Sign in
AH

Acadia Healthcare Company, Inc. (ACHC)·Q1 2025 Earnings Summary

Executive Summary

  • Q1 2025 revenue was $770.5M and adjusted EPS $0.40, landing at the high end of EBITDA guidance ($134.2M) while reaffirming full-year 2025 ranges; same-facility patient days grew 2.2% YoY despite a 1.1% leap-year headwind .
  • Versus S&P Global consensus, revenue modestly beat ($770.5M vs $769.8M*) and adjusted EPS beat ($0.40 vs $0.36*); adjusted EBITDA was within/above consensus depending on definition (Street EBITDA $132.1M* vs reported adjusted EBITDA $134.2M; Street “EBITDA actual” shows $125.5M*, reflecting definitional differences). Values retrieved from S&P Global.
  • Management highlighted start-up losses and underperforming facilities as planned headwinds (approx. $5M EBITDA impact from a Q1 facility closure; $20M FY headwind from certain facilities; $50–$55M FY start-up losses), but maintained bed expansion targets of 800–1,000 additions for 2025 and affirmed guidance .
  • Liquidity remained strong (cash $91.2M; $901.6M availability under a $1B revolver), plus execution of the $300M buyback program (1.6M shares, $47.3M) and new $550M 7.375% senior notes to term-out revolver—key capital allocation signals .
  • Catalysts to watch: timing and magnitude of supplemental Medicaid payments (TN-directed payments), ramp of new facilities (start-up losses abate), and resolution of regulatory/legal scrutiny; all cited by management as potential swing factors for cadence and investor sentiment .

What Went Well and What Went Wrong

What Went Well

  • Adjusted EBITDA at the high end: $134.2M on revenue of $770.5M; management said results landed “in line” with ranges and EBITDA at high-end for Q1 .
  • Volume resilience despite headwinds: same-facility patient days +2.2% YoY with leap-year drag (≈110 bps); admissions +2.1% YoY; total facility patient days +0.8% .
  • Clear strategic execution: 378 newly licensed beds added (90 at existing, 288 new), plus seven new CTCs; two new facilities opened (North Port, FL and JV with Henry Ford Health in West Bloomfield, MI) .
  • Quote: “This year is setting up to be the largest bed expansion year in Acadia’s history…” — CEO Chris Hunter .

What Went Wrong

  • Margin mix and start-up drag: adjusted EBITDA margin ~17.4%; start-up losses were higher YoY and sequentially given the step-up in newly constructed facilities (Q1 start-up losses ≈$16M, better than plan but still elevated) .
  • Same-facility adjusted EBITDA down YoY (-9.0%); total facility adjusted EBITDA down 18.3% YoY amid transaction/legal costs, legal settlements, and a closed facility impact .
  • Specialty revenue softness: management cited multiple facility closures driving ~5% decline in specialty revenue; underperforming facilities continued to weigh on volumes (~90 bps impact in Q1) .

Financial Results

Sequential Trend (Q3 2024 → Q4 2024 → Q1 2025)

MetricQ3 2024Q4 2024Q1 2025
Revenue ($USD Millions)$815.6 $774.2 $770.5
Diluted EPS (GAAP) ($)$0.74 $0.35 $0.09
Adjusted EPS ($)$0.91 $0.64 $0.40
Adjusted EBITDA ($USD Millions)$194.3 $153.1 $134.2
Adjusted EBITDA Margin (%)23.8% 19.8% 17.4%
Revenue per Patient Day ($)$1,001 $997 $994

YoY Comparison (Q1 2024 → Q1 2025)

MetricQ1 2024Q1 2025
Revenue ($USD Millions)$768.1 $770.5
Diluted EPS (GAAP) ($)$0.83 $0.09
Adjusted EPS ($)$0.84 $0.40
Same-Facility Revenue Growth (%)—2.1%
Same-Facility Patient Days Growth (%)—2.2%
Revenue per Patient Day ($)$996 $994

Operating Statistics (Q1 2025 vs Q1 2024)

KPIQ1 2024Q1 2025YoY
Same-Facility Revenue ($USD ‘000)$744,422 $759,697 +2.1%
Same-Facility Patient Days747,394 763,958 +2.2%
Same-Facility Admissions47,503 48,507 +2.1%
Same-Facility Revenue/Patient Day ($)$996 $994 -0.2%
Same-Facility Adjusted EBITDA ($USD ‘000)$210,579 $191,605 -9.0%
Total Facility Revenue ($USD ‘000)$768,051 $770,505 +0.3%
Total Facility Adjusted EBITDA ($USD ‘000)$210,926 $172,361 -18.3%

Estimates vs Actuals (S&P Global – Q1 2025)

MetricConsensusActualBeat/Miss
Revenue ($USD Millions)$769.8*$770.5 Beat (slight)
Primary EPS ($)$0.36*$0.40 Beat
EBITDA ($USD Millions)$132.1*$134.2 (Adjusted EBITDA) Beat (note: Street definition differs)

Values retrieved from S&P Global.
Note: S&P “EBITDA actual” shows $125.5M* for Q1 2025, indicating definitional differences vs company “Adjusted EBITDA” .

Guidance Changes

MetricPeriodPrevious Guidance (2/27/25)Current Guidance (5/12/25)Change
RevenueFY 2025$3.3–$3.4B $3.3–$3.4B Maintained
Adjusted EBITDAFY 2025$675–$725M $675–$725M Maintained
Adjusted EPSFY 2025$2.50–$2.80 $2.50–$2.80 Maintained
Interest ExpenseFY 2025$130–$140M $130–$140M Maintained
Tax RateFY 202525%–26% 25%–26% Maintained
D&AFY 2025$175–$185M $175–$185M Maintained
Stock CompFY 2025$45–$50M $45–$50M Maintained
Operating Cash FlowFY 2025$460–$510M $460–$510M Maintained
Expansion CapexFY 2025$525–$575M $525–$575M Maintained
Maintenance/IT CapexFY 2025$105–$115M $105–$115M Maintained
Total Bed AdditionsFY 2025800–1,000 800–1,000 Maintained

Assumptions reiterated: FY supplemental payments net flat to +$15M (incl. TN), start-up losses ~$50–$55M, low-to-mid single-digit same-facility volume growth, low single-digit rate growth .

Earnings Call Themes & Trends

TopicPrevious Mentions (Q3 2024)Previous Mentions (Q4 2024)Current Period (Q1 2025)Trend
Quality & Safety investmentsExpanded EMR, remote monitoring, dashboards; legal update; facility oversight detail Reiterated tech/safety investments; strong patient engagement metrics “Foundational”; multilayered protection; cloud-based quality systems; 50+ KPIs Continues; deeper operationalization
Labor environmentFavorable wage trends, improved staffing Stable labor; net leverage ~2.7x Premium pay down YoY/QoQ; improved retention Improving
Referral dynamicsMedia headlines created localized pressure; outreach strategy Underperforming facilities headwind (~2% drag); plan to flex costs if needed ~90 bps drag to same-facility volumes; localized media correlation Stabilizing; targeted remediation
Supplemental payments/policyTN program retro to July 1 expected; conservative in guidance FY net flat to +$15M; explicit conservatism on rates Q1 down $10–$15M YoY; FY net flat to +$15M incl. TN Timing-sensitive; 2H skew
Bed expansion cadence~1,200 beds constructed in 2024, ramp to 2025 577 new licensed beds in Q4; pipeline >2,000 under construction 378 beds in Q1; plan for 800–1,000 in 2025 Continuing at high pace; ramping losses now, EBITDA later
Specialty businessNot singled outMAT mid-single-digit growth forward; comp headwind Specialty revenue ~-5% YoY driven by closures Pressured by portfolio actions
Capital structureRevolver upsizing noted $300M buyback authorized $47.3M bought back; $550M 7.375% notes to prepay revolver Strengthening liquidity; terming-out debt

Management Commentary

  • “First quarter revenue of $770.5 million… adjusted EBITDA of $134.2 million… reaffirmed full year guidance” — CEO Chris Hunter .
  • “Same-facility patient days grew 2.2%… included an unfavorable leap year impact of roughly 110 bps” — CEO .
  • “Start-up losses… higher YoY and sequentially… same-facility adjusted EBITDA margin was 25.2%… underperforming facilities impact ~90 bps” — CFO Heather Dixon .
  • “We expect to add between 800 and 1,000 total beds in 2025” — CEO .
  • “We continue to expect Medicaid supplemental payments to be flat to up $15 million in 2025 on a net basis” — CFO .
  • “Share repurchase: approximately 1.6 million shares… $47.3 million” — CFO ; corroborated in PR .

Q&A Highlights

  • EBITDA cadence: Q1 start-up losses and supplemental timing make 1H weaker; expect improvement through the year, with TN DPP timing the biggest swing factor .
  • Rate outlook: conservative stance amid policy noise, but payer discussions “stable”; low single-digit revenue per day growth embedded .
  • Specialty decline drivers: primarily facility closures; Medicaid specialty inpatient mix shift .
  • Cash flow and capex: peak expansion spending in 1H’25; path to positive FCF by end of 2026; leverage to naturally decline as EBITDA grows .
  • Underperforming facilities: targeted actions on referrals, staffing, technology adherence, and local operations; headwind spread across first three quarters with comp tailwind in Q4 .

Estimates Context

  • Q1 2025 beats: revenue $770.5M vs $769.8M*, adjusted EPS $0.40 vs $0.36*, adjusted EBITDA $134.2M vs $132.1M*. Values retrieved from S&P Global.
  • Post-Q1 trajectory: S&P consensus for Q4 2025 revenue $801.8M* and EPS $0.41*; Q1 2026 revenue $817.2M* and EPS $0.39* suggest modest growth as start-up losses ease. Values retrieved from S&P Global.
  • Note on definitions: Street “EBITDA” may differ from company “Adjusted EBITDA”, as S&P “EBITDA actual” for Q1 shows $125.5M*, underscoring the importance of aligning metrics when assessing beats. Values retrieved from S&P Global.

Key Takeaways for Investors

  • Execution vs plan: Quarter delivered within ranges with EBITDA at the high end; reaffirmed FY guide despite known start-up and referral headwinds—supportive for medium-term thesis .
  • Watch quarterly cadence: Supplemental payments (esp. Tennessee) and start-up losses will skew results intra-year; expect 2H improvement if timing aligns .
  • Bed ramp drives 2026+ EBITDA: Management’s 5-year ramp model implies material earnings power beyond 2028; 2026 EBITDA growth expected at high end of long-term 8–10% outlook .
  • Capital deployment: Active buybacks and terming-out revolver via 7.375% 2033 notes point to confidence and liquidity; net leverage ~3.2x offers flexibility .
  • Risk factors: Localized referral sensitivity to media scrutiny, specialty closures, and policy variability in supplemental payments—monitor for stabilization and disclosures .
  • Trading implications (near term): Potential upside if TN DPP recognized earlier/larger, or underperforming facilities recover faster; downside if supplemental timing slips or start-up losses exceed plan .
  • Medium-term: As new facilities mature and capex moderates, free cash flow should inflect by end-2026, improving capital allocation optionality .
S&P Global disclaimer: All consensus estimate values marked with * were retrieved from S&P Global and may reflect differing metric definitions (e.g., EBITDA vs Adjusted EBITDA).

Non-GAAP note: Adjusted EPS and Adjusted EBITDA exclude equity-based compensation, transaction/legal/other costs, debt extinguishment, and legal settlements; reconciliations provided in company releases **[1520697_0001437749-25-016141_ex_816394.htm:5]** **[1520697_0001437749-25-016141_ex_816394.htm:6]** **[1520697_f64a80ea63084339869321bb7cb9b4dd_8]** **[1520697_6370cbcdd8df4e2cb9255a7646eab37d_9]** **[1520697_6370cbcdd8df4e2cb9255a7646eab37d_10]**.