AAC (AACH) 10-K 15 Apr 19 2018 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2018	Mar. 22, 2019	Jun. 29, 2018
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	FY
Trading Symbol	AAC
Entity Registrant Name	AAC Holdings, Inc.
Entity Central Index Key	0001606180
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	No
Entity Voluntary Filers	No
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	true
Entity Ex Transition Period	true
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		24,680,710
Entity Public Float			$ 69,400,000

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended										6 Months Ended		9 Months Ended		12 Months Ended
	Dec. 31, 2018		Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017		Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenues
Total revenues	$ 57,448	[1]	$ 69,034	$ 88,094	$ 81,187	$ 86,136		$ 80,424	$ 78,042	$ 73,039					$ 295,763	$ 317,641	$ 279,770
Operating expenses
Salaries, wages and benefits			44,831	46,850	40,084			36,709	34,508	36,772					174,772	146,390	141,073
Client related services			8,594	8,393	7,747			6,598	6,646	6,378					32,747	27,031	24,446
Provision for doubtful accounts				366				7,406	6,261	4,403	$ 366	$ 10,664	$ 366	$ 18,070	366	25,932	38,549
Advertising and marketing			3,037	2,584	2,599			3,074	3,266	3,775					13,744	12,315	18,275
Professional fees			5,697	4,950	3,650			3,641	3,039	2,642					19,894	12,638	16,468
Other operating expenses			12,833	12,194	10,588			8,306	8,199	8,789					47,716	36,309	29,627
Rentals and leases			2,760	2,563	2,116			2,105	1,849	1,885					10,367	7,514	7,363
Litigation settlement			100	244	2,791										11,136	23,607	1,292
Depreciation and amortization			5,573	5,909	5,464			5,218	5,058	5,469	11,373	10,527	16,946	15,745	21,986	21,504	17,686
Acquisition-related expenses			111	176	305			370	42	183					573	1,162	2,691
Total operating expenses			83,536	84,229	75,344			73,427	68,868	70,296					333,301	314,402	297,470
(Loss) income from operations			(14,502)	3,865	5,843			6,997	9,174	2,743					(37,538)	3,239	(17,700)
Interest expense, net (including change in fair value of interest rate swaps of $0, ($108), and ($180), respectively)			8,738	7,893	6,709			5,492	2,846	2,734					32,220	16,811	8,175
Loss on extinguishment of debt									5,435			5,435		5,435		5,435
Gain on contingent consideration			947	(176)							(176)		771		(501)		(1,350)
Other (income) expense, net			732	(98)	9			49	6	34					465	116	(500)
Loss before income tax expense			(24,919)	(3,754)	(875)			1,456	899	(25)					(69,722)	(19,123)	(24,025)
Income tax (benefit) expense			(1,075)	(162)	(38)			741	741	741					(3,004)	(1,742)	2,345
Net loss	$ (38,445)	[1],[2]	(23,844)	(3,592)	(837)	$ (17,488)	[3]	715	158	(766)	$ (4,429)	$ (608)	$ (28,273)	$ 107	(66,718)	(17,381)	(26,370)
Less: net loss attributable to noncontrolling interest			1,663	1,990	1,893			1,126	982	1,041					7,314	4,508	5,152
Net loss attributable to AAC Holdings, Inc. common stockholders			$ (22,181)	$ (1,602)	$ 1,056			$ 1,841	$ 1,140	$ 275					$ (59,404)	$ (12,873)	$ (21,218)
Basic loss per common share	$ (1.52)		$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)		$ 0.08	$ 0.05	$ 0.01					$ (2.47)	$ (0.55)	$ (0.93)
Diluted loss per common share	$ (1.52)		$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)		$ 0.08	$ 0.05	$ 0.01					$ (2.47)	$ (0.55)	$ (0.93)
Weighted-average common shares outstanding:
Basic			24,205,159	24,166,976	23,744,208			23,331,414	23,242,177	23,163,626					24,090,639	23,277,444	22,718,117
Diluted			24,205,159	24,166,976	23,781,604			23,469,985	23,254,162	23,174,899					24,090,639	23,277,444	22,718,117
Client Related Revenue
Revenues
Total revenues			$ 66,107	$ 84,620	$ 78,630			$ 77,948	$ 75,692	$ 71,219					$ 284,525	$ 308,538	$ 270,569
Non-Client Related Revenue
Revenues
Total revenues			$ 2,927	$ 3,474	$ 2,557			$ 2,476	$ 2,350	$ 1,820					$ 11,238	$ 9,103	$ 9,201
[1]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.
[2]	Refer to Note 15 – Commitments and Contingencies to the Notes to the Consolidated Financial Statements.
[3]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters.

CONSOLIDATED STATEMENTS OF OP_2

CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - USD ($) $ in Thousands	3 Months Ended						12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Swap
Change in fair value of interest rate swaps	$ 0	$ 0	$ 0	$ 0	$ (25)	$ (83)	$ 0	$ (108)	$ (180)

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current assets
Cash and cash equivalents	$ 5,409	$ 5,259	$ 11,353	$ 14,341	$ 13,818	$ 16,412	$ 10,793	$ 5,880	$ 3,964	$ 18,750
Accounts receivable, net of allowances	47,860	59,839	71,057	71,944	63,746	58,909	60,613	54,995
Prepaid expenses and other current assets	10,695	5,547	4,638	3,354	4,022	6,030	4,456	4,897
Total current assets	63,964	70,645	87,048	89,639	81,586	81,351	75,862	65,772
Property and equipment, net	166,921	166,345	168,373	169,744	152,548	151,769	148,965	145,410
Goodwill	198,952	198,952	197,184	197,184	134,396	134,396	134,396	134,396	134,396
Intangible assets, net	12,063	12,561	13,201	13,712	8,829	9,169	9,551	9,953	10,356
Deferred tax assets, net		2,924	1,849	1,687	1,650
Other assets	10,377	10,679	11,069	12,468	12,556	5,664	783	626
Total assets	452,277	462,106	478,724	484,434	391,565	382,349	369,557	356,157
Current liabilities
Accounts payable	13,507	8,722	6,613	3,338	4,579	5,732	10,441	13,711
Accrued and other current liabilities	30,544	31,607	30,487	34,039	27,661	24,633	24,800	24,865
Accrued litigation	8,000			1,000	23,607
Current portion of long-term debt	309,394	8,350	6,723	7,319	4,722	4,736	4,503	10,965
Total current liabilities	361,445	48,679	43,823	45,696	60,569	35,101	39,744	49,541
Deferred tax liabilities	1,227					4,709	3,968	3,227
Long-term debt, net of current portion and debt issuance costs	9,764	297,143	295,322	296,443	196,451	197,872	208,467	187,456
Financing lease obligation, net of current portion	24,421	24,459	24,488	24,515	24,541	24,398
Other long-term liabilities	13,147	11,993	12,322	12,277	10,546	3,836	3,782	4,121
Total liabilities	410,004	382,274	375,955	378,931	292,107	265,916	255,961	244,345
Stockholders’ equity
Common stock, $0.001 par value: 70,000,000 shares authorized, 24,573,679 and 23,872,436 shares issued and outstanding at December 31, 2018 and 2017, respectively	25	25	25	24	24	24	24	24
Additional paid-in capital	161,962	161,209	160,156	158,840	152,430	152,440	150,375	148,323
Retained deficit	(97,574)	(61,030)	(38,703)	(36,642)	(38,170)	(22,564)	(24,462)	(25,176)
Total stockholders’ equity	64,413	100,204	121,478	122,222	114,284	129,900	125,937	123,171
Noncontrolling interest	(22,140)	(20,372)	(18,709)	(16,719)	(14,826)	(13,467)	(12,341)	(11,359)
Total stockholders’ equity including noncontrolling interest	42,273	79,832	102,769	105,503	99,458	116,433	113,596	111,812	$ 110,372	$ 112,701
Total liabilities and stockholders’ equity	$ 452,277	$ 462,106	$ 478,724	$ 484,434	$ 391,565	$ 382,349	$ 369,557	$ 356,157

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 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	24,573,679	23,872,436
Common stock, shares outstanding	24,573,679	23,872,436

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands		Total	Previously Reported	Townsend Acquisition	Solutions Acquisition	Common Stock	Common StockPreviously Reported	Common StockMarketing Intangibles	Common StockTownsend Acquisition	Common StockSolutions Acquisition	Additional Paid-in Capital	Additional Paid-in CapitalPreviously Reported	Additional Paid-in CapitalTownsend Acquisition	Additional Paid-in CapitalSolutions Acquisition	Retained (Deficit) Earnings	Retained (Deficit) EarningsPreviously Reported	Total Stockholders' Equity of AAC Holdings, Inc.	Total Stockholders' Equity of AAC Holdings, Inc.Previously Reported	Total Stockholders' Equity of AAC Holdings, Inc.Townsend Acquisition	Total Stockholders' Equity of AAC Holdings, Inc.Solutions Acquisition	Non-Controlling Interests	Non-Controlling InterestsPreviously Reported
Cumulative effect of restatement on prior years (see Note 2A)		$ (23,787)													$ (23,787)		$ (23,787)
Balance at Dec. 31, 2015		112,701	$ 136,488			$ 23	$ 23				$ 121,923	$ 121,923			(4,079)	$ 19,708	117,867	$ 141,654			$ (5,166)	$ (5,166)
Balance, shares at Dec. 31, 2015						22,813,809	22,813,809
Common stock granted and issued under stock incentive plan, net of forfeitures, amount		8,823									8,823						8,823
Common stock granted and issued under stock incentive plan, net of forfeitures, share						106,663
Common stock withheld for minimum statutory taxes		(895)									(895)						(895)
Common stock withheld for minimum statutory taxes, shares						(65,089)
Effect of employee stock purchase plan		682									682						682
Effect of employee stock purchase plan, shares						44,174
Acquisition of certain assets				$ 9,113	$ 6,318			$ 17,110	$ 1				$ 9,112	$ 6,318					$ 9,113	$ 6,318
Acquisition of certain assets, shares									447,369	309,871
Net loss, restated		(26,370)	(5,741)												(21,218)		(21,218)				(5,152)
Balance at Dec. 31, 2016		110,372				$ 24					145,963				(25,297)		120,690				(10,318)
Balance, shares at Dec. 31, 2016						23,673,907
Net loss, restated		(766)	(1,644)
Balance at Mar. 31, 2017		111,812	155,504
Balance at Dec. 31, 2016		110,372				$ 24					145,963				(25,297)		120,690				(10,318)
Balance, shares at Dec. 31, 2016						23,673,907
Net loss, restated		(608)	(4,542)
Balance at Jun. 30, 2017		113,596	154,658
Balance at Dec. 31, 2016		110,372				$ 24					145,963				(25,297)		120,690				(10,318)
Balance, shares at Dec. 31, 2016						23,673,907
Net loss, restated		107	(4,906)
Balance at Sep. 30, 2017		116,433	156,359
Balance at Dec. 31, 2016		110,372				$ 24					145,963				(25,297)		120,690				(10,318)
Balance, shares at Dec. 31, 2016						23,673,907
Common stock granted and issued under stock incentive plan, net of forfeitures, amount		7,513									7,513						7,513
Common stock granted and issued under stock incentive plan, net of forfeitures, share						229,958
Common stock withheld for minimum statutory taxes		(660)									(660)						(660)
Common stock withheld for minimum statutory taxes, shares						(76,385)
Effect of employee stock purchase plan		614									614						614
Effect of employee stock purchase plan, shares						97,589
Common stock recouped from escrow for contingent consideration on acquisition		(1,000)									(1,000)						(1,000)
Common stock recouped from escrow for contingent consideration on acquisition, shares						(52,633)
Net loss, restated		(17,381)	(25,087)												(12,873)		(12,873)				(4,508)
Balance at Dec. 31, 2017		99,458	136,168			$ 24					152,430				(38,170)		114,284				(14,826)
Balance, shares at Dec. 31, 2017						23,872,436
Balance at Mar. 31, 2017		111,812	155,504
Net loss, restated		158	(2,898)
Balance at Jun. 30, 2017		113,596	154,658
Net loss, restated		715	(364)
Balance at Sep. 30, 2017		116,433	156,359
Balance at Jun. 30, 2017		113,596	154,658
Balance at Dec. 31, 2017		99,458	136,168			$ 24					152,430				(38,170)		114,284				(14,826)
Balance, shares at Dec. 31, 2017						23,872,436
Balance at Sep. 30, 2017		116,433	156,359
Net loss, restated	[1]	(17,488)
Balance at Dec. 31, 2017		99,458	136,168			$ 24					152,430				(38,170)		114,284				(14,826)
Balance, shares at Dec. 31, 2017						23,872,436
Net loss, restated		(837)	(2,095)
Balance at Mar. 31, 2018		105,503	140,483
Balance at Dec. 31, 2017		99,458	136,168			$ 24					152,430				(38,170)		114,284				(14,826)
Balance, shares at Dec. 31, 2017						23,872,436
Net loss, restated		(4,429)	(7,098)
Balance at Jun. 30, 2018		102,769	136,797
Balance at Dec. 31, 2017		99,458	136,168			$ 24					152,430				(38,170)		114,284				(14,826)
Balance, shares at Dec. 31, 2017						23,872,436
Net loss, restated		(28,273)	(20,254)
Balance at Sep. 30, 2018		79,832	124,694
Balance at Dec. 31, 2017		99,458	136,168			$ 24					152,430				(38,170)		114,284				(14,826)
Balance, shares at Dec. 31, 2017						23,872,436
Common stock granted and issued under stock incentive plan, net of forfeitures, amount		3,877									3,877						3,877
Common stock granted and issued under stock incentive plan, net of forfeitures, share						119,785
Common stock withheld for minimum statutory taxes		(166)									(166)						(166)
Common stock withheld for minimum statutory taxes, shares						(28,989)
Effect of employee stock purchase plan		383									383						383
Effect of employee stock purchase plan, shares						48,396
Acquisition of certain assets		5,439				$ 1					5,438						5,439
Acquisition of certain assets, shares						562,051
Net loss, restated		(66,718)													(59,404)		(59,404)				(7,314)
Balance at Dec. 31, 2018		42,273				$ 25					161,962				(97,574)		64,413				(22,140)
Balance, shares at Dec. 31, 2018						24,573,679
Balance at Mar. 31, 2018		105,503	140,483
Net loss, restated		(3,592)	(5,003)
Balance at Jun. 30, 2018		102,769	136,797
Net loss, restated		(23,844)	(13,156)
Balance at Sep. 30, 2018		79,832	124,694
Balance at Jun. 30, 2018		102,769	136,797
Balance at Dec. 31, 2018		42,273				$ 25					161,962				(97,574)		64,413				(22,140)
Balance, shares at Dec. 31, 2018						24,573,679
Balance at Sep. 30, 2018		79,832	$ 124,694
Net loss, restated	[2],[3]	(38,445)
Balance at Dec. 31, 2018		$ 42,273				$ 25					$ 161,962				$ (97,574)		$ 64,413				$ (22,140)
Balance, shares at Dec. 31, 2018						24,573,679
[1]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters.
[2]	Refer to Note 15 – Commitments and Contingencies to the Notes to the Consolidated Financial Statements.
[3]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net loss	$ (66,718)	$ (17,381)	$ (26,370)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts	366	25,932	38,549
Depreciation and amortization	21,986	21,504	17,686
Equity compensation	3,877	7,513	8,823
Loss on disposal of property and equipment	1,007	55	163
Loss on extinguishment of debt		5,435
Gain on contingent consideration	(501)		(1,350)
Amortization of debt issuance costs	2,797	1,564	633
Deferred income taxes	2,878	(4,136)	1,772
Changes in operating assets and liabilities:
Accounts receivable	19,876	(43,676)	(45,838)
Prepaid expenses and other assets	(5,578)	(6,725)	2,510
Accounts payable	5,737	(4,576)	824
Accrued and other current liabilities	1,780	4,685	2,973
Accrued litigation	(15,607)	22,645	162
Other long-term liabilities	(754)	6,453	(394)
Net cash (used in) provided by operating activities	(28,854)	19,292	143
Cash flows from investing activities:
Purchase of property and equipment	(18,949)	(33,041)	(37,304)
Acquisition of subsidiaries	(65,827)		(18,825)
Change in funds held on acquisition		(1,000)	(325)
Net cash used in investing activities	(84,776)	(34,041)	(56,454)
Cash flows from financing activities:
Payments on 2015 Credit Facility and Deerfield Facility		(211,094)	(5,376)
Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs		18,000	48,930
Proceeds from financing lease obligation, net of deferred financing costs		24,621
Payments on capital leases and other	(798)	(791)	(834)
Repayment of long-term debt — related party			(1,195)
Change in funds held on acquisition		1,000
Payment of employee taxes for net share settlement	(621)	(1,080)
Net cash provided by financing activities	105,221	24,603	41,525
Net change in cash and cash equivalents	(8,409)	9,854	(14,786)
Cash and cash equivalents, beginning of period	13,818	3,964	18,750
Cash and cash equivalents, end of period	5,409	13,818	3,964
Cash and cash equivalents paid for:
Interest, net of capitalized interest	31,894	16,088	4,933
Income taxes, net of refunds	968	367	2,626
Supplemental information on non-cash investing and financing transactions:
Acquisition of equipment through capital lease	975	82	1,807
Accrued purchase of property and equipment	1,208	800	2,650
Accrued employee taxes for net share settlement	14	475	895
2017 Credit Facility
Cash flows from financing activities:
Payments on 2017 Credit Facility	(6,896)	(17,126)
Proceeds from 2017 Credit Facility, net of deferred financing costs	114,286	211,073
AdCare, Inc
Cash flows from financing activities:
Payments on AdCare Note	(750)
2018 Acquisition
Supplemental information on non-cash investing and financing transactions:
Purchase price, including contingent consideration	85,103
Buyer common stock issued	(5,439)
Contingent consideration	(501)
Promissory note issued	(9,636)
Cash acquired	(2,700)
Change in funds held on acquisition	(1,000)
Cash paid for acquisition	$ 65,827
2016 Acquisitions
Supplemental information on non-cash investing and financing transactions:
Purchase price, including contingent consideration		(2,000)	33,930
Buyer common stock received (issued)		1,000	(15,105)
Cash (received) paid for acquisition		$ (1,000)	$ 18,825

Description of Business

Description of Business	12 Months Ended
	Dec. 31, 2018
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Description of Business	1. Description of Business AAC Holdings, Inc. (collectively with its subsidiaries, the “Company”), was incorporated on February 12, 2014. The Company is headquartered in Brentwood, Tennessee and provides inpatient and outpatient substance use treatment services for individuals with drug and alcohol addiction. In addition to the Company’s inpatient and outpatient substance use treatment services, the Company performs drug testing, diagnostic laboratory services, and provides physician services to clients. The Company operates numerous facilities located throughout the United States, including inpatient substance abuse treatment standalone outpatient centers and sober living facilities that focused on delivering effective clinical care and treatment solutions.

Basis of Presentation

Basis of Presentation	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Basis of Presentation	2. Basis of Presentation Principles of Consolidation The Company conducts its business through limited liability companies and C-corporations, each of which is a direct or indirect wholly owned subsidiary of the Company. The accompanying consolidated financial statements include the accounts of the Company, its wholly owned subsidiaries, and the accounts of variable interest entities (“VIEs”) in which the Company is the primary beneficiary, which include certain professional groups through rights granted to the Company by contract to manage and control the business of such professional groups. All intercompany transactions and balances have been eliminated in consolidation. The Company consolidated seven professional groups (“Professional Groups”) that constituted VIEs as of December 31, 2018 and 2017. The Professional Groups are responsible for the supervision and delivery of medical services to the Company’s clients. The Company provides management services to the Professional Groups. Based on the Company’s ability to direct the activities that most significantly impact the economic performance of the Professional Groups, provide necessary funding to the Professional Groups and the obligation and likelihood of absorbing all expected gains and losses of the Professional Groups, the Company has determined that it is the primary beneficiary of these Professional Groups. The accompanying consolidated balance sheets include assets of $1.5 million and $2.1 million as of December 31, 2018 and 2017, respectively, and liabilities of $0.6 million and $0.4 million, respectively, related to the VIEs. The accompanying consolidated income statements include net loss attributable to noncontrolling interest of $7.3 million, $4.5 million and $5.2 million related to the VIEs for the years ended December 31, 2018, 2017 and 2016, respectively. The accompanying consolidated financial statements have been prepared in accordance with GAAP. The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates. Change in Accounting Estimate During the three months ended September 30, 2018 and effective as of July 1, 2018, the Company made a change in its accounting estimate of the collectability of accounts receivable, specifically relating to accounts where the Company has received a partial payment from a commercial insurance company and the Company is continuing to pursue additional collections for the balance that the Company estimates remains outstanding (“partial payment accounts receivable”). Based on the limited number of claims that were closed through the Company’s historical appeals process, information with respect to the ultimate resolution of the appeals of these partial payment accounts receivable has been limited. As a result, initial assumptions of the ultimate collectability rates for partial payment accounts receivable were primarily based on industry and other data. During 2018, to enhance the Company’s own collection processes, the Company began using a third-party vendor to pursue collections on these partial payment accounts receivable. As of December 31, 2018, the Company is using this vendor exclusively for collection of the partial payment accounts receivable. As a result of utilizing the third-party vendor, the number of partial payment claims closed through the appeals process has increased allowing the Company to rely on its own collection history and additional information obtained from the third party vendor to estimate ultimate collectability. This recent information indicated that the Company’s current assumptions were different from its historical assumptions. The Company used this additional information to further refine its procedures to more precisely estimate the collectability of partial payment accounts receivable. This change in estimate resulted in a reduction in revenue of approximately $6.0 million, an increase in net loss of approximately $5.7 million, or $0.24 loss per basic and diluted share for year ended December 31, 2018. The Company determined this change in assumptions and estimation procedures of the collectability of partial payment accounts receivable is a change in accounting estimate in accordance with Accounting Standards Codification (“ASC”) 250-10 “Accounting Changes and Error Corrections.” Going Concern The Company incurred a loss from operations and had negative cash flows from operations for the year ended December 31, 2018, which contributed to limited liquidity at December 31, 2018. This resulted primarily from declines in patient census during the third and fourth quarters of 2018. The Company’s revenue is directly impacted by its ability to maintain census, which is dependent on a variety of factors, many of which are outside of the Company’s control, including its referral relationships, average length of stay of its clients, the extent to which third-party payors require preadmission authorization or utilization review controls, competition in the industry, the effectiveness of the Company’s multi-faceted sales and marketing strategy and the individual decisions of the Company’s clients to seek and commit to treatment. On March 8, 2019 the Company entered into an incremental senior credit facility for a principal loan of $30 million which originally matured on March 31, 2020 and was subsequently amended to mature on April 15, 2020. The uncertainties associated with the factors described above raise substantial doubt about the Company's ability to continue as a going concern. In order for the Company to continue operations beyond the next twelve months and to be able to discharge its liabilities and commitments in the normal course of business, the Company must do some or all of the following: (i) improve operating results by increasing census while maintaining efficiency regarding operating expenses through the cost savings initiatives implemented in late 2018 and early 2019; (ii) execute strategic alternatives related to the Company’s real-estate portfolio which could include further sale leasebacks of individual facilities or larger portions of the company’s real estate portfolio (iii) sell additional non-core or non-essential assets; and/or (iv) obtain additional financing. There can be no assurance that the Company will be able to achieve any or all of the foregoing. The consolidated financial statements were prepared on a going concern basis in accordance with U.S. GAAP. The going concern basis of presentation assumes that the Company will continue in operation for the next twelve months and will be able to realize its assets and discharge its liabilities and commitments in the normal course of business. It does not include any adjustments to reflect the possible future effects on the recoverability and classification of assets or the amounts and classification of liabilities that may result from its inability to continue as a going concern. 2A. Restatement of Previously Issued Financial Statements . The cumulative effect of this error on the Company’s consolidated retained earnings at January 1, 2016 has been reflected as a reduction to retained earnings of approximately $23.8 million The impact of the correction of an error on the affected line items of the Company’s consolidated balance sheets as of December 31, 2016 and 2017 and consolidated statements of operations and cash flows for the years ended December 31, 2016 and 2017 is set forth below: AAC Holdings, Inc. Consolidated Statement of Operations (Dollars in thousands, except share data) Year Ended, December 31, 2017 Year Ended, December 31, 2016 As Previously Reported Adjustments Restated As Previously Reported Adjustments Restated Revenues Client related revenue $ 308,538 $ - $ 308,538 $ 270,569 $ - $ 270,569 Non-client related revenue 9,103 - 9,103 9,201 - 9,201 Total revenues 317,641 - 317,641 279,770 - 279,770 Operating expenses Salaries, wages and benefits 146,390 - 146,390 141,073 - 141,073 Client related services 27,031 - 27,031 24,446 - 24,446 Provision for doubtful accounts 36,914 (10,982 ) 25,932 21,485 17,064 38,549 Advertising and marketing 12,315 - 12,315 18,275 - 18,275 Professional fees 12,638 - 12,638 16,468 - 16,468 Other operating expenses 36,309 - 36,309 29,627 - 29,627 Rentals and leases 7,514 - 7,514 7,363 - 7,363 Litigation settlement 23,607 - 23,607 1,292 - 1,292 Depreciation and amortization 21,504 - 21,504 17,686 - 17,686 Acquisition-related expenses 1,162 - 1,162 2,691 - 2,691 Total operating expenses 325,384 (10,982 ) 314,402 280,406 17,064 297,470 (Loss) income from operations (7,743 ) 10,982 3,239 (636 ) (17,064 ) (17,700 ) Interest expense, net (including change in fair value of interest rate swaps of ($108), and ($180), respectively) 16,811 - 16,811 8,175 - 8,175 Loss on extinguishment of debt 5,435 - 5,435 - - - Gain on contingent consideration - - - (1,350 ) - (1,350 ) Other (income) expense, net 116 - 116 (500 ) - (500 ) Loss before income tax expense (30,105 ) 10,982 (19,123 ) (6,961 ) (17,064 ) (24,025 ) Income tax (benefit) expense (5,018 ) 3,276 (1,742 ) (1,220 ) 3,565 2,345 Net loss (25,087 ) 7,706 (17,381 ) (5,741 ) (20,629 ) (26,370 ) Less: net loss attributable to noncontrolling interest 4,508 - 4,508 5,152 - 5,152 Net loss attributable to AAC Holdings, Inc. common stockholders (20,579 ) 7,706 (12,873 ) (589 ) (20,629 ) (21,218 ) Basic loss per common share $ (0.88 ) $ (0.55 ) $ (0.03 ) $ (0.93 ) Diluted loss per common share $ (0.88 ) $ (0.55 ) $ (0.03 ) $ (0.93 ) Weighted-average common shares outstanding: Basic 23,277,444 23,277,444 22,718,117 22,718,117 Diluted 23,277,444 23,277,444 22,718,117 22,718,117 AAC Holdings, Inc. Consolidated Balance Sheet (Dollars in thousands, except share data) Year Ended, December 31, 2017 As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 13,818 $ - $ 13,818 Accounts receivable, net of allowances 94,096 (30,350 ) 63,746 Prepaid expenses and other current assets 4,022 - 4,022 Total current assets 111,936 (30,350 ) 81,586 Property and equipment, net 152,548 - 152,548 Goodwill 134,396 - 134,396 Intangible assets, net 8,829 - 8,829 Deferred tax assets, net 8,010 (6,360 ) 1,650 Other assets 12,556 - 12,556 Total assets $ 428,275 $ (36,710 ) $ 391,565 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 4,579 $ - $ 4,579 Accrued and other current liabilities 27,661 - 27,661 Accrued litigation 23,607 - 23,607 Current portion of long-term debt 4,722 - 4,722 Total current liabilities 60,569 - 60,569 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 196,451 - 196,451 Financing lease obligation, net of current portion 24,541 - 24,541 Other long-term liabilities 10,546 - 10,546 Total liabilities 292,107 - 292,107 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 23,872,436 shares issued and outstanding at December 31, 2017, respectively 24 - 24 Additional paid-in capital 152,430 - 152,430 Retained deficit (1,460 ) (36,710 ) (38,170 ) Total stockholders’ equity 150,994 (36,710 ) 114,284 Noncontrolling interest (14,826 ) - (14,826 ) Total stockholders’ equity including noncontrolling interest 136,168 (36,710 ) 99,458 Total liabilities and stockholders’ equity $ 428,275 $ (36,710 ) $ 391,565 AAC Holdings, Inc. Consolidated Statements of Cash Flows (Dollars in thousands, except share data) Year Ended, December 31, 2017 Year Ended, December 31, 2016 As Previously Reported Adjustments Restated As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (25,087 ) $ 7,706 $ (17,381 ) $ (5,741 ) $ (20,629 ) $ (26,370 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 36,914 (10,982 ) 25,932 21,485 17,064 38,549 Depreciation and amortization 21,504 - 21,504 17,686 - 17,686 Equity compensation 7,513 - 7,513 8,823 - 8,823 Loss on disposal of property and equipment 55 - 55 163 - 163 Loss on extinguishment of debt 5,435 - 5,435 - - - Gain on contingent consideration - - - (1,350 ) - (1,350 ) Amortization of debt issuance costs 1,564 - 1,564 633 - 633 Deferred income taxes (7,412 ) 3,276 (4,136 ) (1,793 ) 3,565 1,772 Changes in operating assets and liabilities: Accounts receivable (43,676 ) - (43,676 ) (45,838 ) - (45,838 ) Prepaid expenses and other assets (6,725 ) - (6,725 ) 2,510 - 2,510 Accounts payable (4,576 ) - (4,576 ) 824 - 824 Accrued and other current liabilities 4,685 - 4,685 2,973 - 2,973 Accrued litigation 22,645 - 22,645 162 - 162 Other long-term liabilities 6,453 - 6,453 (394 ) - (394 ) Net cash provided by operating activities 19,292 - 19,292 143 - 143 Cash flows from investing activities: Purchase of property and equipment (33,041 ) - (33,041 ) (37,304 ) - (37,304 ) Acquisition of subsidiaries - - - (18,825 ) - (18,825 ) Change in funds held on acquisition (1,000 ) - (1,000 ) (325 ) - (325 ) Net cash used in investing activities (34,041 ) - (34,041 ) (56,454 ) - (56,454 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility (211,094 ) - (211,094 ) (5,376 ) - (5,376 ) Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs 18,000 - 18,000 48,930 - 48,930 Payments on 2017 Credit Facility (17,126 ) - (17,126 ) - - - Proceeds from 2017 Credit Facility, net of deferred financing costs 211,073 - 211,073 - - - Proceeds from financing lease obligation, net of deferred financing costs 24,621 - 24,621 - - - Payments on capital leases and other (791 ) - (791 ) (834 ) - (834 ) Payments on AdCare Note - - - - - - Repayment of long-term debt — related party - - - (1,195 ) - (1,195 ) Change in funds held on acquisition 1,000 - 1,000 - - - Payment of employee taxes for net share settlement (1,080 ) - (1,080 ) - - - Net cash provided by financing activities 24,603 - 24,603 41,525 - 41,525 Net change in cash and cash equivalents 9,854 - 9,854 (14,786 ) - (14,786 ) Cash and cash equivalents, beginning of period 3,964 - 3,964 18,750 - 18,750 Cash and cash equivalents, end of period $ 13,818 $ - $ 13,818 $ 3,964 $ - $ 3,964

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	3. Summary of Significant Accounting Policies Use of Estimates The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue and expenses at the date and for the periods that the consolidated financial statements are prepared. On an ongoing basis, the Company evaluates its estimates, including those related to insurance adjustments, provisions for doubtful accounts, goodwill and intangible assets, long-lived assets, deferred revenue and income taxes. The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances. Actual results could materially differ from those estimates. General and Administrative Costs The majority of the Company’s expenses are “cost of revenue” items. Costs that could be classified as general and administrative expenses include the Company’s corporate overhead costs, which were $81.6 million, $96.1 million, and $74.8 million for the years ended December 31, 2018, 2017 and 2016, respectively. Client Related Revenue The Company provides services to its clients in both inpatient and outpatient treatment settings. Client related revenues are recognized when services are performed at estimated net realizable value from clients, third-party payors and others for services provided. The Company receives the majority of payments from commercial payors at out-of-network rates. Client related revenues are recorded at established billing rates less adjustments to estimate net realizable value. Adjustments are recorded to state client service revenue at the amount expected to be collected for the service provided based on historic adjustments for out-of-network services not under contract. Prior to admission, each client’s insurance is verified, and the client self-pay amount is determined. The client self-pay portion is generally collected upon admission. In some instances, clients will pay out-of-pocket as services are provided or will make a deposit and negotiate the remaining payments. These out-of-pocket payments are included in accrued liabilities in the accompanying consolidated balance sheets, and revenue related to these payments is deferred and recognized over the period services are provided. Scholarships may be provided to a limited number of clients. The Company does not recognize revenue for care provided via scholarships. For the year ended December 31, 2018, no payor accounted for more than 10% of the Company’s revenue for the year ended December 31, 2018. For the year ended December 31, 2017, approximately 11.4% of the Company’s revenue was derived from Blue-Cross Blue Shield of Nevada, 10.9% came from Blue-Cross Blue-Shield of Texas and 10.3% came from Blue-Cross Blue-Shield of Florida. No other payor accounted for more than 10% of the Company’s revenue for the year ended December 31, 2017. For the year ended December 31, 2016, approximately 10.5% of the Company’s revenue was derived from Anthem Blue-Cross Blue-Shield of Florida, 10.4% by Blue-Cross Blue-Shield of Texas and 10.4% by Aetna. No other payor accounted for more than 10% of revenue for the year ended December 31, 2016. The following tables summarize the composition of the Company’s 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 year ended December 31, 2018 and 2017, client related revenue was (in thousands): Year Ended December 31, 2018 As Reported Year Ended December 31, 2017 Restated Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 235,513 82.8 $ 246,976 80.0 $ (11,463 ) (4.6 ) Outpatient facility and sober living services 34,405 12.1 29,080 9.4 5,325 18.3 Client related diagnostic services 14,607 5.1 32,482 10.6 (17,875 ) (55.0 ) Total client related revenue $ 284,525 100.0 $ 308,538 100.0 $ (24,013 ) (7.8 ) For the year ended December 31, 2018 and 2017, client related revenue on a comparable basis was (in thousands): Previous Accounting Guidance As Reported Year Ended December 31, 2018 Year Ended December 31, 2017 Restated Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 247,273 80.3 $ 246,976 80.0 $ 297 0.1 Outpatient facility and sober living services 35,947 11.7 29,080 9.4 6,867 23.6 Client related diagnostic services 24,561 8.0 32,482 10.6 (7,921 ) (24.4 ) Total client related revenue $ 307,781 100.0 $ 308,538 100.0 $ (757 ) (0.2 ) Non-Client Related Revenue Our non-client related revenue primarily consists of service charges for diagnostic laboratory services provided to clients of third-party addiction treatment providers, addiction care treatment Non-client revenue is recognized at the point in time that the Company satisfies its performance obligations in each service area. Allowance for Contractual and Other Discounts The Company derives the majority of its revenue from non-governmental commercial payors at out-of-network rates. Management estimates the allowance for contractual and other discounts based on its historical collection experience. The services authorized and provided, and the related reimbursements are often subject to interpretation and negotiation that could result in payments that differ from the Company’s estimates. Accounts Receivable and Allowance for Doubtful Accounts Accounts receivable primarily consists of amounts due from third-party payors and is recorded net of contractual discounts. The Company’s ability to collect outstanding receivables is critical to its results of operations and cash flows. Prior to the adoption of Topic 606, accounts receivable is reported net of an allowance for doubtful accounts, which is management’s best estimate of accounts receivable that could become uncollectible in the future. Accordingly, accounts receivable reported in the Company’s consolidated financial statements is recorded at the net amount expected to be received. The Company’s primary collection risks are (i) the risk of overestimating net revenue at the time of billing that may result in the Company receiving less than the recorded receivable, (ii) the risk of non-payment as a result of commercial insurance companies denying claims, (iii) the risk that clients will fail to remit insurance payments to the Company when the commercial insurance company pays out-of-network claims directly to the client and (iv) resource and capacity constraints that may prevent the Company from handling the volume of billing and collection issues in a timely manner. The Company’s allowance for doubtful accounts is based on historical experience, but management also takes into consideration the age of accounts, creditworthiness of payors and current economic trends when evaluating the adequacy of the allowance for doubtful accounts. Subsequent to the year ended December 31, 2018 and as part of the preparation of the Company’s year-end financial statements, the Company used recently developed financial database analytical tools, in order to analyze cash collection trends for historical and prospective periods relating to its accounts receivable and allowance for doubtful accounts which resulted in more precise estimates being utilized beginning with the fourth quarter of 2018. See Note 2A, Restatement of Previously Issued Financial Statements Unaudited Quarterly Information (Restated) Approximately $2.2 million and $14.6 million of accounts receivable, net of the allowance for doubtful accounts, at December 31, 2018 and 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 estimated balance. The following table presents a summary of the Company’s aging of accounts receivable, net of the allowance for doubtful accounts as of December 31, 2017. 2018 is not presented as under Topic 606, the Company has no allowance for doubtful accounts as of December 31, 2018. Current 31-180 Days Over 180 Days Total December 31, 2017, restated 31.2 % 44.7 % 24.1 % 100.0 % At December 31, 2018, no payor accounted for more than 10% of accounts receivable. At December 31, 2017, 11.6% of accounts receivable was from Anthem Blue-Cross Blue-Shield of Colorado and 10.3% was from Blue-Cross Blue-Shield of California. No other payor accounted for more than 10% of accounts receivable at December 31, 2017. A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2015, restated $ 41,145 Additions charged to provision for doubtful accounts 38,549 Accounts written off, net of recoveries (10,234 ) Balance at December 31, 2016, restated $ 69,460 Additions charged to provision for doubtful accounts 25,932 Accounts written off, net of recoveries (6,968 ) Balance at December 31, 2017, restated $ 88,424 Balance at January 1, 2018 (1) $ - Additions charged to provision for doubtful accounts 366 Accounts written off, net of recoveries (366 ) Balance at December 31, 2018 $ - (1) As discussed at Note 3 to the Notes of the Consolidated Financial Statements, on January 1, 2018, the Company adopted the new revenue recognition standard (Topic 606). Upon adoption of Topic 606, the allowance for doubtful accounts of approximately $88.4 million was reclassified as a component of accounts receivable. The only activity that is now recorded as a provision for doubtful accounts is related to specific customers that experience significant adverse changes in creditworthiness, such as bankruptcies. Cash and Cash Equivalents The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. Property and Equipment Property and equipment are stated at cost or at acquisition date fair value for assets obtained in business combinations, net of accumulated depreciation. Expenditures for maintenance and repairs are charged to expense as incurred. The Company capitalizes interest paid on debt that is outstanding while construction projects are in progress, and such interest is included in the cost of the related asset. Capitalized interest recognized by the Company for the year ended December 31, 2018 was $0.3 million. Assets held for development are classified as construction in progress, and the Company does not depreciate these assets until they are placed in service. Leasehold improvements are amortized over their estimated useful lives or the remaining lease period, whichever is less. Assets under capital leases are amortized over the lease term or in the event of transfer of ownership at the end of the lease over the economic life of the leased asset. Depreciation is calculated using the straight-line method over the estimated economic useful lives of the assets, as follows: Range of Lives Computer software and equipment 3 years Buildings 36 years Furniture, fixtures and equipment 5 years Vehicles 5 years Equipment under capital lease 3-5 years Leasehold improvements Life of the asset or lease, whichever is less Assets and Liabilities Held for Sale We report long-lived assets to be disposed of by sale as held for sale and recognize those assets in the balance sheet at the lower of carrying amount or fair value less cost to sell, and we cease depreciation and amortization. In November 2018, the Company began actively pursuing the sale of its Townsend operations. On January 28, 2019, the Company finalized the sale for $1.9 million in cash proceeds from the buyer. The assets and liabilities deemed held for sale by the Company at December 31,2018 were as follows: • $0.1 million of property, plant and equipment, net; • $0.8 million of intangible assets, net; • $0.1 million of other long-term assets; • $0.1 million of current liabilities. The fair value of the assets deemed as held for sale were considered a Level 1 estimate. Because the implied fair value of the assets and liabilities was greater than the carrying value as of December 31, 2018, the Company did not recognize a gain or loss related to the assets held for sale for the year ended December 31, 2018. The Company recognized a gain of $0.9 million on January 28, 2019 related to the sale. Goodwill and Other Intangible Assets The Company has only one operating segment, substance abuse and behavioral healthcare treatment services, for segment reporting purposes. The substance abuse and behavioral healthcare treatment services operating segment represents one reporting unit for purposes of the Company’s goodwill impairment test. Goodwill represents the excess of the purchase price over the fair value of the identifiable net assets acquired. Goodwill and intangible assets with indefinite lives are not amortized, but instead are tested for impairment at least annually or whenever events or changes in circumstances indicate the carrying value may not be recoverable. If the carrying value of goodwill exceeds its implied fair value, an impairment loss is recorded. While performing the Company’s annual goodwill impairment test as of December 31, 2018, t including, but not limited to, a declining market capitalization, declining cash flows and negative trending performance indicators, such as admissions and total daily census. Because these factors indicated impairment was likely, the Company performed a quantitative analysis to measure the amount of loss due to goodwill impairment, if any. The Company has no intangible assets with indefinite useful lives other than goodwill. The Company’s other intangible assets principally relate to trademarks, marketing intangibles, non-compete agreements, services contracts and leasehold interests acquired during business combinations. Trademarks, marketing intangibles and service contracts are amortized over a period of ten years, non-compete agreements are amortized over the term of the agreements, and leasehold interests are amortized over the remaining life of the leases. Long-Lived Asset Impairment Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net undiscounted cash flows expected to be generated by the asset. Impairment is measured by the amount by which the carrying value of the assets exceeds the fair value of the assets. We review long-lived assets for impairment whenever events or changes in circumstances indicate that the related carrying amounts may not be recoverable. Due to the goodwill impairment recognized as of December 31, 2018, t The Company did not recognize any impairment to long-lived assets during the years ended December 31, 2018, 2017 or 2016. Accrued and Other Current Liabilities The Company’s accrued liabilities, reflected as a current liability in the accompanying consolidated balance sheets, consist of the following (in thousands): Year Ended December 31, 2018 2017 Accrued payroll liabilities 12,892 13,197 Accrued interest 4,792 2,864 Other 12,860 11,600 Total accrued liabilities $ 30,544 $ 27,661 Separately disclosed on the balance sheet as of December 31, 2018 are accrued litigation expenses of $8.0 million of expenses related to shareholder lawsuits that were settled in November 2018. Separately disclosed on the balance sheet as of December 31, 2017 are accrued litigation expenses of $23.6 million, which includes $23.3 million of expenses related to shareholder lawsuits that were settled in principle in December 2017, subject to court approval, which cannot be assured. Refer to Note 15 (Commitments and Contingencies) for further information regarding these matters. Segment The focus of all Company operations is centered on a single service, substance abuse and behavioral healthcare treatment. The Company is organized and operates as one reportable segment, consisting of various treatment facilities located in the United States. The treatment facilities have similar economic characteristics, services and clients. Management has the ability to direct and serve clients in any of these facilities, which allows it to operate the Company’s business and analyze its revenue on a system-wide basis, rather than focusing on any individual facility. The Company’s chief operating decision maker evaluates performance and manages resources based on the results of the consolidated operations as a whole. Advertising Expenses Advertising costs are expensed as the related activity occurs. Stock-Based Compensation The Company accounts for employee stock-based compensation using the fair-value based method for costs related to all share-based payments. The fair value of the portion of the award that is ultimately expected to vest is recognized as expense on a straight-line basis over the requisite service periods in the Company’s consolidated statements of operations. Earnings Per Share Basic and diluted earnings per common share are calculated based on the weighted-average number of common shares outstanding in each period and non-vested shares, to the extent such securities have a dilutive effect on earnings per share using the treasury stock method. Income Taxes The Company accounts for income taxes using the asset and liability method. Under the asset and liability method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on the deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. A valuation allowance is provided for significant deferred tax assets when it is more likely than not that such assets will not be recovered. Fair Value Measurements Fair value, for financial reporting purposes, is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. Disclosure is required about how fair value was determined for assets and liabilities and following a hierarchy for which these assets and liabilities must be grouped, based on significant levels of inputs as follows: Level 1 —quoted prices in active markets for identical assets or liabilities; Level 2 — quoted prices in active markets for similar assets and liabilities and inputs that are observable for the asset or liability; or Level 3 — unobservable inputs for the asset or liability, such as discounted cash flow models or valuations. The determination of where assets and liabilities fall within this hierarchy is based upon the lowest level of input that is significant to the fair value measurement. Comprehensive Income As of December 31, 2018, 2017 and 2016, the Company did not have any components of other comprehensive income. As such, comprehensive income was the same as net income for each of the periods presented in the accompanying consolidated statements of operations. Recent Pronouncements In January 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) 2017-04, “Simplifying the Test for Goodwill Impairment” (“ASU 2017-04”). The new guidance eliminates the requirement to calculate the implied fair value of goodwill (i.e., Step 2 of the current goodwill impairment test) to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit’s carrying amount over its fair value (i.e., measure the charge based on the current Step 1). ASU 2017-04 is effective for annual and interim impairment tests for periods beginning after December 15, 2019. The Company chose to early adopt ASU 2017-04 during the year ended December 31, 2018. The adoption did not have an impact on the Company’s financial statements. 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. In July 2018, the FASB issued amendments in ASU 2018-11, which provide a transition election to not restate comparative periods for the effects of applying the new standard. This transition election, which the Company has elected, permits entities to change the date of initial application to the beginning of the year of adoption and to recognize the effects of applying the new standard as a cumulative-effect adjustment to the opening balance of retained earnings. The Company is substantially complete in evaluating the impact of the standard, including practical expedients and updates to the standard, and has assessed its existing lease portfolio to determine the impact of adoption on its condensed consolidated financial statements and related disclosures. The Company expects to utilize available practical expedients, including the package of practical expedients not to reassess whether a contract is or contains a lease, the lease classification and initial direct costs, as well as the expedient forgoing the separation of lease and non-lease components. Total right-of-use assets and related operating lease obligations of approximately $33 million and $38 million, respectively will be recorded on the consolidated balance sheet on adoption, with no material impact to our Consolidated Statements of Operations. 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 core principle of the new standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The guidance was effective January 1, 2018 and was applied to all contracts on a modified retrospective basis. 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 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 price concessions 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 related to collectability that will be recorded as an operating expense from January 1, 2018 forward 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 the Company’s digital outreach platform customers during the year ended December 31, 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 year ended December 31, 2018, the impact on the Company's Condensed Consolidated Statements of Operations was as follows (in thousands): Year Ended December 31, 2018 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 284,525 $ 307,781 $ (23,256 ) Non-client related revenue $ 11,238 $ 11,727 $ (489 ) Provision for doubtful accounts $ 366 $ 24,111 $ (23,745 )

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2018
Earnings Per Share [Abstract]
Earnings Per Share	4. Earnings Per Share Basic earnings per share (“EPS”) is computed by dividing net income attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period. For the calculation of diluted EPS, net income attributable to common stockholders for basic EPS is adjusted by the effect of dilutive securities, including awards under stock-based payment arrangements, and outstanding convertible debt securities. Diluted EPS attributable to common stockholders is computed by dividing net income attributable to common stockholders by the weighted average number of fully diluted common shares outstanding during the period. The following table sets forth the components of the numerator and denominator used in the calculation of basic and diluted EPS (in thousands except share data): Year Ended December 31, 2018 2017 Restated 2016 Restated Numerator Net loss attributable to AAC Holdings, Inc. common stockholders $ (59,404 ) $ (12,873 ) $ (21,218 ) Denominator Weighted-average shares outstanding – basic 24,090,639 23,277,444 22,718,117 Dilutive securities — — — Weighted-average shares outstanding – diluted 24,090,639 23,277,444 22,718,117 Basic loss per share $ (2.47 ) $ (0.55 ) $ (0.93 ) Diluted loss per share $ (2.47 ) $ (0.55 ) $ (0.93 ) The Company had 42,997; 96,130 and 25,181 shares for the years ended December 31, 2018, 2017 and 2016, respectively, that are not included in the earnings per share calculation above, because to do so would be anti-dilutive for the periods presented.

Property and Equipment, net

Property and Equipment, net	12 Months Ended
	Dec. 31, 2018
Property Plant And Equipment [Abstract]
Property and Equipment, net	5. Property and Equipment, net Property and equipment consisted of the following (in thousands): December 31, 2018 2017 Land $ 19,364 $ 15,766 Buildings and improvements 161,723 130,710 Equipment and software 35,059 32,968 Construction in progress 16,413 22,310 Total property and equipment 232,559 201,754 Less accumulated depreciation (65,638 ) (49,206 ) Property and equipment, net $ 166,921 $ 152,548 Depreciation expense was $20.1 million, $20.0 million and $16.1 million for the years ended December 31, 2018, 2017 and 2016, respectively. Capitalized interest related to the purchase of property, plant and equipment totaled $0.3 million for the year ended December 31, 2018. The Company considered the indicators of goodwill impairment to be an indicator of potential impairment of long-lived assets. The Company performed an analysis of undiscounted cash flows for each facility to determine if impairment existed for long-lived assets. Based on the Company’s analysis, there was no impairment of long-lived assets as of December 31, 2018.

Acquisitions

Acquisitions	12 Months Ended
	Dec. 31, 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”) (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 $85.1 million, including 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 $66.8 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 $0.5 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 $1.7 million, subject to achievement of a certain adjusted EBITDA target over the 12 months following the closing date of the transaction. 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 December 31, 2018 and determined that the fair value was zero. The change in the fair value resulted in the reduction of $0.5 million gain on contingent consideration recognized during the three months ended December 31, 2018. For the year ended December 31, 2018, the Company recorded a net $0.9 million as a reduction to acquisition related expense. 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 allocated to the fair value of the assets acquired and liabilities assumed on the acquisition date. The 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 15,309 Goodwill 64,556 Intangible assets 5,120 Total assets acquired 93,038 Accrued and other current liabilities 5,931 Long-term liabilities 2,004 Net assets acquired $ 85,103 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 December 31, 2018 was approximately $ The pro forma loss before income tax benefit for year ended December 31, 2018 was adjusted to exclude approximately $0.8 million of nonrecurring acquisition costs, to include additional interest expense of $0.4 million and depreciation and amortization expense of $0.2 million. The pro forma income before income tax expense for the year ended December 31, 2017 was adjusted to exclude approximately $0.9 million of nonrecurring acquisition costs and to include additional interest expense of $6.2 million and depreciation and amortization expense of $1.0 million. The following table presents pro forma results as discussed above, which are not indicative of the actual results of operations (in thousands): Year Ended December 31, 2018 2017 Restated Total revenues $ 304,037 $ 370,235 (Loss) income before income tax (benefit) expense $ (70,666 ) $ (14,038 )

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	7. Goodwill and Intangible Assets Goodwill Impairment Test The Company has only one operating segment, substance abuse and behavioral healthcare treatment services, for segment reporting purposes. The substance abuse and behavioral healthcare treatment services operating segment represents one reporting unit for purposes of the Company’s goodwill impairment test. The Company performed its annual test for goodwill impairment as of December 31, 2018 and based on certain qualitative factors, determined that more likely than not, the carrying value of its goodwill was greater than its fair value. These factors included, but were not limited to, a declining market capitalization, declining cash flows and negative trending performance indicators, such as admissions and total daily census. Because certain qualitative factors indicated impairment was likely, the Company performed a quantitative analysis to measure the amount of loss due to goodwill impairment, if any. The Company used a blended approach of a market capitalization approach and income approach to determine the fair value of the reporting unit. For the market capitalization approach, the Company determined its implied fair value of total invested capital based on the number of outstanding shares as of December 31, 2018, its average stock price based on the ten days immediately proceeding and ten days immediately following the valuation date. For the income approach, the Company used a discounted cash flow model in which cash flows are projected using historical and internal forecasts over future periods including growth assumptions regarding revenue, EBITDA, tax depreciation and capital expenditures, plus a terminal value, and are discounted to present value using a risk-adjusted rate of return. The discount rate assumption is based on an assessment of the risk inherent in the future cash flows and was 16% Based on the implied fair value using the aforementioned blended approach, there was no goodwill impairment, as the fair value of goodwill exceeded the carrying value by a minimal amount as of December 31, 2018. There is a risk that future declines in fair value could result in goodwill impairment. The determination of fair value in step one of our goodwill impairment analysis is based on an estimate of fair value utilizing known and estimated inputs at the evaluation date. Some of those inputs include, but are not limited to, the most recent price of our common stock, estimates of future revenue and expenses, estimated market multiples, expected capital expenditures, income tax rates, and costs of invested capital. Future estimates of fair value could be adversely affected if the actual outcome of one or more of these assumptions changes materially in the future, including further decline in our stock price, lower than expected census, higher market interest rates or increased operating costs. Such changes impacting the calculation of our fair value could result in a material impairment charge in the future. The Company’s goodwill balance was $199.0 million and $134.4 million as of December 31, 2018 and 2017, respectively. The changes in goodwill relate to the AdCare Acquisition during the year ended December 31, 2018, as shown below: Balance at December 31, 2016 $ 134,396 2017 Activity - Balance at December 31, 2017 $ 134,396 AdCare Acquisition 64,556 Balance at December 31, 2018 $ 198,952 Other intangible assets and related accumulated amortization consisted of the following as of December 31, 2018 and 2017 (in thousands): Gross Carrying Value Accumulated Amortization December 31, December 31, December 31, December 31, 2018 2017 2018 2017 Trademarks $ 8,422 $ 5,322 $ 2,777 $ 1,986 Non-compete agreements 2,107 1,587 1,583 1,372 Marketing intangibles 5,651 5,651 2,050 1,485 Leasehold interests 1,498 1,498 587 397 Service contracts 950 — 79 — Other 601 51 90 40 Intangible assets $ 19,229 $ 14,109 $ 7,166 $ 5,280 Amortization expense was $1.9 million, $1.5 million, and $1.5 million for the years ended December 31, 2018, 2017 and 2016, respectively. Changes to the net carrying value of intangible assets during the year ended December 31, 2018 and 2017 were as follows (in thousands): Balance at December 31, 2016 $ 10,356 Amortization expense (1,527 ) Balance at December 31, 2017 $ 8,829 Amortization expense (1,886 ) AdCare Acquisition 5,120 Balance at December 31, 2018 $ 12,063 At December 31, 2018, all intangible assets are amortized using a straight-line method. The following table presents amortization expense expected to be recognized during fiscal years subsequent to December 31, 2018 (in thousands): Year ended December 31, 2019 $ 1,955 2020 1,951 2021 1,756 2022 1,619 2023 1,385 Thereafter 3,397 Total $ 12,063

Long-Term Debt

Long-Term Debt	12 Months Ended
	Dec. 31, 2018
Debt Disclosure [Abstract]
Long-Term Debt	8. Long-Term Debt In connection with the 2019 Senior Credit Facility further described below, on March 8, 2019, the Company entered into the Amendments to the 2017 Credit Facility together with the required lenders party thereto, Credit Suisse AG, as administrative agent and collateral agent, and the other loan parties party thereto, amending that certain Credit Agreement (the “2017 Credit Facility”), dated as of June 30, 2017, by and among the Company, Credit Suisse AG, as administrative agent and collateral agent, and the lenders party thereto. The 2017 Credit Facility requires the maintenance of a certain coverage ratio in order for the Company to be in compliance with the agreement. As of December 31, 2018, the Company would have been in violation of this covenant absent the amendment. For the aforementioned factors, and in accordance with ASC 470-10-55, due to the uncertainties noted under Going Concern in Note 2 – Basis of Presentation A summary of the Company’s debt obligations is as follows (in thousands): December 31, 2018 2017 Senior secured loans $ 317,479 $ 207,375 Subordinated debt 8,884 — Unamortized debt issuance costs (8,085 ) (7,233 ) Capital lease obligations 880 1,031 Total debt 319,158 201,173 Less current portion (309,394 ) (4,722 ) Total long-term debt $ 9,764 $ 196,451 2019 Senior Credit Facility On March 8, 2019, the Company entered into the 2019 Senior Credit Facility with Credit Suisse AG, as administrative agent and collateral agent, and the lenders party thereto. The 2019 Senior Credit Facility makes available to the Company a term loan in the principal amount of $30.0 million. The 2019 Senior Credit Facility will mature on April 15, 2020. Net proceeds from funding of the 2019 Senior Credit Facility were approximately $23 million after the payment of fees, costs and other expenses. The 2019 Senior Credit Facility is guaranteed by the Company’s wholly-owned subsidiary, American Addiction Centers, Inc., and certain of its other subsidiaries. The obligations are secured by a first priority lien (senior to liens granted in connection with the 2017 Credit Facility) on substantially all of the Company’s and each subsidiary guarantor’s assets. The 2019 Senior Credit Facility bears interest at a rate per annum equal to LIBOR (with a 1.0% floor) plus 11.00% per annum. In the event of any repayment or prepayment of the 2019 Senior Credit Facility or any acceleration of the 2019 Senior Credit Facility after an event of default, the Company must make a payment equal to 1.00% of the then outstanding principal amount of the 2019 Senior Credit Facility (the “Exit Payment”) if such event occurs on or prior to the date that is nine months after the closing date of the 2019 Senior Credit Facility (the “2019 Senior Credit Facility Closing Date”). The Exit Payment will be increased by an additional 1.0% at the end of each 30-day period after the nine-month anniversary of the 2019 Senior Credit Facility Closing Date until the 2019 Senior Credit Facility matures. The terms of the 2019 Senior Credit Facility contains certain financial covenants, including, a maximum Senior Secured Leverage Ratio of (i) 7.75:1.00 as of the last day of the fiscal quarter ending June 30, 2019, (ii) 6.50:1.00 as of the last day of the fiscal quarter ending September 30, 2019, (iii) 6.25:1.00 as of the last day of the fiscal quarter ending December 31, 2019, (iv) 5.75:1.00 as of the last day of the fiscal quarter ending March 31, 2020, (v) 5.50:1.00 as of the last day of the fiscal quarter ending June 30, 2020, (vi) 5.25:1.00 as of the last day of the fiscal quarters ending September 30, 2020 and December 31, 2020, (vii) 5.00:1.00 as of the last day of the fiscal quarters ending March 31 and June 30, 2021 and (viii) 4.75:1.00 as of the last day of each fiscal quarter ending on and after December 31, 2020. The 2019 Senior Credit Facility requires the Company to periodically report to lenders with respect to, and to comply with, the Company’s operating budget. The Company is also required to (i) maintain no less than $5.0 million at any time of cash, cash equivalents and undrawn revolving loans under the 2017 Credit Facility (“Available Liquidity”) and (ii) to maintain no less than $7.5 million of Available Liquidity for any calendar week. Amendments to the 2017 Credit Facility In connection with the 2019 Senior Credit Facility, on March 8, 2019, the Company entered into the Amendment to the 2017 Credit Facility together with the required lenders party thereto, Credit Suisse AG, as administrative agent and collateral agent, and the other loan parties party thereto, amending that certain Credit Agreement, dated as of June 30, 2017, by and among the Company, Credit Suisse AG, as administrative agent and collateral agent, and the lenders party thereto. The Amendment to the 2017 Credit Facility increased the interest rate on the term loans outstanding under the 2017 Credit Facility (the “2017 Term Loans”) by, at the Company’s option, either (i) 2.00% per annum (which shall be reduced to 1.00% per annum if the Senior Secured Leverage Ratio Condition, as defined in the Amendment to the 2017 Credit Facility is satisfied), payable in cash or (ii) 4.00% per annum, payable-in-kind. In addition, the Amendment to the 2017 Credit Facility increased the commitment fee for the undrawn portion of the revolving credit facility under the 2017 Credit Facility from 0.50% to 1.00% per annum. If the Company has repaid all indebtedness under the 2019 Senior Credit Facility, the Amendments to the 2017 Credit Facility requires the Company to use net cash proceeds of certain asset sales and other dispositions of property to prepay outstanding term and revolving credit loans. If the 2017 Term Loans are prepaid at any time, the Amendment to the 2017 Credit Facility requires the payment of (i) a 2.00% premium if paid on or prior to the first anniversary of the closing of the Amendment to the 2017 Credit Facility and (ii) a 1.00% premium if paid after the first anniversary but before the second anniversary of the closing of the Amendment to the 2017 Credit Facility. The Amendment to the 2017 Credit Facility amended financial covenants with respect to the Senior Secured Leverage Ratio (as defined therein) and budgeting and lender reporting covenants that mirror those contained in the 2019 Senior Credit Facility. It also restricts certain Company actions, including certain acquisitions and joint venture arrangements. On March 1, 2018, in conjunction with the AdCare Acquisition, we secured a $65.0 million incremental term loan commitment under the 2017 Credit Facility. In connection with the incremental term loan, we incurred $2.6 million in deferred financing costs related to underwriting and other professional fees. On March 1, 2018, and also in conjunction with the AdCare Acquisition, in consideration for covenants and agreements set forth in the Purchase Agreement, we 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 monthly until the maturity date. 2017 Credit Facility On June 30, 2017, the Company entered into a senior secured credit agreement with Credit Suisse AG, as administrative agent and collateral agent and the lenders party thereto (the “2017 Credit Facility”). The 2017 Credit Facility initially made available to the Company a $40.0 million revolving line of credit (the “2017 Revolver”) and a term loan in an aggregate original principal amount of $210.0 million (the “2017 Term Loan”). As discussed further below, on September 25, 2017 the 2017 Revolver was increased to $55.0 million. The 2017 Credit Facility also provides for standby letters of credit in an aggregate undrawn amount not to exceed $7.0 million. The 2017 Term Loan matures on June 30, 2023 and requires scheduled quarterly principal repayments in an amount equal to $ 1.7 The 2017 Revolver matures on June 30, 2022. As of December 31, 2018, $52.0 million was outstanding on the 2017 Revolver. The 2017 Credit Facility also includes an incremental facility providing for the Company to incur Additional Term Loans in an aggregate principal amount of up to $25.0 million (plus such additional amounts, so long as, after giving pro forma effect to the incurrence of such additional borrowings, the Company’s Senior Secured Leverage Ratio (as defined in the 2017 Credit Facility) would be less than 3.90:1.00) (each, an “Incremental Term Loan”) and/or Additional Revolving Commitments in an aggregate principal amount of up to million (the “Incremental Revolver”), each subject to the satisfaction of certain conditions contained in the 2017 Credit Facility, including obtaining additional commitments from existing or additional lenders. On September 25, 2017, the Company obtained its Incremental Revolver from certain incremental revolving credit lenders thereby increasing the 2017 pursuant to the 2017 Credit Facility from $40.0 million to $55.0 million. The lenders under the 2017 Credit Facility are not under any obligation to provide any Incremental Term Loans. Borrowings under the 2017 Credit Facility bore interest at a rate tied to the Alternative Base Rate or the Adjusted London Interbank Offered Rate (“LIBOR”) Borrowings under the 2017 Credit Facility are guaranteed by the Company’s wholly owned subsidiary, AAC and certain of its other subsidiaries pursuant to that certain Guarantee and Collateral Agreement, dated as of June 30, 2017, by and among the Company, each of the subsidiary guarantors party thereto and Credit Suisse AG, as collateral agent (the “Guarantee and Collateral Agreement”). The obligations under the 2017 Credit Facility and the Guarantee and Collateral Agreement are secured by a lien on substantially all of the Company’s and each subsidiary guarantor’s assets. The Company is permitted to voluntarily reduce the unutilized portion of the commitment amount and repay outstanding loans under the 2017 Credit Facility at any time without premium or penalty, other than (i) customary “breakage” costs with respect to Eurodollar Loans and, (ii) with respect to the 2017 Term Loan, if certain repricing transactions are consummated or certain mandatory repayments are made, (x) a yield maintenance premium within one year after the closing as set forth in the 2017 Credit Facility, (y) a 2.0% premium if paid after the first anniversary of the closing but before the second anniversary of the closing and (z) a 1.0% premium if paid after the second anniversary of the closing but before the third anniversary of the closing. In addition, the 2017 Credit Facility places certain restrictions on the ability of the Company and its subsidiaries to, among other things, incur debt and liens; merge, consolidate or liquidate; dispose of assets; enter into hedging arrangements; pay dividends and make other restricted payments; undertake transactions with affiliates; enter into restrictive agreements on dividends and other distributions; make negative pledges; enter into certain sale-leaseback transactions; make certain investments; prepay or modify the terms of certain indebtedness and modify the terms of certain organizational agreements. The 2017 Credit Facility contains customary events of default, including payment defaults, breaches of representations and warranties, covenant defaults, cross-defaults to other material indebtedness, certain events of bankruptcy and insolvency, material judgments, certain ERISA events, invalidity of loan documents and certain changes in control. The Company incurred approximately $12.9 million in debt issuance costs related to underwriting and other professional fees, of which $7.6 million related to the 2017 Term Loan and $5.3 million related to the 2017 Revolver. On October 6, 2017, in conjunction with the Company’s pending acquisition of AdCare, Inc., the Company secured a $65.0 million incremental term loan commitment in conjunction with the 2017 Credit Facility, subject to customary closing conditions and regulatory provisions. In connection with the financing, the Company committed to a ticking fee that commenced on October 17, 2017, at a rate of LIBOR plus 3.375%, which increased to LIBOR plus 6.75% from November 2017, until the closing date of the acquisition. As of December 31, 2017, the Company had accrued for $0.8 million of expenses related to the ticking fee. As of December 31, 2018, the Company had fully drawn on the 2017 Revolver less $2.7 million of outstanding letters of credit. 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 Facility On March 9, 2015, the Company entered into a five-year senior secured credit facility (the “2015 Credit Facility”) with Bank of America, N.A., as administrative agent for the lenders party thereto (i n connection with the effectiveness of the 2017 Credit Facility, on June 30, 2017, the 2015 Credit Facility was repaid in full, and as of December 31, 2017, no amounts were outstanding under the 2015 Credit Facility). The Company incurred approximately $2.0 million in debt issuance costs related to underwriting and other professional fees, of which approximately $1.1 were million related to the revolving credit loan and approximately $0.9 million were related to the term loan. The Company deferred these costs over the term of the 2015 Credit Facility. On July 13, 2016, the Company increased its 2015 Credit Facility to $171.3 million, which consisted of a $50.0 million revolving credit facility and a $121.3 million term loan. The facility was scheduled to mature in March 2020 and bore interest at LIBOR plus a margin between 2.25% to 3.75% or a base rate plus a margin between 1.25% and 2.75%, in each case depending on the Company’s leverage ratio. The facility had an accordion feature that provides for an additional $75.0 million of borrowing capacity under the credit facility, subject to certain consents and conditions, including obtaining additional commitments from lenders. As of December 31, 2016, the balance on the term loan was $118.8 million, and the balance on the revolving credit facility was $21.0 million. On February 27, 2017, the Company amended its 2015 Credit Facility, to, among other things, provide for certain modifications to the terms of the 2015 Credit Agreement, dated as of March 19, 2015, as amended (the “2015 Credit Agreement”), including the following: (i) extend the maximum Consolidated Total Leverage Ratio (as defined in the 2015 Credit Agreement) of 4:25:1.00 through the measurement period ending September 30, 2017; and (ii) amend the definition of Applicable Margin (as defined in the 2015 Credit Agreement) to add an additional pricing level of 3.75% for Eurodollar Rate Loans and Letter of Credit Fee, 2.75% for Base Rate Loans and 0.60% for Commitment Fee (as all such terms are defined in the 2015 Credit Agreement), which would have been applicable when the Consolidated Total Leverage Ratio was equal to or exceeded 4.00:1.00 at the end of the applicable measuring period (the “New Pricing Level”) and to provide that the Applicable Rate (as defined in the 2015 Credit Agreement) be set at the New Pricing Level from the date of such amendment until the first business day following the date the Company delivered its next Compliance Certificate (as defined in the 2015 Credit Agreement). The amendment also provided for additional Adjusted EBITDA (as defined in the 2015 Credit Agreement) add backs under the Company’s covenant calculation to account for its February 2017 reduction in workforce. The 2015 Credit Facility required quarterly term loan principal repayments for the outstanding term loan of $2.3 million for March 31, 2017 to December 31, 2017, $3.9 million from March 31, 2018 to December 31, 2018, and $4.7 million from March 31, 2019 to December 31, 2019, with the remaining principal balance of the term loan was scheduled to mature on March 9, 2020. Repayment of the revolving loan is due on the maturity date of March 9, 2020. The 2015 Credit Facility generally required quarterly interest payments and limited the Company’s ability to pay dividends. Borrowings under the 2015 Credit Facility were guaranteed by the Company and each of its subsidiaries and were secured by a lien on substantially all of the Company’s and its subsidiaries’ assets. Borrowings under the 2015 Credit Facility bore interest at a rate tied to the Company’s Consolidated Total Leverage Ratio (defined as Consolidated Funded Indebtedness to Consolidated EBITDA, in each case as defined in the 2015 Credit Facility, as amended). Eurodollar Rate Loans with respect to the 2015 Credit Facility bore interest at the Applicable Rate plus the Eurodollar Rate (each as defined in the 2015 Credit Facility, as amended) (based upon the LIBOR Rate (as defined in the 2015 Credit Facility, as amended) prior to commencement of the interest rate period). Base Rate Loans with respect to the 2015 Credit Facility bore interest at the Applicable Rate plus the highest of (i) the federal funds rate plus 0.50%, (ii) the prime rate and (iii) the Eurodollar Rate plus 1.0% (the interest rate at December 31, 2016 was 4.25%). In addition, the Company was required to pay a commitment fee on undrawn amounts under the revolving loan of the 2015 Credit Facility of 0.35% to 0.60% depending on the Company’s Consolidated Total Leverage Ratio (the commitment fee rate at December 31, 2016 was 0.50%). In 2015, the Company incurred approximately $1.4 million in debt issuance costs related to underwriting and other professional fees, and deferred these costs over the term of the 2015 Credit Facility. As of December 31, 2016, total borrowings under the $50.0 million revolver portion of the 2015 Credit Facility were $21.0 million and $2.5 million in standby letters of credit issued for various corporate purposes resulting in $26.5 million available to the Company. In connection with the effectiveness of the 2017 Credit Facility, on June 30, 2017, the 2015 Credit Facility was repaid in full, and as of December 31, 2017, no amounts were outstanding under the 2015 Credit Facility. 2015 Subordinated Debt On October 2, 2015, the Company entered into two financing facilities with affiliates of Deerfield Management Company, L.P. (“Deerfield”). The financing facilities consisted of $25.0 million of subordinated convertible debt and up to $25.0 million of unsecured subordinated debt, together with an incremental facility of up to an additional $50.0 million of subordinated convertible debt (subject to certain conditions) (the “Deerfield Facility”). The Company issued $25.0 million of subordinated convertible debt at closing. The $25.0 million of subordinated convertible debt bore interest at an annual rate of 2.50% and was scheduled to mature on September 30, 2021. The $25.0 million of subordinated convertible debt funded at closing was convertible into shares of the Company’s common stock at $30.00 per share. In the second quarter of 2016, the Company issued $25.0 million of the unsecured subordinated debt. The unsecured subordinated debt bore interest at an annual rate of 12.0% and was schedule to mature on October 2, 2020. The Company incurred approximately $1.4 million in debt issuance costs related to underwriting and other professional fees and deferred these costs over the term of the debt. As of December 31, 2016, both the $25.0 million of subordinated convertible debt, bearing interest at 2.5%, and the $25.0 million of unsecured subordinated debt, bearing interest at 12.0%, were outstanding. In connection with the effectiveness of the 2017 Credit Facility, on June 30, 2017, the Company terminated the Deerfield Facility and paid to Deerfield the Deerfield Consent Fee, and as of December 31, 2017, no amounts were outstanding under the Deerfield Facility. Interest Rate Swap Agreements In July 2014, the Company entered into two interest rate swap agreements to mitigate its exposure to fluctuations in interest rates. On June 29, 2017, the Company terminated the interest rate swap agreements. The fair value of the interest rate swap agreements as of December 31, 2016 represented a liability of $0.3 million. Refer to Note 13 (Fair Value of Financial Instruments) for further discussion of fair value of 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%, respectively, and were set to mature in May 2018 and August 2019, respectively. The notional amounts of the swap agreements represented amounts used to calculate the exchange of cash flows and were not the Company’s assets or liabilities. The interest payments under these agreements were to be settled on a net basis. The Company did not designate the interest rate swaps as cash flow hedges, and therefore, the changes in the fair value of the interest rate swaps are included within interest expense in the consolidated statements of operations. A summary of future contractual maturities of long-term debt, excluding unamortized debt issuance costs, as of December 31, 2018, is as follows (in thousands): Years ending December 31, Notes Payable 1 Capital Lease Obligations 2019 $ 11,343 $ 626 2020 14,791 208 2021 14,791 62 2022 66,791 12 2023 218,647 8 Thereafter — — Total $ 326,363 $ 916 Less interest portion (36 ) Total, excluding interest $ 880 1 As noted above, as of December 31, 2018 the Company has classified its Term Loan and Revolver under the 2017 Credit Facility as current liabilities. This table presents the scheduled maturities of the loan per their respective agreements.

Financing Lease Obligation

Financing Lease Obligation	12 Months Ended
	Dec. 31, 2018
Leases [Abstract]
Financing Lease Obligation	9. Financing Lease Obligation On August 9, 2017, the Company closed on a sale-leaseback transaction with MedEquities Realty Operating Partnership, LP, a subsidiary of MedEquities Realty Trust, Inc. (“MedEquities”), for $25.0 million (the “2017 Sale-Leaseback”), in which MedEquities purchased from subsidiaries of the Company two Simultaneously with the sale of the Sale The initial annual minimum rent payable to MedEquities pursuant to the Lease is $2.2 million due in equal monthly installments of $0.2 million. On the first, second and third anniversary of the lease date, the annual rent will increase to an amount equal to 101.5% of the annual rent in effect for the immediately preceding year. On the fourth anniversary of the lease date and thereafter during the lease term, the annual rent will increase to the amount equal to the CPI Factor (as defined in the Lease) multiplied by the annual rent in effect for the immediately preceding year; provided, however, that the adjusted annual rent increase will always be between 1.5% and 3.0%. Due to the nature of the agreement between MedEquities and the Company and because of the Company’s continuing involvement in the Sale-Leaseback Facilities, the transaction does not qualify for sale-leaseback accounting under GAAP. Therefore, the Sale-Leaseback Facilities will remain on the Company’s balance sheet and will continue to be depreciated over the remaining life of the asset. The Company accounted for the $25.0 million of proceeds, less $0.4 million of transaction costs, as a financing obligation, of which $0.1 million was classified as a short-term liability. On a monthly basis, a portion of the payment is allocated to principal, which reduces the obligation balance, and interest, computed based on the Company’s incremental borrowing rate. A summary of the Company’s financing lease obligation is as follows (in thousands): December 31, 2018 2017 Financing lease obligation: Sale-Leaseback Facilities $ 24,542 $ 24,621 Less current portion (included in accrued and other current liabilities) (121 ) (80 ) Total financing lease obligation, net of current portion $ 24,421 $ 24,541 The future minimum lease payments with remaining terms of one or more years as of December 31, 2018, as it relates to the 2017 Sale-Leaseback consisted of the following (in thousands): Years ending December 31, Annual Payment 2019 $ 2,233 2020 2,267 2021 2,301 2022 2,336 2023 2,371 Thereafter 22,093 Total $ 33,601

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2018
Equity [Abstract]
Stockholders' Equity	10. Stockholders’ Equity Pursuant to the Articles of Incorporation of the Company, the aggregate number of shares which the Company shall have authority to issue is 75,000,000 shares, consisting of 70,000,000 shares of common stock, par value $0.001 per share, and 5,000,000 shares of preferred stock, par value $0.001 per share. As of December 31, 2018, there were 24,573,679 shares of common stock issued and outstanding and no shares of preferred stock issued and outstanding. Holders of the Company’s common stock are entitled to one vote for each share held of record on all matters on which stockholders may vote. Certain restrictions imposed by the Company’s various debt instruments limit the Company’s ability to pay dividends.

Stock Based Compensation

Stock Based Compensation	12 Months Ended
	Dec. 31, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Based Compensation	11. Stock Based Compensation 2014 Equity Incentive Plan The Company adopted the 2014 Equity Incentive Plan, as amended (“2014 Incentive Plan”) in 2014. An aggregate of 1,571,120 shares of common stock were initially reserved for issuance pursuant to the 2014 Incentive Plan. The 2014 Incentive Plan is administered by the Board of Directors, which determines, subject to the provisions of the 2014 Incentive Plan, the employees, directors or consultants to whom incentives are awarded. On May 16, 2017, the Company approved an amendment to the 2014 Incentive Plan to increase the number of shares reserved for issuance thereunder by 1,800,000 shares. On March 9, 2017, the Company granted 38,000 shares of fully vested common stock to each of its five non-employee directors. Additionally, on March 9, 2017, the Company issued 408,000 shares of restricted common stock under the 2014 Incentive Plan, which vest annually on each December 31 over a three year period. For the years ended December 31, 2018, 2017 and 2016, the Company withheld 28,989, 76,385 and 65,089 common shares, respectively, to satisfy tax withholding obligations. Excluding fully vested shares, the Company recognizes compensation expense on a straight-line basis over the life of each grant. The total compensation is based on the number of restricted shares issued and the fair market value of the restricted shares on the grant date. The Company recognizes compensation expense in its entirety for fully vested common stock on the day of grant based on the number of shares issued and the grant date fair market value of the shares. The Company recognized $3.9 million, $7.5 million, and $8.8 million in stock-based compensation expense for the years ended December 31, 2018, 2017 and 2016, respectively, related to the 2014 Incentive Plan. As of December 31, 2018, there was $1.9 million of unrecognized compensation expense related to unvested restricted stock grants, which is expected to be recognized over the remaining weighted average vesting period of 1.6 years. A summary of share activity under the 2014 Incentive Plan is set forth below: Weighted- Average Grant Shares Date Fair Value Unvested at December 31, 2016 522,175 $ 23.22 Granted 446,000 8.60 Vested (402,267 ) 18.49 Forfeitures (217,053 ) 17.27 Unvested at December 31, 2017 348,855 $ 13.69 Granted 196,000 11.47 Vested (286,817 ) 14.19 Forfeitures (76,213 ) 14.44 Unvested at December 31, 2018 181,825 $ 10.20 The total grant date fair value of restricted common stock vested during the year ended December 31, 2018 was $4.1 million. The Company’s policy is to recognize forfeitures as they occur rather than estimating future forfeitures. Employee Stock Purchase Plan On May 19, 2015, the Company’s shareholders approved the Company’s Employee Stock Purchase Plan, as amended (“ESPP”), which was adopted by the Board of Directors in the fourth quarter of 2014. On May 16, 2017, the Company approved an amendment to the ESPP to increase the number of shares reserved for issuance thereunder by 250,000 shares. The ESPP enables eligible employees to purchase shares of the Company’s common stock through a payroll deduction during certain option periods, generally commencing on January 1 and July 1 of each year and ending on June 30 and December 31 of each year. On the exercise date (the last trading day of each option period), the cumulative amount deducted from each participant’s salary during that option period will be used to purchase the maximum number of shares of the Company’s common stock at a purchase price equal to the lesser of (i) 85% of the closing market price of the Company’s common stock as quoted on the New York Stock Exchange on the exercise date or (ii) 85% of the closing market price of the Company’s common stock as quoted on the New York Stock Exchange on the grant date, subject to certain limitations and restrictions. In 2018, 2017 and 2016, the Company issued 48,396; 97,589 and 44,174 shares of the Company’s common stock, respectively, in connection with employee deductions contributed to the ESPP. At both December 31, 2018 and 2017, the Company recorded a liability of $0.2 million related to employee deductions contributed during the July 1, 2018 and December 31, 2018 and the July 1, 2017 through December 31, 2017 periods, respectively. For the years ended December 31, 2018, 2017 and 2016 the Company recognized $0.1 million, $0.2 million and $0.3 million of compensation expense related to the ESPP, respectively. On January 10, 2019, the Company issued 116,032 shares of the Company’s common stock in connection with employee deductions of $0.1 million contributed in the July 1, 2018 through December 31, 2018 ESPP option period.

Qualified 401(k) Savings Plan

Qualified 401(k) Savings Plan	12 Months Ended
	Dec. 31, 2018
Compensation And Retirement Disclosure [Abstract]
Qualified 401(k) Savings Plan	12. 401(k) Savings Plan The Company has a qualified 401(k) savings plan (the “Plan”) which provides for eligible employees (as defined) to make voluntary contributions to the Plan. The Company makes contributions to the Plan based upon the participants’ level of participation, which is fully vested at the time of contribution. For the years ended December 31, 2018, 2017 and 2016 the Company contributions under this Plan were $1.4 million, $0.9 million and $0.8 million, respectively.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Income Taxes	13. Income Taxes Income tax (benefit) expense consisted of the following for the years ended December 31, 2018, 2017 and 2016: Year Ended December 31, 2018 2017 Restated 2016 Restated Current Federal $ (5,447 ) $ 1,150 $ (456 ) State (438 ) 1,244 1,042 Total current tax expense (5,885 ) 2,394 586 Deferred: Federal (529 ) (3,476 ) 2,782 State 3,410 (660 ) (1,023 ) Total deferred tax (benefit) expense 2,881 (4,136 ) 1,759 Total income tax (benefit) expense $ (3,004 ) $ (1,742 ) $ 2,345 The Company’s effective income tax rate for the years ended December 31, 2018, 2017 and 2016 reconciles with the federal statutory rate as follows: Year Ended December 31, 2018 2017 Restated 2016 Restated Federal statutory rate 21.0 % 35.0 % 35.0 % State income taxes, net of federal tax benefit 7.9 1.8 1.9 Effect of Tax Cuts and Jobs Act - (38.1 ) - Non-deductible expenses (0.5 ) (1.8 ) (0.6 ) Stock compensation adjustment (0.8 ) (8.1 ) (4.6 ) Return to provision adjustment 4.0 (0.1 ) - Change in valuation allowance (27.4 ) 20.3 (41.1 ) Other differences 0.1 0.1 (0.4 ) Effective income tax rate on income before taxes 4.3 % 9.1 % (9.8 ) % The difference between the Company’s effective tax rate and federal statutory rate for 2018 is 16.7%, which is primarily due to the valuation allowance recorded against Federal and certain state deferred tax assets, state income taxes, and change in prior year estimates associated with the filing of 2017 income tax returns. Deferred income tax assets (liabilities) are comprised of the following at December 31, 2018 and 2017: Year Ended December 31, 2018 2017 Restated Employee compensation $ 1,786 $ 1,839 Operating loss carryforwards 27,147 2,894 Business interest limitation 8,295 - Accrued litigation 2,088 5,517 Accounts receivable - 8,059 Tax credits 332 - Acquisition related costs 1,438 1,255 Property, equipment and amortization 3,301 2,377 Other 1,337 - Valuation allowance (34,722 ) (15,091 ) Total deferred tax assets 11,002 6,850 Goodwill and other intangible property (8,891 ) (5,130 ) Other (512 ) - Accounts receivable (2,826 ) (70 ) Total deferred tax liabilities (12,229 ) (5,200 ) Net deferred tax (liabilities) assets $ (1,227 ) $ 1,650 At December 31, 2018, the Company has federal and state income tax NOL carryforwards of $87.5 million and $8.7 million, of which $17.0 million will expire between 2027 and 2038. The remaining $70.5 million will carry forward indefinitely subject to annual taxable income limitations. Management assesses the available positive and negative evidence to estimate whether sufficient future taxable income will be generated to permit use of the existing deferred tax assets. A significant piece of objective negative evidence evaluated was the cumulative loss incurred over the three-year period ended December 31, 2018. Such objective evidence limits the ability to consider other subjective evidence, such as our projections for future growth. On the basis of this evaluation, as of December 31, 2018, a valuation allowance of $34.7 million has been recorded to recognize only the portion of the deferred tax asset that is more likely than not to be realized. The amount of the deferred tax asset considered realizable, however, could be adjusted if estimates of future taxable income during the carryforward period are reduced or increased or if objective negative evidence in the form of cumulative losses is no longer present and additional weight is given to subjective evidence such as our projections for growth. Overall, the Company’s valuation allowance increased by approximately $19.6 million during the year ended December 31, 2018. The Company had no uncertain tax positions as of December 31, 2018 and 2017, respectively The Company has not been notified of any state income tax examinations. The Company’s policy is to recognize interest and penalties associated with uncertain tax positions as part of income tax expense. On December 22, 2017, President Trump signed into law the “Tax Cuts and Jobs Act”. This legislation created significant changes in U.S. tax law, including a reduction in corporate tax rates, changes to net operating loss carryforwards and carrybacks, a limitation on the amount of deductible business interest expense, and a repeal of the corporate alternative minimum tax. The legislation reduced the U.S. corporate tax rate from the current rate of 35% to 21% for tax periods beginning after December 31, 2017. In December 2017, the SEC staff issued Staff Accounting Bulletin No. 118 (“SAB 118”) to address the application of U.S. GAAP in situations when a registrant does not have the necessary information available, prepared, or analyzed (including computations) in reasonable detail to complete the accounting for certain income tax effects of the legislation. At December 31, 2017, the Company recorded a discrete net tax expense of $3.5 million related to provisional amounts under SAB 118 for the remeasurement of U.S. deferred tax assets and liabilities due to reduction in the federal tax rate. The Company completed its accounting under SAB 118 in the fourth quarter and recorded no provisional adjustment to the amount recorded at December 31, 2017.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2018
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	14. Fair Value of Financial Instruments The carrying amounts reported at December 31, 2018 and 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 and are categorized as Level 1 within the GAAP fair value hierarchy. The fair value of the Company’s revolving line of credit is categorized as Level 2. The Company has debt with variable and fixed interest rates. The fair value of debt with fixed interest rates was determined using the quoted market prices of debt instruments with similar terms and maturities, which are considered Level 2 inputs. The fair value of debt with variable interest rates was also measured using other Level 2 inputs, including good faith estimates of the market value for the particular debt instrument, which represent the amount an independent market participant would provide, based upon market observations and other factors relevant under the circumstances. The carrying value of such debt approximated its estimated fair value at December 31, 2018 and 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 our own nonperformance risk and the respective counterparty’s nonperformance risk. The fair value measurement of interest rate swaps utilized Level 2 inputs. Refer to Note 7 (Long-Term Debt) for further discussion of the interest rate swap agreements. Intangible assets are measured at fair value on a non-recurring basis. These assets are classified in Level 3 of the fair value hierarchy. Goodwill and other indefinite-lived intangibles are tested for impairment at least annually, or more frequently if circumstances indicate that the carrying amount exceeds fair value. The Company estimates the fair values of goodwill and other indefinite-lived intangibles utilizing multiple measurement techniques. The estimation is primarily determined based on an estimate of future cash flows (income approach) discounted at a market derived weighted-average cost of capital. The income approach has been determined to be the most representative of fair value. Other unobservable inputs used in these valuations include management’s cash flow projections and estimated terminal growth rates. The valuation of indefinite-lived intangible assets also includes an unobservable input for royalty rate, which is based on rates used by comparable industries. The useful lives of definite-lived intangible assets (customer relationships) are evaluated whenever events or circumstances warrant a revision to the remaining amortization period. The fair value of definite-lived intangible assets is based on estimated cash flows from the future use of the asset, discounted at a market derived weighted-average cost of capital. Long-lived assets are measured at fair value on a non-recurring basis and are classified in Level 3 of the fair value hierarchy. The fair value is estimated utilizing unobservable inputs, including appraisals on real estate as well as evaluations of the marketability and potential relocation of other assets in similar condition and similar market areas. The Company analyzes long-lived assets on an annual basis for any triggering events that would necessitate an impairment test. No impairment charges were recorded for the years ended December 31, 2018, 2017 and 2016.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2018
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	15. Commitments and Contingencies Operating Leases The Company has entered into various operating leases expiring through June 2025. Commercial properties under operating leases primarily include space required to perform client services and space for administrative facilities. Rent expense was $10.4 million, $7.5 million and $7.4 million for the years ended December 31, 2018, 2017 and 2016, respectively. The Company recognizes rent expense on a straight line basis with the difference between rent expense and rent paid recorded as deferred rent. Such amount is included in accrued liabilities in the consolidated balance sheets. The future minimum lease payments under non-cancelable operating leases with remaining terms of one or more years as of December 31, 2018 consisted of the following (in thousands): Years ending December 31, Annual Payment 2019 $ 11,722 2020 9,896 2021 8,816 2022 8,116 2023 7,635 Thereafter 38,357 Total $ 84,542 Litigation RSG Litigation On June 30, 2017, Jeffrey Smith, Abhilash Patel and certain of their affiliates (“Plaintiffs”) 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.) (the “Smith Litigation). Plaintiffs are former owners of Referral Solutions Group, LLC (RSG) and Taj Media, LLC, which were acquired by the Company in July 2015. The plaintiffs generally alleged that, in connection with the Company’s acquisition, the defendants violated California securities laws and further allege intentional misrepresentation, common law fraud, equitable fraud, promissory estoppel, civil conspiracy to conceal an investigation and civil conspiracy to conceal profitability. On November 21, 2018, the Company entered into a settlement (the “Settlement”) with Plaintiffs providing that (i) the Company pay Plaintiffs an aggregate of $8,000,000 (the “Settlement Payment”) in payments to be made throughout 2019, (ii) mutual exchange of releases, (iii) dismissal of the litigation and (iv) other non-monetary terms. In connection with the Settlement, the Company also agreed to release its former officer and director, Jerrod N. Menz (“Menz”) from his agreement to contribute 300,000 shares to the settlement of a previously settled securities class action lawsuit in exchange for Menz releasing his claim for indemnification arising out of the Smith Litigation. SEC Matter The Company provided general accounting, finance and governance documentation in response to a subpoena received from the SEC in March 2018. Following this initial document request, the Commission requested additional information pertaining to the Company’s accounting for partial payments from insurance companies, where the Company is continuing to pursue additional collections for the estimated balance. Beginning in the third quarter of 2018, the Company’s Audit Committee initiated a review of the Company’s accounting for these partial payments. The Audit Committee has completed this review. In connection with this review, the Audit Committee determined that the Company’s change in estimate of the collectability of accounts receivable relating to partial payments was appropriate. See “Note 2. Basis of Presentation and Recently Issued Accounting Pronouncements—Change in Accounting Estimate.” The Commission’s investigation is ongoing, and the Company is continuing to fully cooperate on this matter. The Commission’s investigation is neither an allegation of wrongdoing nor a finding that any violation of law has occurred. At this time, the Company is unable to predict the final outcome of this matter or what impact it might have on the Company’s consolidated financial position, results of operations or cash flows. Other The Company is also aware of various other legal matters arising in the ordinary course of business. To cover these other types of claims as well as the legal matters referenced above, the Company maintains insurance it believes to be sufficient for its operations, although some claims may potentially exceed the scope of coverage in effect and the insurer may argue that some claims, including, without limitation, the claims described above, are excluded from coverage. Plaintiffs in these matters may also request punitive or other damages that may not be covered by insurance. Except as described above, after taking into consideration the evaluation of such matters by the Company’s legal counsel, the Company’s management believes at this time that the anticipated outcome of these matters will not have a material impact on the Company’s consolidated financial position, results of operations or cash flows.

Related Parties

Related Parties	12 Months Ended
	Dec. 31, 2018
Related Party Transactions [Abstract]
Related Parties	16. Related Parties An entity beneficially owned by Mr. Cartwright, the Company’s Chief Executive Officer, owns an airplane that the Company uses for business purposes in the course of its operations pursuant to a written lease agreement. The Company pays an hourly rate for use of the airplane as well as fuel and certain maintenance costs. For the years ended December 31, 2018, 2017 and 2016, the Company made aggregate payments to the related entity for use of the airplane of approximately $1.2

Unaudited Quarterly Information

Unaudited Quarterly Information (Restated)	12 Months Ended
	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Unaudited Quarterly Information (Restated)	17. Unaudited Quarterly Information (Restated) The tables below present summarized unaudited quarterly results of operations for the years ended December 31, 2018 and 2017, as restated to reflect adjustments to our previously issued financial statements as more fully discussed in Note 2A, Restatement of Previously Issued Financial Statements Management believes that all necessary adjustments have been included in the amounts stated below for a fair presentation of the results of operations for the periods presented when read in conjunction with the Company’s consolidated financial statements for the years ended December 31, 2018 and 2017. Results of operations for a particular quarter are not necessarily indicative of results of operations for an annual period and are not predictive of future periods. Quarter Ended March 31, Restated June 30, Restated September 30, Restated December 31, (In thousands except share data) 2018: Revenue $ 81,187 $ 88,094 $ 69,034 $ 57,448 (a) Net loss $ (837 ) $ (3,592 ) $ (23,844 ) $ (38,445 ) (a),(b) Net income (loss) available to AAC Holdings, Inc. common stockholders $ 1,056 $ (1,602 ) $ (22,181 ) $ (36,677 ) (a),(b) Basic net loss per share $ 0.04 $ (0.07 ) $ (0.92 ) $ (1.52 ) Diluted net loss per share $ 0.04 $ (0.07 ) $ (0.92 ) $ (1.52 ) Quarter Ended March 31, Restated June 30, Restated September 30, Restated December 31, Restated 2017: (In thousands except share data) Revenue $ 73,039 $ 78,042 $ 80,424 $ 86,136 Net (loss) income $ (766 ) $ 158 $ 715 $ (17,488 ) (c) Net (loss) income available to AAC Holdings, Inc. common stockholders $ 275 $ 1,140 $ 1,841 $ (16,129 ) (c) Basic net (loss) income per share $ 0.01 $ 0.05 $ 0.08 $ (0.69 ) Diluted net (loss) income per share $ 0.01 $ 0.05 $ 0.08 $ (0.69 ) (a) Refer to Note 2 – Basis of Presentation (b) Refer to Note 15 – Commitments and Contingencies (c) Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters. The following tables present our quarterly historical consolidated financial data as of the dates and for the periods indicated. The quarterly financial data set forth below have been restated to reflect adjustments to our previously issued financial statements as more fully discussed in Note 2A, Restatement of Previously Issued Financial Statements The initial application of Topic 606 caused no impact to the beginning balances of the Company’s consolidated financial statements as of January 1, 2018. The restated impact of the Adoption of Topic 606 on the Company’s Condensed Consolidated Statements of Operations for the first three quarters of 2018 was as follows (in thousands): Three Months Ended March 31, 2018 Restated As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 78,630 $ 82,481 $ (3,851 ) Non-client related revenue 2,557 2,798 (241 ) Provision for doubtful accounts - 4,092 (4,092 ) Three Months Ended June 30, 2018 Restated As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 84,620 $ 96,150 $ (11,530 ) Non-client related revenue 3,474 3,616 (142 ) Provision for doubtful accounts 366 12,038 (11,672 ) Three Months Ended September 30, 2018 Restated As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 66,107 $ 81,626 $ (15,519 ) Non-client related revenue 2,927 3,029 (102 ) Provision for doubtful accounts - 15,621 (15,621 ) A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2016, restated $ 69,460 Additions charged to provision for doubtful accounts 4,403 Accounts written off, net of recoveries (680 ) Balance at March 31, 2017, restated $ 73,183 Additions charged to provision for doubtful accounts 6,261 Accounts written off, net of recoveries (2,231 ) Balance at June 30, 2017, restated $ 77,213 Additions charged to provision for doubtful accounts 7,406 Accounts written off, net of recoveries (2,239 ) Balance at September 30, 2017, restated $ 82,380 Income Taxes The provision for income taxes for the three months ended September 30, 2018 and 2017 reflects an income tax benefit of $1.1 million and expense of $0.7 million, respectively, at an effective tax rate of 4.3% and 50.9%, respectively. The increase in income tax benefit from the comparable period in 2017 and the change in the effective tax rate is primarily related to the change in loss before income tax benefit as well as tax treatment of stock compensation, litigation settlement expense and the effect of the Tax Cuts and Jobs Act. The provision for income taxes for the three months ended June 30, 2018 and 2017 reflects an income tax benefit of $0.2 million and expense of $0.7 million, respectively, at an effective tax rate of 4.3% and 82.4%, respectively. The increase in income tax benefit from the comparable period in 2017 and the change in the effective tax rate is primarily related to the change in loss before income tax benefit as well as tax treatment of stock compensation, litigation settlement expense and the effect of the Tax Cuts and Jobs Act. The provision for income taxes for the three months ended March 31, 2018 and 2017 reflects an income tax benefit of $0.0 million and expense of $0.7 million, respectively, at an effective tax rate of 4.3% and (2,910.0%), respectively. The increase in income tax benefit from the comparable period in 2017 and the change in the effective tax rate is primarily related to the change in loss before income tax benefit as well as tax treatment of stock compensation, litigation settlement expense and the effect of the Tax Cuts and Jobs Act. AAC Holdings, Inc. Unaudited Consolidated Statement of Operations For the Three Months Ended September 30, 2018 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 74,477 $ (8,370 ) $ 66,107 Non-client related revenue 2,996 (69 ) 2,927 Total revenues 77,473 (8,439 ) 69,034 Operating expenses Salaries, wages and benefits 44,831 - 44,831 Client related services 8,594 - 8,594 Provision for doubtful accounts - - - Advertising and marketing 3,037 - 3,037 Professional fees 5,697 - 5,697 Other operating expenses 12,833 - 12,833 Rentals and leases 2,760 - 2,760 Litigation settlement 100 - 100 Depreciation and amortization 5,573 - 5,573 Acquisition-related expenses 1,058 (947 ) 111 Total operating expenses 84,483 (947 ) 83,536 Loss from operations (7,010 ) (7,492 ) (14,502 ) Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 8,738 - 8,738 Loss on contingent consideration - 947 947 Other expense, net 732 - 732 Loss before income tax expense (16,480 ) (8,439 ) (24,919 ) Income tax benefit (3,324 ) 2,249 (1,075 ) Net loss (13,156 ) (10,688 ) (23,844 ) Less: net loss attributable to noncontrolling interest 1,663 - 1,663 Net loss attributable to AAC Holdings, Inc. common stockholders $ (11,493 ) $ (10,688 ) $ (22,181 ) Basic loss per common share $ (0.47 ) $ (0.92 ) Diluted loss per common share $ (0.47 ) $ (0.92 ) Weighted-average common shares outstanding: Basic 24,205,159 24,205,159 Diluted 24,205,159 24,205,159 AAC Holdings, Inc. Unaudited Consolidated Statement of Operations For the Three Months Ended June 30, 2018 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 83,293 $ 1,327 $ 84,620 Non-client related revenue 3,468 6 3,474 Total revenues 86,761 1,333 88,094 Operating expenses Salaries, wages and benefits 46,850 - 46,850 Client related services 8,393 - 8,393 Provision for doubtful accounts 366 - 366 Advertising and marketing 2,584 - 2,584 Professional fees 4,950 - 4,950 Other operating expenses 12,194 - 12,194 Rentals and leases 2,563 - 2,563 Litigation settlement 244 - 244 Depreciation and amortization 5,909 - 5,909 Acquisition-related expenses - 176 176 Total operating expenses 84,053 176 84,229 Income from operations 2,708 1,157 3,865 Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 7,893 - 7,893 Gain on contingent consideration - (176 ) (176 ) Other income, net (98 ) - (98 ) Loss before income tax expense (5,087 ) 1,333 (3,754 ) Income tax benefit (84 ) (78 ) (162 ) Net loss (5,003 ) 1,411 (3,592 ) Less: net loss attributable to noncontrolling interest 1,990 - 1,990 Net loss attributable to AAC Holdings, Inc. common stockholders $ (3,013 ) $ 1,411 $ (1,602 ) Basic loss per common share $ (0.12 ) $ (0.07 ) Diluted loss per common share $ (0.12 ) $ (0.07 ) Weighted-average common shares outstanding: Basic 24,166,976 24,166,976 Diluted 24,166,976 24,166,976 AAC Holdings, Inc. Unaudited Consolidated Statement of Operations For the Three Months Ended March 31, 2018 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 75,923 $ 2,707 $ 78,630 Non-client related revenue 2,550 7 2,557 Total revenues 78,473 2,714 81,187 Operating expenses Salaries, wages and benefits 40,084 - 40,084 Client related services 7,747 - 7,747 Provision for doubtful accounts - - - Advertising and marketing 2,599 - 2,599 Professional fees 3,650 - 3,650 Other operating expenses 10,588 - 10,588 Rentals and leases 2,116 - 2,116 Litigation settlement 2,791 - 2,791 Depreciation and amortization 5,464 - 5,464 Acquisition-related expenses 305 - 305 Total operating expenses 75,344 - 75,344 Income from operations 3,129 2,714 5,843 Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 6,709 - 6,709 Gain on contingent consideration - - - Other expense, net 9 - 9 Loss before income tax expense (3,589 ) 2,714 (875 ) Income tax benefit (1,494 ) 1,456 (38 ) Net loss (2,095 ) 1,258 (837 ) Less: net loss attributable to noncontrolling interest 1,893 - 1,893 Net (loss) income attributable to AAC Holdings, Inc. common stockholders $ (202 ) $ 1,258 $ 1,056 Basic (loss) earnings per common share $ (0.01 ) $ 0.04 Diluted (loss) earnings per common share $ (0.01 ) $ 0.04 Weighted-average common shares outstanding: Basic 23,744,208 23,744,208 Diluted 23,744,208 23,781,604 AAC Holdings, Inc. Unaudited Consolidated Statement of Operations For the Three Months Ended September 30, 2017 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 77,948 $ - $ 77,948 Non-client related revenue 2,476 - 2,476 Total revenues 80,424 - 80,424 Operating expenses Salaries, wages and benefits 36,709 - 36,709 Client related services 6,598 - 6,598 Provision for doubtful accounts 9,682 (2,276 ) 7,406 Advertising and marketing 3,074 - 3,074 Professional fees 3,641 - 3,641 Other operating expenses 8,306 - 8,306 Rentals and leases 2,105 - 2,105 Litigation settlement - - - Depreciation and amortization 5,218 - 5,218 Acquisition-related expenses 370 - 370 Total operating expenses 75,703 (2,276 ) 73,427 Income from operations 4,721 2,276 6,997 Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 5,492 - 5,492 Loss on extinguishment of debt - - - Gain on contingent consideration - - - Other expense, net 49 - 49 (Loss) income before income tax expense (820 ) 2,276 1,456 Income tax expense (benefit) (456 ) 1,197 741 Net (loss) income (364 ) 1,079 715 Less: net loss attributable to noncontrolling interest 1,126 - 1,126 Net income attributable to AAC Holdings, Inc. common stockholders $ 762 $ 1,079 $ 1,841 Basic earnings per common share $ 0.03 $ 0.08 Diluted earnings per common share $ 0.03 $ 0.08 Weighted-average common shares outstanding: Basic 23,331,414 23,331,414 Diluted 23,469,985 23,469,985 AAC Holdings, Inc. Unaudited Consolidated Statement of Operations For the Three Months Ended June 30, 2017 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 75,692 $ - $ 75,692 Non-client related revenue 2,350 - 2,350 Total revenues 78,042 - 78,042 Operating expenses Salaries, wages and benefits 34,508 - 34,508 Client related services 6,646 - 6,646 Provision for doubtful accounts 9,496 (3,235 ) 6,261 Advertising and marketing 3,266 - 3,266 Professional fees 3,039 - 3,039 Other operating expenses 8,199 - 8,199 Rentals and leases 1,849 - 1,849 Litigation settlement - - - Depreciation and amortization 5,058 - 5,058 Acquisition-related expenses 42 - 42 Total operating expenses 72,103 (3,235 ) 68,868 Income from operations 5,939 3,235 9,174 Interest expense, net (including change in fair value of interest rate swaps of ($25), respectively) 2,846 - 2,846 Loss on extinguishment of debt 5,435 - 5,435 Gain on contingent consideration - - - Other income, net 6 - 6 (Loss) income before income tax expense (2,336 ) 3,235 899 Income tax expense 562 179 741 Net (loss) income (2,898 ) 3,056 158 Less: net loss attributable to noncontrolling interest 982 - 982 Net (loss) income attributable to AAC Holdings, Inc. common stockholders $ (1,916 ) $ 3,056 $ 1,140 Basic (loss) earnings per common share $ (0.08 ) $ 0.05 Diluted (loss) earnings per common share $ (0.08 ) $ 0.05 Weighted-average common shares outstanding: Basic 23,242,177 23,242,177 Diluted 23,242,177 23,254,162 AAC Holdings, Inc. Unaudited Consolidated Statement of Operations For the Three Months Ended March 31, 2017 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 71,219 $ - $ 71,219 Non-client related revenue 1,820 - 1,820 Total revenues 73,039 - 73,039 Operating expenses Salaries, wages and benefits 36,772 - 36,772 Client related services 6,378 - 6,378 Provision for doubtful accounts 6,587 (2,184 ) 4,403 Advertising and marketing 3,775 - 3,775 Professional fees 2,642 - 2,642 Other operating expenses 8,789 - 8,789 Rentals and leases 1,885 - 1,885 Litigation settlement - - - Depreciation and amortization 5,469 - 5,469 Acquisition-related expenses 183 - 183 Total operating expenses 72,480 (2,184 ) 70,296 Income from operations 559 2,184 2,743 Interest expense, net (including change in fair value of interest rate swaps of ($83), respectively) 2,734 - 2,734 Loss on extinguishment of debt - - - Gain on contingent consideration - - - Other expense, net 34 - 34 Loss before income tax expense (2,209 ) 2,184 (25 ) Income tax (benefit) expense (565 ) 1,306 741 Net loss (1,644 ) 878 (766 ) Less: net loss attributable to noncontrolling interest 1,041 - 1,041 Net (loss) income attributable to AAC Holdings, Inc. common stockholders $ (603 ) $ 878 $ 275 Basic (loss) earnings per common share $ (0.03 ) $ 0.01 Diluted (loss) earnings per common share $ (0.03 ) $ 0.01 Weighted-average common shares outstanding: Basic 23,163,626 23,163,626 Diluted 23,163,626 23,174,899 AAC Holdings, Inc. Unaudited Consolidated Balance Sheet September 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 5,259 $ - $ 5,259 Accounts receivable, net of allowances 94,583 (34,744 ) 59,839 Prepaid expenses and other current assets 5,547 - 5,547 Total current assets 105,389 (34,744 ) 70,645 Property and equipment, net 166,345 - 166,345 Goodwill 198,952 - 198,952 Intangible assets, net 12,561 - 12,561 Deferred tax assets, net 13,042 (10,118 ) 2,924 Other assets 10,679 - 10,679 Total assets $ 506,968 $ (44,862 ) $ 462,106 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 8,722 $ - $ 8,722 Accrued and other current liabilities 31,607 - 31,607 Accrued litigation - - - Current portion of long-term debt 8,350 - 8,350 Total current liabilities 48,679 - 48,679 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 297,143 - 297,143 Financing lease obligation, net of current portion 24,459 - 24,459 Other long-term liabilities 11,993 - 11,993 Total liabilities 382,274 - 382,274 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,621,653 shares issued and outstanding at September 30, 2018, respectively 25 - 25 Additional paid-in capital 161,209 - 161,209 Retained deficit (16,168 ) (44,862 ) (61,030 ) Total stockholders’ equity 145,066 (44,862 ) 100,204 Noncontrolling interest (20,372 ) - (20,372 ) Total stockholders’ equity including noncontrolling interest 124,694 (44,862 ) 79,832 Total liabilities and stockholders’ equity $ 506,968 $ (44,862 ) $ 462,106 AAC Holdings, Inc. Unaudited Consolidated Balance Sheet June 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 11,353 $ - $ 11,353 Accounts receivable, net of allowances 97,362 (26,305 ) 71,057 Prepaid expenses and other current assets 4,638 - 4,638 Total current assets 113,353 (26,305 ) 87,048 Property and equipment, net 168,373 - 168,373 Goodwill 197,184 - 197,184 Intangible assets, net 13,201 - 13,201 Deferred tax assets, net 9,572 (7,723 ) 1,849 Other assets 11,069 - 11,069 Total assets 512,752 (34,028 ) 478,724 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 6,613 $ - $ 6,613 Accrued and other current liabilities 30,487 - 30,487 Accrued litigation - - - Current portion of long-term debt 6,723 - 6,723 Total current liabilities 43,823 - 43,823 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 295,322 - 295,322 Financing lease obligation, net of current portion 24,488 - 24,488 Other long-term liabilities 12,322 - 12,322 Total liabilities 375,955 - 375,955 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,596,675 shares issued and outstanding at June 30, 2018, respectively 25 - 25 Additional paid-in capital 160,156 - 160,156 Retained deficit (4,675 ) (34,028 ) (38,703 ) Total stockholders’ equity 155,506 (34,028 ) 121,478 Noncontrolling interest (18,709 ) - (18,709 ) Total stockholders’ equity including noncontrolling interest 136,797 (34,028 ) 102,769 Total liabilities and stockholders’ equity $ 512,752 $ (34,028 ) $ 478,724 AAC Holdings, Inc. Unaudited Consolidated Balance Sheet March 31, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 14,341 $ - $ 14,341 Accounts receivable, net of allowances 99,581 (27,637 ) 71,944 Prepaid expenses and other current assets 3,354 - 3,354 Total current assets 117,276 (27,637 ) 89,639 Property and equipment, net 169,744 - 169,744 Goodwill 197,184 - 197,184 Intangible assets, net 13,712 - 13,712 Deferred tax assets, net 9,030 (7,343 ) 1,687 Other assets 12,468 - 12,468 Total assets $ 519,414 $ (34,980 ) $ 484,434 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 3,338 $ - $ 3,338 Accrued and other current liabilities 34,039 - 34,039 Accrued litigation 1,000 - 1,000 Current portion of long-term debt 7,319 - 7,319 Total current liabilities 45,696 - 45,696 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 296,443 - 296,443 Financing lease obligation, net of current portion 24,515 - 24,515 Other long-term liabilities 12,277 - 12,277 Total liabilities 378,931 - 378,931 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,438,739 shares issued and outstanding at March 31, 2018, respectively 24 - 24 Additional paid-in capital 158,840 - 158,840 Retained deficit (1,662 ) (34,980 ) (36,642 ) Total stockholders’ equity 157,202 (34,980 ) 122,222 Noncontrolling interest (16,719 ) - (16,719 ) Total stockholders’ equity including noncontrolling interest 140,483 (34,980 ) 105,503 Total liabilities and stockholders’ equity $ 519,414 $ (34,980 ) $ 484,434 AAC Holdings, Inc. Unaudited Consolidated Balance Sheet September 30, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 16,412 $ - $ 16,412 Accounts receivable, net of allowances 92,547 (33,638 ) 58,909 Prepaid expenses and other current assets 6,030 - 6,030 Total current assets 114,989 (33,638 ) 81,351 Property and equipment, net 151,769 - 151,769 Goodwill 134,396 - 134,396 Intangible assets, net 9,169 - 9,169 Deferred tax assets, net 1,579 (1,579 ) - Other assets 5,664 - 5,664 Total assets $ 417,566 $ (35,217 ) $ 382,349 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 5,732 $ - $ 5,732 Accrued and other current liabilities 24,633 - 24,633 Accrued litigation - - - Current portion of long-term debt 4,736 - 4,736 Total current liabilities 35,101 - 35,101 Deferred tax liabilities - 4,709 4,709 Long-term debt, net of current portion and debt issuance costs 197,872 - 197,872 Financing lease obligation, net of current portion 24,398 - 24,398 Other long-term liabilities 3,836 - 3,836 Total liabilities 261,207 4,709 265,916 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,021,219 shares issued and outstanding at September 30, 2017, respectively 24 - 24 Additional paid-in capital 152,440 - 152,440 Retained earnings (deficit) 17,362 (39,926 ) (22,564 ) Total stockholders’ equity 169,826 (39,926 ) 129,900 Noncontrolling interest (13,467 ) - (13,467 ) Total stockholders’ equity including noncontrolling interest 156,359 (39,926 ) 116,433 Total liabilities and stockholders’ equity $ 417,566 $ (35,217 ) $ 382,349 AAC Holdings, Inc. Unaudited Consolidated Balance Sheet June 30, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 10,793 $ - $ 10,793 Accounts receivable, net of allowances 96,527 (35,914 ) 60,613 Prepaid expenses and other current assets 4,456 - 4,456 Total current assets 111,776 (35,914 ) 75,862 Property and equipment, net 148,965 - 148,965 Goodwill 134,396 - 134,396 Intangible assets, net 9,551 - 9,551 Deferred tax assets, net 1,180 (1,180 ) - Other assets 783 - 783 Total assets $ 406,651 $ (37,094 ) $ 369,557 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 10,441 $ - $ 10,441 Accrued and other current liabilities 24,800 - 24,800 Accrued litigation - - - Current portion of long-term debt 4,503 - 4,503 Total current liabilities 39,744 - 39,744 Deferred tax liabilities - 3,968 3,968 Long-term debt, net of current portion and debt issuance costs 208,467 - 208,467 Financing lease obligation, net of current portion - - - Other long-term liabilities 3,782 - 3,782 Total liabilities 251,993 3,968 255,961 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,060,888 shares issued and outstanding at June 30, 2017, respectively 24 - 24 Additional paid-in capital 150,375 - 150,375 Retained earnings (deficit) 16,600 (41,062 ) (24,462 ) Total stockholders’ equity 166,999 (41,062 ) 125,937 Noncontrolling interest (12,341 ) - (12,341 ) Total stockholders’ equity including noncontrolling interest 154,658 (41,062 ) 113,596 Total liabilities and stockholders’ equity $ 406,651 $ (37,094 ) $ 369,557 AAC Holdings, Inc. Unaudited Consolidated Balance Sheet March 31, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 5,880 $ - $ 5,880 Accounts receivable, net of allowances 94,144 (39,149 ) 54,995 Prepaid expenses and other current assets 4,897 - 4,897 Total current assets 104,921 (39,149 ) 65,772 Property and equipment, net 145,410 - 145,410 Goodwill 134,396 - 134,396 Intangible assets, net 9,953 - 9,953 Deferred tax assets, net 1,316 (1,316 ) - Other assets 626 - 626 Total assets $ 396,622 $ (40,465 ) $ 356,157 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 13,711 $ - $ 13,711 Accrued and other current liabilities 24,865 - 24,865 Accrued litigation - - - Current portion of long-term debt 10,965 - 10,965 Total current liabilities 49,541 - 49,541 Deferred tax liabilities - 3,227 3,227 Long-term debt, net of current portion and debt issuance costs 187,456 - 187,456 Financing lease obligation, net of current portion - - - Other long-term liabilities 4,121 - 4,121 Total liabilities 241,118 3,227 244,345 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,076,469 shares issued and outstanding at March 31, 2017, respectively 24 - 24 Additional paid-in capital 148,323 - 148,323 Retained earnings (deficit) 18,516 (43,692 ) (25,176 ) Total stockholders’ equity 166,863 (43,692 ) 123,171 Noncontrolling interest (11,359 ) - (11,359 ) Total stockholders’ equity including noncontrolling interest 155,504 (43,692 ) 111,812 Total liabilities and stockholders’ equity $ 396,622 $ (40,465 ) $ 356,157 AAC Holdings, Inc. Unaudited Consolidated Statements of Cash Flows For the Nine Months Ended, September 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (20,254 ) $ (8,019 ) $ (28,273 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 366 - 366 Depreciation and amortization 16,946 - 16,946 Equity compensation 3,104 - 3,104 Loss on disposal of property and equipment 1,000 - 1,000 Loss on extinguishment of debt - - - Loss on contingent consideration - 771 771 Amortization of debt issuance costs 2,077 - 2,077 Deferred income taxes (5,032 ) 3,627 (1,405 ) Changes in operating assets and liabilities: Accounts receivable 3,503 4,392 7,895 Prepaid expenses and other assets (461 ) - (461 ) Accounts payable 645 - 645 Accrued and other current liabilities 2,207 (771 ) 1,436 Accrued litigation (23,300 ) - (23,300 ) Other long-term liabilities (559 ) - (559 ) Net cash (used in) provided by operating activities (19,758 ) - (19,758 ) Cash flows from investing activities: Purchase of property and equipment (15,458 ) - (15,458 ) Acquisition of subsidiaries (65,827 ) - (65,827 ) Change in funds held on acquisition - - - Net cash used in investing activities (81,285 ) - (81,285 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility - - - Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs - - - Payments on 2017 Credit Facility (5,172 ) - (5,172 ) Proceeds from 2017 Credit Facility, net of deferred financing costs 99,286 - 99,286 Proceeds from financing lease obligation, net of deferred financing costs - - - Payments on capital leases and other (563 ) - (563 ) Payments on AdCare Note (500 ) - (500 ) Repayment of long-term debt — related party - - - Change in funds held on acquisition - - - Payment of employee taxes for net share settlement (567 ) - (567 ) Net cash provided by financing activities 92,484 - 92,484 Net change in cash and cash equivalents (8,559 ) - (8,559 ) Cash and cash equivalents, beginning of period 13,818 - 13,818 Cash and cash equivalents, end of period $ 5,259 $ - $ 5,259 AAC Holdings, Inc. Unaudited Consolidated Statements of Cash Flows For the Six Months Ended, June 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (7,098 ) $ 2,669 $ (4,429 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 366 - 366 Depreciation and amortization 11,373 - 11,373 Equity compensation 2,159 - 2,159 Loss on disposal of property and equipment 34 - 34 Loss on extinguishment of debt - - - Gain on contingent consideration - (176 ) (176 ) Amortization of debt issuance costs 1,357 - 1,357 Deferred income taxes (1,562 ) 1,378 (184 ) Changes in operating assets and liabilities: Accounts receivable 724 (4,047 ) (3,323 ) Prepaid expenses and other assets 1,475 - 1,475 Accounts payable (1,464 ) - (1,464 ) Accrued and other current liabilities 457 176 633 Accrued litigation (23,300 ) - (23,300 ) Other long-term liabilities (230 ) - (230 ) Net cash (used in) provided by operating activities (15,709 ) - (15,709 ) Cash flows from investing activities: Purchase of property and equipment (11,196 ) - (11,196 ) Acquisition of subsidiaries (65,185 ) - (65,185 ) Change in funds held on acquisition - - - Net cash used in investing activities (76,381 ) - (76,381 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility - - - Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs - - - Payments on 2017 Credit Facility (3,448 ) - (3,448 ) Proceeds from 2017 Credit Facility, net of deferred financing costs 94,286 - 94,286 Proceeds from financing lease obligation, net of deferred financing costs - - - Payments on capital leases and other (440 ) - (440 ) Payments on AdCare Note (250 ) - (250 ) Repayment of long-term debt — related party - - - Change in funds held on acquisition - - - Payment of employee taxes for net share settlement (523 ) - (523 ) Net cash provided by financing activities 89,625 - 89,625 Net change in cash and cash equivalents (2,465 ) - (2,465 ) Cash and cash equivalents, beginning of period 13,818 - 13,818 Cash and cash equivalents, end of period $ 11,353 $ - $ 11,353 AAC Holdings, Inc. Unaudited Consolidated Statements of Cash Flows For the Three Months Ended, March 31, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net Income (loss) $ (2,095 ) $ 1,258 $ (837 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts - - - Depreciation and amortization 5,464 - 5,464 Equity compensation 798 - 798 Loss on disposal of property and equipment 34 - 34 Loss on extinguishment of debt - - - Gain (loss) on contingent consideration - - - Amortization of debt issuance costs 637 - 637 Deferred income taxes (1,020 ) 1,456 436 Changes in operating assets and liabilities: Accounts receivable (1,129 ) (2,714 ) (3,843 ) Prepaid expenses and other assets 1,485 - 1,485 Accounts payable (4,739 ) - (4,739 ) Accrued and other current liabilities 4,141 - 4,141 Accrued litigation (22,300 ) - (22,300 ) Other long-term liabilities (275 ) - (275 ) Net cash (used in) provided by operating activities (18,999 ) - (18,999 ) Cash flows from investing activities: Purchase of property and equipment (7,305 ) - (7,305 ) Acquisition of subsidiaries (65,185 ) - (65,185 ) Change in funds held on acquisition - - - Net cash used in investing activities (72,490 ) - (72,490 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility - - - Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs - - - Payments on 2017 Credit Facility (1,724 ) - (1,724 ) Proceeds from 2017 Credit Facility, net of deferred financing costs 94,432 - 94,432 Proceeds from financing lease obligation, net of deferred financing costs - - - Payments on capital leases and other (221 ) - (221 ) Payments on AdCare Note - - - Repayment of long-term debt — related party - - - Change in funds held on acquisition - - - Payment of employee taxes for net share settlement (475 ) - (475 ) Net cash provided by financing activities 92,012 - 92,012 Net change in cash and cash equivalents 523 - 523 Cash and cash equivalents, beginning of period 13,818 - 13,818 Cash and cash equivalents, end of period $ 14,341 $ - $ 14,341 AAC Holdings, Inc. Unaudited Consolidated Statements of Cash Flows For the Nine Months Ended, September 30, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net Income (loss) $ (4,906 ) $ 5,013 $ 107 Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 25,765 (7,695 ) 18,070 Depreciation and amortization 15,745 - 15,745 Equity compensation 6,048 - 6,048 Loss on disposal of property and equipment - - - Loss on extinguishment of debt 5,435 - 5,435 Gain on contingent consideration - - - Amortization of debt issuance costs 949 - 949 Deferred income taxes (981 ) 2,682 1,701 Changes in operating assets and liabilities: Accounts receivable (30,978 ) - (30,978 ) Prepaid expenses and other assets (703 ) - (703 ) Accounts payable (3,423 ) - (3,423 ) Accrued and other current liabilities 1,171 - 1,171 Accrued litigation 165 - 165 Other long-term liabilities (257 ) - (257 ) Net cash (used in) provided by operating activities 14,030 - 14,030 Cash flows from investing activities: Purchase of property and equipment (27,186 ) - (27,186 ) Acquisition of subsidiaries - - - Change in funds held on acquisition - - - Net cash used in investing activities (27,186 ) - (27,186 ) Cash flows f

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Change in Accounting Estimate	Change in Accounting Estimate During the three months ended September 30, 2018 and effective as of July 1, 2018, the Company made a change in its accounting estimate of the collectability of accounts receivable, specifically relating to accounts where the Company has received a partial payment from a commercial insurance company and the Company is continuing to pursue additional collections for the balance that the Company estimates remains outstanding (“partial payment accounts receivable”). Based on the limited number of claims that were closed through the Company’s historical appeals process, information with respect to the ultimate resolution of the appeals of these partial payment accounts receivable has been limited. As a result, initial assumptions of the ultimate collectability rates for partial payment accounts receivable were primarily based on industry and other data. During 2018, to enhance the Company’s own collection processes, the Company began using a third-party vendor to pursue collections on these partial payment accounts receivable. As of December 31, 2018, the Company is using this vendor exclusively for collection of the partial payment accounts receivable. As a result of utilizing the third-party vendor, the number of partial payment claims closed through the appeals process has increased allowing the Company to rely on its own collection history and additional information obtained from the third party vendor to estimate ultimate collectability. This recent information indicated that the Company’s current assumptions were different from its historical assumptions. The Company used this additional information to further refine its procedures to more precisely estimate the collectability of partial payment accounts receivable. This change in estimate resulted in a reduction in revenue of approximately $6.0 million, an increase in net loss of approximately $5.7 million, or $0.24 loss per basic and diluted share for year ended December 31, 2018. The Company determined this change in assumptions and estimation procedures of the collectability of partial payment accounts receivable is a change in accounting estimate in accordance with Accounting Standards Codification (“ASC”) 250-10 “Accounting Changes and Error Corrections.”
Going Concern	Going Concern The Company incurred a loss from operations and had negative cash flows from operations for the year ended December 31, 2018, which contributed to limited liquidity at December 31, 2018. This resulted primarily from declines in patient census during the third and fourth quarters of 2018. The Company’s revenue is directly impacted by its ability to maintain census, which is dependent on a variety of factors, many of which are outside of the Company’s control, including its referral relationships, average length of stay of its clients, the extent to which third-party payors require preadmission authorization or utilization review controls, competition in the industry, the effectiveness of the Company’s multi-faceted sales and marketing strategy and the individual decisions of the Company’s clients to seek and commit to treatment. On March 8, 2019 the Company entered into an incremental senior credit facility for a principal loan of $30 million which originally matured on March 31, 2020 and was subsequently amended to mature on April 15, 2020. The uncertainties associated with the factors described above raise substantial doubt about the Company's ability to continue as a going concern. In order for the Company to continue operations beyond the next twelve months and to be able to discharge its liabilities and commitments in the normal course of business, the Company must do some or all of the following: (i) improve operating results by increasing census while maintaining efficiency regarding operating expenses through the cost savings initiatives implemented in late 2018 and early 2019; (ii) execute strategic alternatives related to the Company’s real-estate portfolio which could include further sale leasebacks of individual facilities or larger portions of the company’s real estate portfolio (iii) sell additional non-core or non-essential assets; and/or (iv) obtain additional financing. There can be no assurance that the Company will be able to achieve any or all of the foregoing. The consolidated financial statements were prepared on a going concern basis in accordance with U.S. GAAP. The going concern basis of presentation assumes that the Company will continue in operation for the next twelve months and will be able to realize its assets and discharge its liabilities and commitments in the normal course of business. It does not include any adjustments to reflect the possible future effects on the recoverability and classification of assets or the amounts and classification of liabilities that may result from its inability to continue as a going concern.
Reclassifications	2A. Restatement of Previously Issued Financial Statements . The cumulative effect of this error on the Company’s consolidated retained earnings at January 1, 2016 has been reflected as a reduction to retained earnings of approximately $23.8 million The impact of the correction of an error on the affected line items of the Company’s consolidated balance sheets as of December 31, 2016 and 2017 and consolidated statements of operations and cash flows for the years ended December 31, 2016 and 2017 is set forth below: AAC Holdings, Inc. Consolidated Statement of Operations (Dollars in thousands, except share data) Year Ended, December 31, 2017 Year Ended, December 31, 2016 As Previously Reported Adjustments Restated As Previously Reported Adjustments Restated Revenues Client related revenue $ 308,538 $ - $ 308,538 $ 270,569 $ - $ 270,569 Non-client related revenue 9,103 - 9,103 9,201 - 9,201 Total revenues 317,641 - 317,641 279,770 - 279,770 Operating expenses Salaries, wages and benefits 146,390 - 146,390 141,073 - 141,073 Client related services 27,031 - 27,031 24,446 - 24,446 Provision for doubtful accounts 36,914 (10,982 ) 25,932 21,485 17,064 38,549 Advertising and marketing 12,315 - 12,315 18,275 - 18,275 Professional fees 12,638 - 12,638 16,468 - 16,468 Other operating expenses 36,309 - 36,309 29,627 - 29,627 Rentals and leases 7,514 - 7,514 7,363 - 7,363 Litigation settlement 23,607 - 23,607 1,292 - 1,292 Depreciation and amortization 21,504 - 21,504 17,686 - 17,686 Acquisition-related expenses 1,162 - 1,162 2,691 - 2,691 Total operating expenses 325,384 (10,982 ) 314,402 280,406 17,064 297,470 (Loss) income from operations (7,743 ) 10,982 3,239 (636 ) (17,064 ) (17,700 ) Interest expense, net (including change in fair value of interest rate swaps of ($108), and ($180), respectively) 16,811 - 16,811 8,175 - 8,175 Loss on extinguishment of debt 5,435 - 5,435 - - - Gain on contingent consideration - - - (1,350 ) - (1,350 ) Other (income) expense, net 116 - 116 (500 ) - (500 ) Loss before income tax expense (30,105 ) 10,982 (19,123 ) (6,961 ) (17,064 ) (24,025 ) Income tax (benefit) expense (5,018 ) 3,276 (1,742 ) (1,220 ) 3,565 2,345 Net loss (25,087 ) 7,706 (17,381 ) (5,741 ) (20,629 ) (26,370 ) Less: net loss attributable to noncontrolling interest 4,508 - 4,508 5,152 - 5,152 Net loss attributable to AAC Holdings, Inc. common stockholders (20,579 ) 7,706 (12,873 ) (589 ) (20,629 ) (21,218 ) Basic loss per common share $ (0.88 ) $ (0.55 ) $ (0.03 ) $ (0.93 ) Diluted loss per common share $ (0.88 ) $ (0.55 ) $ (0.03 ) $ (0.93 ) Weighted-average common shares outstanding: Basic 23,277,444 23,277,444 22,718,117 22,718,117 Diluted 23,277,444 23,277,444 22,718,117 22,718,117 AAC Holdings, Inc. Consolidated Balance Sheet (Dollars in thousands, except share data) Year Ended, December 31, 2017 As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 13,818 $ - $ 13,818 Accounts receivable, net of allowances 94,096 (30,350 ) 63,746 Prepaid expenses and other current assets 4,022 - 4,022 Total current assets 111,936 (30,350 ) 81,586 Property and equipment, net 152,548 - 152,548 Goodwill 134,396 - 134,396 Intangible assets, net 8,829 - 8,829 Deferred tax assets, net 8,010 (6,360 ) 1,650 Other assets 12,556 - 12,556 Total assets $ 428,275 $ (36,710 ) $ 391,565 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 4,579 $ - $ 4,579 Accrued and other current liabilities 27,661 - 27,661 Accrued litigation 23,607 - 23,607 Current portion of long-term debt 4,722 - 4,722 Total current liabilities 60,569 - 60,569 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 196,451 - 196,451 Financing lease obligation, net of current portion 24,541 - 24,541 Other long-term liabilities 10,546 - 10,546 Total liabilities 292,107 - 292,107 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 23,872,436 shares issued and outstanding at December 31, 2017, respectively 24 - 24 Additional paid-in capital 152,430 - 152,430 Retained deficit (1,460 ) (36,710 ) (38,170 ) Total stockholders’ equity 150,994 (36,710 ) 114,284 Noncontrolling interest (14,826 ) - (14,826 ) Total stockholders’ equity including noncontrolling interest 136,168 (36,710 ) 99,458 Total liabilities and stockholders’ equity $ 428,275 $ (36,710 ) $ 391,565 AAC Holdings, Inc. Consolidated Statements of Cash Flows (Dollars in thousands, except share data) Year Ended, December 31, 2017 Year Ended, December 31, 2016 As Previously Reported Adjustments Restated As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (25,087 ) $ 7,706 $ (17,381 ) $ (5,741 ) $ (20,629 ) $ (26,370 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 36,914 (10,982 ) 25,932 21,485 17,064 38,549 Depreciation and amortization 21,504 - 21,504 17,686 - 17,686 Equity compensation 7,513 - 7,513 8,823 - 8,823 Loss on disposal of property and equipment 55 - 55 163 - 163 Loss on extinguishment of debt 5,435 - 5,435 - - - Gain on contingent consideration - - - (1,350 ) - (1,350 ) Amortization of debt issuance costs 1,564 - 1,564 633 - 633 Deferred income taxes (7,412 ) 3,276 (4,136 ) (1,793 ) 3,565 1,772 Changes in operating assets and liabilities: Accounts receivable (43,676 ) - (43,676 ) (45,838 ) - (45,838 ) Prepaid expenses and other assets (6,725 ) - (6,725 ) 2,510 - 2,510 Accounts payable (4,576 ) - (4,576 ) 824 - 824 Accrued and other current liabilities 4,685 - 4,685 2,973 - 2,973 Accrued litigation 22,645 - 22,645 162 - 162 Other long-term liabilities 6,453 - 6,453 (394 ) - (394 ) Net cash provided by operating activities 19,292 - 19,292 143 - 143 Cash flows from investing activities: Purchase of property and equipment (33,041 ) - (33,041 ) (37,304 ) - (37,304 ) Acquisition of subsidiaries - - - (18,825 ) - (18,825 ) Change in funds held on acquisition (1,000 ) - (1,000 ) (325 ) - (325 ) Net cash used in investing activities (34,041 ) - (34,041 ) (56,454 ) - (56,454 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility (211,094 ) - (211,094 ) (5,376 ) - (5,376 ) Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs 18,000 - 18,000 48,930 - 48,930 Payments on 2017 Credit Facility (17,126 ) - (17,126 ) - - - Proceeds from 2017 Credit Facility, net of deferred financing costs 211,073 - 211,073 - - - Proceeds from financing lease obligation, net of deferred financing costs 24,621 - 24,621 - - - Payments on capital leases and other (791 ) - (791 ) (834 ) - (834 ) Payments on AdCare Note - - - - - - Repayment of long-term debt — related party - - - (1,195 ) - (1,195 ) Change in funds held on acquisition 1,000 - 1,000 - - - Payment of employee taxes for net share settlement (1,080 ) - (1,080 ) - - - Net cash provided by financing activities 24,603 - 24,603 41,525 - 41,525 Net change in cash and cash equivalents 9,854 - 9,854 (14,786 ) - (14,786 ) Cash and cash equivalents, beginning of period 3,964 - 3,964 18,750 - 18,750 Cash and cash equivalents, end of period $ 13,818 $ - $ 13,818 $ 3,964 $ - $ 3,964
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue and expenses at the date and for the periods that the consolidated financial statements are prepared. On an ongoing basis, the Company evaluates its estimates, including those related to insurance adjustments, provisions for doubtful accounts, goodwill and intangible assets, long-lived assets, deferred revenue and income taxes. The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances. Actual results could materially differ from those estimates.
General and Administrative Costs	General and Administrative Costs The majority of the Company’s expenses are “cost of revenue” items. Costs that could be classified as general and administrative expenses include the Company’s corporate overhead costs, which were $81.6 million, $96.1 million, and $74.8 million for the years ended December 31, 2018, 2017 and 2016, respectively.
Client Related Revenue	Client Related Revenue The Company provides services to its clients in both inpatient and outpatient treatment settings. Client related revenues are recognized when services are performed at estimated net realizable value from clients, third-party payors and others for services provided. The Company receives the majority of payments from commercial payors at out-of-network rates. Client related revenues are recorded at established billing rates less adjustments to estimate net realizable value. Adjustments are recorded to state client service revenue at the amount expected to be collected for the service provided based on historic adjustments for out-of-network services not under contract. Prior to admission, each client’s insurance is verified, and the client self-pay amount is determined. The client self-pay portion is generally collected upon admission. In some instances, clients will pay out-of-pocket as services are provided or will make a deposit and negotiate the remaining payments. These out-of-pocket payments are included in accrued liabilities in the accompanying consolidated balance sheets, and revenue related to these payments is deferred and recognized over the period services are provided. Scholarships may be provided to a limited number of clients. The Company does not recognize revenue for care provided via scholarships. For the year ended December 31, 2018, no payor accounted for more than 10% of the Company’s revenue for the year ended December 31, 2018. For the year ended December 31, 2017, approximately 11.4% of the Company’s revenue was derived from Blue-Cross Blue Shield of Nevada, 10.9% came from Blue-Cross Blue-Shield of Texas and 10.3% came from Blue-Cross Blue-Shield of Florida. No other payor accounted for more than 10% of the Company’s revenue for the year ended December 31, 2017. For the year ended December 31, 2016, approximately 10.5% of the Company’s revenue was derived from Anthem Blue-Cross Blue-Shield of Florida, 10.4% by Blue-Cross Blue-Shield of Texas and 10.4% by Aetna. No other payor accounted for more than 10% of revenue for the year ended December 31, 2016. The following tables summarize the composition of the Company’s 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 year ended December 31, 2018 and 2017, client related revenue was (in thousands): Year Ended December 31, 2018 As Reported Year Ended December 31, 2017 Restated Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 235,513 82.8 $ 246,976 80.0 $ (11,463 ) (4.6 ) Outpatient facility and sober living services 34,405 12.1 29,080 9.4 5,325 18.3 Client related diagnostic services 14,607 5.1 32,482 10.6 (17,875 ) (55.0 ) Total client related revenue $ 284,525 100.0 $ 308,538 100.0 $ (24,013 ) (7.8 ) For the year ended December 31, 2018 and 2017, client related revenue on a comparable basis was (in thousands): Previous Accounting Guidance As Reported Year Ended December 31, 2018 Year Ended December 31, 2017 Restated Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 247,273 80.3 $ 246,976 80.0 $ 297 0.1 Outpatient facility and sober living services 35,947 11.7 29,080 9.4 6,867 23.6 Client related diagnostic services 24,561 8.0 32,482 10.6 (7,921 ) (24.4 ) Total client related revenue $ 307,781 100.0 $ 308,538 100.0 $ (757 ) (0.2 )
Non-Client Related Revenue	Non-Client Related Revenue Our non-client related revenue primarily consists of service charges for diagnostic laboratory services provided to clients of third-party addiction treatment providers, addiction care treatment Non-client revenue is recognized at the point in time that the Company satisfies its performance obligations in each service area.
Allowance for Contractual and Other Discounts	Allowance for Contractual and Other Discounts The Company derives the majority of its revenue from non-governmental commercial payors at out-of-network rates. Management estimates the allowance for contractual and other discounts based on its historical collection experience. The services authorized and provided, and the related reimbursements are often subject to interpretation and negotiation that could result in payments that differ from the Company’s estimates.
Accounts Receivable and Allowance for Doubtful Accounts	Accounts Receivable and Allowance for Doubtful Accounts Accounts receivable primarily consists of amounts due from third-party payors and is recorded net of contractual discounts. The Company’s ability to collect outstanding receivables is critical to its results of operations and cash flows. Prior to the adoption of Topic 606, accounts receivable is reported net of an allowance for doubtful accounts, which is management’s best estimate of accounts receivable that could become uncollectible in the future. Accordingly, accounts receivable reported in the Company’s consolidated financial statements is recorded at the net amount expected to be received. The Company’s primary collection risks are (i) the risk of overestimating net revenue at the time of billing that may result in the Company receiving less than the recorded receivable, (ii) the risk of non-payment as a result of commercial insurance companies denying claims, (iii) the risk that clients will fail to remit insurance payments to the Company when the commercial insurance company pays out-of-network claims directly to the client and (iv) resource and capacity constraints that may prevent the Company from handling the volume of billing and collection issues in a timely manner. The Company’s allowance for doubtful accounts is based on historical experience, but management also takes into consideration the age of accounts, creditworthiness of payors and current economic trends when evaluating the adequacy of the allowance for doubtful accounts. Subsequent to the year ended December 31, 2018 and as part of the preparation of the Company’s year-end financial statements, the Company used recently developed financial database analytical tools, in order to analyze cash collection trends for historical and prospective periods relating to its accounts receivable and allowance for doubtful accounts which resulted in more precise estimates being utilized beginning with the fourth quarter of 2018. See Note 2A, Restatement of Previously Issued Financial Statements Unaudited Quarterly Information (Restated) Approximately $2.2 million and $14.6 million of accounts receivable, net of the allowance for doubtful accounts, at December 31, 2018 and 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 estimated balance. The following table presents a summary of the Company’s aging of accounts receivable, net of the allowance for doubtful accounts as of December 31, 2017. 2018 is not presented as under Topic 606, the Company has no allowance for doubtful accounts as of December 31, 2018. Current 31-180 Days Over 180 Days Total December 31, 2017, restated 31.2 % 44.7 % 24.1 % 100.0 % At December 31, 2018, no payor accounted for more than 10% of accounts receivable. At December 31, 2017, 11.6% of accounts receivable was from Anthem Blue-Cross Blue-Shield of Colorado and 10.3% was from Blue-Cross Blue-Shield of California. No other payor accounted for more than 10% of accounts receivable at December 31, 2017. A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2015, restated $ 41,145 Additions charged to provision for doubtful accounts 38,549 Accounts written off, net of recoveries (10,234 ) Balance at December 31, 2016, restated $ 69,460 Additions charged to provision for doubtful accounts 25,932 Accounts written off, net of recoveries (6,968 ) Balance at December 31, 2017, restated $ 88,424 Balance at January 1, 2018 (1) $ - Additions charged to provision for doubtful accounts 366 Accounts written off, net of recoveries (366 ) Balance at December 31, 2018 $ - (1) As discussed at Note 3 to the Notes of the Consolidated Financial Statements, on January 1, 2018, the Company adopted the new revenue recognition standard (Topic 606). Upon adoption of Topic 606, the allowance for doubtful accounts of approximately $88.4 million was reclassified as a component of accounts receivable. The only activity that is now recorded as a provision for doubtful accounts is related to specific customers that experience significant adverse changes in creditworthiness, such as bankruptcies.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents.
Property, Plant and Equipment	Property and Equipment Property and equipment are stated at cost or at acquisition date fair value for assets obtained in business combinations, net of accumulated depreciation. Expenditures for maintenance and repairs are charged to expense as incurred. The Company capitalizes interest paid on debt that is outstanding while construction projects are in progress, and such interest is included in the cost of the related asset. Capitalized interest recognized by the Company for the year ended December 31, 2018 was $0.3 million. Assets held for development are classified as construction in progress, and the Company does not depreciate these assets until they are placed in service. Leasehold improvements are amortized over their estimated useful lives or the remaining lease period, whichever is less. Assets under capital leases are amortized over the lease term or in the event of transfer of ownership at the end of the lease over the economic life of the leased asset. Depreciation is calculated using the straight-line method over the estimated economic useful lives of the assets, as follows: Range of Lives Computer software and equipment 3 years Buildings 36 years Furniture, fixtures and equipment 5 years Vehicles 5 years Equipment under capital lease 3-5 years Leasehold improvements Life of the asset or lease, whichever is less
Assets and Liabilities Held for Sale	Assets and Liabilities Held for Sale We report long-lived assets to be disposed of by sale as held for sale and recognize those assets in the balance sheet at the lower of carrying amount or fair value less cost to sell, and we cease depreciation and amortization. In November 2018, the Company began actively pursuing the sale of its Townsend operations. On January 28, 2019, the Company finalized the sale for $1.9 million in cash proceeds from the buyer. The assets and liabilities deemed held for sale by the Company at December 31,2018 were as follows: • $0.1 million of property, plant and equipment, net; • $0.8 million of intangible assets, net; • $0.1 million of other long-term assets; • $0.1 million of current liabilities. The fair value of the assets deemed as held for sale were considered a Level 1 estimate. Because the implied fair value of the assets and liabilities was greater than the carrying value as of December 31, 2018, the Company did not recognize a gain or loss related to the assets held for sale for the year ended December 31, 2018. The Company recognized a gain of $0.9 million on January 28, 2019 related to the sale.
Goodwill and Other Intangible Assets	Goodwill and Other Intangible Assets The Company has only one operating segment, substance abuse and behavioral healthcare treatment services, for segment reporting purposes. The substance abuse and behavioral healthcare treatment services operating segment represents one reporting unit for purposes of the Company’s goodwill impairment test. Goodwill represents the excess of the purchase price over the fair value of the identifiable net assets acquired. Goodwill and intangible assets with indefinite lives are not amortized, but instead are tested for impairment at least annually or whenever events or changes in circumstances indicate the carrying value may not be recoverable. If the carrying value of goodwill exceeds its implied fair value, an impairment loss is recorded. While performing the Company’s annual goodwill impairment test as of December 31, 2018, t including, but not limited to, a declining market capitalization, declining cash flows and negative trending performance indicators, such as admissions and total daily census. Because these factors indicated impairment was likely, the Company performed a quantitative analysis to measure the amount of loss due to goodwill impairment, if any. The Company has no intangible assets with indefinite useful lives other than goodwill. The Company’s other intangible assets principally relate to trademarks, marketing intangibles, non-compete agreements, services contracts and leasehold interests acquired during business combinations. Trademarks, marketing intangibles and service contracts are amortized over a period of ten years, non-compete agreements are amortized over the term of the agreements, and leasehold interests are amortized over the remaining life of the leases.
Long-Lived Asset Impairment	Long-Lived Asset Impairment Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net undiscounted cash flows expected to be generated by the asset. Impairment is measured by the amount by which the carrying value of the assets exceeds the fair value of the assets. We review long-lived assets for impairment whenever events or changes in circumstances indicate that the related carrying amounts may not be recoverable. Due to the goodwill impairment recognized as of December 31, 2018, t The Company did not recognize any impairment to long-lived assets during the years ended December 31, 2018, 2017 or 2016.
Accrued and Other Current Liabilities	Accrued and Other Current Liabilities The Company’s accrued liabilities, reflected as a current liability in the accompanying consolidated balance sheets, consist of the following (in thousands): Year Ended December 31, 2018 2017 Accrued payroll liabilities 12,892 13,197 Accrued interest 4,792 2,864 Other 12,860 11,600 Total accrued liabilities $ 30,544 $ 27,661 Separately disclosed on the balance sheet as of December 31, 2018 are accrued litigation expenses of $8.0 million of expenses related to shareholder lawsuits that were settled in November 2018. Separately disclosed on the balance sheet as of December 31, 2017 are accrued litigation expenses of $23.6 million, which includes $23.3 million of expenses related to shareholder lawsuits that were settled in principle in December 2017, subject to court approval, which cannot be assured. Refer to Note 15 (Commitments and Contingencies) for further information regarding these matters.
Segment	Segment The focus of all Company operations is centered on a single service, substance abuse and behavioral healthcare treatment. The Company is organized and operates as one reportable segment, consisting of various treatment facilities located in the United States. The treatment facilities have similar economic characteristics, services and clients. Management has the ability to direct and serve clients in any of these facilities, which allows it to operate the Company’s business and analyze its revenue on a system-wide basis, rather than focusing on any individual facility. The Company’s chief operating decision maker evaluates performance and manages resources based on the results of the consolidated operations as a whole.
Advertising Expenses	Advertising Expenses Advertising costs are expensed as the related activity occurs.
Stock-Based Compensation	Stock-Based Compensation The Company accounts for employee stock-based compensation using the fair-value based method for costs related to all share-based payments. The fair value of the portion of the award that is ultimately expected to vest is recognized as expense on a straight-line basis over the requisite service periods in the Company’s consolidated statements of operations.
Earnings Per Share	Earnings Per Share Basic and diluted earnings per common share are calculated based on the weighted-average number of common shares outstanding in each period and non-vested shares, to the extent such securities have a dilutive effect on earnings per share using the treasury stock method.
Income Taxes	Income Taxes The Company accounts for income taxes using the asset and liability method. Under the asset and liability method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on the deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. A valuation allowance is provided for significant deferred tax assets when it is more likely than not that such assets will not be recovered.
Fair Value Measurements	Fair Value Measurements Fair value, for financial reporting purposes, is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. Disclosure is required about how fair value was determined for assets and liabilities and following a hierarchy for which these assets and liabilities must be grouped, based on significant levels of inputs as follows: Level 1 —quoted prices in active markets for identical assets or liabilities; Level 2 — quoted prices in active markets for similar assets and liabilities and inputs that are observable for the asset or liability; or Level 3 — unobservable inputs for the asset or liability, such as discounted cash flow models or valuations. The determination of where assets and liabilities fall within this hierarchy is based upon the lowest level of input that is significant to the fair value measurement.
Comprehensive Income	Comprehensive Income As of December 31, 2018, 2017 and 2016, the Company did not have any components of other comprehensive income. As such, comprehensive income was the same as net income for each of the periods presented in the accompanying consolidated statements of operations.
Recent Pronouncements	Recent Pronouncements In January 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) 2017-04, “Simplifying the Test for Goodwill Impairment” (“ASU 2017-04”). The new guidance eliminates the requirement to calculate the implied fair value of goodwill (i.e., Step 2 of the current goodwill impairment test) to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit’s carrying amount over its fair value (i.e., measure the charge based on the current Step 1). ASU 2017-04 is effective for annual and interim impairment tests for periods beginning after December 15, 2019. The Company chose to early adopt ASU 2017-04 during the year ended December 31, 2018. The adoption did not have an impact on the Company’s financial statements. 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. In July 2018, the FASB issued amendments in ASU 2018-11, which provide a transition election to not restate comparative periods for the effects of applying the new standard. This transition election, which the Company has elected, permits entities to change the date of initial application to the beginning of the year of adoption and to recognize the effects of applying the new standard as a cumulative-effect adjustment to the opening balance of retained earnings. The Company is substantially complete in evaluating the impact of the standard, including practical expedients and updates to the standard, and has assessed its existing lease portfolio to determine the impact of adoption on its condensed consolidated financial statements and related disclosures. The Company expects to utilize available practical expedients, including the package of practical expedients not to reassess whether a contract is or contains a lease, the lease classification and initial direct costs, as well as the expedient forgoing the separation of lease and non-lease components. Total right-of-use assets and related operating lease obligations of approximately $33 million and $38 million, respectively will be recorded on the consolidated balance sheet on adoption, with no material impact to our Consolidated Statements of Operations. 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 core principle of the new standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The guidance was effective January 1, 2018 and was applied to all contracts on a modified retrospective basis. 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 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 price concessions 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 related to collectability that will be recorded as an operating expense from January 1, 2018 forward 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 the Company’s digital outreach platform customers during the year ended December 31, 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 year ended December 31, 2018, the impact on the Company's Condensed Consolidated Statements of Operations was as follows (in thousands): Year Ended December 31, 2018 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 284,525 $ 307,781 $ (23,256 ) Non-client related revenue $ 11,238 $ 11,727 $ (489 ) Provision for doubtful accounts $ 366 $ 24,111 $ (23,745 )

Basis of Presentation (Tables)

Basis of Presentation (Tables)	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Summary of Restated Adjustment of Financial Statements	The impact of the correction of an error on the affected line items of the Company’s consolidated balance sheets as of December 31, 2016 and 2017 and consolidated statements of operations and cash flows for the years ended December 31, 2016 and 2017 is set forth below: Year Ended, December 31, 2017 Year Ended, December 31, 2016 As Previously Reported Adjustments Restated As Previously Reported Adjustments Restated Revenues Client related revenue $ 308,538 $ - $ 308,538 $ 270,569 $ - $ 270,569 Non-client related revenue 9,103 - 9,103 9,201 - 9,201 Total revenues 317,641 - 317,641 279,770 - 279,770 Operating expenses Salaries, wages and benefits 146,390 - 146,390 141,073 - 141,073 Client related services 27,031 - 27,031 24,446 - 24,446 Provision for doubtful accounts 36,914 (10,982 ) 25,932 21,485 17,064 38,549 Advertising and marketing 12,315 - 12,315 18,275 - 18,275 Professional fees 12,638 - 12,638 16,468 - 16,468 Other operating expenses 36,309 - 36,309 29,627 - 29,627 Rentals and leases 7,514 - 7,514 7,363 - 7,363 Litigation settlement 23,607 - 23,607 1,292 - 1,292 Depreciation and amortization 21,504 - 21,504 17,686 - 17,686 Acquisition-related expenses 1,162 - 1,162 2,691 - 2,691 Total operating expenses 325,384 (10,982 ) 314,402 280,406 17,064 297,470 (Loss) income from operations (7,743 ) 10,982 3,239 (636 ) (17,064 ) (17,700 ) Interest expense, net (including change in fair value of interest rate swaps of ($108), and ($180), respectively) 16,811 - 16,811 8,175 - 8,175 Loss on extinguishment of debt 5,435 - 5,435 - - - Gain on contingent consideration - - - (1,350 ) - (1,350 ) Other (income) expense, net 116 - 116 (500 ) - (500 ) Loss before income tax expense (30,105 ) 10,982 (19,123 ) (6,961 ) (17,064 ) (24,025 ) Income tax (benefit) expense (5,018 ) 3,276 (1,742 ) (1,220 ) 3,565 2,345 Net loss (25,087 ) 7,706 (17,381 ) (5,741 ) (20,629 ) (26,370 ) Less: net loss attributable to noncontrolling interest 4,508 - 4,508 5,152 - 5,152 Net loss attributable to AAC Holdings, Inc. common stockholders (20,579 ) 7,706 (12,873 ) (589 ) (20,629 ) (21,218 ) Basic loss per common share $ (0.88 ) $ (0.55 ) $ (0.03 ) $ (0.93 ) Diluted loss per common share $ (0.88 ) $ (0.55 ) $ (0.03 ) $ (0.93 ) Weighted-average common shares outstanding: Basic 23,277,444 23,277,444 22,718,117 22,718,117 Diluted 23,277,444 23,277,444 22,718,117 22,718,117 AAC Holdings, Inc. Consolidated Balance Sheet (Dollars in thousands, except share data) Year Ended, December 31, 2017 As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 13,818 $ - $ 13,818 Accounts receivable, net of allowances 94,096 (30,350 ) 63,746 Prepaid expenses and other current assets 4,022 - 4,022 Total current assets 111,936 (30,350 ) 81,586 Property and equipment, net 152,548 - 152,548 Goodwill 134,396 - 134,396 Intangible assets, net 8,829 - 8,829 Deferred tax assets, net 8,010 (6,360 ) 1,650 Other assets 12,556 - 12,556 Total assets $ 428,275 $ (36,710 ) $ 391,565 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 4,579 $ - $ 4,579 Accrued and other current liabilities 27,661 - 27,661 Accrued litigation 23,607 - 23,607 Current portion of long-term debt 4,722 - 4,722 Total current liabilities 60,569 - 60,569 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 196,451 - 196,451 Financing lease obligation, net of current portion 24,541 - 24,541 Other long-term liabilities 10,546 - 10,546 Total liabilities 292,107 - 292,107 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 23,872,436 shares issued and outstanding at December 31, 2017, respectively 24 - 24 Additional paid-in capital 152,430 - 152,430 Retained deficit (1,460 ) (36,710 ) (38,170 ) Total stockholders’ equity 150,994 (36,710 ) 114,284 Noncontrolling interest (14,826 ) - (14,826 ) Total stockholders’ equity including noncontrolling interest 136,168 (36,710 ) 99,458 Total liabilities and stockholders’ equity $ 428,275 $ (36,710 ) $ 391,565 AAC Holdings, Inc. Consolidated Statements of Cash Flows (Dollars in thousands, except share data) Year Ended, December 31, 2017 Year Ended, December 31, 2016 As Previously Reported Adjustments Restated As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (25,087 ) $ 7,706 $ (17,381 ) $ (5,741 ) $ (20,629 ) $ (26,370 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 36,914 (10,982 ) 25,932 21,485 17,064 38,549 Depreciation and amortization 21,504 - 21,504 17,686 - 17,686 Equity compensation 7,513 - 7,513 8,823 - 8,823 Loss on disposal of property and equipment 55 - 55 163 - 163 Loss on extinguishment of debt 5,435 - 5,435 - - - Gain on contingent consideration - - - (1,350 ) - (1,350 ) Amortization of debt issuance costs 1,564 - 1,564 633 - 633 Deferred income taxes (7,412 ) 3,276 (4,136 ) (1,793 ) 3,565 1,772 Changes in operating assets and liabilities: Accounts receivable (43,676 ) - (43,676 ) (45,838 ) - (45,838 ) Prepaid expenses and other assets (6,725 ) - (6,725 ) 2,510 - 2,510 Accounts payable (4,576 ) - (4,576 ) 824 - 824 Accrued and other current liabilities 4,685 - 4,685 2,973 - 2,973 Accrued litigation 22,645 - 22,645 162 - 162 Other long-term liabilities 6,453 - 6,453 (394 ) - (394 ) Net cash provided by operating activities 19,292 - 19,292 143 - 143 Cash flows from investing activities: Purchase of property and equipment (33,041 ) - (33,041 ) (37,304 ) - (37,304 ) Acquisition of subsidiaries - - - (18,825 ) - (18,825 ) Change in funds held on acquisition (1,000 ) - (1,000 ) (325 ) - (325 ) Net cash used in investing activities (34,041 ) - (34,041 ) (56,454 ) - (56,454 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility (211,094 ) - (211,094 ) (5,376 ) - (5,376 ) Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs 18,000 - 18,000 48,930 - 48,930 Payments on 2017 Credit Facility (17,126 ) - (17,126 ) - - - Proceeds from 2017 Credit Facility, net of deferred financing costs 211,073 - 211,073 - - - Proceeds from financing lease obligation, net of deferred financing costs 24,621 - 24,621 - - - Payments on capital leases and other (791 ) - (791 ) (834 ) - (834 ) Payments on AdCare Note - - - - - - Repayment of long-term debt — related party - - - (1,195 ) - (1,195 ) Change in funds held on acquisition 1,000 - 1,000 - - - Payment of employee taxes for net share settlement (1,080 ) - (1,080 ) - - - Net cash provided by financing activities 24,603 - 24,603 41,525 - 41,525 Net change in cash and cash equivalents 9,854 - 9,854 (14,786 ) - (14,786 ) Cash and cash equivalents, beginning of period 3,964 - 3,964 18,750 - 18,750 Cash and cash equivalents, end of period $ 13,818 $ - $ 13,818 $ 3,964 $ - $ 3,964 Unaudited Consolidated Statement of Operations For the Three Months Ended September 30, 2018 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 74,477 $ (8,370 ) $ 66,107 Non-client related revenue 2,996 (69 ) 2,927 Total revenues 77,473 (8,439 ) 69,034 Operating expenses Salaries, wages and benefits 44,831 - 44,831 Client related services 8,594 - 8,594 Provision for doubtful accounts - - - Advertising and marketing 3,037 - 3,037 Professional fees 5,697 - 5,697 Other operating expenses 12,833 - 12,833 Rentals and leases 2,760 - 2,760 Litigation settlement 100 - 100 Depreciation and amortization 5,573 - 5,573 Acquisition-related expenses 1,058 (947 ) 111 Total operating expenses 84,483 (947 ) 83,536 Loss from operations (7,010 ) (7,492 ) (14,502 ) Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 8,738 - 8,738 Loss on contingent consideration - 947 947 Other expense, net 732 - 732 Loss before income tax expense (16,480 ) (8,439 ) (24,919 ) Income tax benefit (3,324 ) 2,249 (1,075 ) Net loss (13,156 ) (10,688 ) (23,844 ) Less: net loss attributable to noncontrolling interest 1,663 - 1,663 Net loss attributable to AAC Holdings, Inc. common stockholders $ (11,493 ) $ (10,688 ) $ (22,181 ) Basic loss per common share $ (0.47 ) $ (0.92 ) Diluted loss per common share $ (0.47 ) $ (0.92 ) Weighted-average common shares outstanding: Basic 24,205,159 24,205,159 Diluted 24,205,159 24,205,159 Unaudited Consolidated Statement of Operations For the Three Months Ended June 30, 2018 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 83,293 $ 1,327 $ 84,620 Non-client related revenue 3,468 6 3,474 Total revenues 86,761 1,333 88,094 Operating expenses Salaries, wages and benefits 46,850 - 46,850 Client related services 8,393 - 8,393 Provision for doubtful accounts 366 - 366 Advertising and marketing 2,584 - 2,584 Professional fees 4,950 - 4,950 Other operating expenses 12,194 - 12,194 Rentals and leases 2,563 - 2,563 Litigation settlement 244 - 244 Depreciation and amortization 5,909 - 5,909 Acquisition-related expenses - 176 176 Total operating expenses 84,053 176 84,229 Income from operations 2,708 1,157 3,865 Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 7,893 - 7,893 Gain on contingent consideration - (176 ) (176 ) Other income, net (98 ) - (98 ) Loss before income tax expense (5,087 ) 1,333 (3,754 ) Income tax benefit (84 ) (78 ) (162 ) Net loss (5,003 ) 1,411 (3,592 ) Less: net loss attributable to noncontrolling interest 1,990 - 1,990 Net loss attributable to AAC Holdings, Inc. common stockholders $ (3,013 ) $ 1,411 $ (1,602 ) Basic loss per common share $ (0.12 ) $ (0.07 ) Diluted loss per common share $ (0.12 ) $ (0.07 ) Weighted-average common shares outstanding: Basic 24,166,976 24,166,976 Diluted 24,166,976 24,166,976 Unaudited Consolidated Statement of Operations For the Three Months Ended March 31, 2018 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 75,923 $ 2,707 $ 78,630 Non-client related revenue 2,550 7 2,557 Total revenues 78,473 2,714 81,187 Operating expenses Salaries, wages and benefits 40,084 - 40,084 Client related services 7,747 - 7,747 Provision for doubtful accounts - - - Advertising and marketing 2,599 - 2,599 Professional fees 3,650 - 3,650 Other operating expenses 10,588 - 10,588 Rentals and leases 2,116 - 2,116 Litigation settlement 2,791 - 2,791 Depreciation and amortization 5,464 - 5,464 Acquisition-related expenses 305 - 305 Total operating expenses 75,344 - 75,344 Income from operations 3,129 2,714 5,843 Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 6,709 - 6,709 Gain on contingent consideration - - - Other expense, net 9 - 9 Loss before income tax expense (3,589 ) 2,714 (875 ) Income tax benefit (1,494 ) 1,456 (38 ) Net loss (2,095 ) 1,258 (837 ) Less: net loss attributable to noncontrolling interest 1,893 - 1,893 Net (loss) income attributable to AAC Holdings, Inc. common stockholders $ (202 ) $ 1,258 $ 1,056 Basic (loss) earnings per common share $ (0.01 ) $ 0.04 Diluted (loss) earnings per common share $ (0.01 ) $ 0.04 Weighted-average common shares outstanding: Basic 23,744,208 23,744,208 Diluted 23,744,208 23,781,604 Unaudited Consolidated Statement of Operations For the Three Months Ended September 30, 2017 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 77,948 $ - $ 77,948 Non-client related revenue 2,476 - 2,476 Total revenues 80,424 - 80,424 Operating expenses Salaries, wages and benefits 36,709 - 36,709 Client related services 6,598 - 6,598 Provision for doubtful accounts 9,682 (2,276 ) 7,406 Advertising and marketing 3,074 - 3,074 Professional fees 3,641 - 3,641 Other operating expenses 8,306 - 8,306 Rentals and leases 2,105 - 2,105 Litigation settlement - - - Depreciation and amortization 5,218 - 5,218 Acquisition-related expenses 370 - 370 Total operating expenses 75,703 (2,276 ) 73,427 Income from operations 4,721 2,276 6,997 Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 5,492 - 5,492 Loss on extinguishment of debt - - - Gain on contingent consideration - - - Other expense, net 49 - 49 (Loss) income before income tax expense (820 ) 2,276 1,456 Income tax expense (benefit) (456 ) 1,197 741 Net (loss) income (364 ) 1,079 715 Less: net loss attributable to noncontrolling interest 1,126 - 1,126 Net income attributable to AAC Holdings, Inc. common stockholders $ 762 $ 1,079 $ 1,841 Basic earnings per common share $ 0.03 $ 0.08 Diluted earnings per common share $ 0.03 $ 0.08 Weighted-average common shares outstanding: Basic 23,331,414 23,331,414 Diluted 23,469,985 23,469,985 Unaudited Consolidated Statement of Operations For the Three Months Ended June 30, 2017 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 75,692 $ - $ 75,692 Non-client related revenue 2,350 - 2,350 Total revenues 78,042 - 78,042 Operating expenses Salaries, wages and benefits 34,508 - 34,508 Client related services 6,646 - 6,646 Provision for doubtful accounts 9,496 (3,235 ) 6,261 Advertising and marketing 3,266 - 3,266 Professional fees 3,039 - 3,039 Other operating expenses 8,199 - 8,199 Rentals and leases 1,849 - 1,849 Litigation settlement - - - Depreciation and amortization 5,058 - 5,058 Acquisition-related expenses 42 - 42 Total operating expenses 72,103 (3,235 ) 68,868 Income from operations 5,939 3,235 9,174 Interest expense, net (including change in fair value of interest rate swaps of ($25), respectively) 2,846 - 2,846 Loss on extinguishment of debt 5,435 - 5,435 Gain on contingent consideration - - - Other income, net 6 - 6 (Loss) income before income tax expense (2,336 ) 3,235 899 Income tax expense 562 179 741 Net (loss) income (2,898 ) 3,056 158 Less: net loss attributable to noncontrolling interest 982 - 982 Net (loss) income attributable to AAC Holdings, Inc. common stockholders $ (1,916 ) $ 3,056 $ 1,140 Basic (loss) earnings per common share $ (0.08 ) $ 0.05 Diluted (loss) earnings per common share $ (0.08 ) $ 0.05 Weighted-average common shares outstanding: Basic 23,242,177 23,242,177 Diluted 23,242,177 23,254,162 Unaudited Consolidated Statement of Operations For the Three Months Ended March 31, 2017 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 71,219 $ - $ 71,219 Non-client related revenue 1,820 - 1,820 Total revenues 73,039 - 73,039 Operating expenses Salaries, wages and benefits 36,772 - 36,772 Client related services 6,378 - 6,378 Provision for doubtful accounts 6,587 (2,184 ) 4,403 Advertising and marketing 3,775 - 3,775 Professional fees 2,642 - 2,642 Other operating expenses 8,789 - 8,789 Rentals and leases 1,885 - 1,885 Litigation settlement - - - Depreciation and amortization 5,469 - 5,469 Acquisition-related expenses 183 - 183 Total operating expenses 72,480 (2,184 ) 70,296 Income from operations 559 2,184 2,743 Interest expense, net (including change in fair value of interest rate swaps of ($83), respectively) 2,734 - 2,734 Loss on extinguishment of debt - - - Gain on contingent consideration - - - Other expense, net 34 - 34 Loss before income tax expense (2,209 ) 2,184 (25 ) Income tax (benefit) expense (565 ) 1,306 741 Net loss (1,644 ) 878 (766 ) Less: net loss attributable to noncontrolling interest 1,041 - 1,041 Net (loss) income attributable to AAC Holdings, Inc. common stockholders $ (603 ) $ 878 $ 275 Basic (loss) earnings per common share $ (0.03 ) $ 0.01 Diluted (loss) earnings per common share $ (0.03 ) $ 0.01 Weighted-average common shares outstanding: Basic 23,163,626 23,163,626 Diluted 23,163,626 23,174,899 Unaudited Consolidated Balance Sheet September 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 5,259 $ - $ 5,259 Accounts receivable, net of allowances 94,583 (34,744 ) 59,839 Prepaid expenses and other current assets 5,547 - 5,547 Total current assets 105,389 (34,744 ) 70,645 Property and equipment, net 166,345 - 166,345 Goodwill 198,952 - 198,952 Intangible assets, net 12,561 - 12,561 Deferred tax assets, net 13,042 (10,118 ) 2,924 Other assets 10,679 - 10,679 Total assets $ 506,968 $ (44,862 ) $ 462,106 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 8,722 $ - $ 8,722 Accrued and other current liabilities 31,607 - 31,607 Accrued litigation - - - Current portion of long-term debt 8,350 - 8,350 Total current liabilities 48,679 - 48,679 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 297,143 - 297,143 Financing lease obligation, net of current portion 24,459 - 24,459 Other long-term liabilities 11,993 - 11,993 Total liabilities 382,274 - 382,274 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,621,653 shares issued and outstanding at September 30, 2018, respectively 25 - 25 Additional paid-in capital 161,209 - 161,209 Retained deficit (16,168 ) (44,862 ) (61,030 ) Total stockholders’ equity 145,066 (44,862 ) 100,204 Noncontrolling interest (20,372 ) - (20,372 ) Total stockholders’ equity including noncontrolling interest 124,694 (44,862 ) 79,832 Total liabilities and stockholders’ equity $ 506,968 $ (44,862 ) $ 462,106 Unaudited Consolidated Balance Sheet June 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 11,353 $ - $ 11,353 Accounts receivable, net of allowances 97,362 (26,305 ) 71,057 Prepaid expenses and other current assets 4,638 - 4,638 Total current assets 113,353 (26,305 ) 87,048 Property and equipment, net 168,373 - 168,373 Goodwill 197,184 - 197,184 Intangible assets, net 13,201 - 13,201 Deferred tax assets, net 9,572 (7,723 ) 1,849 Other assets 11,069 - 11,069 Total assets 512,752 (34,028 ) 478,724 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 6,613 $ - $ 6,613 Accrued and other current liabilities 30,487 - 30,487 Accrued litigation - - - Current portion of long-term debt 6,723 - 6,723 Total current liabilities 43,823 - 43,823 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 295,322 - 295,322 Financing lease obligation, net of current portion 24,488 - 24,488 Other long-term liabilities 12,322 - 12,322 Total liabilities 375,955 - 375,955 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,596,675 shares issued and outstanding at June 30, 2018, respectively 25 - 25 Additional paid-in capital 160,156 - 160,156 Retained deficit (4,675 ) (34,028 ) (38,703 ) Total stockholders’ equity 155,506 (34,028 ) 121,478 Noncontrolling interest (18,709 ) - (18,709 ) Total stockholders’ equity including noncontrolling interest 136,797 (34,028 ) 102,769 Total liabilities and stockholders’ equity $ 512,752 $ (34,028 ) $ 478,724 Unaudited Consolidated Balance Sheet March 31, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 14,341 $ - $ 14,341 Accounts receivable, net of allowances 99,581 (27,637 ) 71,944 Prepaid expenses and other current assets 3,354 - 3,354 Total current assets 117,276 (27,637 ) 89,639 Property and equipment, net 169,744 - 169,744 Goodwill 197,184 - 197,184 Intangible assets, net 13,712 - 13,712 Deferred tax assets, net 9,030 (7,343 ) 1,687 Other assets 12,468 - 12,468 Total assets $ 519,414 $ (34,980 ) $ 484,434 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 3,338 $ - $ 3,338 Accrued and other current liabilities 34,039 - 34,039 Accrued litigation 1,000 - 1,000 Current portion of long-term debt 7,319 - 7,319 Total current liabilities 45,696 - 45,696 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 296,443 - 296,443 Financing lease obligation, net of current portion 24,515 - 24,515 Other long-term liabilities 12,277 - 12,277 Total liabilities 378,931 - 378,931 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,438,739 shares issued and outstanding at March 31, 2018, respectively 24 - 24 Additional paid-in capital 158,840 - 158,840 Retained deficit (1,662 ) (34,980 ) (36,642 ) Total stockholders’ equity 157,202 (34,980 ) 122,222 Noncontrolling interest (16,719 ) - (16,719 ) Total stockholders’ equity including noncontrolling interest 140,483 (34,980 ) 105,503 Total liabilities and stockholders’ equity $ 519,414 $ (34,980 ) $ 484,434 Unaudited Consolidated Balance Sheet September 30, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 16,412 $ - $ 16,412 Accounts receivable, net of allowances 92,547 (33,638 ) 58,909 Prepaid expenses and other current assets 6,030 - 6,030 Total current assets 114,989 (33,638 ) 81,351 Property and equipment, net 151,769 - 151,769 Goodwill 134,396 - 134,396 Intangible assets, net 9,169 - 9,169 Deferred tax assets, net 1,579 (1,579 ) - Other assets 5,664 - 5,664 Total assets $ 417,566 $ (35,217 ) $ 382,349 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 5,732 $ - $ 5,732 Accrued and other current liabilities 24,633 - 24,633 Accrued litigation - - - Current portion of long-term debt 4,736 - 4,736 Total current liabilities 35,101 - 35,101 Deferred tax liabilities - 4,709 4,709 Long-term debt, net of current portion and debt issuance costs 197,872 - 197,872 Financing lease obligation, net of current portion 24,398 - 24,398 Other long-term liabilities 3,836 - 3,836 Total liabilities 261,207 4,709 265,916 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,021,219 shares issued and outstanding at September 30, 2017, respectively 24 - 24 Additional paid-in capital 152,440 - 152,440 Retained earnings (deficit) 17,362 (39,926 ) (22,564 ) Total stockholders’ equity 169,826 (39,926 ) 129,900 Noncontrolling interest (13,467 ) - (13,467 ) Total stockholders’ equity including noncontrolling interest 156,359 (39,926 ) 116,433 Total liabilities and stockholders’ equity $ 417,566 $ (35,217 ) $ 382,349 Unaudited Consolidated Balance Sheet June 30, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 10,793 $ - $ 10,793 Accounts receivable, net of allowances 96,527 (35,914 ) 60,613 Prepaid expenses and other current assets 4,456 - 4,456 Total current assets 111,776 (35,914 ) 75,862 Property and equipment, net 148,965 - 148,965 Goodwill 134,396 - 134,396 Intangible assets, net 9,551 - 9,551 Deferred tax assets, net 1,180 (1,180 ) - Other assets 783 - 783 Total assets $ 406,651 $ (37,094 ) $ 369,557 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 10,441 $ - $ 10,441 Accrued and other current liabilities 24,800 - 24,800 Accrued litigation - - - Current portion of long-term debt 4,503 - 4,503 Total current liabilities 39,744 - 39,744 Deferred tax liabilities - 3,968 3,968 Long-term debt, net of current portion and debt issuance costs 208,467 - 208,467 Financing lease obligation, net of current portion - - - Other long-term liabilities 3,782 - 3,782 Total liabilities 251,993 3,968 255,961 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,060,888 shares issued and outstanding at June 30, 2017, respectively 24 - 24 Additional paid-in capital 150,375 - 150,375 Retained earnings (deficit) 16,600 (41,062 ) (24,462 ) Total stockholders’ equity 166,999 (41,062 ) 125,937 Noncontrolling interest (12,341 ) - (12,341 ) Total stockholders’ equity including noncontrolling interest 154,658 (41,062 ) 113,596 Total liabilities and stockholders’ equity $ 406,651 $ (37,094 ) $ 369,557 Unaudited Consolidated Balance Sheet March 31, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 5,880 $ - $ 5,880 Accounts receivable, net of allowances 94,144 (39,149 ) 54,995 Prepaid expenses and other current assets 4,897 - 4,897 Total current assets 104,921 (39,149 ) 65,772 Property and equipment, net 145,410 - 145,410 Goodwill 134,396 - 134,396 Intangible assets, net 9,953 - 9,953 Deferred tax assets, net 1,316 (1,316 ) - Other assets 626 - 626 Total assets $ 396,622 $ (40,465 ) $ 356,157 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 13,711 $ - $ 13,711 Accrued and other current liabilities 24,865 - 24,865 Accrued litigation - - - Current portion of long-term debt 10,965 - 10,965 Total current liabilities 49,541 - 49,541 Deferred tax liabilities - 3,227 3,227 Long-term debt, net of current portion and debt issuance costs 187,456 - 187,456 Financing lease obligation, net of current portion - - - Other long-term liabilities 4,121 - 4,121 Total liabilities 241,118 3,227 244,345 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,076,469 shares issued and outstanding at March 31, 2017, respectively 24 - 24 Additional paid-in capital 148,323 - 148,323 Retained earnings (deficit) 18,516 (43,692 ) (25,176 ) Total stockholders’ equity 166,863 (43,692 ) 123,171 Noncontrolling interest (11,359 ) - (11,359 ) Total stockholders’ equity including noncontrolling interest 155,504 (43,692 ) 111,812 Total liabilities and stockholders’ equity $ 396,622 $ (40,465 ) $ 356,157 Unaudited Consolidated Statements of Cash Flows For the Nine Months Ended, September 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (20,254 ) $ (8,019 ) $ (28,273 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 366 - 366 Depreciation and amortization 16,946 - 16,946 Equity compensation 3,104 - 3,104 Loss on disposal of property and equipment 1,000 - 1,000 Loss on extinguishment of debt - - - Loss on contingent consideration - 771 771 Amortization of debt issuance costs 2,077 - 2,077 Deferred income taxes (5,032 ) 3,627 (1,405 ) Changes in operating assets and liabilities: Accounts receivable 3,503 4,392 7,895 Prepaid expenses and other assets (461 ) - (461 ) Accounts payable 645 - 645 Accrued and other current liabilities 2,207 (771 ) 1,436 Accrued litigation (23,300 ) - (23,300 ) Other long-term liabilities (559 ) - (559 ) Net cash (used in) provided by operating activities (19,758 ) - (19,758 ) Cash flows from investing activities: Purchase of property and equipment (15,458 ) - (15,458 ) Acquisition of subsidiaries (65,827 ) - (65,827 ) Change in funds held on acquisition - - - Net cash used in investing activities (81,285 ) - (81,285 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility - - - Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs - - - Payments on 2017 Credit Facility (5,172 ) - (5,172 ) Proceeds from 2017 Credit Facility, net of deferred financing costs 99,286 - 99,286 Proceeds from financing lease obligation, net of deferred financing costs - - - Payments on capital leases and other (563 ) - (563 ) Payments on AdCare Note (500 ) - (500 ) Repayment of long-term debt — related party - - - Change in funds held on acquisition - - - Payment of employee taxes for net share settlement (567 ) - (567 ) Net cash provided by financing activities 92,484 - 92,484 Net change in cash and cash equivalents (8,559 ) - (8,559 ) Cash and cash equivalents, beginning of period 13,818 - 13,818 Cash and cash equivalents, end of period $ 5,259 $ - $ 5,259 Unaudited Consolidated Statements of Cash Flows For the Six Months Ended, June 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (7,098 ) $ 2,669 $ (4,429 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 366 - 366 Depreciation and amortization 11,373 - 11,373 Equity compensation 2,159 - 2,159 Loss on disposal of property and equipment 34 - 34 Loss on extinguishment of debt - - - Gain on contingent consideration - (176 ) (176 ) Amortization of debt issuance costs 1,357 - 1,357 Deferred income taxes (1,562 ) 1,378 (184 ) Changes in operating assets and liabilities: Accounts receivable 724 (4,047 ) (3,323 ) Prepaid expenses and other assets 1,475 - 1,475 Accounts payable (1,464 ) - (1,464 ) Accrued and other current liabilities 457 176 633 Accrued litigation (23,300 ) - (23,300 ) Other long-term liabilities (230 ) - (230 ) Net cash (used in) provided by operating activities (15,709 ) - (15,709 ) Cash flows from investing activities: Purchase of property and equipment (11,196 ) - (11,196 ) Acquisition of subsidiaries (65,185 ) - (65,185 ) Change in funds held on acquisition - - - Net cash used in investing activities (76,381 ) - (76,381 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility - - - Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs - - - Payments on 2017 Credit Facility (3,448 ) - (3,448 ) Proceeds from 2017 Credit Facility, net of deferred financing costs 94,286 - 94,286 Proceeds from financing lease obligation, net of deferred financing costs - - - Payments on capital leases and other (440 ) - (440 ) Payments on AdCare Note (250 ) - (250 ) Repayment of long-term debt — related party - - - Change in funds held on acquisition - - - Payment of employee taxes for net share settlement (523 ) - (523 ) Net cash provided by financing activities 89,625 - 89,625 Net change in cash and cash equivalents (2,465 ) - (2,465 ) Cash and cash equivalents, beginning of period 13,818 - 13,818 Cash and cash equivalents, end of period $ 11,353 $ - $ 11,353 Unaudited Consolidated Statements of Cash Flows For the Three Months Ended, March 31, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net Income (loss) $ (2,095 ) $ 1,258 $ (837 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts - - - Depreciation and amortization 5,464 - 5,464 Equity compensation 798 - 798 Loss on disposal of property and equipment 34 - 34 Loss on extinguishment of debt - - - Gain (loss) on contingent consideration - - - Amortization of debt issuance costs 637 - 637 Deferred income taxes (1,020 ) 1,456 436 Changes in operating assets and liabilities: Accounts receivable (1,129 ) (2,714 ) (3,843 ) Prepaid expenses and other assets 1,485 - 1,485 Accounts payable (4,739 ) - (4,739 ) Accrued and other current liabilities 4,141 - 4,141 Accrued litigation (22,300 ) - (22,300 ) Other long-term liabilities (275 ) - (275 ) Net cash (used in) provided by operating activities (18,999 ) - (18,999 ) Cash flows from investing activities: Purchase of property and equipment (7,305 ) - (7,305 ) Acquisition of subsidiaries (65,185 ) - (65,185 ) Change in funds held on acquisition - - - Net cash used in investing activities (72,490 ) - (72,490 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility - - - Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs - - - Payments on 2017 Credit Facility (1,724 ) - (1,724 ) Proceeds from 2017 Credit Facility, net of deferred financing costs 94,432 - 94,432 Proceeds from financing lease obligation, net of deferred financing costs - - - Payments on capital leases and other (221 ) - (221 ) Payments on AdCare Note - - - Repayment of long-term debt — related party - - - Change in funds held on acquisition - - - Payment of employee taxes for net share settlement (475 ) - (475 ) Net cash provided by financing activities 92,012 - 92,012 Net change in cash and cash equivalents 523 - 523 Cash and cash equivalents, beginning of period 13,818 - 13,818 Cash and cash equivalents, end of period $ 14,341 $ - $ 14,341 Unaudited Consolidated Statements of Cash Flows For the Nine Months Ended, September 30, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net Income (loss) $ (4,906 ) $ 5,013 $ 107 Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 25,765 (7,695 ) 18,070 Depreciation and amortization 15,745 - 15,745 Equity compensation 6,048 - 6,048 Loss on disposal o

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2018
Summary of Composition of Client Related Revenue	For the year ended December 31, 2018 and 2017, client related revenue was (in thousands): Year Ended December 31, 2018 As Reported Year Ended December 31, 2017 Restated Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 235,513 82.8 $ 246,976 80.0 $ (11,463 ) (4.6 ) Outpatient facility and sober living services 34,405 12.1 29,080 9.4 5,325 18.3 Client related diagnostic services 14,607 5.1 32,482 10.6 (17,875 ) (55.0 ) Total client related revenue $ 284,525 100.0 $ 308,538 100.0 $ (24,013 ) (7.8 ) For the year ended December 31, 2018 and 2017, client related revenue on a comparable basis was (in thousands): Previous Accounting Guidance As Reported Year Ended December 31, 2018 Year Ended December 31, 2017 Restated Increase (Decrease) Amount % Amount % Amount % Inpatient treatment facility services $ 247,273 80.3 $ 246,976 80.0 $ 297 0.1 Outpatient facility and sober living services 35,947 11.7 29,080 9.4 6,867 23.6 Client related diagnostic services 24,561 8.0 32,482 10.6 (7,921 ) (24.4 ) Total client related revenue $ 307,781 100.0 $ 308,538 100.0 $ (757 ) (0.2 )
Summary of Aging of Accounts Receivable Net of Allowance for Doubtful Accounts	The following table presents a summary of the Company’s aging of accounts receivable, net of the allowance for doubtful accounts as of December 31, 2017. 2018 is not presented as under Topic 606, the Company has no allowance for doubtful accounts as of December 31, 2018. Current 31-180 Days Over 180 Days Total December 31, 2017, restated 31.2 % 44.7 % 24.1 % 100.0 %
Summary of Allowance for Doubtful Accounts	A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2015, restated $ 41,145 Additions charged to provision for doubtful accounts 38,549 Accounts written off, net of recoveries (10,234 ) Balance at December 31, 2016, restated $ 69,460 Additions charged to provision for doubtful accounts 25,932 Accounts written off, net of recoveries (6,968 ) Balance at December 31, 2017, restated $ 88,424 Balance at January 1, 2018 (1) $ - Additions charged to provision for doubtful accounts 366 Accounts written off, net of recoveries (366 ) Balance at December 31, 2018 $ - (1) As discussed at Note 3 to the Notes of the Consolidated Financial Statements, on January 1, 2018, the Company adopted the new revenue recognition standard (Topic 606). Upon adoption of Topic 606, the allowance for doubtful accounts of approximately $88.4 million was reclassified as a component of accounts receivable. The only activity that is now recorded as a provision for doubtful accounts is related to specific customers that experience significant adverse changes in creditworthiness, such as bankruptcies. A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2016, restated $ 69,460 Additions charged to provision for doubtful accounts 4,403 Accounts written off, net of recoveries (680 ) Balance at March 31, 2017, restated $ 73,183 Additions charged to provision for doubtful accounts 6,261 Accounts written off, net of recoveries (2,231 ) Balance at June 30, 2017, restated $ 77,213 Additions charged to provision for doubtful accounts 7,406 Accounts written off, net of recoveries (2,239 ) Balance at September 30, 2017, restated $ 82,380
Schedule of Useful Life of Property Plant and Equipment	Depreciation is calculated using the straight-line method over the estimated economic useful lives of the assets, as follows: Range of Lives Computer software and equipment 3 years Buildings 36 years Furniture, fixtures and equipment 5 years Vehicles 5 years Equipment under capital lease 3-5 years Leasehold improvements Life of the asset or lease, whichever is less
Schedule of Accrued Liabilities Reflected as a Current Liability in the Accompanying Consolidated Balance Sheet	The Company’s accrued liabilities, reflected as a current liability in the accompanying consolidated balance sheets, consist of the following (in thousands): Year Ended December 31, 2018 2017 Accrued payroll liabilities 12,892 13,197 Accrued interest 4,792 2,864 Other 12,860 11,600 Total accrued liabilities $ 30,544 $ 27,661
Accounting Standards Update 2014-09
Schedule of Impact on Condensed Consolidated Statements of Operations	For the year ended December 31, 2018, the impact on the Company's Condensed Consolidated Statements of Operations was as follows (in thousands): Year Ended December 31, 2018 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 284,525 $ 307,781 $ (23,256 ) Non-client related revenue $ 11,238 $ 11,727 $ (489 ) Provision for doubtful accounts $ 366 $ 24,111 $ (23,745 ) Three Months Ended March 31, 2018 Restated As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 78,630 $ 82,481 $ (3,851 ) Non-client related revenue 2,557 2,798 (241 ) Provision for doubtful accounts - 4,092 (4,092 ) Three Months Ended June 30, 2018 Restated As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 84,620 $ 96,150 $ (11,530 ) Non-client related revenue 3,474 3,616 (142 ) Provision for doubtful accounts 366 12,038 (11,672 ) Three Months Ended September 30, 2018 Restated As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 66,107 $ 81,626 $ (15,519 ) Non-client related revenue 2,927 3,029 (102 ) Provision for doubtful accounts - 15,621 (15,621 )

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 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 sets forth the components of the numerator and denominator used in the calculation of basic and diluted EPS (in thousands except share data): Year Ended December 31, 2018 2017 Restated 2016 Restated Numerator Net loss attributable to AAC Holdings, Inc. common stockholders $ (59,404 ) $ (12,873 ) $ (21,218 ) Denominator Weighted-average shares outstanding – basic 24,090,639 23,277,444 22,718,117 Dilutive securities — — — Weighted-average shares outstanding – diluted 24,090,639 23,277,444 22,718,117 Basic loss per share $ (2.47 ) $ (0.55 ) $ (0.93 ) Diluted loss per share $ (2.47 ) $ (0.55 ) $ (0.93 )

Property and Equipment, net (Ta

Property and Equipment, net (Tables)	12 Months Ended
	Dec. 31, 2018
Property Plant And Equipment [Abstract]
Components of Property and Equipment	Property and equipment consisted of the following (in thousands): December 31, 2018 2017 Land $ 19,364 $ 15,766 Buildings and improvements 161,723 130,710 Equipment and software 35,059 32,968 Construction in progress 16,413 22,310 Total property and equipment 232,559 201,754 Less accumulated depreciation (65,638 ) (49,206 ) Property and equipment, net $ 166,921 $ 152,548

Acquisitions (Tables)

Acquisitions (Tables)	12 Months Ended
	Dec. 31, 2018
Business Combinations [Abstract]
Schedule of Allocation of Assets Acquired and Liabilities Assumed	The 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 15,309 Goodwill 64,556 Intangible assets 5,120 Total assets acquired 93,038 Accrued and other current liabilities 5,931 Long-term liabilities 2,004 Net assets acquired $ 85,103
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): Year Ended December 31, 2018 2017 Restated Total revenues $ 304,037 $ 370,235 (Loss) income before income tax (benefit) expense $ (70,666 ) $ (14,038 )

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The changes in goodwill relate to the AdCare Acquisition during the year ended December 31, 2018, as shown below: Balance at December 31, 2016 $ 134,396 2017 Activity - Balance at December 31, 2017 $ 134,396 AdCare Acquisition 64,556 Balance at December 31, 2018 $ 198,952
Components of Other Intangible Assets	Other intangible assets and related accumulated amortization consisted of the following as of December 31, 2018 and 2017 (in thousands): Gross Carrying Value Accumulated Amortization December 31, December 31, December 31, December 31, 2018 2017 2018 2017 Trademarks $ 8,422 $ 5,322 $ 2,777 $ 1,986 Non-compete agreements 2,107 1,587 1,583 1,372 Marketing intangibles 5,651 5,651 2,050 1,485 Leasehold interests 1,498 1,498 587 397 Service contracts 950 — 79 — Other 601 51 90 40 Intangible assets $ 19,229 $ 14,109 $ 7,166 $ 5,280
Summary of Changes to Net Carrying Value of Intangible Assets	Changes to the net carrying value of intangible assets during the year ended December 31, 2018 and 2017 were as follows (in thousands): Balance at December 31, 2016 $ 10,356 Amortization expense (1,527 ) Balance at December 31, 2017 $ 8,829 Amortization expense (1,886 ) AdCare Acquisition 5,120 Balance at December 31, 2018 $ 12,063
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	At December 31, 2018, all intangible assets are amortized using a straight-line method. The following table presents amortization expense expected to be recognized during fiscal years subsequent to December 31, 2018 (in thousands): Year ended December 31, 2019 $ 1,955 2020 1,951 2021 1,756 2022 1,619 2023 1,385 Thereafter 3,397 Total $ 12,063

Long-Term Debt (Tables)

Long-Term Debt (Tables)	12 Months Ended
	Dec. 31, 2018
Debt Disclosure [Abstract]
Summary of Debt Obligations	A summary of the Company’s debt obligations is as follows (in thousands): December 31, 2018 2017 Senior secured loans $ 317,479 $ 207,375 Subordinated debt 8,884 — Unamortized debt issuance costs (8,085 ) (7,233 ) Capital lease obligations 880 1,031 Total debt 319,158 201,173 Less current portion (309,394 ) (4,722 ) Total long-term debt $ 9,764 $ 196,451
Summary of Future Contractual Maturities of Long-term Debt	A summary of future contractual maturities of long-term debt, excluding unamortized debt issuance costs, as of December 31, 2018, is as follows (in thousands): Years ending December 31, Notes Payable 1 Capital Lease Obligations 2019 $ 11,343 $ 626 2020 14,791 208 2021 14,791 62 2022 66,791 12 2023 218,647 8 Thereafter — — Total $ 326,363 $ 916 Less interest portion (36 ) Total, excluding interest $ 880 1 As noted above, as of December 31, 2018 the Company has classified its Term Loan and Revolver under the 2017 Credit Facility as current liabilities. This table presents the scheduled maturities of the loan per their respective agreements.

Financing Lease Obligation (Tab

Financing Lease Obligation (Tables)	12 Months Ended
	Dec. 31, 2018
Leases [Abstract]
Summary of Financing Lease Obligation	A summary of the Company’s financing lease obligation is as follows (in thousands): December 31, 2018 2017 Financing lease obligation: Sale-Leaseback Facilities $ 24,542 $ 24,621 Less current portion (included in accrued and other current liabilities) (121 ) (80 ) Total financing lease obligation, net of current portion $ 24,421 $ 24,541
Schedule of Future Minimum Lease Payments to Sales-Leaseback	The future minimum lease payments with remaining terms of one or more years as of December 31, 2018, as it relates to the 2017 Sale-Leaseback consisted of the following (in thousands): Years ending December 31, Annual Payment 2019 $ 2,233 2020 2,267 2021 2,301 2022 2,336 2023 2,371 Thereafter 22,093 Total $ 33,601

Stock Based Compensation (Table

Stock Based Compensation (Tables)	12 Months Ended
	Dec. 31, 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 2014 Incentive Plan is set forth below: Weighted- Average Grant Shares Date Fair Value Unvested at December 31, 2016 522,175 $ 23.22 Granted 446,000 8.60 Vested (402,267 ) 18.49 Forfeitures (217,053 ) 17.27 Unvested at December 31, 2017 348,855 $ 13.69 Granted 196,000 11.47 Vested (286,817 ) 14.19 Forfeitures (76,213 ) 14.44 Unvested at December 31, 2018 181,825 $ 10.20

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Schedule of Components of Income Tax Expense (Benefit)	Income tax (benefit) expense consisted of the following for the years ended December 31, 2018, 2017 and 2016: Year Ended December 31, 2018 2017 Restated 2016 Restated Current Federal $ (5,447 ) $ 1,150 $ (456 ) State (438 ) 1,244 1,042 Total current tax expense (5,885 ) 2,394 586 Deferred: Federal (529 ) (3,476 ) 2,782 State 3,410 (660 ) (1,023 ) Total deferred tax (benefit) expense 2,881 (4,136 ) 1,759 Total income tax (benefit) expense $ (3,004 ) $ (1,742 ) $ 2,345
Schedule of Effective Income Tax Rate	The Company’s effective income tax rate for the years ended December 31, 2018, 2017 and 2016 reconciles with the federal statutory rate as follows: Year Ended December 31, 2018 2017 Restated 2016 Restated Federal statutory rate 21.0 % 35.0 % 35.0 % State income taxes, net of federal tax benefit 7.9 1.8 1.9 Effect of Tax Cuts and Jobs Act - (38.1 ) - Non-deductible expenses (0.5 ) (1.8 ) (0.6 ) Stock compensation adjustment (0.8 ) (8.1 ) (4.6 ) Return to provision adjustment 4.0 (0.1 ) - Change in valuation allowance (27.4 ) 20.3 (41.1 ) Other differences 0.1 0.1 (0.4 ) Effective income tax rate on income before taxes 4.3 % 9.1 % (9.8 ) %
Schedule of Deferred Tax Assets (Liabilities)	Deferred income tax assets (liabilities) are comprised of the following at December 31, 2018 and 2017: Year Ended December 31, 2018 2017 Restated Employee compensation $ 1,786 $ 1,839 Operating loss carryforwards 27,147 2,894 Business interest limitation 8,295 - Accrued litigation 2,088 5,517 Accounts receivable - 8,059 Tax credits 332 - Acquisition related costs 1,438 1,255 Property, equipment and amortization 3,301 2,377 Other 1,337 - Valuation allowance (34,722 ) (15,091 ) Total deferred tax assets 11,002 6,850 Goodwill and other intangible property (8,891 ) (5,130 ) Other (512 ) - Accounts receivable (2,826 ) (70 ) Total deferred tax liabilities (12,229 ) (5,200 ) Net deferred tax (liabilities) assets $ (1,227 ) $ 1,650

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2018
Commitments And Contingencies Disclosure [Abstract]
Schedule of Future Minimum Lease Payments Under Non-Cancelable Operating Leases	The future minimum lease payments under non-cancelable operating leases with remaining terms of one or more years as of December 31, 2018 consisted of the following (in thousands): Years ending December 31, Annual Payment 2019 $ 11,722 2020 9,896 2021 8,816 2022 8,116 2023 7,635 Thereafter 38,357 Total $ 84,542

Unaudited Quarterly Informati_2

Unaudited Quarterly Information (Restated) (Tables)	12 Months Ended
	Dec. 31, 2018
Summary of Unaudited Quarterly Information (Restated)	Results of operations for a particular quarter are not necessarily indicative of results of operations for an annual period and are not predictive of future periods. Quarter Ended March 31, Restated June 30, Restated September 30, Restated December 31, (In thousands except share data) 2018: Revenue $ 81,187 $ 88,094 $ 69,034 $ 57,448 (a) Net loss $ (837 ) $ (3,592 ) $ (23,844 ) $ (38,445 ) (a),(b) Net income (loss) available to AAC Holdings, Inc. common stockholders $ 1,056 $ (1,602 ) $ (22,181 ) $ (36,677 ) (a),(b) Basic net loss per share $ 0.04 $ (0.07 ) $ (0.92 ) $ (1.52 ) Diluted net loss per share $ 0.04 $ (0.07 ) $ (0.92 ) $ (1.52 ) Quarter Ended March 31, Restated June 30, Restated September 30, Restated December 31, Restated 2017: (In thousands except share data) Revenue $ 73,039 $ 78,042 $ 80,424 $ 86,136 Net (loss) income $ (766 ) $ 158 $ 715 $ (17,488 ) (c) Net (loss) income available to AAC Holdings, Inc. common stockholders $ 275 $ 1,140 $ 1,841 $ (16,129 ) (c) Basic net (loss) income per share $ 0.01 $ 0.05 $ 0.08 $ (0.69 ) Diluted net (loss) income per share $ 0.01 $ 0.05 $ 0.08 $ (0.69 ) (a) Refer to Note 2 – Basis of Presentation (b) Refer to Note 15 – Commitments and Contingencies (c) Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters.
Summary of Allowance for Doubtful Accounts	A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2015, restated $ 41,145 Additions charged to provision for doubtful accounts 38,549 Accounts written off, net of recoveries (10,234 ) Balance at December 31, 2016, restated $ 69,460 Additions charged to provision for doubtful accounts 25,932 Accounts written off, net of recoveries (6,968 ) Balance at December 31, 2017, restated $ 88,424 Balance at January 1, 2018 (1) $ - Additions charged to provision for doubtful accounts 366 Accounts written off, net of recoveries (366 ) Balance at December 31, 2018 $ - (1) As discussed at Note 3 to the Notes of the Consolidated Financial Statements, on January 1, 2018, the Company adopted the new revenue recognition standard (Topic 606). Upon adoption of Topic 606, the allowance for doubtful accounts of approximately $88.4 million was reclassified as a component of accounts receivable. The only activity that is now recorded as a provision for doubtful accounts is related to specific customers that experience significant adverse changes in creditworthiness, such as bankruptcies. A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands): Balance at December 31, 2016, restated $ 69,460 Additions charged to provision for doubtful accounts 4,403 Accounts written off, net of recoveries (680 ) Balance at March 31, 2017, restated $ 73,183 Additions charged to provision for doubtful accounts 6,261 Accounts written off, net of recoveries (2,231 ) Balance at June 30, 2017, restated $ 77,213 Additions charged to provision for doubtful accounts 7,406 Accounts written off, net of recoveries (2,239 ) Balance at September 30, 2017, restated $ 82,380
Summary of Restated Adjustment of Financial Statements	The impact of the correction of an error on the affected line items of the Company’s consolidated balance sheets as of December 31, 2016 and 2017 and consolidated statements of operations and cash flows for the years ended December 31, 2016 and 2017 is set forth below: Year Ended, December 31, 2017 Year Ended, December 31, 2016 As Previously Reported Adjustments Restated As Previously Reported Adjustments Restated Revenues Client related revenue $ 308,538 $ - $ 308,538 $ 270,569 $ - $ 270,569 Non-client related revenue 9,103 - 9,103 9,201 - 9,201 Total revenues 317,641 - 317,641 279,770 - 279,770 Operating expenses Salaries, wages and benefits 146,390 - 146,390 141,073 - 141,073 Client related services 27,031 - 27,031 24,446 - 24,446 Provision for doubtful accounts 36,914 (10,982 ) 25,932 21,485 17,064 38,549 Advertising and marketing 12,315 - 12,315 18,275 - 18,275 Professional fees 12,638 - 12,638 16,468 - 16,468 Other operating expenses 36,309 - 36,309 29,627 - 29,627 Rentals and leases 7,514 - 7,514 7,363 - 7,363 Litigation settlement 23,607 - 23,607 1,292 - 1,292 Depreciation and amortization 21,504 - 21,504 17,686 - 17,686 Acquisition-related expenses 1,162 - 1,162 2,691 - 2,691 Total operating expenses 325,384 (10,982 ) 314,402 280,406 17,064 297,470 (Loss) income from operations (7,743 ) 10,982 3,239 (636 ) (17,064 ) (17,700 ) Interest expense, net (including change in fair value of interest rate swaps of ($108), and ($180), respectively) 16,811 - 16,811 8,175 - 8,175 Loss on extinguishment of debt 5,435 - 5,435 - - - Gain on contingent consideration - - - (1,350 ) - (1,350 ) Other (income) expense, net 116 - 116 (500 ) - (500 ) Loss before income tax expense (30,105 ) 10,982 (19,123 ) (6,961 ) (17,064 ) (24,025 ) Income tax (benefit) expense (5,018 ) 3,276 (1,742 ) (1,220 ) 3,565 2,345 Net loss (25,087 ) 7,706 (17,381 ) (5,741 ) (20,629 ) (26,370 ) Less: net loss attributable to noncontrolling interest 4,508 - 4,508 5,152 - 5,152 Net loss attributable to AAC Holdings, Inc. common stockholders (20,579 ) 7,706 (12,873 ) (589 ) (20,629 ) (21,218 ) Basic loss per common share $ (0.88 ) $ (0.55 ) $ (0.03 ) $ (0.93 ) Diluted loss per common share $ (0.88 ) $ (0.55 ) $ (0.03 ) $ (0.93 ) Weighted-average common shares outstanding: Basic 23,277,444 23,277,444 22,718,117 22,718,117 Diluted 23,277,444 23,277,444 22,718,117 22,718,117 AAC Holdings, Inc. Consolidated Balance Sheet (Dollars in thousands, except share data) Year Ended, December 31, 2017 As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 13,818 $ - $ 13,818 Accounts receivable, net of allowances 94,096 (30,350 ) 63,746 Prepaid expenses and other current assets 4,022 - 4,022 Total current assets 111,936 (30,350 ) 81,586 Property and equipment, net 152,548 - 152,548 Goodwill 134,396 - 134,396 Intangible assets, net 8,829 - 8,829 Deferred tax assets, net 8,010 (6,360 ) 1,650 Other assets 12,556 - 12,556 Total assets $ 428,275 $ (36,710 ) $ 391,565 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 4,579 $ - $ 4,579 Accrued and other current liabilities 27,661 - 27,661 Accrued litigation 23,607 - 23,607 Current portion of long-term debt 4,722 - 4,722 Total current liabilities 60,569 - 60,569 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 196,451 - 196,451 Financing lease obligation, net of current portion 24,541 - 24,541 Other long-term liabilities 10,546 - 10,546 Total liabilities 292,107 - 292,107 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 23,872,436 shares issued and outstanding at December 31, 2017, respectively 24 - 24 Additional paid-in capital 152,430 - 152,430 Retained deficit (1,460 ) (36,710 ) (38,170 ) Total stockholders’ equity 150,994 (36,710 ) 114,284 Noncontrolling interest (14,826 ) - (14,826 ) Total stockholders’ equity including noncontrolling interest 136,168 (36,710 ) 99,458 Total liabilities and stockholders’ equity $ 428,275 $ (36,710 ) $ 391,565 AAC Holdings, Inc. Consolidated Statements of Cash Flows (Dollars in thousands, except share data) Year Ended, December 31, 2017 Year Ended, December 31, 2016 As Previously Reported Adjustments Restated As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (25,087 ) $ 7,706 $ (17,381 ) $ (5,741 ) $ (20,629 ) $ (26,370 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 36,914 (10,982 ) 25,932 21,485 17,064 38,549 Depreciation and amortization 21,504 - 21,504 17,686 - 17,686 Equity compensation 7,513 - 7,513 8,823 - 8,823 Loss on disposal of property and equipment 55 - 55 163 - 163 Loss on extinguishment of debt 5,435 - 5,435 - - - Gain on contingent consideration - - - (1,350 ) - (1,350 ) Amortization of debt issuance costs 1,564 - 1,564 633 - 633 Deferred income taxes (7,412 ) 3,276 (4,136 ) (1,793 ) 3,565 1,772 Changes in operating assets and liabilities: Accounts receivable (43,676 ) - (43,676 ) (45,838 ) - (45,838 ) Prepaid expenses and other assets (6,725 ) - (6,725 ) 2,510 - 2,510 Accounts payable (4,576 ) - (4,576 ) 824 - 824 Accrued and other current liabilities 4,685 - 4,685 2,973 - 2,973 Accrued litigation 22,645 - 22,645 162 - 162 Other long-term liabilities 6,453 - 6,453 (394 ) - (394 ) Net cash provided by operating activities 19,292 - 19,292 143 - 143 Cash flows from investing activities: Purchase of property and equipment (33,041 ) - (33,041 ) (37,304 ) - (37,304 ) Acquisition of subsidiaries - - - (18,825 ) - (18,825 ) Change in funds held on acquisition (1,000 ) - (1,000 ) (325 ) - (325 ) Net cash used in investing activities (34,041 ) - (34,041 ) (56,454 ) - (56,454 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility (211,094 ) - (211,094 ) (5,376 ) - (5,376 ) Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs 18,000 - 18,000 48,930 - 48,930 Payments on 2017 Credit Facility (17,126 ) - (17,126 ) - - - Proceeds from 2017 Credit Facility, net of deferred financing costs 211,073 - 211,073 - - - Proceeds from financing lease obligation, net of deferred financing costs 24,621 - 24,621 - - - Payments on capital leases and other (791 ) - (791 ) (834 ) - (834 ) Payments on AdCare Note - - - - - - Repayment of long-term debt — related party - - - (1,195 ) - (1,195 ) Change in funds held on acquisition 1,000 - 1,000 - - - Payment of employee taxes for net share settlement (1,080 ) - (1,080 ) - - - Net cash provided by financing activities 24,603 - 24,603 41,525 - 41,525 Net change in cash and cash equivalents 9,854 - 9,854 (14,786 ) - (14,786 ) Cash and cash equivalents, beginning of period 3,964 - 3,964 18,750 - 18,750 Cash and cash equivalents, end of period $ 13,818 $ - $ 13,818 $ 3,964 $ - $ 3,964 Unaudited Consolidated Statement of Operations For the Three Months Ended September 30, 2018 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 74,477 $ (8,370 ) $ 66,107 Non-client related revenue 2,996 (69 ) 2,927 Total revenues 77,473 (8,439 ) 69,034 Operating expenses Salaries, wages and benefits 44,831 - 44,831 Client related services 8,594 - 8,594 Provision for doubtful accounts - - - Advertising and marketing 3,037 - 3,037 Professional fees 5,697 - 5,697 Other operating expenses 12,833 - 12,833 Rentals and leases 2,760 - 2,760 Litigation settlement 100 - 100 Depreciation and amortization 5,573 - 5,573 Acquisition-related expenses 1,058 (947 ) 111 Total operating expenses 84,483 (947 ) 83,536 Loss from operations (7,010 ) (7,492 ) (14,502 ) Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 8,738 - 8,738 Loss on contingent consideration - 947 947 Other expense, net 732 - 732 Loss before income tax expense (16,480 ) (8,439 ) (24,919 ) Income tax benefit (3,324 ) 2,249 (1,075 ) Net loss (13,156 ) (10,688 ) (23,844 ) Less: net loss attributable to noncontrolling interest 1,663 - 1,663 Net loss attributable to AAC Holdings, Inc. common stockholders $ (11,493 ) $ (10,688 ) $ (22,181 ) Basic loss per common share $ (0.47 ) $ (0.92 ) Diluted loss per common share $ (0.47 ) $ (0.92 ) Weighted-average common shares outstanding: Basic 24,205,159 24,205,159 Diluted 24,205,159 24,205,159 Unaudited Consolidated Statement of Operations For the Three Months Ended June 30, 2018 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 83,293 $ 1,327 $ 84,620 Non-client related revenue 3,468 6 3,474 Total revenues 86,761 1,333 88,094 Operating expenses Salaries, wages and benefits 46,850 - 46,850 Client related services 8,393 - 8,393 Provision for doubtful accounts 366 - 366 Advertising and marketing 2,584 - 2,584 Professional fees 4,950 - 4,950 Other operating expenses 12,194 - 12,194 Rentals and leases 2,563 - 2,563 Litigation settlement 244 - 244 Depreciation and amortization 5,909 - 5,909 Acquisition-related expenses - 176 176 Total operating expenses 84,053 176 84,229 Income from operations 2,708 1,157 3,865 Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 7,893 - 7,893 Gain on contingent consideration - (176 ) (176 ) Other income, net (98 ) - (98 ) Loss before income tax expense (5,087 ) 1,333 (3,754 ) Income tax benefit (84 ) (78 ) (162 ) Net loss (5,003 ) 1,411 (3,592 ) Less: net loss attributable to noncontrolling interest 1,990 - 1,990 Net loss attributable to AAC Holdings, Inc. common stockholders $ (3,013 ) $ 1,411 $ (1,602 ) Basic loss per common share $ (0.12 ) $ (0.07 ) Diluted loss per common share $ (0.12 ) $ (0.07 ) Weighted-average common shares outstanding: Basic 24,166,976 24,166,976 Diluted 24,166,976 24,166,976 Unaudited Consolidated Statement of Operations For the Three Months Ended March 31, 2018 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 75,923 $ 2,707 $ 78,630 Non-client related revenue 2,550 7 2,557 Total revenues 78,473 2,714 81,187 Operating expenses Salaries, wages and benefits 40,084 - 40,084 Client related services 7,747 - 7,747 Provision for doubtful accounts - - - Advertising and marketing 2,599 - 2,599 Professional fees 3,650 - 3,650 Other operating expenses 10,588 - 10,588 Rentals and leases 2,116 - 2,116 Litigation settlement 2,791 - 2,791 Depreciation and amortization 5,464 - 5,464 Acquisition-related expenses 305 - 305 Total operating expenses 75,344 - 75,344 Income from operations 3,129 2,714 5,843 Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 6,709 - 6,709 Gain on contingent consideration - - - Other expense, net 9 - 9 Loss before income tax expense (3,589 ) 2,714 (875 ) Income tax benefit (1,494 ) 1,456 (38 ) Net loss (2,095 ) 1,258 (837 ) Less: net loss attributable to noncontrolling interest 1,893 - 1,893 Net (loss) income attributable to AAC Holdings, Inc. common stockholders $ (202 ) $ 1,258 $ 1,056 Basic (loss) earnings per common share $ (0.01 ) $ 0.04 Diluted (loss) earnings per common share $ (0.01 ) $ 0.04 Weighted-average common shares outstanding: Basic 23,744,208 23,744,208 Diluted 23,744,208 23,781,604 Unaudited Consolidated Statement of Operations For the Three Months Ended September 30, 2017 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 77,948 $ - $ 77,948 Non-client related revenue 2,476 - 2,476 Total revenues 80,424 - 80,424 Operating expenses Salaries, wages and benefits 36,709 - 36,709 Client related services 6,598 - 6,598 Provision for doubtful accounts 9,682 (2,276 ) 7,406 Advertising and marketing 3,074 - 3,074 Professional fees 3,641 - 3,641 Other operating expenses 8,306 - 8,306 Rentals and leases 2,105 - 2,105 Litigation settlement - - - Depreciation and amortization 5,218 - 5,218 Acquisition-related expenses 370 - 370 Total operating expenses 75,703 (2,276 ) 73,427 Income from operations 4,721 2,276 6,997 Interest expense, net (including change in fair value of interest rate swaps of $0, respectively) 5,492 - 5,492 Loss on extinguishment of debt - - - Gain on contingent consideration - - - Other expense, net 49 - 49 (Loss) income before income tax expense (820 ) 2,276 1,456 Income tax expense (benefit) (456 ) 1,197 741 Net (loss) income (364 ) 1,079 715 Less: net loss attributable to noncontrolling interest 1,126 - 1,126 Net income attributable to AAC Holdings, Inc. common stockholders $ 762 $ 1,079 $ 1,841 Basic earnings per common share $ 0.03 $ 0.08 Diluted earnings per common share $ 0.03 $ 0.08 Weighted-average common shares outstanding: Basic 23,331,414 23,331,414 Diluted 23,469,985 23,469,985 Unaudited Consolidated Statement of Operations For the Three Months Ended June 30, 2017 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 75,692 $ - $ 75,692 Non-client related revenue 2,350 - 2,350 Total revenues 78,042 - 78,042 Operating expenses Salaries, wages and benefits 34,508 - 34,508 Client related services 6,646 - 6,646 Provision for doubtful accounts 9,496 (3,235 ) 6,261 Advertising and marketing 3,266 - 3,266 Professional fees 3,039 - 3,039 Other operating expenses 8,199 - 8,199 Rentals and leases 1,849 - 1,849 Litigation settlement - - - Depreciation and amortization 5,058 - 5,058 Acquisition-related expenses 42 - 42 Total operating expenses 72,103 (3,235 ) 68,868 Income from operations 5,939 3,235 9,174 Interest expense, net (including change in fair value of interest rate swaps of ($25), respectively) 2,846 - 2,846 Loss on extinguishment of debt 5,435 - 5,435 Gain on contingent consideration - - - Other income, net 6 - 6 (Loss) income before income tax expense (2,336 ) 3,235 899 Income tax expense 562 179 741 Net (loss) income (2,898 ) 3,056 158 Less: net loss attributable to noncontrolling interest 982 - 982 Net (loss) income attributable to AAC Holdings, Inc. common stockholders $ (1,916 ) $ 3,056 $ 1,140 Basic (loss) earnings per common share $ (0.08 ) $ 0.05 Diluted (loss) earnings per common share $ (0.08 ) $ 0.05 Weighted-average common shares outstanding: Basic 23,242,177 23,242,177 Diluted 23,242,177 23,254,162 Unaudited Consolidated Statement of Operations For the Three Months Ended March 31, 2017 (Dollars in thousands, except share data) As Previously Reported Adjustments Restated Revenues Client related revenue $ 71,219 $ - $ 71,219 Non-client related revenue 1,820 - 1,820 Total revenues 73,039 - 73,039 Operating expenses Salaries, wages and benefits 36,772 - 36,772 Client related services 6,378 - 6,378 Provision for doubtful accounts 6,587 (2,184 ) 4,403 Advertising and marketing 3,775 - 3,775 Professional fees 2,642 - 2,642 Other operating expenses 8,789 - 8,789 Rentals and leases 1,885 - 1,885 Litigation settlement - - - Depreciation and amortization 5,469 - 5,469 Acquisition-related expenses 183 - 183 Total operating expenses 72,480 (2,184 ) 70,296 Income from operations 559 2,184 2,743 Interest expense, net (including change in fair value of interest rate swaps of ($83), respectively) 2,734 - 2,734 Loss on extinguishment of debt - - - Gain on contingent consideration - - - Other expense, net 34 - 34 Loss before income tax expense (2,209 ) 2,184 (25 ) Income tax (benefit) expense (565 ) 1,306 741 Net loss (1,644 ) 878 (766 ) Less: net loss attributable to noncontrolling interest 1,041 - 1,041 Net (loss) income attributable to AAC Holdings, Inc. common stockholders $ (603 ) $ 878 $ 275 Basic (loss) earnings per common share $ (0.03 ) $ 0.01 Diluted (loss) earnings per common share $ (0.03 ) $ 0.01 Weighted-average common shares outstanding: Basic 23,163,626 23,163,626 Diluted 23,163,626 23,174,899 Unaudited Consolidated Balance Sheet September 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 5,259 $ - $ 5,259 Accounts receivable, net of allowances 94,583 (34,744 ) 59,839 Prepaid expenses and other current assets 5,547 - 5,547 Total current assets 105,389 (34,744 ) 70,645 Property and equipment, net 166,345 - 166,345 Goodwill 198,952 - 198,952 Intangible assets, net 12,561 - 12,561 Deferred tax assets, net 13,042 (10,118 ) 2,924 Other assets 10,679 - 10,679 Total assets $ 506,968 $ (44,862 ) $ 462,106 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 8,722 $ - $ 8,722 Accrued and other current liabilities 31,607 - 31,607 Accrued litigation - - - Current portion of long-term debt 8,350 - 8,350 Total current liabilities 48,679 - 48,679 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 297,143 - 297,143 Financing lease obligation, net of current portion 24,459 - 24,459 Other long-term liabilities 11,993 - 11,993 Total liabilities 382,274 - 382,274 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,621,653 shares issued and outstanding at September 30, 2018, respectively 25 - 25 Additional paid-in capital 161,209 - 161,209 Retained deficit (16,168 ) (44,862 ) (61,030 ) Total stockholders’ equity 145,066 (44,862 ) 100,204 Noncontrolling interest (20,372 ) - (20,372 ) Total stockholders’ equity including noncontrolling interest 124,694 (44,862 ) 79,832 Total liabilities and stockholders’ equity $ 506,968 $ (44,862 ) $ 462,106 Unaudited Consolidated Balance Sheet June 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 11,353 $ - $ 11,353 Accounts receivable, net of allowances 97,362 (26,305 ) 71,057 Prepaid expenses and other current assets 4,638 - 4,638 Total current assets 113,353 (26,305 ) 87,048 Property and equipment, net 168,373 - 168,373 Goodwill 197,184 - 197,184 Intangible assets, net 13,201 - 13,201 Deferred tax assets, net 9,572 (7,723 ) 1,849 Other assets 11,069 - 11,069 Total assets 512,752 (34,028 ) 478,724 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 6,613 $ - $ 6,613 Accrued and other current liabilities 30,487 - 30,487 Accrued litigation - - - Current portion of long-term debt 6,723 - 6,723 Total current liabilities 43,823 - 43,823 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 295,322 - 295,322 Financing lease obligation, net of current portion 24,488 - 24,488 Other long-term liabilities 12,322 - 12,322 Total liabilities 375,955 - 375,955 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,596,675 shares issued and outstanding at June 30, 2018, respectively 25 - 25 Additional paid-in capital 160,156 - 160,156 Retained deficit (4,675 ) (34,028 ) (38,703 ) Total stockholders’ equity 155,506 (34,028 ) 121,478 Noncontrolling interest (18,709 ) - (18,709 ) Total stockholders’ equity including noncontrolling interest 136,797 (34,028 ) 102,769 Total liabilities and stockholders’ equity $ 512,752 $ (34,028 ) $ 478,724 Unaudited Consolidated Balance Sheet March 31, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 14,341 $ - $ 14,341 Accounts receivable, net of allowances 99,581 (27,637 ) 71,944 Prepaid expenses and other current assets 3,354 - 3,354 Total current assets 117,276 (27,637 ) 89,639 Property and equipment, net 169,744 - 169,744 Goodwill 197,184 - 197,184 Intangible assets, net 13,712 - 13,712 Deferred tax assets, net 9,030 (7,343 ) 1,687 Other assets 12,468 - 12,468 Total assets $ 519,414 $ (34,980 ) $ 484,434 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 3,338 $ - $ 3,338 Accrued and other current liabilities 34,039 - 34,039 Accrued litigation 1,000 - 1,000 Current portion of long-term debt 7,319 - 7,319 Total current liabilities 45,696 - 45,696 Deferred tax liabilities - - - Long-term debt, net of current portion and debt issuance costs 296,443 - 296,443 Financing lease obligation, net of current portion 24,515 - 24,515 Other long-term liabilities 12,277 - 12,277 Total liabilities 378,931 - 378,931 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,438,739 shares issued and outstanding at March 31, 2018, respectively 24 - 24 Additional paid-in capital 158,840 - 158,840 Retained deficit (1,662 ) (34,980 ) (36,642 ) Total stockholders’ equity 157,202 (34,980 ) 122,222 Noncontrolling interest (16,719 ) - (16,719 ) Total stockholders’ equity including noncontrolling interest 140,483 (34,980 ) 105,503 Total liabilities and stockholders’ equity $ 519,414 $ (34,980 ) $ 484,434 Unaudited Consolidated Balance Sheet September 30, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 16,412 $ - $ 16,412 Accounts receivable, net of allowances 92,547 (33,638 ) 58,909 Prepaid expenses and other current assets 6,030 - 6,030 Total current assets 114,989 (33,638 ) 81,351 Property and equipment, net 151,769 - 151,769 Goodwill 134,396 - 134,396 Intangible assets, net 9,169 - 9,169 Deferred tax assets, net 1,579 (1,579 ) - Other assets 5,664 - 5,664 Total assets $ 417,566 $ (35,217 ) $ 382,349 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 5,732 $ - $ 5,732 Accrued and other current liabilities 24,633 - 24,633 Accrued litigation - - - Current portion of long-term debt 4,736 - 4,736 Total current liabilities 35,101 - 35,101 Deferred tax liabilities - 4,709 4,709 Long-term debt, net of current portion and debt issuance costs 197,872 - 197,872 Financing lease obligation, net of current portion 24,398 - 24,398 Other long-term liabilities 3,836 - 3,836 Total liabilities 261,207 4,709 265,916 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,021,219 shares issued and outstanding at September 30, 2017, respectively 24 - 24 Additional paid-in capital 152,440 - 152,440 Retained earnings (deficit) 17,362 (39,926 ) (22,564 ) Total stockholders’ equity 169,826 (39,926 ) 129,900 Noncontrolling interest (13,467 ) - (13,467 ) Total stockholders’ equity including noncontrolling interest 156,359 (39,926 ) 116,433 Total liabilities and stockholders’ equity $ 417,566 $ (35,217 ) $ 382,349 Unaudited Consolidated Balance Sheet June 30, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 10,793 $ - $ 10,793 Accounts receivable, net of allowances 96,527 (35,914 ) 60,613 Prepaid expenses and other current assets 4,456 - 4,456 Total current assets 111,776 (35,914 ) 75,862 Property and equipment, net 148,965 - 148,965 Goodwill 134,396 - 134,396 Intangible assets, net 9,551 - 9,551 Deferred tax assets, net 1,180 (1,180 ) - Other assets 783 - 783 Total assets $ 406,651 $ (37,094 ) $ 369,557 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 10,441 $ - $ 10,441 Accrued and other current liabilities 24,800 - 24,800 Accrued litigation - - - Current portion of long-term debt 4,503 - 4,503 Total current liabilities 39,744 - 39,744 Deferred tax liabilities - 3,968 3,968 Long-term debt, net of current portion and debt issuance costs 208,467 - 208,467 Financing lease obligation, net of current portion - - - Other long-term liabilities 3,782 - 3,782 Total liabilities 251,993 3,968 255,961 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,060,888 shares issued and outstanding at June 30, 2017, respectively 24 - 24 Additional paid-in capital 150,375 - 150,375 Retained earnings (deficit) 16,600 (41,062 ) (24,462 ) Total stockholders’ equity 166,999 (41,062 ) 125,937 Noncontrolling interest (12,341 ) - (12,341 ) Total stockholders’ equity including noncontrolling interest 154,658 (41,062 ) 113,596 Total liabilities and stockholders’ equity $ 406,651 $ (37,094 ) $ 369,557 Unaudited Consolidated Balance Sheet March 31, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Assets Current assets Cash and cash equivalents $ 5,880 $ - $ 5,880 Accounts receivable, net of allowances 94,144 (39,149 ) 54,995 Prepaid expenses and other current assets 4,897 - 4,897 Total current assets 104,921 (39,149 ) 65,772 Property and equipment, net 145,410 - 145,410 Goodwill 134,396 - 134,396 Intangible assets, net 9,953 - 9,953 Deferred tax assets, net 1,316 (1,316 ) - Other assets 626 - 626 Total assets $ 396,622 $ (40,465 ) $ 356,157 Liabilities and Stockholders’ Equity Current liabilities Accounts payable $ 13,711 $ - $ 13,711 Accrued and other current liabilities 24,865 - 24,865 Accrued litigation - - - Current portion of long-term debt 10,965 - 10,965 Total current liabilities 49,541 - 49,541 Deferred tax liabilities - 3,227 3,227 Long-term debt, net of current portion and debt issuance costs 187,456 - 187,456 Financing lease obligation, net of current portion - - - Other long-term liabilities 4,121 - 4,121 Total liabilities 241,118 3,227 244,345 Stockholders’ equity Common stock, $0.001 par value: 70,000,000 shares authorized, 24,076,469 shares issued and outstanding at March 31, 2017, respectively 24 - 24 Additional paid-in capital 148,323 - 148,323 Retained earnings (deficit) 18,516 (43,692 ) (25,176 ) Total stockholders’ equity 166,863 (43,692 ) 123,171 Noncontrolling interest (11,359 ) - (11,359 ) Total stockholders’ equity including noncontrolling interest 155,504 (43,692 ) 111,812 Total liabilities and stockholders’ equity $ 396,622 $ (40,465 ) $ 356,157 Unaudited Consolidated Statements of Cash Flows For the Nine Months Ended, September 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (20,254 ) $ (8,019 ) $ (28,273 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 366 - 366 Depreciation and amortization 16,946 - 16,946 Equity compensation 3,104 - 3,104 Loss on disposal of property and equipment 1,000 - 1,000 Loss on extinguishment of debt - - - Loss on contingent consideration - 771 771 Amortization of debt issuance costs 2,077 - 2,077 Deferred income taxes (5,032 ) 3,627 (1,405 ) Changes in operating assets and liabilities: Accounts receivable 3,503 4,392 7,895 Prepaid expenses and other assets (461 ) - (461 ) Accounts payable 645 - 645 Accrued and other current liabilities 2,207 (771 ) 1,436 Accrued litigation (23,300 ) - (23,300 ) Other long-term liabilities (559 ) - (559 ) Net cash (used in) provided by operating activities (19,758 ) - (19,758 ) Cash flows from investing activities: Purchase of property and equipment (15,458 ) - (15,458 ) Acquisition of subsidiaries (65,827 ) - (65,827 ) Change in funds held on acquisition - - - Net cash used in investing activities (81,285 ) - (81,285 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility - - - Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs - - - Payments on 2017 Credit Facility (5,172 ) - (5,172 ) Proceeds from 2017 Credit Facility, net of deferred financing costs 99,286 - 99,286 Proceeds from financing lease obligation, net of deferred financing costs - - - Payments on capital leases and other (563 ) - (563 ) Payments on AdCare Note (500 ) - (500 ) Repayment of long-term debt — related party - - - Change in funds held on acquisition - - - Payment of employee taxes for net share settlement (567 ) - (567 ) Net cash provided by financing activities 92,484 - 92,484 Net change in cash and cash equivalents (8,559 ) - (8,559 ) Cash and cash equivalents, beginning of period 13,818 - 13,818 Cash and cash equivalents, end of period $ 5,259 $ - $ 5,259 Unaudited Consolidated Statements of Cash Flows For the Six Months Ended, June 30, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net loss $ (7,098 ) $ 2,669 $ (4,429 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 366 - 366 Depreciation and amortization 11,373 - 11,373 Equity compensation 2,159 - 2,159 Loss on disposal of property and equipment 34 - 34 Loss on extinguishment of debt - - - Gain on contingent consideration - (176 ) (176 ) Amortization of debt issuance costs 1,357 - 1,357 Deferred income taxes (1,562 ) 1,378 (184 ) Changes in operating assets and liabilities: Accounts receivable 724 (4,047 ) (3,323 ) Prepaid expenses and other assets 1,475 - 1,475 Accounts payable (1,464 ) - (1,464 ) Accrued and other current liabilities 457 176 633 Accrued litigation (23,300 ) - (23,300 ) Other long-term liabilities (230 ) - (230 ) Net cash (used in) provided by operating activities (15,709 ) - (15,709 ) Cash flows from investing activities: Purchase of property and equipment (11,196 ) - (11,196 ) Acquisition of subsidiaries (65,185 ) - (65,185 ) Change in funds held on acquisition - - - Net cash used in investing activities (76,381 ) - (76,381 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility - - - Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs - - - Payments on 2017 Credit Facility (3,448 ) - (3,448 ) Proceeds from 2017 Credit Facility, net of deferred financing costs 94,286 - 94,286 Proceeds from financing lease obligation, net of deferred financing costs - - - Payments on capital leases and other (440 ) - (440 ) Payments on AdCare Note (250 ) - (250 ) Repayment of long-term debt — related party - - - Change in funds held on acquisition - - - Payment of employee taxes for net share settlement (523 ) - (523 ) Net cash provided by financing activities 89,625 - 89,625 Net change in cash and cash equivalents (2,465 ) - (2,465 ) Cash and cash equivalents, beginning of period 13,818 - 13,818 Cash and cash equivalents, end of period $ 11,353 $ - $ 11,353 Unaudited Consolidated Statements of Cash Flows For the Three Months Ended, March 31, 2018 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net Income (loss) $ (2,095 ) $ 1,258 $ (837 ) Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts - - - Depreciation and amortization 5,464 - 5,464 Equity compensation 798 - 798 Loss on disposal of property and equipment 34 - 34 Loss on extinguishment of debt - - - Gain (loss) on contingent consideration - - - Amortization of debt issuance costs 637 - 637 Deferred income taxes (1,020 ) 1,456 436 Changes in operating assets and liabilities: Accounts receivable (1,129 ) (2,714 ) (3,843 ) Prepaid expenses and other assets 1,485 - 1,485 Accounts payable (4,739 ) - (4,739 ) Accrued and other current liabilities 4,141 - 4,141 Accrued litigation (22,300 ) - (22,300 ) Other long-term liabilities (275 ) - (275 ) Net cash (used in) provided by operating activities (18,999 ) - (18,999 ) Cash flows from investing activities: Purchase of property and equipment (7,305 ) - (7,305 ) Acquisition of subsidiaries (65,185 ) - (65,185 ) Change in funds held on acquisition - - - Net cash used in investing activities (72,490 ) - (72,490 ) Cash flows from financing activities: Payments on 2015 Credit Facility and Deerfield Facility - - - Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs - - - Payments on 2017 Credit Facility (1,724 ) - (1,724 ) Proceeds from 2017 Credit Facility, net of deferred financing costs 94,432 - 94,432 Proceeds from financing lease obligation, net of deferred financing costs - - - Payments on capital leases and other (221 ) - (221 ) Payments on AdCare Note - - - Repayment of long-term debt — related party - - - Change in funds held on acquisition - - - Payment of employee taxes for net share settlement (475 ) - (475 ) Net cash provided by financing activities 92,012 - 92,012 Net change in cash and cash equivalents 523 - 523 Cash and cash equivalents, beginning of period 13,818 - 13,818 Cash and cash equivalents, end of period $ 14,341 $ - $ 14,341 Unaudited Consolidated Statements of Cash Flows For the Nine Months Ended, September 30, 2017 (Dollars in thousands) As Previously Reported Adjustments Restated Cash flows from operating activities: Net Income (loss) $ (4,906 ) $ 5,013 $ 107 Adjustments to reconcile net loss to net cash provided by operating activities: Provision for doubtful accounts 25,765 (7,695 ) 18,070 Depreciation and amortization 15,745 - 15,745 Equity compensation 6,048 - 6,048 Loss on disposal o
Accounting Standards Update 2014-09
Schedule of Impact on Condensed Consolidated Statements of Operations	For the year ended December 31, 2018, the impact on the Company's Condensed Consolidated Statements of Operations was as follows (in thousands): Year Ended December 31, 2018 As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 284,525 $ 307,781 $ (23,256 ) Non-client related revenue $ 11,238 $ 11,727 $ (489 ) Provision for doubtful accounts $ 366 $ 24,111 $ (23,745 ) Three Months Ended March 31, 2018 Restated As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 78,630 $ 82,481 $ (3,851 ) Non-client related revenue 2,557 2,798 (241 ) Provision for doubtful accounts - 4,092 (4,092 ) Three Months Ended June 30, 2018 Restated As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 84,620 $ 96,150 $ (11,530 ) Non-client related revenue 3,474 3,616 (142 ) Provision for doubtful accounts 366 12,038 (11,672 ) Three Months Ended September 30, 2018 Restated As Reported Previous Accounting Guidance Impact of Adopting Topic 606 Client related revenue $ 66,107 $ 81,626 $ (15,519 ) Non-client related revenue 2,927 3,029 (102 ) Provision for doubtful accounts - 15,621 (15,621 )

Basis of Presentation - Additio

Basis of Presentation - Additional Information (Details)	Mar. 08, 2019USD ($)	Dec. 31, 2018USD ($)ProfessionalGroup		Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Mar. 31, 2018USD ($)	Dec. 31, 2017USD ($)ProfessionalGroup		Sep. 30, 2017USD ($)	Jun. 30, 2017USD ($)	Mar. 31, 2017USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)	Sep. 30, 2018USD ($)	Sep. 30, 2017USD ($)	Dec. 31, 2018USD ($)ProfessionalGroup$ / shares	Dec. 31, 2017USD ($)ProfessionalGroup	Dec. 31, 2016USD ($)	Jan. 01, 2016USD ($)	Dec. 31, 2015USD ($)
Business And Basis Of Presentation [Line Items]
Assets		$ 452,277,000		$ 462,106,000	$ 478,724,000	$ 484,434,000	$ 391,565,000		$ 382,349,000	$ 369,557,000	$ 356,157,000	$ 478,724,000	$ 369,557,000	$ 462,106,000	$ 382,349,000	$ 452,277,000	$ 391,565,000
Liabilities		410,004,000		382,274,000	375,955,000	378,931,000	292,107,000		265,916,000	255,961,000	244,345,000	375,955,000	255,961,000	382,274,000	265,916,000	410,004,000	292,107,000
Net loss attributable to noncontrolling interest				1,663,000	1,990,000	1,893,000			1,126,000	982,000	1,041,000					7,314,000	4,508,000	$ 5,152,000
Revenue		57,448,000	[1]	69,034,000	88,094,000	81,187,000	86,136,000		80,424,000	78,042,000	73,039,000					295,763,000	317,641,000	279,770,000
Net loss		$ (38,445,000)	[1],[2]	$ (23,844,000)	$ (3,592,000)	$ (837,000)	$ (17,488,000)	[3]	$ 715,000	$ 158,000	$ (766,000)	$ (4,429,000)	$ (608,000)	$ (28,273,000)	$ 107,000	$ (66,718,000)	$ (17,381,000)	(26,370,000)
Cumulative effect of restatement on prior years (see Note 2A)																				$ (23,787,000)
2019 Senior Credit Facility
Business And Basis Of Presentation [Line Items]
Senior credit facility maturity date																Mar. 31, 2020
2019 Senior Credit Facility | Subsequent Event
Business And Basis Of Presentation [Line Items]
Credit facility borrowing capacity	$ 30,000,000
Senior credit facility maturity date	Apr. 15, 2020
Change in Accounting Estimate
Business And Basis Of Presentation [Line Items]
Cumulative effect of restatement on prior years (see Note 2A)																			$ 23,800
Change in Accounting Estimate | Collectability from Third Party Vendor
Business And Basis Of Presentation [Line Items]
Revenue																$ (6,000,000)
Net loss																$ 5,700,000
Loss per basic and diluted share | $ / shares																$ 0.24
VIEs
Business And Basis Of Presentation [Line Items]
Number of professional groups | ProfessionalGroup		7					7									7	7
Assets		$ 1,500,000					$ 2,100,000									$ 1,500,000	$ 2,100,000
Liabilities		$ 600,000					$ 400,000									600,000	400,000
Net loss attributable to noncontrolling interest																$ 7,300,000	$ 4,500,000	$ 5,200,000
[1]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.
[2]	Refer to Note 15 – Commitments and Contingencies to the Notes to the Consolidated Financial Statements.
[3]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters.

Basis of Presentation - Summary

Basis of Presentation - Summary of Consolidated Statement of Operations (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended										6 Months Ended		9 Months Ended		12 Months Ended
	Dec. 31, 2018		Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017		Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenues
Total revenues	$ 57,448	[1]	$ 69,034	$ 88,094	$ 81,187	$ 86,136		$ 80,424	$ 78,042	$ 73,039					$ 295,763	$ 317,641	$ 279,770
Operating expenses
Salaries, wages and benefits			44,831	46,850	40,084			36,709	34,508	36,772					174,772	146,390	141,073
Client related services			8,594	8,393	7,747			6,598	6,646	6,378					32,747	27,031	24,446
Provision for doubtful accounts				366				7,406	6,261	4,403	$ 366	$ 10,664	$ 366	$ 18,070	366	25,932	38,549
Advertising and marketing			3,037	2,584	2,599			3,074	3,266	3,775					13,744	12,315	18,275
Professional fees			5,697	4,950	3,650			3,641	3,039	2,642					19,894	12,638	16,468
Other operating expenses			12,833	12,194	10,588			8,306	8,199	8,789					47,716	36,309	29,627
Rentals and leases			2,760	2,563	2,116			2,105	1,849	1,885					10,367	7,514	7,363
Litigation settlement			100	244	2,791										11,136	23,607	1,292
Depreciation and amortization			5,573	5,909	5,464			5,218	5,058	5,469	11,373	10,527	16,946	15,745	21,986	21,504	17,686
Acquisition-related expenses			111	176	305			370	42	183					573	1,162	2,691
Total operating expenses			83,536	84,229	75,344			73,427	68,868	70,296					333,301	314,402	297,470
(Loss) income from operations			(14,502)	3,865	5,843			6,997	9,174	2,743					(37,538)	3,239	(17,700)
Interest expense, net (including change in fair value of interest rate swaps of ($108), and ($180), respectively)			8,738	7,893	6,709			5,492	2,846	2,734					32,220	16,811	8,175
Loss on extinguishment of debt									5,435			5,435		5,435		5,435
Gain on contingent consideration			947	(176)							(176)		771		(501)		(1,350)
Other (income) expense, net			732	(98)	9			49	6	34					465	116	(500)
Loss before income tax expense			(24,919)	(3,754)	(875)			1,456	899	(25)					(69,722)	(19,123)	(24,025)
Income tax (benefit) expense			(1,075)	(162)	(38)			741	741	741					(3,004)	(1,742)	2,345
Net loss	$ (38,445)	[1],[2]	(23,844)	(3,592)	(837)	$ (17,488)	[3]	715	158	(766)	(4,429)	(608)	(28,273)	107	(66,718)	(17,381)	(26,370)
Less: net loss attributable to noncontrolling interest			1,663	1,990	1,893			1,126	982	1,041					7,314	4,508	5,152
Net loss attributable to AAC Holdings, Inc. common stockholders			$ (22,181)	$ (1,602)	$ 1,056			$ 1,841	$ 1,140	$ 275					$ (59,404)	$ (12,873)	$ (21,218)
Basic loss per common share	$ (1.52)		$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)		$ 0.08	$ 0.05	$ 0.01					$ (2.47)	$ (0.55)	$ (0.93)
Diluted loss per common share	$ (1.52)		$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)		$ 0.08	$ 0.05	$ 0.01					$ (2.47)	$ (0.55)	$ (0.93)
Weighted-average common shares outstanding:
Basic			24,205,159	24,166,976	23,744,208			23,331,414	23,242,177	23,163,626					24,090,639	23,277,444	22,718,117
Diluted			24,205,159	24,166,976	23,781,604			23,469,985	23,254,162	23,174,899					24,090,639	23,277,444	22,718,117
As Previously Reported
Revenues
Total revenues			$ 77,473	$ 86,761	$ 78,473			$ 80,424	$ 78,042	$ 73,039						$ 317,641	$ 279,770
Operating expenses
Salaries, wages and benefits			44,831	46,850	40,084			36,709	34,508	36,772						146,390	141,073
Client related services			8,594	8,393	7,747			6,598	6,646	6,378						27,031	24,446
Provision for doubtful accounts				366				9,682	9,496	6,587	366	16,083	366	25,765		36,914	21,485
Advertising and marketing			3,037	2,584	2,599			3,074	3,266	3,775						12,315	18,275
Professional fees			5,697	4,950	3,650			3,641	3,039	2,642						12,638	16,468
Other operating expenses			12,833	12,194	10,588			8,306	8,199	8,789						36,309	29,627
Rentals and leases			2,760	2,563	2,116			2,105	1,849	1,885						7,514	7,363
Litigation settlement			100	244	2,791											23,607	1,292
Depreciation and amortization			5,573	5,909	5,464			5,218	5,058	5,469	11,373	10,527	16,946	15,745		21,504	17,686
Acquisition-related expenses			1,058		305			370	42	183						1,162	2,691
Total operating expenses			84,483	84,053	75,344			75,703	72,103	72,480						325,384	280,406
(Loss) income from operations			(7,010)	2,708	3,129			4,721	5,939	559						(7,743)	(636)
Interest expense, net (including change in fair value of interest rate swaps of ($108), and ($180), respectively)			8,738	7,893	6,709			5,492	2,846	2,734						16,811	8,175
Loss on extinguishment of debt									5,435			5,435		5,435		5,435
Gain on contingent consideration																	(1,350)
Other (income) expense, net			732	(98)	9			49	6	34						116	(500)
Loss before income tax expense			(16,480)	(5,087)	(3,589)			(820)	(2,336)	(2,209)						(30,105)	(6,961)
Income tax (benefit) expense			(3,324)	(84)	(1,494)			(456)	562	(565)						(5,018)	(1,220)
Net loss			(13,156)	(5,003)	(2,095)			(364)	(2,898)	(1,644)	(7,098)	(4,542)	(20,254)	(4,906)		(25,087)	(5,741)
Less: net loss attributable to noncontrolling interest			1,663	1,990	1,893			1,126	982	1,041						4,508	5,152
Net loss attributable to AAC Holdings, Inc. common stockholders			$ (11,493)	$ (3,013)	$ (202)			$ 762	$ (1,916)	$ (603)						$ (20,579)	$ (589)
Basic loss per common share			$ (0.47)	$ (0.12)	$ (0.01)			$ 0.03	$ (0.08)	$ (0.03)						$ (0.88)	$ (0.03)
Diluted loss per common share			$ (0.47)	$ (0.12)	$ (0.01)			$ 0.03	$ (0.08)	$ (0.03)						$ (0.88)	$ (0.03)
Weighted-average common shares outstanding:
Basic			24,205,159	24,166,976	23,744,208			23,331,414	23,242,177	23,163,626						23,277,444	22,718,117
Diluted			24,205,159	24,166,976	23,744,208			23,469,985	23,242,177	23,163,626						23,277,444	22,718,117
Adjustments
Revenues
Total revenues			$ (8,439)	$ 1,333	$ 2,714
Operating expenses
Provision for doubtful accounts								$ (2,276)	$ (3,235)	$ (2,184)		(5,419)		(7,695)		$ (10,982)	$ 17,064
Acquisition-related expenses			(947)	176
Total operating expenses			(947)	176				(2,276)	(3,235)	(2,184)						(10,982)	17,064
(Loss) income from operations			(7,492)	1,157	2,714			2,276	3,235	2,184						10,982	(17,064)
Gain on contingent consideration			947	(176)							(176)		771
Loss before income tax expense			(8,439)	1,333	2,714			2,276	3,235	2,184						10,982	(17,064)
Income tax (benefit) expense			2,249	(78)	1,456			1,197	179	1,306						3,276	3,565
Net loss			(10,688)	1,411	1,258			1,079	3,056	878	$ 2,669	$ 3,934	$ (8,019)	$ 5,013		7,706	(20,629)
Net loss attributable to AAC Holdings, Inc. common stockholders			(10,688)	1,411	1,258			1,079	3,056	878						7,706	(20,629)
Client Related Revenue
Revenues
Total revenues			66,107	84,620	78,630			77,948	75,692	71,219					$ 284,525	308,538	270,569
Client Related Revenue | As Previously Reported
Revenues
Total revenues			74,477	83,293	75,923			77,948	75,692	71,219						308,538	270,569
Client Related Revenue | Adjustments
Revenues
Total revenues			(8,370)	1,327	2,707
Non-Client Related Revenue
Revenues
Total revenues			2,927	3,474	2,557			2,476	2,350	1,820					$ 11,238	9,103	9,201
Non-Client Related Revenue | As Previously Reported
Revenues
Total revenues			2,996	3,468	2,550			$ 2,476	$ 2,350	$ 1,820						$ 9,103	$ 9,201
Non-Client Related Revenue | Adjustments
Revenues
Total revenues			$ (69)	$ 6	$ 7
[1]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.
[2]	Refer to Note 15 – Commitments and Contingencies to the Notes to the Consolidated Financial Statements.
[3]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters.

Basis of Presentation - Summa_2

Basis of Presentation - Summary of Consolidated Statement of Operations (Parenthetical) (Details) - USD ($) $ in Thousands	3 Months Ended						12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Swap
Change in fair value of interest rate swaps	$ 0	$ 0	$ 0	$ 0	$ (25)	$ (83)	$ 0	$ (108)	$ (180)

Basis of Presentation - Summa_3

Basis of Presentation - Summary of Consolidated Balance Sheet (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current assets
Cash and cash equivalents	$ 5,409	$ 5,259	$ 11,353	$ 14,341	$ 13,818	$ 16,412	$ 10,793	$ 5,880	$ 3,964	$ 18,750
Accounts receivable, net of allowances	47,860	59,839	71,057	71,944	63,746	58,909	60,613	54,995
Prepaid expenses and other current assets	10,695	5,547	4,638	3,354	4,022	6,030	4,456	4,897
Total current assets	63,964	70,645	87,048	89,639	81,586	81,351	75,862	65,772
Property and equipment, net	166,921	166,345	168,373	169,744	152,548	151,769	148,965	145,410
Goodwill	198,952	198,952	197,184	197,184	134,396	134,396	134,396	134,396	134,396
Intangible assets, net	12,063	12,561	13,201	13,712	8,829	9,169	9,551	9,953	10,356
Deferred tax assets, net		2,924	1,849	1,687	1,650
Other assets	10,377	10,679	11,069	12,468	12,556	5,664	783	626
Total assets	452,277	462,106	478,724	484,434	391,565	382,349	369,557	356,157
Current liabilities
Accounts payable	13,507	8,722	6,613	3,338	4,579	5,732	10,441	13,711
Accrued and other current liabilities	30,544	31,607	30,487	34,039	27,661	24,633	24,800	24,865
Accrued litigation	8,000			1,000	23,607
Current portion of long-term debt	309,394	8,350	6,723	7,319	4,722	4,736	4,503	10,965
Total current liabilities	361,445	48,679	43,823	45,696	60,569	35,101	39,744	49,541
Deferred tax liabilities	1,227					4,709	3,968	3,227
Long-term debt, net of current portion and debt issuance costs	9,764	297,143	295,322	296,443	196,451	197,872	208,467	187,456
Financing lease obligation, net of current portion	24,421	24,459	24,488	24,515	24,541	24,398
Other long-term liabilities	13,147	11,993	12,322	12,277	10,546	3,836	3,782	4,121
Total liabilities	410,004	382,274	375,955	378,931	292,107	265,916	255,961	244,345
Stockholders’ equity
Common stock, $0.001 par value: 70,000,000 shares authorized, 24,573,679 and 23,872,436 shares issued and outstanding at December 31, 2018 and 2017, respectively	25	25	25	24	24	24	24	24
Additional paid-in capital	161,962	161,209	160,156	158,840	152,430	152,440	150,375	148,323
Retained deficit	(97,574)	(61,030)	(38,703)	(36,642)	(38,170)	(22,564)	(24,462)	(25,176)
Total stockholders’ equity	64,413	100,204	121,478	122,222	114,284	129,900	125,937	123,171
Noncontrolling interest	(22,140)	(20,372)	(18,709)	(16,719)	(14,826)	(13,467)	(12,341)	(11,359)
Total stockholders’ equity including noncontrolling interest	42,273	79,832	102,769	105,503	99,458	116,433	113,596	111,812	110,372	112,701
Total liabilities and stockholders’ equity	$ 452,277	462,106	478,724	484,434	391,565	382,349	369,557	356,157
As Previously Reported
Current assets
Cash and cash equivalents		5,259	11,353	14,341	13,818	16,412	10,793	5,880	$ 3,964	18,750
Accounts receivable, net of allowances		94,583	97,362	99,581	94,096	92,547	96,527	94,144
Prepaid expenses and other current assets		5,547	4,638	3,354	4,022	6,030	4,456	4,897
Total current assets		105,389	113,353	117,276	111,936	114,989	111,776	104,921
Property and equipment, net		166,345	168,373	169,744	152,548	151,769	148,965	145,410
Goodwill		198,952	197,184	197,184	134,396	134,396	134,396	134,396
Intangible assets, net		12,561	13,201	13,712	8,829	9,169	9,551	9,953
Deferred tax assets, net		13,042	9,572	9,030	8,010	1,579	1,180	1,316
Other assets		10,679	11,069	12,468	12,556	5,664	783	626
Total assets		506,968	512,752	519,414	428,275	417,566	406,651	396,622
Current liabilities
Accounts payable		8,722	6,613	3,338	4,579	5,732	10,441	13,711
Accrued and other current liabilities		31,607	30,487	34,039	27,661	24,633	24,800	24,865
Accrued litigation				1,000	23,607
Current portion of long-term debt		8,350	6,723	7,319	4,722	4,736	4,503	10,965
Total current liabilities		48,679	43,823	45,696	60,569	35,101	39,744	49,541
Long-term debt, net of current portion and debt issuance costs		297,143	295,322	296,443	196,451	197,872	208,467	187,456
Financing lease obligation, net of current portion		24,459	24,488	24,515	24,541	24,398
Other long-term liabilities		11,993	12,322	12,277	10,546	3,836	3,782	4,121
Total liabilities		382,274	375,955	378,931	292,107	261,207	251,993	241,118
Stockholders’ equity
Common stock, $0.001 par value: 70,000,000 shares authorized, 24,573,679 and 23,872,436 shares issued and outstanding at December 31, 2018 and 2017, respectively		25	25	24	24	24	24	24
Additional paid-in capital		161,209	160,156	158,840	152,430	152,440	150,375	148,323
Retained deficit		(16,168)	(4,675)	(1,662)	(1,460)	17,362	16,600	18,516
Total stockholders’ equity		145,066	155,506	157,202	150,994	169,826	166,999	166,863
Noncontrolling interest		(20,372)	(18,709)	(16,719)	(14,826)	(13,467)	(12,341)	(11,359)
Total stockholders’ equity including noncontrolling interest		124,694	136,797	140,483	136,168	156,359	154,658	155,504		$ 136,488
Total liabilities and stockholders’ equity		506,968	512,752	519,414	428,275	417,566	406,651	396,622
Adjustments
Current assets
Accounts receivable, net of allowances		(34,744)	(26,305)	(27,637)	(30,350)	(33,638)	(35,914)	(39,149)
Total current assets		(34,744)	(26,305)	(27,637)	(30,350)	(33,638)	(35,914)	(39,149)
Deferred tax assets, net		(10,118)	(7,723)	(7,343)	(6,360)	(1,579)	(1,180)	(1,316)
Total assets		(44,862)	(34,028)	(34,980)	(36,710)	(35,217)	(37,094)	(40,465)
Current liabilities
Deferred tax liabilities						4,709	3,968	3,227
Total liabilities						4,709	3,968	3,227
Stockholders’ equity
Retained deficit		(44,862)	(34,028)	(34,980)	(36,710)	(39,926)	(41,062)	(43,692)
Total stockholders’ equity		(44,862)	(34,028)	(34,980)	(36,710)	(39,926)	(41,062)	(43,692)
Total stockholders’ equity including noncontrolling interest		(44,862)	(34,028)	(34,980)	(36,710)	(39,926)	(41,062)	(43,692)
Total liabilities and stockholders’ equity		$ (44,862)	$ (34,028)	$ (34,980)	$ (36,710)	$ (35,217)	$ (37,094)	$ (40,465)

Basis of Presentation - Summa_4

Basis of Presentation - Summary of Consolidated Balance Sheet (Details) (Parenthetical) - $ / shares	Dec. 31, 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	24,573,679	23,872,436
Common stock, shares outstanding	24,573,679	23,872,436

Basis of Presentation - Summa_5

Basis of Presentation - Summary of Consolidated Statements of Cash Flows (Details) - USD ($) $ in Thousands	3 Months Ended										6 Months Ended		9 Months Ended		12 Months Ended
	Dec. 31, 2018		Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017		Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net loss	$ (38,445)	[1],[2]	$ (23,844)	$ (3,592)	$ (837)	$ (17,488)	[3]	$ 715	$ 158	$ (766)	$ (4,429)	$ (608)	$ (28,273)	$ 107	$ (66,718)	$ (17,381)	$ (26,370)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts				366				7,406	6,261	4,403	366	10,664	366	18,070	366	25,932	38,549
Depreciation and amortization			5,573	5,909	5,464			5,218	5,058	5,469	11,373	10,527	16,946	15,745	21,986	21,504	17,686
Equity compensation					798					2,137	2,159	4,189	3,104	6,048	3,877	7,513	8,823
Loss on disposal of property and equipment					34						34		1,000		1,007	55	163
Loss on extinguishment of debt									5,435			5,435		5,435		5,435
Gain on contingent consideration			947	(176)							(176)		771		(501)		(1,350)
Amortization of debt issuance costs					637					173	1,357	364	2,077	949	2,797	1,564	633
Deferred income taxes					436					588	(184)	903	(1,405)	1,701	2,878	(4,136)	1,772
Changes in operating assets and liabilities:
Accounts receivable					(3,843)					(13,397)	(3,323)	(25,276)	7,895	(30,978)	19,876	(43,676)	(45,838)
Prepaid expenses and other assets					1,485					406	1,475	690	(461)	(703)	(5,578)	(6,725)	2,510
Accounts payable					(4,739)					4,556	(1,464)	1,286	645	(3,423)	5,737	(4,576)	824
Accrued and other current liabilities					4,141					759	633	526	1,436	1,171	1,780	4,685	2,973
Accrued litigation					(22,300)						(23,300)		(23,300)	165	(15,607)	22,645	162
Other long-term liabilities					(275)					28	(230)	(311)	(559)	(257)	(754)	6,453	(394)
Net cash (used in) provided by operating activities					(18,999)					4,356	(15,709)	8,389	(19,758)	14,030	(28,854)	19,292	143
Cash flows from investing activities:
Purchase of property and equipment					(7,305)					(10,687)	(11,196)	(18,665)	(15,458)	(27,186)	(18,949)	(33,041)	(37,304)
Acquisition of subsidiaries					(65,185)						(65,185)		(65,827)		(65,827)		(18,825)
Change in funds held on acquisition																(1,000)	(325)
Net cash used in investing activities					(72,490)					(10,687)	(76,381)	(18,665)	(81,285)	(27,186)	(84,776)	(34,041)	(56,454)
Cash flows from financing activities:
Payments on 2015 Credit Facility and Deerfield Facility												(193,094)		(211,094)		(211,094)	(5,376)
Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs														18,000		18,000	48,930
Proceeds from financing lease obligation, net of deferred financing costs														24,617		24,621
Payments on capital leases and other					(221)					(2,537)	(440)	(400)	(563)	(596)	(798)	(791)	(834)
Repayment of long-term debt — related party																	(1,195)
Change in funds held on acquisition																1,000
Payment of employee taxes for net share settlement					(475)					(895)	(523)	(895)	(567)	(1,004)	(621)	(1,080)
Net cash provided by financing activities					92,012					8,247	89,625	17,105	92,484	25,604	105,221	24,603	41,525
Net change in cash and cash equivalents					523					1,916	(2,465)	6,829	(8,559)	12,448	(8,409)	9,854	(14,786)
Cash and cash equivalents, beginning of period	5,259		11,353	14,341	13,818	16,412		10,793	5,880	3,964	13,818	3,964	13,818	3,964	13,818	3,964	18,750
Cash and cash equivalents, end of period	5,409		5,259	11,353	14,341	13,818		16,412	10,793	5,880	11,353	10,793	5,259	16,412	5,409	13,818	3,964
2017 Credit Facility
Cash flows from financing activities:
Payments on 2017 Credit Facility					(1,724)						(3,448)		(5,172)	(15,813)	(6,896)	(17,126)
Proceeds from 2017 Credit Facility, net of deferred financing costs					94,432						94,286	9,169	99,286	211,494	114,286	211,073
AdCare, Inc
Cash flows from financing activities:
Payments on AdCare Note											(250)		(500)		(750)
As Previously Reported
Cash flows from operating activities:
Net loss			(13,156)	(5,003)	(2,095)			(364)	(2,898)	(1,644)	(7,098)	(4,542)	(20,254)	(4,906)		(25,087)	(5,741)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts				366				9,682	9,496	6,587	366	16,083	366	25,765		36,914	21,485
Depreciation and amortization			5,573	5,909	5,464			5,218	5,058	5,469	11,373	10,527	16,946	15,745		21,504	17,686
Equity compensation					798					2,137	2,159	4,189	3,104	6,048		7,513	8,823
Loss on disposal of property and equipment					34						34		1,000			55	163
Loss on extinguishment of debt									5,435			5,435		5,435		5,435
Gain on contingent consideration																	(1,350)
Amortization of debt issuance costs					637					173	1,357	364	2,077	949		1,564	633
Deferred income taxes					(1,020)					(718)	(1,562)	(582)	(5,032)	(981)		(7,412)	(1,793)
Changes in operating assets and liabilities:
Accounts receivable					(1,129)					(13,397)	724	(25,276)	3,503	(30,978)		(43,676)	(45,838)
Prepaid expenses and other assets					1,485					406	1,475	690	(461)	(703)		(6,725)	2,510
Accounts payable					(4,739)					4,556	(1,464)	1,286	645	(3,423)		(4,576)	824
Accrued and other current liabilities					4,141					759	457	526	2,207	1,171		4,685	2,973
Accrued litigation					(22,300)						(23,300)		(23,300)	165		22,645	162
Other long-term liabilities					(275)					28	(230)	(311)	(559)	(257)		6,453	(394)
Net cash (used in) provided by operating activities					(18,999)					4,356	(15,709)	8,389	(19,758)	14,030		19,292	143
Cash flows from investing activities:
Purchase of property and equipment					(7,305)					(10,687)	(11,196)	(18,665)	(15,458)	(27,186)		(33,041)	(37,304)
Acquisition of subsidiaries					(65,185)						(65,185)		(65,827)				(18,825)
Change in funds held on acquisition																(1,000)	(325)
Net cash used in investing activities					(72,490)					(10,687)	(76,381)	(18,665)	(81,285)	(27,186)		(34,041)	(56,454)
Cash flows from financing activities:
Payments on 2015 Credit Facility and Deerfield Facility												(193,094)		(211,094)		(211,094)	(5,376)
Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs														18,000		18,000	48,930
Proceeds from financing lease obligation, net of deferred financing costs														24,617		24,621
Payments on capital leases and other					(221)					(2,537)	(440)	(400)	(563)	(596)		(791)	(834)
Repayment of long-term debt — related party																	(1,195)
Change in funds held on acquisition																1,000
Payment of employee taxes for net share settlement					(475)					(895)	(523)	(895)	(567)	(1,004)		(1,080)
Net cash provided by financing activities					92,012					8,247	89,625	17,105	92,484	25,604		24,603	41,525
Net change in cash and cash equivalents					523					1,916	(2,465)	6,829	(8,559)	12,448		9,854	(14,786)
Cash and cash equivalents, beginning of period	$ 5,259		11,353	14,341	13,818	16,412		10,793	5,880	3,964	13,818	3,964	13,818	3,964	$ 13,818	3,964	18,750
Cash and cash equivalents, end of period			5,259	11,353	14,341	$ 13,818		16,412	10,793	5,880	11,353	10,793	5,259	16,412		13,818	3,964
As Previously Reported | 2017 Credit Facility
Cash flows from financing activities:
Payments on 2017 Credit Facility					(1,724)						(3,448)		(5,172)	(15,813)		(17,126)
Proceeds from 2017 Credit Facility, net of deferred financing costs					94,432						94,286	9,169	99,286	211,494		211,073
As Previously Reported | AdCare, Inc
Cash flows from financing activities:
Payments on AdCare Note											(250)		(500)
Adjustments
Cash flows from operating activities:
Net loss			(10,688)	1,411	1,258			1,079	3,056	878	2,669	3,934	(8,019)	5,013		7,706	(20,629)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts								$ (2,276)	$ (3,235)	(2,184)		(5,419)		(7,695)		(10,982)	17,064
Gain on contingent consideration			$ 947	$ (176)							(176)		771
Deferred income taxes					1,456					$ 1,306	1,378	$ 1,485	3,627	$ 2,682		$ 3,276	$ 3,565
Changes in operating assets and liabilities:
Accounts receivable					$ (2,714)						(4,047)		4,392
Accrued and other current liabilities											$ 176		$ (771)
[1]	Refer to Note 15 – Commitments and Contingencies to the Notes to the Consolidated Financial Statements.
[2]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.
[3]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters.

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Details)	Jan. 28, 2019USD ($)	Nov. 21, 2018USD ($)	Dec. 31, 2017USD ($)	Jun. 30, 2018USD ($)	Dec. 31, 2017USD ($)	Sep. 30, 2017USD ($)	Jun. 30, 2017USD ($)	Mar. 31, 2017USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)	Sep. 30, 2018USD ($)	Sep. 30, 2017USD ($)	Dec. 31, 2018USD ($)Segment	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)	Mar. 31, 2018USD ($)
Summary Of Significant Accounting Policies [Line Items]
General and administrative expense													$ 81,600,000	$ 96,100,000	$ 74,800,000
Cash And Cash Equivalents Highly Liquid Investments Maximum Maturity Period													3 months
Capitalized interest recognized													$ 300,000
Gain on sale of assets	$ 900,000
Number of operating segments | Segment													1
Number of reportable segments | Segment													1
Intangible assets with indefinite useful lives other than goodwill													$ 0
Percentage of discount rate assumption based on assessment of risk inherent in future cash flows													16.00%
Impairment of long-lived assets													$ 0	0	0
Accrued litigation			$ 23,607,000		$ 23,607,000								8,000,000	23,607,000		$ 1,000,000
Settlement amount related to shareholder lawsuits		$ 8,000,000	23,300,000		23,300,000
Bad debt expense				$ 366,000		$ 7,406,000	$ 6,261,000	$ 4,403,000	$ 366,000	$ 10,664,000	$ 366,000	$ 18,070,000	366,000	25,932,000	$ 38,549,000
ASU 2016-02 | Minimum
Summary Of Significant Accounting Policies [Line Items]
Operating Lease, right-of-use assets													33,000,000
Operating lease obligations													33,000,000
ASU 2016-02 | Maximum
Summary Of Significant Accounting Policies [Line Items]
Operating Lease, right-of-use assets													38,000,000
Operating lease obligations													$ 38,000,000
Trademarks, Marketing Intangibles and Service Contracts
Summary Of Significant Accounting Policies [Line Items]
Amortization period													10 years
Townsend Facilities and Operations
Summary Of Significant Accounting Policies [Line Items]
Property, plant and equipment, net													$ 100,000
Intangible assets, net													800,000
Other long-term assets													100,000
current liabilities													100,000
Subsequent Event | Townsend Facilities and Operations
Summary Of Significant Accounting Policies [Line Items]
Proceeds from sale of assets	$ 1,900,000
Commercial Insurance Company
Summary Of Significant Accounting Policies [Line Items]
Accounts receivable, net of allowance for doubtful accounts			$ 14,600,000		$ 14,600,000								2,200,000	$ 14,600,000
Digital Outreach Platform Customers
Summary Of Significant Accounting Policies [Line Items]
Bad debt expense													$ 400,000
Revenues | Blue Cross Blue Shield | NEVADA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage														11.40%
Revenues | Blue Cross Blue Shield | TEXAS
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage														10.90%	10.40%
Revenues | Blue Cross Blue Shield | FLORIDA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage														10.30%
Revenues | Anthem Blue Cross Blue Shield | FLORIDA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage															10.50%
Revenues | Aetna
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage															10.40%
Accounts Receivable | Blue Cross Blue Shield | CALIFORNIA
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage														10.30%
Accounts Receivable | Anthem Blue Cross Blue Shield | COLORADO
Summary Of Significant Accounting Policies [Line Items]
Concentration percentage														11.60%

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Summary of Composition of Client Related Revenue (Details) - USD ($) $ in Thousands	3 Months Ended									12 Months Ended
	Dec. 31, 2018	[1]	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Summary Of Significant Accounting Policies [Line Items]
Client Related Revenue, Amount	$ 57,448		$ 69,034	$ 88,094	$ 81,187	$ 86,136	$ 80,424	$ 78,042	$ 73,039	$ 295,763	$ 317,641	$ 279,770
Inpatient Treatment Facility Services
Summary Of Significant Accounting Policies [Line Items]
Client Related Revenue, Amount										$ 235,513	$ 246,976
Client Related Revenue, Percentage										82.80%	80.00%
Client Related Revenue, Increase (Decrease), Amount										$ (11,463)
Client Related Revenue, Increase (Decrease) , Percentage										(4.60%)
Inpatient Treatment Facility Services | Previous Accounting Guidance
Summary Of Significant Accounting Policies [Line Items]
Client Related Revenue, Amount										$ 247,273	$ 246,976
Client Related Revenue, Percentage										80.30%	80.00%
Client Related Revenue, Increase (Decrease), Amount										$ 297
Client Related Revenue, Increase (Decrease) , Percentage										0.10%
Outpatient Facility and Sober Living Services
Summary Of Significant Accounting Policies [Line Items]
Client Related Revenue, Amount										$ 34,405	$ 29,080
Client Related Revenue, Percentage										12.10%	9.40%
Client Related Revenue, Increase (Decrease), Amount										$ 5,325
Client Related Revenue, Increase (Decrease) , Percentage										18.30%
Outpatient Facility and Sober Living Services | Previous Accounting Guidance
Summary Of Significant Accounting Policies [Line Items]
Client Related Revenue, Amount										$ 35,947	$ 29,080
Client Related Revenue, Percentage										11.70%	9.40%
Client Related Revenue, Increase (Decrease), Amount										$ 6,867
Client Related Revenue, Increase (Decrease) , Percentage										23.60%
Client Related Diagnostic Services
Summary Of Significant Accounting Policies [Line Items]
Client Related Revenue, Amount										$ 14,607	$ 32,482
Client Related Revenue, Percentage										5.10%	10.60%
Client Related Revenue, Increase (Decrease), Amount										$ (17,875)
Client Related Revenue, Increase (Decrease) , Percentage										(55.00%)
Client Related Diagnostic Services | Previous Accounting Guidance
Summary Of Significant Accounting Policies [Line Items]
Client Related Revenue, Amount										$ 24,561	$ 32,482
Client Related Revenue, Percentage										8.00%	10.60%
Client Related Revenue, Increase (Decrease), Amount										$ (7,921)
Client Related Revenue, Increase (Decrease) , Percentage										(24.40%)
Client Related Revenue
Summary Of Significant Accounting Policies [Line Items]
Client Related Revenue, Amount			$ 66,107	$ 84,620	$ 78,630		$ 77,948	$ 75,692	$ 71,219	$ 284,525	$ 308,538	$ 270,569
Client Related Revenue, Percentage										100.00%	100.00%
Client Related Revenue, Increase (Decrease), Amount										$ (24,013)
Client Related Revenue, Increase (Decrease) , Percentage										(7.80%)
Client Related Revenue | Previous Accounting Guidance
Summary Of Significant Accounting Policies [Line Items]
Client Related Revenue, Amount										$ 307,781	$ 308,538
Client Related Revenue, Percentage										100.00%	100.00%
Client Related Revenue, Increase (Decrease), Amount										$ (757)
Client Related Revenue, Increase (Decrease) , Percentage										(0.20%)
[1]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Summary of Aging of Accounts Receivable Net of Allowance for Doubtful Accounts (Details) - Accounts Receivable	Dec. 31, 2017
Accounts Notes And Loans Receivable [Line Items]
Aging of accounts receivable, net of allowance for doubtful accounts, current	31.20%
Aging of accounts receivable, net of allowance for doubtful accounts	100.00%
31-180 Days
Accounts Notes And Loans Receivable [Line Items]
Aging of accounts receivable, net of allowance for doubtful accounts	44.70%
Over 180 Days
Accounts Notes And Loans Receivable [Line Items]
Aging of accounts receivable, net of allowance for doubtful accounts	24.10%

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Summary of Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended		9 Months Ended		12 Months Ended
	Jun. 30, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Balance at beginning of year		$ 77,213	$ 73,183	$ 69,460	$ 88,424	$ 69,460	$ 88,424	$ 69,460	$ 88,424	$ 69,460	$ 41,145
Additions charged to provision for doubtful accounts	$ 366	7,406	6,261	4,403	$ 366	10,664	$ 366	18,070	366	25,932	38,549
Accounts written off, net of recoveries		(2,239)	(2,231)	(680)					$ (366)	(6,968)	(10,234)
Balance at end of year		$ 82,380	$ 77,213	$ 73,183		$ 77,213		$ 82,380		$ 88,424	$ 69,460

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Summary of Allowance for Doubtful Accounts (Parenthetical) (Details) - USD ($) $ in Thousands	Jan. 01, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Summary Of Significant Accounting Policies [Line Items]
Allowance for doubtful accounts receivable		$ 88,424	$ 82,380	$ 77,213	$ 73,183	$ 69,460	$ 41,145
Accounting Standards Update 2014-09
Summary Of Significant Accounting Policies [Line Items]
Allowance for doubtful accounts receivable	$ 88,400

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Schedule of Useful Life of Property Plant and Equipment (Details)	12 Months Ended
	Dec. 31, 2018
Computer software and equipment
Property Plant And Equipment [Line Items]
Useful life of property and equipment	3 years
Building
Property Plant And Equipment [Line Items]
Useful life of property and equipment	36 years
Furniture, fixtures and equipment
Property Plant And Equipment [Line Items]
Useful life of property and equipment	5 years
Vehicles
Property Plant And Equipment [Line Items]
Useful life of property and equipment	5 years
Leasehold improvements
Property Plant And Equipment [Line Items]
Useful life of property and equipment	Life of the asset or lease, whichever is less
Minimum | Equipment under capital lease
Property Plant And Equipment [Line Items]
Useful life of property and equipment	3 years
Maximum | Equipment under capital lease
Property Plant And Equipment [Line Items]
Useful life of property and equipment	5 years

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Schedule of Accrued Liabilities Reflected as a Current Liability in the Accompanying Consolidated Balance Sheet (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017
Accounting Policies [Abstract]
Accrued payroll liabilities	$ 12,892				$ 13,197
Accrued interest	4,792				2,864
Other	12,860				11,600
Total accrued liabilities	$ 30,544	$ 31,607	$ 30,487	$ 34,039	$ 27,661	$ 24,633	$ 24,800	$ 24,865

Summary of Significant Accou_11

Summary of Significant Accounting Policies - Schedule of Impact on Condensed Consolidated Statements of Operations (Details) - USD ($) $ in Thousands	3 Months Ended									6 Months Ended		9 Months Ended		12 Months Ended
	Dec. 31, 2018	[1]	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Summary Of Significant Accounting Policies [Line Items]
Revenues	$ 57,448		$ 69,034	$ 88,094	$ 81,187	$ 86,136	$ 80,424	$ 78,042	$ 73,039					$ 295,763	$ 317,641	$ 279,770
Provision for doubtful accounts				366			7,406	6,261	4,403	$ 366	$ 10,664	$ 366	$ 18,070	366	25,932	38,549
Client Related Revenue
Summary Of Significant Accounting Policies [Line Items]
Revenues			66,107	84,620	78,630		77,948	75,692	71,219					284,525	308,538	270,569
Client Related Revenue | Previous Accounting Guidance
Summary Of Significant Accounting Policies [Line Items]
Revenues														307,781	308,538
Non-Client Related Revenue
Summary Of Significant Accounting Policies [Line Items]
Revenues			2,927	3,474	2,557		$ 2,476	$ 2,350	$ 1,820					11,238	$ 9,103	$ 9,201
Accounting Standards Update 2014-09 | Previous Accounting Guidance
Summary Of Significant Accounting Policies [Line Items]
Provision for doubtful accounts			15,621	12,038	4,092									24,111
Accounting Standards Update 2014-09 | Impact of Adopting Topic 606
Summary Of Significant Accounting Policies [Line Items]
Provision for doubtful accounts			(15,621)	(11,672)	(4,092)									(23,745)
Accounting Standards Update 2014-09 | Client Related Revenue | Previous Accounting Guidance
Summary Of Significant Accounting Policies [Line Items]
Revenues			81,626	96,150	82,481									307,781
Accounting Standards Update 2014-09 | Client Related Revenue | Impact of Adopting Topic 606
Summary Of Significant Accounting Policies [Line Items]
Revenues			(15,519)	(11,530)	(3,851)									(23,256)
Accounting Standards Update 2014-09 | Non-Client Related Revenue | Previous Accounting Guidance
Summary Of Significant Accounting Policies [Line Items]
Revenues			3,029	3,616	2,798									11,727
Accounting Standards Update 2014-09 | Non-Client Related Revenue | Impact of Adopting Topic 606
Summary Of Significant Accounting Policies [Line Items]
Revenues			$ (102)	$ (142)	$ (241)									$ (489)
[1]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Components of Numerator and Denominator Used in Calculation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Numerator
Net loss attributable to AAC Holdings, Inc. common stockholders		$ (22,181)	$ (1,602)	$ 1,056		$ 1,841	$ 1,140	$ 275	$ (59,404)	$ (12,873)	$ (21,218)
Denominator
Weighted-average shares outstanding – basic		24,205,159	24,166,976	23,744,208		23,331,414	23,242,177	23,163,626	24,090,639	23,277,444	22,718,117
Weighted-average shares outstanding – diluted		24,205,159	24,166,976	23,781,604		23,469,985	23,254,162	23,174,899	24,090,639	23,277,444	22,718,117
Basic loss per share	$ (1.52)	$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)	$ 0.08	$ 0.05	$ 0.01	$ (2.47)	$ (0.55)	$ (0.93)
Diluted loss per share	$ (1.52)	$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)	$ 0.08	$ 0.05	$ 0.01	$ (2.47)	$ (0.55)	$ (0.93)

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Details) - shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Earnings Per Share [Abstract]
Anti-dilutive shares excluded from calculation of earnings per share	42,997	96,130	25,181

Property and Equipment, net - C

Property and Equipment, net - Components of Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017
Property Plant And Equipment [Line Items]
Total property and equipment	$ 232,559				$ 201,754
Less accumulated depreciation	(65,638)				(49,206)
Property and equipment, net	166,921	$ 166,345	$ 168,373	$ 169,744	152,548	$ 151,769	$ 148,965	$ 145,410
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	161,723				130,710
Equipment and Software
Property Plant And Equipment [Line Items]
Total property and equipment	35,059				32,968
Construction in progress
Property Plant And Equipment [Line Items]
Total property and equipment	$ 16,413				$ 22,310

Property and Equipment, net - A

Property and Equipment, net - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Property Plant And Equipment [Abstract]
Depreciation expense	$ 20,100,000	$ 20,000,000	$ 16,100,000
Capitalized interest recognized	300,000
Impairment of long-lived assets	$ 0	$ 0	$ 0

Acquisitions - Additional Infor

Acquisitions - Additional Information (Details)	Mar. 01, 2018USD ($)BedCenter$ / sharesshares	Dec. 31, 2018USD ($)	Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Mar. 31, 2018USD ($)	Jun. 30, 2018USD ($)	Sep. 30, 2018USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)
Business Acquisition [Line Items]
Consideration paid in cash, excluding expenses and other adjustments					$ 65,185,000	$ 65,185,000	$ 65,827,000		$ 65,827,000		$ 18,825,000
Change in fair value of contingent consideration liability resulted in reduction of gain on contingent consideration and reduction to acquisition related expense			$ (947,000)	$ 176,000		$ 176,000	$ (771,000)		501,000		$ 1,350,000
AdCare, Inc. and AdCare Holding Trust
Business Acquisition [Line Items]
Consideration paid	$ 85,100,000
Consideration paid in cash, excluding expenses and other adjustments	66,800,000
Contingent consideration		$ 0						$ 0	$ 0
Cash acquired	2,700,000
Contingent consideration, description									The contingent consideration that can be earned by the seller ranges from zero to $1.7 million, subject to achievement of a certain adjusted EBITDA target over the 12 months following the closing date of the transaction.
Change in fair value of contingent consideration liability resulted in reduction of gain on contingent consideration and reduction to acquisition related expense		$ 500,000							$ 900,000
Revenues								44,400,000
Income before income tax expense								$ 6,600,000
Nonrecurring acquisition cost									800,000	$ 900,000
Depreciation and amortization expense									200,000	1,000,000
Addtional interest expense									$ 400,000	$ 6,200,000
AdCare, Inc. and AdCare Holding Trust | Accrued and Other Current Liabilities
Business Acquisition [Line Items]
Contingent consideration	500,000
AdCare, Inc. and AdCare Holding Trust | Minimum
Business Acquisition [Line Items]
Contingent consideration	0
AdCare, Inc. and AdCare Holding Trust | Maximum
Business Acquisition [Line Items]
Contingent consideration	$ 1,700,000
Period of return to seller	60 days
AdCare, Inc. and AdCare Holding Trust | AdCare Note
Business Acquisition [Line Items]
Aggregate principal amount of promissory note	$ 9,600,000
AdCare, Inc. and AdCare Holding Trust | 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
AdCare, Inc. and AdCare Holding Trust | 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
AdCare, Inc. and AdCare Holding Trust | 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 Allo

Acquisitions - Schedule of Allocation of Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Mar. 01, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill	$ 198,952	$ 198,952	$ 197,184	$ 197,184		$ 134,396	$ 134,396	$ 134,396	$ 134,396	$ 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					15,309
Goodwill					64,556
Intangible assets					5,120
Total assets acquired					93,038
Accrued and other current liabilities					5,931
Long-term liabilities					2,004
Net assets acquired					$ 85,103

Acquisitions - Schedule of Unau

Acquisitions - Schedule of Unaudited Proforma Results (Details) - AdCare, Inc. and AdCare Holding Trust - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Total revenues	$ 304,037	$ 370,235
(Loss) income before income tax (benefit) expense	$ (70,666)	$ (14,038)

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Additional Information (Details)	12 Months Ended
	Dec. 31, 2018USD ($)Segment	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)	Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Mar. 31, 2018USD ($)	Sep. 30, 2017USD ($)	Jun. 30, 2017USD ($)	Mar. 31, 2017USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
Number of reportable segments | Segment	1
Maximum valuation period for average stock price	10 days
Percentage of discount rate assumption based on assessment of risk inherent in future cash flows	16.00%
Goodwill impairment	$ 0
Goodwill	198,952,000	$ 134,396,000	$ 134,396,000	$ 198,952,000	$ 197,184,000	$ 197,184,000	$ 134,396,000	$ 134,396,000	$ 134,396,000
Amortization expense	$ 1,886,000	$ 1,527,000	$ 1,500,000

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Schedule of Goodwill (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
Beginning balance	$ 134,396
AdCare Acquisition	64,556
Ending balance	$ 198,952

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Components of Other Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 19,229	$ 14,109
Accumulated Amortization	7,166	5,280
Trademarks and trade names
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	8,422	5,322
Accumulated Amortization	2,777	1,986
Non-compete agreements
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	2,107	1,587
Accumulated Amortization	1,583	1,372
Marketing Intangibles
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	5,651	5,651
Accumulated Amortization	2,050	1,485
Leasehold interests
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	1,498	1,498
Accumulated Amortization	587	397
Service contracts
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	950
Accumulated Amortization	79
Other
Finite Lived Intangible Assets [Line Items]
Gross Carrying Value	601	51
Accumulated Amortization	$ 90	$ 40

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Summary of Changes to Net Carrying Value of Intangible Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Goodwill And Intangible Assets Disclosure [Abstract]
Beginning balance	$ 8,829	$ 10,356
Amortization expense	(1,886)	(1,527)	$ (1,500)
AdCare Acquisition	5,120
Ending balance	$ 12,063	$ 8,829	$ 10,356

Goodwill and Intangible Asset_6

Goodwill and Intangible Assets - Schedule of Finite Lived Intangible Assets Future Amortization Expense (Details) $ in Thousands	Dec. 31, 2018USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
2019	$ 1,955
2020	1,951
2021	1,756
2022	1,619
2023	1,385
Thereafter	3,397
Total	$ 12,063

Long-Term Debt - Summary of Deb

Long-Term Debt - Summary of Debt Obligations (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017
Line Of Credit Facility [Line Items]
Unamoritzed debt issuance costs	$ (8,085)				$ (7,233)
Capital lease obligations	880				1,031
Total debt	319,158				201,173
Less current portion	(309,394)	$ (8,350)	$ (6,723)	$ (7,319)	(4,722)	$ (4,736)	$ (4,503)	$ (10,965)
Total long-term debt	9,764				196,451
Senior Secured Term Loan
Line Of Credit Facility [Line Items]
Long term debt	317,479				$ 207,375
Subordinated Debt
Line Of Credit Facility [Line Items]
Subordinated debt	$ 8,884

Long-Term Debt - Senior Credit

Long-Term Debt - Senior Credit Facility - Additional Information (Details) - USD ($)	Mar. 08, 2019	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Line Of Credit Facility [Line Items]
Proceeds from senior credit facility		$ 18,000,000		$ 18,000,000	$ 48,930,000
2019 Senior Credit Facility
Line Of Credit Facility [Line Items]
Senior credit facility maturity date			Mar. 31, 2020
2019 Senior Credit Facility | Subsequent Event
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity	$ 30,000,000
Senior credit facility maturity date	Apr. 15, 2020
Proceeds from senior credit facility	$ 23,000,000
Interest rate	1.00%
Percentage of exit payment for outstanding principal amount	1.00%
Percentage of additional exit payment for end of each 30-day period after the nine-month anniversary	1.00%
2019 Senior Credit Facility | Subsequent Event | Maximum | Last Day of Fiscal Quarter Ending June 30, 2019
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	775.00%
2019 Senior Credit Facility | Subsequent Event | Maximum | Last Day of Fiscal Quarter Ending September 30, 2019
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	650.00%
2019 Senior Credit Facility | Subsequent Event | Maximum | Last Day of Fiscal Quarter Ending December 31, 2019
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	625.00%
2019 Senior Credit Facility | Subsequent Event | Maximum | Last Day of Fiscal Quarter Ending March 31, 2020
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	575.00%
2019 Senior Credit Facility | Subsequent Event | Maximum | Last Day of Fiscal Quarter Ending June 30, 2020
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	550.00%
2019 Senior Credit Facility | Subsequent Event | Maximum | Last Day of Fiscal Quarters Ending September 30, 2020 and December 31, 2020
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	525.00%
2019 Senior Credit Facility | Subsequent Event | Maximum | Last Day of Fiscal Quarters Ending March 31 and June 30, 2021
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	500.00%
2019 Senior Credit Facility | Subsequent Event | Maximum | Last Day of each Fiscal Quarter Ending on and After December 31, 2020
Line Of Credit Facility [Line Items]
Senior secured leverage ratio	475.00%
2019 Senior Credit Facility | Subsequent Event | Minimum | Revolving Loans under 2017 Credit Facility
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity	$ 5,000
2019 Senior Credit Facility | Subsequent Event | Minimum | Available Liquidity
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity	$ 7,500
2019 Senior Credit Facility | Subsequent Event | London Interbank Offered Rate (LIBOR)
Line Of Credit Facility [Line Items]
Interest rate	11.00%

Long-Term Debt - Amendments to

Long-Term Debt - Amendments to the 2017 Credit Facility - Additional Information (Details) - USD ($) $ in Millions	Mar. 08, 2019	Mar. 01, 2018	Dec. 31, 2018
AdCare Note | AdCare, Inc
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%
Amendments to the 2017 Credit Facility | Incremental Term Loan | AdCare, Inc
Line Of Credit Facility [Line Items]
Credit facility borrowing capacity		$ 65
Deferred financing costs		$ 2.6
Amendments to the 2017 Credit Facility | AdCare Note | AdCare, Inc
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%
Amendments to the 2017 Credit Facility | 2017 Revolver
Line Of Credit Facility [Line Items]
Quarterly commitment fee on undrawn amounts, percentage			0.50%
Amendments to the 2017 Credit Facility | Subsequent Event
Line Of Credit Facility [Line Items]
Payable in cash	2.00%
Senior secured leverage ratio condition is satisfied	1.00%
Payable-in-kind	4.00%
Amendments to the 2017 Credit Facility | Subsequent Event | Paid on or Prior to First Anniversary of Closing of Amendment
Line Of Credit Facility [Line Items]
Premium percentage for repayment of outstanding loan	2.00%
Amendments to the 2017 Credit Facility | Subsequent Event | Paid After First Anniversary but Before Second Anniversary of Closing of Amendment
Line Of Credit Facility [Line Items]
Premium percentage for repayment of outstanding loan	1.00%
Amendments to the 2017 Credit Facility | Subsequent Event | 2017 Revolver
Line Of Credit Facility [Line Items]
Quarterly commitment fee on undrawn amounts, percentage	1.00%

Long-Term Debt - Credit Facilit

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

Oct. 17, 2017

Jun. 30, 2017

Feb. 27, 2017

Jul. 13, 2016

Mar. 09, 2015

Nov. 30, 2017

Jun. 30, 2017

Dec. 31, 2018

Dec. 31, 2016

Dec. 31, 2017

Oct. 06, 2017

Sep. 25, 2017

Dec. 31, 2015

2017 Revolver

Line Of Credit Facility [Line Items]

Interest rate

3.375%

6.75%

Accrued expense related to ticking fee

$ 800,000

2017 Revolver | AdCare, Inc

Line Of Credit Facility [Line Items]

Business acquisition secured financing commitment subject to customary closing costs and regulatory provisions

$ 65,000,000

2017 Credit Facility

Line Of Credit Facility [Line Items]

Yield maintenance premium period

1 year

Debt issuance costs

$ 12,900,000

2017 Credit Facility | First Anniversary of Closing But Before Second Anniversary of Closing

Line Of Credit Facility [Line Items]

Premium percentage for repayment of outstanding loan

2.00%

2017 Credit Facility | Second Anniversary of Closing But Before Third Anniversary of Closing

Line Of Credit Facility [Line Items]

Premium percentage for repayment of outstanding loan

1.00%

2017 Credit Facility | 2017 Term Loan

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

$ 210,000,000

$ 210,000,000

Revolving line of credit maturity date

Jun. 30, 2023

Interest rate

1.00%

1.00%

Debt issuance costs

$ 7,600,000

2017 Credit Facility | 2017 Term Loan | Base Rate

Line Of Credit Facility [Line Items]

Interest rate

5.75%

2017 Credit Facility | 2017 Term Loan | London Interbank Offered Rate (LIBOR)

Line Of Credit Facility [Line Items]

Interest rate

6.75%

2017 Credit Facility | 2017 Term Loan | September 30, 2017 through June 30, 2019

Line Of Credit Facility [Line Items]

Monthly principal payments

$ 1,700,000

2017 Credit Facility | 2017 Term Loan | September 30, 2019 through March 31, 2023

Line Of Credit Facility [Line Items]

Monthly principal payments

3,400,000

2017 Credit Facility | Incremental Term Loan

Line Of Credit Facility [Line Items]

Additional maximum borrowing amount under satisfaction of certain conditions

25,000,000

$ 25,000,000

2017 Credit Facility | Incremental Term Loan | Minimum

Line Of Credit Facility [Line Items]

Senior secured leverage ratio

390.00%

2017 Credit Facility | Standby Letters of Credit

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

$ 7,000,000

2017 Credit Facility | 2017 Revolver

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

40,000,000

$ 40,000,000

Credit facility borrowing capacity

55,000,000

Revolving line of credit maturity date

Jun. 30, 2022

Revolver outstanding loans

$ 52,000,000

Commitment fee on undrawn amounts, percentage

0.50%

Debt issuance costs

5,300,000

Letters of credit outstanding

$ 2,700,000

2017 Credit Facility | 2017 Revolver | Base Rate

Line Of Credit Facility [Line Items]

Interest rate

5.00%

2017 Credit Facility | 2017 Revolver | London Interbank Offered Rate (LIBOR)

Line Of Credit Facility [Line Items]

Interest rate

6.00%

2017 Credit Facility | 2017 Revolver | Incremental Revolver

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

40,000,000

$ 40,000,000

Credit facility borrowing capacity

$ 55,000,000

Additional maximum borrowing amount under satisfaction of certain conditions

$ 15,000,000

$ 15,000,000

2015 Credit Facility

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

$ 75,000,000

Credit facility borrowing capacity

$ 171,300,000

Revolver outstanding loans

$ 0

Commitment fee on undrawn amounts, percentage

0.50%

Debt issuance costs

$ 2,000,000

Debt instrument, term

5 years

Revolving line of credit maturity month

2020-03

Description of payment of principal installments

The 2015 Credit Facility generally required quarterly interest payments.

Description of interest rate

Applicable Rate plus the highest of (i) the federal funds rate plus 0.50%, (ii) the prime rate and (iii) the Eurodollar Rate plus 1.0% (the interest rate at December 31, 2016 was 4.25%).

Interest rate at the end of period

4.25%

Deferred debt issuance costs

$ 1,400,000

2015 Credit Facility | Minimum

Line Of Credit Facility [Line Items]

Commitment fee on undrawn amounts, percentage

0.35%

2015 Credit Facility | Minimum | Base Rate

Line Of Credit Facility [Line Items]

Interest rate

1.25%

2015 Credit Facility | Minimum | London Interbank Offered Rate (LIBOR)

Line Of Credit Facility [Line Items]

Interest rate

2.25%

2015 Credit Facility | Maximum

Line Of Credit Facility [Line Items]

Commitment fee on undrawn amounts, percentage

0.60%

Leverage Ratio

425.00%

2015 Credit Facility | Maximum | Base Rate

Line Of Credit Facility [Line Items]

Interest rate

2.75%

2015 Credit Facility | Maximum | London Interbank Offered Rate (LIBOR)

Line Of Credit Facility [Line Items]

Interest rate

3.75%

2015 Credit Facility | Pricing Tier 1

Line Of Credit Facility [Line Items]

Commitment fee on undrawn amounts, percentage

0.60%

2015 Credit Facility | Pricing Tier 1 | Minimum

Line Of Credit Facility [Line Items]

Leverage Ratio

400.00%

2015 Credit Facility | Term Loan

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

$ 121,300,000

$ 75,000,000

Revolving line of credit maturity date

Mar. 9, 2020

Revolver outstanding loans

$ 118,800,000

Debt issuance costs

$ 900,000

2015 Credit Facility | Term Loan | March 31, 2017 to December 31, 2017

Line Of Credit Facility [Line Items]

Monthly principal payments

2,300,000

2015 Credit Facility | Term Loan | March 31, 2018 to December 31, 2018

Line Of Credit Facility [Line Items]

Monthly principal payments

3,900,000

2015 Credit Facility | Term Loan | March 31, 2019 to December 31, 2019

Line Of Credit Facility [Line Items]

Monthly principal payments

$ 4,700,000

2015 Credit Facility | Eurodollar Rate Loans | Pricing Tier 1

Line Of Credit Facility [Line Items]

Interest rate

3.75%

2015 Credit Facility | Base Rate Loans | Federal Funds Rate

Line Of Credit Facility [Line Items]

Interest rate

0.50%

2015 Credit Facility | Base Rate Loans | Eurodollar Rate

Line Of Credit Facility [Line Items]

Interest rate

1.00%

2015 Credit Facility | Base Rate Loans | Pricing Tier 1

Line Of Credit Facility [Line Items]

Interest rate

2.75%

2015 Credit Facility | 2017 Revolver

Line Of Credit Facility [Line Items]

Credit facility borrowing capacity

$ 50,000,000

$ 50,000,000

50,000,000

Revolving line of credit maturity date

Mar. 9, 2020

Revolver outstanding loans

21,000,000

Debt issuance costs

$ 1,100,000

Credit facility remaining borrowing capacity

26,500,000

2015 Credit Facility | 2017 Revolver | Standby Letters of Credit

Line Of Credit Facility [Line Items]

Revolver outstanding loans

$ 2,500,000

Long-Term Debt - Subordinated N

Long-Term 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%

Long-Term Debt - 2015 Subordina

Long-Term Debt - 2015 Subordinated Debt - Additional Information (Details) - USD ($)	Oct. 02, 2015	Jun. 30, 2016	Dec. 31, 2017	Dec. 31, 2016
2.50% Subordinated Convertible Debt Maturing September 30, 2021
Line Of Credit Facility [Line Items]
Debt instrument, face amount	$ 25,000,000
Debt instrument, unused capacity	50,000,000
Proceeds from long-term debt	$ 25,000,000
Interest rate	2.50%
Maturity Date	Sep. 30, 2021
Conversion price per share	$ 30
Long term debt			$ 0	$ 25,000,000
Debt instrument, interest rate				2.50%
12.0% Unsecured Subordinated Convertible Debt Maturing October 02, 2020
Line Of Credit Facility [Line Items]
Debt instrument, face amount	$ 25,000,000	$ 25,000,000
Interest rate		12.00%
Maturity Date		Oct. 2, 2020
Long term debt			$ 0	$ 25,000,000
Debt instrument, interest rate				12.00%
2015 Subordinated Debt Issuance [Member]
Line Of Credit Facility [Line Items]
Deferred debt issuance costs	$ 1,400,000

Long-Term Debt - Interest Rate

Long-Term Debt - Interest Rate Swap Agreements - Additional Information (Details) $ in Millions	Jun. 28, 2017USD ($)	Jul. 31, 2014Agreement	Dec. 31, 2018	Dec. 31, 2016USD ($)
Line Of Credit Facility [Line Items]
Number of interest rate swap agreement | Agreement		2
Fair value of interest rate swaps, liability				$ 0.3
Agreement Two
Line Of Credit Facility [Line Items]
Interest rate swap agreement initial notional amount	$ 7.2
Interest rate swap agreement percentage	4.21%
Maturity Date			May 31, 2018
Agreement One
Line Of Credit Facility [Line Items]
Interest rate swap agreement initial notional amount	$ 10.5
Interest rate swap agreement percentage	4.73%
Maturity Date			Aug. 31, 2019

Long-Term Debt - Summary of Fut

Long-Term Debt - Summary of Future Contractual Maturities of Long-term Debt (Details) $ in Thousands	Dec. 31, 2018USD ($)
Notes Payable
Disclosure Notes Payable And Revolving Line Of Credit Summary Of Future Maturities Of Long Term Debt Details [Line Items]
2019	$ 11,343	[1]
2020	14,791	[1]
2021	14,791	[1]
2022	66,791	[1]
2023	218,647	[1]
Total	326,363	[1]
Capital Lease Obligations
Disclosure Notes Payable And Revolving Line Of Credit Summary Of Future Maturities Of Long Term Debt Details [Line Items]
2019	626
2020	208
2021	62
2022	12
2023	8
Total	916
Less interest portion	(36)
Total, excluding interest	$ 880
[1]	As noted above, as of December 31, 2018 the Company has classified its Term Loan and Revolver under the 2017 Credit Facility as current liabilities. This table presents the scheduled maturities of the loan per their respective agreements.

Financing Lease Obligation - Ad

Financing Lease Obligation - Additional Information (Details) $ in Thousands	Aug. 09, 2017USD ($)FacilityRenewal	Dec. 31, 2018USD ($)	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		101.50%
Sale-leaseback financing obligation, proceeds		$ 25,000
Sale-leaseback financing obligation, transaction costs		400
Sale-leaseback financing obligation, short term liability		$ 121	$ 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	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017
Sale Leaseback Transaction [Line Items]
Total financing lease obligation, net of current portion	$ 24,421	$ 24,459	$ 24,488	$ 24,515	$ 24,541	$ 24,398
MedEquities Realty Trust, Inc.
Sale Leaseback Transaction [Line Items]
Financing lease obligation: Sale-Leaseback Facilities	24,542				24,621
Less current portion (included in accrued and other current liabilities)	(121)				(80)
Total financing lease obligation, net of current portion	$ 24,421				$ 24,541

Financing Lease Obligation - Sc

Financing Lease Obligation - Schedule of Future Minimum Lease Payments to Sales-Leaseback (Details) $ in Thousands	Dec. 31, 2018USD ($)
Leases [Abstract]
2019	$ 2,233
2020	2,267
2021	2,301
2022	2,336
2023	2,371
Thereafter	22,093
Total	$ 33,601

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Details) - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Equity [Abstract]
Aggregate number of shares authorized to issue	75,000,000
Common stock, shares authorized	70,000,000	70,000,000
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares issued	24,573,679	23,872,436
Common stock, shares outstanding	24,573,679	23,872,436
Preferred stock, shares, authorized	5,000,000
Preferred stock, par value	$ 0.001
Preferred stock, shares issued	0
Preferred stock, shares outstanding	0
Holders of the Company's common stock, voting rights	one vote for each share

Stock Based Compensation - Addi

Stock Based Compensation - Additional Information (Details) - USD ($) $ in Thousands	Jan. 10, 2019	Mar. 09, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	May 16, 2017	Dec. 31, 2014
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Fully vested common stock granted					286,817	402,267
Stock options, granted					196,000	446,000
Effect of employee stock purchase plan					$ 383	$ 614	$ 682
Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for issuance								250,000
Common stock available for issuance			297,204		297,204
Compensation expense					$ 100	$ 200	$ 300
Employee stock purchase plan, purchase price, Description					On the exercise date (the last trading day of each option period), the cumulative amount deducted from each participant’s salary during that option period will be used to purchase the maximum number of shares of the Company’s common stock at a purchase price equal to the lesser of (i) 85% of the closing market price of the Company’s common stock as quoted on the New York Stock Exchange on the exercise date or (ii) 85% of the closing market price of the Company’s common stock as quoted on the New York Stock Exchange on the grant date, subject to certain limitations and restrictions.
Payroll deduction percentage of closing market price of common stock					85.00%
Employee stock purchase plan, shares issued					48,396	97,589	44,174
Effect of employee stock purchase plan			$ 200	$ 200
Employee Stock Purchase Plan | Subsequent Event
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Employee stock purchase plan, shares issued	116,032
Effect of employee stock purchase plan	$ 100
Restricted Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Grant date fair value of common stock vested					$ 4,100
Five Non Employee Directors | Restricted Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Fully vested common stock granted		38,000
2014 Equity Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for issuance								1,800,000	1,571,120
Common stock available for issuance			2,015,920		2,015,920
Common shares withheld for minimum statutory tax purposes					28,989	76,385	65,089
Compensation expense					$ 3,900	$ 7,500	$ 8,800
2014 Equity Incentive Plan | Restricted Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation, award vesting period		3 years
Stock options, granted		408,000
Unrecognized compensation expenses			$ 1,900		$ 1,900
Weighted average life of remaining vesting period					1 year 7 months 6 days

Stock Based Compensation - Summ

Stock Based Compensation - Summary of Share Activity Under 2014 Equity Incentive Plan (Details) - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Nonvested, Number of Shares [Roll Forward]
Beginning Balance, Shares	348,855	522,175
Granted, Shares	196,000	446,000
Vested, Shares	(286,817)	(402,267)
Forfeitures, Shares	(76,213)	(217,053)
Ending Balance, Shares	181,825	348,855
Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Beginning Balance, Weighted-Average Grant Date Fair Value	$ 13.69	$ 23.22
Granted, Weighted-Average Grant Date Fair Value	11.47	8.60
Vested, Weighted-Average Grant Date Fair Value	14.19	18.49
Forfeitures, Weighted-Average Grant Date Fair Value	14.44	17.27
Ending Balance, Weighted-Average Grant Date Fair Value	$ 10.20	$ 13.69

Qualified 401(k) Savings Plan -

Qualified 401(k) Savings Plan - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Compensation And Retirement Disclosure [Abstract]
Company contributions under the 401(k) plan	$ 1.4	$ 0.9	$ 0.8
401(k) Defined Contribution Plan, Sponsor Location [Extensible List]	country:US	country:US	country:US
401(k) Defined Contribution Plan, Tax Status [Extensible List]	us-gaap:QualifiedPlanMember	us-gaap:QualifiedPlanMember	us-gaap:QualifiedPlanMember

Income Taxes - Schedule of Comp

Income Taxes - Schedule of Components of Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands	3 Months Ended						12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Current
Federal							$ (5,447)	$ 1,150	$ (456)
State							(438)	1,244	1,042
Total current tax expense							(5,885)	2,394	586
Deferred:
Federal							(529)	(3,476)	2,782
State							3,410	(660)	(1,023)
Total deferred tax (benefit) expense							2,881	(4,136)	1,759
Total income tax (benefit) expense	$ (1,075)	$ (162)	$ (38)	$ 741	$ 741	$ 741	$ (3,004)	$ (1,742)	$ 2,345

Income Taxes - Schedule of Effe

Income Taxes - Schedule of Effective Income Tax Rate (Details)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Federal statutory rate	21.00%	35.00%	35.00%
State income taxes, net of federal tax benefit	7.90%	1.80%	1.90%
Effect of Tax Cuts and Jobs Act		(38.10%)
Non-deductible expenses	(0.50%)	(1.80%)	(0.60%)
Stock compensation adjustment	(0.80%)	(8.10%)	(4.60%)
Return to provision adjustment	4.00%	(0.10%)
Change in valuation allowance	(27.40%)	20.30%	(41.10%)
Other differences	0.10%	0.10%	(0.40%)
Effective income tax rate on income before taxes	4.30%	9.10%	(9.80%)

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax [Line Items]
Difference between effective tax rate and federal statutory rate	16.70%
Net operating loss carryforwards expire between 2027 and 2038	$ 17,000,000
Remaining operating loss carryforwards	$ 70,500,000
Period of cumulative loss incurred	3 years
Valuation allowance	$ 34,722,000	$ 15,091,000
Increase in valuation allowance	19,600,000
Uncertain tax position	$ 0	$ 0
U.S. corporate tax rate	21.00%	35.00%	35.00%
Income tax expense in continuing operations		$ 3,500,000
Minimum | Internal Revenue Service (IRS)
Income Tax [Line Items]
Open tax year	2013
Tax year under examination	2013
Maximum | Internal Revenue Service (IRS)
Income Tax [Line Items]
Open tax year	2018
Tax year under examination	2014
Deferred Tax Assets Evaluation
Income Tax [Line Items]
Valuation allowance	$ 34,700,000
Federal
Income Tax [Line Items]
Net operating loss	87,500,000
State
Income Tax [Line Items]
Net operating loss	$ 8,700,000

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Assets (Liabilities) (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Employee compensation	$ 1,786	$ 1,839
Operating loss carryforwards	27,147	2,894
Business interest limitation	8,295
Accrued litigation	2,088	5,517
Accounts receivable		8,059
Tax credits	332
Acquisition related costs	1,438	1,255
Property, equipment and amortization	3,301	2,377
Other	1,337
Valuation allowance	(34,722)	(15,091)
Total deferred tax assets	11,002	6,850
Goodwill and other intangible property	(8,891)	(5,130)
Other	(512)
Accounts receivable	(2,826)	(70)
Total deferred tax liabilities	(12,229)	(5,200)
Net deferred tax (liabilities) assets	$ (1,227)
Net deferred tax (liabilities) assets		$ 1,650

Fair Value of Financial Instr_2

Fair Value of Financial Instruments - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Interest rate swap agreements termination date	Jun. 29, 2017
Long lived assets impairment charges	$ 0	$ 0	$ 0

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($)	Nov. 21, 2018	Dec. 31, 2017	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Commitments And Contingencies Disclosure [Abstract]
Operating lease expiration period										2025-06
Rent expense			$ 2,760,000	$ 2,563,000	$ 2,116,000		$ 2,105,000	$ 1,849,000	$ 1,885,000	$ 10,367,000	$ 7,514,000	$ 7,363,000
Settlement payment	$ 8,000,000	$ 23,300,000				$ 23,300,000
Litigation settlement description										The Company entered into a settlement (the ?Settlement?) with Plaintiffs providing that (i) the Company pay Plaintiffs an aggregate of $8,000,000 (the ?Settlement Payment?) in payments to be made throughout 2019, (ii) mutual exchange of releases, (iii) dismissal of the litigation and (iv) other non-monetary terms.
Number of shares contributed to settlement	300,000

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Future Minimum Lease Payments Under Non-Cancelable Operating Leases (Details) $ in Thousands	Dec. 31, 2018USD ($)
Future minimum rental payments, by year and in the aggregate, under operating leases
2019	$ 11,722
2020	9,896
2021	8,816
2022	8,116
2023	7,635
Thereafter	38,357
Total	$ 84,542

Related Parties - Additional In

Related Parties - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Chief Executive Officer
Related Party Transaction [Line Items]
Expenses related to agreement	$ 1.2	$ 1	$ 0.9

Unaudited Quarterly Informati_3

Unaudited Quarterly Information (Restated) - Summary of Unaudited Quarterly Results of Operations (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended										6 Months Ended		9 Months Ended		12 Months Ended
	Dec. 31, 2018		Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017		Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Revenue	$ 57,448	[1]	$ 69,034	$ 88,094	$ 81,187	$ 86,136		$ 80,424	$ 78,042	$ 73,039					$ 295,763	$ 317,641	$ 279,770
Net (loss) income	(38,445)	[1],[2]	(23,844)	(3,592)	(837)	(17,488)	[3]	715	158	(766)	$ (4,429)	$ (608)	$ (28,273)	$ 107	$ (66,718)	$ (17,381)	$ (26,370)
Net income (loss) available to AAC Holdings, Inc. common stockholders	$ (36,677)	[1],[2]	$ (22,181)	$ (1,602)	$ 1,056	$ (16,129)	[3]	$ 1,841	$ 1,140	$ 275
Basic net (loss) income per share	$ (1.52)		$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)		$ 0.08	$ 0.05	$ 0.01					$ (2.47)	$ (0.55)	$ (0.93)
Diluted net (loss) income per share	$ (1.52)		$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)		$ 0.08	$ 0.05	$ 0.01					$ (2.47)	$ (0.55)	$ (0.93)
[1]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.
[2]	Refer to Note 15 – Commitments and Contingencies to the Notes to the Consolidated Financial Statements.
[3]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters.

Unaudited Quarterly Informati_4

Unaudited Quarterly Information (Restated) - Summary of Unaudited Quarterly Results of Operations (Parenthetical) (Details) - USD ($)	Nov. 21, 2018	Dec. 31, 2017	Dec. 31, 2017
Quarterly Financial Information Disclosure [Abstract]
Settlement payment	$ 8,000,000	$ 23,300,000	$ 23,300,000

Unaudited Quarterly Informati_5

Unaudited Quarterly Information (Restated) - Schedule of Restated Impact on Condensed Consolidated Statements of Operations (Details) - USD ($) $ in Thousands	3 Months Ended									6 Months Ended		9 Months Ended		12 Months Ended
	Dec. 31, 2018	[1]	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenues	$ 57,448		$ 69,034	$ 88,094	$ 81,187	$ 86,136	$ 80,424	$ 78,042	$ 73,039					$ 295,763	$ 317,641	$ 279,770
Provision for doubtful accounts				366			7,406	6,261	4,403	$ 366	$ 10,664	$ 366	$ 18,070	366	25,932	38,549
Client Related Revenue
Revenues			66,107	84,620	78,630		77,948	75,692	71,219					284,525	308,538	270,569
Non-Client Related Revenue
Revenues			2,927	3,474	2,557		$ 2,476	$ 2,350	$ 1,820					11,238	9,103	$ 9,201
Previous Accounting Guidance | Client Related Revenue
Revenues														307,781	$ 308,538
Accounting Standards Update 2014-09 | Previous Accounting Guidance
Provision for doubtful accounts			15,621	12,038	4,092									24,111
Accounting Standards Update 2014-09 | Previous Accounting Guidance | Client Related Revenue
Revenues			81,626	96,150	82,481									307,781
Accounting Standards Update 2014-09 | Previous Accounting Guidance | Non-Client Related Revenue
Revenues			3,029	3,616	2,798									11,727
Accounting Standards Update 2014-09 | Impact of Adopting Topic 606
Provision for doubtful accounts			(15,621)	(11,672)	(4,092)									(23,745)
Accounting Standards Update 2014-09 | Impact of Adopting Topic 606 | Client Related Revenue
Revenues			(15,519)	(11,530)	(3,851)									(23,256)
Accounting Standards Update 2014-09 | Impact of Adopting Topic 606 | Non-Client Related Revenue
Revenues			$ (102)	$ (142)	$ (241)									$ (489)
[1]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.

Unaudited Quarterly Informati_6

Unaudited Quarterly Information (Restated) - Summary of Activity in Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended		9 Months Ended		12 Months Ended
	Jun. 30, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Statement Of Financial Position [Abstract]
Balance at beginning of year		$ 77,213	$ 73,183	$ 69,460	$ 88,424	$ 69,460	$ 88,424	$ 69,460	$ 88,424	$ 69,460	$ 41,145
Additions charged to provision for doubtful accounts	$ 366	7,406	6,261	4,403	$ 366	10,664	$ 366	18,070	366	25,932	38,549
Accounts written off, net of recoveries		(2,239)	(2,231)	(680)					$ (366)	(6,968)	(10,234)
Balance at end of year		$ 82,380	$ 77,213	$ 73,183		$ 77,213		$ 82,380		$ 88,424	$ 69,460

Unaudited Quarterly Informati_7

Unaudited Quarterly Information (Restated) - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended						12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Income tax (benefit) expense	$ (1,075)	$ (162)	$ (38)	$ 741	$ 741	$ 741	$ (3,004)	$ (1,742)	$ 2,345
Effective tax rates on provision for income taxes	4.30%	4.30%	4.30%	50.90%	82.40%	2910.00%

Unaudited Quarterly Informati_8

Unaudited Quarterly Information (Restated) - Summary of Consolidated Statement of Operations (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended										6 Months Ended		9 Months Ended		12 Months Ended
	Dec. 31, 2018		Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017		Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenues
Total revenues	$ 57,448	[1]	$ 69,034	$ 88,094	$ 81,187	$ 86,136		$ 80,424	$ 78,042	$ 73,039					$ 295,763	$ 317,641	$ 279,770
Operating expenses
Salaries, wages and benefits			44,831	46,850	40,084			36,709	34,508	36,772					174,772	146,390	141,073
Client related services			8,594	8,393	7,747			6,598	6,646	6,378					32,747	27,031	24,446
Provision for doubtful accounts				366				7,406	6,261	4,403	$ 366	$ 10,664	$ 366	$ 18,070	366	25,932	38,549
Advertising and marketing			3,037	2,584	2,599			3,074	3,266	3,775					13,744	12,315	18,275
Professional fees			5,697	4,950	3,650			3,641	3,039	2,642					19,894	12,638	16,468
Other operating expenses			12,833	12,194	10,588			8,306	8,199	8,789					47,716	36,309	29,627
Rentals and leases			2,760	2,563	2,116			2,105	1,849	1,885					10,367	7,514	7,363
Litigation settlement			100	244	2,791										11,136	23,607	1,292
Depreciation and amortization			5,573	5,909	5,464			5,218	5,058	5,469	11,373	10,527	16,946	15,745	21,986	21,504	17,686
Acquisition-related expenses			111	176	305			370	42	183					573	1,162	2,691
Total operating expenses			83,536	84,229	75,344			73,427	68,868	70,296					333,301	314,402	297,470
(Loss) income from operations			(14,502)	3,865	5,843			6,997	9,174	2,743					(37,538)	3,239	(17,700)
Interest expense, net (including change in fair value of interest rate swaps of $0, ($108), and ($180), respectively)			8,738	7,893	6,709			5,492	2,846	2,734					32,220	16,811	8,175
Loss on extinguishment of debt									5,435			5,435		5,435		5,435
(Gain) loss on contingent consideration			947	(176)							(176)		771		(501)		(1,350)
Other (income) expense, net			732	(98)	9			49	6	34					465	116	(500)
Loss before income tax expense			(24,919)	(3,754)	(875)			1,456	899	(25)					(69,722)	(19,123)	(24,025)
Income tax (benefit) expense			(1,075)	(162)	(38)			741	741	741					(3,004)	(1,742)	2,345
Net loss	$ (38,445)	[1],[2]	(23,844)	(3,592)	(837)	$ (17,488)	[3]	715	158	(766)	(4,429)	(608)	(28,273)	107	(66,718)	(17,381)	(26,370)
Less: net loss attributable to noncontrolling interest			1,663	1,990	1,893			1,126	982	1,041					7,314	4,508	5,152
Net loss attributable to AAC Holdings, Inc. common stockholders			$ (22,181)	$ (1,602)	$ 1,056			$ 1,841	$ 1,140	$ 275					$ (59,404)	$ (12,873)	$ (21,218)
Basic loss per common share	$ (1.52)		$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)		$ 0.08	$ 0.05	$ 0.01					$ (2.47)	$ (0.55)	$ (0.93)
Diluted loss per common share	$ (1.52)		$ (0.92)	$ (0.07)	$ 0.04	$ (0.69)		$ 0.08	$ 0.05	$ 0.01					$ (2.47)	$ (0.55)	$ (0.93)
Weighted-average common shares outstanding:
Basic			24,205,159	24,166,976	23,744,208			23,331,414	23,242,177	23,163,626					24,090,639	23,277,444	22,718,117
Diluted			24,205,159	24,166,976	23,781,604			23,469,985	23,254,162	23,174,899					24,090,639	23,277,444	22,718,117
As Previously Reported
Revenues
Total revenues			$ 77,473	$ 86,761	$ 78,473			$ 80,424	$ 78,042	$ 73,039						$ 317,641	$ 279,770
Operating expenses
Salaries, wages and benefits			44,831	46,850	40,084			36,709	34,508	36,772						146,390	141,073
Client related services			8,594	8,393	7,747			6,598	6,646	6,378						27,031	24,446
Provision for doubtful accounts				366				9,682	9,496	6,587	366	16,083	366	25,765		36,914	21,485
Advertising and marketing			3,037	2,584	2,599			3,074	3,266	3,775						12,315	18,275
Professional fees			5,697	4,950	3,650			3,641	3,039	2,642						12,638	16,468
Other operating expenses			12,833	12,194	10,588			8,306	8,199	8,789						36,309	29,627
Rentals and leases			2,760	2,563	2,116			2,105	1,849	1,885						7,514	7,363
Litigation settlement			100	244	2,791											23,607	1,292
Depreciation and amortization			5,573	5,909	5,464			5,218	5,058	5,469	11,373	10,527	16,946	15,745		21,504	17,686
Acquisition-related expenses			1,058		305			370	42	183						1,162	2,691
Total operating expenses			84,483	84,053	75,344			75,703	72,103	72,480						325,384	280,406
(Loss) income from operations			(7,010)	2,708	3,129			4,721	5,939	559						(7,743)	(636)
Interest expense, net (including change in fair value of interest rate swaps of $0, ($108), and ($180), respectively)			8,738	7,893	6,709			5,492	2,846	2,734						16,811	8,175
Loss on extinguishment of debt									5,435			5,435		5,435		5,435
(Gain) loss on contingent consideration																	(1,350)
Other (income) expense, net			732	(98)	9			49	6	34						116	(500)
Loss before income tax expense			(16,480)	(5,087)	(3,589)			(820)	(2,336)	(2,209)						(30,105)	(6,961)
Income tax (benefit) expense			(3,324)	(84)	(1,494)			(456)	562	(565)						(5,018)	(1,220)
Net loss			(13,156)	(5,003)	(2,095)			(364)	(2,898)	(1,644)	(7,098)	(4,542)	(20,254)	(4,906)		(25,087)	(5,741)
Less: net loss attributable to noncontrolling interest			1,663	1,990	1,893			1,126	982	1,041						4,508	5,152
Net loss attributable to AAC Holdings, Inc. common stockholders			$ (11,493)	$ (3,013)	$ (202)			$ 762	$ (1,916)	$ (603)						$ (20,579)	$ (589)
Basic loss per common share			$ (0.47)	$ (0.12)	$ (0.01)			$ 0.03	$ (0.08)	$ (0.03)						$ (0.88)	$ (0.03)
Diluted loss per common share			$ (0.47)	$ (0.12)	$ (0.01)			$ 0.03	$ (0.08)	$ (0.03)						$ (0.88)	$ (0.03)
Weighted-average common shares outstanding:
Basic			24,205,159	24,166,976	23,744,208			23,331,414	23,242,177	23,163,626						23,277,444	22,718,117
Diluted			24,205,159	24,166,976	23,744,208			23,469,985	23,242,177	23,163,626						23,277,444	22,718,117
Adjustments
Revenues
Total revenues			$ (8,439)	$ 1,333	$ 2,714
Operating expenses
Provision for doubtful accounts								$ (2,276)	$ (3,235)	$ (2,184)		(5,419)		(7,695)		$ (10,982)	$ 17,064
Acquisition-related expenses			(947)	176
Total operating expenses			(947)	176				(2,276)	(3,235)	(2,184)						(10,982)	17,064
(Loss) income from operations			(7,492)	1,157	2,714			2,276	3,235	2,184						10,982	(17,064)
(Gain) loss on contingent consideration			947	(176)							(176)		771
Loss before income tax expense			(8,439)	1,333	2,714			2,276	3,235	2,184						10,982	(17,064)
Income tax (benefit) expense			2,249	(78)	1,456			1,197	179	1,306						3,276	3,565
Net loss			(10,688)	1,411	1,258			1,079	3,056	878	$ 2,669	$ 3,934	$ (8,019)	$ 5,013		7,706	(20,629)
Net loss attributable to AAC Holdings, Inc. common stockholders			(10,688)	1,411	1,258			1,079	3,056	878						7,706	(20,629)
Client Related Revenue
Revenues
Total revenues			66,107	84,620	78,630			77,948	75,692	71,219					$ 284,525	308,538	270,569
Client Related Revenue | As Previously Reported
Revenues
Total revenues			74,477	83,293	75,923			77,948	75,692	71,219						308,538	270,569
Client Related Revenue | Adjustments
Revenues
Total revenues			(8,370)	1,327	2,707
Non-Client Related Revenue
Revenues
Total revenues			2,927	3,474	2,557			2,476	2,350	1,820					$ 11,238	9,103	9,201
Non-Client Related Revenue | As Previously Reported
Revenues
Total revenues			2,996	3,468	2,550			$ 2,476	$ 2,350	$ 1,820						$ 9,103	$ 9,201
Non-Client Related Revenue | Adjustments
Revenues
Total revenues			$ (69)	$ 6	$ 7
[1]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.
[2]	Refer to Note 15 – Commitments and Contingencies to the Notes to the Consolidated Financial Statements.
[3]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters.

Unaudited Quarterly Informati_9

Unaudited Quarterly Information (Restated) - Summary of Consolidated Statement of Operations (Parenthetical) (Details) - USD ($) $ in Thousands	3 Months Ended						12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Swap
Change in fair value of interest rate swaps	$ 0	$ 0	$ 0	$ 0	$ (25)	$ (83)	$ 0	$ (108)	$ (180)

Unaudited Quarterly Informat_10

Unaudited Quarterly Information (Restated) - Summary of Consolidated Balance Sheet (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current assets
Cash and cash equivalents	$ 5,409	$ 5,259	$ 11,353	$ 14,341	$ 13,818	$ 16,412	$ 10,793	$ 5,880	$ 3,964	$ 18,750
Accounts receivable, net of allowances	47,860	59,839	71,057	71,944	63,746	58,909	60,613	54,995
Prepaid expenses and other current assets	10,695	5,547	4,638	3,354	4,022	6,030	4,456	4,897
Total current assets	63,964	70,645	87,048	89,639	81,586	81,351	75,862	65,772
Property and equipment, net	166,921	166,345	168,373	169,744	152,548	151,769	148,965	145,410
Goodwill	198,952	198,952	197,184	197,184	134,396	134,396	134,396	134,396	134,396
Intangible assets, net	12,063	12,561	13,201	13,712	8,829	9,169	9,551	9,953	10,356
Deferred tax assets, net		2,924	1,849	1,687	1,650
Other assets	10,377	10,679	11,069	12,468	12,556	5,664	783	626
Total assets	452,277	462,106	478,724	484,434	391,565	382,349	369,557	356,157
Current liabilities
Accounts payable	13,507	8,722	6,613	3,338	4,579	5,732	10,441	13,711
Accrued and other current liabilities	30,544	31,607	30,487	34,039	27,661	24,633	24,800	24,865
Accrued litigation	8,000			1,000	23,607
Current portion of long-term debt	309,394	8,350	6,723	7,319	4,722	4,736	4,503	10,965
Total current liabilities	361,445	48,679	43,823	45,696	60,569	35,101	39,744	49,541
Deferred tax liabilities	1,227					4,709	3,968	3,227
Long-term debt, net of current portion and debt issuance costs	9,764	297,143	295,322	296,443	196,451	197,872	208,467	187,456
Financing lease obligation, net of current portion	24,421	24,459	24,488	24,515	24,541	24,398
Other long-term liabilities	13,147	11,993	12,322	12,277	10,546	3,836	3,782	4,121
Total liabilities	410,004	382,274	375,955	378,931	292,107	265,916	255,961	244,345
Stockholders’ equity
Common stock, $0.001 par value: 70,000,000 shares authorized, 24,573,679 and 23,872,436 shares issued and outstanding at December 31, 2018 and 2017, respectively	25	25	25	24	24	24	24	24
Additional paid-in capital	161,962	161,209	160,156	158,840	152,430	152,440	150,375	148,323
Retained earnings (deficit)	(97,574)	(61,030)	(38,703)	(36,642)	(38,170)	(22,564)	(24,462)	(25,176)
Total stockholders’ equity	64,413	100,204	121,478	122,222	114,284	129,900	125,937	123,171
Noncontrolling interest	(22,140)	(20,372)	(18,709)	(16,719)	(14,826)	(13,467)	(12,341)	(11,359)
Total stockholders’ equity including noncontrolling interest	42,273	79,832	102,769	105,503	99,458	116,433	113,596	111,812	110,372	112,701
Total liabilities and stockholders’ equity	$ 452,277	462,106	478,724	484,434	391,565	382,349	369,557	356,157
As Previously Reported
Current assets
Cash and cash equivalents		5,259	11,353	14,341	13,818	16,412	10,793	5,880	$ 3,964	18,750
Accounts receivable, net of allowances		94,583	97,362	99,581	94,096	92,547	96,527	94,144
Prepaid expenses and other current assets		5,547	4,638	3,354	4,022	6,030	4,456	4,897
Total current assets		105,389	113,353	117,276	111,936	114,989	111,776	104,921
Property and equipment, net		166,345	168,373	169,744	152,548	151,769	148,965	145,410
Goodwill		198,952	197,184	197,184	134,396	134,396	134,396	134,396
Intangible assets, net		12,561	13,201	13,712	8,829	9,169	9,551	9,953
Deferred tax assets, net		13,042	9,572	9,030	8,010	1,579	1,180	1,316
Other assets		10,679	11,069	12,468	12,556	5,664	783	626
Total assets		506,968	512,752	519,414	428,275	417,566	406,651	396,622
Current liabilities
Accounts payable		8,722	6,613	3,338	4,579	5,732	10,441	13,711
Accrued and other current liabilities		31,607	30,487	34,039	27,661	24,633	24,800	24,865
Accrued litigation				1,000	23,607
Current portion of long-term debt		8,350	6,723	7,319	4,722	4,736	4,503	10,965
Total current liabilities		48,679	43,823	45,696	60,569	35,101	39,744	49,541
Long-term debt, net of current portion and debt issuance costs		297,143	295,322	296,443	196,451	197,872	208,467	187,456
Financing lease obligation, net of current portion		24,459	24,488	24,515	24,541	24,398
Other long-term liabilities		11,993	12,322	12,277	10,546	3,836	3,782	4,121
Total liabilities		382,274	375,955	378,931	292,107	261,207	251,993	241,118
Stockholders’ equity
Common stock, $0.001 par value: 70,000,000 shares authorized, 24,573,679 and 23,872,436 shares issued and outstanding at December 31, 2018 and 2017, respectively		25	25	24	24	24	24	24
Additional paid-in capital		161,209	160,156	158,840	152,430	152,440	150,375	148,323
Retained earnings (deficit)		(16,168)	(4,675)	(1,662)	(1,460)	17,362	16,600	18,516
Total stockholders’ equity		145,066	155,506	157,202	150,994	169,826	166,999	166,863
Noncontrolling interest		(20,372)	(18,709)	(16,719)	(14,826)	(13,467)	(12,341)	(11,359)
Total stockholders’ equity including noncontrolling interest		124,694	136,797	140,483	136,168	156,359	154,658	155,504		$ 136,488
Total liabilities and stockholders’ equity		506,968	512,752	519,414	428,275	417,566	406,651	396,622
Adjustments
Current assets
Accounts receivable, net of allowances		(34,744)	(26,305)	(27,637)	(30,350)	(33,638)	(35,914)	(39,149)
Total current assets		(34,744)	(26,305)	(27,637)	(30,350)	(33,638)	(35,914)	(39,149)
Deferred tax assets, net		(10,118)	(7,723)	(7,343)	(6,360)	(1,579)	(1,180)	(1,316)
Total assets		(44,862)	(34,028)	(34,980)	(36,710)	(35,217)	(37,094)	(40,465)
Current liabilities
Deferred tax liabilities						4,709	3,968	3,227
Total liabilities						4,709	3,968	3,227
Stockholders’ equity
Retained earnings (deficit)		(44,862)	(34,028)	(34,980)	(36,710)	(39,926)	(41,062)	(43,692)
Total stockholders’ equity		(44,862)	(34,028)	(34,980)	(36,710)	(39,926)	(41,062)	(43,692)
Total stockholders’ equity including noncontrolling interest		(44,862)	(34,028)	(34,980)	(36,710)	(39,926)	(41,062)	(43,692)
Total liabilities and stockholders’ equity		$ (44,862)	$ (34,028)	$ (34,980)	$ (36,710)	$ (35,217)	$ (37,094)	$ (40,465)

Unaudited Quarterly Informat_11

Unaudited Quarterly Information (Restated) - Summary of Consolidated Statements of Cash Flows (Details) - USD ($) $ in Thousands	3 Months Ended										6 Months Ended		9 Months Ended		12 Months Ended
	Dec. 31, 2018		Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017		Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net loss	$ (38,445)	[1],[2]	$ (23,844)	$ (3,592)	$ (837)	$ (17,488)	[3]	$ 715	$ 158	$ (766)	$ (4,429)	$ (608)	$ (28,273)	$ 107	$ (66,718)	$ (17,381)	$ (26,370)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts				366				7,406	6,261	4,403	366	10,664	366	18,070	366	25,932	38,549
Depreciation and amortization			5,573	5,909	5,464			5,218	5,058	5,469	11,373	10,527	16,946	15,745	21,986	21,504	17,686
Equity compensation					798					2,137	2,159	4,189	3,104	6,048	3,877	7,513	8,823
Loss on disposal of property and equipment					34						34		1,000		1,007	55	163
Loss on extinguishment of debt									5,435			5,435		5,435		5,435
(Gain) loss on contingent consideration			947	(176)							(176)		771		(501)		(1,350)
Amortization of debt issuance costs					637					173	1,357	364	2,077	949	2,797	1,564	633
Deferred income taxes					436					588	(184)	903	(1,405)	1,701	2,878	(4,136)	1,772
Changes in operating assets and liabilities:
Accounts receivable					(3,843)					(13,397)	(3,323)	(25,276)	7,895	(30,978)	19,876	(43,676)	(45,838)
Prepaid expenses and other assets					1,485					406	1,475	690	(461)	(703)	(5,578)	(6,725)	2,510
Accounts payable					(4,739)					4,556	(1,464)	1,286	645	(3,423)	5,737	(4,576)	824
Accrued and other current liabilities					4,141					759	633	526	1,436	1,171	1,780	4,685	2,973
Accrued litigation					(22,300)						(23,300)		(23,300)	165	(15,607)	22,645	162
Other long-term liabilities					(275)					28	(230)	(311)	(559)	(257)	(754)	6,453	(394)
Net cash (used in) provided by operating activities					(18,999)					4,356	(15,709)	8,389	(19,758)	14,030	(28,854)	19,292	143
Cash flows from investing activities:
Purchase of property and equipment					(7,305)					(10,687)	(11,196)	(18,665)	(15,458)	(27,186)	(18,949)	(33,041)	(37,304)
Acquisition of subsidiaries					(65,185)						(65,185)		(65,827)		(65,827)		(18,825)
Change in funds held on acquisition																(1,000)	(325)
Net cash used in investing activities					(72,490)					(10,687)	(76,381)	(18,665)	(81,285)	(27,186)	(84,776)	(34,041)	(56,454)
Cash flows from financing activities:
Proceeds from revolving line of credit, net										11,679
Payments on 2015 Credit Facility and Deerfield Facility												(193,094)		(211,094)		(211,094)	(5,376)
Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs														18,000		18,000	48,930
Proceeds from financing lease obligation, net of deferred financing costs														24,617		24,621
Payments on capital leases and other					(221)					(2,537)	(440)	(400)	(563)	(596)	(798)	(791)	(834)
Repayment of long-term debt — related party																	(1,195)
Change in funds held on acquisition																1,000
Payment of employee taxes for net share settlement					(475)					(895)	(523)	(895)	(567)	(1,004)	(621)	(1,080)
Net cash provided by financing activities					92,012					8,247	89,625	17,105	92,484	25,604	105,221	24,603	41,525
Net change in cash and cash equivalents					523					1,916	(2,465)	6,829	(8,559)	12,448	(8,409)	9,854	(14,786)
Cash and cash equivalents, beginning of period	5,259		11,353	14,341	13,818	16,412		10,793	5,880	3,964	13,818	3,964	13,818	3,964	13,818	3,964	18,750
Cash and cash equivalents, end of period	5,409		5,259	11,353	14,341	13,818		16,412	10,793	5,880	11,353	10,793	5,259	16,412	5,409	13,818	3,964
AdCare, Inc
Cash flows from financing activities:
Payments on AdCare Note											(250)		(500)		(750)
2017 Credit Facility
Cash flows from financing activities:
Payments on 2017 Credit Facility					(1,724)						(3,448)		(5,172)	(15,813)	(6,896)	(17,126)
Proceeds from 2017 Credit Facility, net of deferred financing costs					94,432						94,286	9,169	99,286	211,494	114,286	211,073
2017 Term Loan
Cash flows from financing activities:
Proceeds from 2017 Credit Facility, net of deferred financing costs												202,325
As Previously Reported
Cash flows from operating activities:
Net loss			(13,156)	(5,003)	(2,095)			(364)	(2,898)	(1,644)	(7,098)	(4,542)	(20,254)	(4,906)		(25,087)	(5,741)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts				366				9,682	9,496	6,587	366	16,083	366	25,765		36,914	21,485
Depreciation and amortization			5,573	5,909	5,464			5,218	5,058	5,469	11,373	10,527	16,946	15,745		21,504	17,686
Equity compensation					798					2,137	2,159	4,189	3,104	6,048		7,513	8,823
Loss on disposal of property and equipment					34						34		1,000			55	163
Loss on extinguishment of debt									5,435			5,435		5,435		5,435
(Gain) loss on contingent consideration																	(1,350)
Amortization of debt issuance costs					637					173	1,357	364	2,077	949		1,564	633
Deferred income taxes					(1,020)					(718)	(1,562)	(582)	(5,032)	(981)		(7,412)	(1,793)
Changes in operating assets and liabilities:
Accounts receivable					(1,129)					(13,397)	724	(25,276)	3,503	(30,978)		(43,676)	(45,838)
Prepaid expenses and other assets					1,485					406	1,475	690	(461)	(703)		(6,725)	2,510
Accounts payable					(4,739)					4,556	(1,464)	1,286	645	(3,423)		(4,576)	824
Accrued and other current liabilities					4,141					759	457	526	2,207	1,171		4,685	2,973
Accrued litigation					(22,300)						(23,300)		(23,300)	165		22,645	162
Other long-term liabilities					(275)					28	(230)	(311)	(559)	(257)		6,453	(394)
Net cash (used in) provided by operating activities					(18,999)					4,356	(15,709)	8,389	(19,758)	14,030		19,292	143
Cash flows from investing activities:
Purchase of property and equipment					(7,305)					(10,687)	(11,196)	(18,665)	(15,458)	(27,186)		(33,041)	(37,304)
Acquisition of subsidiaries					(65,185)						(65,185)		(65,827)				(18,825)
Change in funds held on acquisition																(1,000)	(325)
Net cash used in investing activities					(72,490)					(10,687)	(76,381)	(18,665)	(81,285)	(27,186)		(34,041)	(56,454)
Cash flows from financing activities:
Proceeds from revolving line of credit, net										11,679
Payments on 2015 Credit Facility and Deerfield Facility												(193,094)		(211,094)		(211,094)	(5,376)
Proceeds from 2015 Credit Facility and Deerfield Facility, net of deferred financing costs														18,000		18,000	48,930
Proceeds from financing lease obligation, net of deferred financing costs														24,617		24,621
Payments on capital leases and other					(221)					(2,537)	(440)	(400)	(563)	(596)		(791)	(834)
Repayment of long-term debt — related party																	(1,195)
Change in funds held on acquisition																1,000
Payment of employee taxes for net share settlement					(475)					(895)	(523)	(895)	(567)	(1,004)		(1,080)
Net cash provided by financing activities					92,012					8,247	89,625	17,105	92,484	25,604		24,603	41,525
Net change in cash and cash equivalents					523					1,916	(2,465)	6,829	(8,559)	12,448		9,854	(14,786)
Cash and cash equivalents, beginning of period	$ 5,259		11,353	14,341	13,818	16,412		10,793	5,880	3,964	13,818	3,964	13,818	3,964	$ 13,818	3,964	18,750
Cash and cash equivalents, end of period			5,259	11,353	14,341	$ 13,818		16,412	10,793	5,880	11,353	10,793	5,259	16,412		13,818	3,964
As Previously Reported | AdCare, Inc
Cash flows from financing activities:
Payments on AdCare Note											(250)		(500)
As Previously Reported | 2017 Credit Facility
Cash flows from financing activities:
Payments on 2017 Credit Facility					(1,724)						(3,448)		(5,172)	(15,813)		(17,126)
Proceeds from 2017 Credit Facility, net of deferred financing costs					94,432						94,286	9,169	99,286	211,494		211,073
As Previously Reported | 2017 Term Loan
Cash flows from financing activities:
Proceeds from 2017 Credit Facility, net of deferred financing costs												202,325
Adjustments
Cash flows from operating activities:
Net loss			(10,688)	1,411	1,258			1,079	3,056	878	2,669	3,934	(8,019)	5,013		7,706	(20,629)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts								$ (2,276)	$ (3,235)	(2,184)		(5,419)		(7,695)		(10,982)	17,064
(Gain) loss on contingent consideration			$ 947	$ (176)							(176)		771
Deferred income taxes					1,456					$ 1,306	1,378	$ 1,485	3,627	$ 2,682		$ 3,276	$ 3,565
Changes in operating assets and liabilities:
Accounts receivable					$ (2,714)						(4,047)		4,392
Accrued and other current liabilities											$ 176		$ (771)
[1]	Refer to Note 15 – Commitments and Contingencies to the Notes to the Consolidated Financial Statements.
[2]	Refer to Note 2 – Basis of Presentation to the Notes to the Consolidated Financial Statements.
[3]	Fourth quarter results include a $23.3 million litigation settlement expense related to the estimated settlement of the Tennessee class action litigation and the Nevada derivative litigation matters.