AAC (AACH) 10-Q 3 Aug 18 2018 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2018	Jul. 27, 2018
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q2
Trading Symbol	AAC
Entity Registrant Name	AAC Holdings, Inc.
Entity Central Index Key	1,606,180
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		24,596,675

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Revenues
Total revenues	$ 86,761,000	$ 78,042,000	$ 165,234,000	$ 151,081,000
Operating expenses
Salaries, wages and benefits	46,850,000	34,508,000	86,934,000	71,280,000
Client related services	8,393,000	6,646,000	16,140,000	13,024,000
Provision for doubtful accounts	366,000	9,496,000	366,000	16,083,000
Advertising and marketing	2,584,000	3,266,000	5,183,000	7,041,000
Professional fees	4,950,000	3,039,000	8,600,000	5,681,000
Other operating expenses	12,194,000	8,199,000	22,782,000	16,988,000
Rentals and leases	2,563,000	1,849,000	4,679,000	3,734,000
Litigation settlement	244,000		3,035,000
Depreciation and amortization	5,909,000	5,058,000	11,373,000	10,527,000
Acquisition-related expenses		42,000	305,000	225,000
Total operating expenses	84,053,000	72,103,000	159,397,000	144,583,000
Income from operations	2,708,000	5,939,000	5,837,000	6,498,000
Interest expense, net (change in fair value of interest rate swaps of $0, ($25), $0 and ($108), respectively)	7,893,000	2,846,000	14,602,000	5,580,000
Loss on extinguishment of debt		5,435,000		5,435,000
Other (income) expense, net	(98,000)	(6,000)	(89,000)	28,000
Loss before income tax (benefit) expense	(5,087,000)	(2,336,000)	(8,676,000)	(4,545,000)
Income tax (benefit) expense	(84,000)	562,000	(1,578,000)	(3,000)
Net loss	(5,003,000)	(2,898,000)	(7,098,000)	(4,542,000)
Less: net loss attributable to noncontrolling interest	1,990,000	982,000	3,883,000	2,023,000
Net loss attributable to AAC Holdings, Inc. common stockholders	$ (3,013,000)	$ (1,916,000)	$ (3,215,000)	$ (2,519,000)
Basic loss per common share	$ (0.12)	$ (0.08)	$ (0.13)	$ (0.11)
Diluted loss per common share	$ (0.12)	$ (0.08)	$ (0.13)	$ (0.11)
Weighted-average common shares outstanding:
Basic	24,166,976	23,242,177	23,956,760	23,203,081
Diluted	24,166,976	23,242,177	23,956,760	23,203,081
Client Related Revenue
Revenues
Total revenues	$ 83,293,000	$ 75,692,000	$ 159,216,000	$ 146,911,000
Non-Client Related Revenue
Revenues
Total revenues	$ 3,468,000	$ 2,350,000	$ 6,018,000	$ 4,170,000

CONDENSED CONSOLIDATED STATEME3

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Swap
Change in fair value of interest rate swaps	$ 0	$ (25)	$ 0	$ (108)

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Current assets
Cash and cash equivalents	$ 11,353	$ 13,818
Accounts receivable, net of allowances	97,362	94,096
Prepaid expenses and other current assets	4,638	4,022
Total current assets	113,353	111,936
Property and equipment, net	168,373	152,548
Goodwill	197,184	134,396
Intangible assets, net	13,201	8,829
Deferred tax assets, net	9,572	8,010
Other assets	11,069	12,556
Total assets	512,752	428,275
Current liabilities
Accounts payable	6,613	4,579
Accrued and other current liabilities	30,487	27,661
Accrued litigation		23,607
Current portion of long-term debt	6,723	4,722
Total current liabilities	43,823	60,569
Long-term debt, net of current portion and deferred financing costs	295,322	196,451
Financing lease obligation, net of current portion	24,488	24,541
Other long-term liabilities	12,322	10,546
Total liabilities	375,955	292,107
Stockholders’ equity
Common stock, $0.001 par value: 70,000,000 shares authorized, 24,596,675 and 23,872,436 shares issued and outstanding at June 30, 2018 and December 31, 2017, respectively	25	24
Additional paid-in capital	160,156	152,430
Retained deficit	(4,675)	(1,460)
Total stockholders’ equity	155,506	150,994
Noncontrolling interest	(18,709)	(14,826)
Total stockholders’ equity including noncontrolling interest	136,797	136,168
Total liabilities and stockholders’ equity	$ 512,752	$ 428,275

CONDENSED CONSOLIDATED BALANCE5

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Jun. 30, 2018	Dec. 31, 2017
Statement Of Financial Position [Abstract]
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	70,000,000	70,000,000
Common stock, shares issued	24,596,675	23,872,436
Common stock, shares outstanding	24,596,675	23,872,436

CONDENSED CONSOLIDATED STATEME6

CONDENSED CONSOLIDATED STATEMENT OF STOCKHOLDERS' EQUITY - 6 months ended Jun. 30, 2018 - USD ($) $ in Thousands	Total	AdCare, Inc	Common Stock	Common StockAdCare, Inc	Additional Paid-in Capital	Additional Paid-in CapitalAdCare, Inc	Retained Deficit	AAC Holdings, Inc.	AAC Holdings, Inc.AdCare, Inc	Noncontrolling Interest
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
Common stock granted and issued under stock incentive plan, net of forfeitures, amount	2,159				2,159			2,159
Common stock granted and issued under stock incentive plan, net of forfeitures, share			141,895
Common stock withheld for minimum statutory taxes	(92)				(92)			(92)
Common stock withheld for minimum statutory taxes, shares			(7,607)
Effect of employee stock purchase plan	221				221			221
Effect of employee stock purchase plan, shares			27,900
Common stock issued upon acquisition of AdCare, Inc.		$ 5,439		$ 1		$ 5,438			$ 5,439
Common stock issued upon acquisition of AdCare, Inc. shares				562,051
Net loss	(7,098)						(3,215)	(3,215)		(3,883)
Balance at Jun. 30, 2018	$ 136,797		$ 25		$ 160,156		$ (4,675)	$ 155,506		$ (18,709)
Balance, shares at Jun. 30, 2018			24,596,675

CONDENSED CONSOLIDATED STATEME7

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Cash flows (used in) provided by operating activities:
Net loss	$ (7,098)	$ (4,542)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Provision for doubtful accounts	366	16,083
Depreciation and amortization	11,373	10,527
Equity compensation	2,159	4,189
Loss on extinguishment of debt		5,435
Loss on disposal of property and equipment	34
Amortization of deferred financing costs	1,357	364
Deferred income tax benefit	(1,562)	(582)
Changes in operating assets and liabilities:
Accounts receivable	724	(25,276)
Prepaid expenses and other assets	1,475	690
Accounts payable	(1,464)	1,286
Accrued and other current liabilities	457	932
Accrued litigation	(23,300)	(406)
Other long-term liabilities	(230)	(311)
Net cash (used in) provided by operating activities	(15,709)	8,389
Cash flows used in investing activities:
Purchase of property and equipment	(11,196)	(18,665)
Net cash used in investing activities	(76,381)	(18,665)
Cash flows provided by financing activities:
Payments on 2015 Credit Facility and Deerfield Facility		(204,773)
Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs		11,679
Payments on capital leases and other	(440)	(400)
Payment of employee taxes for net share settlement	(523)	(895)
Net cash provided by financing activities	89,625	17,105
Net change in cash and cash equivalents	(2,465)	6,829
Cash and cash equivalents, beginning of period	13,818	3,964
Cash and cash equivalents, end of period	11,353	10,793
Supplemental information on non-cash investing and financing transactions:
Accrued purchase of property and equipment	136	1,300
Accrued employee taxes for net share settlement	44	109
2017 Credit Facility
Cash flows provided by financing activities:
Payments on 2017 Credit Facility	(3,448)
Proceeds from 2017 Credit Facility, net of deferred financing costs	94,286	$ 211,494
AdCare, Inc
Cash flows used in investing activities:
Acquisition of AdCare, Inc., net of cash acquired	(65,185)
Cash flows provided by financing activities:
Payments on AdCare Note	(250)
2018 Acquisition
Supplemental information on non-cash investing and financing transactions:
Purchase price, including contingent consideration	83,905
Buyer common stock issued	(5,439)
Contingent consideration	(945)
Promissory note issued	(9,636)
Cash acquired	(2,700)
Cash paid for acquisition	$ 65,185

Description of Business

Description of Business	6 Months Ended
	Jun. 30, 2018
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Description of Business	1. AAC Holdings, Inc. (collectively with its subsidiaries, the “Company” or “AAC Holdings”) was incorporated on February 12, 2014. The Company is headquartered in Brentwood, Tennessee, and provides inpatient and outpatient substance use treatment services for individuals with drug addiction, alcohol addiction and co-occurring mental/behavioral health issues. In connection with the Company’s substance use treatment services, the Company performs drug testing, diagnostic laboratory services and provides physician services to clients. T he Company operates numerous facilities located throughout the United States, including inpatient substance abuse treatment facilities, standalone outpatient centers and sober living facilities that focus on delivering effective clinical care and treatment solutions.

Basis of Presentation and Recen

Basis of Presentation and Recently Issued Accounting Pronouncements	6 Months Ended
	Jun. 30, 2018
Accounting Policies [Abstract]
Basis of Presentation and Recently Issued Accounting Pronouncements	2. Principles of Consolidation The Company conducts its business through limited liability companies and C-corporations, each of which is a direct or indirect wholly owned subsidiary of the Company. The accompanying condensed consolidated financial statements include the accounts of the Company, its wholly owned subsidiaries, and the accounts of variable interest entities (“VIEs”) in which the Company is the primary beneficiary. All intercompany transactions and balances have been eliminated in consolidation. The Company consolidated seven professional groups (“Professional Groups”) that constituted VIEs as of June 30, 2018 and 2017. The Professional Groups are responsible for the supervision and delivery of medical services to the Company’s clients, and the Company provides management services to the Professional Groups. Based on the Company’s ability to direct the activities that most significantly impact the economic performance of the Professional Groups, provide necessary funding and the obligation and likelihood of absorbing all expected gains and losses, the Company has determined that it is the primary beneficiary of these Professional Groups. The accompanying condensed consolidated balance sheets as of June 30, 2018 and December 31, 2017 include assets of $1.0 million and $2.1 million, respectively, and liabilities of $0.7 million and $0.4 million, respectively related to the VIEs. The accompanying condensed consolidated statements of operations include net loss attributable to noncontrolling interest of $2.0 million and $1.0 million for the three months ended June 30, 2018 and 2017, respectively, and net loss of $3.9 and $2.0 million for the six months ended June 30, 2018 and 2017, respectively. The accompanying condensed consolidated financial statements are unaudited, with the exception of the December 31, 2017 balance sheet, which is consistent with the audited financial statements at that date but does not include all of the information and footnotes required by U.S. generally accepted accounting principles (“GAAP”) for a complete set of financial statements. The information contained in these condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements and notes thereto for the fiscal year ended December 31, 2017 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on February 23, 2018. Management believes that all adjustments of a normal, recurring nature considered necessary for a fair presentation have been included. In addition, the interim financial information does not necessarily represent or indicate what the operating results will be for the year ending December 31, 2018 for many reasons including, but not limited to, acquisitions, dispositions, capital financing transactions, changes in interest rates and the effects of other trends, risks and uncertainties. Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation. Recently Issued Accounting Standards Updates In 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 statements of operations. 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 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 operating results under Topic 606. The analysis of the Company’s processes under the new revenue standard is complete and supports the recognition of revenue over time as clients simultaneously receive and consume the benefits of the services provided. However, the adoption of the standard has an impact on the presentation of revenue recognized and the provision for doubtful accounts due to additional requirements within Topic 606. 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 as opposed to the provision for doubtful accounts included within operating expenses. The only activity that will be recorded in operating expenses from 2018 onward will be bad debt related to specific customers that experience significant adverse changes in creditworthiness, such as bankruptcies. The Company recorded $0.4 million of expense related to one of our digital outreach platform customers during the quarter ended June 30, 2018. The initial application of Topic 606 had no impact to the beginning balances of the Company's consolidated financial statements as of January 1, 2018. In adopting Topic 606, the Company elected the practical expedients related to immaterial contract acquisition costs and insignificant financing components of the transaction price. For the three and six months ended June 30, 2018, t he impact on the Company's Condensed Consolidated Statements of Operations was as follows (in thousands): Three Months Ended June 30, 2018 Six Months Ended June 30, 2018 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 83,293 $ 96,150 $ (12,857 ) $ 159,216 $ 178,630 $ (19,414 ) Non-client related revenue $ 3,468 $ 3,616 $ (148 ) $ 6,018 $ 6,414 $ (396 ) Provision for doubtful accounts $ 366 $ 13,371 $ (13,005 ) $ 366 $ 20,176 $ (19,810 )

Client Related Revenue and Non-

Client Related Revenue and Non-Client Related Revenue	6 Months Ended
	Jun. 30, 2018
Revenue From Contract With Customer [Abstract]
Client Related Revenue and Non-Client Related Revenue	3 . Client Related Revenue Client related revenue primarily consists of service charges related to providing addiction treatment and related services, including diagnostic laboratory services. As it relates to recognizing revenue, the Company’s contracts are with the individuals for whom the Company provides care. The majority of the Company’s contracts with clients have a single performance obligation because the promise to deliver services is not separately identifiable from other promises in the contracts. The Company’s performance obligations are satisfied over time as clients simultaneously receive and consume the benefits provided. Therefore, the Company recognizes revenue in the same period the services are performed, and there are no remaining performance obligations at period-end. Due to the nature of the industry, there are often more than two parties to the service transactions (including customers, providers and payors), and the estimation of revenue is complex and requires significant judgment. Management estimates variable consideration using the expected value method. The expected value method is used when an entity has a large number of contracts with similar characteristics, as is the case with the Company’s contracts. The transaction price is recorded based on the estimated ultimate value remaining after all uncertainty is resolved. The estimates of variable consideration are based largely on an assessment of the Company’s anticipated performance as well as historical, current, and forecasted information. The Company updates 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. The following tables summarize the composition of our client related revenue for inpatient treatment facility services, outpatient facility and sober living services, and client related diagnostic services. Inpatient treatment facility services include revenues from related professional services, and client related diagnostic services includes revenues from point of care services as well as laboratory services. For the three months ended June 30, 2018 and 2017, on an as reported basis (in thousands): Three Months Ended June 30, 2018 Three Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 66,721 80.1 $ 61,754 81.6 $ 4,967 8.0 Outpatient facility and sober living services 9,028 10.8 6,238 8.2 2,790 44.7 Client related diagnostic services 7,544 9.1 7,700 10.2 (156 ) (2.0 ) Total client related revenue $ 83,293 100.0 $ 75,692 100.0 $ 7,601 10.0 For the three months ended June 30, 2018 and 2017, on a comparable accounting basis as if the Company had not adopted Topic 606 (in thousands): Previous Accounting Guidance As Reported Three Months Ended June 30, 2018 Three Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 74,527 77.5 $ 61,754 81.6 $ 12,773 20.7 Outpatient facility and sober living services 11,515 12.0 6,238 8.2 5,277 84.6 Client related diagnostic services 10,108 10.5 7,700 10.2 2,408 31.3 Total client related revenue $ 96,150 100.0 $ 75,692 100.0 $ 20,458 27.0 For the six months ended June 30, 2018 and 2017, on an as reported basis (in thousands): Six Months Ended June 30, 2018 Six Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 131,616 82.7 $ 111,249 75.7 $ 20,367 18.3 Outpatient facility and sober living services 17,440 11.0 11,953 8.1 5,487 45.9 Client related diagnostic services 10,160 6.3 23,709 16.2 (13,549 ) (57.1 ) Total client related revenue $ 159,216 100.0 $ 146,911 100.0 $ 12,305 8.4 For the six months ended June 30, 2018 and 2017, on a comparable accounting basis as if the Company had not adopted Topic 606 (in thousands): Previous Accounting Guidance As Reported Six Months Ended June 30, 2018 Six Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 142,750 79.9 $ 111,249 75.7 $ 31,501 28.3 Outpatient facility and sober living services 19,026 10.7 11,953 8.1 7,073 59.2 Client related diagnostic services 16,854 9.4 23,709 16.2 (6,855 ) (28.9 ) Total client related revenue $ 178,630 100.0 $ 146,911 100.0 $ 31,719 21.6 Non-Client Related Revenue Non-client related revenue consists of diagnostic laboratory services provided to clients of third-party addiction treatment providers, addiction care treatment services for individuals in the criminal justice system and services provided to third-party behavioral health providers who use our digital outreach platforms. Revenue from diagnostic laboratory services provided to clients of third-party addiction treatment providers is recognized at the point in time when the order is completed. These contracts have a single performance obligation, and the transaction price is agreed upon between the Company and the third-party lab provider to services being rendered. Revenue for addiction care treatment services for individuals in the criminal justice system is recognized as services are provided in accordance with contracts with certain Massachusetts state agencies. Revenue from third-party behavioral health providers who use our digital outreach platforms is recognized over time as these customers simultaneously receive and consume the benefits of the services provided. The Company’s marketing contracts typically have one performance obligation. There are no significant judgments in determining the transaction price as the price is listed in the contract and not subject to change.

General and Administrative Cost

General and Administrative Costs	6 Months Ended
	Jun. 30, 2018
General And Administrative Costs [Abstract]
General and Administrative Costs	4. The majority of the Company’s expenses are cost of revenue items. Costs that could be classified as general and administrative expenses include the Company’s corporate overhead costs, which were $21.3 million and $17.6 million for the three months ended June 30, 2018 and 2017, respectively, and $43.3 and $36.7 million for the six months ended June 30, 2018 and 2017, respectively.

Earnings (Loss) Per Share

Earnings (Loss) Per Share	6 Months Ended
	Jun. 30, 2018
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	5. Earnings (Loss) Per Share Basic earnings (loss) 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 diluted common shares outstanding during the period. The following table presents the components of the numerator and denominator used in the calculation of basic and diluted EPS for the three and six months ended June 30, 2018 and 2017 (in thousands, except share data): Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Numerator Net loss attributable to AAC Holdings, Inc. common stockholders $ (3,013 ) $ (1,916 ) $ (3,215 ) $ (2,519 ) Denominator Weighted-average common shares outstanding – basic 24,166,976 23,242,177 23,956,760 23,203,081 Dilutive securities — — — — Weighted-average common shares outstanding – diluted 24,166,976 23,242,177 23,956,760 23,203,081 Basic loss per common share $ (0.12 ) $ (0.08 ) $ (0.13 ) $ (0.11 ) Diluted loss per common share $ (0.12 ) $ (0.08 ) $ (0.13 ) $ (0.11 ) For the three months ended June 30, 2018 and 2017, t he Company had 156,779 and 11,985 potentially dilutive shares, respectively. These dilutive shares are not included in the diluted EPS calculation above because to do so would be anti-dilutive for the periods presented.

Acquisitions

Acquisitions	6 Months Ended
	Jun. 30, 2018
Business Combinations [Abstract]
Acquisitions	6. Acquisition On March 1, 2018, the Company acquired all of the outstanding shares of AdCare, Inc., a Massachusetts corporation (“AdCare”), and wholly owned subsidiary of AdCare Holding Trust, a Massachusetts business trust (the “Seller”), which we refer to as the “AdCare Acquisition.” AdCare and its subsidiaries offer treatment of drug and alcohol addiction and own, among other things, a 114-bed hospital, five outpatient centers in Massachusetts, a 59-bed residential inpatient treatment center and two outpatient centers in Rhode Island. AdCare was purchased for total consideration of $83.9 million, subject to adjustments as set forth in the Securities Purchase Agreement (the “Purchase Agreement”), by and among AAC Healthcare Network, Inc., AAC Holdings, AdCare, and the Seller. The consideration was comprised of (i) approximately $65.2 million in cash, excluding expenses and other adjustments, (ii) approximately $5.4 million in shares of AAC Holdings’ common stock (or 562,051 shares at $9.68 per share), (iii) a promissory note in the aggregate principal amount of approximately $9.6 million (the “AdCare Note”), and (iv) contingent consideration valued at $0.9 million recorded in accrued and other current liabilities. The Company acquired $2.7 million of cash on hand at AdCare, which was returned to the Seller within 60 days of the acquisition as required by the Purchase Agreement. The contingent consideration that can be earned by the seller ranges from zero to $3.1 million, subject to achievement of a certain adjusted EBITDA target over the 12 months following the transaction date. FASB ASC 805 requires that the fair value of a contingent consideration liability be updated at each reporting period until the contingency is resolved. The Company remeasured the fair value of the contingent consideration related to the AdCare Acquisition as of June 30, 2018 and determined that the fair value as of this date was $0.7 million. The decrease in the fair value of $0.2 million was included as an acquisition related expense for the three months ended June 30, 2018. The AdCare Acquisition was accounted for as a business combination in accordance with FASB ASC 805, Business Combinations . For U.S. federal income tax purposes, the Purchase Agreement contemplates that the AdCare Acquisition shall be treated as an “applicable asset acquisition” as defined in Section 1060 of the Code. The Company recorded the transaction based upon the fair value of the consideration paid. This consideration was preliminarily allocated to the fair value of the assets acquired and liabilities assumed on the acquisition date. The Company is further assessing the valuation of receivables, assumed liabilities, real property, intangible assets, and contingent consideration, some of which are dependent on the completion of the valuation assessment being performed by independent specialists. The preliminary allocation of assets acquired and liabilities assumed on the acquisition date, based on the fair value of AdCare, is as follows (in thousands): AdCare Acquisition Cash and cash equivalents $ 2,700 Accounts receivable 4,357 Prepaid expenses and other assets 996 Property and equipment 15,719 Goodwill 62,788 Intangible assets 5,280 Total assets acquired 91,840 Accrued and other current liabilities 5,931 Long-term liabilities 2,004 Net assets acquired $ 83,905 Acquisition-related costs for the transaction were recorded as acquisition-related expenses in the consolidated statements of operations. Total AdCare revenue and income before income tax expense from the date of acquisition through June 30, 2018 was approximately $17.2 million 2.3 The pro forma loss before income tax benefit for six months ended June 30, 2018 was adjusted to exclude approximately $0.4 million of nonrecurring acquisition costs and to include additional interest expense of $0.4 million and depreciation and amortization expense of $0.2 million. The pro forma loss before income tax benefit for the three months ended June 30, 2017 was adjusted to include additional interest expense of $1.5 million and depreciation and amortization expense of $0.2 million. The pro forma loss before income tax benefit for the six months ended June 30, 2017 was adjusted to include additional interest expense of $3.0 million and depreciation and amortization expense of $0.5 million. The following table presents pro forma results as discussed above, which are not indicative of the actual results of operations (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Total revenues $ 86,761 $ 90,131 $ 173,508 $ 175,479 Loss before income tax benefit $ (5,087 ) $ (2,308 ) $ (10,017 ) $ (4,610 )

Accounts Receivable

Accounts Receivable	6 Months Ended
	Jun. 30, 2018
Receivables [Abstract]
Accounts Receivable	7. Accounts Receivable For the six months ended June 30, 2018, approximately 12.4% of the Company’s revenues were reimbursed by Anthem Blue-Cross Blue-Shield of Texas and 10.3% were reimbursed by Blue-Cross Blue-Shield of Florida. No other payor accounted for more than 10.0% of revenue reimbursements for the six months ended June 30, 2018. For the six months ended June 30, 2017, approximately 11.1% of the Company’s revenues were reimbursed by Anthem Blue-Cross Blue-Shield of Nevada, 10.2% were reimbursed by Blue-Cross Blue-Shield of Florida and 10.0% were reimbursed by Blue-Cross Blue-Shield of Texas. No other payor accounted for more than 10.0% of revenue reimbursements for the six months ended June 30, 2017. As of June 30, 2018, substantially all accounts receivable aged greater than 360 days were fully reserved in our condensed consolidated financial statements. The following table presents a summary of our aging of accounts receivable, net of the allowance for doubtful accounts as of June 30, 2018 and 2017: Current 31-180 Days Over 180 Days Total June 30, 2018 41.8 % 40.0 % 18.2 % 100.0 % June 30, 2017 31.0 % 44.6 % 24.4 % 100.0 % Approximately $12.3 million and $14.6 million of accounts receivable, net of the allowance for doubtful accounts, at June 30, 2018 and December 31, 2017, 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 remaining balance. An account is written off only after the Company has pursued collection efforts or otherwise determines an account to be uncollectible.

Property and Equipment, Net

Property and Equipment, Net	6 Months Ended
	Jun. 30, 2018
Property Plant And Equipment [Abstract]
Property and Equipment, Net	8. Property and Equipment, Net Property and equipment consisted of the following (in thousands): June 30, December 31, 2018 2017 Land $ 19,364 $ 15,766 Buildings and improvements 158,647 130,710 Equipment and software 32,936 32,968 Construction in progress 16,881 22,310 Total property and equipment 227,828 201,754 Less accumulated depreciation (59,455 ) (49,206 ) Property and equipment, net $ 168,373 $ 152,548 For the three months ended June 30, 2018 and 2017, depreciation expense was $5.4 million and $4.7 million, respectively. For the six months ended June 30, 2018 and 2017, depreciation expense was $10.5 million and $9.7 million, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	9. Goodwill and Intangible Assets The Company has only one operating segment, substance use 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 has no intangible assets with indefinite useful lives other than goodwill. The Company’s goodwill balance as of June 30, 2018 and December 31, 2017 was $197.2 and $134.4 million, respectively. The increase in goodwill is due to the AdCare Acquisition as shown below and discussed in Note 6 (Acquisition) (in thousands): Balance at December 31, 2017 $ 134,396 AdCare Acquisition 62,788 Balance at June 30, 2018 $ 197,184 Other identifiable intangible assets and related accumulated amortization consisted of the following as of June 30, 2018 and December 31, 2017 (in thousands): Gross Carrying Value Accumulated Amortization June 30, December 31, June 30, December 31, 2018 2017 2018 2017 Trademarks and trade names $ 8,422 $ 5,322 $ 2,356 $ 1,986 Non-compete agreements 2,267 1,587 1,481 1,372 Marketing intangibles 5,651 5,651 1,767 1,485 Leasehold interests 1,498 1,498 492 397 Service contracts 950 — 32 — Other 601 51 60 40 $ 19,389 $ 14,109 $ 6,188 $ 5,280 Amortization expense for the three months ended June 30, 2018 and 2017 was $0.5 million and $0.4 million, respectively. Amortization expense for the six months ended June 30, 2018 and 2017 was $0.9 million and $0.8 million, respectively. A ll intangible assets are amortized using the straight-line method. The following table presents amortization expense expected to be recognized during fiscal years subsequent to June 30, 2018 (in thousands): Fiscal Year Ended Expected Amortization Expense 2018 (1) $ 1,022 2019 2,008 2020 2,005 2021 1,765 2022 1,619 Thereafter 4,782 Total $ 13,201 (1) Presents expected amortization from July 1, 2018 through December 31, 2018.

Debt

Debt	6 Months Ended
	Jun. 30, 2018
Debt Disclosure [Abstract]
Debt	10. Debt A summary of the Company’s debt obligations is as follows (in thousands): June 30, December 31, 2018 2017 Senior secured loans $ 300,927 $ 207,375 Subordinated debt 9,383 — Unamortized deferred financing costs (8,983 ) (7,233 ) Capital lease obligations 718 1,031 Total debt 302,045 201,173 Less current portion of long-term debt (6,723 ) (4,722 ) Long-term debt, net of current portion and deferred financing costs $ 295,322 $ 196,451 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 quarterly principal repayments in an amount equal to $ 1.7 million for September 30, 2017 through June 30, 2019, $3.4 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. A s of June 30, 2018, there was an outstanding balance of $32.0 million under the 2017 . The 2017 Credit Facility also includes an incremental facility allowing 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 (as defined in the 2017 Credit Facility) 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 the 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. On March 1, 2018, in conjunction with the AdCare Acquisition, the Company borrowed $65.0 million of Incremental Term Loans under the 2017 Credit Facility. The Company incurred approximately $2.6 million Borrowings under the 2017 Credit Facility bear interest at a rate tied to the Alternative Base Rate (as defined in the 2017 Credit Facility) or the Adjusted London Interbank Offered Rate (“LIBOR”) Borrowings under the 2017 Credit Facility are guaranteed by the Company’s wholly owned subsidiary, American Addiction Centers, Inc., and certain of its other subsidiaries pursuant to that certain Guarantee and Collateral Agreement, dated as of June 30, 2017, by and among the Company, each of the subsidiary guarantors party thereto and Credit Suisse AG, as collateral agent (the “Guarantee and Collateral Agreement”). The obligations under the 2017 Credit Facility and the Guarantee and Collateral Agreement are secured by a lien on substantially all of the Company’s and each subsidiary guarantor’s assets. The Company is permitted to voluntarily reduce the unutilized portion of the commitment amount and repay outstanding loans under the 2017 Credit Facility at any time without premium or penalty, other than customary “breakage” costs with respect to Eurodollar Loans and, with respect to the 2017 Term Loan, if certain repricing transactions are consummated or certain mandatory repayments are made, (i) a yield maintenance premium within one year after the closing as set forth in the 2017 Credit Facility, (ii) a 2.0% premium if paid after the first anniversary of the closing but before the second anniversary of the closing and (iii) a 1.0% premium if paid after the second anniversary of the closing but before the third anniversary of the closing. In addition, the 2017 Credit Facility requires the Company to prepay the outstanding 2017 Term Loan, subject to certain exceptions, with: • 75.0% (which percentage will be reduced to 50.0% if the Company’s Senior Secured Leverage Ratio is not greater than 3.25:1.00 and to 25.0% if the Company’s Senior Secured Leverage Ratio is not greater than 2.75:1.00) of the Company’s annual excess cash flow (as defined by the 2017 Credit Facility); • 100.0% of the net cash proceeds of certain asset sales or other dispositions of property or certain casualty events, in each case subject to certain exceptions and provided that the Company may, subject to certain conditions, reinvest within 365 days in assets to be used in its business or certain other permitted investments; • 100.0% of the net cash proceeds of the incurrence of debt and issuance of Disqualified Stock (as defined by the 2017 Credit Facility) other than proceeds from debt permitted under the 2017 Credit Facility; and • 100.0% of the net cash proceeds of equity issuances in the event the Senior Secured Leverage Ratio is greater than 3.00:1.00, calculated on a pro forma basis, at the time of such issuances (or such lesser percentage required for the Senior Secured Leverage Ratio to be equal to or less than 3.00:1.00), other than equity proceeds that are utilized within 270 days of issuance for Permitted Acquisitions (as defined in the 2017 Credit Facility) or material expansion of facilities. The 2017 Credit Facility requires the Company to not permit its Senior Secured Leverage Ratio (as defined in the 2017 Credit Agreement) to exceed the following ratios on or after each quarter end: Each Fiscal Quarter Ending During the Period Maximum Senior Secured Leverage Ratio Ending before March 31, 2019 5.25:1.00 Ending on or after March 31, 2019 but before March 31, 2020 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 deferred financing costs related to the initial underwriting and other professional fees, of which $7.6 million related to the 2017 Term Loan and $5.3 million related to the 2017 Revolver. As of June 30, 2018, $300.9 million was outstanding under the 2017 Credit Facility, including $32.0 million related to the 2017 Revolver and $268.9 million related to the 2017 Term Loan. The Company’s availability under the 2017 Revolver was $23.0 million, less $5.0 million of outstanding letters of credit. As of June 30, 2018, the Company was in compliance with all applicable covenants under the 2017 Credit Facility. Subordinated Note On March 1, 2018, in conjunction with the AdCare Acquisition, in consideration for covenants and agreements set forth in the Purchase Agreement, the Company issued the AdCare Note to the Seller, in the original principal amount of $9.6 million, which matures on September 29, 2023 and accrues interest at a fixed rate per annum equal to 5.0%, compounded annually. Payments of principal and interest pursuant to the AdCare Note commenced on April 30, 2018 and will continue until the maturity date. 2015 Credit Facilities On March 9, 2015, the Company entered into a five-year senior secured credit facility (the “2015 Credit Facility”) with Bank of America, N.A., as administrative agent for the lenders party thereto. The 2015 Credit Facility initially consisted of a $50.0 million revolving credit facility and a $75.0 million term loan. In connection with entering into the 2017 Credit Facility on June 30, 2017, all amounts outstanding under the 2015 Credit Facility were fully repaid. On October 2, 2015, the Company entered into two financing facilities with affiliates of Deerfield Management Company, L.P. (“Deerfield”). The financing facilities consisted of $25.0 million of subordinated convertible debt and up to $25.0 million of unsecured subordinated debt (the “Deerfield Facility”). In connection with entering into the 2017 Credit Facility on June 30, 2017, all amounts outstanding under the Deerfield Facility were fully repaid. During the quarter ended June 30, 2017, the Company incurred approximately $5.4 million in debt extinguishment costs related to the repayment of the 2015 Credit Facility and the Deerfield Facility, which consisted of a $3.0 million consent fee related to calling the Deerfield Facility (the “Deerfield Facility Consent Fee”), as well as a write-off of $2.3 million of previously deferred financing costs. 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. As of December 31, 2017, there was no remaining liability related to the interest rate swap agreements. Prior to terminating the interest rate swap agreements on June 29, 2017, the interest rate swap agreements had notional amounts of $7.2 million and $10.5 million which fixed the interest rates over the life of the respective swap agreement at 4.21% and 4.73%, and were set to mature in May 2018 and August 2019, respectively. The notional amounts of the swap agreements represented amounts used to calculate the exchange of cash flows and were not the Company’s assets or liabilities. The interest payments under these agreements were to be settled on a net basis. The Company did not designate the interest rate swaps as cash flow hedges, and therefore, the changes in the fair value of the interest rate swaps are included within interest expense in the condensed consolidated statements of operations.

Financing Lease Obligation

Financing Lease Obligation	6 Months Ended
	Jun. 30, 2018
Leases [Abstract]
Financing Lease Obligation	11. Financing Lease Obligation On August 9, 2017, the Company closed on a sale-leaseback transaction with MedEquities Realty Operating Partnership, LP, a subsidiary of MedEquities Realty Trust, Inc. (“MedEquities”), for MedEquities purchased from subsidiaries of the Company two drug and alcohol rehabilitation outpatient facilities and two sober living facilities: the Desert Hope Facility and Resolutions Las Vegas, each located in Las Vegas, Nevada, and the Greenhouse Facility and Resolutions Arlington, each located in Arlington, Texas (collectively, the “Sale-Leaseback Facilities”). Simultaneously with the sale of the Sale-Leaseback Facilities, the Company, through its subsidiaries and MedEquities entered into an operating lease, dated August 9, 2017, in which the Company will continue to operate the Sale-Leaseback Facilities. The operating lease provides for a 15-year term for each facility with two separate renewal terms of five years each if the Company chooses to exercise its right to extend the lease term. The initial annual minimum rent payable from the Company to MedEquities is $2.2 million due in equal monthly installments of $0.2 million. On the first, second and third anniversary of the lease date, the annual rent will increase 1.5% from 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 increase will always be between 1.5% and 3.0%. Due to the nature of the agreement between MedEquities and the Company, the transaction did not qualify for sale-leaseback accounting under GAAP. Therefore, the Sale-Leaseback Facilities remain on the Company’s balance sheets and continue to be depreciated over their remaining useful lives. 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 at the time of the transaction. A summary of the Company’s financing lease obligation is as follows (in thousands): June 30, December 31, 2018 2017 Financing lease obligation: Sale-Leaseback facilities $ 24,589 $ 24,621 Less current portion (included in accrued and other current liabilities) (101 ) (80 ) Total Financing lease obligation, net of current portion $ 24,488 $ 24,541

Stockholders' Equity and Stock

Stockholders' Equity and Stock Based Compensation	6 Months Ended
	Jun. 30, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stockholders' Equity and Stock Based Compensation	12. Stockholders’ Equity and Stock Based Compensation Stock Based Compensation Plans The Company granted 150,000 and 408,000 shares of restricted common stock to certain of its employees as part of the 2014 Equity Incentive Plan, as amended from time to time (the “Plan”), during the six months ended June 30, 2018 and 2017, respectively. These restricted common shares vest annually over a period of three years beginning on December 31 of the year the restricted common stock was granted. Additionally, the Company granted 36,000 and 38,000 shares of fully vested common stock during the six months ended June 30, 2018 and 2017, respectively, to its non-employee directors pursuant to the Plan. The Company recognized $0.4 million and $0.3 million of compensation expense for the six months ended June 30, 2018 and 2017, respectively, as a result of the non-employee director grants. The Company recognized $1.4 million and $2.1 million in equity-based compensation expense for the three months ended June 30, 2018 and 2017, respectively. The Company recognized $2.2 million and $4.2 million in equity-based compensation expense for the six months ended June 30, 2018 and 2017, respectively. As of June 30, 2018, there was $3.8 million of unrecognized compensation expense related to unvested restricted stock, which is expected to be recognized over the remaining weighted average vesting period of 1.7 years. A summary of share activity under the Plan is set forth below: Shares Weighted- Average Grant Date Fair Value Unvested at December 31, 2017 348,855 $ 13.69 Granted 186,000 11.68 Vested (81,314 ) 17.31 Forfeitures (44,105 ) 16.14 Unvested at June 30, 2018 409,436 $ 11.79 Employee Stock Purchase Plan For the six months ended June 30, 2018 and 2017, the Company issued 27,900 and 50,362 shares, respectively, of the Company’s common stock under its Employee Stock Purchase Plan, as amended from time to time (“ESPP”). For both the six months ended June 30, 2018 and 2017, the Company recognized $0.1 million of compensation expense related to the ESPP. Registration Statement On June 8, 2018, the Company filed a shelf registration statement on Form S-3 (File No. 333-225536) with the SEC (the “Registration Statement”). The Registration Statement, which was declared effective by the SEC on June 22, 2018, permits us to offer to the public from time to time in one or more offerings issue up to an aggregate of $150.0 million in securities, consisting of common stock, preferred stock, warrants and units, at prices and on terms that the Company will decide at the time of any offering. To date, no securities have been issued pursuant to the Registration Statement.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2018
Income Tax Disclosure [Abstract]
Income Taxes	13. Income Taxes The provision for income taxes for the three and six months ended June 30, 2018 reflects an income tax benefit of $ 0.1 million 1.7 The provision for income taxes for the three and six months ended June 30, 2017 reflects an income tax expense of $0.6 million and an income tax benefit of $3,000, respectively, at an effective tax rate of 24.1% and 0.1%, respectively. The increase in income tax benefit from the comparable periods in 2017 and the change in the effective tax rate is primarily related to the tax treatment of stock compensation, litigation settlement expense and the effect of the Tax Cuts and Jobs Act. The Company’s effective income tax rate for the six months ended June 30, 2018 and 2017 reconciles with the federal statutory rate as follows: Six Months Ended June 30, 2018 2017 Federal statutory rate 21.0 % 35.0 % State income taxes, net of federal tax benefit (1.9 ) (7.6 ) Non-deductible expenses (1.5 ) (6.6 ) Stock compensation adjustment (2.5 ) (22.3 ) Other differences 3.1 1.6 Effective income tax rate on income before taxes 18.2 % 0.1 %

Fair Value of Financial Instrum

Fair Value of Financial Instruments	6 Months Ended
	Jun. 30, 2018
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	14. Fair Value of Financial Instruments The carrying amounts reported at June 30, 2018 and December 31, 2017 for cash and cash equivalents, accounts receivable, prepaid expenses and other current assets, accounts payable and accrued liabilities approximate fair value because of the short-term maturity of these instruments. The Company has debt with variable interest rates. The fair value of this debt was measured using Level 2 inputs, including good faith estimates of the market value for the particular debt instrument, which represent the amount an independent market participant would provide based upon market observations and other factors relevant under the circumstances. The carrying value of such debt approximated its estimated fair value at June 30, 2018 and December 31, 2017. 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 the Company’s nonperformance risk and the respective counterparty’s nonperformance risk. The fair value measurement of interest rate swaps utilized Level 2 inputs. Refer to Note 10 (Debt) for further discussion of the interest rate swap agreements.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2018
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	15. Commitments and Contingencies Litigation Shareholder Litigation On August 24, 2015, a shareholder filed a purported class action in the United States District Court for the Middle District of Tennessee against the Company and certain of its current and former officers ( Kasper v. AAC Holdings, Inc. et al.) Tenzyk v. AAC Holdings, Inc. et al.) 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 ($22.3 million related the Tennessee claim and $1.0 million related to the Nevada claim). The Company paid $25.0 million related to the Tennessee claim and recognized $2.7 million of additional litigation settlement expense in the first quarter of 2018. In the second quarter of 2018, the Company paid the remaining $1.0 million of accrued litigation related to the Nevada claim. 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.

Basis of Presentation and Rec23

Basis of Presentation and Recently Issued Accounting Pronouncements (Policies)	6 Months Ended
	Jun. 30, 2018
Accounting Policies [Abstract]
Reclassifications	Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.
Recently Issued Accounting Standards Updates	Recently Issued Accounting Standards Updates In 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 statements of operations. 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 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 operating results under Topic 606. The analysis of the Company’s processes under the new revenue standard is complete and supports the recognition of revenue over time as clients simultaneously receive and consume the benefits of the services provided. However, the adoption of the standard has an impact on the presentation of revenue recognized and the provision for doubtful accounts due to additional requirements within Topic 606. 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 as opposed to the provision for doubtful accounts included within operating expenses. The only activity that will be recorded in operating expenses from 2018 onward will be bad debt related to specific customers that experience significant adverse changes in creditworthiness, such as bankruptcies. The Company recorded $0.4 million of expense related to one of our digital outreach platform customers during the quarter ended June 30, 2018. The initial application of Topic 606 had no impact to the beginning balances of the Company's consolidated financial statements as of January 1, 2018. In adopting Topic 606, the Company elected the practical expedients related to immaterial contract acquisition costs and insignificant financing components of the transaction price. For the three and six months ended June 30, 2018, t he impact on the Company's Condensed Consolidated Statements of Operations was as follows (in thousands): Three Months Ended June 30, 2018 Six Months Ended June 30, 2018 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 83,293 $ 96,150 $ (12,857 ) $ 159,216 $ 178,630 $ (19,414 ) Non-client related revenue $ 3,468 $ 3,616 $ (148 ) $ 6,018 $ 6,414 $ (396 ) Provision for doubtful accounts $ 366 $ 13,371 $ (13,005 ) $ 366 $ 20,176 $ (19,810 )
Client Related Revenue	Client Related Revenue Client related revenue primarily consists of service charges related to providing addiction treatment and related services, including diagnostic laboratory services. As it relates to recognizing revenue, the Company’s contracts are with the individuals for whom the Company provides care. The majority of the Company’s contracts with clients have a single performance obligation because the promise to deliver services is not separately identifiable from other promises in the contracts. The Company’s performance obligations are satisfied over time as clients simultaneously receive and consume the benefits provided. Therefore, the Company recognizes revenue in the same period the services are performed, and there are no remaining performance obligations at period-end. Due to the nature of the industry, there are often more than two parties to the service transactions (including customers, providers and payors), and the estimation of revenue is complex and requires significant judgment. Management estimates variable consideration using the expected value method. The expected value method is used when an entity has a large number of contracts with similar characteristics, as is the case with the Company’s contracts. The transaction price is recorded based on the estimated ultimate value remaining after all uncertainty is resolved. The estimates of variable consideration are based largely on an assessment of the Company’s anticipated performance as well as historical, current, and forecasted information. The Company updates 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. The following tables summarize the composition of our client related revenue for inpatient treatment facility services, outpatient facility and sober living services, and client related diagnostic services. Inpatient treatment facility services include revenues from related professional services, and client related diagnostic services includes revenues from point of care services as well as laboratory services. For the three months ended June 30, 2018 and 2017, on an as reported basis (in thousands): Three Months Ended June 30, 2018 Three Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 66,721 80.1 $ 61,754 81.6 $ 4,967 8.0 Outpatient facility and sober living services 9,028 10.8 6,238 8.2 2,790 44.7 Client related diagnostic services 7,544 9.1 7,700 10.2 (156 ) (2.0 ) Total client related revenue $ 83,293 100.0 $ 75,692 100.0 $ 7,601 10.0 For the three months ended June 30, 2018 and 2017, on a comparable accounting basis as if the Company had not adopted Topic 606 (in thousands): Previous Accounting Guidance As Reported Three Months Ended June 30, 2018 Three Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 74,527 77.5 $ 61,754 81.6 $ 12,773 20.7 Outpatient facility and sober living services 11,515 12.0 6,238 8.2 5,277 84.6 Client related diagnostic services 10,108 10.5 7,700 10.2 2,408 31.3 Total client related revenue $ 96,150 100.0 $ 75,692 100.0 $ 20,458 27.0 For the six months ended June 30, 2018 and 2017, on an as reported basis (in thousands): Six Months Ended June 30, 2018 Six Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 131,616 82.7 $ 111,249 75.7 $ 20,367 18.3 Outpatient facility and sober living services 17,440 11.0 11,953 8.1 5,487 45.9 Client related diagnostic services 10,160 6.3 23,709 16.2 (13,549 ) (57.1 ) Total client related revenue $ 159,216 100.0 $ 146,911 100.0 $ 12,305 8.4 For the six months ended June 30, 2018 and 2017, on a comparable accounting basis as if the Company had not adopted Topic 606 (in thousands): Previous Accounting Guidance As Reported Six Months Ended June 30, 2018 Six Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 142,750 79.9 $ 111,249 75.7 $ 31,501 28.3 Outpatient facility and sober living services 19,026 10.7 11,953 8.1 7,073 59.2 Client related diagnostic services 16,854 9.4 23,709 16.2 (6,855 ) (28.9 ) Total client related revenue $ 178,630 100.0 $ 146,911 100.0 $ 31,719 21.6
Non-Client Related Revenue	Non-Client Related Revenue Non-client related revenue consists of diagnostic laboratory services provided to clients of third-party addiction treatment providers, addiction care treatment services for individuals in the criminal justice system and services provided to third-party behavioral health providers who use our digital outreach platforms. Revenue from diagnostic laboratory services provided to clients of third-party addiction treatment providers is recognized at the point in time when the order is completed. These contracts have a single performance obligation, and the transaction price is agreed upon between the Company and the third-party lab provider to services being rendered. Revenue for addiction care treatment services for individuals in the criminal justice system is recognized as services are provided in accordance with contracts with certain Massachusetts state agencies. Revenue from third-party behavioral health providers who use our digital outreach platforms is recognized over time as these customers simultaneously receive and consume the benefits of the services provided. The Company’s marketing contracts typically have one performance obligation. There are no significant judgments in determining the transaction price as the price is listed in the contract and not subject to change.

Basis of Presentation and Rec24

Basis of Presentation and Recently Issued Accounting Pronouncements (Tables)	6 Months Ended
	Jun. 30, 2018
Accounting Standards Update 2014-09
Schedule of Impact on Condensed Consolidated Statements of Operations	For the three and six months ended June 30, 2018, t he impact on the Company's Condensed Consolidated Statements of Operations was as follows (in thousands): Three Months Ended June 30, 2018 Six Months Ended June 30, 2018 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 83,293 $ 96,150 $ (12,857 ) $ 159,216 $ 178,630 $ (19,414 ) Non-client related revenue $ 3,468 $ 3,616 $ (148 ) $ 6,018 $ 6,414 $ (396 ) Provision for doubtful accounts $ 366 $ 13,371 $ (13,005 ) $ 366 $ 20,176 $ (19,810 )

Client Related Revenue and No25

Client Related Revenue and Non-Client Related Revenue (Tables)	6 Months Ended
	Jun. 30, 2018
Accounting Standards Update 2014-09
Summary of Composition of Client Related Revenue	The following tables summarize the composition of our client related revenue for inpatient treatment facility services, outpatient facility and sober living services, and client related diagnostic services. Inpatient treatment facility services include revenues from related professional services, and client related diagnostic services includes revenues from point of care services as well as laboratory services. For the three months ended June 30, 2018 and 2017, on an as reported basis (in thousands): Three Months Ended June 30, 2018 Three Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 66,721 80.1 $ 61,754 81.6 $ 4,967 8.0 Outpatient facility and sober living services 9,028 10.8 6,238 8.2 2,790 44.7 Client related diagnostic services 7,544 9.1 7,700 10.2 (156 ) (2.0 ) Total client related revenue $ 83,293 100.0 $ 75,692 100.0 $ 7,601 10.0 For the three months ended June 30, 2018 and 2017, on a comparable accounting basis as if the Company had not adopted Topic 606 (in thousands): Previous Accounting Guidance As Reported Three Months Ended June 30, 2018 Three Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 74,527 77.5 $ 61,754 81.6 $ 12,773 20.7 Outpatient facility and sober living services 11,515 12.0 6,238 8.2 5,277 84.6 Client related diagnostic services 10,108 10.5 7,700 10.2 2,408 31.3 Total client related revenue $ 96,150 100.0 $ 75,692 100.0 $ 20,458 27.0 For the six months ended June 30, 2018 and 2017, on an as reported basis (in thousands): Six Months Ended June 30, 2018 Six Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 131,616 82.7 $ 111,249 75.7 $ 20,367 18.3 Outpatient facility and sober living services 17,440 11.0 11,953 8.1 5,487 45.9 Client related diagnostic services 10,160 6.3 23,709 16.2 (13,549 ) (57.1 ) Total client related revenue $ 159,216 100.0 $ 146,911 100.0 $ 12,305 8.4 For the six months ended June 30, 2018 and 2017, on a comparable accounting basis as if the Company had not adopted Topic 606 (in thousands): Previous Accounting Guidance As Reported Six Months Ended June 30, 2018 Six Months Ended June 30, 2017 Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 142,750 79.9 $ 111,249 75.7 $ 31,501 28.3 Outpatient facility and sober living services 19,026 10.7 11,953 8.1 7,073 59.2 Client related diagnostic services 16,854 9.4 23,709 16.2 (6,855 ) (28.9 ) Total client related revenue $ 178,630 100.0 $ 146,911 100.0 $ 31,719 21.6

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	6 Months Ended
	Jun. 30, 2018
Earnings Per Share [Abstract]
Schedule of Components of Numerator and Denominator Used in Calculation of Basic and Diluted Earnings Per Share	The following table presents the components of the numerator and denominator used in the calculation of basic and diluted EPS for the three and six months ended June 30, 2018 and 2017 (in thousands, except share data): Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Numerator Net loss attributable to AAC Holdings, Inc. common stockholders $ (3,013 ) $ (1,916 ) $ (3,215 ) $ (2,519 ) Denominator Weighted-average common shares outstanding – basic 24,166,976 23,242,177 23,956,760 23,203,081 Dilutive securities — — — — Weighted-average common shares outstanding – diluted 24,166,976 23,242,177 23,956,760 23,203,081 Basic loss per common share $ (0.12 ) $ (0.08 ) $ (0.13 ) $ (0.11 ) Diluted loss per common share $ (0.12 ) $ (0.08 ) $ (0.13 ) $ (0.11 )

Acquisitions (Tables)

Acquisitions (Tables)	6 Months Ended
	Jun. 30, 2018
Business Combinations [Abstract]
Schedule of Preliminary Allocation of Assets Acquired and Liabilities Assumed	The preliminary allocation of assets acquired and liabilities assumed on the acquisition date, based on the fair value of AdCare, is as follows (in thousands): AdCare Acquisition Cash and cash equivalents $ 2,700 Accounts receivable 4,357 Prepaid expenses and other assets 996 Property and equipment 15,719 Goodwill 62,788 Intangible assets 5,280 Total assets acquired 91,840 Accrued and other current liabilities 5,931 Long-term liabilities 2,004 Net assets acquired $ 83,905
Schedule of Unaudited Proforma Results	The following table presents pro forma results as discussed above, which are not indicative of the actual results of operations (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Total revenues $ 86,761 $ 90,131 $ 173,508 $ 175,479 Loss before income tax benefit $ (5,087 ) $ (2,308 ) $ (10,017 ) $ (4,610 )

Accounts Receivable (Tables)

Accounts Receivable (Tables)	6 Months Ended
	Jun. 30, 2018
Receivables [Abstract]
Summary of Aging of Accounts Receivable Net of Allowance for Doubtful Accounts	The following table presents a summary of our aging of accounts receivable, net of the allowance for doubtful accounts as of June 30, 2018 and 2017: Current 31-180 Days Over 180 Days Total June 30, 2018 41.8 % 40.0 % 18.2 % 100.0 % June 30, 2017 31.0 % 44.6 % 24.4 % 100.0 %

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	6 Months Ended
	Jun. 30, 2018
Property Plant And Equipment [Abstract]
Components of Property and Equipment	Property and equipment consisted of the following (in thousands): June 30, December 31, 2018 2017 Land $ 19,364 $ 15,766 Buildings and improvements 158,647 130,710 Equipment and software 32,936 32,968 Construction in progress 16,881 22,310 Total property and equipment 227,828 201,754 Less accumulated depreciation (59,455 ) (49,206 ) Property and equipment, net $ 168,373 $ 152,548

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The increase in goodwill is due to the AdCare Acquisition as shown below and discussed in Note 6 (Acquisition) (in thousands): Balance at December 31, 2017 $ 134,396 AdCare Acquisition 62,788 Balance at June 30, 2018 $ 197,184
Components of Other Identifiable Intangible Assets	Other identifiable intangible assets and related accumulated amortization consisted of the following as of June 30, 2018 and December 31, 2017 (in thousands): Gross Carrying Value Accumulated Amortization June 30, December 31, June 30, December 31, 2018 2017 2018 2017 Trademarks and trade names $ 8,422 $ 5,322 $ 2,356 $ 1,986 Non-compete agreements 2,267 1,587 1,481 1,372 Marketing intangibles 5,651 5,651 1,767 1,485 Leasehold interests 1,498 1,498 492 397 Service contracts 950 — 32 — Other 601 51 60 40 $ 19,389 $ 14,109 $ 6,188 $ 5,280
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	A ll intangible assets are amortized using the straight-line method. The following table presents amortization expense expected to be recognized during fiscal years subsequent to June 30, 2018 (in thousands): Fiscal Year Ended Expected Amortization Expense 2018 (1) $ 1,022 2019 2,008 2020 2,005 2021 1,765 2022 1,619 Thereafter 4,782 Total $ 13,201 (1) Presents expected amortization from July 1, 2018 through December 31, 2018.

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2018
Debt Disclosure [Abstract]
Summary of Debt Obligations	A summary of the Company’s debt obligations is as follows (in thousands): June 30, December 31, 2018 2017 Senior secured loans $ 300,927 $ 207,375 Subordinated debt 9,383 — Unamortized deferred financing costs (8,983 ) (7,233 ) Capital lease obligations 718 1,031 Total debt 302,045 201,173 Less current portion of long-term debt (6,723 ) (4,722 ) Long-term debt, net of current portion and deferred financing costs $ 295,322 $ 196,451
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 but before March 31, 2020 4.75:1.00 Ending on or after March 31, 2020 4.25:1.00

Financing Lease Obligation (Tab

Financing Lease Obligation (Tables)	6 Months Ended
	Jun. 30, 2018
Leases [Abstract]
Summary of Financing Lease Obligation	A summary of the Company’s financing lease obligation is as follows (in thousands): June 30, December 31, 2018 2017 Financing lease obligation: Sale-Leaseback facilities $ 24,589 $ 24,621 Less current portion (included in accrued and other current liabilities) (101 ) (80 ) Total Financing lease obligation, net of current portion $ 24,488 $ 24,541

Stockholders' Equity and Stoc33

Stockholders' Equity and Stock Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Summary of Share Activity Under 2014 Equity Incentive Plan	A summary of share activity under the Plan is set forth below: Shares Weighted- Average Grant Date Fair Value Unvested at December 31, 2017 348,855 $ 13.69 Granted 186,000 11.68 Vested (81,314 ) 17.31 Forfeitures (44,105 ) 16.14 Unvested at June 30, 2018 409,436 $ 11.79

Income Taxes (Tables)

Income Taxes (Tables)	6 Months Ended
	Jun. 30, 2018
Income Tax Disclosure [Abstract]
Schedule of Effective Income Tax Rate	The Company’s effective income tax rate for the six months ended June 30, 2018 and 2017 reconciles with the federal statutory rate as follows: Six Months Ended June 30, 2018 2017 Federal statutory rate 21.0 % 35.0 % State income taxes, net of federal tax benefit (1.9 ) (7.6 ) Non-deductible expenses (1.5 ) (6.6 ) Stock compensation adjustment (2.5 ) (22.3 ) Other differences 3.1 1.6 Effective income tax rate on income before taxes 18.2 % 0.1 %

Basis of Presentation and Rec35

Basis of Presentation and Recently Issued Accounting Pronouncements - Additional Information (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018USD ($)ProfessionalGroup	Jun. 30, 2017USD ($)ProfessionalGroup	Jun. 30, 2018USD ($)ProfessionalGroup	Jun. 30, 2017USD ($)ProfessionalGroup	Dec. 31, 2017USD ($)
Business And Basis Of Presentation [Line Items]
Assets	$ 512,752		$ 512,752		$ 428,275
Liabilities	375,955		375,955		292,107
Net loss attributable to noncontrolling interest	1,990	$ 982	3,883	$ 2,023
Bad debt expense	$ 366	$ 9,496	366	$ 16,083
Digital Outreach Platform Customers
Business And Basis Of Presentation [Line Items]
Bad debt expense			$ 400
VIEs
Business And Basis Of Presentation [Line Items]
Number of professional groups | ProfessionalGroup	7	7	7	7
Assets	$ 1,000		$ 1,000		2,100
Liabilities	700		700		$ 400
Net loss attributable to noncontrolling interest	$ 2,000	$ 1,000	$ 3,900	$ 2,000

Basis of Presentation and Rec36

Basis of Presentation and Recently Issued Accounting Pronouncements - Schedule of Impact on Condensed Consolidated Statements of Operations (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Business And Basis Of Presentation [Line Items]
Total revenues	$ 86,761	$ 78,042	$ 165,234	$ 151,081
Provision for doubtful accounts	366	9,496	366	16,083
Client Related Revenue
Business And Basis Of Presentation [Line Items]
Total revenues	83,293	75,692	159,216	146,911
Client Related Revenue | Calculated under Revenue Guidance in Effect before Topic 606
Business And Basis Of Presentation [Line Items]
Total revenues	96,150	75,692	178,630	146,911
Non-Client Related Revenue
Business And Basis Of Presentation [Line Items]
Total revenues	3,468	$ 2,350	6,018	$ 4,170
Accounting Standards Update 2014-09 | Calculated under Revenue Guidance in Effect before Topic 606
Business And Basis Of Presentation [Line Items]
Provision for doubtful accounts	13,371		20,176
Accounting Standards Update 2014-09 | Impact of Adopting Topic 606
Business And Basis Of Presentation [Line Items]
Provision for doubtful accounts	(13,005)		(19,810)
Accounting Standards Update 2014-09 | Client Related Revenue | Calculated under Revenue Guidance in Effect before Topic 606
Business And Basis Of Presentation [Line Items]
Total revenues	96,150		178,630
Accounting Standards Update 2014-09 | Client Related Revenue | Impact of Adopting Topic 606
Business And Basis Of Presentation [Line Items]
Total revenues	(12,857)		(19,414)
Accounting Standards Update 2014-09 | Non-Client Related Revenue | Calculated under Revenue Guidance in Effect before Topic 606
Business And Basis Of Presentation [Line Items]
Total revenues	3,616		6,414
Accounting Standards Update 2014-09 | Non-Client Related Revenue | Impact of Adopting Topic 606
Business And Basis Of Presentation [Line Items]
Total revenues	$ (148)		$ (396)

Client Related Revenue and No37

Client Related Revenue and Non-Client Related Revenue - Summary of Composition of Client Related Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Client Related Revenue, Amount	$ 86,761	$ 78,042	$ 165,234	$ 151,081
Client Related Revenue
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Client Related Revenue, Amount	$ 83,293	$ 75,692	$ 159,216	$ 146,911
Client Related Revenue, Percentage	100.00%	100.00%	100.00%	100.00%
Client Related Revenue, Increase (Decrease), Amount	$ 7,601		$ 12,305
Client Related Revenue, Increase (Decrease) , Percentage	10.00%		8.40%
Client Related Revenue | Not Adopted Topic 606
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Client Related Revenue, Amount	$ 96,150	$ 75,692	$ 178,630	$ 146,911
Client Related Revenue, Percentage	100.00%	100.00%	100.00%	100.00%
Client Related Revenue, Increase (Decrease), Amount	$ 20,458		$ 31,719
Client Related Revenue, Increase (Decrease) , Percentage	27.00%		21.60%
Client Related Revenue | Inpatient Treatment Facility Services
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Client Related Revenue, Amount	$ 66,721	$ 61,754	$ 131,616	$ 111,249
Client Related Revenue, Percentage	80.10%	81.60%	82.70%	75.70%
Client Related Revenue, Increase (Decrease), Amount	$ 4,967		$ 20,367
Client Related Revenue, Increase (Decrease) , Percentage	8.00%		18.30%
Client Related Revenue | Inpatient Treatment Facility Services | Not Adopted Topic 606
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Client Related Revenue, Amount	$ 74,527	$ 61,754	$ 142,750	$ 111,249
Client Related Revenue, Percentage	77.50%	81.60%	79.90%	75.70%
Client Related Revenue, Increase (Decrease), Amount	$ 12,773		$ 31,501
Client Related Revenue, Increase (Decrease) , Percentage	20.70%		28.30%
Client Related Revenue | Outpatient Facility and Sober Living Services
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Client Related Revenue, Amount	$ 9,028	$ 6,238	$ 17,440	$ 11,953
Client Related Revenue, Percentage	10.80%	8.20%	11.00%	8.10%
Client Related Revenue, Increase (Decrease), Amount	$ 2,790		$ 5,487
Client Related Revenue, Increase (Decrease) , Percentage	44.70%		45.90%
Client Related Revenue | Outpatient Facility and Sober Living Services | Not Adopted Topic 606
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Client Related Revenue, Amount	$ 11,515	$ 6,238	$ 19,026	$ 11,953
Client Related Revenue, Percentage	12.00%	8.20%	10.70%	8.10%
Client Related Revenue, Increase (Decrease), Amount	$ 5,277		$ 7,073
Client Related Revenue, Increase (Decrease) , Percentage	84.60%		59.20%
Client Related Revenue | Client Related Diagnostic Services
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Client Related Revenue, Amount	$ 7,544	$ 7,700	$ 10,160	$ 23,709
Client Related Revenue, Percentage	9.10%	10.20%	6.30%	16.20%
Client Related Revenue, Increase (Decrease), Amount	$ (156)		$ (13,549)
Client Related Revenue, Increase (Decrease) , Percentage	(2.00%)		(57.10%)
Client Related Revenue | Client Related Diagnostic Services | Not Adopted Topic 606
Health Care Organization Receivable And Revenue Disclosures [Line Items]
Client Related Revenue, Amount	$ 10,108	$ 7,700	$ 16,854	$ 23,709
Client Related Revenue, Percentage	10.50%	10.20%	9.40%	16.20%
Client Related Revenue, Increase (Decrease), Amount	$ 2,408		$ (6,855)
Client Related Revenue, Increase (Decrease) , Percentage	31.30%		(28.90%)

General and Administrative Co38

General and Administrative Costs - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
General And Administrative Costs [Abstract]
General and administrative expense	$ 21.3	$ 17.6	$ 43.3	$ 36.7

Earnings (Loss) Per Share - Sch

Earnings (Loss) 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		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Numerator
Net loss attributable to AAC Holdings, Inc. common stockholders	$ (3,013)	$ (1,916)	$ (3,215)	$ (2,519)
Denominator
Weighted-average common shares outstanding – basic	24,166,976	23,242,177	23,956,760	23,203,081
Weighted-average common shares outstanding – diluted	24,166,976	23,242,177	23,956,760	23,203,081
Basic loss per common share	$ (0.12)	$ (0.08)	$ (0.13)	$ (0.11)
Diluted loss per common share	$ (0.12)	$ (0.08)	$ (0.13)	$ (0.11)

Earnings (Loss) Per Share - Add

Earnings (Loss) Per Share - Additional Information (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Earnings Per Share [Abstract]
Potentially anti-dilutive shares excluded from calculation of earnings per share	156,779	11,985	90,288	23,970

Acquisitions - Additional Infor

Acquisitions - Additional Information (Details) - AdCare, Inc. and AdCare Holding Trust	Mar. 01, 2018USD ($)BedCenter$ / sharesshares	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)
Business Acquisition [Line Items]
Consideration paid	$ 83,900,000
Consideration paid in cash, excluding expenses and other adjustments	65,200,000
Contingent consideration		$ 700,000		$ 700,000	$ 700,000
Cash acquired	2,700,000
Contingent consideration, description					The contingent consideration that can be earned by the seller ranges from zero to $3.1 million, subject to achievement of a certain adjusted EBITDA target over the 12 months following the transaction date.
Decrease in fair value of contingent consideration liability included in acquisition related expense		200,000
Revenues				17,200,000
Income before income tax expense				$ 2,300,000
Nonrecurring acquisition cost					$ 400,000
Depreciation and amortization expense		200,000	$ 200,000		200,000	$ 500,000
Addtional interest expense		$ 400,000	$ 1,500,000		$ 400,000	$ 3,000,000
Accrued and Other Current Liabilities
Business Acquisition [Line Items]
Contingent consideration	900,000
Minimum
Business Acquisition [Line Items]
Contingent consideration	0
Maximum
Business Acquisition [Line Items]
Contingent consideration	$ 3,100,000
Period of return to seller	60 days
Promissory Note
Business Acquisition [Line Items]
Aggregate principal amount of promissory note	$ 9,600,000
Common Stock
Business Acquisition [Line Items]
Consideration paid in shares, amount	$ 5,400,000
Consideration paid in shares | shares	562,051
Average closing stock price | $ / shares	$ 9.68
Massachusetts
Business Acquisition [Line Items]
Date of acquisition	Mar. 1, 2018
Number of bed capacity in acquired hospital | Bed	114
Number of outpatient centers acquired | Center	5
Rhode Island
Business Acquisition [Line Items]
Number of outpatient centers acquired | Center	2
Number of bed capacity in acquired residential inpatient treatment center | Bed	59

Acquisitions - Schedule of Prel

Acquisitions - Schedule of Preliminary Allocation of Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Mar. 01, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill	$ 197,184		$ 134,396
AdCare, Inc. and AdCare Holding Trust
Business Acquisition [Line Items]
Cash and cash equivalents		$ 2,700
Accounts receivable		4,357
Prepaid expenses and other assets		996
Property and equipment		15,719
Goodwill		62,788
Intangible assets		5,280
Total assets acquired		91,840
Accrued and other current liabilities		5,931
Long-term liabilities		2,004
Net assets acquired		$ 83,905

Acquisitions - Schedule of Unau

Acquisitions - Schedule of Unaudited Proforma Results (Details) - AdCare, Inc. and AdCare Holding Trust - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Business Acquisition [Line Items]
Total revenues	$ 86,761	$ 90,131	$ 173,508	$ 175,479
Loss before income tax benefit	$ (5,087)	$ (2,308)	$ (10,017)	$ (4,610)

Accounts Receivable - Additiona

Accounts Receivable - Additional Information (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Commercial Insurance Company
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, net of allowance for doubtful accounts	$ 12.3		$ 14.6
Revenues | Anthem Blue Cross Blue Shield | NEVADA
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed	12.40%	11.10%
Revenues | Blue Cross Blue Shield | FLORIDA
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed	10.30%	10.20%
Revenues | Blue Cross Blue Shield | TEXAS
Accounts Notes And Loans Receivable [Line Items]
Percentage of revenues reimbursed		10.00%

Accounts Receivable - Summary o

Accounts Receivable - Summary of Aging of Accounts Receivable Net of Allowance for Doubtful Accounts (Details) - Accounts Receivable	Jun. 30, 2018	Jun. 30, 2017
Accounts Notes And Loans Receivable [Line Items]
Aging of accounts receivable, net of allowance for doubtful accounts, current	41.80%	31.00%
Aging of accounts receivable, net of allowance for doubtful accounts	100.00%	100.00%
31-180 Days
Accounts Notes And Loans Receivable [Line Items]
Aging of accounts receivable, net of allowance for doubtful accounts	40.00%	44.60%
Over 180 Days
Accounts Notes And Loans Receivable [Line Items]
Aging of accounts receivable, net of allowance for doubtful accounts	18.20%	24.40%

Property and Equipment, Net - C

Property and Equipment, Net - Components of Property and Equipment (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Property Plant And Equipment [Line Items]
Total property and equipment	$ 227,828	$ 201,754
Less accumulated depreciation	(59,455)	(49,206)
Property and equipment, net	168,373	152,548
Land
Property Plant And Equipment [Line Items]
Total property and equipment	19,364	15,766
Buildings and Improvements
Property Plant And Equipment [Line Items]
Total property and equipment	158,647	130,710
Equipment and Software
Property Plant And Equipment [Line Items]
Total property and equipment	32,936	32,968
Construction in progress
Property Plant And Equipment [Line Items]
Total property and equipment	$ 16,881	$ 22,310

Property and Equipment, Net - A

Property and Equipment, Net - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Property Plant And Equipment [Abstract]
Depreciation expense	$ 5.4	$ 4.7	$ 10.5	$ 9.7

Goodwill and Intangible Asset48

Goodwill and Intangible Assets - Additional Information (Details)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)	Jun. 30, 2018USD ($)Segment	Jun. 30, 2017USD ($)	Dec. 31, 2017USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
Intangible assets					$ 0
Goodwill impairment charge					0
Number of operating segments | Segment			1
Number of reportable segments | Segment			1
Goodwill	$ 197,184,000		$ 197,184,000		$ 134,396,000
Amortization expense	$ 500,000	$ 400,000	$ 900,000	$ 800,000

Goodwill and Intangible Asset49

Goodwill and Intangible Assets - Schedule of Goodwill (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2018USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
Balance at December 31, 2017	$ 134,396
AdCare Acquisition	62,788
Balance at June 30, 2018	$ 197,184

Goodwill and Intangible Asset50

Goodwill and Intangible Assets - Components of Other Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 19,389	$ 14,109
Accumulated Amortization	6,188	5,280
Trademarks and trade names
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	8,422	5,322
Accumulated Amortization	2,356	1,986
Non-compete agreements
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	2,267	1,587
Accumulated Amortization	1,481	1,372
Marketing Intangibles
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	5,651	5,651
Accumulated Amortization	1,767	1,485
Leasehold interests
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	1,498	1,498
Accumulated Amortization	492	397
Service contracts
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	950
Accumulated Amortization	32
Other
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	601	51
Accumulated Amortization	$ 60	$ 40

Goodwill and Intangible Asset51

Goodwill and Intangible Assets - Schedule of Finite Lived Intangible Assets Future Amortization Expense (Details) $ in Thousands	Jun. 30, 2018USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
2,018	$ 1,022	[1]
2,019	2,008
2,020	2,005
2,021	1,765
2,022	1,619
Thereafter	4,782
Total	$ 13,201
[1]	Presents expected amortization from July 1, 2018 through December 31, 2018.

Debt - Summary of Debt Obligati

Debt - Summary of Debt Obligations (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Line Of Credit Facility [Line Items]
Unamortized deferred financing costs	$ (8,983)	$ (7,233)
Capital lease obligations	718	1,031
Total debt	302,045	201,173
Less current portion of long-term debt	(6,723)	(4,722)
Long-term debt, net of current portion and deferred financing costs	295,322	196,451
Senior Secured Term Loan
Line Of Credit Facility [Line Items]
Long term debt	300,927	$ 207,375
Subordinated Debt
Line Of Credit Facility [Line Items]
Subordinated debt	$ 9,383

Debt - Credit Facility - Additi

Debt - Credit Facility - Additional Information (Details) - USD ($) $ in Millions	Jun. 30, 2017	Mar. 09, 2015	Jun. 30, 2017	Jun. 30, 2017	Jun. 30, 2018	Mar. 01, 2018	Sep. 25, 2017	Oct. 02, 2015
Line Of Credit Facility [Line Items]
Repayments of debt extinguishment costs				$ 5.4
2017 Credit Facility
Line Of Credit Facility [Line Items]
Revolver outstanding loans					$ 300.9
Deferred financing costs	$ 12.9		$ 12.9	12.9
Yield maintenance premium period	1 year
Debt instrument, covenant compliance description					As of June 30, 2018, 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		$ 210	210
Revolving line of credit maturity date			Jun. 30, 2023
Revolver outstanding loans					$ 268.9
Deferred financing costs	$ 7.6		$ 7.6	$ 7.6
Interest rate	1.00%		1.00%	1.00%
Prepayment percentage of outstanding loan	75.00%
Percentage of net cash proceeds of certain asset sales or other dispositions of property	100.00%
Percentage of net cash proceeds of incurrence of certain debt and issuance of disqualified stock	100.00%
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			$ 1.7
2017 Credit Facility | 2017 Term Loan | September 30, 2019 through March 31, 2023
Line Of Credit Facility [Line Items]
Monthly principal payments			3.4
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		$ 25	$ 25
2017 Credit Facility | Incremental Term Loan | AdCare, Inc
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity						$ 65
Deferred financing costs						$ 2.6
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		$ 7	7
2017 Credit Facility | 2017 Revolver
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity	40		40	40
Credit facility borrowing capacity	55		$ 55	55	23
Revolving line of credit maturity date			Jun. 30, 2022
Revolver outstanding loans					32
Deferred financing costs	5.3		$ 5.3	5.3
Quarterly commitment fee on undrawn amounts, percentage			0.50%
Letters of credit outstanding					$ 5
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
Credit facility borrowing capacity							$ 55
Additional maximum borrowing amount under satisfaction of certain conditions	$ 15		$ 15	15
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]
Debt instrument, term		5 years
2015 Credit Facility | Term Loan
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity		$ 75
2015 Credit Facility | 2017 Revolver
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity		$ 50
Deerfield Facility
Line Of Credit Facility [Line Items]
Payment of consent fee				3
Write off of deferred financing cost				$ 2.3
Deerfield Facility | Subordinated Convertible Debt
Line Of Credit Facility [Line Items]
Debt instrument, face amount								$ 25
Deerfield Facility | Unsecured Subordinated Debt
Line Of Credit Facility [Line Items]
Debt instrument, face amount								$ 25

Debt - Schedule of Senior Secur

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

Debt - Subordinated Note - Addi

Debt - Subordinated Note - Additional Information (Details) - AdCare, Inc - AdCare Note $ in Millions	Mar. 01, 2018USD ($)
Line Of Credit Facility [Line Items]
Date of acquisition	Mar. 1, 2018
Debt instrument, face amount	$ 9.6
Maturity Date	Sep. 29, 2023
Interest rate	5.00%

Debt - Interest Rate Swap Agree

Debt - Interest Rate Swap Agreements - Additional Information (Details)	Jun. 28, 2017USD ($)	Jul. 31, 2014Agreement	Jun. 30, 2018	Dec. 31, 2017USD ($)
Line Of Credit Facility [Line Items]
Number of interest rate swap agreement | Agreement		2
Interest rate swaps, remaining liability				$ 0
Interest rate swap agreements termination date			Jun. 29, 2017
Agreement Two
Line Of Credit Facility [Line Items]
Interest rate swap agreement initial notional amount	$ 7,200,000
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	$ 10,500,000
Interest rate swap agreement percentage	4.73%
Maturity Date			Aug. 31, 2019

Financing Lease Obligation - Ad

Financing Lease Obligation - Additional Information (Details) $ in Thousands	Aug. 09, 2017USD ($)FacilityRenewal	Jun. 30, 2018USD ($)	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, operating lease term	15-year
Sale-leaseback transaction, number of separate renewals | Renewal	2
Sale-leaseback transaction, each renewal term	5 years
Sale-leaseback transaction, initial annual minimum rent payable		$ 2,200
Sale-leaseback transaction, equal monthly installments		$ 200
Sale-leaseback transaction, percentage of rent increase annually in years one to three		1.50%
Sale-leaseback financing obligation, proceeds		$ 25,000
Sale-leaseback financing obligation, transaction costs		400
Sale-leaseback financing obligation, short term liability		$ 101	$ 80
MedEquities Realty Trust, Inc. | Minimum
Sale Leaseback Transaction [Line Items]
Sale-leaseback transaction, percentage of rent increase annually in years four and thereafter		1.50%
MedEquities Realty Trust, Inc. | Maximum
Sale Leaseback Transaction [Line Items]
Sale-leaseback transaction, percentage of rent increase annually in years four and thereafter		3.00%

Financing Lease Obligation - Su

Financing Lease Obligation - Summary of Financing Lease Obligation (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Sale Leaseback Transaction [Line Items]
Total Financing lease obligation, net of current portion	$ 24,488	$ 24,541
MedEquities Realty Trust, Inc.
Sale Leaseback Transaction [Line Items]
Financing lease obligation: Sale-Leaseback facilities	24,589	24,621
Less current portion (included in accrued and other current liabilities)	(101)	(80)
Total Financing lease obligation, net of current portion	$ 24,488	$ 24,541

Stockholders' Equity and Stoc59

Stockholders' Equity and Stock Based Compensation - Additional Information (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Jun. 22, 2018
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted			186,000
Fully vested common stock granted			81,314
Compensation expense	$ 1,400,000	$ 2,100,000	$ 2,200,000	$ 4,200,000
Maximum aggregate initial offering price of offered securities					$ 150,000,000
Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Compensation expense			$ 100,000	$ 100,000
Employee stock purchase plan, shares issued			27,900	50,362
Restricted Common Stock | Non Employee Directors
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Fully vested common stock granted			36,000	38,000
Compensation expense			$ 400,000	$ 300,000
2014 Equity Incentive Plan | Restricted Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted			150,000	408,000
Share-based compensation, award vesting period			3 years	3 years
Unrecognized compensation expenses	$ 3,800,000		$ 3,800,000
Weighted average life of remaining vesting period			1 year 8 months 12 days

Stockholders' Equity and Stoc60

Stockholders' Equity and Stock Based Compensation - Summary of Share Activity Under 2014 Equity Incentive Plan (Details)	6 Months Ended
	Jun. 30, 2018$ / sharesshares
Nonvested, Number of Shares [Roll Forward]
Beginning Balance, Shares | shares	348,855
Granted, Shares | shares	186,000
Vested, Shares | shares	(81,314)
Forfeitures, Shares | shares	(44,105)
Ending Balance, Shares | shares	409,436
Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Beginning Balance, Weighted-Average Grant Date Fair Value | $ / shares	$ 13.69
Granted, Weighted-Average Grant Date Fair Value | $ / shares	11.68
Vested, Weighted-Average Grant Date Fair Value | $ / shares	17.31
Forfeitures, Weighted-Average Grant Date Fair Value | $ / shares	16.14
Ending Balance, Weighted-Average Grant Date Fair Value | $ / shares	$ 11.79

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Income Tax Disclosure [Abstract]
Effective tax rates on provision for income taxes	1.70%	24.10%	18.20%	0.10%
Income tax expense (benefit)	$ (84,000)	$ 562,000	$ (1,578,000)	$ (3,000)

Income Taxes - Schedule of Effe

Income Taxes - Schedule of Effective Income Tax Rate (Details)	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Income Tax Disclosure [Abstract]
Federal statutory rate	21.00%	35.00%
State income taxes, net of federal tax benefit	(1.90%)	(7.60%)
Non-deductible expenses	(1.50%)	(6.60%)
Stock compensation adjustment	(2.50%)	(22.30%)
Other differences	3.10%	1.60%
Effective income tax rate on income before taxes	18.20%	0.10%

Fair Value of Financial Instr63

Fair Value of Financial Instruments - Additional Information (Details)	6 Months Ended
	Jun. 30, 2018
Fair Value Disclosures [Abstract]
Interest rate swap agreements termination date	Jun. 29, 2017

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($)	Feb. 15, 2018	Feb. 14, 2018	Jun. 30, 2018	Mar. 31, 2018	Jun. 30, 2018	Dec. 31, 2017
Loss Contingencies [Line Items]
Settlement amount	$ 25,000,000	$ 1,000,000
Litigation settlement description					The Stipulation of Settlement provides that the Settlement Fund was to 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).
Number of shares will be sold in future for settlement fund	300,000
Accrued litigation costs			$ 1,000,000		$ 1,000,000	$ 23,300,000
Litigation settlement expense			$ 244,000		$ 3,035,000
Tennessee Claim [Member]
Loss Contingencies [Line Items]
Accrued litigation costs				$ 25,000,000		22,300,000
Litigation settlement expense				$ 2,700,000
Nevada Claim [Member]
Loss Contingencies [Line Items]
Accrued litigation costs						$ 1,000,000