Before Acadia Healthcare: Debbie Osteen’s 19 Years Building UHS’s Behavioral Division
Debbie Osteen’s appointment as Acadia Healthcare CEO in January 2026 brought an executive whose career in behavioral healthcare began decades before she first joined Acadia in 2018. Her 19 years at Universal Health Services shaped her approach to managing large-scale behavioral health operations across multiple states.
Board Chairman Reeve Waud selected Osteen for her second CEO tenure, citing her role in transforming Acadia during her first term from 2018 to 2022.
Joining UHS’s Behavioral Health Division
Osteen joined Universal Health Services in the late 1990s and rose to become Executive Vice President of UHS and President of its behavioral health division. UHS operates as one of the largest hospital systems in the United States, with behavioral health representing a significant portion of its operations.
During her tenure, Osteen led the behavioral health division’s growth into one of the nation’s largest networks of freestanding behavioral health facilities. The experience provided her with knowledge of operational systems, regulatory requirements, and workforce management at scale.
Building a National Network
Managing a multi-state behavioral health network requires coordination across numerous operational dimensions: clinical programming, regulatory compliance, workforce recruitment, facility management, and payer relations. UHS’s behavioral health division operates facilities across multiple states, each with distinct regulatory environments and market conditions.
Osteen’s nearly two decades leading this division provided experience relevant to Acadia’s even larger network. Acadia operates 278 facilities across 40 states and Puerto Rico, serving more than 82,000 patients daily.
Lessons Learned at Scale
Large behavioral health organizations face challenges different from smaller providers. Workforce recruitment and retention require national strategies rather than local approaches. Quality assurance must function consistently across hundreds of facilities. Regulatory compliance spans dozens of state licensing requirements.
Osteen’s UHS experience developed capabilities in each of these areas. When Reeve Waud and the Acadia board recruited her in 2018, she brought institutional knowledge about operating behavioral health networks at national scale.
Bringing Experience to Acadia
Her first Acadia tenure from 2018 to 2022 saw what the company describes as “a period of significant progress and evolution.” That description suggests her UHS experience translated effectively to Acadia’s operations.
Reeve Waud’s January 2026 announcement emphasized this 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.” Her return applies two decades of behavioral health leadership experience to Acadia’s current challenges.
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