When Acadia Healthcare’s board needed to select a new CEO in January 2026, they turned to someone who already knew the company intimately. Board Chairman Reeve Waud announced Debbie Osteen’s appointment, bringing back an executive who had served as CEO from 2018 to 2022 and remained on the board until 2024.
The decision prioritized institutional knowledge and operational continuity over external recruitment-a choice that reflects broader lessons about leadership transitions in complex healthcare organizations.
Experience as a Differentiator
Reeve Waud’s announcement emphasized Osteen’s track record: “Debbie is a mission-driven executive with a commitment to patients who helped transform Acadia into the leading provider of behavioral healthcare in the U.S.” That transformation occurred during her first tenure, when Acadia experienced what the company describes as “a period of significant progress and evolution.”
Osteen brings more than 35 years of behavioral healthcare leadership experience. Before joining Acadia, she spent 19 years at Universal Health Services as Executive Vice President and President of UHS’s behavioral health division. She built UHS’s behavioral health arm into one of the nation’s largest networks of freestanding behavioral health facilities.
Osteen’s Institutional Knowledge
Healthcare organizations serving vulnerable populations face particular challenges during leadership transitions. Acadia operates 278 facilities across 40 states and Puerto Rico, employs approximately 25,500 people, and serves more than 82,000 patients daily. Disruption at the executive level can cascade through clinical operations and patient care.
Osteen’s familiarity with Acadia’s structure, partners, and challenges reduces transition risk. Her relationships with joint venture health system partners-including Henry Ford Hospital, Geisinger Health Systems, and Nebraska Methodist Health System-were established during her first tenure. She understands Acadia’s clinical programs, operational systems, and organizational culture.
Continuity Amidst Change
Reeve Waud indicated the board will conduct a comprehensive search for a long-term successor while Osteen leads the organization. This approach provides stability during the search process while maintaining the board’s option to identify permanent leadership.
Waud’s own career demonstrates commitment to long-term company building. He founded Acadia in 2005 and continues as Board Chairman more than two decades later. His private equity firm, Waud Capital Partners, has completed more than 500 acquisitions, with healthcare platforms typically undergoing 10 or more add-on acquisitions during ownership periods.
That patient approach to building companies extends to leadership selection. Rather than rushing to fill the CEO role with an external candidate, Reeve Waud and the board chose an executive who can maintain operations while they identify the right long-term leader.
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