AAC (AACH) 10-K 23 Feb 18 2017 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2017	Feb. 16, 2018	Jun. 30, 2017
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	FY
Trading Symbol	AAC
Entity Registrant Name	AAC Holdings, Inc.
Entity Central Index Key	1,606,180
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		23,897,669
Entity Public Float			$ 100,400,000

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Revenues
Client related revenue	$ 308,538	$ 270,569	$ 205,752
Non-client related revenue	9,103	9,201	6,509
Total revenue	317,641	279,770	212,261
Operating expenses
Salaries, wages and benefits	146,390	141,073	91,406
Client related services	27,031	24,446	15,754
Provision for doubtful accounts	36,914	21,485	18,113
Advertising and marketing	12,315	18,275	20,821
Professional fees	12,638	16,468	10,316
Other operating expenses	36,309	29,627	22,708
Rentals and leases	7,514	7,363	5,298
Litigation settlement	23,607	1,292	2,379
Depreciation and amortization	21,504	17,686	7,837
Acquisition-related expenses	1,162	2,691	3,401
Total operating expenses	325,384	280,406	198,033
(Loss) income from operations	(7,743)	(636)	14,228
Interest expense, net (including change in fair value of interest rate swaps of ($108), ($180), and $431, respectively)	16,811	8,175	3,607
Loss on extinguishment of debt	5,435
Gain on contingent consideration		(1,350)
Bargain purchase gain			(1,775)
Other income (loss), net	116	(500)	(725)
(Loss) income before income tax expense	(30,105)	(6,961)	13,121
Income tax (benefit) expense	(5,018)	(1,220)	4,780
Net (loss) income	(25,087)	(5,741)	8,341
Less: net loss attributable to noncontrolling interest	4,508	5,152	2,833
Net (loss) income attributable to AAC Holdings, Inc. stockholders	(20,579)	(589)	11,174
Net (loss) income available to AAC Holdings, Inc. common stockholders	$ (20,579)	$ (589)	$ 10,493
Basic (loss) earnings per common share	$ (0.88)	$ (0.03)	$ 0.49
Diluted (loss) earnings per common share	$ (0.88)	$ (0.03)	$ 0.48
Weighted-average common shares outstanding:
Basic	23,277,444	22,718,117	21,605,037
Diluted	23,277,444	22,718,117	21,661,259
BHR | Series A Preferred Stock
Operating expenses
BHR Series A Preferred Unit dividends			$ (147)
Redemption of BHR Series A Preferred Units			$ (534)

CONSOLIDATED STATEMENTS OF OPE3

CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Swap
Change in fair value of interest rate swaps	$ (108)	$ (180)	$ 431

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Current assets
Cash and cash equivalents	$ 13,818	$ 3,964
Accounts receivable, net of allowances	94,096	87,334
Prepaid expenses and other current assets	4,022	5,181
Total current assets	111,936	96,479
Property and equipment, net	152,548	141,307
Goodwill	134,396	134,396
Intangible assets, net	8,829	10,356
Deferred tax assets, net	8,010	598
Other assets	12,556	748
Total assets	428,275	383,884
Current liabilities
Accounts payable	4,579	9,155
Accrued and other current liabilities	27,661	25,780
Accrued litigation	23,607	962
Current portion of long-term debt	4,722	9,445
Total current liabilities	60,569	45,342
Long-term debt, net of current portion and debt issuance costs	196,451	179,661
Financing lease obligation, net of current portion	24,541
Other long-term liabilities	10,546	4,093
Total liabilities	292,107	229,096
Stockholders’ equity
Common stock, $0.001 par value: 70,000,000 shares authorized, 23,872,436 and 23,673,907 shares issued and outstanding at December 31, 2017 and 2016, respectively	24	24
Additional paid-in capital	152,430	145,963
Retained (deficit) earnings	(1,460)	19,119
Total stockholders’ equity	150,994	165,106
Noncontrolling interest	(14,826)	(10,318)
Total stockholders’ equity including noncontrolling interest	136,168	154,788
Total liabilities and stockholders’ equity	$ 428,275	$ 383,884

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 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	23,872,436	23,673,907
Common stock, shares outstanding	23,872,436	23,673,907

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Marketing Intangibles	Townsend Acquisition	Solutions Acquisition	BHRSeries A Preferred Stock	Clinical Services Of Rhode Island Inc	Referral Solutions Group LLC	Taj Media LLC	Common Stock	Common StockMarketing Intangibles	Common StockTownsend Acquisition	Common StockSolutions Acquisition	Common StockClinical Services Of Rhode Island Inc	Common StockReferral Solutions Group LLC	Common StockTaj Media LLC	Additional Paid-in Capital	Additional Paid-in CapitalMarketing Intangibles	Additional Paid-in CapitalTownsend Acquisition	Additional Paid-in CapitalSolutions Acquisition	Additional Paid-in CapitalClinical Services Of Rhode Island Inc	Additional Paid-in CapitalReferral Solutions Group LLC	Additional Paid-in CapitalTaj Media LLC	Retained (Deficit) Earnings	Retained (Deficit) EarningsBHRSeries A Preferred Stock	Total Stockholders' Equity of AAC Holdings, Inc.	Total Stockholders' Equity of AAC Holdings, Inc.Marketing Intangibles	Total Stockholders' Equity of AAC Holdings, Inc.Townsend Acquisition	Total Stockholders' Equity of AAC Holdings, Inc.Solutions Acquisition	Total Stockholders' Equity of AAC Holdings, Inc.BHRSeries A Preferred Stock	Total Stockholders' Equity of AAC Holdings, Inc.Clinical Services Of Rhode Island Inc	Total Stockholders' Equity of AAC Holdings, Inc.Referral Solutions Group LLC	Total Stockholders' Equity of AAC Holdings, Inc.Taj Media LLC	Non-Controlling Interests
Balance at Dec. 31, 2014	$ 95,141								$ 21							$ 88,238							$ 9,215		$ 97,474								$ (2,333)
Balance, shares at Dec. 31, 2014									21,374,374
Common stock granted and issued under stock incentive plan, net of forfeitures, amount	5,376								$ 1							5,375									5,376
Common stock granted and issued under stock incentive plan, net of forfeitures, share									806,892
Excess tax benefit from equity awards	33															33									33
Effect of employee stock purchase plan	554															554									554
Effect of employee stock purchase plan, shares									12,637
BHR Series A Preferred Unit dividends					$ (147)																			$ (147)					$ (147)
Redemption of BHR Series A Preferred Units					$ (534)																			$ (534)					$ (534)
Acquisition of certain assets		$ 540				$ 1,343	$ 24,174	$ 1,667						$ 1			$ 540			$ 1,343	$ 24,173	$ 1,667				$ 540				$ 1,343	$ 24,174	$ 1,667
Acquisition of certain assets, shares													42,460	540,193	37,253
Net (loss) income	8,341																						11,174		11,174								(2,833)
Balance at Dec. 31, 2015	136,488								$ 23							121,923							19,708		141,654								(5,166)
Balance, shares at Dec. 31, 2015									22,813,809
Common stock granted and issued under stock incentive plan, net of forfeitures, amount	8,823															8,823									8,823
Common stock granted and issued under stock incentive plan, net of forfeitures, share									106,663
Common stock withheld for minimum statutory taxes	(895)															(895)									(895)
Common stock withheld for minimum statutory taxes, shares									(65,089)
Effect of employee stock purchase plan	682															682									682
Effect of employee stock purchase plan, shares									44,174
Acquisition of certain assets			$ 9,113	$ 6,318							$ 1							$ 9,112	$ 6,318								$ 9,113	$ 6,318
Acquisition of certain assets, shares										17,110	447,369	309,871
Net (loss) income	(5,741)																						(589)		(589)								(5,152)
Balance at Dec. 31, 2016	154,788								$ 24							145,963							19,119		165,106								(10,318)
Balance, shares at Dec. 31, 2016									23,673,907
Common stock granted and issued under stock incentive plan, net of forfeitures, amount	7,513															7,513									7,513
Common stock granted and issued under stock incentive plan, net of forfeitures, share									229,958
Common stock withheld for minimum statutory taxes	(660)															(660)									(660)
Common stock withheld for minimum statutory taxes, shares									(76,385)
Effect of employee stock purchase plan	614															614									614
Effect of employee stock purchase plan, shares									97,589
Common stock recouped from escrow for contingent consideration on acquisition	(1,000)															(1,000)									(1,000)
Common stock recouped from escrow for contingent consideration on acquisition, shares									(52,633)
Net (loss) income	(25,087)																						(20,579)		(20,579)								(4,508)
Balance at Dec. 31, 2017	$ 136,168								$ 24							$ 152,430							$ (1,460)		$ 150,994								$ (14,826)
Balance, shares at Dec. 31, 2017									23,872,436

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Cash flows from operating activities:
Net (loss) income	$ (25,087)	$ (5,741)	$ 8,341
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Provision for doubtful accounts	36,914	21,485	18,113
Depreciation and amortization	21,504	17,686	7,837
Equity compensation	7,513	8,823	5,757
Loss on disposal of property and equipment	55	163	365
Loss on extinguishment of debt	5,435
Gain on contingent consideration		(1,350)
Bargain purchase gain			(1,775)
Amortization of debt issuance costs	1,564	633	261
Deferred income taxes	(7,412)	(1,793)	962
Changes in operating assets and liabilities:
Accounts receivable	(43,676)	(45,838)	(46,097)
Prepaid expenses and other assets	(6,725)	2,510	(1,924)
Accounts payable	(4,576)	824	5,061
Accrued liabilities	4,685	2,973	8,821
Accrued litigation	22,645	162	642
Other long term liabilities	6,453	(394)	(171)
Net cash provided by operating activities	19,292	143	6,193
Cash flows from investing activities:
Purchase of property and equipment	(33,041)	(37,304)	(51,525)
Acquisition of subsidiaries		(18,825)	(89,985)
Change in funds held on acquisition	(1,000)	(325)	(1,100)
Purchase of intangible assets			(540)
Purchase of other assets, net			(252)
Net cash used in investing activities	(34,041)	(56,454)	(143,402)
Cash flows from financing activities:
Payments on 2015 Credit Facility and Deerfield Facility	(211,094)	(5,376)	(27,770)
Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs	18,000	48,930	145,007
Proceeds from financing lease obligation, net of deferred financing costs	24,621
Payments on capital leases	(791)	(834)	(747)
Repayment of long-term debt — related party		(1,195)	(542)
Change in funds held on acquisition	1,000
Payment of employee taxes for net share settlement	(1,080)
Net cash provided by financing activities	24,603	41,525	107,419
Net change in cash and cash equivalents	9,854	(14,786)	(29,790)
Cash and cash equivalents, beginning of period	3,964	18,750	48,540
Cash and cash equivalents, end of period	13,818	3,964	18,750
Cash and cash equivalents paid for:
Interest, net of capitalized interest	16,088	4,933	3,404
Income taxes, net of refunds	367	2,626	1,250
Supplemental information on non-cash investing and financing transactions:
Acquisition of equipment through capital lease	82	1,807	291
Accrued purchase of property and equipment	800	2,650	1,487
Accrued employee taxes for net share settlement	475	895
2017 Credit Facility
Cash flows from financing activities:
Payments on 2017 Credit Facility	(17,126)
Proceeds from 2017 Credit Facility, net of deferred financing costs	211,073
BHR | Series A Preferred Stock
Cash flows from financing activities:
Redemption of BHR Series A Preferred Units			(8,529)
2016 Acquisitions
Supplemental information on non-cash investing and financing transactions:
Purchase price, including contingent consideration	(2,000)	33,930	1,100
Buyer common stock received (issued)	1,000	(15,105)
Cash (received) paid for acquisition	$ (1,000)	$ 18,825	1,100
2015 Acquisitions
Supplemental information on non-cash investing and financing transactions:
Purchase price			117,168
Buyer common stock issued			(27,183)
Cash paid for acquisition			$ 89,985

Description of Business

Description of Business	12 Months Ended
	Dec. 31, 2017
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Description of Business	1. Description of Business AAC Holdings, Inc. (collectively with its subsidiaries, the “Company”), was incorporated on February 12, 2014. The Company is headquartered in Brentwood, Tennessee and provides inpatient and outpatient substance use treatment services for individuals with drug and alcohol addiction. In addition to the Company’s inpatient and outpatient substance use treatment services, the Company performs drug testing, diagnostic laboratory services, and provides physician services to clients. As of December 31, 2017, we operated numerous facilities located throughout the United States, including residential substance abuse treatment standalone outpatient centers and sober living facilities, that focused on delivering effective clinical care and treatment solutions. The Company is also an internet marketer in the addiction treatment industry operating a broad portfolio of internet assets that service millions of website visits each month. Through the Company’s portfolio of websites, such as Rehabs.com and Recovery.org, it serves families and individuals struggling with addiction and seeking treatment options through comprehensive online directories of treatment providers, treatment provider reviews, forums and professional communities. The Company also provides online marketing solutions to other treatment providers such as enhanced facility profiles, audience targeting, lead generation and tools for digital reputation management.

Basis of Presentation

Basis of Presentation	12 Months Ended
	Dec. 31, 2017
Accounting Policies [Abstract]
Basis of Presentation	2. Basis of Presentation 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 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, which include certain professional groups through rights granted to the Company by contract to manage and control the business of such professional groups. All intercompany transactions and balances have been eliminated in consolidation. The Company consolidated seven professional groups (“Professional Groups”) that constituted VIEs as of December 31, 2017 and seven Professional Groups that constituted VIEs as of December 31, 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 to the Professional Groups and the obligation and likelihood of absorbing all expected gains and losses of the Professional Groups, the Company has determined that it is the primary beneficiary of these Professional Groups. The accompanying consolidated balance sheets include assets of $2.1 million and $1.4 million as of December 31, 2017 and 2016, respectively, and liabilities of $0.4 million and $0.7 million, respectively, related to the VIEs. The accompanying consolidated income statements include net loss attributable to noncontrolling interest of $4.5 million, $5.2 million and $2.8 million related to the VIEs for the years ended December 31, 2017, 2016 and 2015, respectively. The accompanying consolidated financial statements have been prepared in accordance with GAAP. The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates. Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2017
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	3. Summary of Significant Accounting Policies Use of Estimates The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue and expenses at the date and for the periods that the consolidated financial statements are prepared. On an ongoing basis, the Company evaluates its estimates, including those related to insurance adjustments, provisions for doubtful accounts, goodwill and intangible assets, long-lived assets, deferred revenue and income taxes. The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances. Actual results could materially differ from those estimates. General and Administrative Costs 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 $96.1 million, $74.8 million, and $48.2 million for the years ended December 31, 2017, 2016, and 2015, respectively. Client Related Revenue The Company provides services to its clients in both inpatient and outpatient treatment settings. Client related revenues are recognized when services are performed at estimated net realizable value from clients, third-party payors and others for services provided. The Company receives the majority of payments from commercial payors at out-of-network rates. Client related revenues are recorded at established billing rates less adjustments to estimate net realizable value. Adjustments are recorded to state client service revenue at the amount expected to be collected for the service provided based on historic adjustments for out-of-network services not under contract. Prior to admission, each client’s insurance is verified and the client self-pay amount is determined. The client self-pay portion is generally collected upon admission. In some instances, clients will pay out-of-pocket as services are provided or will make a deposit and negotiate the remaining payments. These out-of-pocket payments are included in accrued liabilities in the accompanying consolidated balance sheets, and revenue related to these payments is deferred and recognized over the period services are provided. From time to time, scholarships may be provided to a limited number of clients. The Company does not recognize revenue for care provided via scholarships. For the year ended December 31, 2017, approximately 11.4% of the Company’s revenue was derived from Blue-Cross Blue Shield of Nevada, 10.9% came from Blue-Cross Blue-Shield of Texas and 10.3% came from Blue-Cross Blue-Shield of Florida. No other payor accounted for more than 10% of the Company’s revenue for the year ended December 31, 2017. For the year ended December 31, 2016, approximately 10.5% of the Company’s revenue was derived from Anthem Blue-Cross Blue-Shield of Florida, 10.4% by Blue-Cross Blue-Shield of Texas and 10.4% by Aetna. No other payor accounted for more than 10% of revenue for the year ended December 31, 2016. For the year ended December 31, 2015, approximately 15.1% of the Company’s revenue was derived from Anthem Blue-Cross Blue-Shield of Colorado, 12.5% came from Blue-Cross Blue-Shield of Texas, 11.5% came from Aetna and 11.1% Non-Client Related Revenue Our non-client related revenue consists of service charges from the delivery of quality targeted leads to behavioral and mental health service businesses and diagnostic laboratory services provided to clients of third-party addiction treatment providers. Non-client related 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. Allowance for Contractual and Other Discounts The Company derives the majority of its revenue from non-governmental commercial payors at out-of-network rates. Management estimates the allowance for contractual and other discounts based on its historical collection experience. The services authorized and provided and the related reimbursements are often subject to interpretation and negotiation that could result in payments that differ from the Company’s estimates. Accounts Receivable and Allowance for Doubtful Accounts Accounts receivable primarily consists of amounts due from third-party payors and is recorded net of contractual discounts. The Company’s ability to collect outstanding receivables is critical to its results of operations and cash flows. Accounts receivable is reported net of an allowance for doubtful accounts, which is management’s best estimate of accounts receivable that could become uncollectible in the future. Accordingly, accounts receivable reported in the Company’s consolidated financial statements is recorded at the net amount expected to be received. The Company’s primary collection risks are (i) the risk of overestimating net revenue at the time of billing that may result in the Company receiving less than the recorded receivable, (ii) the risk of non-payment as a result of commercial insurance companies denying claims, (iii) the risk that clients will fail to remit insurance payments to the Company when the commercial insurance company pays out-of-network claims directly to the client and (iv) resource and capacity constraints that may prevent the Company from handling the volume of billing and collection issues in a timely manner. The Company’s allowance for doubtful accounts is based on historical experience, but management also takes into consideration the age of accounts, creditworthiness of payors and current economic trends when evaluating the adequacy of the allowance for doubtful accounts. Approximately $14.6 million and $10.4 million of accounts receivable, net of the allowance for doubtful accounts, at December 31, 2017 and 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 estimated balance. At December 31, 2017, 13.0% of accounts receivable was from Anthem Blue-Cross Blue-Shield of Nevada and 10.0% was from Blue-Cross Blue-Shield of Texas. At December 31, 2016, 11.6% of accounts receivable was from Anthem Blue-Cross Blue-Shield of Colorado and 10.3% was from Blue-Cross Blue-Shield of California. No other payor accounted for more than 10% of accounts receivable at December 31, 2017 or 2016. A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2014 $ 8,468 Additions charged to provision for doubtful accounts 18,113 Accounts written off, net of recoveries (9,704 ) Balance at December 31, 2015 $ 16,877 Additions charged to provision for doubtful accounts 21,485 Accounts written off, net of recoveries (10,234 ) Balance at December 31, 2016 $ 28,128 Additions charged to provision for doubtful accounts 36,914 Accounts written off, net of recoveries (6,968 ) Balance at December 31, 2017 $ 58,074 Cash and Cash Equivalents The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. Property and Equipment Property and equipment are stated at cost or at acquisition date fair value for assets obtained in business combinations, net of accumulated depreciation. Expenditures for maintenance and repairs are charged to expense as incurred. The Company capitalizes interest paid on debt that is outstanding while construction projects are in progress, and such interest is included in the cost of the related asset. Capitalized interest recognized by the Company for the year ended December 31, 2017 was $0.7 million. Assets held for development are classified as construction in progress, and the Company does not depreciate these assets until they are placed in service. Leasehold improvements are amortized over their estimated useful lives or the remaining lease period, whichever is less. Assets under capital leases are amortized over the lease term or in the event of transfer of ownership at the end of the lease over the economic life of the leased asset. Depreciation is calculated using the straight-line method over the estimated economic useful lives of the assets, as follows: Range of Lives Computer software and equipment 3 years Buildings 36 years Furniture, fixtures and equipment 5 years Vehicles 5 years Equipment under capital lease 3-5 years Leasehold improvements Life of the asset or lease, whichever is less Goodwill and Intangible Assets The Company has only one operating segment, substance abuse and behavioral healthcare treatment services, for segment reporting purposes. The substance abuse and behavioral healthcare treatment services operating segment represents one reporting unit for purposes of the Company’s goodwill impairment test. 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’s annual impairment tests of goodwill and other indefinite-lived intangibles in 2017 and 2016 resulted in no impairment charges. The Company’s other intangible assets principally relate to trademarks, marketing intangibles, non-compete agreements, and leasehold interests acquired during business combinations. Trademarks and marketing intangibles are amortized over a period of ten years, non-compete agreements are amortized over the term of the agreements, and leasehold interests are amortized over the remaining life of the leases. Long-Lived Asset Impairment Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net undiscounted cash flows expected to be generated by the asset. Impairment is measured by the amount by which the carrying value of the assets exceeds the fair value of the assets. The Company did not identify any indicators of impairment during the years ended December 31, 2017, 2016 and 2015. Accrued and Other Current Liabilities The Company’s accrued liabilities, reflected as a current liability in the accompanying consolidated balance sheets, consist of the following (in thousands): Year Ended December 31, 2017 2016 Accrued payroll liabilities 13,197 13,501 Income taxes payable 2,066 244 Accrued property, plant, and equipment 800 2,650 Other 11,598 9,385 Total accrued liabilities $ 27,661 $ 25,780 Separately disclosed on the balance sheet as of December 31, 2017 are accrued litigation expenses of $23.6 million, which includes $23.3 million of expenses related to shareholder lawsuits that were settled in principle in December 2017, subject to court approval, which cannot be assured. Refer to Note 14 (Commitments and Contingencies) for further information regarding these matters. Segments The focus of all Company operations is centered on a single service, substance abuse and behavioral healthcare treatment. The Company is organized and operates as one reportable segment, consisting of various treatment facilities located in the United States. The treatment facilities have similar economic characteristics, services and clients. Management has the ability to direct and serve clients in any of these facilities, which allows it to operate the Company’s business and analyze its revenue on a system-wide basis, rather than focusing on any individual facility. The Company’s chief operating decision maker evaluates performance and manages resources based on the results of the consolidated operations as a whole. Advertising Expenses Advertising costs are expensed as the related activity occurs. Stock-Based Compensation The Company accounts for employee stock-based compensation using the fair-value based method for costs related to all share-based payments. The fair value of the portion of the award that is ultimately expected to vest is recognized as expense on a straight-line basis over the requisite service periods in the Company’s consolidated statements of operations. Earnings Per Share Basic and diluted earnings per common share are calculated based on the weighted-average number of common shares outstanding in each period and non-vested shares, to the extent such securities have a dilutive effect on earnings per share using the treasury stock method. Income Taxes The Company accounts for income taxes using the asset and liability method. Under the asset and liability method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on the deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. A valuation allowance is provided for significant deferred tax assets when it is more likely than not that such assets will not be recovered. Fair Value Measurements Fair value, for financial reporting purposes, is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. Disclosure is required about how fair value was determined for assets and liabilities and following a hierarchy for which these assets and liabilities must be grouped, based on significant levels of inputs as follows: Level 1—quoted prices in active markets for identical assets or liabilities; Level 2—quoted prices in active markets for similar assets and liabilities and inputs that are observable for the asset or liability; or Level 3—unobservable inputs for the asset or liability, such as discounted cash flow models or valuations. The determination of where assets and liabilities fall within this hierarchy is based upon the lowest level of input that is significant to the fair value measurement. Comprehensive Income As of December 31, 2017, 2016, and 2015, the Company did not have any components of other comprehensive income. As such, comprehensive income was the same as net income for each of the periods presented in the accompanying consolidated statements of operations. Recent Pronouncements 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 chose to early adopt ASU 2017-04 during the year ended December 31, 2017. The adoption did not have an 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 Company chose to early adopt the provisions of ASU 2016-15 during the year ended December 31, 2017, which impacted the consolidated statement of cash flows by allowing debt extinguishment costs incurred during the year ended December 31, 2017 to be classified as a financing activity rather than an operating activity. 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. The Company’s policy is to recognize forfeitures as they occur rather than estimating future forfeitures. 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 an 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 five-step model for recognizing revenue and supersedes most existing revenue recognition guidance, including guidance specific to the healthcare industry. The standard is effective for public entities for annual and interim periods beginning after December 15, 2017. The core principle of the new standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The two permitted transition methods under the new standard are the full retrospective method and the modified retrospective approach. The Company adopted the standard on January 1, 2018 using the modified retrospective approach. The Company has analyzed the impact of the standard based on a review of its accounting policies and practices in relation to the five-step model to ensure proper assessment of our operating results under Topic 606. The analysis of our processes under the new revenue standard is substantially complete and supports the recognition of revenue over time as our clients simultaneously receive and consume the benefits of our services. However, the adoption of the standard will have an impact on the calculation of revenue recognized and the provision for doubtful accounts due to additional requirements within Topic 606. The Company is required to update its estimate of the transaction price at the end of each reporting period, and any amounts allocated to a satisfied performance obligation are recognized as revenue or a reduction of revenue in the period in which the transaction price changes. Changes in the Company’s expectation of the amount it will receive from the patient or commercial payors will be recorded in revenue unless there is a specific event that suggests the client or third-party payor no longer has the ability and intent to pay the amount due and, therefore, the changes in its estimate of variable consideration better represent an impairment, or bad debt. As a result of these new requirements, substantially all of the Company’s adjustments related to bad debt will now be recorded as a direct reduction to revenue. Adoption of the new standard will have no material impact on our consolidated balance sheet, cash flows statements or net income.

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2017
Earnings Per Share [Abstract]
Earnings Per Share	4. 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, and outstanding convertible debt securities. 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 table sets forth the components of the numerator and denominator used in the calculation of basic and diluted EPS (in thousands except share data): Year Ended December 31, 2017 2016 2015 Numerator Net (loss) income attributable to AAC Holdings, Inc. $ (20,579 ) $ (589 ) $ 11,174 Less: Series A Preferred Unit dividends — — (147 ) Less: Redemption of BHR Series A Preferred Units — — (534 ) Net (loss) income available to common shares $ (20,579 ) $ (589 ) $ 10,493 Denominator Weighted-average shares outstanding – basic 23,277,444 22,718,117 21,605,037 Dilutive securities — — 56,222 Weighted-average shares outstanding – diluted 23,277,444 22,718,117 21,661,259 Basic (loss) earnings per share $ (0.88 ) $ (0.03 ) $ 0.49 Diluted (loss) earnings per share $ (0.88 ) $ (0.03 ) $ 0.48 The Company had 96,130 and 25,181 shares for the years ended December 31, 2017 and 2016, respectively, that are not included in the earnings per share calculation above, because to do so would be anti-dilutive for the periods presented.

Property and Equipment, net

Property and Equipment, net	12 Months Ended
	Dec. 31, 2017
Property Plant And Equipment [Abstract]
Property and Equipment, net	5. Property and Equipment, net Property and equipment consisted of the following (in thousands): December 31, 2017 2016 Land $ 15,766 $ 14,705 Buildings and improvements 130,710 103,742 Equipment and software 32,968 25,206 Construction in progress 22,310 27,841 Total property and equipment 201,754 171,494 Less accumulated depreciation (49,206 ) (30,187 ) Property and equipment, net $ 152,548 $ 141,307 Depreciation expense was $20.0 million, $16.1 million and $6.9 million for the years ended December 31, 2017, 2016 and 2015, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2017
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	6. Goodwill and Intangible Assets The Company’s goodwill balance was $134.4 million as of both December 31, 2017 and 2016. Other intangible assets and related accumulated amortization consisted of the following as of December 31, 2017 and 2016 (in thousands): Gross Carrying Value Accumulated Amortization December 31, December 31, December 31, December 31, 2017 2016 2017 2016 Trademarks $ 5,322 $ 5,322 $ 1,986 $ 1,454 Non-compete agreements 1,587 1,587 1,372 1,139 Marketing intangibles 5,651 5,651 1,485 920 Leasehold interests 1,498 1,498 397 206 Other 51 51 40 34 Intangible assets $ 14,109 $ 14,109 $ 5,280 $ 3,753 Amortization expense was $1.5 million, $1.5 million, and $0.9 million for the years ended December 31, 2017, 2016 and 2015, respectively. Changes to the net carrying value of intangible assets during the year ended December 31, 2017 were as follows (in thousands): Balance at December 31, 2016 $ 10,356 Amortization expense (1,527 ) Balance at December 31, 2017 $ 8,829 At December 31, 2017, all intangible assets are amortized using a straight-line method. The following table presents amortization expense expected to be recognized during fiscal years subsequent to December 31, 2017 (in thousands): Year Ended December 31, 2018 $ 1,358 2019 1,322 2020 1,318 2021 1,267 2022 1,159 Thereafter 2,405 Total $ 8,829

Long-Term Debt

Long-Term Debt	12 Months Ended
	Dec. 31, 2017
Debt Disclosure [Abstract]
Long-Term Debt	7. Long-Term Debt A summary of the Company’s debt obligations is as follows (in thousands): December 31, 2017 2016 Senior secured loans $ 207,375 $ 139,750 Subordinated debt — 50,000 Unamortized debt issuance costs (7,233 ) (2,386 ) Capital lease obligations 1,031 1,742 Total debt 201,173 189,106 Less current portion (4,722 ) (9,445 ) Total long-term debt $ 196,451 $ 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 matures 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 matures 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 December 31, 2017, there were no outstanding loans related to the 2017 Revolver. 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, AAC 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 (i) customary “breakage” costs with respect to Eurodollar Loans and, (ii) with respect to the 2017 Term Loan, if certain repricing transactions are consummated or certain mandatory repayments are made, (x) a yield maintenance premium within one year after the closing as set forth in the 2017 Credit Facility, (y) a 2.0% premium if paid after the first anniversary of the closing but before the second anniversary of the closing and (z) 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. On October 6, 2017, in conjunction with the Company’s pending acquisition of AdCare, Inc., 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%, which increased to LIBOR plus 6.75% from November 2017, until the closing date of the acquisition. As of December 31, 2017, the Company had accrued for $0.8 million of expenses related to the ticking fee. As of December 31, 2017, the Company’s availability under the 2017 Revolver was $55.0 million, less $3.5 million of outstanding letters of credit. As of December 31, 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 (i n connection with the effectiveness of the 2017 Credit Facility, on June 30, 2017, the 2015 Credit Facility was repaid in full, and as of December 31, 2017, no amounts were outstanding under the 2015 Credit Facility). The Company incurred approximately $2.0 million in debt issuance costs related to underwriting and other professional fees, of which approximately $1.1 were million related to the revolving credit loan and approximately $0.9 million were 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, which consisted 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 leverage ratio. The facility had 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 December 31, 2016, the balance on the term loan was $118.8 million, and the balance on the revolving credit facility was $21.0 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 would have been applicable when the Consolidated Total Leverage Ratio was equal to or exceeded 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 delivered 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 the Company’s covenant calculation to account for its February 2017 reduction in workforce. The 2015 Credit Facility required 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 was scheduled to mature on March 9, 2020. Repayment of the revolving loan is due on the maturity date of March 9, 2020. The 2015 Credit Facility generally required quarterly interest payments, and limited the Company’s ability to pay dividends. Borrowings under the 2015 Credit Facility were guaranteed by the Company and each of its subsidiaries and were secured by a lien on substantially all of the Company’s and its subsidiaries’ assets. Borrowings under the 2015 Credit Facility bore 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 bore 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 bore 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 December 31, 2016 was 4.25%). In addition, the Company was 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 December 31, 2016 was 0.50%). The Applicable Rates and the unused commitment fees of the 2015 Credit Facility, after the February 27, 2017 amendment, were 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 required 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 would have been required to pay all of its indebtedness immediately if the Company had defaulted on any of the financial or other restrictive covenants contained in the 2015 Credit Facility. The financial covenants, after the February 27, 2017 amendment, included maintenance of the following: • Fixed Charge Coverage Ratio: not permitted to be less than 1.50:1.00 as of the end of any fiscal quarter. • Consolidated Total Leverage Ratio: not permitted to be greater than the following levels as of the end of each fiscal quarter: Each Fiscal Quarter Ending During the Period Maximum Senior Secured Leverage Ratio Ending before December 31, 2017 4.00:1.00 • Consolidated Senior Secured Leverage Ratio: not permitted to be greater than the following levels as of the end of each fiscal quarter: Measurement Period Ending Maximum Consolidated Senior Secured Leverage Ratio December 31, 2017 and each fiscal quarter thereafter 3.50:1.00 At December 31, 2016, the Company was in compliance with all applicable covenants under the 2015 Credit Facility. In 2015, the Company incurred approximately $1.4 million in debt issuance costs related to underwriting and other professional fees, and deferred these costs over the term of the 2015 Credit Facility. As of December 31, 2016, total borrowings under the $50.0 million revolver portion of the 2015 Credit Facility were $21.0 million and $2.5 million in standby letters of credit issued for various corporate purposes resulting in $26.5 million available to the Company. In connection with the effectiveness of the 2017 Credit Facility, on June 30, 2017, the 2015 Credit Facility was repaid in full, and as of December 31, 2017, no amounts were outstanding under the 2015 Credit Facility. 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, 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. The $25.0 million of subordinated convertible debt bore interest at an annual rate of 2.50% and was scheduled to mature on September 30, 2021. The $25.0 million of subordinated convertible debt funded at closing 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 the unsecured subordinated debt. The unsecured subordinated debt bore interest at an annual rate of 12.0% and was schedule to mature on October 2, 2020. The Company incurred approximately $1.4 million in debt issuance costs related to underwriting and other professional fees and deferred these costs over the term of the debt. As of December 31, 2016, 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. In connection with the effectiveness of the 2017 Credit Facility, on June 30, 2017, the Company terminated the Deerfield Facility and paid to Deerfield the Deerfield Consent Fee, and as of December 31, 2017, no amounts were outstanding under the Deerfield Facility. Acquisition Related Debt At December 31, 2015, the Company had outstanding notes payable of $1.2 million resulting from the seller financing of the acquisition of certain assets of AJG Solutions and its subsidiaries and the equity of B&B Holdings INTL LLC. On February 29, 2016, the Company paid in full the outstanding balance, including principal of $1.2 million and accrued interest of $0.2 million, and accordingly, as of December 31, 2017 and December 31, 2016, no amounts 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. 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%, respectively, 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 consolidated statements of operations. A summary of future maturities of long-term debt, excluding unamortized debt issuance costs, as of December 31, 2017, is as follows (in thousands): Years ending December 31, Notes Payable Capital Lease Obligations Total 2018 $ 5,250 $ 738 $ 5,988 2019 7,875 287 8,162 2020 10,500 6 10,506 2021 10,500 — 10,500 2022 10,500 — 10,500 Thereafter 162,750 — 162,750 Total $ 207,375 $ 1,031 $ 208,406

Financing Lease Obligation

Financing Lease Obligation	12 Months Ended
	Dec. 31, 2017
Leases [Abstract]
Financing Lease Obligation	8. 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 $25.0 million (the “2017 Sale-Leaseback”), in which MedEquities purchased from subsidiaries of the Company two Simultaneously with the sale of the Sale The initial annual minimum rent payable to MedEquities pursuant to the Lease 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 and because of the Company’s continuing involvement in the Sale-Leaseback Facilities, 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 $0.1 million was classified as a short-term liability. On a monthly basis, a portion of the payment is allocated to principal, which reduces the obligation balance, and interest, computed based on the Company’s incremental borrowing rate. A summary of the Company’s financing lease obligation is as follows (in thousands): December 31, 2017 December 31, 2016 Financing lease obligation: Sale-Leaseback Facilities $ 24,621 $ — Less current portion (included in accrued and other current liabilities) (80 ) — Total financing lease obligation, net of current portion $ 24,541 $ — The future minimum lease payments with remaining terms of one or more years as of December 31, 2017, as it relates to the 2017 Sale-Leaseback consisted of the following (in thousands): Years ending December 31, Annual Payment 2018 $ 80 2019 122 2020 168 2021 218 2022 274 Thereafter 6,858 Total $ 7,720

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2017
Equity [Abstract]
Stockholders' Equity	9. Stockholders’ Equity Pursuant to the Articles of Incorporation of the Company, the aggregate number of shares which the Company shall have authority to issue is 75,000,000 shares, consisting of 70,000,000 shares of common stock, par value $0.001 per share, and 5,000,000 shares of preferred stock, par value $0.001 per share. As of December 31, 2017, there were 23,872,436 shares of common stock issued and outstanding and no shares of preferred stock issued and outstanding. Holders of the Company’s common stock are entitled to one vote for each share held of record on all matters on which stockholders may vote. Certain restrictions imposed by the Company’s various debt instruments limit the Company’s ability to pay dividends.

Stock Based Compensation

Stock Based Compensation	12 Months Ended
	Dec. 31, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Based Compensation	10. Stock Based Compensation 2014 Equity Incentive Plan The Company adopted the 2014 Equity Incentive Plan, as amended from time to time (“2014 Incentive Plan”) in 2014. An aggregate of 1,571,120 shares of common stock were initially reserved for issuance pursuant to the 2014 Incentive Plan. The Incentive Plan is administered by the Board of Directors, which determines, subject to the provisions of the 2014 Incentive Plan, the employees, directors or consultants to whom incentives are awarded. On May 16, 2017, the Company approved an amendment to the 2014 Equity Incentive Plan to increase the number of shares reserved for issuance thereunder by 1,800,000 shares. On January 7, 2015, the Company granted a total of 400,000 shares of restricted common stock under the 2014 Incentive Plan. The shares vest quarterly over a period of three years. On January 8, 2015, the Company granted 2,544 shares of fully vested common stock to each of its five non-employee directors. On July 9, 2015, the Company granted 3,174 shares of restricted common stock under the 2014 Incentive Plan. Of these shares, 75% vested immediately, with the remaining amount vesting quarterly over a one year period. On November 23, 2015, the Company granted 405,000 shares of restricted common stock under the 2014 Incentive Plan. The shares vest quarterly over a period of three years. On January 13, 2016, the Company granted 30,000 shares of fully vested common stock to each of its five non-employee directors. Additionally, on January 13, 2016, the Company issued 110,000 shares of restricted common stock under the 2014 Incentive Plan which vest quarterly over a three year period. On March 9, 2017, the Company granted 38,000 shares of fully vested common stock to each of its five non-employee directors. Additionally, on March 9, 2017, the Company issued 408,000 shares of restricted common stock under the 2014 Incentive Plan, which vest annually on each December 31 over a three year period. For the years ended December 31, 2017 and 2016, the Company withheld 76,385 and 65,089 common shares, respectively, to satisfy tax withholding obligations. There were no common shares withheld to satisfy tax withholding obligations for the year ended December 31, 2015. Excluding fully vested shares, the Company recognizes compensation expense on a straight-line basis over the life of each grant. The total compensation is based on the number of restricted shares issued and the fair market value of the restricted shares on the grant date. The Company recognizes compensation expense in its entirety for fully vested common stock on the day of grant based on the number of shares issued and the grant date fair market value of the shares. The Company recognized $7.5 million, $8.8 million, and $5.8 million in stock based compensation expense for the years ended December 31, 2017, 2016 and 2015, respectively. As of December 31, 2017, there was $4.4 million of unrecognized compensation expense related to unvested restricted stock grants, which is expected to be recognized over the remaining weighted average vesting period of 1.7 years. A summary of share activity under the Incentive Plan is set forth below: Weighted- Average Grant Shares Date Fair Value Unvested at December 31, 2015 777,019 $ 24.99 Granted 140,000 16.24 Vested (361,507 ) 23.64 Forfeitures (33,337 ) 23.89 Unvested at December 31, 2016 522,175 $ 23.22 Granted 446,000 8.60 Vested (402,267 ) 18.49 Forfeitures (217,053 ) 17.27 Unvested at December 31, 2017 348,855 $ 13.69 The total grant date fair value of restricted common stock vested during the year ended December 31, 2017 was $7.4 million. The Company’s policy is to recognize forfeitures as they occur rather than estimating future forfeitures. Employee Stock Purchase Plan On May 19, 2015, the Company’s shareholders approved the Company’s Employee Stock Purchase Plan, as amended from time to time (“ESPP”), which was adopted by the Board of Directors in the fourth quarter of 2014. On May 16, 2017, the Company approved an amendment to the ESPP to increase the number of shares reserved for issuance thereunder by 250,000 shares. The ESPP enables eligible employees to purchase shares of the Company’s common stock through a payroll deduction during certain option periods, generally commencing on January 1 and July 1 of each year and ending on June 30 and December 31 of each year. On the exercise date (the last trading day of each option period), the cumulative amount deducted from each participant’s salary during that option period will be used to purchase the maximum number of shares of the Company’s common stock at a purchase price equal to the lesser of (i) 85% of the closing market price of the Company’s common stock as quoted on the New York Stock Exchange on the exercise date or (ii) 85% of the closing market price of the Company’s common stock as quoted on the New York Stock Exchange on the grant date, subject to certain limitations and restrictions. In 2017, 2016 and 2015, the Company issued 97,589; 44,174 and 12,637 shares of the Company’s common stock, respectively, in connection with employee deductions contributed to the ESPP. At December 31, 2017 and 2016, the Company recorded a liability of $0.2 million and $0.3 million, respectively, related to employee deductions contributed during the July 1, 2017 and December 31, 2017 and the July 1, 2016 through December 31, 2016 periods, respectively. For the years ended December 31, 2017, 2016 and 2015 the Company recognized $0.2 million, $0.3 million and $0.2 million of compensation expense related to the ESPP, respectively. On January 10, 2018, the Company issued 27,900 shares of the Company’s common stock in connection with employee deductions of $0.2 million contributed in the July 1, 2017 through December 31, 2017 ESPP option period.

Qualified 401(k) Savings Plan

Qualified 401(k) Savings Plan	12 Months Ended
	Dec. 31, 2017
Compensation And Retirement Disclosure [Abstract]
Qualified 401(k) Savings Plan	11. 401(k) Savings Plan The Company has a qualified 401(k) savings plan (the “Plan”) which provides for eligible employees (as defined) to make voluntary contributions to the Plan. The Company makes contributions to the Plan based upon the participants’ level of participation, which is fully vested at the time of contribution. For the years ended December 31, 2017, 2016 and 2015 the Company contributions under this Plan were $0.9 million, $0.8 million and $0.8 million, respectively.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Income Taxes	12. Income Taxes Income tax (benefit) expense consisted of the following for the years ended December 31, 2017, 2016 and 2015: Year Ended December 31, 2017 2016 2015 Current Federal $ 1,150 $ (197 ) $ 3,580 State 1,244 1,042 285 Total current tax expense 2,394 845 3,865 Deferred: Federal (6,373 ) (1,282 ) 1,052 State (1,039 ) (783 ) (137 ) Total deferred tax (benefit) expense (7,412 ) (2,065 ) 915 Total income tax (benefit) expense $ (5,018 ) $ (1,220 ) $ 4,780 The company’s effective income tax rate for the years ended December 31, 2017, 2016 and 2015 reconciles with the federal statutory rate as follows: Year Ended December 31, 2017 2016 2015 Federal statutory rate 35.0 % 35.0 % 35.0 % State income taxes, net of federal tax benefit 1.7 3.2 3.5 Effect of Tax Cuts and Jobs Act (11.5 ) — — Non-deductible expenses (1.2 ) (2.2 ) 2.7 Stock compensation adjustment (5.1 ) (15.8 ) — Return to provision adjustment (0.3 ) (2.6 ) — Change in valuation allowance (2.4 ) (0.1 ) (0.3 ) Benefit from tax deductible dividends — — (1.9 ) State tax credits — — (2.7 ) Other differences 0.5 — 0.1 Effective income tax rate on income before taxes 16.7 % 17.5 % 36.4 % The difference between the Company’s effective tax rate and federal statutory rate for 2017 is 18.3%, which is primarily due to the tax treatment of stock compensation and the effect of the Tax Cuts and Jobs Act. Deferred income tax assets (liabilities) are comprised of the following at December 31, 2017 and 2016: Year Ended December 31, 2017 2016 Employee compensation $ 1,839 $ 2,628 Operating loss carryforwards 2,894 1,462 Accrued litigation 5,517 213 Accounts receivable 966 542 Tax credits — 178 Acquisition related costs 1,255 1,891 Property, equipment and amortization 2,377 — Other — 363 Valuation allowances (1,638 ) (623 ) Total deferred tax assets $ 13,210 $ 6,654 Property, equipment and amortization — (209 ) Goodwill and other intangible property (5,130 ) (5,368 ) Other (70 ) (479 ) Accounts receivable — — Total deferred tax liabilities (5,200 ) (6,056 ) Net deferred tax assets (liabilities) $ 8,010 $ 598 At December 31, 2017, the Company had $3.2 million in state net operating losses which expire between 2027 and 2037. T he Company’s valuation allowance of The Company had no uncertain tax positions as of December 31, 2017 and 2016, respectively. Generally, for federal and state purposes, the Company's 2013 through 2016 tax years remain open for examination by tax authorities. Additionally, any net operating losses that were generated in prior years and utilized in these years may also be subject to examination by the IRS. The Company has not been notified of any state income tax examinations. There are no federal net operating loss carryforwards that were generated during tax periods ending as of or prior to December 31, 2017. Net operating losses generated during tax periods beginning after December 31, 2017 will have limitations but will carry-forward indefinitely. The Company is not subject to alternative minimum tax. On December 22, 2017, President Trump signed into law the “Tax Cuts and Jobs Act”. This legislation creates significant changes in U.S. tax law, including a reduction in corporate tax rates, changes to net operating loss carryforwards and carrybacks, and a repeal of the corporate alternative minimum tax. The legislation reduced the U.S. corporate tax rate from the current rate of 35% to 21% for tax periods beginning after December 31, 2017. The Company is required to recognize the effect of the change from the tax law in the period of enactment by remeasuring its deferred tax assets and liabilities as well as reassessing the net realizability of its deferred tax assets and liabilities. In December 2017, the SEC staff issued Staff Accounting Bulletin No. 118, Income Tax Accounting Implications of the Tax Cuts and Jobs Act (“SAB 118”), which allows the Company to record provisional amounts during a measurement period not to extend beyond one year of the enactment date. The Company revalued its deferred tax assets and liabilities at the enacted rate in effect during their scheduled reversals, the Federal rate of which is 21%. This revaluation of $29.5 million of net deferred tax assets resulted in an expense of $3.5 million to income tax expense in continuing operations and a corresponding reduction in the deferred tax assets. Due to the timing of the enactment of the law, ongoing accounting guidance and interpretation is expected. The Company considers the accounting for the deferred tax re-measurements and other items to be preliminary due to the forthcoming guidance and its ongoing analysis of year-end tax positions. The Company expects to complete its analysis within the measurement period in accordance with SAB 118.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2017
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	13. Fair Value of Financial Instruments The carrying amounts reported at December 31, 2017 and 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 fair value of the Company’s revolving line of credit is categorized as Level 2. 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 other 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 December 31, 2017 and 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 7 (Long-Term Debt) for further discussion of the interest rate swap agreements. Intangible assets are measured at fair value on a non-recurring basis. These assets are classified in Level 3 of the fair value hierarchy. Goodwill and other indefinite-lived intangibles are tested for impairment at least annually, or more frequently if circumstances indicate that the carrying amount exceeds fair value. The Company estimates the fair values of goodwill and other indefinite-lived intangibles utilizing multiple measurement techniques. The estimation is primarily determined based on an estimate of future cash flows (income approach) discounted at a market derived weighted-average cost of capital. The income approach has been determined to be the most representative of fair value. Other unobservable inputs used in these valuations include management’s cash flow projections and estimated terminal growth rates. The valuation of indefinite-lived intangible assets also includes an unobservable input for royalty rate, which is based on rates used by comparable industries. The useful lives of definite-lived intangible assets (customer relationships) are evaluated whenever events or circumstances warrant a revision to the remaining amortization period. The fair value of definite-lived intangible assets is based on estimated cash flows from the future use of the asset, discounted at a market derived weighted-average cost of capital. No impairment charges were recorded related to goodwill or other intangible assets for the years ended December 31, 2017, 2016 and 2015. Long-lived assets are measured at fair value on a non-recurring basis and are classified in Level 3 of the fair value hierarchy. The fair value is estimated utilizing unobservable inputs, including appraisals on real estate as well as evaluations of the marketability and potential relocation of other assets in similar condition and similar market areas. The Company analyzes long-lived assets on an annual basis for any triggering events that would necessitate an impairment test. No impairment charges were recorded for the years ended December 31, 2017, 2016 and 2015.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2017
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	14. Commitments and Contingencies Operating Leases The Company has entered into various operating leases expiring through June 2025. Commercial properties under operating leases primarily include space required to perform client services and space for administrative facilities. Rent expense was $7.5 million, $7.4 million and $5.3 million for the years ended December 31, 2017, 2016 and 2015, respectively. The Company recognizes rent expense on a straight line basis with the difference between rent expense and rent paid recorded as deferred rent. Such amount is included in accrued liabilities in the consolidated balance sheets. The future minimum lease payments under non-cancelable operating leases with remaining terms of one or more years as of December 31, 2017 consisted of the following (in thousands): Years ending December 31, Annual Payment 2018 $ 9,090 2019 8,527 2020 7,132 2021 6,650 2022 6,103 Thereafter 33,171 Total $ 70,673 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.) 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.) The claims presented for the actions pending in Tennessee and Nevada have been presented to the Company’s insurance carriers, which have denied coverage. However, the Company and insurers have continued to discuss the Company’s demand for coverage. The Company, at this time, is unable to predict what, if any, settlement amount will be contributed by its insurance carriers. As of December 31, 2017, the Company had accrued $23.3 million in litigation costs related to the Tennessee and Nevada claims. A discussion of the Company’s litigation settlement expense related to the Tennessee and Nevada actions 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.

Related Parties

Related Parties	12 Months Ended
	Dec. 31, 2017
Related Party Transactions [Abstract]
Related Parties	15. Related Parties An entity beneficially owned by Mr. Cartwright, the Company’s Chief Executive Officer, owns an airplane that the Company uses for business purposes in the course of its operations pursuant to a written lease agreement. The Company pays an hourly rate for use of the airplane as well as fuel and certain maintenance costs. For the years ended December 31, 2017, 2016 and 2015, the Company made aggregate payments to the related entity for use of the airplane of approximately $ 1.0

Quarterly Information (Unaudite

Quarterly Information (Unaudited)	12 Months Ended
	Dec. 31, 2017
Quarterly Financial Information Disclosure [Abstract]
Quarterly Information (Unaudited)	16. Quarterly Information (Unaudited) The tables below present summarized unaudited quarterly results of operations for the years ended December 31, 2017 and 2016. Management believes that all necessary adjustments have been included in the amounts stated below for a fair presentation of the results of operations for the periods presented when read in conjunction with the Company’s consolidated financial statements for the years ended December 31, 2017 and 2016. Results of operations for a particular quarter are not necessarily indicative of results of operations for an annual period and are not predictive of future periods. Quarter Ended March 31, June 30, September 30, December 31, (In thousands except per share data) 2017: Revenue $ 73,039 $ 78,042 $ 80,424 $ 86,136 Net loss $ (1,644 ) $ (2,898)(a) $ (364 ) $ 20,181(b) Net (loss) income available to AAC Holdings, Inc. common stockholders $ (603 ) $ (1,916)(a) $ 762 $ (18,822)(b) Basic net (loss) income per share $ (0.03 ) $ (0.08 ) $ 0.03 $ (0.80 ) Diluted net (loss) income per share $ (0.03 ) $ (0.08 ) $ 0.03 $ (0.80 ) 2016: Revenue $ 65,348 $ 71,542 $ 70,528 $ 72,352 Net loss $ (269 ) $ (158 ) $ (4,011 ) $ (1,303 ) Net income (loss) available to AAC Holdings, Inc. common stockholders $ 586 $ 872 $ (2,525 ) $ 478 Basic net income (loss) per share $ 0.03 $ 0.04 $ (0.11 ) $ 0.02 Diluted net income (loss) per share $ 0.03 $ 0.04 $ (0.11 ) $ 0.02 (a) Second quarter results include a $5.4 million loss on extinguishment of debt related to the repayment of the 2015 Credit Facility. (b) Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters. Refer to Footnote 14 (Commitments and Contingencies) for further information.

Summary of Significant Accoun24

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2017
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue and expenses at the date and for the periods that the consolidated financial statements are prepared. On an ongoing basis, the Company evaluates its estimates, including those related to insurance adjustments, provisions for doubtful accounts, goodwill and intangible assets, long-lived assets, deferred revenue and income taxes. The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances. Actual results could materially differ from those estimates.
General and Administrative Costs	General and Administrative Costs 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 $96.1 million, $74.8 million, and $48.2 million for the years ended December 31, 2017, 2016, and 2015, respectively.
Client Related Revenue	Client Related Revenue The Company provides services to its clients in both inpatient and outpatient treatment settings. Client related revenues are recognized when services are performed at estimated net realizable value from clients, third-party payors and others for services provided. The Company receives the majority of payments from commercial payors at out-of-network rates. Client related revenues are recorded at established billing rates less adjustments to estimate net realizable value. Adjustments are recorded to state client service revenue at the amount expected to be collected for the service provided based on historic adjustments for out-of-network services not under contract. Prior to admission, each client’s insurance is verified and the client self-pay amount is determined. The client self-pay portion is generally collected upon admission. In some instances, clients will pay out-of-pocket as services are provided or will make a deposit and negotiate the remaining payments. These out-of-pocket payments are included in accrued liabilities in the accompanying consolidated balance sheets, and revenue related to these payments is deferred and recognized over the period services are provided. From time to time, scholarships may be provided to a limited number of clients. The Company does not recognize revenue for care provided via scholarships. For the year ended December 31, 2017, approximately 11.4% of the Company’s revenue was derived from Blue-Cross Blue Shield of Nevada, 10.9% came from Blue-Cross Blue-Shield of Texas and 10.3% came from Blue-Cross Blue-Shield of Florida. No other payor accounted for more than 10% of the Company’s revenue for the year ended December 31, 2017. For the year ended December 31, 2016, approximately 10.5% of the Company’s revenue was derived from Anthem Blue-Cross Blue-Shield of Florida, 10.4% by Blue-Cross Blue-Shield of Texas and 10.4% by Aetna. No other payor accounted for more than 10% of revenue for the year ended December 31, 2016. For the year ended December 31, 2015, approximately 15.1% of the Company’s revenue was derived from Anthem Blue-Cross Blue-Shield of Colorado, 12.5% came from Blue-Cross Blue-Shield of Texas, 11.5% came from Aetna and 11.1%
Non-Client Related Revenue	Non-Client Related Revenue Our non-client related revenue consists of service charges from the delivery of quality targeted leads to behavioral and mental health service businesses and diagnostic laboratory services provided to clients of third-party addiction treatment providers. Non-client related 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.
Allowance for Contractual and Other Discounts	Allowance for Contractual and Other Discounts The Company derives the majority of its revenue from non-governmental commercial payors at out-of-network rates. Management estimates the allowance for contractual and other discounts based on its historical collection experience. The services authorized and provided and the related reimbursements are often subject to interpretation and negotiation that could result in payments that differ from the Company’s estimates.
Accounts Receivable and Allowance for Doubtful Accounts	Accounts Receivable and Allowance for Doubtful Accounts Accounts receivable primarily consists of amounts due from third-party payors and is recorded net of contractual discounts. The Company’s ability to collect outstanding receivables is critical to its results of operations and cash flows. Accounts receivable is reported net of an allowance for doubtful accounts, which is management’s best estimate of accounts receivable that could become uncollectible in the future. Accordingly, accounts receivable reported in the Company’s consolidated financial statements is recorded at the net amount expected to be received. The Company’s primary collection risks are (i) the risk of overestimating net revenue at the time of billing that may result in the Company receiving less than the recorded receivable, (ii) the risk of non-payment as a result of commercial insurance companies denying claims, (iii) the risk that clients will fail to remit insurance payments to the Company when the commercial insurance company pays out-of-network claims directly to the client and (iv) resource and capacity constraints that may prevent the Company from handling the volume of billing and collection issues in a timely manner. The Company’s allowance for doubtful accounts is based on historical experience, but management also takes into consideration the age of accounts, creditworthiness of payors and current economic trends when evaluating the adequacy of the allowance for doubtful accounts. Approximately $14.6 million and $10.4 million of accounts receivable, net of the allowance for doubtful accounts, at December 31, 2017 and 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 estimated balance. At December 31, 2017, 13.0% of accounts receivable was from Anthem Blue-Cross Blue-Shield of Nevada and 10.0% was from Blue-Cross Blue-Shield of Texas. At December 31, 2016, 11.6% of accounts receivable was from Anthem Blue-Cross Blue-Shield of Colorado and 10.3% was from Blue-Cross Blue-Shield of California. No other payor accounted for more than 10% of accounts receivable at December 31, 2017 or 2016. A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2014 $ 8,468 Additions charged to provision for doubtful accounts 18,113 Accounts written off, net of recoveries (9,704 ) Balance at December 31, 2015 $ 16,877 Additions charged to provision for doubtful accounts 21,485 Accounts written off, net of recoveries (10,234 ) Balance at December 31, 2016 $ 28,128 Additions charged to provision for doubtful accounts 36,914 Accounts written off, net of recoveries (6,968 ) Balance at December 31, 2017 $ 58,074
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents.
Property, Plant and Equipment	Property and Equipment Property and equipment are stated at cost or at acquisition date fair value for assets obtained in business combinations, net of accumulated depreciation. Expenditures for maintenance and repairs are charged to expense as incurred. The Company capitalizes interest paid on debt that is outstanding while construction projects are in progress, and such interest is included in the cost of the related asset. Capitalized interest recognized by the Company for the year ended December 31, 2017 was $0.7 million. Assets held for development are classified as construction in progress, and the Company does not depreciate these assets until they are placed in service. Leasehold improvements are amortized over their estimated useful lives or the remaining lease period, whichever is less. Assets under capital leases are amortized over the lease term or in the event of transfer of ownership at the end of the lease over the economic life of the leased asset. Depreciation is calculated using the straight-line method over the estimated economic useful lives of the assets, as follows: Range of Lives Computer software and equipment 3 years Buildings 36 years Furniture, fixtures and equipment 5 years Vehicles 5 years Equipment under capital lease 3-5 years Leasehold improvements Life of the asset or lease, whichever is less
Goodwill and Intangible Assets	Goodwill and Intangible Assets The Company has only one operating segment, substance abuse and behavioral healthcare treatment services, for segment reporting purposes. The substance abuse and behavioral healthcare treatment services operating segment represents one reporting unit for purposes of the Company’s goodwill impairment test. 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’s annual impairment tests of goodwill and other indefinite-lived intangibles in 2017 and 2016 resulted in no impairment charges. The Company’s other intangible assets principally relate to trademarks, marketing intangibles, non-compete agreements, and leasehold interests acquired during business combinations. Trademarks and marketing intangibles are amortized over a period of ten years, non-compete agreements are amortized over the term of the agreements, and leasehold interests are amortized over the remaining life of the leases.
Long-Lived Asset Impairment	Long-Lived Asset Impairment Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net undiscounted cash flows expected to be generated by the asset. Impairment is measured by the amount by which the carrying value of the assets exceeds the fair value of the assets. The Company did not identify any indicators of impairment during the years ended December 31, 2017, 2016 and 2015.
Accrued and Other Current Liabilities	Accrued and Other Current Liabilities The Company’s accrued liabilities, reflected as a current liability in the accompanying consolidated balance sheets, consist of the following (in thousands): Year Ended December 31, 2017 2016 Accrued payroll liabilities 13,197 13,501 Income taxes payable 2,066 244 Accrued property, plant, and equipment 800 2,650 Other 11,598 9,385 Total accrued liabilities $ 27,661 $ 25,780 Separately disclosed on the balance sheet as of December 31, 2017 are accrued litigation expenses of $23.6 million, which includes $23.3 million of expenses related to shareholder lawsuits that were settled in principle in December 2017, subject to court approval, which cannot be assured. Refer to Note 14 (Commitments and Contingencies) for further information regarding these matters.
Segments	Segments The focus of all Company operations is centered on a single service, substance abuse and behavioral healthcare treatment. The Company is organized and operates as one reportable segment, consisting of various treatment facilities located in the United States. The treatment facilities have similar economic characteristics, services and clients. Management has the ability to direct and serve clients in any of these facilities, which allows it to operate the Company’s business and analyze its revenue on a system-wide basis, rather than focusing on any individual facility. The Company’s chief operating decision maker evaluates performance and manages resources based on the results of the consolidated operations as a whole.
Advertising Expenses	Advertising Expenses Advertising costs are expensed as the related activity occurs.
Stock-Based Compensation	Stock-Based Compensation The Company accounts for employee stock-based compensation using the fair-value based method for costs related to all share-based payments. The fair value of the portion of the award that is ultimately expected to vest is recognized as expense on a straight-line basis over the requisite service periods in the Company’s consolidated statements of operations.
Earnings Per Share	Earnings Per Share Basic and diluted earnings per common share are calculated based on the weighted-average number of common shares outstanding in each period and non-vested shares, to the extent such securities have a dilutive effect on earnings per share using the treasury stock method.
Income Taxes	Income Taxes The Company accounts for income taxes using the asset and liability method. Under the asset and liability method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on the deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. A valuation allowance is provided for significant deferred tax assets when it is more likely than not that such assets will not be recovered.
Fair Value Measurements	Fair Value Measurements Fair value, for financial reporting purposes, is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. Disclosure is required about how fair value was determined for assets and liabilities and following a hierarchy for which these assets and liabilities must be grouped, based on significant levels of inputs as follows: Level 1—quoted prices in active markets for identical assets or liabilities; Level 2—quoted prices in active markets for similar assets and liabilities and inputs that are observable for the asset or liability; or Level 3—unobservable inputs for the asset or liability, such as discounted cash flow models or valuations. The determination of where assets and liabilities fall within this hierarchy is based upon the lowest level of input that is significant to the fair value measurement.
Comprehensive Income	Comprehensive Income As of December 31, 2017, 2016, and 2015, the Company did not have any components of other comprehensive income. As such, comprehensive income was the same as net income for each of the periods presented in the accompanying consolidated statements of operations.
Recent Pronouncements	Recent Pronouncements 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 chose to early adopt ASU 2017-04 during the year ended December 31, 2017. The adoption did not have an 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 Company chose to early adopt the provisions of ASU 2016-15 during the year ended December 31, 2017, which impacted the consolidated statement of cash flows by allowing debt extinguishment costs incurred during the year ended December 31, 2017 to be classified as a financing activity rather than an operating activity. 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. The Company’s policy is to recognize forfeitures as they occur rather than estimating future forfeitures. 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 an 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 five-step model for recognizing revenue and supersedes most existing revenue recognition guidance, including guidance specific to the healthcare industry. The standard is effective for public entities for annual and interim periods beginning after December 15, 2017. The core principle of the new standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The two permitted transition methods under the new standard are the full retrospective method and the modified retrospective approach. The Company adopted the standard on January 1, 2018 using the modified retrospective approach. The Company has analyzed the impact of the standard based on a review of its accounting policies and practices in relation to the five-step model to ensure proper assessment of our operating results under Topic 606. The analysis of our processes under the new revenue standard is substantially complete and supports the recognition of revenue over time as our clients simultaneously receive and consume the benefits of our services. However, the adoption of the standard will have an impact on the calculation of revenue recognized and the provision for doubtful accounts due to additional requirements within Topic 606. The Company is required to update its estimate of the transaction price at the end of each reporting period, and any amounts allocated to a satisfied performance obligation are recognized as revenue or a reduction of revenue in the period in which the transaction price changes. Changes in the Company’s expectation of the amount it will receive from the patient or commercial payors will be recorded in revenue unless there is a specific event that suggests the client or third-party payor no longer has the ability and intent to pay the amount due and, therefore, the changes in its estimate of variable consideration better represent an impairment, or bad debt. As a result of these new requirements, substantially all of the Company’s adjustments related to bad debt will now be recorded as a direct reduction to revenue. Adoption of the new standard will have no material impact on our consolidated balance sheet, cash flows statements or net income.

Summary of Significant Accoun25

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2017
Accounting Policies [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, 2014 $ 8,468 Additions charged to provision for doubtful accounts 18,113 Accounts written off, net of recoveries (9,704 ) Balance at December 31, 2015 $ 16,877 Additions charged to provision for doubtful accounts 21,485 Accounts written off, net of recoveries (10,234 ) Balance at December 31, 2016 $ 28,128 Additions charged to provision for doubtful accounts 36,914 Accounts written off, net of recoveries (6,968 ) Balance at December 31, 2017 $ 58,074
Schedule of Useful Life of Property Plant and Equipment	Depreciation is calculated using the straight-line method over the estimated economic useful lives of the assets, as follows: Range of Lives Computer software and equipment 3 years Buildings 36 years Furniture, fixtures and equipment 5 years Vehicles 5 years Equipment under capital lease 3-5 years Leasehold improvements Life of the asset or lease, whichever is less
Schedule of Accrued Liabilities Reflected as a Current Liability in the Accompanying Consolidated Balance Sheet	The Company’s accrued liabilities, reflected as a current liability in the accompanying consolidated balance sheets, consist of the following (in thousands): Year Ended December 31, 2017 2016 Accrued payroll liabilities 13,197 13,501 Income taxes payable 2,066 244 Accrued property, plant, and equipment 800 2,650 Other 11,598 9,385 Total accrued liabilities $ 27,661 $ 25,780

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2017
Earnings Per Share [Abstract]
Schedule of Components of Numerator and Denominator Used in Calculation of Basic and Diluted Earnings Per Share	The following table sets forth the components of the numerator and denominator used in the calculation of basic and diluted EPS (in thousands except share data): Year Ended December 31, 2017 2016 2015 Numerator Net (loss) income attributable to AAC Holdings, Inc. $ (20,579 ) $ (589 ) $ 11,174 Less: Series A Preferred Unit dividends — — (147 ) Less: Redemption of BHR Series A Preferred Units — — (534 ) Net (loss) income available to common shares $ (20,579 ) $ (589 ) $ 10,493 Denominator Weighted-average shares outstanding – basic 23,277,444 22,718,117 21,605,037 Dilutive securities — — 56,222 Weighted-average shares outstanding – diluted 23,277,444 22,718,117 21,661,259 Basic (loss) earnings per share $ (0.88 ) $ (0.03 ) $ 0.49 Diluted (loss) earnings per share $ (0.88 ) $ (0.03 ) $ 0.48

Property and Equipment, net (Ta

Property and Equipment, net (Tables)	12 Months Ended
	Dec. 31, 2017
Property Plant And Equipment [Abstract]
Components of Property and Equipment	Property and equipment consisted of the following (in thousands): December 31, 2017 2016 Land $ 15,766 $ 14,705 Buildings and improvements 130,710 103,742 Equipment and software 32,968 25,206 Construction in progress 22,310 27,841 Total property and equipment 201,754 171,494 Less accumulated depreciation (49,206 ) (30,187 ) Property and equipment, net $ 152,548 $ 141,307

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2017
Goodwill And Intangible Assets Disclosure [Abstract]
Components of Other Intangible Assets	Other intangible assets and related accumulated amortization consisted of the following as of December 31, 2017 and 2016 (in thousands): Gross Carrying Value Accumulated Amortization December 31, December 31, December 31, December 31, 2017 2016 2017 2016 Trademarks $ 5,322 $ 5,322 $ 1,986 $ 1,454 Non-compete agreements 1,587 1,587 1,372 1,139 Marketing intangibles 5,651 5,651 1,485 920 Leasehold interests 1,498 1,498 397 206 Other 51 51 40 34 Intangible assets $ 14,109 $ 14,109 $ 5,280 $ 3,753
Summary of Changes to Net Carrying Value of Intangible Assets	Amortization expense was $1.5 million, $1.5 million, and $0.9 million for the years ended December 31, 2017, 2016 and 2015, respectively. Changes to the net carrying value of intangible assets during the year ended December 31, 2017 were as follows (in thousands): Balance at December 31, 2016 $ 10,356 Amortization expense (1,527 ) Balance at December 31, 2017 $ 8,829
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	At December 31, 2017, all intangible assets are amortized using a straight-line method. The following table presents amortization expense expected to be recognized during fiscal years subsequent to December 31, 2017 (in thousands): Year Ended December 31, 2018 $ 1,358 2019 1,322 2020 1,318 2021 1,267 2022 1,159 Thereafter 2,405 Total $ 8,829

Long-Term Debt (Tables)

Long-Term Debt (Tables)	12 Months Ended
	Dec. 31, 2017
Debt Disclosure [Abstract]
Summary of Debt Obligations	A summary of the Company’s debt obligations is as follows (in thousands): December 31, 2017 2016 Senior secured loans $ 207,375 $ 139,750 Subordinated debt — 50,000 Unamortized debt issuance costs (7,233 ) (2,386 ) Capital lease obligations 1,031 1,742 Total debt 201,173 189,106 Less current portion (4,722 ) (9,445 ) Total long-term debt $ 196,451 $ 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 • Consolidated Total Leverage Ratio: not permitted to be greater than the following levels as of the end of each fiscal quarter: Each Fiscal Quarter Ending During the Period Maximum Senior Secured Leverage Ratio Ending before December 31, 2017 4.00:1.00 • Consolidated Senior Secured Leverage Ratio: not permitted to be greater than the following levels as of the end of each fiscal quarter: Measurement Period Ending Maximum Consolidated Senior Secured Leverage Ratio December 31, 2017 and each fiscal quarter thereafter 3.50:1.00
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, were 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 %
Summary of Future Maturities of Long-term Debt	A summary of future maturities of long-term debt, excluding unamortized debt issuance costs, as of December 31, 2017, is as follows (in thousands): Years ending December 31, Notes Payable Capital Lease Obligations Total 2018 $ 5,250 $ 738 $ 5,988 2019 7,875 287 8,162 2020 10,500 6 10,506 2021 10,500 — 10,500 2022 10,500 — 10,500 Thereafter 162,750 — 162,750 Total $ 207,375 $ 1,031 $ 208,406

Financing Lease Obligation (Tab

Financing Lease Obligation (Tables)	12 Months Ended
	Dec. 31, 2017
Leases [Abstract]
Summary of Financing Lease Obligation	A summary of the Company’s financing lease obligation is as follows (in thousands): December 31, 2017 December 31, 2016 Financing lease obligation: Sale-Leaseback Facilities $ 24,621 $ — Less current portion (included in accrued and other current liabilities) (80 ) — Total financing lease obligation, net of current portion $ 24,541 $ —
Schedule of Future Minimum Lease Payments to Sales-Leaseback	The future minimum lease payments with remaining terms of one or more years as of December 31, 2017, as it relates to the 2017 Sale-Leaseback consisted of the following (in thousands): Years ending December 31, Annual Payment 2018 $ 80 2019 122 2020 168 2021 218 2022 274 Thereafter 6,858 Total $ 7,720

Stock Based Compensation (Table

Stock Based Compensation (Tables)	12 Months Ended
	Dec. 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 Incentive Plan is set forth below: Weighted- Average Grant Shares Date Fair Value Unvested at December 31, 2015 777,019 $ 24.99 Granted 140,000 16.24 Vested (361,507 ) 23.64 Forfeitures (33,337 ) 23.89 Unvested at December 31, 2016 522,175 $ 23.22 Granted 446,000 8.60 Vested (402,267 ) 18.49 Forfeitures (217,053 ) 17.27 Unvested at December 31, 2017 348,855 $ 13.69

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Schedule of Components of Income Tax Expense (Benefit)	Income tax (benefit) expense consisted of the following for the years ended December 31, 2017, 2016 and 2015: Year Ended December 31, 2017 2016 2015 Current Federal $ 1,150 $ (197 ) $ 3,580 State 1,244 1,042 285 Total current tax expense 2,394 845 3,865 Deferred: Federal (6,373 ) (1,282 ) 1,052 State (1,039 ) (783 ) (137 ) Total deferred tax (benefit) expense (7,412 ) (2,065 ) 915 Total income tax (benefit) expense $ (5,018 ) $ (1,220 ) $ 4,780
Schedule of Effective Income Tax Rate	The company’s effective income tax rate for the years ended December 31, 2017, 2016 and 2015 reconciles with the federal statutory rate as follows: Year Ended December 31, 2017 2016 2015 Federal statutory rate 35.0 % 35.0 % 35.0 % State income taxes, net of federal tax benefit 1.7 3.2 3.5 Effect of Tax Cuts and Jobs Act (11.5 ) — — Non-deductible expenses (1.2 ) (2.2 ) 2.7 Stock compensation adjustment (5.1 ) (15.8 ) — Return to provision adjustment (0.3 ) (2.6 ) — Change in valuation allowance (2.4 ) (0.1 ) (0.3 ) Benefit from tax deductible dividends — — (1.9 ) State tax credits — — (2.7 ) Other differences 0.5 — 0.1 Effective income tax rate on income before taxes 16.7 % 17.5 % 36.4 %
Schedule of Deferred Tax Assets (Liabilities)	Deferred income tax assets (liabilities) are comprised of the following at December 31, 2017 and 2016: Year Ended December 31, 2017 2016 Employee compensation $ 1,839 $ 2,628 Operating loss carryforwards 2,894 1,462 Accrued litigation 5,517 213 Accounts receivable 966 542 Tax credits — 178 Acquisition related costs 1,255 1,891 Property, equipment and amortization 2,377 — Other — 363 Valuation allowances (1,638 ) (623 ) Total deferred tax assets $ 13,210 $ 6,654 Property, equipment and amortization — (209 ) Goodwill and other intangible property (5,130 ) (5,368 ) Other (70 ) (479 ) Accounts receivable — — Total deferred tax liabilities (5,200 ) (6,056 ) Net deferred tax assets (liabilities) $ 8,010 $ 598

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2017
Commitments And Contingencies Disclosure [Abstract]
Schedule of Future Minimum Lease Payments Under Non-Cancelable Operating Leases	The future minimum lease payments under non-cancelable operating leases with remaining terms of one or more years as of December 31, 2017 consisted of the following (in thousands): Years ending December 31, Annual Payment 2018 $ 9,090 2019 8,527 2020 7,132 2021 6,650 2022 6,103 Thereafter 33,171 Total $ 70,673

Quarterly Information (Unaudi34

Quarterly Information (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2017
Quarterly Financial Information Disclosure [Abstract]
Summary of Unaudited Quarterly Results of Operations	Results of operations for a particular quarter are not necessarily indicative of results of operations for an annual period and are not predictive of future periods. Quarter Ended March 31, June 30, September 30, December 31, (In thousands except per share data) 2017: Revenue $ 73,039 $ 78,042 $ 80,424 $ 86,136 Net loss $ (1,644 ) $ (2,898)(a) $ (364 ) $ 20,181(b) Net (loss) income available to AAC Holdings, Inc. common stockholders $ (603 ) $ (1,916)(a) $ 762 $ (18,822)(b) Basic net (loss) income per share $ (0.03 ) $ (0.08 ) $ 0.03 $ (0.80 ) Diluted net (loss) income per share $ (0.03 ) $ (0.08 ) $ 0.03 $ (0.80 ) 2016: Revenue $ 65,348 $ 71,542 $ 70,528 $ 72,352 Net loss $ (269 ) $ (158 ) $ (4,011 ) $ (1,303 ) Net income (loss) available to AAC Holdings, Inc. common stockholders $ 586 $ 872 $ (2,525 ) $ 478 Basic net income (loss) per share $ 0.03 $ 0.04 $ (0.11 ) $ 0.02 Diluted net income (loss) per share $ 0.03 $ 0.04 $ (0.11 ) $ 0.02 (a) Second quarter results include a $5.4 million loss on extinguishment of debt related to the repayment of the 2015 Credit Facility. (b) Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters. Refer to Footnote 14 (Commitments and Contingencies) for further information.

Basis of Presentation - Additio

Basis of Presentation - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2017USD ($)ProfessionalGroup	Dec. 31, 2016USD ($)ProfessionalGroup	Dec. 31, 2015USD ($)
Business And Basis Of Presentation [Line Items]
Assets	$ 428,275	$ 383,884
Liabilities	292,107	229,096
Net loss attributable to noncontrolling interest	$ 4,508	$ 5,152	$ 2,833
VIEs
Business And Basis Of Presentation [Line Items]
Number of professional groups | ProfessionalGroup	7	7
Assets	$ 2,100	$ 1,400
Liabilities	400	700
Net loss attributable to noncontrolling interest	$ 4,500	$ 5,200	$ 2,800

Summary of Significant Accoun36

Summary of Significant Accounting Policies - Additional Information (Details)	1 Months Ended	3 Months Ended	12 Months Ended
	Dec. 31, 2017USD ($)	Dec. 31, 2017USD ($)	Dec. 31, 2017USD ($)Segment	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)
Summary Of Significant Accounting Policies [Line Items]
General and administrative expense			$ 96,100,000	$ 74,800,000	$ 48,200,000
Accounts receivable, net of allowances	$ 94,096,000	$ 94,096,000	$ 94,096,000	87,334,000
Cash And Cash Equivalents Highly Liquid Investments Maximum Maturity Period			3 months
Capitalized interest recognized			$ 700,000
Number of operating segment | Segment			1
Number of reportable segment | Segment			1
Impairment charges			$ 0	0
Accrued litigation	23,607,000	23,607,000	23,607,000	962,000
Settlement amount related to shareholder lawsuits	23,300,000	23,300,000
Payment of employee taxes for net share settlement			1,080,000
ASU 2016-09
Summary Of Significant Accounting Policies [Line Items]
Payment of employee taxes for net share settlement			$ 1,100,000
Trademarks and Marketing Intangibles
Summary Of Significant Accounting Policies [Line Items]
Amortization period			10 years
Commercial Insurance Company
Summary Of Significant Accounting Policies [Line Items]
Accounts receivable, net of allowances	$ 14,600,000	$ 14,600,000	$ 14,600,000	$ 10,400,000
Revenues | Blue Cross Blue Shield | NEVADA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage			11.40%
Revenues | Blue Cross Blue Shield | TEXAS
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage			10.90%	10.40%	12.50%
Revenues | Blue Cross Blue Shield | FLORIDA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage			10.30%
Revenues | Blue Cross Blue Shield | CALIFORNIA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage					11.10%
Revenues | Anthem Blue Cross Blue Shield | FLORIDA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage				10.50%
Revenues | Anthem Blue Cross Blue Shield | COLORADO
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage					15.10%
Revenues | Aetna
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage				10.40%	11.50%
Accounts Receivable | Blue Cross Blue Shield | TEXAS
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage			10.00%
Accounts Receivable | Blue Cross Blue Shield | CALIFORNIA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage				10.30%
Accounts Receivable | Anthem Blue Cross Blue Shield | NEVADA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage			13.00%
Accounts Receivable | Anthem Blue Cross Blue Shield | COLORADO
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage				11.60%

Summary of Significant Accoun37

Summary of Significant Accounting Policies - Summary of Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Accounting Policies [Abstract]
Balance at beginning of year	$ 28,128	$ 16,877	$ 8,468
Additions charged to provision for doubtful accounts	36,914	21,485	18,113
Accounts written off, net of recoveries	(6,968)	(10,234)	(9,704)
Balance at end of year	$ 58,074	$ 28,128	$ 16,877

Summary of Significant Accoun38

Summary of Significant Accounting Policies - Schedule of Useful Life of Property Plant and Equipment (Details)	12 Months Ended
	Dec. 31, 2017
Computer software and equipment
Property Plant And Equipment [Line Items]
Useful life of property and equipment	3 years
Building
Property Plant And Equipment [Line Items]
Useful life of property and equipment	36 years
Furniture, fixtures and equipment
Property Plant And Equipment [Line Items]
Useful life of property and equipment	5 years
Vehicles
Property Plant And Equipment [Line Items]
Useful life of property and equipment	5 years
Leasehold improvements
Property Plant And Equipment [Line Items]
Useful life of property and equipment	Life of the asset or lease, whichever is less
Minimum | Equipment under capital lease
Property Plant And Equipment [Line Items]
Useful life of property and equipment	3 years
Maximum | Equipment under capital lease
Property Plant And Equipment [Line Items]
Useful life of property and equipment	5 years

Summary of Significant Accoun39

Summary of Significant Accounting Policies - Schedule of Accrued Liabilities Reflected as a Current Liability in the Accompanying Consolidated Balance Sheet (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Accrued payroll liabilities	$ 13,197	$ 13,501
Income taxes payable	2,066	244
Accrued property, plant, and equipment	800	2,650
Other	11,598	9,385
Total accrued liabilities	$ 27,661	$ 25,780

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Components of Numerator and Denominator Used in Calculation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended										12 Months Ended
	Dec. 31, 2017		Sep. 30, 2017	Jun. 30, 2017		Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Numerator
Net (loss) income attributable to AAC Holdings, Inc.											$ (20,579)	$ (589)	$ 11,174
Net (loss) income available to AAC Holdings, Inc. common stockholders	$ (18,822)	[1]	$ 762	$ (1,916)	[2]	$ (603)	$ 478	$ (2,525)	$ 872	$ 586	$ (20,579)	$ (589)	$ 10,493
Denominator
Weighted-average shares outstanding – basic											23,277,444	22,718,117	21,605,037
Dilutive securities													56,222
Weighted-average shares outstanding – diluted											23,277,444	22,718,117	21,661,259
Basic (loss) earnings per share	$ (0.80)		$ 0.03	$ (0.08)		$ (0.03)	$ 0.02	$ (0.11)	$ 0.04	$ 0.03	$ (0.88)	$ (0.03)	$ 0.49
Diluted (loss) earnings per share	$ (0.80)		$ 0.03	$ (0.08)		$ (0.03)	$ 0.02	$ (0.11)	$ 0.04	$ 0.03	$ (0.88)	$ (0.03)	$ 0.48
BHR | Series A Preferred Stock
Numerator
BHR Series A Preferred Unit dividends													$ (147)
Redemption of BHR Series A Preferred Units													$ (534)
[1]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters. Refer to Footnote 14 (Commitments and Contingencies) for further information
[2]	Second quarter results include a $5.4 million loss on extinguishment of debt related to the repayment of the 2015 Credit Facility.

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Details) - shares	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Earnings Per Share [Abstract]
Anti-dilutive shares excluded from calculation of earnings per share	96,130	25,181

Property and Equipment, net - C

Property and Equipment, net - Components of Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Property Plant And Equipment [Line Items]
Total property and equipment	$ 201,754	$ 171,494
Less accumulated depreciation	(49,206)	(30,187)
Property and equipment, net	152,548	141,307
Land
Property Plant And Equipment [Line Items]
Total property and equipment	15,766	14,705
Buildings and Improvements
Property Plant And Equipment [Line Items]
Total property and equipment	130,710	103,742
Equipment and Software
Property Plant And Equipment [Line Items]
Total property and equipment	32,968	25,206
Construction in progress
Property Plant And Equipment [Line Items]
Total property and equipment	$ 22,310	$ 27,841

Property and Equipment, net - A

Property and Equipment, net - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Property Plant And Equipment [Abstract]
Depreciation expense	$ 20	$ 16.1	$ 6.9

Goodwill and Intangible Asset44

Goodwill and Intangible Assets - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill	$ 134,396	$ 134,396
Amortization expense	$ 1,527	$ 1,500	$ 900

Goodwill and Intangible Asset45

Goodwill and Intangible Assets - Components of Other Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 14,109	$ 14,109
Accumulated Amortization	5,280	3,753
Trademarks
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	5,322	5,322
Accumulated Amortization	1,986	1,454
Non-compete agreements
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	1,587	1,587
Accumulated Amortization	1,372	1,139
Marketing Intangibles
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	5,651	5,651
Accumulated Amortization	1,485	920
Leasehold interests
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	1,498	1,498
Accumulated Amortization	397	206
Other
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	51	51
Accumulated Amortization	$ 40	$ 34

Goodwill and Intangible Asset46

Goodwill and Intangible Assets - Summary of Changes to Net Carrying Value of Intangible Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Goodwill And Intangible Assets Disclosure [Abstract]
Beginning balance	$ 10,356
Amortization expense	(1,527)	$ (1,500)	$ (900)
Ending balance	$ 8,829	$ 10,356

Goodwill and Intangible Asset47

Goodwill and Intangible Assets - Schedule of Finite Lived Intangible Assets Future Amortization Expense (Details) $ in Thousands	Dec. 31, 2017USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
2,018	$ 1,358
2,019	1,322
2,020	1,318
2,021	1,267
2,022	1,159
Thereafter	2,405
Total	$ 8,829

Long-Term Debt - Summary of Deb

Long-Term Debt - Summary of Debt Obligations (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Line Of Credit Facility [Line Items]
Unamoritzed debt issuance costs	$ (7,233)	$ (2,386)
Capital lease obligations	1,031	1,742
Total debt	201,173	189,106
Less current portion	(4,722)	(9,445)
Total long-term debt	196,451	179,661
Senior Secured Term Loan
Line Of Credit Facility [Line Items]
Long term debt	$ 207,375	139,750
Subordinated Debt
Line Of Credit Facility [Line Items]
Subordinated debt		$ 50,000

Long-Term Debt - Credit Facilit

Long-Term Debt - Credit Facility - Additional Information (Details) - USD ($)

Jun. 30, 2017

Feb. 27, 2017

Jul. 13, 2016

Mar. 09, 2015

Nov. 30, 2017

Oct. 31, 2017

Jun. 30, 2017

Dec. 31, 2017

Dec. 31, 2016

Oct. 06, 2017

Sep. 25, 2017

Dec. 31, 2015

2017 Revolver

Line Of Credit Facility [Line Items]

Interest rate

6.75%

3.375%

Accrued expense related to ticking fee

$ 800,000

2017 Revolver | AdCare, Inc

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 December 31, 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

Revolving line of credit maturity date

Jun. 30, 2023

Interest rate

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

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

2017 Credit Facility | 2017 Revolver

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

40,000,000

40,000,000

Credit facility borrowing capacity

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

0

Quarterly commitment fee on undrawn amounts, percentage

0.50%

Debt issuance costs

5,300,000

Letters of credit outstanding

3,500,000

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

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

$ 75,000,000

Credit facility borrowing capacity

$ 171,300,000

Revolver outstanding loans

$ 0

Debt issuance costs

$ 2,000,000

Debt instrument, covenant compliance description

At December 31, 2016, the Company was in compliance with all applicable covenants under the 2015 Credit Facility.

Debt instrument, term

5 years

Revolving line of credit maturity month

2020-03

Commitment fee on undrawn amounts, percentage

0.50%

Description of payment of principal installments

The 2015 Credit Facility generally required 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 December 31, 2016 was 4.25%).

Interest rate at the end of period

4.25%

Deferred debt issuance costs

$ 1,400,000

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 | 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]

Leverage Ratio

425.00%

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 | Pricing Tier 1

Line Of Credit Facility [Line Items]

Commitment fee on undrawn amounts, percentage

0.60%

0.60%

2015 Credit Facility | Pricing Tier 1 | Minimum

Line Of Credit Facility [Line Items]

Leverage Ratio

400.00%

400.00%

2015 Credit Facility | Term Loan

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

$ 121,300,000

$ 75,000,000

Revolving line of credit maturity date

Mar. 9, 2020

Revolver outstanding loans

$ 118,800,000

Debt issuance costs

$ 900,000

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 | 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%

2015 Credit Facility | Base Rate Loans | Pricing Tier 1

Line Of Credit Facility [Line Items]

Interest rate

2.75%

2.75%

2015 Credit Facility | 2017 Revolver

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

$ 50,000,000

$ 50,000,000

50,000,000

Revolving line of credit maturity date

Mar. 9, 2020

Revolver outstanding loans

21,000,000

Debt issuance costs

$ 1,100,000

Credit facility remaining borrowing capacity

26,500,000

2015 Credit Facility | 2017 Revolver | Standby Letters of Credit

Line Of Credit Facility [Line Items]

Revolver outstanding loans

$ 2,500,000

Long-Term Debt - Schedule of Se

Long-Term 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%

Long-Term Debt - Schedule of Ap

Long-Term Debt - Schedule of Applicable Rates and Unused Commitment Fees (Details) - 2015 Credit Facility	Feb. 27, 2017	Mar. 09, 2015	Dec. 31, 2016
Line Of Credit Facility [Line Items]
Commitment Fee			0.50%
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%

Long-Term Debt - Schedule of Co

Long-Term Debt - Schedule of Consolidated Total Leverage Ratio (Details)	Mar. 09, 2015
2015 Credit Facility | Maximum | Ending before December 31, 2017
Line Of Credit Facility [Line Items]
Senior Secured Leverage Ratio	400.00%

Long-Term Debt - Schedule of 53

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

Long-Term Debt - 2015 Subordina

Long-Term Debt - 2015 Subordinated Debt - Additional Information (Details) - USD ($)	Oct. 02, 2015	Jun. 30, 2016	Dec. 31, 2017	Dec. 31, 2016
Line Of Credit Facility [Line Items]
Long term debt			$ 208,406,000
2.50% Subordinated Convertible Debt Maturing September 30, 2021
Line Of Credit Facility [Line Items]
Debt instrument, face amount	$ 25,000,000
Debt instrument, unused capacity	50,000,000
Proceeds from long-term debt	$ 25,000,000
Interest rate	2.50%
Maturity Date	Sep. 30, 2021
Conversion price per share	$ 30
Long term debt			0	$ 25,000,000
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	$ 25,000,000	$ 25,000,000
Interest rate		12.00%
Maturity Date		Oct. 2, 2020
Long term debt			$ 0	$ 25,000,000
Debt instrument, interest rate				12.00%
2015 Subordinated Debt Issuance [Member]
Line Of Credit Facility [Line Items]
Deferred debt issuance costs	$ 1,400,000

Long-Term Debt - Acquisition Re

Long-Term Debt - Acquisition Related Debt - Additional Information (Details) - USD ($)	Feb. 29, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Line Of Credit Facility [Line Items]
Long term debt		$ 208,406,000
Notes Payable
Line Of Credit Facility [Line Items]
Long term debt		207,375,000
Acquisition-Related Debt | TSN Acquisition | Notes Payable
Line Of Credit Facility [Line Items]
Amount of subordinated note payable				$ 1,200,000
Monthly principal payments	$ 1,200,000
Accrued interest	$ 200,000
Long term debt		$ 0	$ 0

Long-Term Debt - Interest Rate

Long-Term Debt - Interest Rate Swap Agreements - Additional Information (Details) $ in Millions	Jun. 28, 2017USD ($)	Jul. 31, 2014Agreement	Dec. 31, 2017	Dec. 31, 2016USD ($)
Line Of Credit Facility [Line Items]
Number of interest rate swap agreement | Agreement		2
Fair value of interest rate swaps, liability				$ 0.3
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

Long-Term Debt - Summary of Fut

Long-Term Debt - Summary of Future Maturities of Long-term Debt (Details) $ in Thousands	Dec. 31, 2017USD ($)
Disclosure Notes Payable And Revolving Line Of Credit Summary Of Future Maturities Of Long Term Debt Details [Line Items]
2,018	$ 5,988
2,019	8,162
2,020	10,506
2,021	10,500
2,022	10,500
Thereafter	162,750
Total	208,406
Notes Payable
Disclosure Notes Payable And Revolving Line Of Credit Summary Of Future Maturities Of Long Term Debt Details [Line Items]
2,018	5,250
2,019	7,875
2,020	10,500
2,021	10,500
2,022	10,500
Thereafter	162,750
Total	207,375
Capital Lease Obligations
Disclosure Notes Payable And Revolving Line Of Credit Summary Of Future Maturities Of Long Term Debt Details [Line Items]
2,018	738
2,019	287
2,020	6
Total	$ 1,031

Financing Lease Obligation - Ad

Financing Lease Obligation - Additional Information (Details) $ in Thousands	Aug. 09, 2017USD ($)FacilityRenewal	Dec. 31, 2017USD ($)
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, 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		$ 80
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	Dec. 31, 2017USD ($)
Sale Leaseback Transaction [Line Items]
Financing lease obligation, net of current portion	$ 24,541
MedEquities Realty Trust, Inc.
Sale Leaseback Transaction [Line Items]
Financing lease obligation: Sale-Leaseback Facilities	24,621
Less current portion (included in accrued and other current liabilities)	(80)
Financing lease obligation, net of current portion	$ 24,541

Financing Lease Obligation - Sc

Financing Lease Obligation - Schedule of Future Minimum Lease Payments to Sales-Leaseback (Details) $ in Thousands	Dec. 31, 2017USD ($)
Leases [Abstract]
2,018	$ 80
2,019	122
2,020	168
2,021	218
2,022	274
Thereafter	6,858
Total	$ 7,720

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Details) - $ / shares	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Equity [Abstract]
Aggregate number of shares authorized to issue	75,000,000
Common stock, shares authorized	70,000,000	70,000,000
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares issued	23,872,436	23,673,907
Common stock, shares outstanding	23,872,436	23,673,907
Preferred stock, shares, authorized	5,000,000
Preferred stock, par value	$ 0.001
Preferred stock, shares issued	0
Preferred stock, shares outstanding	0
Holders of the Company's common stock, voting rights	one vote for each share

Stock Based Compensation - Addi

Stock Based Compensation - Additional Information (Details) - USD ($) $ in Thousands	Jan. 10, 2018	Mar. 09, 2017	Jan. 13, 2016	Nov. 23, 2015	Jul. 09, 2015	Jan. 08, 2015	Jan. 07, 2015	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	May 16, 2017	Dec. 31, 2014
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted										446,000	140,000
Fully vested common stock granted										402,267	361,507
Compensation expense										$ 7,500	$ 8,800	$ 5,800
Effect of employee stock purchase plan										$ 614	682	554
Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for issuance													250,000
Common stock available for issuance								345,600		345,600
Compensation expense										$ 200	$ 300	$ 200
Employee stock purchase plan, purchase price, Description										On the exercise date (the last trading day of each option period), the cumulative amount deducted from each participant’s salary during that option period will be used to purchase the maximum number of shares of the Company’s common stock at a purchase price equal to the lesser of (i) 85% of the closing market price of the Company’s common stock as quoted on the New York Stock Exchange on the exercise date or (ii) 85% of the closing market price of the Company’s common stock as quoted on the New York Stock Exchange on the grant date, subject to certain limitations and restrictions.
Payroll deduction percentage of closing market price of common stock										85.00%
Employee stock purchase plan, shares issued										97,589	44,174	12,637
Effect of employee stock purchase plan								$ 200	$ 300
Employee Stock Purchase Plan | Subsequent Event
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Employee stock purchase plan, shares issued	27,900
Effect of employee stock purchase plan	$ 200
Restricted Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted							400,000
Grant date fair value of common stock vested										$ 7,400
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			2,544
2014 Equity Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for issuance													1,800,000	1,571,120
Common stock available for issuance								2,135,707		2,135,707
Share-based compensation, award vesting period							3 years
Common shares withheld for minimum statutory tax purposes										76,385	65,089	0
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	405,000	3,174
Share-based compensation, award vesting period		3 years	3 years	3 years	1 year
Vested percentage					75.00%
Unrecognized compensation expenses								$ 4,400		$ 4,400
Weighted average life of remaining vesting period										1 year 8 months 12 days

Stock Based Compensation - Summ

Stock Based Compensation - Summary of Share Activity Under 2014 Equity Incentive Plan (Details) - $ / shares	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Nonvested, Number of Shares [Roll Forward]
Beginning Balance, Shares	522,175	777,019
Granted, Shares	446,000	140,000
Vested, Shares	(402,267)	(361,507)
Forfeitures, Shares	(217,053)	(33,337)
Ending Balance, Shares	348,855	522,175
Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Beginning Balance, Weighted-Average Grant Date Fair Value	$ 23.22	$ 24.99
Granted, Weighted-Average Grant Date Fair Value	8.60	16.24
Vested, Weighted-Average Grant Date Fair Value	18.49	23.64
Forfeitures, Weighted-Average Grant Date Fair Value	17.27	23.89
Ending Balance, Weighted-Average Grant Date Fair Value	$ 13.69	$ 23.22

Qualified 401(k) Savings Plan -

Qualified 401(k) Savings Plan - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Compensation And Retirement Disclosure [Abstract]
Company contributions under the 401(k) plan	$ 0.9	$ 0.8	$ 0.8

Income Taxes - Schedule of Comp

Income Taxes - Schedule of Components of Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current
Federal	$ 1,150	$ (197)	$ 3,580
State	1,244	1,042	285
Total current tax expense	2,394	845	3,865
Deferred:
Federal	(6,373)	(1,282)	1,052
State	(1,039)	(783)	(137)
Total deferred tax (benefit) expense	(7,412)	(2,065)	915
Income tax (benefit) expense	$ (5,018)	$ (1,220)	$ 4,780

Income Taxes - Schedule of Effe

Income Taxes - Schedule of Effective Income Tax Rate (Details)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Federal statutory rate	35.00%	35.00%	35.00%
State income taxes, net of federal tax benefit	1.70%	3.20%	3.50%
Effect of Tax Cuts and Jobs Act	(11.50%)
Non-deductible expenses	(1.20%)	(2.20%)	2.70%
Stock compensation adjustment	(5.10%)	(15.80%)
Return to provision adjustment	(0.30%)	(2.60%)
Change in valuation allowance	(2.40%)	(0.10%)	(0.30%)
Benefit from tax deductible dividends			(1.90%)
State tax credits			(2.70%)
Other differences	0.50%		0.10%
Effective income tax rate on income before taxes	16.70%	17.50%	36.40%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax [Line Items]
Difference between effective tax rate and federal statutory rate		18.30%
Valuation allowance		$ 1,600,000
Uncertain tax position		0	$ 0
Federal net operating loss carryforwards		$ 0
U.S. corporate tax rate		35.00%	35.00%	35.00%
Revaluation of net deferred tax assets		$ 29,500,000
Income tax expense in continuing operations		$ 3,500,000
Scenario, Forecast
Income Tax [Line Items]
U.S. corporate tax rate	21.00%
Minimum | Internal Revenue Service (IRS)
Income Tax [Line Items]
Open tax year		2,013
Tax year under examination		2,013
Maximum | Internal Revenue Service (IRS)
Income Tax [Line Items]
Open tax year		2,016
Tax year under examination		2,014
Expire between 2027 and 2037 | State
Income Tax [Line Items]
Net operating loss		$ 3,200,000

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Assets (Liabilities) (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Employee compensation	$ 1,839	$ 2,628
Operating loss carryforwards	2,894	1,462
Accrued litigation	5,517	213
Accounts receivable	966	542
Tax credits		178
Acquisition related costs	1,255	1,891
Property, equipment and amortization	2,377
Other		363
Valuation allowances	(1,638)	(623)
Total deferred tax assets	13,210	6,654
Property, equipment and amortization		(209)
Goodwill and other intangible property	(5,130)	(5,368)
Other	(70)	(479)
Total deferred tax liabilities	(5,200)	(6,056)
Net deferred tax assets (liabilities)	$ 8,010	$ 598

Fair Value of Financial Instr69

Fair Value of Financial Instruments - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Fair Value Disclosures [Abstract]
Goodwill, Impairment Loss	$ 0	$ 0	$ 0
Impairment of Intangible Assets (Excluding Goodwill)	0	0	0
Long lived assets impairment charges	$ 0	$ 0	$ 0

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($)	Feb. 15, 2018	Feb. 14, 2018	Dec. 31, 2017	Dec. 31, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Loss Contingencies [Line Items]
Operating lease expiration period					2025-06
Rent expense					$ 7,514,000	$ 7,363,000	$ 5,298,000
Settlement amount			$ 23,300,000	$ 23,300,000
Litigation settlement description					The Settlement Fund will be funded as follows: (a) defendant Jerrod N. Menz will sell 300,000 shares and contribute the cash derived from such sale(s) to the Settlement Fund; and (b) the Company and individual defendants will pay in cash the difference, if any, between the Settlement Fund and the stock component addressed in (a).
Accrued litigation costs			$ 23,300,000	$ 23,300,000	$ 23,300,000
Subsequent Event
Loss Contingencies [Line Items]
Settlement amount	$ 25,000,000	$ 1,000,000
Number of shares will be sold in future for settlement fund	300,000

Commitments and Contingencies71

Commitments and Contingencies - Schedule of Future Minimum Lease Payments Under Non-Cancelable Operating Leases (Details) $ in Thousands	Dec. 31, 2017USD ($)
Future minimum rental payments, by year and in the aggregate, under operating leases
2,018	$ 9,090
2,019	8,527
2,020	7,132
2,021	6,650
2,022	6,103
Thereafter	33,171
Total	$ 70,673

Related Parties - Additional In

Related Parties - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Chief Executive Officer
Related Party Transaction [Line Items]
Expenses related to agreement	$ 1	$ 0.9	$ 1

Quarterly Information (Unaudi73

Quarterly Information (Unaudited) - Summary of Unaudited Quarterly Results of Operations (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended										12 Months Ended
	Dec. 31, 2017		Sep. 30, 2017	Jun. 30, 2017		Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Quarterly Financial Information Disclosure [Abstract]
Revenue	$ 86,136		$ 80,424	$ 78,042		$ 73,039	$ 72,352	$ 70,528	$ 71,542	$ 65,348	$ 317,641	$ 279,770	$ 212,261
Net loss	20,181	[1]	(364)	(2,898)	[2]	(1,644)	(1,303)	(4,011)	(158)	(269)	(25,087)	(5,741)	8,341
Net income (loss) available to AAC Holdings, Inc. common stockholders	$ (18,822)	[1]	$ 762	$ (1,916)	[2]	$ (603)	$ 478	$ (2,525)	$ 872	$ 586	$ (20,579)	$ (589)	$ 10,493
Basic net income (loss) per share	$ (0.80)		$ 0.03	$ (0.08)		$ (0.03)	$ 0.02	$ (0.11)	$ 0.04	$ 0.03	$ (0.88)	$ (0.03)	$ 0.49
Diluted net income (loss) per share	$ (0.80)		$ 0.03	$ (0.08)		$ (0.03)	$ 0.02	$ (0.11)	$ 0.04	$ 0.03	$ (0.88)	$ (0.03)	$ 0.48
[1]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters. Refer to Footnote 14 (Commitments and Contingencies) for further information
[2]	Second quarter results include a $5.4 million loss on extinguishment of debt related to the repayment of the 2015 Credit Facility.

Quarterly Information (Unaudi74

Quarterly Information (Unaudited) - Summary of Unaudited Quarterly Results of Operations (Parenthetical) (Details) - USD ($) $ in Millions	1 Months Ended	3 Months Ended
	Dec. 31, 2017	Dec. 31, 2017	Jun. 30, 2017
Quarterly Financial Information Disclosure [Abstract]
Repayments of debt extinguishment costs			$ 5.4
Settlement amount	$ 23.3	$ 23.3