The company faces persistent liquidity challenges, evidenced by negative free cash flow in eight of the last ten quarters and a peak capital expenditure intensity of 26.3% of revenue in 2024Q4.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 |
|---|
| Cash from Operations | 181.95M | 131.9M | 129.69M | 462.34M | 380.57M | 374.48M | 658.81M | 332.9M | 414.08M | 399.58M | 361.48M | 240.4M | 115.29M | 65.56M | 33.9M | -20.67M |
| Operating CF Margin % | - | 3.98% | 4.11% | 15.79% | 14.58% | 16.18% | 31.52% | 16.58% | 13.75% | 14.09% | 12.86% | 13.4% | 11.48% | 9.19% | 8.32% | -9.34% |
| Operating CF Growth % | 185.06% | 1.7% | -71.95% | 21.49% | 1.63% | -43.16% | 97.9% | -19.6% | 3.63% | 10.54% | 50.36% | 108.53% | 75.84% | 93.41% | 264.03% | - |
| Net Income | -1.11B | -1.09B | 264.48M | -15.66M | 280.03M | 195.56M | 140.26M | 110.12M | -175.49M | 199.59M | 4.18M | 118.47M | 83.04M | 42.58M | 20.5M | 2.02M |
| Depreciation & Amortization | 194.64M | 189.25M | 149.59M | 132.35M | 117.77M | 106.72M | 95.26M | 164.04M | 158.83M | 143.01M | 135.1M | 63.55M | 32.67M | 17.09M | 7.98M | 4.29M |
| Stock-Based Compensation | 30.99M | 31.71M | 37.11M | 32.29M | 29.64M | 37.53M | 0 | 17.31M | 22M | 23.47M | 28.34M | 20.47M | 10.06M | 5.25M | 2.27M | 17.32M |
| Deferred Taxes | 17.05M | 1.09M | 67.71M | -93.98M | 16.55M | 11.77M | 53.11M | 1.78M | -9.71M | 31.37M | 28.65M | 36.62M | 7.21M | 10.08M | 2.85M | -6.44M |
| Other Non-Cash Items | 1B | 1.01B | 16.68M | 400.71M | 5.94M | 66.4M | 207.06M | 70.41M | 382.06M | 20.38M | 187.32M | 19.22M | -11.58M | 12.56M | 8.48M | -32.62M |
| Working Capital Changes | 30.82M | -8.67M | -405.88M | 6.63M | -69.35M | -43.5M | 163.12M | -30.76M | 36.39M | -18.25M | -22.11M | -17.93M | -6.11M | -22M | -8.18M | -5.23M |
| Change in Receivables | -75.18M | -75.02M | -2.33M | -39.01M | -41.98M | 2.45M | 15.34M | -19.06M | -16.82M | -28.57M | -15.72M | -24.95M | -15.11M | -21.24M | -16.73M | -5.05M |
| Change in Inventory | 0 | 0 | 0 | 0 | 0 | -13.99M | 0 | 6.48M | 29.61M | 11.82M | -29.22M | -1.06M | 9.97M | -849K | 6.72M | -1.64M |
| Change in Payables | 48.53M | 14.88M | -420.89M | 17.4M | 5.17M | 6.16M | 77.99M | -21.35M | 26.05M | -10.11M | 22.69M | 6.87M | 2.79M | -848K | 485K | 3.35M |
| Cash from Investing | -424.55M | -547.58M | -736.48M | -397.22M | -305.83M | 1.02B | -281.84M | -201.14M | -360.96M | -336.53M | -660.37M | -884.47M | -860.77M | -242.98M | -524.64M | -225.57M |
| Capital Expenditures | -397.18M | -571.81M | -690.38M | -424.13M | -296.15M | -244.81M | -216.62M | -284.68M | -341.46M | -274.18M | -307.47M | -276.05M | -113.24M | -68.94M | -27.59M | -9.56M |
| CapEx % of Revenue | 11.78% | 17.26% | 21.89% | 14.48% | 11.34% | 10.58% | 10.36% | 14.17% | 11.34% | 9.67% | 10.94% | 15.38% | 11.27% | 9.66% | 6.77% | 4.32% |
| Acquisitions | 9.77M | 24.32M | -53.55M | -349K | -9.51M | 1.37B | 92K | -45.68M | -18.19M | -18.19M | -310.19M | -574.78M | -738.7M | -164.02M | -443.47M | -206.38M |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -37.14M | -90K | 7.46M | 27.26M | -174K | -269.58M | -56.97M | 31.83M | -1.31M | -44.16M | -42.7M | -33.65M | 89.15M | -10.02M | -53.58M | -9.63M |
| Cash from Financing | 309.83M | 472.61M | 583.02M | -62.7M | -110.9M | -1.64B | -51.5M | -61.63M | -67.33M | -60.07M | 358.84M | 563.6M | 837.97M | 132.59M | 479.03M | 298.74M |
| Debt Issued (Net) | 322.75M | 532.34M | 583.67M | -16.25M | -113.59M | -1.64B | -44.37M | -52.98M | -61.66M | -57.3M | -276.92M | 274.07M | 481.31M | 143.32M | 170.06M | 267.44M |
| Equity Issued (Net) | -3.15M | -50.03M | -8.55M | 0 | 0 | -5.73M | 0 | -2.22M | -3.41M | 0 | -10.23M | 331.31M | -4.67M | -1.55M | 311.84M | 67.16M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -375K |
| Share Repurchases | -3.15M | -50.03M | -8.55M | 0 | 0 | -5.73M | 0 | -1.65M | -3.41M | -3.46M | 0 | 0 | 0 | -205K | 0 | 0 |
| Other Financing | -9.76M | -9.69M | 7.9M | -46.45M | 2.69M | 5.58M | -7.13M | -6.42M | -2.27M | -2.77M | 646M | -41.77M | 361.34M | -9.18M | -2.88M | 38.96M |
| Net Change in Cash | 67.24M | 56.94M | -23.77M | 2.42M | -36.16M | -244.88M | 279.16M | 73.68M | -16.78M | 10.23M | 45.85M | -82.83M | 89.47M | -44.83M | -11.72M | 52.5M |
| Free Cash Flow | -215.22M | -439.91M | -560.69M | 38.21M | 84.42M | 129.67M | 442.19M | 48.22M | 72.62M | 125.4M | 54.01M | -35.64M | 2.04M | -3.38M | 6.3M | -30.22M |
| FCF Margin % | -6.38% | -13.28% | -17.78% | 1.3% | 3.23% | 5.6% | 21.16% | 2.4% | 2.41% | 4.42% | 1.92% | -1.99% | 0.2% | -0.47% | 1.55% | -13.65% |
| FCF Growth % | 17.27% | 21.54% | -1567.51% | -54.74% | -34.89% | -70.68% | 816.99% | -33.6% | -42.09% | 132.2% | 251.52% | -1845.54% | 160.43% | -153.61% | 120.85% | - |
| FCF per Share | -2.37 | -4.85 | -6.09 | 0.42 | 0.92 | 1.43 | 4.99 | 0.55 | 0.83 | 1.44 | 0.63 | -0.52 | 0.04 | -0.07 | 0.16 | -1.61 |
| FCF Conversion (FCF/Net Income) | 0.19x | -0.12x | 0.51x | -21.34x | 1.39x | 1.96x | -0.98x | 3.06x | -2.36x | 2.00x | 58.84x | 2.01x | 1.39x | 1.54x | 1.66x | 0.59x |
| Interest Paid | 0 | 0 | 113.4M | 80.75M | 65.69M | 93.67M | 0 | 173.24M | 175.2M | 159.1M | 161.15M | 87.03M | 36.78M | 33.27M | 27.24M | 5.05M |
| Taxes Paid | 0 | 0 | 28.15M | 66.4M | 86.19M | 79.3M | 0 | 31.91M | 6.14M | 10.29M | 15.48M | 6.91M | 32.26M | 16.96M | 3.93M | 2.56M |
Clinical labor cost inflation
Based on reported financial data, the relationship between net income and operating cash flow is highly erratic, with the OCF/NI ratio swinging from a negative 4.21 in 2024Q1 to a positive 4.43 in 2025Q2, indicating significant non-cash adjustments and accounting noise within the earnings profile.
The extreme variance in the conversion of net income to cash suggests that reported earnings are heavily influenced by non-recurring items, likely related to legal contingencies or impairment charges. Investors should view the net income figures with skepticism, as the underlying cash generation appears decoupled from the bottom-line results.
As reported in quarterly filings, Acadia has struggled to generate positive free cash flow, with the company recording negative FCF in eight of the last ten quarters, including a significant outflow of $179.5 million during the 2025Q4 period due to heavy capital expenditure requirements.
The persistent inability to generate positive free cash flow suggests that the company's aggressive expansion strategy is consuming all available internal liquidity. This trajectory implies that the business model is currently dependent on external financing or existing cash reserves to fund its ongoing growth and maintenance needs.
According to recent financial statements, Acadia's capital intensity remains elevated, with CapEx as a percentage of revenue peaking at 26.3% in 2024Q4, reflecting a heavy reliance on continuous investment to maintain and expand its 10,600-bed network across the United States and Puerto Rico.
The high level of capital expenditure relative to revenue suggests that the company is in a constant state of reinvestment, which may be necessary to combat facility aging or to meet regulatory standards. This high capital intensity limits the company's ability to pivot toward shareholder returns or debt reduction in the near term.
Financial data indicates that working capital changes have been highly inconsistent, ranging from a $96.1 million inflow in 2023Q4 to a $56.1 million outflow in 2024Q1, suggesting potential challenges in managing patient receivables and the timing of government supplemental payments across the facility network.
The volatility in working capital movements may indicate that the company is experiencing lumpy cash collections, which complicates short-term liquidity planning. This inconsistency warrants further investigation into the effectiveness of the company's revenue cycle management and its ability to convert services rendered into actual cash inflows.
Quick answers to the most common questions about buying ACHC stock.
Acadia Healthcare Company, Inc. (ACHC) generated $131.9M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Acadia Healthcare Company, Inc. (ACHC) reported negative free cash flow of $439.9M in 2025, indicating capital requirements exceeded cash from operations.
Acadia Healthcare Company, Inc. (ACHC) spent $571.8M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
In 2025, Acadia Healthcare Company, Inc. (ACHC) spent $50.0M on share repurchases. This shows the company's commitment to returning capital to its equity investors.