Acadia Healthcare Company, Inc.

Q2 2026 revenue was $866 million, flat year over year. Adjusted EBITDA was $149.2 million, and same-facility adjusted EBITDA was $200.9 million. Reported revenue included $22.3 million from the Florida supplemental payment program; Q2 2025 included $48.7 million of Tennessee supplemental-payment revenue related to prior periods. Excluding those items, total revenue growth would have been 2.8%, and same-facility revenue growth would have been 3.2%. Same-facility revenue was flat reported, with a 0.8% increase in patient days offset by a 0.8% decrease in revenue per patient day. Free cash flow was $124 million, operating cash flow was $162 million, capex was $39 million, cash and equivalents were $171 million, and net leverage was approximately 4.1x adjusted EBITDA. The company updated full-year guidance to revenue of $3.4 billion to $3.45 billion, adjusted EBITDA of $590 million to $615 million, adjusted EPS of $1.45 to $1.60, and operating cash flow of $350 million to $400 million. Full-year capex was revised to $235 million to $255 million, with $120 million to $140 million expected in the second half. Management said the current-year supplemental-payment baseline includes $5 million for Florida in Q3 expectations, and that Florida and Ohio programs under review could add more than $20 million in incremental EBITDA if approved.

Debra Osteen framed the quarter as solid and in line with expectations, emphasizing a reset toward operational execution, patient care, and disciplined capital deployment. She said the team has made significant progress on ramping new facilities, improving licensing/accreditation/payer contracting timelines, and tightening expense control, and she pointed to stronger-than-expected performance from the 2023-2026 cohorts. Her tone was confident and constructive, especially around the company’s ability to deliver the previously discussed $200 million of incremental adjusted EBITDA from the new-bed cohort and to add 500 to 600 beds in 2026.

David Duckworth focused on the bridge from reported results to normalized growth, explaining that Florida and Tennessee supplemental-payment timing materially affected the quarter and that underlying revenue growth would have been 2.8%. He highlighted second-quarter adjusted EBITDA of $149.2 million, the $26.1 million Florida benefit, and a $28.6 million PLGL reserve increase, which together created a $2.5 million net negative versus guidance. He also pointed to $171 million of cash, $124 million of free cash flow, $113 million of debt paydown, improving DSOs at 49 days, stable bad debt/denials, and a reduced full-year capex outlook of $235 million to $255 million as signs of better cash generation and tighter capital discipline.

Analysts focused on the confidence behind the $200 million incremental EBITDA ramp, free cash flow versus EBITDA guidance, PLGL reserve risk, payer friction, labor, revenue-cycle trends, and the de novo pipeline. Management said the new facilities are ahead of expectations, with Coachella Valley above 90% occupancy and some cohorts already positive EBITDA, while also noting faster approvals and better JV coordination. On PLGL, David Duckworth said the $28.6 million reserve increase was tied mainly to prior-year cases and a midyear actuarial review, that current-year 2026 reserve expectations remain $100 million to $110 million before the prior-year adjustment, and that predicting additional reserve changes is difficult. On payer and labor questions, management said labor is stable with wage growth around 3%, payer relationships remain generally strong though tense at times, and bad debt/denials are improving with more progress expected in the back half.