Acadia Healthcare Company (ACHC) Q1 2026 earnings summary

Executive summary

• Revenue reached $828.8 million in Q1 2026, up 7.6% year-over-year, at the high end of guidance, driven by same-facility growth, new facility openings, and higher patient volumes.

• Adjusted EBITDA rose to $144.2 million, exceeding guidance, while Adjusted EPS was $0.37, down from $0.40 due to higher legal, depreciation, and interest expenses.

• Acute inpatient psychiatric facilities drove 14% year-over-year revenue growth, with inpatient volumes up 6.2%.

• Leadership changes, operational restructuring, and improved staff retention enhanced execution and oversight.

• 82 beds were added in Q1, with ongoing expansion and over 2,500 beds added in the past three years.

Financial highlights

• Q1 2026 revenue was $828.8–$829 million, up 7.6–8% year-over-year.

• Adjusted EBITDA was $144.2 million, up 7–7.5% from Q1 2025 and above guidance.

• Free cash flow improved by $148 million year-over-year, though Q1 was negative $15 million due to CapEx timing.

• Salaries, wages, and benefits rose to $467 million, or 56.4% of revenue, but declined as a percentage of revenue year-over-year.

• Net leverage ratio stood at 3.9x Adjusted EBITDA as of March 31, 2026.

Outlook and guidance

• Full-year 2026 revenue guidance: $3.37–$3.45 billion; Adjusted EBITDA: $580–$615 million; Adjusted EPS: $1.35–$1.60.

• Q2 2026 guidance: revenue $835–$850 million, Adjusted EBITDA $142–$152 million, Adjusted EPS $0.30–$0.40.

• Net leverage expected to temporarily rise to 4.4–4.5x in Q2, returning to 3.9–4.2x by year-end.

• Guidance excludes unapproved supplemental payment programs and future acquisitions or divestitures.

• Minimal impact expected from new Medicaid eligibility requirements due to exemptions for core patient populations.