ACHC earnings analysis
What we found in ACHC's 10-Q: the parts that mattered, the offsets in the same document, and what the company said about what comes next.
Our reading of the filing · Free to read, no account needed
Acadia's Q2 revenue was essentially flat year over year at $865.8 million, with admissions growth of 6.4% offset by a 0.8% decline in same-facility revenue per patient day. Earnings and margins deteriorated sharply, as attributable net income declined to $10.9 million from $30.1 million amid a $28.6 million adverse liability-reserve adjustment, higher labor and professional-fee ratios, and impairment charges. Offsetting factors include substantially stronger first-half operating cash flow of $223.6 million, lower investigation-related costs, and continued capacity additions. Item 1A did not add or revise risk factors relative to the 2025 10-K; it incorporated those prior risks by reference.
The parts that mattered.
Pulled out of the filing itself, with the figures the company reported.
- Sequential revenue recovery, but YoY decline
- Q2 revenue was $865.8 million, down $3.4 million (0.4%) year over year from $869.2 million, but up from $828.8 million in Q1 2026. For the first six months, revenue increased $54.9 million (3.3%) to $1.695 billion.
- Volume growth offset by lower yield
- Same-facility Q2 revenue declined 0.1%: patient days increased 0.8% and admissions increased 6.4%, but revenue per patient day fell 0.8%. The six-month same-facility revenue growth rate was 3.4%.
- Capacity expansion continues
- Management added 322 beds in the first six months, including 42 beds at existing facilities and 280 beds through one wholly owned and three joint-venture facilities. Acadia operated 279 facilities and approximately 12,600 beds at June 30, 2026.
- Cash generation improved materially
- Six-month operating cash flow rose to $223.6 million from $145.0 million, while capital expenditures fell to $115.1 million from $342.4 million. This implies $108.5 million of operating cash flow less capex for the first half, with capex equal to 6.8% of revenue.
- Investigation-related costs declined
- Transaction, legal and other costs fell to $22.6 million in Q2 from $64.4 million a year earlier, including government-investigation costs of $7.5 million versus $53.5 million.
- Liquidity increased and revolver was repaid
- Cash and cash equivalents increased to $171.3 million at June 30, 2026 from $133.2 million at December 31, 2025. Revolver availability was $669.8 million after $85.0 million of borrowings and $160.0 million of repayments during the first half.
And the other side of it.
The offsets in the same document — the things a summary that only listed the good news would have left out.
- Claims reserve adjustment pressured margins
- Profitability weakened despite nearly flat revenue: net income attributable to Acadia fell to $10.9 million from $30.1 million, while the implied operating margin was 7.0% versus 9.8% a year earlier. A $28.6 million unfavorable adjustment to self-insured professional and general-liability claims was recorded in other operating expense.
- High Medicaid reimbursement exposure
- Medicaid represented $540.2 million, or 62.4%, of Q2 revenue. Management says OBBBA-related Medicaid eligibility and state-directed-payment changes may negatively affect performance; state compliance with new eligibility requirements is required by December 31, 2026, and grandfathered payment programs begin reducing January 1, 2028.
- Leverage and floating-rate exposure
- Debt and rate sensitivity remain substantial: debt consisted of $1.464 billion fixed-rate and $951.1 million variable-rate obligations at June 30, 2026. A hypothetical 1% rate increase would reduce annual pretax income by approximately $9.5 million; leverage was 4.1x versus a 5.0x covenant limit.
- Older receivables increased
- Receivables aging deteriorated even as days sales outstanding stayed at 49 days: balances aged over 150 days were 23.2% at June 30, 2026 versus 19.3% at December 31, 2025.
What they reported.
What the company itself reported, taken out of the document.
- Earnings per share
- $0.12
- Operating margin
- 7.0%
What they said about what is next.
The 10-Q contains no quantitative revenue or EPS outlook. Management states that it expects to continue pursuing bed additions, de novos, joint ventures and acquisitions; no numeric guidance was embedded in MD&A.
The filing reads worse than the one before it.
What came before.
- 10-Q · April 29, 2026
- Acadia Healthcare reported Q1 2026 revenue of $828.8 million, a 7.6% increase from Q1 2025, and an EPS of $0.37, exceeding analyst estimates by $0.10. The company demonstrated growth in patient volumes across its…
- 10-K · February 27, 2026
- Acadia grew revenue to $3,312.8 million in 2025 (from $3,154.0 million in 2024) and expanded scale to 277 facilities and over 12,500 beds, adding 1,089 beds (311 bed adds to existing facilities and 778 via one…
- 10-Q · May 12, 2025
- Acadia reported Q1 2025 revenue of $770,505,000, up modestly from $768,051,000 a year earlier, but profitability deteriorated materially: income before taxes fell to $13,468,000 (from $98,844,000) and diluted EPS…
- 10-K · February 27, 2025
- Acadia positions itself as the leading publicly traded pure‑play behavioral healthcare provider, growing to 262 facilities and $3,154.0 million of revenue in 2024 while adding 776 beds and opening nine CTCs. Management…
This is our reading of a public filing, not the filing. Read the original on SEC.gov · Educational only. Nothing here is investment advice.
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