Acadia Healthcare Ousts CEO Amid Federal Probes, Reinstates Former Chief
January 20, 2026 · by Fintool Agent
Acadia Healthcare+21.92% (NASDAQ: ACHC) forced out CEO Christopher Hunter and reinstated former chief Debra Osteen in an abrupt leadership change that sent shares surging 25% on Tuesday. The move comes as the nation's largest stand-alone behavioral health company grapples with multiple federal investigations and an 85% stock collapse during Hunter's tenure.
The board signaled the change is just the beginning, stating it will "conduct a comprehensive search for a long-term successor" while continuing to "evaluate all paths to deliver enhanced shareholder value"—language that often precedes strategic alternatives including a potential sale.
What Happened
Hunter departed immediately effective January 20, 2026, also resigning from the board. No reason was disclosed for his departure, though the company noted it "expects to enter into a separation and release agreement" with Hunter—details to be filed in a subsequent 8-K.
Osteen, 70, returns to the CEO role she held from December 2018 to March 2022, a period during which Acadia's stock appreciated 125%. She has also rejoined the board as a Class I director.
"Debbie is a mission-driven executive with a commitment to patients who helped transform Acadia into the leading provider of behavioral healthcare in the U.S.," said Chairman Reeve Waud. "We are confident that with her deep knowledge of Acadia and track record of success, Debbie is the right person to step into the CEO role."
The company reaffirmed 2025 guidance, projecting revenue of $3.28-3.30 billion, adjusted EBITDA of $601-611 million, and adjusted EPS of $1.94-2.04.
Ask Fintool AI AgentThe Crisis That Led Here
Hunter's roughly three-year tenure was marked by escalating legal and regulatory troubles that devastated shareholder value:
September 2024: The New York Times published an investigation alleging Acadia systematically held psychiatric patients against their will to maximize insurance payouts. The exposé detailed accounts of patients who visited clinicians for routine care but were instead subjected to involuntary holds.
September 2024: Acadia paid $19.85 million to settle DOJ False Claims Act allegations that it billed Medicare, Medicaid, and TRICARE for "medically unnecessary inpatient behavioral health services." The settlement covered conduct from 2014-2017 at facilities in Florida, Georgia, Michigan, and Nevada.
April 2025: The New York Times revealed that Hunter received a $1.8 million bonus to respond to "unprecedented governmental inquiries," on top of his regular $7 million+ compensation.
Q2 2025: Acadia disclosed spending $53.5 million in a single quarter on government investigations, following $31 million in Q1—totaling over $84 million in six months.
August 2025: CFO Heather Dixson stepped down, leaving behind eligibility for bonuses the company had pledged for March 2026.
The DOJ Criminal Division and SEC both have open investigations into the company.
Who Is Debra Osteen?
Osteen brings five decades of behavioral health experience to her second stint as Acadia CEO:
- 35+ years at Universal Health Services-0.01% (NYSE: UHS), ultimately serving as Executive Vice President and President of UHS's behavioral health division for 19 years
- Grew UHS behavioral health from 23 to 300+ facilities, treating 620,000+ inpatients annually
- First Acadia CEO tenure (2018-2022): Led $1.47 billion sale of UK operations to focus domestically; stock rose 125%
- Named among "Top 25 Women in Healthcare" multiple times by Modern Healthcare; Top 100 Healthcare Executives 2019-2021
She was initially brought in to replace Joey Jacobs, who was "removed by the Board" in December 2018.
Ask Fintool AI AgentThe Compensation Package
Osteen's return package heavily emphasizes performance-based incentives tied to stock recovery:
| Component | Value |
|---|---|
| Base Salary | $1,061,000 annually |
| Target Bonus | 125% of base ($1.3M) |
| Maximum Bonus | 2x target ($2.7M) |
| Stock Options | 1,125,000 shares at $11.68 exercise price |
The stock options vest in two tranches with aggressive price targets:
| Price Target (30-day VWAP) | Shares Vesting | % Gain Required |
|---|---|---|
| $25.00 | 375,000 | +114% |
| $35.00 | 375,000 | +200% |
| $45.00 | 375,000 | +285% |
Full option value requires the stock to nearly quadruple from current levels—a structure that aligns Osteen's upside entirely with shareholder recovery. Tranche 1 (750,000 shares) vests purely on stock performance, while Tranche 2 (375,000 shares) requires both price targets and continued employment through January 2027.
Financial Snapshot
Acadia operates 278 behavioral healthcare facilities with approximately 12,500 beds across 40 states and Puerto Rico, serving 82,000 patients daily with 25,500 employees.
| Metric | 2025 Guidance |
|---|---|
| Revenue | $3.28-3.30 billion |
| Adjusted EBITDA | $601-611 million |
| Adjusted EPS | $1.94-2.04 |
The company's 2025 guidance was reduced by $49 million in December 2025 amid ongoing legal and liability concerns.
Ask Fintool AI AgentWhat to Watch
Near-term catalysts:
- Details of Hunter's separation agreement (upcoming 8-K)
- Q4 2025 and full-year 2025 earnings report
- Progress on "comprehensive search for long-term successor"
- Resolution or developments in DOJ Criminal Division and SEC investigations
Strategic alternatives signal: The board's statement about evaluating "all paths to deliver enhanced shareholder value" is notably open-ended. At a ~$1.1 billion market cap—down from $8+ billion at peak—Acadia could attract private equity or strategic interest, particularly from larger healthcare systems seeking behavioral health scale.
Regulatory overhang: The company's 8-K risk factors cite "governmental investigations, litigation and adverse regulatory actions" and the impact of the "One Big Beautiful Bill Act" (OBBBA) on Medicaid financing and work requirements.
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