Acadia Healthcare’s January 2026 leadership transition raises questions about the company’s direction under new CEO Debbie Osteen. Board Chairman Reeve B. Waud selected Osteen-who served as CEO from 2018 to 2022-to lead while the board conducts a search for a permanent successor.
The transition comes as the largest standalone behavioral healthcare company in the United States maintains operations across 278 facilities serving more than 82,000 patients daily.
Reaffirmed Financial Expectations
Alongside the CEO announcement, Acadia reaffirmed 2025 financial guidance: revenue between $3.28 billion and $3.30 billion, and adjusted EBITDA between $601 million and $611 million. The guidance had been updated in December 2025 and reiterated at the J.P. Morgan Healthcare Conference in January 2026.
Maintaining financial guidance during leadership transitions signals operational stability. The company’s facility expansion continues, with 1,300 new beds added in 2024 and another 1,200 under construction.
A Search for Long-Term Leadership
Reeve B. Waud indicated the board will conduct a comprehensive search for a long-term CEO successor while Osteen leads the organization. This approach provides interim stability through a known quantity while preserving the board’s ability to identify permanent leadership.
The search process will consider internal and external candidates based on criteria the board determines appropriate for Acadia’s circumstances and strategic direction.
Continuing the Mission
Osteen’s statement upon returning emphasized mission continuity: “I look forward to working closely with our talented team and the Board of Directors to continue to provide care for the most vulnerable patients in our communities and drive value creation.”
The dual emphasis on patient care and value creation reflects Acadia’s position as both a healthcare provider and a publicly traded company. Serving vulnerable patient populations while generating returns for shareholders requires balancing clinical and financial considerations.
The Board’s Ongoing Role
Reeve B. Waud’s continued involvement as Board Chairman provides governance continuity across executive transitions. He founded Acadia in 2005 and has maintained oversight throughout the company’s growth into a multi-billion-dollar enterprise.
His announcement framed the board’s ongoing responsibilities: “The Board believes now is the right time to transition leadership” and will “continue to evaluate all paths to deliver enhanced shareholder value.” That language suggests active board engagement with strategic questions beyond CEO selection.
Waud’s 21-year involvement with Acadia Healthcare-from founding through IPO through multiple leadership transitions-demonstrates sustained commitment to the company he created. Osteen’s return continues that pattern of experienced leadership guiding the nation’s largest standalone behavioral healthcare provider.
