AAC (AACH) 10-Q 6 Nov 17 2017 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2017	Oct. 27, 2017
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q3
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		23,998,467

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Revenues
Client related revenue	$ 77,948	$ 68,491	$ 224,859	$ 199,423
Non-client related revenue	2,476	2,037	6,646	7,995
Total revenues	80,424	70,528	231,505	207,418
Operating expenses
Salaries, wages and benefits	36,709	36,479	107,989	104,641
Client related services	6,598	7,040	19,622	17,459
Provision for doubtful accounts	9,682	4,794	25,765	15,220
Advertising and marketing	3,074	4,687	10,115	13,593
Professional fees	3,641	5,278	9,322	13,454
Other operating expenses	8,306	7,757	25,294	21,708
Rentals and leases	2,105	2,108	5,839	5,532
Depreciation and amortization	5,218	4,629	15,745	12,769
Acquisition-related expenses	370	468	595	2,428
Total operating expenses	75,703	73,240	220,286	206,804
Income (loss) from operations	4,721	(2,712)	11,219	614
Interest expense, net (change in fair value of interest rate swaps of $0 and ($141) and ($108) and $49, respectively)	5,492	1,927	11,072	5,850
Loss on extinguishment of debt			5,435
Other expense, net	49	130	77	87
Loss before income tax benefit	(820)	(4,769)	(5,365)	(5,323)
Income tax benefit	456	758	459	885
Net loss	(364)	(4,011)	(4,906)	(4,438)
Less: net loss attributable to noncontrolling interest	1,126	1,486	3,149	3,371
Net income (loss) available to AAC Holdings, Inc. common stockholders	$ 762	$ (2,525)	$ (1,757)	$ (1,067)
Basic earnings (loss) per common share	$ 0.03	$ (0.11)	$ (0.08)	$ (0.05)
Diluted earnings (loss) per common share	$ 0.03	$ (0.11)	$ (0.08)	$ (0.05)
Weighted-average common shares outstanding:
Basic	23,331,414	22,957,834	23,246,353	22,607,194
Diluted	23,469,985	22,957,834	23,246,353	22,607,194

CONDENSED CONSOLIDATED STATEME3

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Swap
Change in fair value of interest rate swaps	$ 0	$ (141)	$ (108)	$ 49

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Current assets
Cash and cash equivalents	$ 16,412	$ 3,964
Accounts receivable, net of allowances	92,547	87,334
Prepaid expenses and other current assets	6,030	5,181
Total current assets	114,989	96,479
Property and equipment, net	151,769	141,307
Goodwill	134,396	134,396
Intangible assets, net	9,169	10,356
Deferred tax assets, net	1,579	598
Other assets	5,664	748
Total assets	417,566	383,884
Current liabilities
Accounts payable	5,732	9,155
Accrued and other current liabilities	24,633	26,742
Current portion of long-term debt	4,736	9,445
Total current liabilities	35,101	45,342
Long-term debt, net of current portion and debt issuance costs	197,872	179,661
Financing lease obligation, net of current portion	24,398
Other long-term liabilities	3,836	4,093
Total liabilities	261,207	229,096
Stockholders’ equity
Common stock, $0.001 par value: 70,000,000 shares authorized, 24,021,219 and 23,673,907 shares issued and outstanding at September 30, 2017 and December 31, 2016, respectively	24	24
Additional paid-in capital	152,440	145,963
Retained earnings	17,362	19,119
Total stockholders’ equity	169,826	165,106
Noncontrolling interest	(13,467)	(10,318)
Total stockholders’ equity including noncontrolling interest	156,359	154,788
Total liabilities and stockholders’ equity	$ 417,566	$ 383,884

CONDENSED CONSOLIDATED BALANCE5

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 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	24,021,219	23,673,907
Common stock, shares outstanding	24,021,219	23,673,907

CONDENSED CONSOLIDATED STATEME6

CONDENSED CONSOLIDATED STATEMENT OF STOCKHOLDERS' EQUITY - 9 months ended Sep. 30, 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	5,988		5,988		5,988
Common stock granted and issued under stock incentive plan, net of forfeitures, share		287,311
Common stock withheld for minimum statutory taxes	(185)		(185)		(185)
Common stock withheld for minimum statutory taxes, shares		(37,588)
Effect of employee stock purchase plan	674		674		674
Effect of employee stock purchase plan, shares		97,589
Net loss	(4,906)			(1,757)	(1,757)	(3,149)
Balance at Sep. 30, 2017	$ 156,359	$ 24	$ 152,440	$ 17,362	$ 169,826	$ (13,467)
Balance, shares at Sep. 30, 2017		24,021,219

CONDENSED CONSOLIDATED STATEME7

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Cash flows from operating activities:
Net loss	$ (4,906)	$ (4,438)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts	25,765	15,220
Depreciation and amortization	15,745	12,769
Equity compensation	6,048	6,840
Loss on disposal of property and equipment		163
Loss on extinguishment of debt	5,435
Amortization of debt issuance costs	949	404
Deferred income taxes	(981)	(904)
Changes in operating assets and liabilities:
Accounts receivable	(30,978)	(32,867)
Prepaid expenses and other assets	(703)	1,387
Accounts payable	(3,423)	1,973
Accrued liabilities	1,336	949
Other long-term liabilities	(257)	(180)
Net cash provided by operating activities	14,030	1,316
Cash flows from investing activities:
Purchase of property and equipment	(27,186)	(29,985)
Acquisition of subsidiaries, net of cash acquired		(19,150)
Net cash used in investing activities	(27,186)	(49,135)
Cash flows from financing activities:
Payments on 2015 Credit Facility and Deerfield Facility	(211,094)	(2,812)
Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs	18,000	46,929
Proceeds from financing lease obligation, net of deferred financing costs	24,617
Payments on capital leases	(596)	(577)
Payment of employee taxes for net share settlement	(1,004)
Repayment of long-term debt — related party		(1,195)
Net cash provided by financing activities	25,604	42,345
Net change in cash and cash equivalents	12,448	(5,474)
Cash and cash equivalents, beginning of period	3,964	18,750
Cash and cash equivalents, end of period	16,412	13,276
Supplemental information on non-cash investing and financing transactions:
Accrued purchase of property and equipment	419	1,205
Accrued employee taxes for net share settlement	76
Common stock issued for acquisition of subsidiaries		$ 15,430
2017 Credit Facility
Cash flows from financing activities:
Payments on 2017 Credit Facility	(15,813)
2017 Term Loan
Cash flows from financing activities:
Proceeds from 2017 Term Loan, net of deferred financing costs	$ 211,494

Description of Business

Description of Business	9 Months Ended
	Sep. 30, 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 addiction, alcohol addiction and co-occurring mental/behavioral health issues. In addition to the Company’s substance abuse treatment services, the Company performs clinical 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 September 30, 2017, the Company, through its subsidiaries, operated 10 residential substance abuse treatment facilities, 18 standalone outpatient centers, and 4 sober living facilities.

Basis of Presentation and Recen

Basis of Presentation and Recently Issued Accounting Pronouncements	9 Months Ended
	Sep. 30, 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”) that constituted VIEs as of September 30, 2017 and 2016. 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 September 30, 2017 and December 31, 2016 include assets of $2.3 million and $1.4 million and liabilities of $0.4 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 $1.1 million and $1.5 million related to the VIEs for the three months ended September 30, 2017 and 2016, respectively, and net loss attributable to noncontrolling interest of $3.1 million and $3.4 million for the nine months ended September 30, 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. Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation. 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 interim impairment tests for periods beginning after December 15, 2019. The Company does not believe that the provisions of ASU 2017-04 will have a material impact on the Company’s financial statements upon adoption. 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 Company chose to early adopt the provisions of ASU 2016-15 during the nine months ended September 30, 2017, which impacted the condensed consolidated statement of cash flows by allowing debt extinguishment costs incurred during the nine months ended September 30, 2017 to be classified as a financing activity rather than an operating activity. 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 , resulting in $1.0 million of tax payments being classified as a financing activity during the nine months ended September 30, 2017. In February 2016, the FASB issued ASU 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 financing 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 FASB issued ASU 2014-09, “Revenue from Contracts with Customers” (“Topic 606”), 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 standard. Companies across all industries will use a new five-step model to recognize revenue from customer contracts. The new standard, will require significant management judgment in addition to changing the way many companies recognize revenue in their financial statements. The new guidance will also require enhanced disclosures about the nature, amount, timing, and uncertainty of revenue and cash flows arising from customer contracts, including revenue recognition policies to identify performance obligations, assets recognized from costs incurred to obtain and fulfill a contract, and significant judgments in measurement and recognition. 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. The Company will adopt the standard on January 1, 2018. As the Company progresses with its implementation efforts to adopt Topic 606, 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. The Company continues to evaluate and currently expects that it may adopt the modified retrospective method of adoption. Additionally, the Company currently anticipates that as a result of changes required by Topic 606, a significant majority of the provision for doubtful accounts will be presented as a direct reduction to revenue as opposed to being presented as a separate line item. To date, the Company is in the early stages of its implementation process.

Non-Client Related Revenue

Non-Client Related Revenue	9 Months Ended
	Sep. 30, 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	9 Months Ended
	Sep. 30, 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 $17.5 million and $20.7 million for the three months ended September 30, 2017 and 2016, respectively, and $54.2 million and $55.8 million for the nine months ended September 30, 2017 and 2016, respectively.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2017
Earnings Per Share [Abstract]
Earnings Per Share	5. Earnings Per Share Basic earnings per share (“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 and nine months ended September 30, 2017 and 2016 (in thousands except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Numerator Net income (loss) available to AAC Holdings, Inc. common stockholders $ 762 $ (2,525 ) $ (1,757 ) $ (1,067 ) Denominator Weighted-average common shares outstanding – basic 23,331,414 22,957,834 23,246,353 22,607,194 Dilutive securities 138,571 — — — Weighted-average common shares outstanding – diluted 23,469,985 22,957,834 23,246,353 22,607,194 Basic earnings (loss) per common share $ 0.03 $ (0.11 ) $ (0.08 ) $ (0.05 ) Diluted earnings (loss) per common share $ 0.03 $ (0.11 ) $ (0.08 ) $ (0.05 ) For the three months ended September 30, 2017 and 2016, t he Company had 138,571 and 4,879 potentially dilutive shares, respectively. For the nine months ended September 30, 2017 and 2016, the Company had 902,293 and 9,759 potentially dilutive shares, respectively. These shares are not included in the EPS calculation above for the nine months ended September 30, 2017 and 2016, because to do so would be anti-dilutive for the periods presented.

Accounts Receivable and Allowan

Accounts Receivable and Allowance for Doubtful Accounts	9 Months Ended
	Sep. 30, 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 25,765 Accounts written off, net of recoveries (5,150 ) Balance at September 30, 2017 $ 48,743 For the nine months ended September 30, 2017, approximately 11.3% of the Company’s revenues were reimbursed by Anthem Blue Cross Blue Shield of Nevada; 10.8% by Blue Cross Blue Shield of Texas; and 10.0% by Blue Cross Blue Shield of Florida. No other payor accounted for more than 10.0% of revenue reimbursements for the nine months ended September 30, 2017. For the nine months ended September 30, 2016, approximately 11.0% of the Company’s revenues were reimbursed by Anthem Blue Cross Blue Shield of Colorado; 10.7% by Blue Cross Blue Shield of Texas; 10.3% by Aetna; and 10.3% by Blue Cross Blue Shield of Florida. No other payor accounted for more than 10.0% of revenue reimbursements for the nine months ended September 30, 2016. Approximately $12.1 million and $10.4 million of the accounts receivable, net of the allowance for doubtful accounts, at September 30, 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	9 Months Ended
	Sep. 30, 2017
Property Plant And Equipment [Abstract]
Property and Equipment, net	7. Property and Equipment, net Property and equipment consisted of the following (in thousands): September 30, December 31, 2017 2016 Land $ 14,705 $ 14,705 Buildings and improvements 130,498 103,742 Equipment and software 32,690 25,206 Construction in progress 18,710 27,841 Total property and equipment 196,603 171,494 Less accumulated depreciation (44,834 ) (30,187 ) Property and equipment, net $ 151,769 $ 141,307

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 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 both September 30, 2017 and December 31, 2016 was $134.4 million. Other identifiable intangible assets and related accumulated amortization consisted of the following as of September 30, 2017 and December 31, 2016 (in thousands): Gross Carrying Value Accumulated Amortization September 30, December 31, September 30, December 31, 2017 2016 2017 2016 Trademarks $ 5,322 $ 5,322 $ 1,853 $ 1,454 Non-compete agreements 1,587 1,587 1,356 1,139 Marketing intangibles 5,651 5,651 1,344 920 Leasehold interests 1,498 1,498 349 206 Other 51 51 38 34 $ 14,109 $ 14,109 $ 4,940 $ 3,753 Amortization expense for both the three months ended September 30, 2017 and 2016 was $0.4 million. Amortization expense for the nine months ended September 30, 2017 and 2016 was $1.2 million and $1.1 million, respectively.

Debt

Debt	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Debt	9. Debt A summary of the Company’s debt obligations, net of debt issuance costs, is as follows (in thousands): September 30, December 31, 2017 2016 Senior secured loans $ 208,688 $ 139,750 Subordinated debt — 50,000 Unamortized debt issuance costs (7,289 ) (2,386 ) Capital lease obligations 1,209 1,742 Total debt 202,608 189,106 Less current portion of long-term debt (4,736 ) (9,445 ) Total long-term debt, net of current portion $ 197,872 $ 179,661 2017 Credit Facility On June 30, 2017, the Company entered into a senior secured credit agreement with Credit Suisse AG, as administrative agent and collateral agent and the lenders party thereto (the “2017 Credit Facility”). The 2017 Credit Facility initially made available to the Company a $40.0 million revolving line of credit (the “2017 Revolver”) and a term loan in an aggregate original principal amount of $210.0 million (the “2017 Term Loan”). As discussed further below, on September 25, 2017 the 2017 Revolver was increased to $55.0 million. The 2017 Credit Facility also provides for standby letters of credit in an aggregate undrawn amount not to exceed $7.0 million. The 2017 Term Loan will mature on June 30, 2023 and requires scheduled quarterly principal repayments in an amount equal to $ 1.3 million for September 30, 2017 through June 30, 2019, $2.6 million for September 30, 2019 through March 31, 2023, with the remaining principal balance of the term loan due on the maturity date of June 30, 2023. The 2017 Revolver will mature on June 30, 2022 and $14.5 million was drawn on the 2017 Revolver on June 30, 2017. The Company paid down the outstanding loans under the 2017 Revolver during the three months ended September 30, 2017 and as of September 30, 2017, there were no outstanding loans related to the 2017 . The 2017 Credit Facility also includes an incremental facility providing for the Company to incur Additional Term Loans in an aggregate principal amount of up to $25.0 million (plus such additional amounts, so long as, after giving pro forma effect to the incurrence of such additional borrowings, the Company’s Senior Secured Leverage Ratio (as defined in the 2017 Credit Facility) would be less than 3.90:1.00) (each, an “Incremental Term Loan”) and/or Additional Revolving Commitments in an aggregate principal amount of up to million (the “Incremental Revolver”), each subject to the satisfaction of certain conditions contained in the 2017 Credit Facility, including obtaining additional commitments from existing or additional lenders. On September 25, 2017, the Company obtained its Incremental Revolver from certain incremental revolving credit lenders thereby increasing the 2017 pursuant to the 2017 Credit Facility from $40.0 million to $55.0 million. The lenders under the 2017 Credit Facility are not under any obligation to provide any Incremental Term Loans. Borrowings under the 2017 Credit Facility bear interest at a rate tied to the Alternative Base Rate or the Adjusted London Interbank Offered Rate (“LIBOR”) Borrowings under the 2017 Credit Facility are guaranteed by the Company’s wholly owned subsidiary, American Addiction Centers, Inc., and certain of its other subsidiaries pursuant to that certain Guarantee and Collateral Agreement, dated as of June 30, 2017, by and among the Company, each of the subsidiary guarantors party thereto and Credit Suisse AG, as collateral agent (the “Guarantee and Collateral Agreement”). The obligations under the 2017 Credit Facility and the Guarantee and Collateral Agreement are secured by a lien on substantially all of the Company’s and each subsidiary guarantor’s assets. The Company is permitted to voluntarily reduce the unutilized portion of the commitment amount and repay outstanding loans under the 2017 Credit Facility at any time without premium or penalty, other than customary “breakage” costs with respect to Eurodollar Loans and, with respect to the 2017 Term Loan, if certain repricing transactions are consummated or certain mandatory repayments are made, (i) a yield maintenance premium within one year after the closing as set forth in the 2017 Credit Facility, (ii) a 2.0% premium if paid after the first anniversary of the closing but before the second anniversary of the closing and (iii) a 1.0% premium if paid after the second anniversary of the closing but before the third anniversary of the closing. In addition, the 2017 Credit Facility requires the Company to prepay the outstanding 2017 Term Loan, subject to certain exceptions, with: • 75.0% (which percentage will be reduced to 50.0% if the Company’s Senior Secured Leverage Ratio is not greater than 3.25:1.00 and to 25.0% if the Company’s Senior Secured Leverage Ratio is not greater than 2.75:1.00) of the Company’s annual excess cash flow (as defined by the 2017 Credit Facility); • 100.0% of the net cash proceeds of certain asset sales or other dispositions of property or certain casualty events, in each case subject to certain exceptions and provided that the Company may, subject to certain conditions, reinvest within 365 days in assets to be used in its business or certain other permitted investments; • 100.0% of the net cash proceeds of the incurrence of debt and issuance of Disqualified Stock (as defined by the 2017 Credit Facility) other than proceeds from debt permitted under the 2017 Credit Facility; and • 100.0% of the net cash proceeds of equity issuances in the event the Senior Secured Leverage Ratio is greater than 3.00:1.00, calculated on a pro forma basis, at the time of such issuances (or such lesser percentage required for the Senior Secured Leverage Ratio to be equal to or less than 3.00:1.00), other than equity proceeds that are utilized within 270 days of issuance for Permitted Acquisitions (as defined in the 2017 Credit Facility) or material expansion of facilities. The 2017 Credit Facility requires the Company to not permit its Senior Secured Leverage Ratio (as defined in the 2017 Credit Agreement) to exceed the following ratios on or after each quarter end: Each Fiscal Quarter Ending During the Period Maximum Senior Secured Leverage Ratio Ending before March 31, 2019 5.25:1.00 Ending on or after March 31, 2019 4.75:1.00 Ending on or after March 31, 2020 4.25:1.00 In addition, the 2017 Credit Facility places certain restrictions on the ability of the Company and its subsidiaries to, among other things, incur debt and liens; merge, consolidate or liquidate; dispose of assets; enter into hedging arrangements; pay dividends and make other restricted payments; undertake transactions with affiliates; enter into restrictive agreements on dividends and other distributions; make negative pledges; enter into certain sale-leaseback transactions; make certain investments; prepay or modify the terms of certain indebtedness; and modify the terms of certain organizational agreements. The 2017 Credit Facility contains customary events of default, including payment defaults, breaches of representations and warranties, covenant defaults, cross-defaults to other material indebtedness, certain events of bankruptcy and insolvency, material judgments, certain ERISA events, invalidity of loan documents and certain changes in control. The Company incurred approximately $12.9 million in debt issuance costs related to underwriting and other professional fees, of which $7.6 million related to the 2017 Term Loan and $5.3 million related to the 2017 Revolver. As of September 30, 2017, the Company’s availability under the 2017 Revolver was $55.0 million, less any outstanding letters of credit. In addition, subsequent to September 30, 2017, the Company also secured a $65.0 million acquisition financing commitment related to the pending acquisition of AdCare, Inc. (“AdCare”). See Note 15 (Subsequent Events) for further discussion. As of September 30, 2017, the Company was in compliance with all applicable covenants under the 2017 Credit Facility. 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. In connection with entering into the 2017 Credit Facility on June 30, 2017, all amounts outstanding under the 2015 Credit Facility were fully repaid. The 2015 Credit Facility initially consisted of a $50.0 million revolving credit facility and a $75.0 million term loan. 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 was scheduled to mature in March 2020 and bore 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 Total Consolidated Leverage Ratio . During the quarter ended June 30, 2017, the Company incurred approximately $5.4 million in debt extinguishment costs related to the repayment of the 2015 Credit Facility and the Deerfield Facility, which consisted of a $3.0 million consent fee related to calling the Deerfield Facility (the “Deerfield Facility Consent Fee”), as well as a write-off of $2.3 million of previously deferred debt issuance costs. 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 consisted of $25.0 million of subordinated convertible debt and up to $25.0 million of unsecured subordinated debt (the “Deerfield Facility”). In connection with entering into the 2017 Credit Facility on June 30, 2017, all amounts outstanding under the Deerfield Facility were fully repaid. The Company issued $25.0 million of subordinated convertible debt at closing of the Deerfield Facility. The $25.0 million of subordinated convertible debt bore interest at an annual rate of 2.50% and would have matured on September 30, 2021. The $25.0 million of subordinated convertible debt funded at closing of the Deerfield Facility was 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 unsecured subordinated debt under the Deerfield Facility and used the proceeds to fund the acquisitions of Wetsman Forensic Medicine, LLC (d/b/a Townsend) and its affiliates, a hotel in Arlington, Texas and Solutions Recovery, Inc., its affiliates and unsecured real estate assets. The unsecured subordinated debt bore interest at an annual rate of 12.0% and would have matured on October 2, 2020. 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. On June 29, 2017, the Company terminated the interest rate swap agreements. The fair value of the interest rate swap agreements as of December 31, 2016 represented a liability of $0.3 million . Prior to terminating the interest rate swap agreements on June 29, 2017, the interest rate swap agreements had notional amounts of $7.2 million and $10.5 million which fixed the interest rates over the life of the respective swap agreement at 4.21% and 4.73%, and were set to mature in May 2018 and August 2019, respectively. The notional amounts of the swap agreements represented amounts used to calculate the exchange of cash flows and were not the Company’s assets or liabilities. The interest payments under these agreements were to be settled on a net basis. The Company did not designate 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.

Financing Lease Obligation

Financing Lease Obligation	9 Months Ended
	Sep. 30, 2017
Leases [Abstract]
Financing Lease Obligation	10. Financing Lease Obligation On August 9, 2017, the Company closed on a sale-leaseback transaction with MedEquities Realty Operating Partnership, LP, a subsidiary of MedEquities Realty Trust, Inc. (“MedEquities”), for MedEquities purchased from subsidiaries of the Company two drug and alcohol rehabilitation outpatient facilities and two sober living facilities: the Desert Hope Facility and Resolutions Las Vegas, each located in Las Vegas, Nevada, and the Greenhouse Facility and Resolutions Arlington, each located in Arlington, Texas (collectively, the “Sale-Leaseback Facilities”). Simultaneously with the sale of the Sale-Leaseback Facilities, the Company, through its subsidiaries and MedEquities entered into an operating lease, dated August 9, 2017, in which the Company will continue to operate the Sale-Leaseback Facilities. The operating lease provides for a 15-year term for each facility with two separate renewal terms of five years each if the Company chooses to exercise its right to extend the lease term. The initial annual minimum rent payable from the Company to MedEquities is $2.2 million due in equal monthly installments of $0.2 million. On the first, second and third anniversary of the lease date, the annual rent will increase to an amount equal to 101.5% of the annual rent in effect for the immediately preceding year. On the fourth anniversary of the lease date and thereafter during the lease term, the annual rent will increase to the amount equal to the CPI Factor (as defined in the Lease) multiplied by the annual rent in effect for the immediately preceding year; provided, however, that the adjusted annual rent will never be less than an amount equal to 101.5% or greater than an amount equal to 103.0% of the annual rent in effect for the immediately preceding year. Due to the nature of the agreement between MedEquities and the Company, the transaction does not qualify for sale-leaseback accounting under GAAP. Therefore, the Sale-Leaseback Facilities will remain on the Company’s balance sheet and will continue to be depreciated over the remaining life of the asset. The Company accounted for the $25.0 million of proceeds, less $0.4 million of transaction costs, as a financing obligation, of which $ 0.2 A summary of the Company’s financing lease obligation is as follows (in thousands): September 30, December 31, 2017 2016 Financing lease obligation: Sale-Leaseback facilities $ 24,617 $ — Less current portion (included in Accrued and other current liabilities) (219 ) — Total Financing lease obligation, net of current portion $ 24,398 $ —

Stockholders' Equity and Stock

Stockholders' Equity and Stock Based Compensation	9 Months Ended
	Sep. 30, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stockholders' Equity and Stock Based Compensation	11. 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 as amended from time to time (the “Plan”) during the nine months ended September 30, 2017 and 2016, respectively. The restricted common stock granted during the nine months ended September 30, 2017 vest annually over a period of three years beginning on December 31, 2017. The restricted common stock granted during the nine months ended September 30, 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 nine months ended September 30, 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 nine months ended September 30, 2017 and 2016, respectively, as a result of the non-employee director grants. The Company recognized $1.9 million and $2.1 million in equity-based compensation expense for the three months ended September 30, 2017 and 2016, respectively. The Company recognized $6.0 million and $6.8 million in equity-based compensation expense for the nine months ended September 30, 2017 and 2016, respectively. As of September 30, 2017, there was $6.8 million of unrecognized compensation expense related to unvested restricted stock, which is expected to be recognized over the remaining weighted average vesting period of 1.9 years. A summary of share activity under the Plan is set forth below: Shares Weighted- Average Grant Date Fair Value Unvested at December 31, 2016 522,175 $ 23.22 Granted 446,000 8.60 Vested (210,918 ) 21.97 Forfeitures (158,687 ) 17.94 Unvested at September 30, 2017 598,570 $ 14.17 Employee Stock Purchase Plan For the nine months ended September 30, 2017 and 2016, the Company issued 97,589 and 44,174 shares of the Company’s common stock under its Employee Stock Purchase Plan, as amended from time to time (“ESPP”), respectively, for an aggregate purchase price of $7.09 and $18.71, respectively. For both the three months ended September 30, 2017 and 2016, the Company recognized $0.1 million of compensation expense related to the ESPP. For the nine months ended

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2017
Income Tax Disclosure [Abstract]
Income Taxes	12. Income Taxes The provision for income taxes for the three and nine months ended September 30, 2017, both reflect an income tax benefit of $0.5 million, at an effective tax rate of 55.6% and 8.6%, respectively. The provision for income taxes for the three and nine months ended September 30, 2016 reflects an income tax benefit of $0.8 million and $0.9 million, respectively, at an effective rate of 15.9% and 16.6%, respectively. The change in effective tax rate is primarily due to the effect of permanent tax differences when compared to pre-tax book loss as well as discrete items pertaining to stock compensation. 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 results of operation are not known at this time.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	9 Months Ended
	Sep. 30, 2017
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	13. Fair Value of Financial Instruments The carrying amounts reported at September 30, 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. The Company has debt with variable interest rates. The fair value of this debt was 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 September 30, 2017 and December 31, 2016. Prior to terminating the interest rate swap agreements on June 29, 2017, the Company had entered into the agreements to manage exposure to fluctuations in interest rates. Fair value of the interest rate swaps was 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 utilized Level 2 inputs. Refer to Note 9 (Debt) for further discussion of the interest rate swap agreements.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2017
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	14. 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.) Bushansky v. Jerrod N. Menz et al.) RSG Litigation On June 30, 2017, Jeffrey Smith, Abhilash Patel and certain of their affiliates filed a lawsuit in the Superior Court of the State of California in Los Angeles County against the Company, AAC, Sober Media Group, LLC, and certain of the Company’s current and former officers ( Jeffrey Smith, Abhilash Patel v. American Addiction Centers, Inc. et al. 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, including, without limitation, the claims described above, 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.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2017
Subsequent Events [Abstract]
Subsequent Events	15. Subsequent Events On October 6, 2017, in conjunction with the Company’s pending acquisition of AdCare, the Company secured a $65.0 million incremental term loan commitment in conjunction with the 2017 Credit Facility, subject to customary closing conditions and regulatory provisions. In connection with the financing, the Company committed to a ticking fee that commenced on October 17, 2017, at a rate of LIBOR plus 3.375%, and will increase to LIBOR plus 6.75% for November 2017 through the closing date of the acquisition.

Basis of Presentation and Rec23

Basis of Presentation and Recently Issued Accounting Pronouncements (Policies)	9 Months Ended
	Sep. 30, 2017
Accounting Policies [Abstract]
Reclassifications	Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.
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 interim impairment tests for periods beginning after December 15, 2019. The Company does not believe that the provisions of ASU 2017-04 will have a material impact on the Company’s financial statements upon adoption. 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 Company chose to early adopt the provisions of ASU 2016-15 during the nine months ended September 30, 2017, which impacted the condensed consolidated statement of cash flows by allowing debt extinguishment costs incurred during the nine months ended September 30, 2017 to be classified as a financing activity rather than an operating activity. 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 , resulting in $1.0 million of tax payments being classified as a financing activity during the nine months ended September 30, 2017. In February 2016, the FASB issued ASU 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 financing 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 FASB issued ASU 2014-09, “Revenue from Contracts with Customers” (“Topic 606”), 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 standard. Companies across all industries will use a new five-step model to recognize revenue from customer contracts. The new standard, will require significant management judgment in addition to changing the way many companies recognize revenue in their financial statements. The new guidance will also require enhanced disclosures about the nature, amount, timing, and uncertainty of revenue and cash flows arising from customer contracts, including revenue recognition policies to identify performance obligations, assets recognized from costs incurred to obtain and fulfill a contract, and significant judgments in measurement and recognition. 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. The Company will adopt the standard on January 1, 2018. As the Company progresses with its implementation efforts to adopt Topic 606, 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. The Company continues to evaluate and currently expects that it may adopt the modified retrospective method of adoption. Additionally, the Company currently anticipates that as a result of changes required by Topic 606, a significant majority of the provision for doubtful accounts will be presented as a direct reduction to revenue as opposed to being presented as a separate line item. To date, the Company is in the early stages of its implementation process.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 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 and nine months ended September 30, 2017 and 2016 (in thousands except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Numerator Net income (loss) available to AAC Holdings, Inc. common stockholders $ 762 $ (2,525 ) $ (1,757 ) $ (1,067 ) Denominator Weighted-average common shares outstanding – basic 23,331,414 22,957,834 23,246,353 22,607,194 Dilutive securities 138,571 — — — Weighted-average common shares outstanding – diluted 23,469,985 22,957,834 23,246,353 22,607,194 Basic earnings (loss) per common share $ 0.03 $ (0.11 ) $ (0.08 ) $ (0.05 ) Diluted earnings (loss) per common share $ 0.03 $ (0.11 ) $ (0.08 ) $ (0.05 )

Accounts Receivable and Allow25

Accounts Receivable and Allowance for Doubtful Accounts (Tables)	9 Months Ended
	Sep. 30, 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 25,765 Accounts written off, net of recoveries (5,150 ) Balance at September 30, 2017 $ 48,743

Property and Equipment, net (Ta

Property and Equipment, net (Tables)	9 Months Ended
	Sep. 30, 2017
Property Plant And Equipment [Abstract]
Components of Property and Equipment	Property and equipment consisted of the following (in thousands): September 30, December 31, 2017 2016 Land $ 14,705 $ 14,705 Buildings and improvements 130,498 103,742 Equipment and software 32,690 25,206 Construction in progress 18,710 27,841 Total property and equipment 196,603 171,494 Less accumulated depreciation (44,834 ) (30,187 ) Property and equipment, net $ 151,769 $ 141,307

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 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 September 30, 2017 and December 31, 2016 (in thousands): Gross Carrying Value Accumulated Amortization September 30, December 31, September 30, December 31, 2017 2016 2017 2016 Trademarks $ 5,322 $ 5,322 $ 1,853 $ 1,454 Non-compete agreements 1,587 1,587 1,356 1,139 Marketing intangibles 5,651 5,651 1,344 920 Leasehold interests 1,498 1,498 349 206 Other 51 51 38 34 $ 14,109 $ 14,109 $ 4,940 $ 3,753

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Summary of Debt Obligations, Net of Debt Issuance Costs	A summary of the Company’s debt obligations, net of debt issuance costs, is as follows (in thousands): September 30, December 31, 2017 2016 Senior secured loans $ 208,688 $ 139,750 Subordinated debt — 50,000 Unamortized debt issuance costs (7,289 ) (2,386 ) Capital lease obligations 1,209 1,742 Total debt 202,608 189,106 Less current portion of long-term debt (4,736 ) (9,445 ) Total long-term debt, net of current portion $ 197,872 $ 179,661
Schedule of Senior Secured Leverage Ratio	The 2017 Credit Facility requires the Company to not permit its Senior Secured Leverage Ratio (as defined in the 2017 Credit Agreement) to exceed the following ratios on or after each quarter end: Each Fiscal Quarter Ending During the Period Maximum Senior Secured Leverage Ratio Ending before March 31, 2019 5.25:1.00 Ending on or after March 31, 2019 4.75:1.00 Ending on or after March 31, 2020 4.25:1.00

Financing Lease Obligation (Tab

Financing Lease Obligation (Tables)	9 Months Ended
	Sep. 30, 2017
Leases [Abstract]
Summary of Financing Lease Obligation	A summary of the Company’s financing lease obligation is as follows (in thousands): September 30, December 31, 2017 2016 Financing lease obligation: Sale-Leaseback facilities $ 24,617 $ — Less current portion (included in Accrued and other current liabilities) (219 ) — Total Financing lease obligation, net of current portion $ 24,398 $ —

Stockholders' Equity and Stoc30

Stockholders' Equity and Stock Based Compensation (Tables)	9 Months Ended
	Sep. 30, 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: Shares Weighted- Average Grant Date Fair Value Unvested at December 31, 2016 522,175 $ 23.22 Granted 446,000 8.60 Vested (210,918 ) 21.97 Forfeitures (158,687 ) 17.94 Unvested at September 30, 2017 598,570 $ 14.17

Description of Business - Addit

Description of Business - Additional Information (Details)	Sep. 30, 2017FacilityCenter
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Number of operating facilities	10
Number of standalone outpatient centers | Center	18
Number of sober living facilities	4

Basis of Presentation and Rec32

Basis of Presentation and Recently Issued Accounting Pronouncements - Additional Information (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017USD ($)ProfessionalGroup	Sep. 30, 2016USD ($)ProfessionalGroup	Sep. 30, 2017USD ($)ProfessionalGroup	Sep. 30, 2016USD ($)ProfessionalGroup	Dec. 31, 2016USD ($)
Business And Basis Of Presentation [Line Items]
Assets	$ 417,566		$ 417,566		$ 383,884
Liabilities	261,207		261,207		229,096
Net loss attributable to noncontrolling interest	$ 1,126	$ 1,486	3,149	$ 3,371
Payment of employee taxes for net share settlement			1,004
ASU 2016-09
Business And Basis Of Presentation [Line Items]
Payment of employee taxes for net share settlement			$ 1,000
VIEs
Business And Basis Of Presentation [Line Items]
Number of professional groups | ProfessionalGroup	7	7	7	7
Assets	$ 2,300		$ 2,300		1,400
Liabilities	400		400		$ 700
Net loss attributable to noncontrolling interest	$ 1,100	$ 1,500	$ 3,100	$ 3,400

Non-Client Related Revenue - Ad

Non-Client Related Revenue - Additional Information (Details)	9 Months Ended
	Sep. 30, 2017
Referral Solutions Group LLC and Recovery Brands LLC
Revenues
Business acquisition, effective date of acquisition	Jul. 2, 2015

General and Administrative Co34

General and Administrative Costs - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
General And Administrative Costs [Abstract]
General and administrative expense	$ 17.5	$ 20.7	$ 54.2	$ 55.8

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		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Numerator
Net income (loss) available to AAC Holdings, Inc. common stockholders	$ 762	$ (2,525)	$ (1,757)	$ (1,067)
Denominator
Weighted-average common shares outstanding – basic	23,331,414	22,957,834	23,246,353	22,607,194
Dilutive securities	138,571
Weighted-average common shares outstanding – diluted	23,469,985	22,957,834	23,246,353	22,607,194
Basic earnings (loss) per common share	$ 0.03	$ (0.11)	$ (0.08)	$ (0.05)
Diluted earnings (loss) per common share	$ 0.03	$ (0.11)	$ (0.08)	$ (0.05)

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Earnings Per Share [Abstract]
Potentially anti-dilutive shares excluded from calculation of earnings per share	138,571	4,879	902,293	9,759

Accounts Receivable and Allow37

Accounts Receivable and Allowance for Doubtful Accounts - Summary of Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Receivables [Abstract]
Balance at December 31, 2016			$ 28,128
Additions charged to provision for doubtful accounts	$ 9,682	$ 4,794	25,765	$ 15,220
Accounts written off, net of recoveries			(5,150)
Balance at September 30, 2017	$ 48,743		$ 48,743

Accounts Receivable and Allow38

Accounts Receivable and Allowance for Doubtful Accounts - Additional Information (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, net of allowances	$ 92,547		$ 87,334
Commercial Insurance Company
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, net of allowances	$ 12,100		$ 10,400
Revenues | Anthem Blue Cross Blue Shield | NEVADA
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed	11.30%
Revenues | Anthem Blue Cross Blue Shield | COLORADO
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed		11.00%
Revenues | Blue Cross Blue Shield | TEXAS
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed	10.80%	10.70%
Revenues | Blue Cross Blue Shield | FLORIDA
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed	10.00%	10.30%
Revenues | Aetna
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed		10.30%

Property and Equipment, net - C

Property and Equipment, net - Components of Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Property Plant And Equipment [Line Items]
Total property and equipment	$ 196,603	$ 171,494
Less accumulated depreciation	(44,834)	(30,187)
Property and equipment, net	151,769	141,307
Land
Property Plant And Equipment [Line Items]
Total property and equipment	14,705	14,705
Buildings and Improvements
Property Plant And Equipment [Line Items]
Total property and equipment	130,498	103,742
Equipment and Software
Property Plant And Equipment [Line Items]
Total property and equipment	32,690	25,206
Construction in progress
Property Plant And Equipment [Line Items]
Total property and equipment	$ 18,710	$ 27,841

Goodwill and Intangible Asset40

Goodwill and Intangible Assets - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Goodwill And Intangible Assets Disclosure [Abstract]
Intangible assets			$ 0
Goodwill impairment charge					$ 0
Goodwill	$ 134,396,000		134,396,000		$ 134,396,000
Amortization expense	$ 400,000	$ 400,000	$ 1,200,000	$ 1,100,000

Goodwill and Intangible Asset41

Goodwill and Intangible Assets - Components of Other Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 14,109	$ 14,109
Accumulated Amortization	4,940	3,753
Trademarks
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	5,322	5,322
Accumulated Amortization	1,853	1,454
Non-compete agreements
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	1,587	1,587
Accumulated Amortization	1,356	1,139
Marketing Intangibles
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	5,651	5,651
Accumulated Amortization	1,344	920
Leasehold interests
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	1,498	1,498
Accumulated Amortization	349	206
Other
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	51	51
Accumulated Amortization	$ 38	$ 34

Debt - Summary of Debt Obligati

Debt - Summary of Debt Obligations, Net of Debt Issuance Costs (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Line Of Credit Facility [Line Items]
Unamoritzed debt issuance costs	$ (7,289)	$ (2,386)
Long term debt	1,209	1,742
Total debt	202,608	189,106
Less current portion of long-term debt	(4,736)	(9,445)
Total long-term debt, net of current portion	197,872	179,661
Senior Secured Term Loan
Line Of Credit Facility [Line Items]
Long term debt	$ 208,688	139,750
Subordinated Debt
Line Of Credit Facility [Line Items]
Subordinated debt		$ 50,000

Debt - Credit Facility - Additi

Debt - Credit Facility - Additional Information (Details) - USD ($)	Jun. 30, 2017	Jul. 13, 2016	Mar. 09, 2015	Oct. 31, 2017	Jun. 30, 2017	Jun. 30, 2017	Sep. 30, 2017	Oct. 06, 2017	Sep. 25, 2017
Line Of Credit Facility [Line Items]
Repayments of debt extinguishment costs						$ 5,400,000
2017 Revolver | Subsequent Event
Line Of Credit Facility [Line Items]
Interest rate				3.375%
2017 Revolver | AdCare, Inc | Subsequent Event
Line Of Credit Facility [Line Items]
Business acquisition secured financing commitment subject to customary closing costs and regulatory provisions								$ 65,000,000
2017 Credit Facility
Line Of Credit Facility [Line Items]
Yield maintenance premium period	1 year
Debt issuance costs	$ 12,900,000
Debt instrument, covenant compliance description							As of September 30, 2017, the Company was in compliance with all applicable covenants under the 2017 Credit Facility.
2017 Credit Facility | First Anniversary of Closing But Before Second Anniversary of Closing
Line Of Credit Facility [Line Items]
Premium percentage for repayment of outstanding loan	2.00%
2017 Credit Facility | Second Anniversary of Closing But Before Third Anniversary of Closing
Line Of Credit Facility [Line Items]
Premium percentage for repayment of outstanding loan	1.00%
2017 Credit Facility | 2017 Term Loan
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity	$ 210,000,000				$ 210,000,000	$ 210,000,000
Revolving line of credit maturity date					Jun. 30, 2023
Floor interest rate	1.00%				1.00%	1.00%
Prepayment percentage of outstanding loan	75.00%
Percentage of net cash proceeds of certain asset sales or other dispositions of property	100.00%
Percentage of net cash proceeds of incurrence of certain debt and issuance of disqualified stock	100.00%
Debt issuance costs	$ 7,600,000
2017 Credit Facility | 2017 Term Loan | Base Rate
Line Of Credit Facility [Line Items]
Interest rate					5.75%
2017 Credit Facility | 2017 Term Loan | London Interbank Offered Rate (LIBOR)
Line Of Credit Facility [Line Items]
Interest rate					6.75%
2017 Credit Facility | 2017 Term Loan | September 30, 2017 through June 30, 2019
Line Of Credit Facility [Line Items]
Monthly principal payments					$ 1,300,000
2017 Credit Facility | 2017 Term Loan | September 30, 2019 through March 31, 2023
Line Of Credit Facility [Line Items]
Monthly principal payments					2,600,000
2017 Credit Facility | 2017 Term Loan | Senior Secured Leverage Ratio is Not Greater Than 3.25
Line Of Credit Facility [Line Items]
Prepayment percentage of outstanding loan	50.00%
2017 Credit Facility | 2017 Term Loan | Senior Secured Leverage Ratio is Not Greater Than 3.25 | Maximum
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	325.00%
2017 Credit Facility | 2017 Term Loan | Senior Secured Leverage Ratio is Not Greater Than 2.75
Line Of Credit Facility [Line Items]
Prepayment percentage of outstanding loan	25.00%
2017 Credit Facility | 2017 Term Loan | Senior Secured Leverage Ratio is Not Greater Than 2.75 | Maximum
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	275.00%
2017 Credit Facility | Incremental Term Loan
Line Of Credit Facility [Line Items]
Additional maximum borrowing amount under satisfaction of certain conditions	$ 25,000,000				$ 25,000,000	$ 25,000,000
2017 Credit Facility | Incremental Term Loan | Minimum
Line Of Credit Facility [Line Items]
Senior secured leverage ratio					390.00%
2017 Credit Facility | Standby Letters of Credit
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity	7,000,000				$ 7,000,000	7,000,000
2017 Credit Facility | 2017 Revolver
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity	40,000,000				40,000,000	40,000,000
Credit facility borrowing capacity	55,000,000				$ 55,000,000	55,000,000	$ 55,000,000
Revolving line of credit maturity date					Jun. 30, 2022
Revolver outstanding loans	14,500,000				$ 14,500,000	14,500,000	$ 0
Quarterly commitment fee on undrawn amounts, percentage					0.50%
Debt issuance costs	5,300,000
2017 Credit Facility | 2017 Revolver | Base Rate
Line Of Credit Facility [Line Items]
Interest rate					5.00%
2017 Credit Facility | 2017 Revolver | London Interbank Offered Rate (LIBOR)
Line Of Credit Facility [Line Items]
Interest rate					6.00%
2017 Credit Facility | 2017 Revolver | Incremental Revolver
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity									$ 40,000,000
Credit facility borrowing capacity									$ 55,000,000
Additional maximum borrowing amount under satisfaction of certain conditions	$ 15,000,000				$ 15,000,000	15,000,000
2017 Credit Facility | 2017 Term Loan
Line Of Credit Facility [Line Items]
Percentage of net cash proceeds from equity issuances	100.00%
2017 Credit Facility | 2017 Term Loan | Minimum
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	300.00%
2017 Credit Facility | 2017 Term Loan | Maximum
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	300.00%
2015 Credit Facility
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity		$ 171,300,000
Debt instrument, term			5 years
Revolving line of credit maturity month		2020-03
2015 Credit Facility | Minimum
Line Of Credit Facility [Line Items]
Commitment fee on undrawn amounts, percentage			0.35%
2015 Credit Facility | Minimum | Base Rate
Line Of Credit Facility [Line Items]
Interest rate		1.25%
2015 Credit Facility | Minimum | London Interbank Offered Rate (LIBOR)
Line Of Credit Facility [Line Items]
Interest rate		2.25%
2015 Credit Facility | Maximum
Line Of Credit Facility [Line Items]
Commitment fee on undrawn amounts, percentage			0.60%
2015 Credit Facility | Maximum | Base Rate
Line Of Credit Facility [Line Items]
Interest rate		2.75%
2015 Credit Facility | Maximum | London Interbank Offered Rate (LIBOR)
Line Of Credit Facility [Line Items]
Interest rate		3.75%
2015 Credit Facility | Term Loan
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity		$ 121,300,000	$ 75,000,000
2015 Credit Facility | 2017 Revolver
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity		$ 50,000,000	$ 50,000,000
Deerfield Facility
Line Of Credit Facility [Line Items]
Payment of consent fee						3,000,000
Write off of deferred debt issuance cost						$ 2,300,000

Debt - Schedule of Senior Secur

Debt - Schedule of Senior Secured Leverage Ratio (Details) - 2017 Credit Facility - Maximum	Jun. 30, 2017
Ending before March 31, 2019
Line Of Credit Facility [Line Items]
Senior Secured Leverage Ratio	525.00%
Ending on or after March 31, 2019
Line Of Credit Facility [Line Items]
Senior Secured Leverage Ratio	475.00%
Ending on or after March 31, 2020
Line Of Credit Facility [Line Items]
Senior Secured Leverage Ratio	425.00%

Debt - 2015 Subordinated Debt -

Debt - 2015 Subordinated Debt - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	Oct. 02, 2015	Jun. 30, 2016
2.50% Subordinated Convertible Debt Maturing September 30, 2021
Line Of Credit Facility [Line Items]
Debt instrument, face amount	$ 25
Proceeds from long-term debt	$ 25
Interest rate	2.50%
Maturity Date	Sep. 30, 2021
Conversion price per share	$ 30
12.0% Unsecured Subordinated Convertible Debt Maturing October 02, 2020
Line Of Credit Facility [Line Items]
Debt instrument, face amount	$ 25
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
Interest rate		12.00%
Maturity Date		Oct. 2, 2020

Debt - Interest Rate Swap Agree

Debt - Interest Rate Swap Agreements - Additional Information (Details) $ in Millions	1 Months Ended	9 Months Ended
	Jul. 31, 2014Agreement	Sep. 30, 2017	Jun. 28, 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				$ 0.3
Interest rate swap agreements termination date		Jun. 29, 2017
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

Financing Lease Obligation - Ad

Financing Lease Obligation - Additional Information (Details) $ in Thousands	Aug. 09, 2017USD ($)FacilityRenewal	Sep. 30, 2017USD ($)
MedEquities Realty Operating Partnership, LP
Sale Leaseback Transaction [Line Items]
Sale-leaseback transaction, date	August 9, 2017
Sale-leaseback transaction, value	$ 25,000
Sale-leaseback transaction, assets description		drug and alcohol rehabilitation outpatient facilities and two sober living facilities: the Desert Hope Facility and Resolutions Las Vegas, each located in Las Vegas, Nevada, and the Greenhouse Facility and Resolutions Arlington, each located in Arlington, Texas (collectively, the “Sale-Leaseback Facilities”).
MedEquities Realty Trust, Inc.
Sale Leaseback Transaction [Line Items]
Sale-leaseback transaction, date	August 9, 2017
Number of drug and alcohol rehabilitation outpatient facilities sold | Facility	2
Number of sober living facilities sold | Facility	2
Sale-leaseback transaction, operating lease term	15-year
Sale-leaseback transaction, number of separate renewals | Renewal	2
Sale-leaseback transaction, each renewal term	5 years
Sale-leaseback transaction, initial annual minimum rent payable		$ 2,200
Sale-leaseback transaction, equal monthly installments		$ 200
Sale-leaseback transaction, percentage of rent increase annually in years one to three		101.50%
Sale-leaseback financing obligation, proceeds		$ 25,000
Sale-leaseback financing obligation, transaction costs		400
Sale-leaseback financing obligation, short term liability		$ 219
MedEquities Realty Trust, Inc. | Minimum
Sale Leaseback Transaction [Line Items]
Sale-leaseback transaction, percentage of rent increase annually in years four and thereafter		101.50%
MedEquities Realty Trust, Inc. | Maximum
Sale Leaseback Transaction [Line Items]
Sale-leaseback transaction, percentage of rent increase annually in years four and thereafter		103.00%

Financing Lease Obligation - Su

Financing Lease Obligation - Summary of Financing Lease Obligation (Details) $ in Thousands	Sep. 30, 2017USD ($)
Sale Leaseback Transaction [Line Items]
Total Financing lease obligation, net of current portion	$ 24,398
MedEquities Realty Trust, Inc.
Sale Leaseback Transaction [Line Items]
Financing lease obligation: Sale-Leaseback facilities	24,617
Less current portion (included in Accrued and other current liabilities)	(219)
Total Financing lease obligation, net of current portion	$ 24,398

Stockholders' Equity and Stoc49

Stockholders' Equity and Stock Based Compensation - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted			446,000
Fully vested common stock granted			210,918
Compensation expense	$ 1.9	$ 2.1	$ 6	$ 6.8
Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Compensation expense	$ 0.1	$ 0.1	$ 0.2	$ 0.3
Employee stock purchase plan, shares issued			97,589	44,174
Aggregate purchase price per share	$ 7.09	$ 18.71	$ 7.09	$ 18.71
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			$ 0.3	$ 0.5
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	$ 6.8		$ 6.8
Weighted average life of remaining vesting period			1 year 10 months 25 days

Stockholders' Equity and Stoc50

Stockholders' Equity and Stock Based Compensation - Summary of Share Activity Under 2014 Equity Incentive Plan (Details)	9 Months Ended
	Sep. 30, 2017$ / sharesshares
Nonvested, Number of Shares [Roll Forward]
Beginning Balance, Shares | shares	522,175
Granted, Shares | shares	446,000
Vested, Shares | shares	(210,918)
Forfeitures, Shares | shares	(158,687)
Ending Balance, Shares | shares	598,570
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	21.97
Forfeitures, Weighted-Average Grant Date Fair Value | $ / shares	17.94
Ending Balance, Weighted-Average Grant Date Fair Value | $ / shares	$ 14.17

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Income Tax Disclosure [Abstract]
Effective tax rates on provision for income taxes	55.60%	15.90%	8.60%	16.60%
Income tax benefit	$ 456	$ 758	$ 459	$ 885

Fair Value of Financial Instr52

Fair Value of Financial Instruments - Additional Information (Details)	9 Months Ended
	Sep. 30, 2017
Fair Value Disclosures [Abstract]
Interest rate swap agreements termination date	Jun. 29, 2017

Subsequent Events - Additional

Subsequent Events - Additional Information (Details) - 2017 Revolver - USD ($) $ in Millions	1 Months Ended
	Nov. 30, 2017	Oct. 31, 2017	Oct. 06, 2017
Scenario, Forecast
Subsequent Event [Line Items]
Interest rate	6.75%
Subsequent Event
Subsequent Event [Line Items]
Interest rate		3.375%
AdCare, Inc | Subsequent Event
Subsequent Event [Line Items]
Business acquisition secured financing commitment subject to customary closing costs and regulatory provisions			$ 65