1,406
Interest expense, net (change in fair value of interest rate swaps of ($83) and $175, respectively)	2,734	1,702
Other expense (income), net	34	(7)
Loss before income tax benefit	(2,209)	(289)
Income tax benefit	(565)	(20)
Net loss	(1,644)	(269)
Less: net loss attributable to noncontrolling interest	1,041	855
Net (loss) income available to AAC Holdings, Inc. stockholders	$ (603)	$ 586
Basic (loss) earnings per common share	$ (0.03)	$ 0.03
Diluted (loss) earnings per common share	$ (0.03)	$ 0.03
Weighted-average common shares outstanding:
Basic	23,163,626	22,094,790
Diluted	23,163,626	22,113,500

CONDENSED CONSOLIDATED STATEME3

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Swap
Change in fair value of interest rate swaps	$ (83)	$ 175

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Current assets
Cash and cash equivalents	$ 5,880	$ 3,964
Accounts receivable, net of allowances	94,144	87,334
Prepaid expenses and other current assets	4,897	5,181
Total current assets	104,921	96,479
Property and equipment, net	145,410	141,307
Goodwill	134,396	134,396
Intangible assets, net	9,953	10,356
Deferred tax assets	1,316	598
Other assets	626	748
Total assets	396,622	383,884
Current liabilities
Accounts payable	13,711	9,155
Accrued liabilities	24,865	26,742
Current portion of long-term debt	10,965	9,445
Total current liabilities	49,541	45,342
Long-term debt, net of current portion and debt issuance costs	187,456	179,661
Other long-term liabilities	4,121	4,093
Total liabilities	241,118	229,096
Stockholders’ equity
Common stock, $0.001 par value: 70,000,000 shares authorized, 24,076,469 and 23,673,907 shares issued and outstanding at March 31, 2017 and December 31, 2016, respectively	24	24
Additional paid-in capital	148,323	145,963
Retained earnings	18,516	19,119
Total stockholders’ equity	166,863	165,106
Noncontrolling interest	(11,359)	(10,318)
Total stockholders’ equity including noncontrolling interest	155,504	154,788
Total liabilities and stockholders’ equity	$ 396,622	$ 383,884

CONDENSED CONSOLIDATED BALANCE5

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2017	Dec. 31, 2016
Statement Of Financial Position [Abstract]
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	70,000,000	70,000,000
Common stock, shares issued	24,076,469	23,673,907
Common stock, shares outstanding	24,076,469	23,673,907

CONDENSED CONSOLIDATED STATEME6

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - 3 months ended Mar. 31, 2017 - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Retained Earnings	AAC Holdings, Inc.	Noncontrolling Interest
Balance at Dec. 31, 2016	$ 154,788	$ 24	$ 145,963	$ 19,119	$ 165,106	$ (10,318)
Balance, share at Dec. 31, 2016		23,673,907
Common stock granted and issued under stock incentive plan, net of forfeitures, amount	2,077		2,077		2,077
Common stock granted and issued under stock incentive plan, net of forfeitures, share		365,813
Common stock withheld for minimum statutory taxes	(109)		(109)		(109)
Common stock withheld for minimum statutory taxes, shares		(13,613)
Effect of employee stock purchase plan	392		392		392
Effect of employee stock purchase plan, shares		50,362
Net loss	(1,644)			(603)	(603)	(1,041)
Balance at Mar. 31, 2017	$ 155,504	$ 24	$ 148,323	$ 18,516	$ 166,863	$ (11,359)
Balance, shares at Mar. 31, 2017		23,673,907

CONDENSED CONSOLIDATED STATEME7

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Cash flows from operating activities:
Net loss	$ (1,644)	$ (269)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts	6,587	5,483
Depreciation and amortization	5,469	3,915
Equity compensation	2,137	2,638
Amortization of debt issuance costs	173	95
Deferred income taxes	(718)
Changes in operating assets and liabilities:
Accounts receivable	(13,397)	(7,471)
Prepaid expenses and other assets	406	(7)
Accounts payable	4,556	(462)
Accrued liabilities	759	302
Other long term liabilities	28	55
Net cash provided by operating activities	4,356	4,279
Cash flows from investing activities:
Purchase of property and equipment	(10,687)	(7,017)
Escrow funds held on acquisition		(550)
Net cash used in investing activities	(10,687)	(7,567)
Cash flows from financing activities:
Proceeds from revolving line of credit, net	11,679
Payments on long-term debt and capital leases	(2,537)	(1,030)
Payment of employee taxes for net share settlement	(895)
Repayment of long-term debt — related party		(1,195)
Net cash provided by (used in) financing activities	8,247	(2,225)
Net change in cash and cash equivalents	1,916	(5,513)
Cash and cash equivalents, beginning of period	3,964	18,750
Cash and cash equivalents, end of period	5,880	13,237
Supplemental information on non-cash investing and financing transactions:
Accrued purchase of property and equipment	1,132	222
Accrued employee taxes for net share settlement	$ 109	$ 77

Description of Business

Description of Business	3 Months Ended
	Mar. 31, 2017
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Description of Business	1. AAC Holdings, Inc. (collectively with its subsidiaries, the “Company” or “AAC Holdings”) was incorporated on February 12, 2014. The Company is headquartered in Brentwood, Tennessee and provides substance abuse treatment services for individuals with drug and alcohol addiction. In addition to the Company’s substance abuse treatment services, the Company performs drug testing and diagnostic laboratory services, provides physician services to clients and operates a broad portfolio of internet assets that service millions of website visits each month serving families and individuals struggling with addiction and seeking treatment options. As of March 31, 2017, the Company, through its subsidiaries, operated 12 residential substance abuse treatment facilities and 18 standalone outpatient centers, and three sober living facilities with an aggregate

Basis of Presentation and Recen

Basis of Presentation and Recently Issued Accounting Pronouncements	3 Months Ended
	Mar. 31, 2017
Accounting Policies [Abstract]
Basis of Presentation and Recently Issued Accounting Pronouncements	2. Principles of Consolidation The Company conducts its business through limited liability companies and C-corporations, each of which is a direct or indirect wholly owned subsidiary of the Company. The accompanying condensed consolidated financial statements include the accounts of the Company, its wholly owned subsidiaries, and the accounts of variable interest entities (“VIEs”) in which the Company is the primary beneficiary. All intercompany transactions and balances have been eliminated in consolidation. The Company consolidated seven professional groups (“Professional Groups”) and six professional groups that constituted VIEs as of March 31, 2017 and 2016, respectively. The Professional Groups are responsible for the supervision and delivery of medical services to the Company’s clients. The Company provides management services to the Professional Groups. Based on the Company’s ability to direct the activities that most significantly impact the economic performance of the Professional Groups, provide necessary funding and the obligation and likelihood of absorbing all expected gains and losses, the Company has determined that it is the primary beneficiary of these Professional Groups. The accompanying condensed consolidated balance sheets as of March 31, 2017 and December 31, 2016 include assets of $2.5 million and $1.4 million and liabilities of $1.0 million and $0.7 million related to the VIEs, respectively. The accompanying condensed consolidated statements of operations include net loss attributable to noncontrolling interest of $1.0 million and $0.9 million related to the VIEs for the three months ended March 31, 2017 and 2016, respectively. The accompanying condensed consolidated financial statements are unaudited, with the exception of the December 31, 2016 balance sheet, which is consistent with the audited financial statements at that date but does not include all of the information and footnotes required by U.S. generally accepted accounting principles (“GAAP”) for a complete set of financial statements. The information contained in these condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements and notes thereto for the fiscal year ended December 31, 2016 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on March 7, 2017. Management believes that all adjustments of a normal, recurring nature considered necessary for a fair presentation have been included. In addition, the interim financial information does not necessarily represent or indicate what the operating results will be for the year ending December 31, 2017 for many reasons including, but not limited to, acquisitions, dispositions, capital financing transactions, changes in interest rates and the effects of other trends, risks and uncertainties. Recently Issued Accounting Standards Updates In January 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) 2017-04, “Simplifying the Test for Goodwill Impairment” (“ASU 2017-04”). The new guidance eliminates the requirement to calculate the implied fair value of goodwill (i.e., Step 2 of the current goodwill impairment test) to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit’s carrying amount over its fair value (i.e., measure the charge based on the current Step 1). ASU 2017-04 is effective for annual and any interim impairment tests for periods beginning after December 15, 2019. The Company is currently evaluating the provisions of ASU 2017-04 to determine the impact on the Company’s financial statements. In August 2016, the FASB issued ASU 2016-15, “Statement of Cash Flows: Classification of Certain Cash Receipts and Cash Payments” (“ASU 2016-15”). Among other clarifications, ASU 2016-15 clarifies certain items, including the classification of payments for debt prepayment or debt extinguishment costs, including third-party costs, premiums paid, and other fees paid to lenders that are directly related to the debt prepayment or debt extinguishment, excluding accrued interest, which will now be included in the Financing Activities section in the Statements of Cash Flows. The new standard is effective for fiscal years beginning after December 15, 2017, including interim periods within those fiscal years. The adoption of ASU 2016-15 is not expected to have a material impact on the Company’s Statements of Cash Flows. In June 2016, the FASB issued ASU 2016-13, “Financial Instruments-Credit Losses: Measurement of Credit Losses In March 2016, the FASB issued ASU 2016-09, “Compensation-Stock Compensation: Improvements to Employee Share-Based Payment Accounting” (“ASU 2016-09”). ASU 2016-09 requires that all excess tax benefits and tax deficiencies resulting from share-based payments be recognized as income tax expense or benefit in the income statement, which eliminates the accounting for additional paid-in capital pools. ASU 2016-09 also allows companies to make an entity-wide policy election to either estimate the number of stock-based awards that are expected to vest or account for forfeitures as they occur. With regards to the Statement of Cash Flows, both inflows and outflows of cash related to excess tax benefits will be classified as operating activities, whereas prior to this update, excess tax benefits as cash inflows were to be classified as financing activities. Also, cash paid by an employer when directly withholding shares for tax-withholding purposes (“net share settlement”) will now be classified as a financing activity. The new standard is effective for fiscal years beginning after December 15, 2016, including interim periods within those fiscal years. The Company adopted ASU 2016-09 on a prospective basis, effective January 1, 2017. Prior periods have not been adjusted. The adoption of the ASU impacted the classification of tax payments made by the Company on behalf of its employees for net share settlement amounts within the Condensed Consolidated Statement of Cash Flows, resulting in $0.8 million of tax payments being classified as a financing activity during the three months ended March 31, 2017. In February 2016, the FASB issued ASU No. 2016-02, “Leases” (“ASU 2016-02”). The new standard establishes a right-of-use (ROU) model that requires a lessee to record a ROU asset and a lease liability on the balance sheet for all leases with terms longer than 12 months. Leases will be classified as either finance or operating, with classification affecting the pattern of expense recognition in the income statement. The new standard is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. A modified retrospective transition approach is required for lessees for capital and operating leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements, with certain practical expedients available. The Company anticipates that the adoption of ASU 2016-02 will result in an increase in both total assets and total liabilities. The Company is continuing to evaluate the impact that adoption of this standard will have on its consolidated financial statements. In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2014-09, “Revenue from Contracts with Customers”, which outlines a single comprehensive model for recognizing revenue and supersedes most existing revenue recognition guidance, including guidance specific to the healthcare industry. Updates to this standard have been issued subsequent to the initial ASU 2014-09. Companies across all industries will use a new five-step model to recognize revenue from customer contracts. The new standard, which replaces nearly all existing GAAP revenue recognition guidance, will require significant management judgment in addition to changing the way many companies recognize revenue in their financial statements. The standard is effective for public entities for annual and interim periods beginning after December 15, 2017, with early adoption permitted for annual periods beginning after December 15, 2016. As the Company progresses with its implementation efforts to adopt ASU 2014-09, management continues to evaluate and refine its estimates of the anticipated impact the new standard will have on its revenue recognition policies, procedures, financial position, results of operations, cash flows and financial disclosures. Specifically, the Company continues to evaluate the impact the adoption will have on the presentation of the provision for doubtful accounts in the consolidated statements of operations and whether some or all of the provision for doubtful accounts will continue to be presented as a separate line item or will be recorded as a direct reduction to revenues.

Non-Client Related Revenue

Non-Client Related Revenue	3 Months Ended
	Mar. 31, 2017
Health Care Organization Revenue [Abstract]
Non-Client Related Revenue	3 . Our non-client related revenue consists of service charges from the delivery of quality targeted leads to behavioral and mental health service businesses through our operating subsidiary Referral Solutions Group, LLC and its wholly owned subsidiary, Recovery Brands, LLC, which was acquired on July 2, 2015 and diagnostic laboratory services provided to clients of third-party addiction treatment providers. Revenue is recognized when persuasive evidence of an arrangement exists, services have been rendered, the fee for services is fixed or determinable, and collectability of the fee is reasonably assured.

General and Administrative Cost

General and Administrative Costs	3 Months Ended
	Mar. 31, 2017
General And Administrative Costs [Abstract]
General and Administrative Costs	4. 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 overhead costs, which were $19.1 million and $17.3 million for the three months ended March 31, 2017 and 2016, respectively.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2017
Earnings Per Share [Abstract]
Earnings Per Share	5. Earnings Per Share Earnings per share (“EPS”) is calculated using the two-class method required for participating securities. Undistributed earnings allocated to these participating securities are subtracted from net income in determining net income attributable to common stockholders. Net losses, if any, are not allocated to these participating securities. Basic EPS is computed by dividing net income attributable to common stockholders by the weighted-average number of shares of common stock outstanding for the period. For the calculation of diluted EPS, net income attributable to common stockholders for basic EPS is adjusted by the effect of dilutive securities, including awards under stock-based payment arrangements. Diluted EPS attributable to common stockholders is computed by dividing net income attributable to common stockholders by the weighted-average number of fully diluted common shares outstanding during the period. The following tables reconcile the numerator and denominator used in the calculation of basic and diluted EPS for the three months ended March 31, 2017 and 2016 (in thousands except share and per share amounts): Three Months Ended March 31, 2017 2016 Numerator Net (loss) income attributable to common shares $ (603 ) $ 586 Denominator Weighted-average common shares outstanding – basic 23,163,626 22,094,790 Dilutive securities — 18,710 Weighted-average common shares outstanding – diluted 23,163,626 22,113,500 Basic (loss) earnings per common share $ (0.03 ) $ 0.03 Diluted (loss) earnings per common share $ (0.03 ) $ 0.03 The Company had 11,273 dilutive shares as of March 31, 2017 that are not included in the earnings per share calculation above, because to do so would be anti-dilutive for the period presented.

Accounts Receivable and Allowan

Accounts Receivable and Allowance for Doubtful Accounts	3 Months Ended
	Mar. 31, 2017
Receivables [Abstract]
Accounts Receivable and Allowance for Doubtful Accounts	6. A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2016 $ 28,128 Additions charged to provision for doubtful accounts 6,587 Accounts written off, net of recoveries (680 ) Balance at March 31, 2017 $ 34,035 For the three months ended March 31, 2017, approximately 10.8% of the Company’s revenues were reimbursed by Anthem Blue Cross Blue Shield of Nevada; 10.7% by Blue Cross Blue Shield of Florida; and 10.1% by Blue Cross Blue Shield of Texas. No other payor accounted for more than 10.0% of revenue reimbursements for the three months ended March 31, 2017. For the three months ended March 31, 2016, approximately 13.1% of the Company’s revenues were reimbursed by Anthem Blue Cross Blue Shield of Colorado; 10.7% by Blue Cross Blue Shield of Texas; and 10.7% by Aetna. No other payor accounted for more than 10.0% of revenue reimbursements for the three months ended March 31, 2016. Approximately $15.1 million and $10.4 million of the accounts receivable, net the of the allowance for doubtful accounts, at March 31, 2017 and December 31, 2016, respectively, includes accounts where the Company has received a partial payment from a commercial insurance company and the Company is continuing to pursue additional collections for the balance that the Company estimates remains outstanding. An account is written off only after the Company has pursued collection efforts or otherwise determines an account to be uncollectible.

Property and Equipment, net

Property and Equipment, net	3 Months Ended
	Mar. 31, 2017
Property Plant And Equipment [Abstract]
Property and Equipment, net	7. Property and Equipment, net Property and equipment consisted of the following (in thousands): March 31, December 31, 2017 2016 Land $ 14,701 $ 14,705 Buildings and improvements 112,294 103,742 Equipment and software 28,722 25,206 Construction in progress 25,036 27,841 Total property and equipment 180,753 171,494 Less accumulated depreciation (35,343 ) (30,187 ) Property and equipment, net $ 145,410 $ 141,307

Goodwill and Intangible Assets

Goodwill and Intangible Assets	3 Months Ended
	Mar. 31, 2017
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	8. Goodwill and Intangible Assets The Company’s business comprises a single reporting segment for impairment test purposes. Goodwill represents the excess of the purchase price over the fair value of the identifiable net assets acquired. Goodwill and intangible assets with indefinite lives are not amortized but instead are tested for impairment at least annually or whenever events or changes in circumstances indicate the carrying value may not be recoverable. If the carrying value of goodwill exceeds its implied fair value, an impairment loss is recorded. The Company has no intangible assets with indefinite useful lives other than goodwill. The Company’s goodwill balance as of March 31, 2017 and December 31, 2016 was $134.4 million. Other identifiable intangible assets and related accumulated amortization consisted of the following as of March 31, 2017 and December 31, 2016 (in thousands): Gross Carrying Value Accumulated Amortization March 31, December 31, March 31, December 31, 2017 2016 2017 2016 Trademarks 5,322 $ 5,322 1,587 $ 1,454 Non-compete agreements 1,587 1,587 1,218 1,139 Marketing intangibles 5,651 5,651 1,061 920 Leasehold interests 1,498 1,498 254 206 Other 51 51 36 34 $ 14,109 $ 14,109 $ 4,156 $ 3,753 Amortization expense for the three months ended March 31, 2017 and 2016 was $0.4 million and $0.3 million, respectively.

Debt

Debt	3 Months Ended
	Mar. 31, 2017
Debt Disclosure [Abstract]
Debt	9. Debt A summary of the Company’s debt obligations, net of unamortized discounts and debt issuance costs, is as follows (in thousands): March 31, December 31, 2017 2016 Debt: Senior secured loans $ 149,407 $ 139,750 Subordinated debt 50,000 50,000 Unamoritzed debt issuance costs (2,533 ) (2,386 ) Capital lease obligations 1,547 1,742 Total debt 198,421 189,106 Less current portion of long-term debt (10,965 ) (9,445 ) Total long-term debt, net of current portion $ 187,456 $ 179,661 2015 Credit Facility On March 9, 2015, the Company entered into a five-year senior secured credit facility (the “2015 Credit Facility”) with Bank of America, N.A., as administrative agent for the lenders party thereto. The 2015 Credit Facility initially consisted of a $50.0 million revolving credit facility and a $75.0 million term loan. The Company incurred approximately $2.0 million in debt issuance costs related to underwriting and other professional fees, of which approximately $1.1 million related to the revolving credit loan and approximately $0.9 million related to the term loan. The Company deferred these costs over the term of the 2015 Credit Facility. On July 13, 2016, the Company increased its 2015 Credit Facility to $171.3 million, consisting of a $50.0 million revolving credit facility and a $121.3 million term loan. The facility is scheduled to mature in March 2020 and bears interest at LIBOR plus a margin between 2.25% to 3.75% or a base rate plus a margin between 1.25% and 2.75%, in each case depending on the Company’s leverage ratio. The facility has an accordion feature that provides for an additional $75.0 million of borrowing capacity under the credit facility, subject to certain consents and conditions, including obtaining additional commitments from lenders. As of March 31, 2017, the balance on the term loan was $116.4 million, and the balance on the revolving credit facility was $33.0 million. On February 27, 2017, the Company amended its 2015 Credit Facility, to, among other things, provide for certain modifications to the terms of the 2015 Credit Agreement, dated as of March 19, 2015, as amended from time to time (the “2015 Credit Agreement”), including the following: (i) extend the maximum Consolidated Total Leverage Ratio (as defined in the 2015 Credit Agreement) of 4.25:1.00 through the measurement period ending September 30, 2017; and (ii) amend the definition of Applicable Margin (as defined in the 2015 Credit Agreement) to add an additional pricing level of 3.75% for Eurodollar Rate Loans and Letter of Credit Fee, 2.75% for Base Rate Loans and 0.60% for Commitment Fee (as all such terms are defined in the 2015 Credit Agreement), which will be applicable when the Consolidated Total Leverage Ratio is equal to or exceeds 4.00:1.00 at the end of the applicable measuring period (the “New Pricing Level”) and to provide that the Applicable Rate (as defined in the 2015 Credit Agreement) be set at the New Pricing Level from the date of such amendment until the first business day following the date the Company delivers its next Compliance Certificate (as defined in the 2015 Credit Agreement). The amendment also provided for additional Adjusted EBITDA (as defined in the 2015 Credit Agreement) add backs under its covenant calculation to account for its February 2017 reduction in workforce. The 2015 Credit Facility requires quarterly term loan principal repayments for the outstanding term loan of $2.3 million for March 31, 2017 to December 31, 2017, $3.9 million from March 31, 2018 to December 31, 2018, and $4.7 million from March 31, 2019 to December 31, 2019, with the remaining principal balance of the term loan due on the maturity date of March 9, 2020. Repayment of the revolving loan is due on the maturity date of March 9, 2020. The 2015 Credit Facility generally requires quarterly interest payments, and limits our ability to pay dividends. Borrowings under the 2015 Credit Facility are guaranteed by the Company and each of its subsidiaries and are secured by a lien on substantially all of the Company’s and its subsidiaries’ assets. Borrowings under the 2015 Credit Facility bear interest at a rate tied to the Company’s Consolidated Total Leverage Ratio (defined as Consolidated Funded Indebtedness to Consolidated EBITDA, in each case as defined in the 2015 Credit Facility, as amended). Eurodollar Rate Loans with respect to the 2015 Credit Facility bear interest at the Applicable Rate plus the Eurodollar Rate (each as defined in the 2015 Credit Facility, as amended) (based upon the LIBOR Rate (as defined in the 2015 Credit Facility, as amended) prior to commencement of the interest rate period). Base Rate Loans with respect to the 2015 Credit Facility bear interest at the Applicable Rate plus the highest of (i) the federal funds rate plus 0.50%, (ii) the prime rate and (iii) the Eurodollar Rate plus 1.0% (the interest rate at March 31, 2017 was 4.73%). In addition, the Company is required to pay a commitment fee on undrawn amounts under the revolving loan of the 2015 Credit Facility of 0.35% to 0.60% depending on the Company’s Consolidated Total Leverage Ratio (the commitment fee rate at March 31, 2017 was 0.60%). The Applicable Rates and the unused commitment fees of the 2015 Credit Facility, after the February 27, 2017 amendment, are based upon the following tiers: Pricing Tier Consolidated Total Leverage Ratio Eurodollar Rate Loans Base Rate Loans Commitment Fee 1 > 3.75 % 2.75 % 0.60 % 2 > 3.25 % 2.25 % 0.50 % 3 > 3.00 % 2.00 % 0.45 % 4 > 2.75 % 1.75 % 0.40 % 5 > 2.50 % 1.50 % 0.35 % 6 < 2.00:1.00 2.25 % 1.25 % 0.35 % The 2015 Credit Facility requires the Company to comply with customary affirmative, negative and financial covenants, including a Consolidated Fixed Charge Coverage Ratio, Consolidated Total Leverage Ratio and a Consolidated Senior Secured Leverage Ratio (each as defined in the 2015 Credit Facility, as amended). The Company may be required to pay all of its indebtedness immediately if the Company defaults on any of the financial or other restrictive covenants contained in the 2015 Credit Facility. The financial covenants, after the February 27, 2017 amendment, include maintenance of the following: • Fixed Charge Coverage Ratio may not be less than 1.50:1.00 as of the end of any fiscal quarter. • Consolidated Total Leverage Ratio: may not be greater than the following levels as of the end of each fiscal quarter: Measurement Period Ending Maximum Consolidated Total Leverage Ratio March 31, 2017 4.25:1.00 June 30, 2017 4.25:1.00 September 30, 2017 4.25:1.00 December 31, 2017 and each fiscal quarter thereafter 4.00:1.00 • Consolidated Senior Secured Leverage Ratio may not be greater than the following levels as of the end of each fiscal quarter: Measurement Period Ending Maximum Consolidated Senior Secured Leverage Ratio March 31, 2017 and each fiscal quarter thereafter 3.50:1.00 As of March 31, 2017 the Company was in compliance with all applicable covenants under the 2015 Credit Agreement. The Company has incurred a total of approximately $2.2 million in debt issuance costs, of which $1.5 million was unamortized as of March 31, 2017. The issuance costs were related to underwriting and other professional fees, which the Company deferred over the term of the 2015 Credit Facility. As of March 31, 2017, our total borrowings under the $50.0 million revolver portion of the 2015 Credit Facility were $33.0 million and $2.5 million in standby letters of credit issued for various corporate purposes resulting in $14.5 million available to the Company. 2015 Subordinated Debt On October 2, 2015, the Company entered into two financing facilities with affiliates of Deerfield Management Company, L.P. (“Deerfield”). The financing facilities consist of $25.0 million of subordinated convertible debt and up to $25.0 million of unsecured subordinated debt, together with an incremental facility of up to an additional $50.0 million of subordinated convertible debt (subject to certain conditions) (the “Deerfield Facility”). The Company issued $25.0 million of subordinated convertible debt at closing and used the proceeds to fund acquisitions, its de novo projects and for general corporate purposes. The $25.0 million of subordinated convertible debt bears interest at an annual rate of 2.50% and matures on September 30, 2021. The $25.0 million of subordinated convertible debt funded at closing is convertible into shares of the Company’s common stock at $30.00 per share. In the second quarter of 2016, the Company issued $25.0 million of the unsecured subordinated debt and used the proceeds to fund the acquisitions of Wetsman Forensic Medicine, LLC (d/b/a Townsend) and its affiliates (“Townsend”), the hotel in Arlington, Texas and Solutions Recovery, Inc., its affiliates and unsecured real estate assets (collectively, “Solutions”). The unsecured subordinated debt bears interest at an annual rate of 12.0% and matures on October 2, 2020. The Company has incurred a total of approximately $1.3 million in debt issuance costs, of which $1.0 million was unamortized as of March 31, 2017. The issuance costs were related to the underwriting and other professional fees, which the Company deferred over the term of the Deerfield Facility. As of March 31, 2017, both the $25.0 million of subordinated convertible debt, bearing interest at 2.5%, and the $25.0 million of unsecured subordinated debt, bearing interest at 12.0%, were outstanding. Interest Rate Swap Agreements In July 2014, the Company entered into two interest rate swap agreements to mitigate its exposure to fluctuations in interest rates. As of March 31, 2017, the interest rate swap agreements had notional amounts of $7.2 million and $10.5 million which fix the interest rates over the life of the respective swap agreement at 4.21% and 4.73%, and mature in May 2018 and August 2019, respectively. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not the Company’s assets or liabilities. The interest payments under these agreements are settled on a net basis. The Company has not designated the interest rate swaps as cash flow hedges, and therefore, the changes in the fair value of the interest rate swaps are included within interest expense in the condensed consolidated statements of operations. The fair value of the interest rate swaps at March 31, 2017 and December 31, 2016 represented a liability of $0.2 million and $0.3 million, respectively, and is reflected in other long-term liabilities on the condensed consolidated balance sheets. Refer to Note 12 (Fair Value of Financial Instruments) for further discussion of fair value of the interest rate swap agreements. The Company’s credit risk related to these agreements is considered low because the swap agreements are with a creditworthy financial institution.

Stockholders' Equity and Stock

Stockholders' Equity and Stock Based Compensation	3 Months Ended
	Mar. 31, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stockholders' Equity and Stock Based Compensation	10. Stockholders’ Equity and Stock Based Compensation Stock Based Compensation Plans The Company granted 408,000 and 110,000 shares of restricted common stock as part of the 2014 Equity Incentive Plan (“the Plan”) during the three months ended March 31, 2017 and 2016, respectively. The restricted common stock granted during the three months ended March 31, 2017 vest annually over a period of three years beginning on December 31, 2017. The restricted common stock granted during the three months ended March 31, 2016 vest quarterly over a period of three years beginning on March 31, 2016. Additionally, the Company granted 38,000 and 30,000 shares of fully vested common stock during the three months ended March 31, 2017 and 2016, respectively, to its five non-employee directors pursuant to the Plan. The Company recognized $0.3 million and $0.5 million of compensation expense for the three months ended March 31, 2017 and 2016, respectively, as a result of the non-employee director grants. The Company recognized $2.1 million and $2.6 million in equity-based compensation expense for the three months ended March 31, 2017 and 2016, respectively. As of March 31, 2017, there was $12.8 million of unrecognized compensation expense related to unvested restricted stock, which is expected to be recognized over the remaining weighted average vesting period of 2.3 years. A summary of share activity under the Plan is set forth below: Weighted- average Grant Shares Date Fair Value Unvested at December 31, 2016 522,175 $ 23.22 Granted 446,000 8.60 Vested (96,855 ) 18.52 Forfeitures (80,186 ) 23.59 Unvested at March 31, 2017 791,134 $ 15.52 Employee Stock Purchase Plan For the three months ended March 31, 2017 and 2016, the Company issued 50,362 and 15,445 shares of the Company’s common stock under its Employee Stock Purchase Plan (“ESPP”), respectively, at a purchase price of $7.24 and $19.06 per share, respectively, in connection with employee deductions of $0.3 million contributed in the July 1, 2016 through December 31, 2016 ESPP option period and $0.2 million contributed in the July 1, 2015 through December 31, 2015 ESPP option period. For both the three months ended March 31, 2017 and 2016, the Company recognized $0.1 million of compensation expense related to the ESPP.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2017
Income Tax Disclosure [Abstract]
Income Taxes	11. Income Taxes The provision for income taxes for the three months ended March 31, 2017 reflects an income tax benefit of $0.6 million at an effective tax rate of 25.6%, compared to an income tax benefit of $20,000 at an effective tax rate of 6.9% for the three months ended March 31, 2016. The change in effective tax rate is primarily due to the tax treatment of employee stock compensation expense which is determined by the stock price as of the vesting date. The Internal Revenue Service is currently conducting a routine examination of the Company’s 2013 and 2014 tax returns. The results of such examination and impact on the Company’s result of operations are not known at this time.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2017
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	12. Fair Value of Financial Instruments The carrying amounts reported at March 31, 2017 and December 31, 2016 for cash and cash equivalents, accounts receivable, prepaid expenses and other current assets, accounts payable and accrued liabilities approximate fair value because of the short-term maturity of these instruments and are categorized as Level 1 within the GAAP fair value hierarchy. The Company has debt with variable and fixed interest rates. The fair value of debt with fixed interest rates was determined using the quoted market prices of debt instruments with similar terms and maturities, which are considered Level 2 inputs. The fair value of debt with variable interest rates was also measured using Level 2 inputs, including good faith estimates of the market value for the particular debt instrument, which represent the amount an independent market participant would provide based upon market observations and other factors relevant under the circumstances. The carrying value of such debt approximated its estimated fair value at March 31, 2017 and December 31, 2016. The Company has entered into interest rate swap agreements to manage exposure to fluctuations in interest rates. Fair value of the interest rate swaps is determined using a pricing model based on published interest rates and other observable market data. The fair value was determined after considering the potential impact of collateralization, adjusted to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk. The fair value measurement of interest rate swaps utilizes Level 2 inputs. At March 31, 2017, the fair value of the interest rate swaps represented a liability of $0.2 million. Refer to Note 9 (Debt) for further discussion of the interest rate swap agreements.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2017
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	13. Commitments and Contingencies Litigation Shareholder Litigation On August 24, 2015, a shareholder filed a purported class action in the United States District Court for the Middle District of Tennessee against the Company and certain of its current and former officers ( Kasper v. AAC Holdings, Inc. et al.) Tenzyk v. AAC Holdings, Inc. et al.) consolidating these two described actions into one action. On April 14, 2016, the Company and the individual defendants filed a motion to dismiss the complaint for failure to state a claim. On July 1, 2016, the court denied the motion to dismiss. In a related matter, on November 28, 2015, a shareholder filed a derivative action on behalf of AAC Holdings, Inc. in the Eighth Judicial District Court for Clark County, Nevada ( Bushansky v. Jerrod N. Menz et al.) against AAC Holding’s board of directors and certain of its officers alleging that these directors and officers breached their fiduciary duties and engaged in mismanagement and illegal conduct. On January 19, 2016, the Court entered an Order staying this litigation pending the earlier of the close of discovery in the related securities class action pending in Tennessee or the deadline for appealing any dismissal of the securities class action. The Company is vigorously defending these actions. At this time, the Company cannot predict the results of litigation with certainty. However, it is reasonably possible that the Company may incur a loss in connection with these matters. The Company is unable to reasonably estimate the amount or range of any such loss given that the matter is still in the early stages of discovery. Any loss incurred in connection with adverse outcomes in these matters could be material. New Jersey Department of Banking and Insurance The New Jersey Department of Banking and Insurance (“NJ-DOBI”) and Leading Edge Recovery Center, LLC (“Leading Edge”), a former indirect operating subsidiary of American Addiction Centers, Inc. that was acquired in September 2012 and was subsequently closed in 2013, have been negotiating a possible resolution to certain information provided to NJ-DOBI following Leading Edge’s recent claim settlement with Horizon Blue Cross Blue Shield of New Jersey. Based on these discussions, the Company has now settled in principle the claim with NJ-DOBI. The settlement payment was previously fully reserved. Other The Company is also aware of various other legal matters arising in the ordinary course of business. To cover these other types of claims as well as the legal matters referenced above, the Company maintains insurance it believes to be sufficient for its operations, although some claims may potentially exceed the scope of coverage in effect and the insurer may argue that some claims are excluded from coverage. Plaintiffs in these matters may also request punitive or other damages that may not be covered by insurance. Except as described above, after taking into consideration the evaluation of such matters by the Company’s legal counsel, the Company’s management believes at this time that the anticipated outcome of these matters will not have a material impact on the Company’s consolidated financial position, results of operations or cash flows.

Basis of Presentation and Rec21

Basis of Presentation and Recently Issued Accounting Pronouncements (Policies)	3 Months Ended
	Mar. 31, 2017
Accounting Policies [Abstract]
Recently Issued Accounting Standards Updates	Recently Issued Accounting Standards Updates In January 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) 2017-04, “Simplifying the Test for Goodwill Impairment” (“ASU 2017-04”). The new guidance eliminates the requirement to calculate the implied fair value of goodwill (i.e., Step 2 of the current goodwill impairment test) to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit’s carrying amount over its fair value (i.e., measure the charge based on the current Step 1). ASU 2017-04 is effective for annual and any interim impairment tests for periods beginning after December 15, 2019. The Company is currently evaluating the provisions of ASU 2017-04 to determine the impact on the Company’s financial statements. In August 2016, the FASB issued ASU 2016-15, “Statement of Cash Flows: Classification of Certain Cash Receipts and Cash Payments” (“ASU 2016-15”). Among other clarifications, ASU 2016-15 clarifies certain items, including the classification of payments for debt prepayment or debt extinguishment costs, including third-party costs, premiums paid, and other fees paid to lenders that are directly related to the debt prepayment or debt extinguishment, excluding accrued interest, which will now be included in the Financing Activities section in the Statements of Cash Flows. The new standard is effective for fiscal years beginning after December 15, 2017, including interim periods within those fiscal years. The adoption of ASU 2016-15 is not expected to have a material impact on the Company’s Statements of Cash Flows. In June 2016, the FASB issued ASU 2016-13, “Financial Instruments-Credit Losses: Measurement of Credit Losses In March 2016, the FASB issued ASU 2016-09, “Compensation-Stock Compensation: Improvements to Employee Share-Based Payment Accounting” (“ASU 2016-09”). ASU 2016-09 requires that all excess tax benefits and tax deficiencies resulting from share-based payments be recognized as income tax expense or benefit in the income statement, which eliminates the accounting for additional paid-in capital pools. ASU 2016-09 also allows companies to make an entity-wide policy election to either estimate the number of stock-based awards that are expected to vest or account for forfeitures as they occur. With regards to the Statement of Cash Flows, both inflows and outflows of cash related to excess tax benefits will be classified as operating activities, whereas prior to this update, excess tax benefits as cash inflows were to be classified as financing activities. Also, cash paid by an employer when directly withholding shares for tax-withholding purposes (“net share settlement”) will now be classified as a financing activity. The new standard is effective for fiscal years beginning after December 15, 2016, including interim periods within those fiscal years. The Company adopted ASU 2016-09 on a prospective basis, effective January 1, 2017. Prior periods have not been adjusted. The adoption of the ASU impacted the classification of tax payments made by the Company on behalf of its employees for net share settlement amounts within the Condensed Consolidated Statement of Cash Flows, resulting in $0.8 million of tax payments being classified as a financing activity during the three months ended March 31, 2017. In February 2016, the FASB issued ASU No. 2016-02, “Leases” (“ASU 2016-02”). The new standard establishes a right-of-use (ROU) model that requires a lessee to record a ROU asset and a lease liability on the balance sheet for all leases with terms longer than 12 months. Leases will be classified as either finance or operating, with classification affecting the pattern of expense recognition in the income statement. The new standard is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. A modified retrospective transition approach is required for lessees for capital and operating leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements, with certain practical expedients available. The Company anticipates that the adoption of ASU 2016-02 will result in an increase in both total assets and total liabilities. The Company is continuing to evaluate the impact that adoption of this standard will have on its consolidated financial statements. In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2014-09, “Revenue from Contracts with Customers”, which outlines a single comprehensive model for recognizing revenue and supersedes most existing revenue recognition guidance, including guidance specific to the healthcare industry. Updates to this standard have been issued subsequent to the initial ASU 2014-09. Companies across all industries will use a new five-step model to recognize revenue from customer contracts. The new standard, which replaces nearly all existing GAAP revenue recognition guidance, will require significant management judgment in addition to changing the way many companies recognize revenue in their financial statements. The standard is effective for public entities for annual and interim periods beginning after December 15, 2017, with early adoption permitted for annual periods beginning after December 15, 2016. As the Company progresses with its implementation efforts to adopt ASU 2014-09, management continues to evaluate and refine its estimates of the anticipated impact the new standard will have on its revenue recognition policies, procedures, financial position, results of operations, cash flows and financial disclosures. Specifically, the Company continues to evaluate the impact the adoption will have on the presentation of the provision for doubtful accounts in the consolidated statements of operations and whether some or all of the provision for doubtful accounts will continue to be presented as a separate line item or will be recorded as a direct reduction to revenues.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2017
Earnings Per Share [Abstract]
Schedule of Reconciliation of Numerator and Denominator Used in Calculation of Basic and Diluted Earnings Per Share	The following tables reconcile the numerator and denominator used in the calculation of basic and diluted EPS for the three months ended March 31, 2017 and 2016 (in thousands except share and per share amounts): Three Months Ended March 31, 2017 2016 Numerator Net (loss) income attributable to common shares $ (603 ) $ 586 Denominator Weighted-average common shares outstanding – basic 23,163,626 22,094,790 Dilutive securities — 18,710 Weighted-average common shares outstanding – diluted 23,163,626 22,113,500 Basic (loss) earnings per common share $ (0.03 ) $ 0.03 Diluted (loss) earnings per common share $ (0.03 ) $ 0.03

Accounts Receivable and Allow23

Accounts Receivable and Allowance for Doubtful Accounts (Tables)	3 Months Ended
	Mar. 31, 2017
Receivables [Abstract]
Summary of Allowance for Doubtful Accounts	A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2016 $ 28,128 Additions charged to provision for doubtful accounts 6,587 Accounts written off, net of recoveries (680 ) Balance at March 31, 2017 $ 34,035

Property and Equipment, net (Ta

Property and Equipment, net (Tables)	3 Months Ended
	Mar. 31, 2017
Property Plant And Equipment [Abstract]
Components of Property and Equipment	Property and equipment consisted of the following (in thousands): March 31, December 31, 2017 2016 Land $ 14,701 $ 14,705 Buildings and improvements 112,294 103,742 Equipment and software 28,722 25,206 Construction in progress 25,036 27,841 Total property and equipment 180,753 171,494 Less accumulated depreciation (35,343 ) (30,187 ) Property and equipment, net $ 145,410 $ 141,307

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2017
Goodwill And Intangible Assets Disclosure [Abstract]
Components of Other Identifiable Intangible Assets	Other identifiable intangible assets and related accumulated amortization consisted of the following as of March 31, 2017 and December 31, 2016 (in thousands): Gross Carrying Value Accumulated Amortization March 31, December 31, March 31, December 31, 2017 2016 2017 2016 Trademarks 5,322 $ 5,322 1,587 $ 1,454 Non-compete agreements 1,587 1,587 1,218 1,139 Marketing intangibles 5,651 5,651 1,061 920 Leasehold interests 1,498 1,498 254 206 Other 51 51 36 34 $ 14,109 $ 14,109 $ 4,156 $ 3,753

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2017
Debt Disclosure [Abstract]
Summary of Debt Obligations, Net of Unamortized Discounts And Debt Issuance Costs	A summary of the Company’s debt obligations, net of unamortized discounts and debt issuance costs, is as follows (in thousands): March 31, December 31, 2017 2016 Debt: Senior secured loans $ 149,407 $ 139,750 Subordinated debt 50,000 50,000 Unamoritzed debt issuance costs (2,533 ) (2,386 ) Capital lease obligations 1,547 1,742 Total debt 198,421 189,106 Less current portion of long-term debt (10,965 ) (9,445 ) Total long-term debt, net of current portion $ 187,456 $ 179,661
Schedule of Applicable Rates and Unused Commitment Fees	The Applicable Rates and the unused commitment fees of the 2015 Credit Facility, after the February 27, 2017 amendment, are based upon the following tiers: Pricing Tier Consolidated Total Leverage Ratio Eurodollar Rate Loans Base Rate Loans Commitment Fee 1 > 3.75 % 2.75 % 0.60 % 2 > 3.25 % 2.25 % 0.50 % 3 > 3.00 % 2.00 % 0.45 % 4 > 2.75 % 1.75 % 0.40 % 5 > 2.50 % 1.50 % 0.35 % 6 < 2.00:1.00 2.25 % 1.25 % 0.35 %
Schedule of Consolidated Total Leverage Ratio	• Consolidated Total Leverage Ratio: may not be greater than the following levels as of the end of each fiscal quarter: Measurement Period Ending Maximum Consolidated Total Leverage Ratio March 31, 2017 4.25:1.00 June 30, 2017 4.25:1.00 September 30, 2017 4.25:1.00 December 31, 2017 and each fiscal quarter thereafter 4.00:1.00
Schedule of Consolidated Senior Secured Leverage Ratio	• Consolidated Senior Secured Leverage Ratio may not be greater than the following levels as of the end of each fiscal quarter: Measurement Period Ending Maximum Consolidated Senior Secured Leverage Ratio March 31, 2017 and each fiscal quarter thereafter 3.50:1.00

Stockholders' Equity and Stoc27

Stockholders' Equity and Stock Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Summary of Share Activity Under 2014 Equity Incentive Plan	A summary of share activity under the Plan is set forth below: Weighted- average Grant Shares Date Fair Value Unvested at December 31, 2016 522,175 $ 23.22 Granted 446,000 8.60 Vested (96,855 ) 18.52 Forfeitures (80,186 ) 23.59 Unvested at March 31, 2017 791,134 $ 15.52

Description of Business - Addit

Description of Business - Additional Information (Details)	Mar. 31, 2017FacilityCenterBed
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Number of operating facilities	12
Number of standalone outpatient centers | Center	18
Number of sober living facilities	3
Number of sober living beds | Bed	242

Basis of Presentation and Rec29

Basis of Presentation and Recently Issued Accounting Pronouncements - Additional Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)ProfessionalGroup	Mar. 31, 2016USD ($)ProfessionalGroup	Dec. 31, 2016USD ($)
Business And Basis Of Presentation [Line Items]
Assets	$ 396,622		$ 383,884
Liabilities	241,118		229,096
Net loss attributable to noncontrolling interest	1,041	$ 855
Payment of employee taxes for net share settlement	895
ASU 2016-09
Business And Basis Of Presentation [Line Items]
Payment of employee taxes for net share settlement	$ 800
VIEs
Business And Basis Of Presentation [Line Items]
Number of professional groups | ProfessionalGroup	7	6
Assets	$ 2,500		1,400
Liabilities	1,000		$ 700
Net loss attributable to noncontrolling interest	$ 1,000	$ 900

Non-Client Related Revenue - Ad

Non-Client Related Revenue - Additional Information (Details)	3 Months Ended
	Mar. 31, 2017
Referral Solutions Group LLC and Recovery Brands LLC
Revenues
Business acquisition, effective date of acquisition	Jul. 2, 2015

General and Administrative Co31

General and Administrative Costs - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
General And Administrative Costs [Abstract]
General and administrative expense	$ 19.1	$ 17.3

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Reconciliation of Numerator and Denominator Used in Calculation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Numerator
Net (loss) income attributable to common shares	$ (603)	$ 586
Denominator
Weighted-average common shares outstanding – basic	23,163,626	22,094,790
Dilutive securities		18,710
Weighted-average common shares outstanding – diluted	23,163,626	22,113,500
Basic (loss) earnings per common share	$ (0.03)	$ 0.03
Diluted (loss) earnings per common share	$ (0.03)	$ 0.03

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Details)	3 Months Ended
	Mar. 31, 2017shares
Earnings Per Share [Abstract]
Anti-dilutive shares excluded from calculation of earnings per share	11,273

Accounts Receivable and Allow34

Accounts Receivable and Allowance for Doubtful Accounts - Summary of Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Receivables [Abstract]
Balance at December 31, 2016	$ 28,128
Additions charged to provision for doubtful accounts	6,587	$ 5,483
Accounts written off, net of recoveries	(680)
Balance at March 31, 2017	$ 34,035

Accounts Receivable and Allow35

Accounts Receivable and Allowance for Doubtful Accounts - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016	Dec. 31, 2016
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, net of allowances	$ 94,144		$ 87,334
Commercial Insurance Company
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, net of allowances	$ 15,100		$ 10,400
Revenues | Anthem Blue Cross Blue Shield | NEVADA
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed	10.80%
Revenues | Anthem Blue Cross Blue Shield | COLORADO
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed		13.10%
Revenues | Blue Cross Blue Shield | FLORIDA
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed	10.70%
Revenues | Blue Cross Blue Shield | TEXAS
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed	10.10%	10.70%
Revenues | Aetna
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed		10.70%

Property and Equipment, net - C

Property and Equipment, net - Components of Property and Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Property Plant And Equipment [Line Items]
Total property and equipment	$ 180,753	$ 171,494
Less accumulated depreciation	(35,343)	(30,187)
Property and equipment, net	145,410	141,307
Land
Property Plant And Equipment [Line Items]
Total property and equipment	14,701	14,705
Buildings and Improvements
Property Plant And Equipment [Line Items]
Total property and equipment	112,294	103,742
Equipment and Software
Property Plant And Equipment [Line Items]
Total property and equipment	28,722	25,206
Construction in progress
Property Plant And Equipment [Line Items]
Total property and equipment	$ 25,036	$ 27,841

Goodwill and Intangible Asset37

Goodwill and Intangible Assets - Additional Information (Details) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2017	Mar. 31, 2016	Dec. 31, 2016
Goodwill And Intangible Assets Disclosure [Abstract]
Intangible assets	$ 0
Goodwill impairment charge			$ 0
Goodwill	134,396,000		$ 134,396,000
Amortization expense	$ 400,000	$ 300,000

Goodwill and Intangible Asset38

Goodwill and Intangible Assets - Components of Other Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 14,109	$ 14,109
Accumulated Amortization	4,156	3,753
Trademarks
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	5,322	5,322
Accumulated Amortization	1,587	1,454
Non-compete agreements
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	1,587	1,587
Accumulated Amortization	1,218	1,139
Marketing Intangibles
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	5,651	5,651
Accumulated Amortization	1,061	920
Leasehold interests
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	1,498	1,498
Accumulated Amortization	254	206
Other
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	51	51
Accumulated Amortization	$ 36	$ 34

Debt - Summary of Debt Obligati

Debt - Summary of Debt Obligations, Net of Unamortized Discounts and Debt Issuance Costs (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Line Of Credit Facility [Line Items]
Unamoritzed debt issuance costs	$ (2,533)	$ (2,386)
Long term debt	1,547	1,742
Total debt	198,421	189,106
Less current portion of long-term debt	(10,965)	(9,445)
Total long-term debt, net of current portion	187,456	179,661
Senior Secured Term Loan
Line Of Credit Facility [Line Items]
Long term debt	149,407	139,750
Subordinated Debt
Line Of Credit Facility [Line Items]
Subordinated debt	$ 50,000	$ 50,000

Debt - Credit Facility - Additi

Debt - Credit Facility - Additional Information (Details) - USD ($)	Feb. 27, 2017	Jul. 13, 2016	Mar. 09, 2015	Mar. 31, 2017	Dec. 31, 2016
Line Of Credit Facility [Line Items]
Unamoritzed debt issuance costs				$ 2,533,000	$ 2,386,000
2015 Credit Facility
Line Of Credit Facility [Line Items]
Debt instrument, term			5 years
Credit facility borrowing capacity		$ 171,300,000
Debt issuance costs			$ 2,000,000
Repayment of outstanding debt			$ 24,900,000
Revolving line of credit maturity month		2020-03
Maximum borrowing limit		$ 75,000,000
Commitment fee on undrawn amounts, percentage				0.60%
Description of payment of principal installments			The 2015 Credit Facility generally requires quarterly interest payments,
Description of interest rate				Applicable Rate plus the highest of (i) the federal funds rate plus 0.50%, (ii) the prime rate and (iii) the Eurodollar Rate plus 1.0% (the interest rate at March 31, 2017 was 4.73%).
Interest rate at the end of period				4.73%
Debt instrument, covenant compliance				the Company was in compliance with all applicable covenants
Deferred debt issuance costs				$ 2,200,000
Unamoritzed debt issuance costs				1,500,000
2015 Credit Facility | Pricing Tier 1
Line Of Credit Facility [Line Items]
Commitment fee on undrawn amounts, percentage	0.60%		0.60%
2015 Credit Facility | Minimum
Line Of Credit Facility [Line Items]
Commitment fee on undrawn amounts, percentage			0.35%
Fixed charge coverage ratio			1.50%
2015 Credit Facility | Minimum | Pricing Tier 1
Line Of Credit Facility [Line Items]
Leverage Ratio	400.00%		400.00%
2015 Credit Facility | Maximum
Line Of Credit Facility [Line Items]
Leverage Ratio	425.00%
Commitment fee on undrawn amounts, percentage			0.60%
2015 Credit Facility | London Interbank Offered Rate (LIBOR) | Minimum
Line Of Credit Facility [Line Items]
Interest rate		2.25%
2015 Credit Facility | London Interbank Offered Rate (LIBOR) | Maximum
Line Of Credit Facility [Line Items]
Interest rate		3.75%
2015 Credit Facility | Base Rate | Minimum
Line Of Credit Facility [Line Items]
Interest rate		1.25%
2015 Credit Facility | Base Rate | Maximum
Line Of Credit Facility [Line Items]
Interest rate		2.75%
2015 Credit Facility | Revolving Credit Facility
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity		$ 50,000,000	$ 50,000,000	50,000,000
Debt issuance costs			$ 1,100,000
Long-term Line of Credit				33,000,000
Revolving line of credit maturity date			Mar. 9, 2020
Available for borrowings under revolver				14,500,000
2015 Credit Facility | Revolving Credit Facility | Standby Letters of Credit
Line Of Credit Facility [Line Items]
Long-term Line of Credit				2,500,000
2015 Credit Facility | Term Loan
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity		$ 121,300,000	$ 75,000,000
Debt issuance costs			$ 900,000
Long-term Line of Credit				$ 116,400,000
Revolving line of credit maturity date			Mar. 9, 2020
2015 Credit Facility | Term Loan | March 31, 2017 to December 31, 2017
Line Of Credit Facility [Line Items]
Monthly principal payments			$ 2,300,000
2015 Credit Facility | Term Loan | March 31, 2018 to December 31, 2018
Line Of Credit Facility [Line Items]
Monthly principal payments			3,900,000
2015 Credit Facility | Term Loan | March 31, 2019 to December 31, 2019
Line Of Credit Facility [Line Items]
Monthly principal payments			$ 4,700,000
2015 Credit Facility | Eurodollar Rate Loans | Pricing Tier 1
Line Of Credit Facility [Line Items]
Interest rate	3.75%		3.75%
2015 Credit Facility | Base Rate Loans | Pricing Tier 1
Line Of Credit Facility [Line Items]
Interest rate	2.75%		2.75%
2015 Credit Facility | Base Rate Loans | Federal Funds Rate
Line Of Credit Facility [Line Items]
Interest rate			0.50%
2015 Credit Facility | Base Rate Loans | Eurodollar Rate
Line Of Credit Facility [Line Items]
Interest rate			1.00%

Debt - Schedule of Applicable R

Debt - Schedule of Applicable Rates and Unused Commitment Fees (Details) - 2015 Credit Facility	Feb. 27, 2017	Mar. 09, 2015	Mar. 31, 2017
Line Of Credit Facility [Line Items]
Commitment Fee			0.60%
Minimum
Line Of Credit Facility [Line Items]
Commitment Fee		0.35%
Maximum
Line Of Credit Facility [Line Items]
Leverage Ratio	425.00%
Commitment Fee		0.60%
Pricing Tier 1
Line Of Credit Facility [Line Items]
Commitment Fee	0.60%	0.60%
Pricing Tier 1 | Eurodollar Rate Loans
Line Of Credit Facility [Line Items]
Interest rate	3.75%	3.75%
Pricing Tier 1 | Base Rate Loans
Line Of Credit Facility [Line Items]
Interest rate	2.75%	2.75%
Pricing Tier 1 | Minimum
Line Of Credit Facility [Line Items]
Leverage Ratio	400.00%	400.00%
Pricing Tier 2
Line Of Credit Facility [Line Items]
Commitment Fee		0.50%
Pricing Tier 2 | Eurodollar Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		3.25%
Pricing Tier 2 | Base Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		2.25%
Pricing Tier 2 | Minimum
Line Of Credit Facility [Line Items]
Leverage Ratio		350.00%
Pricing Tier 2 | Maximum
Line Of Credit Facility [Line Items]
Leverage Ratio		400.00%
Pricing Tier 3
Line Of Credit Facility [Line Items]
Commitment Fee		0.45%
Pricing Tier 3 | Eurodollar Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		3.00%
Pricing Tier 3 | Base Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		2.00%
Pricing Tier 3 | Minimum
Line Of Credit Facility [Line Items]
Leverage Ratio		300.00%
Pricing Tier 3 | Maximum
Line Of Credit Facility [Line Items]
Leverage Ratio		350.00%
Pricing Tier 4
Line Of Credit Facility [Line Items]
Commitment Fee		0.40%
Pricing Tier 4 | Eurodollar Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		2.75%
Pricing Tier 4 | Base Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		1.75%
Pricing Tier 4 | Minimum
Line Of Credit Facility [Line Items]
Leverage Ratio		250.00%
Pricing Tier 4 | Maximum
Line Of Credit Facility [Line Items]
Leverage Ratio		300.00%
Pricing Tier 5
Line Of Credit Facility [Line Items]
Commitment Fee		0.35%
Pricing Tier 5 | Eurodollar Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		2.50%
Pricing Tier 5 | Base Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		1.50%
Pricing Tier 5 | Minimum
Line Of Credit Facility [Line Items]
Leverage Ratio		200.00%
Pricing Tier 5 | Maximum
Line Of Credit Facility [Line Items]
Leverage Ratio		250.00%
Pricing Tier 6
Line Of Credit Facility [Line Items]
Commitment Fee		0.35%
Pricing Tier 6 | Eurodollar Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		2.25%
Pricing Tier 6 | Base Rate Loans
Line Of Credit Facility [Line Items]
Interest rate		1.25%
Pricing Tier 6 | Maximum
Line Of Credit Facility [Line Items]
Leverage Ratio		200.00%

Debt - Schedule of Consolidated

Debt - Schedule of Consolidated Total Leverage Ratio (Details) - 2015 Credit Facility - Maximum	Feb. 27, 2017	Mar. 09, 2015
Line Of Credit Facility [Line Items]
Leverage Ratio	425.00%
March 31, 2017
Line Of Credit Facility [Line Items]
Leverage Ratio		425.00%
June 30, 2017
Line Of Credit Facility [Line Items]
Leverage Ratio		425.00%
September 30, 2017
Line Of Credit Facility [Line Items]
Leverage Ratio		425.00%
December 31, 2017 and Each Fiscal Quarter Thereafter
Line Of Credit Facility [Line Items]
Leverage Ratio		400.00%

Debt - Schedule of Consolidat43

Debt - Schedule of Consolidated Senior Secured Leverage Ratio (Details)	Mar. 09, 2015
2015 Credit Facility | March 31, 2017 and Each Fiscal Quarter Thereafter | Maximum
Line Of Credit Facility [Line Items]
Consolidated Senior Secured Leverage Ratio	350.00%

Debt - 2015 Subordinated Debt -

Debt - 2015 Subordinated Debt - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	Oct. 02, 2015	Jun. 30, 2016	Mar. 31, 2017	Dec. 31, 2016
Line Of Credit Facility [Line Items]
Unamoritzed debt issuance costs			$ 2,533	$ 2,386
2.50% Subordinated Convertible Debt Maturing September 30, 2021
Line Of Credit Facility [Line Items]
Debt instrument, face amount	$ 25,000
Debt instrument, unused capacity	50,000
Proceeds from long-term debt	$ 25,000
Interest rate	2.50%
Maturity Date	Sep. 30, 2021
Conversion price per share	$ 30
Long term debt			$ 25,000
Debt instrument, interest rate			2.50%
12.0% Unsecured Subordinated Convertible Debt Maturing October 02, 2020
Line Of Credit Facility [Line Items]
Debt instrument, face amount	$ 25,000
Long term debt			$ 25,000
Debt instrument, interest rate			12.00%
12.0% Unsecured Subordinated Convertible Debt Maturing October 02, 2020 | Townsend and Solutions [Member]
Line Of Credit Facility [Line Items]
Debt instrument, face amount		$ 25,000
Interest rate		12.00%
Maturity Date		Oct. 2, 2020
2015 Subordinated Debt Issuance [Member]
Line Of Credit Facility [Line Items]
Deferred debt issuance costs			$ 1,300
Unamoritzed debt issuance costs			$ 1,000

Debt - Interest Rate Swap Agree

Debt - Interest Rate Swap Agreements - Additional Information (Details) $ in Millions	1 Months Ended	3 Months Ended
	Jul. 31, 2014Agreement	Mar. 31, 2017USD ($)	Dec. 31, 2016USD ($)
Line Of Credit Facility [Line Items]
Number of interest rate swap agreement | Agreement	2
Fair value of interest rate swaps, liability		$ 0.2	$ 0.3
Agreement Two
Line Of Credit Facility [Line Items]
Interest rate swap agreement initial notional amount		$ 7.2
Interest rate swap agreement percentage		4.21%
Maturity Date		May 31, 2018
Agreement One
Line Of Credit Facility [Line Items]
Interest rate swap agreement initial notional amount		$ 10.5
Interest rate swap agreement percentage		4.73%
Maturity Date		Aug. 31, 2019

Stockholders' Equity and Stoc46

Stockholders' Equity and Stock Based Compensation - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Mar. 31, 2017	Mar. 31, 2016	Dec. 31, 2016	Dec. 31, 2015
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted	446,000
Fully vested common stock granted	96,855
Compensation expense	$ 2,100	$ 2,600
Effect of employee stock purchase plan	392
Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Compensation expense	$ 100	$ 100
Employee stock purchase plan, shares issued	50,362	15,445
Purchase price per share	$ 7.24	$ 19.06
Effect of employee stock purchase plan			$ 300	$ 200
Restricted Common Stock | Five Non Employee Directors
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Fully vested common stock granted	38,000	30,000
Compensation expense	$ 300	$ 500
2014 Equity Incentive Plan | Restricted Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted	408,000	110,000
Share-based compensation, award vesting period	3 years	3 years
Unrecognized compensation expenses	$ 12,800
Weighted average life of remaining vesting period	2 years 3 months 18 days

Stockholders' Equity and Stoc47

Stockholders' Equity and Stock Based Compensation - Summary of Share Activity Under 2014 Equity Incentive Plan (Details)	3 Months Ended
	Mar. 31, 2017$ / sharesshares
Nonvested, Number of Shares [Roll Forward]
Beginning Balance, Shares | shares	522,175
Granted, Shares | shares	446,000
Vested, Shares | shares	(96,855)
Forfeitures, Shares | shares	(80,186)
Ending Balance, Shares | shares	791,134
Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Beginning Balance, Weighted-average Grant Date Fair Value | $ / shares	$ 23.22
Granted, Weighted-average Grant Date Fair Value | $ / shares	8.60
Vested, Weighted-average Grant Date Fair Value | $ / shares	18.52
Forfeitures, Weighted-average Grant Date Fair Value | $ / shares	23.59
Ending Balance, Weighted-average Grant Date Fair Value | $ / shares	$ 15.52

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Income Tax Disclosure [Abstract]
Effective tax rates on provision for income taxes	25.60%	6.90%
Income tax benefit	$ 565	$ 20

Fair Value of Financial Instr49

Fair Value of Financial Instruments - Additional Information (Details) $ in Millions	Mar. 31, 2017USD ($)
Fair Value Disclosures [Abstract]
Fair value of interest rate swap	$ 0.2