UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
☒ |
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the quarterly period ended June 30, 2018
or
☐ |
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the transition period from to
Commission File Number: 001-35331
ACADIA HEALTHCARE COMPANY, INC.
(Exact name of registrant as specified in its charter)
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Delaware |
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45-2492228 |
(State or other jurisdiction of incorporation or organization) |
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(I.R.S. Employer Identification No.) |
6100 Tower Circle, Suite 1000
Franklin, Tennessee 37067
(Address, including zip code, of registrant’s principal executive offices)
(615) 861-6000
(Registrant’s telephone number, including area code)
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). Yes ☒ No ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer |
☒ |
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Accelerated filer |
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Non-accelerated filer |
☐ |
(Do not check if a smaller reporting company) |
Smaller reporting company |
☐ |
Emerging growth company |
☐ |
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If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒
At July 31, 2018, there were 88,274,373 shares of the registrant’s common stock outstanding.
ACADIA HEALTHCARE COMPANY, INC.
QUARTERLY REPORT ON FORM 10-Q
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Item 1. |
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1 |
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Condensed Consolidated Balance Sheets (Unaudited) at June 30, 2018 and December 31, 2017 |
1 |
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2 |
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3 |
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Condensed Consolidated Statement of Equity (Unaudited) for the Six Months Ended June 30, 2018 |
4 |
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5 |
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Notes to Condensed Consolidated Financial Statements (Unaudited) |
6 |
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Item 2. |
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Management’s Discussion and Analysis of Financial Condition and Results of Operations |
31 |
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Item 3. |
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42 |
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Item 4. |
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42 |
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Item 1. |
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44 |
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Item 1A. |
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44 |
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Item 2. |
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44 |
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Item 6. |
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45 |
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46 |
PART I – FINANCIAL INFORMATION
Acadia Healthcare Company, Inc.
Condensed Consolidated Balance Sheets
(Unaudited)
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June 30, 2018 |
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December 31, 2017 |
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(In thousands, except share and per share amounts) |
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ASSETS |
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Current assets: |
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Cash and cash equivalents |
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$ |
79,463 |
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$ |
67,290 |
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Accounts receivable, net |
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329,256 |
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296,925 |
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Other current assets |
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80,503 |
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107,335 |
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Total current assets |
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489,222 |
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471,550 |
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Property and equipment, net |
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3,103,331 |
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3,048,130 |
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Goodwill |
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2,739,303 |
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2,751,174 |
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Intangible assets, net |
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91,566 |
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87,348 |
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Deferred tax assets |
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3,664 |
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3,731 |
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Derivative instrument assets |
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24,989 |
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12,997 |
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Other assets |
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51,072 |
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49,572 |
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Total assets |
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$ |
6,503,147 |
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$ |
6,424,502 |
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LIABILITIES AND EQUITY |
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Current liabilities: |
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Current portion of long-term debt |
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$ |
33,264 |
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$ |
34,830 |
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Accounts payable |
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130,228 |
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102,299 |
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Accrued salaries and benefits |
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102,840 |
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99,047 |
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Other accrued liabilities |
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127,786 |
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141,213 |
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Total current liabilities |
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394,118 |
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377,389 |
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Long-term debt |
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3,187,788 |
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3,205,058 |
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Deferred tax liabilities |
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78,340 |
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80,333 |
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Other liabilities |
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160,809 |
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166,434 |
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Total liabilities |
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3,821,055 |
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3,829,214 |
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Redeemable noncontrolling interests |
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28,791 |
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22,417 |
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Equity: |
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Preferred stock, $0.01 par value; 10,000,000 shares authorized, no shares issued |
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— |
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— |
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Common stock, $0.01 par value; 180,000,000 shares authorized; 87,330,276 and 87,060,114 issued and outstanding at June 30, 2018 and December 31, 2017, respectively |
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873 |
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871 |
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Additional paid-in capital |
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2,530,083 |
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2,517,545 |
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Accumulated other comprehensive loss |
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(415,883 |
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(374,118 |
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Retained earnings |
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538,228 |
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428,573 |
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Total equity |
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2,653,301 |
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2,572,871 |
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Total liabilities and equity |
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$ |
6,503,147 |
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$ |
6,424,502 |
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See accompanying notes.
1
Acadia Healthcare Company, Inc.
Condensed Consolidated Statements of Income
(Unaudited)
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Three Months Ended June 30, |
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Six Months Ended June 30, |
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2018 |
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2017 |
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2018 |
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2017 |
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(In thousands, except per share amounts) |
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Revenue before provision for doubtful accounts |
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$ |
765,738 |
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$ |
725,643 |
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$ |
1,507,979 |
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$ |
1,414,984 |
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Provision for doubtful accounts |
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— |
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(9,747 |
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— |
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(19,894 |
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Revenue |
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765,738 |
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715,896 |
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1,507,979 |
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1,395,090 |
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Salaries, wages and benefits (including equity-based compensation expense of $7,129, $7,436, $14,048 and $14,832, respectively) |
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416,741 |
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383,595 |
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828,269 |
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760,016 |
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Professional fees |
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53,461 |
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46,321 |
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107,479 |
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89,730 |
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Supplies |
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30,133 |
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28,639 |
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59,497 |
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56,348 |
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Rents and leases |
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20,236 |
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19,435 |
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40,524 |
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38,406 |
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Other operating expenses |
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87,282 |
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83,122 |
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175,513 |
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166,833 |
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Depreciation and amortization |
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39,928 |
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35,201 |
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79,701 |
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68,814 |
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Interest expense, net |
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45,812 |
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43,505 |
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91,055 |
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86,262 |
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Debt extinguishment costs |
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— |
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810 |
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940 |
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810 |
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Transaction-related expenses |
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2,887 |
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9,052 |
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7,655 |
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13,171 |
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Total expenses |
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696,480 |
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649,680 |
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1,390,633 |
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1,280,390 |
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Income before income taxes |
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69,258 |
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66,216 |
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117,346 |
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114,700 |
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Provision for income taxes |
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10,368 |
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16,578 |
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7,582 |
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30,289 |
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Net income |
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58,890 |
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49,638 |
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109,764 |
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84,411 |
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Net (income) loss attributable to noncontrolling interests |
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(54 |
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(8 |
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(109 |
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177 |
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Net income attributable to Acadia Healthcare Company, Inc. |
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$ |
58,836 |
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$ |
49,630 |
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$ |
109,655 |
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$ |
84,588 |
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Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders: |
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Basic |
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$ |
0.67 |
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$ |
0.57 |
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$ |
1.26 |
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$ |
0.97 |
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Diluted |
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$ |
0.67 |
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$ |
0.57 |
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$ |
1.26 |
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$ |
0.97 |
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Weighted-average shares outstanding: |
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Basic |
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87,303 |
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86,954 |
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87,205 |
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86,859 |
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Diluted |
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87,467 |
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87,080 |
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87,351 |
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86,997 |
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See accompanying notes.
2
Acadia Healthcare Company, Inc.
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)
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Three Months Ended June 30, |
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Six Months Ended June 30, |
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2018 |
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2017 |
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2018 |
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2017 |
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(In thousands) |
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Net income |
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$ |
58,890 |
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$ |
49,638 |
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$ |
109,764 |
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$ |
84,411 |
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Other comprehensive (loss) income: |
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Foreign currency translation (loss) gain |
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(143,599 |
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92,076 |
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(50,819 |
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119,122 |
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Gain (loss) on derivative instruments, net of tax of $10.5 million, $(6.5) million, $3.2 million and $(12.1) million, respectively |
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29,107 |
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(9,084 |
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9,054 |
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(14,952 |
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Other comprehensive (loss) income |
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(114,492 |
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82,992 |
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(41,765 |
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104,170 |
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Comprehensive (loss) income |
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(55,602 |
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132,630 |
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67,999 |
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188,581 |
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Comprehensive (gain) loss attributable to noncontrolling interests |
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(54 |
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(8 |
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(109 |
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177 |
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Comprehensive (loss) income attributable to Acadia Healthcare Company, Inc. |
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$ |
(55,656 |
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$ |
132,622 |
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$ |
67,890 |
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$ |
188,758 |
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See accompanying notes.
3
Acadia Healthcare Company, Inc.
Condensed Consolidated Statement of Equity
(Unaudited)
(In thousands)
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Common Stock |
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Additional Paid-in |
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Accumulated Other Comprehensive |
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Retained |
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Shares |
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Amount |
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Capital |
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Loss |
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Earnings |
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Total |
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Balance at December 31, 2017 |
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87,060 |
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$ |
871 |
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$ |
2,517,545 |
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$ |
(374,118 |
) |
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$ |
428,573 |
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$ |
2,572,871 |
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Common stock issued under stock incentive plans |
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270 |
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2 |
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222 |
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— |
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— |
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|
224 |
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Common stock withheld for minimum statutory taxes |
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— |
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— |
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(2,358 |
) |
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— |
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— |
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(2,358 |
) |
Equity-based compensation expense |
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— |
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— |
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14,048 |
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— |
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— |
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|
14,048 |
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Other comprehensive loss |
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— |
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— |
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— |
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(41,765 |
) |
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— |
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(41,765 |
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Other |
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— |
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— |
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|
626 |
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— |
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— |
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|
626 |
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Net income attributable to Acadia Healthcare Company, Inc. |
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— |
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— |
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— |
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— |
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|
109,655 |
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|
109,655 |
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Balance at June 30, 2018 |
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87,330 |
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$ |
873 |
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$ |
2,530,083 |
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$ |
(415,883 |
) |
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$ |
538,228 |
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$ |
2,653,301 |
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See accompanying notes.
4
Acadia Healthcare Company, Inc.
Condensed Consolidated Statements of Cash Flows
(Unaudited)
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Six Months Ended June 30, |
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2018 |
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2017 |
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(In thousands) |
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Operating activities: |
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Net income |
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$ |
109,764 |
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$ |
84,411 |
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Adjustments to reconcile net income to net cash provided by continuing operating activities: |
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Depreciation and amortization |
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79,701 |
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|
68,814 |
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Amortization of debt issuance costs |
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5,124 |
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4,845 |
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Equity-based compensation expense |
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14,048 |
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|
14,832 |
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Deferred income taxes |
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(3,978 |
) |
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|
17,096 |
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Debt extinguishment costs |
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|
940 |
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|
810 |
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Other |
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1,040 |
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|
6,558 |
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Change in operating assets and liabilities: |
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Accounts receivable, net |
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(26,104 |
) |
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(22,404 |
) |
Other current assets |
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9,953 |
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|
20,457 |
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Other assets |
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2,761 |
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|
1,809 |
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Accounts payable and other accrued liabilities |
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21,066 |
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(4,893 |
) |
Accrued salaries and benefits |
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4,364 |
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(9,157 |
) |
Other liabilities |
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(793 |
) |
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|
5,257 |
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Net cash provided by continuing operating activities |
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217,886 |
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|
188,435 |
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Net cash used in discontinued operating activities |
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(572 |
) |
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(829 |
) |
Net cash provided by operating activities |
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217,314 |
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|
187,606 |
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Investing activities: |
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Cash paid for capital expenditures |
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(161,555 |
) |
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(117,521 |
) |
Cash paid for real estate acquisitions |
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(8,857 |
) |
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(22,850 |
) |
Other |
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(3,337 |
) |
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(5,938 |
) |
Net cash used in investing activities |
|
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(173,749 |
) |
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(146,309 |
) |
Financing activities: |
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Principal payments on long-term debt |
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(23,246 |
) |
|
|
(17,275 |
) |
Common stock withheld for minimum statutory taxes, net |
|
|
(2,134 |
) |
|
|
(3,678 |
) |
Other |
|
|
(5,172 |
) |
|
|
(2,270 |
) |
Net cash used in financing activities |
|
|
(30,552 |
) |
|
|
(23,223 |
) |
Effect of exchange rate changes on cash |
|
|
(840 |
) |
|
|
4,297 |
|
Net increase in cash and cash equivalents |
|
|
12,173 |
|
|
|
22,371 |
|
Cash and cash equivalents at beginning of the period |
|
|
67,290 |
|
|
|
57,063 |
|
Cash and cash equivalents at end of the period |
|
$ |
79,463 |
|
|
$ |
79,434 |
|
See accompanying notes.
5
Acadia Healthcare Company, Inc.
Notes to Condensed Consolidated Financial Statements
June 30, 2018
(Unaudited)
1. |
Description of Business and Basis of Presentation |
Description of Business
Acadia Healthcare Company, Inc. (the “Company”) develops and operates inpatient psychiatric facilities, residential treatment centers, group homes, substance abuse facilities and facilities providing outpatient behavioral healthcare services to serve the behavioral health and recovery needs of communities throughout the United States (“U.S.”), the United Kingdom (“U.K.”) and Puerto Rico. At June 30, 2018, the Company operated 585 behavioral healthcare facilities with approximately 17,900 beds in 40 states, the U.K. and Puerto Rico.
Basis of Presentation
The business of the Company is conducted through limited liability companies, partnerships and C-corporations. The Company’s consolidated financial statements include the accounts of the Company and all subsidiaries controlled by the Company through its’ direct or indirect ownership of majority interests and exclusive rights granted to the Company as the controlling member of an entity. All intercompany accounts and transactions have been eliminated in consolidation.
The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for fair presentation of our financial position and results of operations have been included. The Company’s fiscal year ends on December 31 and interim results are not necessarily indicative of results for a full year or any other interim period. The condensed consolidated balance sheet at December 31, 2017 has been derived from the audited financial statements as of that date. The information contained in these condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements and notes thereto for the fiscal year ended December 31, 2017 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on February 27, 2018. The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates.
Certain reclassifications have been made to prior years to conform to the current year presentation.
2. |
Recently Issued Accounting Standards |
In August 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2017-12, “Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities” (“ASU 2017-12”). ASU 2017-12 amends the hedge accounting model to enable entities to better portray the economics of their risk management activities in the financial statements and simplifies the application of hedge accounting in certain situations. ASU 2017-12 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2018. Early adoption is permitted. Management is evaluating the impact of ASU 2017-12 on the Company’s consolidated financial statements.
In January 2017, the FASB issued ASU 2017-04, “Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment” (“ASU 2017-04”). ASU 2017-04 simplifies the measurement of goodwill by eliminating the requirement to calculate the implied fair value of goodwill (step 2 of the current impairment test) to measure the goodwill impairment charge. Instead, entities will record impairment charges based on the excess of a reporting unit’s carrying amount over its fair value. ASU 2017-04 is effective for fiscal years beginning after December 15, 2019. Early adoption is permitted. The Company has elected to early adopt ASU 2017-04 on January 1, 2018, and there was no significant impact on the Company’s consolidated financial statements.
In August 2016, the FASB issued ASU 2016-15, “Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments” (“ASU 2016-15”). ASU 2016-15 addresses treatment of how certain cash receipts and cash payments are presented and classified in the statement of cash flows to reduce the diversity in practice. ASU 2016-15 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017. The Company adopted ASU 2016-15 on January 1, 2018. There is no significant impact on the Company’s consolidated financial statements.
6
In March 2016, the FASB issued ASU 2016-02, “Leases” (“ASU 2016-02”). ASU 2016-02’s core principle is to increase transparency and comparability among organizations by recognizing lease assets and liabilities on the balance sheet and disclosing key information. ASU 2016-02 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2018. Additionally, ASU 2016-02 would permit both public and nonpublic organizations to adopt the new standard early. Management believes the primary effect of adopting the new standard will be to record right-of-use assets and obligations for current operating leases. Management is currently evaluating the impact ASU 2016-02 will have on the Company’s consolidated financial statements, internal controls, policies and procedures.
In January 2016, the FASB issued ASU 2016-01, “Financial Instruments-Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities” (“ASU 2016-01”). ASU 2016-01 amends how entities recognize, measure, present and disclose certain financial assets and financial liabilities. It requires entities to measure equity investments (except for those accounted for under equity method) at fair value and recognize any changes in fair value in net income. ASU 2016-15 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017. The Company adopted ASU 2016-01 on January 1, 2018. There was no significant impact on the Company’s consolidated financial statements.
In May 2014, the FASB and the International Accounting Standards Board issued ASU 2014-09, “Revenue from Contracts with Customers (Topic 606)” (“ASU 2014-09”). ASU 2014-09’s core principle is that a company will recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. ASU 2014-09 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017. The Company adopted ASU 2014-09 on January 1, 2018 as described in Note 3 – Revenue.
3. |
Revenue |
ASU 2014-09 requires companies to exercise more judgment and recognize revenue using a five-step process. The Company adopted ASU 2014-09 using the modified retrospective method for all contracts effective January 1, 2018 and is using a portfolio approach to group contracts with similar characteristics and analyze historical cash collections trends. Modified retrospective adoption requires entities to apply the standard retrospectively to the most current period presented in the financial statements, requiring the cumulative effect of the retrospective application as an adjustment to the opening balance of retained earnings at the date of initial application. Prior periods have not been adjusted. No cumulative-effect adjustment in retained earnings was recorded as the adoption of ASU 2014-09 did not significantly impact the Company’s reported historical revenue.
As a result of certain changes required by ASU 2014-09, the majority of the Company’s provision for doubtful accounts are recorded as a direct reduction to revenue instead of being presented as a separate line item on the condensed consolidated statements of income. The adoption of ASU 2014-09 has no impact on the Company’s accounts receivable as it was historically recorded net of allowance for doubtful accounts and contractual adjustments, and the Company has eliminated the presentation of allowance for doubtful accounts on the condensed consolidated balance sheets. The adoption of ASU 2014-09 did not have a significant impact on the Company’s condensed consolidated statements of income. The impact of adopting ASU 2014-09 on the condensed consolidated statements of income for the three and six months ended June 30, 2018 was as follows (in thousands):
|
|
Three Months Ended June 30, 2018 |
|
|
Six Months Ended June 30, 2018 |
|
||||||||||
|
|
As Reported |
|
|
Prior to Adopting ASU 2014-09 |
|
|
As Reported |
|
|
Prior to Adopting ASU 2014-09 |
|
||||
Revenue before provision for doubtful accounts |
|
$ |
765,738 |
|
|
$ |
775,203 |
|
|
$ |
1,507,979 |
|
|
$ |
1,525,704 |
|
Provision for doubtful accounts |
|
|
— |
|
|
|
(9,465 |
) |
|
|
— |
|
|
|
(17,725 |
) |
Revenue |
|
$ |
765,738 |
|
|
$ |
765,738 |
|
|
$ |
1,507,979 |
|
|
$ |
1,507,979 |
|
The Company evaluated the nature, amount, timing and uncertainty of revenue and cash flows using the five-step process provided within ASU 2014-09.
Revenue is primarily derived from services rendered to patients for inpatient psychiatric and substance abuse care, outpatient psychiatric care and adolescent residential treatment. The services provided by the Company have no fixed duration and can be terminated by the patient or the facility at any time, and therefore, each treatment is its own stand-alone contract.
7
Services ordered by a healthcare provider in an episode of care are not separately identifiable and therefore have been combined into a single performance obligation for each contract. The Company recognizes revenue as its performance obligations are completed. The performance obligation is satisfied over time as the customer simultaneously receives and consumes the benefits of the healthcare services provided. For inpatient services, the Company recognizes revenue equally over the patient stay on a daily basis. For outpatient services, the Company recognizes revenue equally over the number of treatments provided in a single episode of care. Typically, patients and third-party payors are billed within several days of the service being performed or the patient being discharged, and payments are due based on contract terms.
As our performance obligations relate to contracts with a duration of one year or less, the Company elected the optional exemption in ASC 606-10-50-14(a). Therefore, the Company is not required to disclose the transaction price for the remaining performance obligations at the end of the reporting period or when the Company expects to recognize the revenue. The Company has minimal unsatisfied performance obligations at the end of the reporting period as our patients typically are under no obligation to remain admitted in our facilities.
The Company disaggregates revenue from contracts with customers by service type and by payor within each of the Company’s segments.
U.S. Facilities
The Company’s facilities in the United States (the “U.S. Facilities”) and services provided by the U.S. Facilities can generally be classified into the following categories: acute inpatient psychiatric facilities; specialty treatment facilities; residential treatment centers; and outpatient community-based services.
Acute inpatient psychiatric facilities. Acute inpatient psychiatric facilities provide a high level of care in order to stabilize patients that are either a threat to themselves or to others. The acute setting provides 24-hour observation, daily intervention and monitoring by psychiatrists.
Specialty treatment facilities. Specialty treatment facilities include residential recovery facilities, eating disorder facilities and comprehensive treatment centers. The Company provides a comprehensive continuum of care for adults with addictive disorders and co-occurring mental disorders. Inpatient, including detoxification and rehabilitation, partial hospitalization and outpatient treatment programs give patients access to the least restrictive level of care.
Residential treatment centers. Residential treatment centers treat patients with behavioral disorders in a non-hospital setting, including outdoor programs. The facilities balance therapy activities with social, academic and other activities.
Outpatient community-based services. Outpatient community-based programs are designed to provide therapeutic treatment to children and adolescents who have a clinically-defined emotional, psychiatric or chemical dependency disorder while enabling the youth to remain at home and within their community.
The table below presents total U.S. revenue attributed to each category (in thousands):
|
|
Three Months Ended June 30, |
|
|
Six Months Ended June 30, |
|
||||||||||
|
|
2018 |
|
|
2017 |
|
|
2018 |
|
|
2017 |
|
||||
Acute inpatient psychiatric facilities |
|
$ |
203,535 |
|
|
$ |
193,989 |
|
|
$ |
399,426 |
|
|
$ |
378,676 |
|
Specialty treatment facilities |
|
|
192,894 |
|
|
|
182,748 |
|
|
|
377,429 |
|
|
|
357,945 |
|
Residential treatment centers |
|
|
74,133 |
|
|
|
73,180 |
|
|
|
145,690 |
|
|
|
142,467 |
|
Outpatient community-based services |
|
|
10,908 |
|
|
|
11,497 |
|
|
|
21,330 |
|
|
|
22,549 |
|
Revenue |
|
$ |
481,470 |
|
|
$ |
461,414 |
|
|
$ |
943,875 |
|
|
$ |
901,637 |
|
The Company receives payments from the following sources for services rendered in our U.S. Facilities: (i) state governments under their respective Medicaid and other programs; (ii) commercial insurers; (iii) the federal government under the Medicare program administered by the Centers for Medicare and Medicaid Services (“CMS”); and (iv) individual patients and clients. As the period between the time of service and time of payment is typically one year or less, the Company elected the practical expedient under ASC 606-10-32-18 and did not adjust for the effects of a significant financing component.
8
The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients and implicit price concessions. Contractual adjustments and discounts are based on contractual agreements, discount policies and historical experience. Implicit price concessions are based on historical collection experience. Most of our U.S. Facilities have contracts containing variable consideration. However, it is unlikely a significant reversal of revenue will occur when the uncertainty is resolved, and therefore, the Company has included the variable consideration in the estimated transaction price. Subsequent changes resulting from a patient’s ability to pay are recorded as bad debt expense, which is included as a component of other operating expenses in the condensed consolidating statements of income. Bad debt expense for the three and six months ended June 30, 2018 was not significant.
The Company derives a significant portion of its revenue from Medicare, Medicaid and other payors that receive discounts from established billing rates. The Medicare and Medicaid regulations and various managed care contracts under which these discounts must be calculated are complex, subject to interpretation and adjustment, and may include multiple reimbursement mechanisms for different types of services provided in the Company’s inpatient facilities and cost settlement provisions. Management estimates the transaction price on a payor-specific basis given its interpretation of the applicable regulations or contract terms. The services authorized and provided and related reimbursement are often subject to interpretation that could result in payments that differ from the Company’s estimates. Additionally, updated regulations and contract renegotiations occur frequently, necessitating regular review and assessment of the estimation process by management.
Settlements under cost reimbursement agreements with third-party payors are estimated and recorded in the period in which the related services are rendered and are adjusted in future periods as final settlements are determined. Final determination of amounts earned under the Medicare and Medicaid programs often occurs in subsequent years because of audits by such programs, rights of appeal and the application of numerous technical provisions. In the opinion of management, adequate provision has been made for any adjustments and final settlements. However, there can be no assurance that any such adjustments and final settlements will not have a material effect on the Company’s financial condition or results of operations. The Company’s cost report receivables were $12.2 million and $9.0 million at June 30, 2018 and December 31, 2017, respectively, and were included in other current assets in the condensed consolidated balance sheets. Management believes that these receivables are properly stated and are not likely to be settled for a significantly different amount. The net adjustments to estimated cost report settlements were not significant for the three and six months ended June 30, 2018.
Management believes that we comply in all material respects with applicable laws and regulations and is not aware of any material pending or threatened investigations involving allegations of wrongdoing. Compliance with such laws and regulations can be subject to future government review and interpretation, as well as significant regulatory action including fines, penalties and exclusion from the Medicare and Medicaid programs.
The Company provides care without charge to patients who are financially unable to pay for the healthcare services they receive based on Company policies and federal and state poverty thresholds. Such amounts determined to qualify as charity care are not reported as revenue. The cost of providing charity care services were $1.2 million and $1.4 million for the three months ended June 30, 2018 and 2017, respectively. The cost of providing charity care services were $2.8 million and $3.0 million for the six months ended June 30, 2018 and 2017, respectively. The estimated cost of charity care services was determined using a ratio of cost to gross charges determined from our most recently filed Medicare cost reports and applying that ratio to the gross charges associated with providing charity care for the period.
The following table presents revenue generated by each payor type (in thousands):
|
|
Three Months Ended June 30, |
|
|
Six Months Ended June 30, |
|
||||||||||
|
|
2018 |
|
|
2017 |
|
|
2018 |
|
|
2017 |
|
||||
Commercial |
|
$ |
147,279 |
|
|
$ |
149,493 |
|
|
$ |
284,898 |
|
|
$ |
288,948 |
|
Medicare |
|
|
69,508 |
|
|
|
71,559 |
|
|
|
136,779 |
|
|
|
139,399 |
|
Medicaid |
|
|
225,567 |
|
|
|
197,279 |
|
|
|
438,846 |
|
|
|
388,113 |
|
Self-Pay |
|
|
33,379 |
|
|
|
43,561 |
|
|
|
70,286 |
|
|
|
87,243 |
|
Other |
|
|
5,737 |
|
|
|
9,269 |
|
|
|
13,066 |
|
|
|
17,822 |
|
Revenue before provision for doubtful accounts |
|
|
481,470 |
|
|
|
471,161 |
|
|
|
943,875 |
|
|
|
921,525 |
|
Provision for doubtful accounts |
|
|
— |
|
|
|
(9,747 |
) |
|
|
— |
|
|
|
(19,888 |
) |
Revenue |
|
$ |
481,470 |
|
|
$ |
461,414 |
|
|
$ |
943,875 |
|
|
$ |
901,637 |
|
9
The Company’s facilities located in the United Kingdom (the “U.K. Facilities”) and services provided by the U.K. Facilities can generally be classified into the following categories: healthcare facilities, education and children’s services, adult care facilities and elderly care facilities.
Healthcare facilities. Healthcare facilities provide psychiatric treatment and nursing for sufferers of mental disorders, including for patients whose risk of harm to others and risk of escape from hospitals cannot be managed safely within other mental health settings. In order to manage the risks involved with treating patients, the facility is managed through the application of a range of security measures depending on the level of dependency and risk exhibited by the patient.
Education and children’s services. Education and children’s services provide specialist education for children and young people with special educational needs, including autism, Asperger’s Syndrome, social, emotional and mental health, and specific learning difficulties, such as dyslexia. The division also offers standalone children’s homes for children that require 52-week residential care to support complex and challenging behavior and fostering services.
Adult care facilities. Adult care focuses on care of individuals with a variety of learning difficulties, mental health illnesses and adult autism spectrum disorders. It also includes long-term, short-term and respite nursing care to high-dependency elderly individuals who are physically frail or suffering from dementia. Care is provided in a number of settings, including in residential care homes and through supported living.
The table below presents total U.K. revenue attributed to each category (in thousands):
|
|
Three Months Ended June 30, |
|
|
Six Months Ended June 30, |
|
||||||||||
|
|
2018 |
|
|
2017 |
|
|
2018 |
|
|
2017 |
|
||||
Healthcare facilities |
|
$ |
159,060 |
|
|
$ |
141,187 |
|
|
$ |
313,860 |
|
|
$ |
273,285 |
|
Education and Children’s Services |
|
|
49,310 |
|
|
|
42,199 |
|
|
|
98,643 |
|
|
|
81,896 |
|
Adult Care facilities |
|
|
75,898 |
|
|
|
71,096 |
|
|
|
151,601 |
|
|
|
138,272 |
|
Revenue |
|
$ |
284,268 |
|
|
$ |
254,482 |
|
|
$ |
564,104 |
|
|
$ |
493,453 |
|
The Company receives payments from approximately 500 public funded sources in the U.K. (including the National Health Service (“NHS”), Clinical Commissioning Groups (“CCGs”) and local authorities in England, Scotland and Wales) and individual patients and clients. The Company determines the transaction price based on established billing rates by payor and is reduced by implicit price concessions. Implicit price concessions are insignificant in our U.K. Facilities. There is no significant variable consideration in our U.K. Facilities’ contracts. As the period between the time of service and time of payment is typically one year or less, the Company elected the practical expedient under ASC 606-10-32-18 and did not adjust for the effects of a significant financing component.
The following table presents revenue generated by each payor type (in thousands):
|
|
Three Months Ended June 30, |
|
|
Six Months Ended June 30, |
|
||||||||||
|
|
2018 |
|
|
2017 |
|
|
2018 |
|
|
2017 |
|
||||
U.K. public funded sources |
|
$ |
256,881 |
|
|
$ |
226,380 |
|
|
$ |
510,175 |
|
|
$ |
441,845 |
|
Self-Pay |
|
|
27,272 |
|
|
|
23,889 |
|
|
|
52,340 |
|
|
|
46,090 |
|
Other |
|
|
115 |
|
|
|
4,213 |
|
|
|
1,589 |
|
|
|
5,524 |
|
Revenue before provision for doubtful accounts |
|
|
284,268 |
|
|
|
254,482 |
|
|
|
564,104 |
|
|
|
493,459 |
|
Provision for doubtful accounts |
|
|
— |
|
|
|
— |
|
|
|
— |
|
|
|
(6 |
) |
Revenue |
|
$ |
284,268 |
|
|
$ |
254,482 |
|
|
$ |
564,104 |
|
|
$ |
493,453 |
|
10
The Company’s contract liabilities primarily consist of unearned revenue in our U.K. Facilities and are included in other accrued liabilities on the condensed consolidated balance sheets. A summary of the activity in unearned revenue in the U.K. Facilities is as follows (in thousands):
Balance at December 31, 2017 |
|
$ |
30,812 |
|
Payments received |
|
|
84,541 |
|
Revenue recognized |
|
|
(82,580 |
) |
Foreign currency translation loss |
|
|
(1,340 |
) |
Balance at June 30, 2018 |
|
$ |
31,433 |
|
4. |
Earnings Per Share |
The following table sets forth the computation of basic and diluted earnings per share for the three and six months ended June 30, 2018 and 2017 (in thousands, except per share amounts):
|
|
Three Months Ended June 30, |
|
|
Six Months Ended June 30, |
|
||||||||||
|
|
2018 |
|
|
2017 |
|
|
2018 |
|
|
2017 |
|
||||
Numerator: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income attributable to Acadia Healthcare Company, Inc. |
|
$ |
58,836 |
|
|
$ |
49,630 |
|
|
$ |
109,655 |
|
|
$ |
84,588 |
|
Denominator: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average shares outstanding for basic earnings per share |
|
|
87,303 |
|
|
|
86,954 |
|
|
|
87,205 |
|
|
|
86,859 |
|
Effect of dilutive instruments |
|
|
164 |
|
|
|
126 |
|
|
|
146 |
|
|
|
138 |
|
Shares used in computing diluted earnings per common share |
|
|
87,467 |
|
|
|
87,080 |
|
|
|
87,351 |
|
|
|
86,997 |
|
Earnings per share attributable to Acadia Healthcare Company, Inc. stockholders: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic |
|
$ |
0.67 |
|
|
$ |
0.57 |
|
|
$ |
1.26 |
|
|
$ |
0.97 |
|
Diluted |
|
$ |
0.67 |
|
|
$ |
0.57 |
|
|
$ |
1.26 |
|
|
$ |
0.97 |
|
Approximately 1.6 million shares of common stock issuable upon exercise of outstanding stock option awards were excluded from the calculation of diluted earnings per share for both the three months ended June 30, 2018 and 2017, respectively, because their effect would have been anti-dilutive. Approximately 2.0 million and 1.1 million shares of common stock issuable upon exercise of outstanding stock option awards were excluded from the calculation of diluted earnings per share for the six months ended June 30, 2018 and 2017, respectively, because their effect would have been anti-dilutive.
11
Other identifiable intangible assets and related accumulated amortization consisted of the following at June 30, 2018 and December 31, 2017 (in thousands):
|
|
Gross Carrying Amount |
|
|
Accumulated Amortization |
|
||||||||||
|
|
June 30, 2018 |
|
|
December 31, 2017 |
|
|
June 30, 2018 |
|
|
December 31, 2017 |
|
||||
Intangible assets subject to amortization: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Contract intangible assets |
|
$ |
2,100 |
|
|
$ |
2,100 |
|
|
$ |
(2,100 |
) |
|
$ |
(2,100 |
) |
Non-compete agreements |
|
|
1,147 |
|
|
|
1,147 |
|
|
|
(1,147 |
) |
|
|
(1,147 |
) |
|
|
|
3,247 |
|
|
|
3,247 |
|
|
|
(3,247 |
) |
|
|
(3,247 |
) |
Intangible assets not subject to amortization: |
|
|
|
|
|
|
|
|
|