Document and Entity Information
Document and Entity Information - USD ($) | 12 Months Ended | ||
Dec. 31, 2017 | Feb. 26, 2018 | Jun. 30, 2017 | |
Document Documentand Entity Information [Abstract] | |||
Document Type | 10-K | ||
Amendment Flag | false | ||
Document Period End Date | Dec. 31, 2017 | ||
Document Fiscal Year Focus | 2,017 | ||
Document Fiscal Period Focus | FY | ||
Trading Symbol | CCRN | ||
Entity Registrant Name | CROSS COUNTRY HEALTHCARE INC | ||
Entity Central Index Key | 1,141,103 | ||
Current Fiscal Year End Date | --12-31 | ||
Entity Well-known Seasoned Issuer | No | ||
Entity Current Reporting Status | Yes | ||
Entity Voluntary Filers | No | ||
Entity Filer Category | Accelerated Filer | ||
Entity Common Stock, Shares Outstanding | 36,431,790 | ||
Entity Public Float | $ 454,055,531 |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016 |
Current assets: | ||
Cash and cash equivalents | $ 25,537 | $ 20,630 |
Accounts receivable, net of allowances of $3,688 in 2017 and $3,245 in 2016 | 173,603 | 173,620 |
Prepaid expenses | 5,287 | 6,126 |
Insurance recovery receivable | 3,497 | 3,037 |
Other current assets | 963 | 2,198 |
Total current assets | 208,887 | 205,611 |
Property and equipment, net | 14,086 | 12,818 |
Goodwill | 117,589 | 79,648 |
Trade names | 26,702 | 35,402 |
Other intangible assets, net | 60,976 | 36,835 |
Non-current deferred tax assets | 20,219 | 0 |
Other non-current assets | 19,228 | 18,064 |
Total assets | 467,687 | 388,378 |
Current liabilities: | ||
Accounts payable and accrued expenses | 50,597 | 58,850 |
Accrued compensation and benefits | 34,271 | 33,243 |
Current portion of long-term debt | 6,875 | 2,250 |
Other current liabilities | 2,845 | 2,749 |
Total current liabilities | 94,588 | 97,092 |
Long-term debt, less current portion | 92,259 | 84,750 |
Non-current deferred tax liabilities | 105 | 13,154 |
Long-term accrued claims | 28,757 | 28,870 |
Contingent consideration | 5,088 | 5,301 |
Other long-term liabilities | 9,171 | 7,409 |
Total liabilities | 229,968 | 236,576 |
Commitments and contingencies | ||
Stockholders' equity: | ||
Common stock—$0.0001 par value; 100,000,000 shares authorized; 35,838,108 and 32,339,285 shares issued and outstanding at December 31, 2017 and 2016, respectively | 4 | 3 |
Additional paid-in capital | 305,362 | 256,570 |
Accumulated other comprehensive loss | (1,166) | (1,241) |
Accumulated deficit | (67,111) | (104,089) |
Total Cross Country Healthcare, Inc. stockholders' equity | 237,089 | 151,243 |
Noncontrolling interest in subsidiary | 630 | 559 |
Total stockholders' equity | 237,719 | 151,802 |
Total liabilities and stockholders' equity | $ 467,687 | $ 388,378 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016 |
Statement of Financial Position [Abstract] | ||
Accounts receivable, allowance for doubtful accounts | $ 3,688 | $ 3,245 |
Common stock, par value (usd per share) | $ 0.0001 | $ 0.0001 |
Common stock, shares authorized | 100,000,000 | 100,000,000 |
Common stock, shares issued | 35,838,108 | 32,339,285 |
Common stock, shares outstanding | 35,838,108 | 32,339,285 |
CONSOLIDATED STATEMENTS OF OPER
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Income Statement [Abstract] | |||
Revenue from services | $ 865,048 | $ 833,537 | $ 767,421 |
Operating expenses: | |||
Direct operating expenses | 636,462 | 611,802 | 570,056 |
Selling, general, and administrative expenses | 187,435 | 179,820 | 161,275 |
Bad debt expense | 1,828 | 593 | 999 |
Depreciation and amortization | 10,174 | 9,182 | 8,066 |
Loss on sale of business | 0 | 0 | 2,184 |
Acquisition-related contingent consideration | 44 | 814 | 0 |
Acquisition and integration costs | 1,975 | 78 | 902 |
Restructuring costs | 1,026 | 753 | 1,274 |
Impairment charges | 14,356 | 24,311 | 2,100 |
Total operating expenses | 853,300 | 827,353 | 746,856 |
Income from operations | 11,748 | 6,184 | 20,565 |
Other expenses (income): | |||
Interest expense | 4,214 | 6,106 | 6,810 |
(Gain) loss on derivative liability | (1,581) | (5,805) | 9,901 |
Loss on early extinguishment of debt | 4,969 | 1,568 | 0 |
Other income, net | (155) | (230) | (306) |
Income before income taxes | 4,301 | 4,545 | 4,160 |
Income tax benefit | (34,501) | (4,186) | (794) |
Consolidated net income | 38,802 | 8,731 | 4,954 |
Less: Net income attributable to noncontrolling interest in subsidiary | 1,289 | 764 | 536 |
Net income attributable to common shareholders | $ 37,513 | $ 7,967 | $ 4,418 |
Net income per share attributable to common shareholders - Basic (usd per share) | $ 1.07 | $ 0.25 | $ 0.14 |
Net income per share attributable to common shareholders - Diluted (usd per share) | $ 1.01 | $ 0.15 | $ 0.14 |
Weighted average common shares outstanding—basic (shares) | 35,018 | 32,132 | 31,514 |
Weighted average common shares outstanding—diluted (shares) | 36,166 | 36,246 | 32,162 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Statement of Comprehensive Income [Abstract] | |||
Consolidated net income | $ 38,802 | $ 8,731 | $ 4,954 |
Other comprehensive income (loss), before income tax: | |||
Unrealized foreign currency translation gain (loss) | 75 | (34) | (89) |
Other comprehensive income (loss), net of tax | 75 | (34) | (89) |
Comprehensive income | 38,877 | 8,697 | 4,865 |
Less: Comprehensive income attributable to noncontrolling interest in subsidiary | 1,289 | 764 | 536 |
Comprehensive income attributable to common shareholders | $ 37,588 | $ 7,933 | $ 4,329 |
CONSOLIDATED STATEMENTS OF STOC
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands | Total | Common Stock | Additional Paid-In Capital | Accumulated Other Total Comprehensive Loss, net | (Accumulated Deficit) Retained Earnings | Noncontrolling Interest in Subsidiary |
Beginning Balance (in shares) at Dec. 31, 2014 | 31,292,000 | |||||
Beginning Balance at Dec. 31, 2014 | $ 130,332 | $ 3 | $ 247,467 | $ (1,118) | $ (116,474) | $ 454 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Exercise of share options (in shares) | 119,000 | |||||
Vesting of restricted stock and performance stock awards (in shares) | 191,000 | |||||
Vesting of restricted stock and performance stock awards | (543) | (543) | ||||
Equity compensation | 2,460 | 2,460 | ||||
Foreign currency translation adjustment | (89) | (89) | ||||
Acquisition of Mediscan (in shares) | 350,000 | |||||
Acquisition of Mediscan | 4,724 | 4,724 | ||||
Distribution to noncontrolling shareholder | (494) | (494) | ||||
Net income | 4,954 | 4,418 | 536 | |||
Ending Balance (in shares) at Dec. 31, 2015 | 31,952,000 | |||||
Ending Balance at Dec. 31, 2015 | 141,344 | $ 3 | 254,108 | (1,207) | (112,056) | 496 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Exercise of share options (in shares) | 103,000 | |||||
Vesting of restricted stock and performance stock awards (in shares) | 284,000 | |||||
Vesting of restricted stock and performance stock awards | (917) | (917) | ||||
Equity compensation | 3,379 | 3,379 | ||||
Foreign currency translation adjustment | (34) | (34) | ||||
Distribution to noncontrolling shareholder | (701) | (701) | ||||
Net income | 8,731 | 7,967 | 764 | |||
Ending Balance (in shares) at Dec. 31, 2016 | 32,339,000 | |||||
Ending Balance at Dec. 31, 2016 | $ 151,802 | $ 3 | 256,570 | (1,241) | (104,089) | 559 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Exercise of share options (in shares) | 74,625 | 41,000 | ||||
Vesting of restricted stock and performance stock awards (in shares) | 282,000 | |||||
Vesting of restricted stock and performance stock awards | $ (1,774) | (1,774) | ||||
Shares issued for Convertible Notes (in shares) | 3,176,000 | |||||
Shares issued for Convertible Notes | 45,952 | $ 1 | 45,951 | |||
Equity compensation | 4,080 | 4,080 | ||||
Cumulative-effect adjustment - share-based compensation | 0 | 535 | (535) | |||
Foreign currency translation adjustment | 75 | 75 | ||||
Distribution to noncontrolling shareholder | (1,218) | (1,218) | ||||
Net income | 38,802 | 37,513 | 1,289 | |||
Ending Balance (in shares) at Dec. 31, 2017 | 35,838,000 | |||||
Ending Balance at Dec. 31, 2017 | $ 237,719 | $ 4 | $ 305,362 | $ (1,166) | $ (67,111) | $ 630 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Cash flows from operating activities | |||
Consolidated net income | $ 38,802 | $ 8,731 | $ 4,954 |
Adjustments to reconcile net income to net cash provided by operating activities: | |||
Depreciation and amortization | 10,174 | 9,182 | 8,066 |
Amortization of debt discount and debt issuance costs | 651 | 1,728 | 1,886 |
Provision for allowances | 4,705 | 4,034 | 1,779 |
Deferred income tax benefit | (33,812) | (5,322) | (1,544) |
(Gain) loss on derivative liability | (1,581) | (5,805) | 9,901 |
Acquisition-related contingent consideration | 44 | 769 | 0 |
Impairment charges | 14,356 | 24,311 | 2,100 |
Loss on early extinguishment of debt | 4,969 | 1,568 | 0 |
Equity compensation | 4,080 | 3,379 | 2,460 |
Other noncash costs, including loss on sale of business | 24 | 6 | 2,204 |
Changes in operating assets and liabilities: | |||
Accounts receivable | 9,708 | (30,781) | (28,708) |
Prepaid expenses and other assets | 1,816 | (1,882) | 2,663 |
Accounts payable and accrued expenses | (9,275) | 20,370 | 11,213 |
Other liabilities | 847 | (143) | 1,261 |
Net cash provided by operating activities | 45,508 | 30,145 | 18,235 |
Cash flows from investing activities | |||
Proceeds from sale of business | 0 | 500 | 7,500 |
Acquisitions, net of cash acquired | (85,977) | (1,900) | (28,721) |
Acquisition-related settlements | (292) | (1,858) | (149) |
Transaction costs related to sale of business | 0 | 0 | (338) |
Purchases of property and equipment | (5,111) | (6,522) | (2,362) |
Net cash used in investing activities | (91,380) | (9,780) | (24,070) |
Cash flows from financing activities | |||
Proceeds from Term Loans | 62,000 | 40,000 | 0 |
Principal payments on Term Loans | (1,500) | (30,500) | 0 |
Convertible Note cash payment | (5,000) | 0 | 0 |
Borrowings on revolving credit facility | 39,000 | 59,800 | 64,100 |
Repayments on revolving credit facility | (39,000) | (67,800) | (59,600) |
Debt issuance costs | (901) | (1,182) | 0 |
Extinguishment fees | (578) | (641) | 0 |
Cash paid for shares withheld for taxes | (1,774) | (917) | (543) |
Payment of contingent consideration | (261) | (152) | 0 |
Cash payments to noncontrolling shareholder | (1,217) | (701) | (494) |
Other | (13) | (71) | (108) |
Net cash provided by (used in) financing activities | 50,756 | (2,164) | 3,355 |
Effect of exchange rate changes on cash | 23 | (24) | (62) |
Change in cash and cash equivalents | 4,907 | 18,177 | (2,542) |
Cash and cash equivalents at beginning of year | 20,630 | 2,453 | 4,995 |
Cash and cash equivalents at end of year | 25,537 | 20,630 | 2,453 |
Supplemental disclosure of cash flow information: | |||
Interest paid | 3,408 | 3,893 | 5,052 |
Income taxes paid | $ 697 | $ 1,773 | $ 1,035 |
Organization and Basis of Prese
Organization and Basis of Presentation | 12 Months Ended |
Dec. 31, 2017 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Organization and Basis of Presentation | Organization and Basis of Presentation Cross Country Healthcare, Inc. (the Company) was incorporated in Delaware on July 29, 1999 as a business providing travel nurse and allied health staffing services. As of December 31, 2017, the Company is a leading national provider of nurse and allied staffing, recruiting, and value-added workforce solution services, multi-specialty locum tenens (temporary physician staffing) services, as well as a provider of other human capital management services focused on healthcare. The consolidated financial statements include the accounts of the Company and its direct and indirect wholly-owned subsidiaries. The consolidated financial statements include all assets, liabilities, revenue, and expenses of Cross Country Talent Acquisition Group, LLC (formerly InteliStaf of Oklahoma, LLC), which is controlled by the Company but not wholly owned. The Company records the ownership interest of the noncontrolling shareholder as noncontrolling interest in subsidiary. All intercompany transactions and balances have been eliminated in consolidation. Certain prior year amounts have been reclassified to conform to the current year presentation. See consolidated balance sheets and consolidated statements of cash flows. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2017 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | Summary of Significant Accounting Policies Use of Estimates The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (U.S. GAAP), requires management to make estimates and assumptions that affect the reported amounts in the consolidated financial statements and accompanying notes. Significant estimates and assumptions are used for, but not limited to: (1) the valuation of accounts receivable; (2) goodwill, trade names, and other intangible assets; (3) other long-lived assets; (4) share-based compensation; (5) accruals for health, workers’ compensation, and professional liability claims; (6) valuation of deferred tax assets; (7) purchase price allocation; (8) derivative liability; (9) legal contingencies; (10) contingent considerations; (11) income taxes; and, (12) sales and other non-income tax liabilities. Accrued insurance claims and reserves include estimated settlements from known claims and actuarial estimates for claims incurred but not reported. Actual results could differ from those estimates. Cash and Cash Equivalents The Company considers all investments with original maturities of three months or less to be cash and cash equivalents. The Company invests its excess cash in highly rated overnight funds and other highly rated liquid accounts. The Company is exposed to credit risk associated with these investments. The Company minimizes its credit risk relating to these positions by monitoring the financial condition of the financial institutions involved and by primarily conducting business with large, well established financial institutions, and diversifying its counterparties. The Company does not currently anticipate nonperformance by any of its significant counterparties. Interest income on cash and cash equivalents is included in other income, net, on the Company’s consolidated statements of operations. Accounts Receivable, Allowance for Doubtful Accounts, and Concentration of Credit Risk Accounts receivable potentially subject the Company to concentrations of credit risk. The Company’s customers are primarily healthcare providers, and accounts receivable represent amounts due from them. The Company generally does not require collateral and mitigates its credit risk by performing credit evaluations and monitoring at-risk accounts. The allowance for doubtful accounts represents the Company’s estimate of uncollectible receivables based on a review of specific accounts and the Company’s historical collection experience. The Company writes off specific accounts based on an ongoing review of collectability as well as past experience with the customer. In addition, the Company maintains a sales allowance for customer disputes which may arise in the ordinary course, which is recorded as contra-revenue. The Company’s contract terms typically require payment between 15 to 60 days from the date services are provided and are considered past due based on the particular negotiated contract terms. The majority of the Company's business activity is with hospitals located throughout the United States. No single customer accounted for more than 10% of the Company’s accounts receivable balance as of December 31, 2017 and 2016 , or revenue for the years ended December 31, 2017 , 2016 , and 2015 . Prepaid Rent and Deposits The Company leases apartments for eligible field employees under short-term agreements (typically three to six months), which generally coincide with each employee’s staffing contract. Costs relating to these leases are included in direct operating expenses on the accompanying consolidated statements of operations. As a condition of these agreements, the Company may place security deposits on the leased apartments. Deposits on field employees’ apartments related to these short-term agreements are included in other current assets on the accompanying consolidated balance sheets. Property and Equipment Property and equipment are stated at cost, less accumulated depreciation. Depreciation is determined on a straight-line basis over the estimated useful lives of the assets, which generally range from three to seven years. Leasehold improvements are depreciated over the shorter of their estimated useful life or the term of the individual lease. On an annual basis, the Company reviews its property and equipment listings and disposes of assets that are no longer in use. Certain software development costs have been capitalized in accordance with the provisions of the Intangibles-Goodwill and Other/Internal-Use Software Topic of the Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC). Such costs include charges for consulting services and costs for Company personnel associated with programming, coding, and testing such software. Amortization of capitalized software costs begins when the software is ready for use and is included in depreciation expense in the accompanying consolidated statements of operations. Software development costs are being amortized using the straight-line method over three to five years. Business Combinations The Company applies accounting in accordance with the Business Combinations Topic of the FASB ASC when it acquires control over a business. Business combinations are accounted for at fair value. The associated acquisition costs are expensed as incurred and recorded as acquisition and integration costs; noncontrolling interests, if any, are reflected at fair value at the acquisition date; restructuring costs associated with a business combination are expensed; contingent consideration is measured at fair value at the acquisition date, with changes in the fair value after the acquisition date affecting earnings; and goodwill is determined as the excess of the fair value of the consideration conveyed in the acquisition over the fair value of the net assets acquired. The accounting for business combinations requires estimates and judgments as to expectations for future cash flows of the acquired business, and the allocation of those cash flows to identifiable intangible assets, in determining the estimated fair value for assets and liabilities acquired. The fair values assigned to tangible and intangible assets acquired and liabilities assumed are based on management's estimates and assumptions, including valuations that utilize customary valuation procedures and techniques. If the actual results differ from the estimates and judgments used in these estimates, the amounts recorded in the financial statements could result in a possible impairment of the intangible assets and goodwill, or require acceleration of the amortization expense of finite-lived intangible assets. The results of the acquired businesses' operations are included in the consolidated statements of operations of the combined entity beginning on the date of acquisition. See Note 3 - Acquisitions. Goodwill, Trade Names, and Other Intangible Assets Goodwill represents the excess of purchase price and related costs over the fair value assigned to the net tangible and identifiable intangible assets of businesses acquired. Other identifiable intangible assets with definite lives are being amortized using the straight-line method over their estimated useful lives which range from 1 to 16 years. Goodwill and certain intangible assets with indefinite lives are not amortized. Instead, in accordance with the Intangibles-Goodwill and Other Topic of the FASB ASC, these assets are reviewed for impairment annually at the beginning of the fourth quarter, and whenever circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. When reviewed, the Company has the option to first assess qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount, as a basis for determining whether it is necessary to perform the quantitative testing. If it is determined that a quantitative test is necessary or more efficient than a qualitative approach, the Company generally measures the fair value of its reporting units using a combination of income and market approaches. For the periods prior to the fourth quarter of 2017, the performance of the quantitative impairment test involved a two-step process. The first step required the Company to determine the fair value of each of its reporting units and compare it to the reporting unit’s carrying amount. If the reporting unit's fair value was less than its carrying amount, the Company was required to perform a second step to calculate the implied value of goodwill. The implied value was then compared to its carrying amount to calculate the impairment charge, if any. Beginning in the fourth quarter of 2017, for its annual review on October, 1, 2017, the Company early adopted the provisions of Accounting Standards Update (ASU) 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment. Under ASU 2017-04, the second step of the quantitative assessment is eliminated, and, if the reporting unit’s carrying value exceeds its fair value, an impairment charge is recognized for the amount by which the carrying amount exceeds the reporting unit’s fair value not to exceed the total amount of goodwill allocated to that reporting unit. Additionally, income tax effects from any tax deductible goodwill on the carrying amount of the reporting unit when measuring the goodwill impairment loss is considered, if applicable. See Recently Adopted Accounting Pronouncements. The Company determines its reporting units by identifying its operating segments and any component businesses and aggregates the components businesses if they have similar economic characteristics. The Company had the following reporting units that it reviewed for impairment: 1) Nurse and Allied Staffing; 2) Physician Staffing; and 3) Search. Management considers historical experience and all available information at the time the fair values of its reporting units are estimated. However, fair values that could be realized in an actual transaction may have differed from those used to evaluate the potential impairment of goodwill. Long-lived assets and identifiable intangible assets with definite lives are evaluated for impairment in accordance with the Property, Plant, and Equipment Topic of the FASB ASC. In accordance with this Topic, long-lived assets and definite-lived intangible assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount may not be recoverable. Recoverability of long-lived assets is measured by a comparison of the carrying amount of the asset group to the future undiscounted net cash flow that is expected to be generated by those assets. If such assets are considered to be impaired, the impairment charge recognized is the amount by which the carrying amount of the assets exceeds the fair value of the assets. Any related impairment losses are recognized in earnings and included in the caption impairment charges on the consolidated statements of operations. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets. Debt Discount and Debt Issuance Costs Stated discounts on proceeds, and other fees reimbursed to lender, as well as the initial value of any embedded derivative features of the Convertible Notes and Term Loans, as defined in Note 8 - Debt, are treated as a discount associated with the respective debt instrument and presented in the balance sheet as an offset to the carrying amount of the debt. Discounts are amortized to interest expense using the effective interest rate method, or a method that approximates the effective interest rate method, over the expected life of the debt. Deferred costs related to the issuance of the Convertible Notes and the Term Loans were capitalized and are presented in the balance sheet as a direct deduction from the carrying amount of the debt liability. Deferred costs are amortized using the effective interest method. Deferred costs related to the Convertible Notes were written off in connection with the repayment of such Convertible Notes. See Note 8 - Debt. Deferred costs related to the issuance of the Company’s Revolving Credit Facilities and Senior Secured Asset-Based Loan, as defined in Note 8 - Debt, have been capitalized and included in other assets on the consolidated balance sheets, and amortized using the straight line method over the term of the related credit agreement. Derivative Financial Instruments The Company evaluates embedded conversion features within its convertible debt in accordance with the Derivatives and Hedging Topic of the FASB ASC to determine whether the embedded conversion feature should be bifurcated from the host instrument and accounted for as a derivative at fair value. The Company used a trinomial lattice model to estimate the fair value of embedded conversion and redemption features in its convertible debt at the end of each applicable reporting period. Changes in the fair value of these derivatives during each reporting period were reported in other expenses (income) on the consolidated statements of operations. The fair value at inception had been recorded as debt discount and was being amortized to interest expense over the term of the note using the effective interest method. On March 17, 2017, the Company paid in full its Convertible Notes and, as a result, derecognized the derivative liability. See Note 8 - Debt. Sales and Other State Non-income Tax Liabilities The Company accrues sales and other state non-income tax liabilities based on the Company’s best estimate of its probable liability utilizing currently available information and interpretation of relevant tax regulations. Given the nature of the Company’s business, significant subjectivity exists as to both whether sales and other state non-income taxes can be assessed on its activity and how the sales tax will ultimately be measured by the relevant jurisdictions. The Company makes a determination for each reporting period whether the estimates for sales and other non-income taxes in certain states should be revised. Insurance Claims The Company provides workers’ compensation insurance coverage, professional liability coverage, and healthcare benefits for eligible employees. The Company records its estimate of the ultimate cost of, and reserves for, workers' compensation and professional liability benefits based on actuarial models prepared or reviewed by an independent actuary using the Company’s loss history as well as industry statistics. The healthcare insurance accrual is for estimated claims that have occurred but have not been reported and is based on the Company’s historical claim submission patterns. Furthermore, in determining its reserves, the Company includes reserves for estimated claims incurred but not reported as well as unfavorable claims development. The Other Expenses/Insurance Costs Topic of the FASB ASC previously issued authoritative accounting guidance in the area of insurance contracts and related activity thereto. This topic concluded that, under circumstances such as in the Company’s insured professional liability and workers' compensation policies, since a right of legal offset does not exist due to the fact that there are three parties to an incurred claim, the insured, the insurer, and the claimant, the related liability to the claimant should be classified separately on a gross basis with a separate related receivable from the insurer recognized as being due from insurance carriers. Accordingly, the Company’s consolidated balance sheets as of December 31, 2017 and 2016 reflect the related short-term liabilities in accrued compensation and benefits and the related long-term liabilities as long-term accrued claims, and the short-term receivable portion as insurance recovery receivable and the long-term portion as non-current insurance recovery receivable. See Note 7 - Balance Sheet Details. The ultimate cost of workers’ compensation, professional liability, and health insurance claims will depend on actual amounts incurred to settle those claims and may differ from the amounts reserved by the Company for those claims. Workers’ compensation benefits are provided under a partially self-insured plan. The Company has letters of credit to guarantee payments of claims. At December 31, 2017 and 2016 , the Company had outstanding approximately $19.6 million and $20.2 million , respectively, of standby letters of credit as collateral to secure the self-insured portion of this plan. The Company has occurrence-based primary professional liability policies that provide the Company and each working professional in its nurse and allied healthcare business with coverage. Effective January 1, 2016, the Company has a claims-made professional liability policy for its physicians and advanced practitioners, with a $0.5 million self-insured retention per claim. Prior to January 1, 2016, the Company had an occurrence-based professional liability policy for its independent contractor physicians and advanced practitioners which was insured by a wholly-owned subsidiary, Jamestown Indemnity, Ltd., a wholly-owned Cayman Island captive company (the Captive), until its voluntary liquidation in the third quarter of 2015. Beginning in March 2015, the Company's Physician subsidiary self-insured $0.5 million for each of its professional liability claims. Under the terms of the Captive’s reinsurance policy there was a requirement to guarantee the payment of claims to its insured party’s primary medical malpractice insurance carrier via a letter of credit. As a result of the Captive's liquidation, the letter of credit was reduced. As of both December 31, 2017 and 2016 , the value of the letter of credit was $2.0 million. Subject to certain limitations, the Company also has umbrella liability coverage for its working nurses and allied healthcare professionals. While this umbrella coverage does not extend to professional liability claims against its independent contractor physicians and advanced practitioners, it does cover claims brought against all of the Company’s subsidiaries for non-patient general liability. Revenue Recognition The Company recognizes revenue when it is earned and when all of the following criteria are met: persuasive evidence of the arrangement exists; delivery has occurred or the service has been provided and the Company has no remaining obligations; the fee is fixed or determinable; and, collectability is reasonably assured. The Company includes reimbursable expenses in revenues, and the associated amounts of reimbursable expenses in cost of services. Temporary Staffing Revenue Revenue from services consists primarily of temporary staffing revenue. Revenues from temporary staffing, net of sales adjustments and discounts, are recognized when earned, based on hours worked by the Company’s healthcare professionals. Billings to customers are based on specific contract provisions which may include approval of submitted time by our customers. Accordingly, accounts receivable includes estimated revenue for employees’ and independent contractors’ time worked but not yet invoiced. At December 31, 2017 and 2016 , the Company's estimate of amounts that had not been billed totaled $41.8 million and $41.2 million, respectively, and are included in accounts receivable on the consolidated balance sheets. Permanent Placement Revenue on permanent placements is recognized when services provided are substantially completed. The Company does not, in the ordinary course of business, provide refunds. If a candidate leaves a permanent placement within a relatively short period of time, it is customary for the Company to provide a replacement at no additional cost. Gross Versus Net Policies The Company records revenue on a gross basis as a principal or on a net basis as an agent depending on the arrangement, as follows: Managed Service Programs Arrangements The Company has entered into certain contracts with acute care facilities to provide comprehensive managed service programs (MSP). Under these contract arrangements, the Company uses its healthcare professionals along with those of third-party subcontractors to fulfill customer orders. If its healthcare professional is used, revenue is recorded on a gross basis. If a subcontractor is used, the customer is invoiced for their services and a subcontractor liability is recorded in accrued expenses, but only the resulting administrative fee is recognized as revenue. The subcontractor is paid after the Company has received payment from the acute care facility. The Company determined that it acts as an agent in these arrangements. Physician Staffing The Physician Staffing business enters into contracts with its healthcare customers to provide temporary staffing services. The Company uses independent contractors for these services. The Company determined that it acts as a principal in this arrangement and, therefore, revenue is reported on a gross basis in the consolidated statements of operations. Education Seminars During the third quarter of 2015, the Company completed the sale of its education seminars business, Cross Country Education, LLC (CCE). See Note 4 - Disposal. Prior to the sale of CCE, revenue from the Company’s Education Seminars services was recognized as the independent contractor-led seminars were performed. In the Company’s Education Seminars business, revenue was recorded in the consolidated statements of operations on a gross basis as a principal. Share-Based Compensation The Company has, from time to time, granted stock options, stock appreciation rights, performance-based stock awards, and restricted stock for a fixed number of common shares to employees. In accordance with the Compensation-Stock-Compensation Topic of the FASB ASC, companies may choose from alternative valuation models. The Company used the Black-Scholes method of valuing its options and stock appreciation rights. The Company has elected to recognize compensation expense on a straight-line basis over the requisite service period of the entire award. The Company values its restricted stock awards and the fair value of its performance-based stock awards by reference to its stock price on the date of grant. The Company granted performance-based stock awards to certain key personnel pursuant to its 2014 Omnibus Incentive Plan as described in Note 14 - Stockholders' Equity. Pursuant to the plan, the number of target shares that vest are determined based on the level of attainment of the targets. If a minimum level of performance is attained for the awards, restricted stock is issued with a vesting date in the future, subject to the employee's continuing employment. The Company recognizes performance-based restricted stock as compensation expense based on the most likely probability of attaining the prescribed performance and over the requisite service period beginning at its grant date and through the date the restricted stock vests. The Company used historical data of options with similar characteristics to estimate pre-vesting option forfeitures, as it believed that historical behavior patterns are the best indicators of future behavior patterns. Compensation expense related to share-based payments is included in selling, general, and administrative expenses in the consolidated statements of operations, and totaled $4.1 million, $3.4 million, and $2.5 million, during the years ended December 31, 2017 , 2016 , and 2015 , respectively. See Note 14 - Stockholders’ Equity. Advertising The Company’s advertising expense consists primarily of online advertising, internet direct marketing, print media, promotional material and, prior to the sale of CCE, direct mail marketing. Advertising costs that were expensed as incurred totaled $7.6 million , $10.2 million, and $4.9 million, for the years ended December 31, 2017 , 2016 , and 2015 , respectively. Prior to the sale of CCE, direct mail marketing costs associated with the Company’s education seminars services were capitalized when the Company determined that there was a reasonable expectation that the cost of the incurred advertising would be recovered from the gross profit generated by the advertised event and expensed when the related event took place. There are no such costs included in prepaid expenses on the December 31, 2017 and 2016 consolidated balance sheets. Restructuring Costs The Company considers restructuring activities to be programs whereby it fundamentally changes its operations, such as closing and consolidating facilities, reducing headcount and realigning operations in response to changing market conditions. As a result, restructuring costs on the consolidated statements of operations include on-going benefit costs for its employees and exit costs. Reconciliations of the beginning and ending total restructuring liability balances are presented below: Year Ended December 31, 2017 2016 2015 (amounts in thousands) On-Going Benefit Costs Exit Costs On-Going Benefit Costs Exit Costs On-Going Benefit Costs Exit Costs Balance at beginning of period $ 325 $ 273 $ 44 $ 338 $ — $ — Charged to restructuring costs 522 504 563 190 633 641 Payments (760 ) (336 ) (282 ) (255 ) (589 ) (303 ) Balance at end of period $ 87 $ 441 $ 325 $ 273 $ 44 $ 338 Deferred Rent Deferred rent consists of free rent, rent escalation, tenant improvement allowances, and other incentives received from landlords related to the operating leases for our facilities. Rent escalation represents the difference between actual operating lease payments due and straight-line rent expense, which we record over the term of the lease. The excess is recorded as a deferred credit in the early periods of the lease, when cash payments are generally lower than straight-line rent expense, and is reduced in the later periods of the lease when payments begin to exceed the straight-line expense. Tenant allowances from landlords for tenant improvements are generally comprised of cash received from the landlord or paid on our behalf as part of the negotiated terms of the lease. These tenant improvement allowances and other leasehold incentives are recorded when realizable as deferred rent and are amortized as a reduction of periodic rent expense, over the term of the applicable lease. See Note 12 - Commitments and Contingencies. Income Taxes The Company accounts for income taxes under the Income Taxes Topic of the FASB ASC. Deferred income tax assets and liabilities are determined based upon differences between the financial reporting and tax basis of assets and liabilities, and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to reverse. The Company recognizes in its financial statements the impact of a tax position if that position is more likely than not of being sustained on audit, based on the technical merits of the position. The Company recognizes interest and penalties related to unrecognized tax benefits in the provision for income taxes. The Company determines the need for a valuation allowance by assessing the probability of realizing deferred tax assets, taking into consideration all available positive and negative evidence, including historical operating results, expectations of future taxable income, carryforward periods available to the Company for tax reporting purposes, the evaluation of various income tax planning strategies, and other relevant factors. The Company maintains a valuation allowance when it is more likely than not that all or a portion of a deferred tax asset will not be realized based on consideration of all available evidence. Adjustments to the deferred tax valuation allowances are made to earnings in the period when such assessments are made. Significant judgment is required in making this assessment and to the extent future expectations change, the Company would have to assess the recoverability of its deferred tax assets at that time. See Note 13 - Income Taxes. Comprehensive Income (Loss) Total comprehensive income (loss) includes net income or loss and foreign currency translation adjustments, net of any related deferred taxes. Certain of the Company’s foreign subsidiaries use their respective local currency as their functional currency. In accordance with the Foreign Currency Matters Topic of the FASB ASC, assets and liabilities of these operations are translated at the exchange rates in effect on the balance sheet date. Income statement items are translated at the average exchange rates for the period. The cumulative impact of currency fluctuations related to the balance sheet translation is included in accumulated other comprehensive loss in the accompanying consolidated balance sheets and was approximately $1.2 million at both December 31, 2017 and 2016 . During the period ended December 31, 2017, $0.2 million of income tax expense was included in the consolidated statements of operations due to the impact of a change in federal tax rate on the deferred tax asset related to foreign currency cumulative translation. See Note 13 - Income Taxes. There was no income tax impact related to foreign currency translation adjustments for the period ended December 31, 2016. During the period ended December 31, 2015 , $0.2 million of income tax expense related to foreign currency translation adjustments was included on the Company's consolidated statements of comprehensive income (loss). Fair Value Measurements The Company complies with the provisions of the Fair Value Measurements and Disclosures Topic of the FASB ASC, which defines fair value, establishes a framework for measuring fair value under U.S. GAAP, and expands disclosures about fair value measurements. As of December 31, 2017 and 2016 , the Company’s financial assets and liabilities required to be measured on a recurring basis were its deferred compensation liability, its Convertible Notes derivative liability, and its contingent consideration liabilities. See Note 10 - Fair Value Measurements. Earnings Per Share In accordance with the requirements of the Earnings Per Share Topic of the FASB ASC, basic earnings per share is computed by dividing net income available to common shareholders (numerator) by the weighted average number of vested unrestricted common shares outstanding during the period (denominator). Diluted earnings per share gives effect to all dilutive potential common shares outstanding during the period including stock appreciation rights and options and unvested restricted stock, as calculated utilizing the treasury stock method, and Convertible Notes using the if-converted method prior to their payment in full in the first quarter of 2017. Recently Adopted Accounting Pronouncements In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment, to simplify how an entity is required to test goodwill for impairment by eliminating Step 2 from the goodwill impairment test. Under this guidance, an entity would perform its annual, or interim goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount. An impairment charge would be recognized for the amount by which the carrying amount exceeds the reporting unit’s fair value; however, the loss recognized should not exceed the total amount of goodwill allocated to that reporting unit. Additionally, an entity would consider income tax effects from any tax deductible goodwill on the carrying amount of the reporting unit when measuring the goodwill impairment loss. An entity still has the option to perform the qualitative assessment for a reporting unit to determine if the quantitative impairment test is necessary. ASU 2017-04 is effective for annual or any interim goodwill impairment tests in fiscal years beginning after December 15, 2019 and is to be applied prospectively. Early adoption was permitted for interim or annual goodwill impairment tests performed on testing dates after January 1, 2017. The Company elected to early adopt this standard in its fourth quarter of 2017, which was the first quarter in which an impairment test was performed. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets. In August 2016, the Financial Accounting Standards Board (FASB) issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments , which amends the guidance in ASC 230 on the classification of certain cash receipts and payments in the statement of cash flows. This update intended to reduce the diver |
Acquisitions
Acquisitions | 12 Months Ended |
Dec. 31, 2017 | |
Business Combinations [Abstract] | |
Acquisitions | Acquisitions Advantage RN Effective July 1, 2017, the Company acquired all of the assets of Advantage RN, LLC and its subsidiaries (collectively, Advantage) for cash consideration of $86.6 million , net of cash acquired. The total purchase price of $88.0 million was subject to a net working capital reduction of $0.6 million at the closing and an additional $0.8 million was received during the third quarter of 2017 as the final adjustment for net working capital. Additionally, $0.6 million of the purchase price was deferred as of the closing and is due the seller within 20 months , less any Cobra and healthcare payments incurred by the Company on behalf of the seller. As of December 31, 2017, approximately $0.3 million has been paid for claims and the remaining $0.3 million liability is included in other current and long-term liabilities on the Company’s balance sheet. Included in the amount paid at closing were two escrow accounts, the first was $14.5 million which related to tax liabilities and the second was $7.5 million which was to cover any post-close liabilities. On July 28, 2017, $7.3 million related to the tax liabilities was released from escrow, leaving a balance of $7.2 million , with the escrow to cover post-close liabilities remaining unchanged. The Company financed the purchase using $19.9 million in available cash and $66.9 million in borrowing under its Credit Facility, including a $40.0 million incremental term loan, which was subsequently refinanced on August 1, 2017. See Note 8 - Debt for further information. The transaction was treated as a purchase of assets for income tax purposes. Advantage is primarily a travel nurse staffing company that deploys many of its nurses through MSPs and Vendor Management Systems, and Advantage maintains direct relationships with many hospitals throughout the United States. This was a strategic acquisition to help the Company fill its recent MSP contract wins and for revenue growth. The acquisition has been accounted for in accordance with the Business Combinations Topic of the FASB ASC, using the acquisition method of accounting. As such, the results of Advantage from July 1, 2017 are included in the Company's consolidated statement of operations and were: revenue of $47.0 million and contribution income, as defined in Note 17 - Segment Data, of $3.8 million . The acquisition results have been substantially aggregated with the Company's Nurse and Allied Staffing business segment, with less than 2% of the business included in the Physician Staffing business segment. See Note 17 - Segment Data. The following is the estimated fair value of the purchase price for Advantage on July 1, 2017: (amounts in thousands) Purchase price $ 88,000 Net working capital adjustments (1,438 ) Cash consideration 86,562 Cash acquired 2,833 Total consideration $ 89,395 The purchase price was allocated to the assets acquired and the liabilities assumed based on the estimated fair value at the date of acquisition. The Company used a third-party appraiser to assist with the determination of the fair value and estimated useful lives of certain acquired assets and liabilities. The following table is an estimate of the fair value of the assets acquired and liabilities assumed on July 1, 2017. (amounts in thousands) Cash and cash equivalents $ 2,833 Accounts receivable 14,396 Other current assets 392 Property and equipment 333 Goodwill 43,596 Other intangible assets 29,900 Total assets acquired 91,450 Accounts payable and accrued expenses 368 Accrued employee compensation and benefits 1,685 Other current liabilities 2 Total liabilities assumed 2,055 Net assets acquired $ 89,395 The Company assigned the following values to other identifiable intangible assets: $4.5 million to trade names with a weighted average estimated useful life of 10 years, $13.8 million to customer relationships with a weighted average estimated useful life of 10 years, $11.3 million to a database, consisting of healthcare professionals, with a weighted average estimated useful life of 10 years, and $0.3 million to non-compete agreements with a weighted average estimated useful life of 5 years, for a total of $29.9 million in definite life intangible assets with a weighted average estimated useful life of 10 years. The remaining excess purchase price over the fair value of net assets acquired of $43.6 million was recorded as goodwill, which is expected to be deductible for tax purposes. Associated acquisition-related costs incurred were $2.0 million and have been included in acquisition and integration costs on the Company's condensed consolidated statement of operations for the year ended December 31, 2017. Pro Forma Financial Information The following unaudited pro forma financial information approximates the consolidated results of operations of the Company as if the Advantage acquisition had occurred as of January 1, 2016, after giving effect to certain adjustments, including additional interest expense on the amount the Company borrowed on the date of the transaction, the amortization of acquired intangible assets, and the elimination of certain expenses that will not be recurring in post-acquisition periods, net of an estimated income tax impact. These adjustments include removing transaction-related expenses of approximately $2.0 million for the year ended December 31, 2017. These results are not necessarily indicative of future results as they do not include incremental investments in support functions, elimination of costs for integration or operating synergies, or an estimate of any impact on interest expense resulting from the operating cash flow of the acquired businesses, among other adjustments that could be made in the future but are not factually supportable on the date of the transaction. Year Ended December 31, 2017 2016 (unaudited, amounts in thousands except per share data) Revenue from services $ 916,149 $ 934,904 Net income attributable to common shareholders $ 40,255 $ 11,391 Net income per common share attributable to common shareholders - basic $ 1.16 $ 0.35 Net income per common share attributable to common shareholders - diluted $ 1.09 $ 0.25 US Resources Healthcare On December 1, 2016, the Company completed the acquisition of a recruitment process outsourcing business, US Resources Healthcare, LLC (USR). This acquisition expands the Company's workforce solutions offerings to deliver financial and operating efficiencies through labor optimization services while enhancing the quality of care. The agreement specified that the sellers were eligible to receive additional purchase price consideration of $4.5 million , with a maximum of $1.0 million for 2017, $2.0 million for 2018, and $1.5 million for 2019, based on attainment of specific performance criteria achieved in each of those years. In the fourth quarter of 2017, the Company recognized a decrease in the fair value of the liability of $1.3 million included as acquisition-related contingent consideration on its consolidated statements of operations. The adjustment was driven by the decrease in the projected USR 2018 and 2019 revenue and EBITDA amounts. As of December 31, 2017, the fair value of the remaining obligation was estimated at $0.2 million and is included in other current liabilities and contingent consideration on the condensed consolidated balance sheets. See Note 10 - Fair Value Measurements. The acquisition was deemed immaterial and has been accounted for in accordance with the Business Combinations Topic of the FASB ASC, using the acquisition method of accounting. USR's results of operations are included in the consolidated statements of operations from December 1, 2016 and have been included in the Company's Nurse and Allied Staffing business segment. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets and Note 10 - Fair Value Measurements. Mediscan On October 30, 2015, the Company completed the acquisition of all of the membership interests of New Mediscan II, LLC, Mediscan Diagnostic Services, LLC, and Mediscan Nursing Staffing, LLC (collectively Mediscan) for a purchase price of $29.9 million in cash ( $28.0 million plus working capital estimate) and $4.7 million in shares (or 349,871 shares) of the Company's Common Stock, subject to a net working capital adjustment. The shares of Common Stock issued in connection with the acquisition were subject to a lockup period, which ended April 30, 2016. The Company financed the purchase price through a combination of cash-on-hand and borrowings under the Company's senior credit facility. The transaction has been treated as a purchase of assets for income tax purposes. In the first quarter of 2016, a net working capital adjustment of $0.3 million was settled. Additionally, an amount of $5.0 million of the purchase price that was held in escrow to cover any post-closing liabilities, was released to the sellers on May 3, 2017. The agreement also specified that the sellers were eligible to receive additional purchase price consideration of $7.0 million , with $3.5 million per year based on attainment of specific performance criteria in 2016 and 2017. As of December 31, 2016, the Company determined that the first year earnout was not achieved for 2016 and, as of September 30, 2017, the Company determined that the second year earnout would not be achieved for 2017. In connection with the Mediscan acquisition, the Company also assumed additional contingent purchase price liabilities for a previously acquired business that are payable annually based on specific performance criteria for the 2016 through 2019 years. Payments related to the 2016 through 2018 years are limited to $0.3 million per year and 2019 is uncapped. As of December 31, 2017 , the fair value of the remaining obligations was estimated at $5.2 million and is included in other current liabilities and contingent consideration on the consolidated balance sheets. See Note 10 - Fair Value Measurements. Mediscan provides temporary healthcare staffing and workforce solutions to both the healthcare and education markets - both public and charter schools. At the time of acquisition, while largely concentrated in California, Mediscan provided services across 11 states to more than 300 clients through more than 70 specialties. The Mediscan acquisition provided the Company a new customer base in the healthcare staffing market for public schools and the workforce solutions arena for charter schools. The acquisition has been accounted for in accordance with the Business Combinations Topic of the FASB ASC , using the acquisition method of accounting. Mediscan's results of operations are included in the consolidated statements of operations from October 30, 2015 and have been included in the Company's Nurse and Allied Staffing business segment. As such, the associated goodwill related to the acquisition is fully allocated to Nurse and Allied Staffing. The amounts of revenue and net income included in the Company's consolidated income statement from the acquisition date to the period ended December 31, 2015 were $6.7 million and $0.3 million , respectively. The following is the estimated fair value of the purchase price for Mediscan on October 30, 2015: (amounts in thousands) Cash purchase price paid at closing $ 28,000 Fair value of shares 4,723 Fair value of contingent consideration 3,686 Net working capital adjustment, including receivable 503 Total consideration $ 36,912 The purchase price was allocated to the assets acquired and the liabilities assumed based on the estimated fair value at the date of acquisition. The following table summarizes the fair value of the assets acquired and liabilities assumed. The Company used a third-party appraiser to assist with the determination of the fair value and estimated useful lives of acquired assets and liabilities assumed as of October 30, 2015: (amounts in thousands) Cash and cash equivalents $ 79 Accounts receivable 6,851 Other current assets 140 Property and equipment 20 Goodwill 14,338 Other intangible assets 17,200 Total assets acquired 38,628 Accounts payable and accrued expenses 306 Accrued employee compensation and benefits 1,410 Total liabilities assumed 1,716 Net assets acquired $ 36,912 The Company assigned the following values to other intangible assets: $3.2 million to trade names with a weighted average estimated useful life of 11 years, $5.2 million to customer relations with an estimated useful life of 10 years, and $8.8 million to a database with an estimated useful life of 10 years, for a total of $17.2 million in definite life intangible assets with a weighted average estimated useful life of 10 years. The remaining excess purchase price over the fair value of net assets acquired of $14.3 million was recorded as goodwill, which is expected to be deductible for tax purposes. Associated acquisition costs incurred were $0.7 million and have been included in acquisition and integration costs on the Company's consolidated statement of operations for the year ended December 31, 2015. Medical Staffing Network On June 30, 2014, the Company acquired substantially all of the assets and certain liabilities of Medical Staffing Network Healthcare, LLC (MSN). Of the purchase price, $2.5 million was deferred and due to the seller 21 months from the acquisition date, less any COBRA expenses incurred by the Company on behalf of former MSN employees over that period. The Company incurred $0.4 million in COBRA expenses since the MSN acquisition and, on April 1, 2016, released to the seller the remaining liability of $2.1 million . |
Disposal
Disposal | 12 Months Ended |
Dec. 31, 2017 | |
Discontinued Operations and Disposal Groups [Abstract] | |
Disposal | Disposal On July 21, 2015, the Company's Board of Directors approved an agreement to sell the Company's education seminars business, CCE, which provided in-person seminars to healthcare professionals and was non-core to the Company’s business. The operating results of CCE were included in the Other Human Capital Management Services segment. See Note 17 - Segment Data for further information. The Company used the net proceeds from the transaction to finance, in part, the Mediscan acquisition in the fourth quarter of 2015. See Note 3 - Acquisitions. Since the disposal of the education seminars business did not represent a strategic shift that would have a major effect on the Company’s operations and financial results, it was not reflected as discontinued operations. On July 27, 2015, the Company entered into an Agreement and Plan of Merger to sell its wholly-owned subsidiary, CCE, to a third party (Buyer) and on August 31, 2015, the sale was completed. The Company received $8.0 million in cash, subject to a net working capital adjustment, of which $0.5 million was held in escrow for a period of 12 months following the closing to provide partial security to the Buyer in the event of any breach of the representations, warranties and covenants of the Company. In September 2016, the full amount of escrow, which had been reflected as an escrow receivable, was released to the Company. The purchase price also included an earnout of up to $0.5 million related to the performance of CCE for the year ended December 31, 2015, which was treated as contingent consideration. The Company assigned no fair value to this earnout as of December 31, 2015 as the performance-based milestones were not met. The original escrow amount was released to the Buyer in the first quarter of 2016. The Company recognized a pre-tax loss of $2.2 million related to the sale of the business, which is included in income (loss) from operations in its consolidated statements of operations for the year ended December 31, 2015. In addition, the Company recorded a tax benefit of $3.5 million from the reversal of valuation allowances associated with this business, resulting in an after-tax gain on the sale of CCE of $1.3 million . |
Goodwill, Trade Names, and Othe
Goodwill, Trade Names, and Other Intangible Assets | 12 Months Ended |
Dec. 31, 2017 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Goodwill, Trade Names, and Other Intangible Assets | The Company had the following acquired intangible assets: December 31, 2017 December 31, 2016 Gross Accumulated Net Gross Accumulated Net (amounts in thousands) Intangible assets subject to amortization: Databases $ 42,909 $ 18,702 $ 24,207 $ 31,609 $ 16,147 $ 15,462 Customer relationships 55,524 25,912 29,612 41,724 23,316 18,408 Non-compete agreements 3,919 3,600 319 3,619 3,527 92 Trade names 7,716 878 6,838 3,216 343 2,873 Other intangible assets, net $ 110,068 $ 49,092 $ 60,976 $ 80,168 $ 43,333 $ 36,835 Intangible assets not subject to amortization: Trade names 26,702 35,402 $ 87,678 $ 72,237 As of December 31, 2017 , estimated annual amortization expense is as follows: Years Ending December 31: (amounts in thousands) 2018 $ 7,167 2019 7,131 2020 7,027 2021 6,819 2022 6,743 Thereafter 26,089 $ 60,976 The changes in the carrying amount of goodwill by segment are as follows: Nurse and Allied Staffing Segment Physician Staffing Segment Other Human Capital Management Services Segment Total (amounts in thousands) Balances as of December 31, 2016 Aggregate goodwill acquired $ 304,277 $ 43,405 $ 19,307 $ 366,989 Sale of CCE — — (9,889 ) (9,889 ) Accumulated impairment loss (259,732 ) (17,720 ) — (277,452 ) Goodwill, net of impairment loss 44,545 25,685 9,418 79,648 Changes to aggregate goodwill in 2017 Goodwill acquired (a) 43,596 — — 43,596 Impairment charges — (5,655 ) — (5,655 ) Balances as of December 31, 2017 Aggregate goodwill acquired 347,873 43,405 19,307 410,585 Sale of CCE — — (9,889 ) (9,889 ) Accumulated impairment loss (259,732 ) (23,375 ) — (283,107 ) Goodwill, net of impairment loss $ 88,141 $ 20,030 $ 9,418 $ 117,589 _______________ (a) Goodwill acquired from the acquisition of Advantage. See Note 3 - Acquisitions. 2017 Impairment Charges The Company performed its annual quantitative impairment test of goodwill and other indefinite-lived intangible assets as of October 1, 2017. Upon completion of the impairment testing, it was determined that the estimated fair value of the Physician Staffing reporting unit’s trade name was less than its carrying amount resulting in impairment. For its goodwill impairment testing, with the exception of its Physician Staffing reporting unit, the estimated fair value of its reporting units exceeded their respective carrying values. Projections of revenue, operating costs, and expected cash flows of each reporting unit are inputs into the quantitative testing for goodwill and intangible assets. The Company reduced its long-term revenue forecast for the Physician Staffing business segment in the fourth quarter. The lower than expected revenue was driven by lower booking volumes, partly due to the loss of customers. In addition, margins of the reporting unit were negatively impacted from continued investments in the business. As a result, the Company recorded non-cash impairment charges of $8.7 million related to its trade names and $5.7 million related to goodwill during the fourth quarter. 2016 and 2015 Impairment Charges The Company performed its annual impairment test as of October 1, 2016. Upon completion of the impairment testing, the Company determined that no impairment of goodwill, trade names, or other intangible assets was warranted. During an evaluation of goodwill, trade names, and other intangible assets at June 30, 2016, the Company determined that indicators were present in the Physician Staffing reporting unit which would suggest the fair value of the reporting unit may have declined below its carrying value. The Physician Staffing reporting unit was under-performing relative to management’s expectations. The lower than expected revenue was driven by lower booking volumes partly due to the loss of customers, and margins were negatively impacted from continued investments in the business all through the first half of 2016. The Company considered these factors to be impairment indicators that warranted impairment testing of goodwill, trade names, and other intangible assets. The interim impairment testing resulted in the carrying values of goodwill, trade names, and other intangible assets for Physician Staffing to exceed their estimated fair values. As a result, the interim impairment testing was performed which resulted in the carrying values of goodwill, trade names, and other intangible assets for Physician Staffing to exceed their estimated fair values. As a result, the Company recorded a non-cash impairment charge totaling $24.3 million : $17.7 million related to goodwill, $0.6 million related to trade names, and $6.0 million related to customer relationships. The Company performed its annual impairment testing as of October 1, 2015. Upon completion of the impairment testing, the Company determined that the estimated fair value of its reporting units exceeded their respective carrying values. Accordingly, no goodwill impairment charges were warranted for these reporting units. However, in conjunction with the annual impairment testing of trade names in the fourth quarter of 2015, the Company reduced its long-term revenue forecast for the Physician Staffing business segment which caused the calculation of estimated fair value of the trade names to be less than its carrying amount, resulting in a non-cash impairment charge of $2.1 million . The reduced long-term revenue forecast for 2015 was impacted by lower projected volume resulting from an under-investment in new revenue producers to keep pace with attrition. No additional impairments of indefinite-lived intangible assets were identified. Quantitative Methods and Assumptions Trade Names The Relief From Royalty methodology was utilized to value the Physician Staffing trade names using projected cash flows of an estimated royalty fee. The royalty rate was determined by a blended rate using the Market Royalty Rate Method and the Apportionment of Profit Method. Goodwill The discounted cash flows serve as the primary basis for the income approach and are based on the Company’s discrete financial forecast of revenue, gross profit margins, operating costs and cash flows. The forecast considers historical and estimated future results, general economic and market conditions, as well as the impact of planned business and operational strategies. For its 2017 testing, the assumptions used in the income approach included discount rates of 11.0% to 15.0% and a terminal value growth rate of 3.0% for cash flows beyond the discrete forecast period of ten years. Assumptions used in the market approach testing included valuation multiples based on an analysis of multiples for comparable public companies. The Company utilized total enterprise value/Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA) multiples ranging from 5.8 to 15.0 . The concluded fair value was based on a weighting of 75% applied to the income approach and 25% to the market approach for its Physician Staffing and Search reporting units and a 50% weighting was applied to the components of each approach to estimate the total fair value of goodwill for its Nurse and Allied Staffing reporting unit. This weighting was an estimate by management and was developed based on the specific characteristics, risks and uncertainties of the reporting units. Customer Relationships The Multi-Period Excess Earnings Method (MPEEM) methodology was utilized for valuing the Physician Staffing customer relationships in its interim impairment testing for the second quarter of 2016. The MPEEM estimates the fair value based on the present value of the allocated future economic benefits. The inputs include the projected revenue and associated expenses from the customers, an estimated attrition rate, and a discount rate of 13.5% . Although management believes that the Company's current estimates and assumptions are reasonable and supportable, there can be no assurance that the estimates and assumptions made for purposes of the impairment testing will prove to be accurate predictions of future performance. |
Property and Equipment
Property and Equipment | 12 Months Ended |
Dec. 31, 2017 | |
Property, Plant and Equipment [Abstract] | |
Property and Equipment | The Company's property and equipment consists of the following: December 31, Useful Lives 2017 2016 (amounts in thousands) Computer equipment 3-5 years $ 6,432 $ 13,584 Computer software 3-5 years 24,933 28,752 Office equipment 5-7 years 1,379 2,397 Furniture and fixtures 5-7 years 4,680 3,969 Leasehold improvements (a) 7,340 7,257 44,764 55,959 Less accumulated depreciation and amortization (30,678 ) (43,141 ) $ 14,086 $ 12,818 _______________ (a) See Note 2 – Summary of Significant Accounting Policies. |
Balance Sheet Details
Balance Sheet Details | 12 Months Ended |
Dec. 31, 2017 | |
Balance Sheet Related Disclosures [Abstract] | |
Balance Sheet Details | December 31, 2017 2016 (amounts in thousands) Insurance recovery receivable: Insurance recovery for health $ — $ 279 Insurance recovery for workers’ compensation 1,623 1,271 Insurance recovery for professional liability 1,874 1,487 $ 3,497 $ 3,037 Other non-current assets: Insurance recovery for workers’ compensation claims $ 6,093 $ 5,857 Insurance recovery for professional liability claims 10,011 10,353 Non-current security deposits 1,095 925 Non-current income tax receivable 1,044 — Net debt issuance costs 985 929 $ 19,228 $ 18,064 Accrued compensation and benefits: Salaries and payroll taxes $ 16,342 $ 15,480 Bonuses 2,067 3,915 Accrual for workers’ compensation claims 5,957 5,266 Accrual for professional liability claims 2,683 2,433 Accrual for healthcare benefits 5,105 4,053 Accrual for vacation 2,117 2,096 $ 34,271 $ 33,243 Long-term accrued claims: Accrual for workers’ compensation claims $ 13,160 $ 12,817 Accrual for professional liability claims 15,597 16,053 $ 28,757 $ 28,870 Other long-term liabilities: Deferred compensation $ 1,467 $ 1,472 Deferred rent 6,875 5,011 Long-term unrecognized tax benefits 485 874 Other 344 52 $ 9,171 $ 7,409 |
Debt
Debt | 12 Months Ended |
Dec. 31, 2017 | |
Debt Disclosure [Abstract] | |
Debt | he Company's long-term debt consists of the following: December 31, 2017 December 31, 2016 Principal Unamortized Discount and Debt Issuance Costs Principal Unamortized Discount and Debt Issuance Costs (amounts in thousands) Term Loan, interest of 3.61% and 2.62% at December 31, 2017 and 2016, respectively $ 100,000 $ (866 ) $ 39,500 $ (363 ) Convertible Notes, fixed rate interest of 8.00% — — 25,000 (4,669 ) Convertible Notes derivative liability — — 27,532 — Total debt 100,000 (866 ) 92,032 (5,032 ) Less current portion (6,875 ) — (2,250 ) — Long-term debt $ 93,125 $ (866 ) $ 89,782 $ (5,032 ) As of December 31, 2017 , the aggregate scheduled maturities of debt are as follows: Term Loan (amounts in thousands) Through Years Ending December 31: 2018 $ 6,875 2019 7,500 2020 8,125 2021 10,000 2022 67,500 Total $ 100,000 Amendment and Restatement of Senior Credit Facility On August 1, 2017, the Company entered into an Amendment and Restatement of its Credit Agreement dated June 22, 2016 (Amended and Restated Credit Agreement), to refinance and increase the current aggregate committed size of the facility to $215.0 million , including a term loan of $100.0 million (Amended Term Loan) and a $115.0 million revolving credit facility (Amended Revolving Credit Facility) (together with the Amended Term Loan, the Amended Credit Facilities). The Amended Revolving Credit Facility includes a subfacility for swingline loans up to an amount not to exceed $15.0 million , and a $35.0 million sublimit for the issuance of standby letters of credit. The proceeds of $106.5 million from this refinancing included $6.5 million under the new revolving credit facility and were used to repay borrowings under the Company’s 2016 Senior Credit Facilities (as defined below), as well as to pay related interest, fees, and expenses of the transaction. In addition to increasing the size of the facilities, the maturity date was extended to August 1, 2022. The Amended and Restated Credit Agreement also includes an accordion feature permitting the Company, subject to certain conditions, to increase the aggregate amount of the commitments under the Amended Revolving Credit Facility or establish one or more additional term loans in an aggregate amount not to exceed $50.0 million with optional additional commitments from existing lenders or new commitments from additional lenders. Other terms and pricing are substantially similar to the 2016 Credit Agreement (as defined below). Borrowings under the Amended Term Loan are payable in quarterly installments, commencing January 2, 2018, in an aggregate per annum amount equal to 5% for the first four installments, 7.5% for the next eight installments, and 10% for the remaining installments; provided that, to the extent not previously paid, the aggregate unpaid principal balance would be due and payable on the maturity date. Subject to the Amended and Restated Credit Agreement, the Company pays interest on (i) each Base Rate Loan at the Base Rate (as defined therein) plus the Applicable Margin in effect from time to time, (ii) each LIBOR Index Rate Loan at the One Month LIBOR Index Rate (as defined therein) plus the Applicable Margin in effect from time to time and (iii) each Eurodollar Loan at the Adjusted LIBOR for the applicable Interest Period (as defined therein) in effect for such Loan plus the Applicable Margin in effect from time to time. The Applicable Margin, as of any date, is a percentage per annum determined by reference to the applicable Consolidated Net Leverage Ratio (as defined by the agreement) in effect on such date as set forth in the table below. Level Consolidated Net Leverage Ratio Eurodollar Loans, LIBOR Index Rate Loans and Letter of Credit Fee Base Rate Loans Commitment Fee I Less than 1.50:1.00 1.75% 0.75% 0.25% II Greater than or equal to 1.50:1.00 but less than 2.00:1.00 2.00% 1.00% 0.30% III Greater than or equal to 2.00:1.00 but less than 2.50:1.00 2.25% 1.25% 0.30% IV Greater than or equal to 2.50:1.00 but less than 3.00:1.00 2.50% 1.50% 0.35% V Greater than or equal to 3.00:1.00 2.75% 1.75% 0.40% As of December 31, 2017 , the Amended Term Loan and Amended Revolving Credit Facility bore interest at a rate equal to One Month LIBOR plus 2.25% . The interest rate is subject to an increase of 2.00% if an event of default exists under the Amended and Restated Credit Agreement. The Company is required to pay a commitment fee on the average daily unused portion of the Amended Revolving Credit Facility, based on the Applicable Margin which was 0.30% as of December 31, 2017 . The Company has the right at any time and from time to time to prepay any borrowing, in whole or in part, without premium or penalty, by giving irrevocable written notice (or telephonic notice promptly confirmed in writing) except that such notice shall be revocable if a prepayment is being made in anticipation of concluding a financing arrangement, and the Company is ultimately unable to secure such financing arrangement. The Company is required to prepay the Amended Credit Facilities under certain circumstances including from net cash proceeds from asset sales or dispositions in excess of certain thresholds, as well as from net cash proceeds from the issuance of certain debt by the Company. The Amended and Restated Credit Agreement contains customary representations, warranties, and affirmative covenants. The Amended and Restated Credit Agreement also contains customary negative covenants, subject to some exceptions, on: (i) indebtedness and preferred equity; (ii) liens; (iii) fundamental changes; (iv) investments; (v) restricted payments; and, (vi) sale of assets and certain other restrictive agreements. The Amended and Restated Credit Agreement also contains customary events of default, such as payment defaults, cross-defaults to other material indebtedness, bankruptcy and insolvency, the occurrence of a defined change in control and the failure to observe the negative covenants and other covenants related to the operation of the Company’s business. The Amended and Restated Credit Agreement also includes two financial covenants: (i) limiting a maximum Consolidated Total Leverage ratio (as defined therein) to be no greater than 3.50 :1.00 for the fiscal quarters ending September 30, 2017 through June 30, 2018, 3.25 :1.00 for the fiscal quarters ending September 30, 2018 through June 30, 2019, and 3.00 :1.00 for each fiscal quarter ending thereafter and as adjusted pursuant to a Qualified Permitted Acquisition (as defined therein); and (ii) requiring a minimum Consolidated Fixed Charge Coverage ratio (as defined therein) as of the end of each fiscal quarter of 1.50 :1.00. As of December 31, 2017 , the Company was in compliance with the financial covenants and other covenants contained in the Credit Agreement. The obligations under the Amended and Restated Credit Agreement are guaranteed by all of the Company’s domestic wholly-owned subsidiaries and are secured by a first-priority security interest in the Collateral (as defined therein). As of December 31, 2017 , the Company has $21.6 million letters of credit outstanding and $93.4 million available under the Amended Revolving Credit Facility. The letters of credit relate to the Company’s workers’ compensation and professional liability insurance policies. 2016 Senior Credit Facilities On June 22, 2016, the Company entered into a senior credit agreement (2016 Credit Agreement), which provided for an initial term loan of $40.0 million (Term Loan) and a revolving credit facility of up to $100.0 million (Revolving Credit Facility) (together with the Term Loan, the 2016 Senior Credit Facilities) both of which would have matured on June 22, 2021. The Revolving Credit Facility included a subfacility for swingline loans up to an amount not to exceed $15.0 million , and a $35.0 million sublimit for the issuance of standby letters of credit. Proceeds of the Senior Credit Facilities were used primarily to refinance the Company’s prior senior secured asset-based credit facility and $30.0 million Second Lien Term Loan and to pay related transaction fees and expenses, including a redemption premium of $0.6 million . The repayment of the Second Lien Term Loan was treated as extinguishment of debt and, as a result, the Company recognized a loss on extinguishment of debt of approximately $1.6 million in the second quarter of 2016, related to the write-off of unamortized net debt discount and issuance costs as well as transaction fees and expenses. On July 5, 2017, the Company entered into a Second Amendment to its 2016 Credit Agreement primarily to allow for the acquisition of Advantage including a reset of the Applicable Margin to Level III, based on the incremental borrowings and consistent with the prior pricing grid (or 2.25% for Eurodollar Loans and LIBOR Index Rate Loans, 1.25% for Base Rate Loans and a 0.30% commitment fee). Also, on July 5, 2017, the Company entered into an Incremental Term Loan Agreement for $40.0 million with SunTrust as Lender and Administrative Agent to pay for part of the consideration of the acquisition of Advantage. The Incremental Term Loan maturity date was June 22, 2021 and was prepayable at any time without penalty. Borrowings under the Incremental Term Loan were payable in quarterly installments, commencing September 30, 2017, with each such installment being in the aggregate principal amount (subject to adjustment as a result of prepayments) for the first eight installments equal to 1.875% and 2.5% of the principal amount of the Incremental Term Loan for the remaining installments; provided that, to the extent not previously paid, the aggregate unpaid principal balance would be due and payable on the maturity date. As of July 5, 2017 the Applicable Margin for Eurodollar Loans and LIBOR Index Rate Loans was 2.25% and the Applicable Margin for Base Rate Loans was 1.25% . Convertible Notes The Company and certain of its domestic subsidiaries entered into a Convertible Note Purchase Agreement (the Note Purchase Agreement), with certain note holders (collectively, the Noteholders) on June 30, 2014. Pursuant to the Note Purchase Agreement, the Company sold to the Noteholders an aggregate of $25.0 million of convertible notes (the Convertible Notes). On March 17, 2017, the Company paid in full the Convertible Notes. In connection with the repayment, the Company issued to the Noteholders an aggregate of 3,175,584 shares of Common Stock, par value $0.0001 , and cash in the aggregate amount of $5.6 million (of which $5.0 million is included in repayment of debt and $0.6 million is presented as extinguishment fees, both within financing activities on the condensed consolidated statements of cash flows). Upon derecognition of the net carrying amounts of the Convertible Notes (the remaining $20.0 million after the $5.0 million cash payment) and derivative liability ( $26.0 million ), the Company recognized a non-cash charge of $5.0 million as loss on early extinguishment and a non-cash addition to additional paid-in capital of $46.0 million for the fair value of the shares, which is not presented on the consolidated statements of cash flows. The loss on early extinguishment of debt includes the write-off of unamortized loan fees and remaining interest due through the Forced Conversion date (defined below) of June 30, 2017. The Convertible Notes were convertible at the option of the holders thereof at any time into shares of the Common Stock at a conversion price of $7.10 per share, or 3,521,126 shares of Common Stock. After three years from the issuance date, the Company had the right to force a conversion of the Convertible Notes if the volume-weighted average price (VWAP) per share of its Common Stock exceeded 125% of the then conversion price for 20 days of a 30 day trading period (Forced Conversion date). The Convertible Notes bore interest at a rate of 8.00% per annum, payable in quarterly cash installments. The Convertible Notes would have matured on June 30, 2020, unless earlier repurchased, redeemed or converted. Subject to certain exceptions, the Company was not permitted to redeem the Convertible Notes until June 30, 2017. |
Convertible Notes Derivative Li
Convertible Notes Derivative Liability | 12 Months Ended |
Dec. 31, 2017 | |
Derivative Instruments and Hedging Activities Disclosure [Abstract] | |
Convertible Notes Derivative Liability | Convertible Notes Derivative Liability On March 17, 2017, the Company paid in full its Convertible Notes and, as a result, derecognized the derivative liability. See Note 8 - Debt. The Company has not used derivative financial instruments to hedge exposures to cash-flow, market or foreign-currency risks. However, the Company issued Convertible Notes with features that were either (i) not afforded equity classification, (ii) embody risks not clearly and closely related to host contracts, or (iii) may be net-cash settled by the counterparty. As required by the Accounting for Derivative Financial Instruments and Hedging Activities Topic of the FASB ASC, in certain instances, these instruments were required to be carried as derivative liabilities, at fair value, in the financial statements. The Convertible Notes were subject to anti-dilution adjustments that allowed for the reduction in the Conversion Price, as defined in the agreement, in the event the Company subsequently issued equity securities including Common Stock or any security convertible or exchangeable for shares of Common Stock for a price less than the then current conversion price. In addition, the Convertible Notes allowed the issuer to exercise optional redemption features and the holder to exercise an offer to purchase feature, under certain conditions. The Company accounted for the conversion option in accordance with the Accounting for Derivative Financial Instruments and Hedging Activities Topic of the FASB ASC. Since this conversion feature is not considered to be solely indexed to the Company’s own stock the derivative was recorded as a liability in the line item long-term debt on the Company's consolidated balance sheets. The Company’s Convertible Notes derivative liability was measured at fair value using a trinomial lattice model. The optional redemption features, along with the offer to purchase features, were incorporated into the valuation model. Inputs into the model required estimates, including such items as estimated volatility of the Company’s stock, estimated credit risk of the Company, estimated probabilities of change of control and issuance of additional financing, risk-free interest rate, and the estimated life of the financial instruments being fair valued. In addition, since the conversion price contained an anti-dilution adjustment, the probability that the Conversion Price of the Notes would decrease as the share price decreased was incorporated into the valuation calculation. The fair value of the derivative liability was primarily determined by fluctuations in the Company's stock price. In addition, changes in the Company's credit risk profile impacted the fair value determination. These fluctuations resulted in a current period gain or loss that was presented on the consolidated statements of operations as (gain) loss on derivative liability. |
Fair Value Measurements
Fair Value Measurements | 12 Months Ended |
Dec. 31, 2017 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | Fair Value Measurements The Fair Value Measurements and Disclosures Topic of the FASB ASC defines fair value as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. This topic also establishes a fair value hierarchy which requires an entity to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. The standard describes three levels of inputs that may be used to measure fair value: Level 1 —Quoted prices in active markets for identical assets or liabilities. Level 2 —Observable inputs other than Level 1 prices such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 —Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. Items Measured at Fair Value on a Recurring Basis The Company’s financial assets/liabilities required to be measured on a recurring basis were its: deferred compensation liability included in other long-term liabilities, Convertible Notes derivative liability included in long-term debt and capital lease obligations, and contingent consideration liabilities. Deferred compensation —The Company utilizes Level 1 inputs to value its deferred compensation liability. The Company’s deferred compensation liability is measured using publicly available indices that define the liability amounts, as per the plan documents. Convertible notes derivative liability —The Company utilized Level 3 inputs to value its Convertible Notes derivative liability. See Note 9 - Convertible Notes Derivative Liability. Contingent purchase price liabilities —Potential earnout payments related to the acquisition of Mediscan and USR are contingent upon meeting certain performance requirements through 2019. The long-term portion of these liabilities is included in contingent consideration, and the short-term portion is included in other current liabilities on the consolidated balance sheets. The Company utilized Level 3 inputs to value these contingent consideration liabilities as significant unobservable inputs were used in the calculation of their fair value. Both of the Mediscan contingent consideration liabilities have been measured at fair value using a discounted cash flow model in a Monte Carlo simulation setting, utilizing significant unobservable inputs, including the expected volatility of the acquisitions' gross profits and an estimated discount rate commensurate with the risks of the expected gross profit stream. In the third quarter of 2017, the Company determined that one of the contingent consideration earnouts related to the Mediscan acquisition would not be achieved for 2017 and, as a result, the entire earnout was reversed. The USR contingent consideration is recorded as a liability and measured at fair value using a discounted cash flow model utilizing significant unobservable inputs, including the probability of achieving each of the potential milestones and an estimated discount rate commensurate with the risks of the expected cash flows attributable to the milestones. See Note 3 - Acquisitions. The fair value of contingent consideration and the associated liabilities will be adjusted to fair value at each reporting date until actual settlement occurs, with the changes in fair value and related accretion reflected as acquisition-related contingent consideration on the consolidated statements of operations. Significant increases (decreases) in the volatility or in any of the probabilities of success, or decreases (increases) in the discount rate would result in a significantly higher (lower) fair value, respectively, and commensurate changes to these liabilities. The table which follows summarizes the estimated fair value of the Company’s financial assets and liabilities measured on a recurring basis: Fair Value Measurements December 31, 2017 December 31, 2016 Financial Liabilities: (amounts in thousands) (Level 1) Deferred compensation $ 1,467 $ 1,472 (Level 3) Convertible Notes derivative liability $ — $ 27,532 Contingent purchase price liabilities $ 5,368 $ 5,603 The table which follows reconciles the opening balances to the closing balances for fair value measurements categorized within Level 3 of the fair value hierarchy: Contingent Purchase Convertible Notes Price Liabilities (a) Derivative Liability (amounts in thousands) December 31, 2015 $ 3,686 $ 33,337 Additions 1,300 — Payments (152 ) — Accretion expense 887 — Valuation gain for the period (118 ) (5,805 ) December 31, 2016 5,603 27,532 Payments/Settlements (280 ) (25,951 ) Accretion expense 967 — Valuation gain for the period (922 ) (1,581 ) December 31, 2017 $ 5,368 $ — _______________ (a) Related to the Mediscan acquisition on October 30, 2015 and the USR acquisition on December 1, 2016. See Note 3 - Acquisitions. Valuation gain and accretion expense is included as acquisition-related contingent consideration on the consolidated statements of operations. Items Measured at Fair Value on a Non-recurring Basis The Company's non-financial assets, such as goodwill, trade names, other intangible assets, and property and equipment, are measured at fair value when there is an indicator of impairment and are recorded at fair value only when an impairment charge is recognized. During an evaluation of goodwill, trade names, and other intangible assets during the years ended December 31, 2017, 2016, and 2015, the carrying value of goodwill, trade names, and other intangible assets in the Physician Staffing reporting unit exceeded their fair values. As a result, the Company recorded impairment charges that incorporates fair value measurements based on Level 3 inputs. For further discussion on measuring the Company's non-financial assets, specifically goodwill, trade names, and customer relationships. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets. Other Fair Value Disclosures Financial instruments not measured or recorded at fair value in the accompanying consolidated balance sheets consist of cash and cash equivalents, accounts receivable, accounts payable and accrued expenses, and short and long-term debt. The estimated fair value of accounts receivable, accounts payable, and accrued expenses approximate their carrying amount due to the short-term nature of these instruments. The estimated fair value of the Company’s debt was calculated using a discounted cash flow analysis and appropriate valuation methodologies using Level 2 inputs from available market information. The following table represents the carrying amounts and estimated fair value of the Company’s significant financial instruments that were not measured at fair value: December 31, 2017 December 31, 2016 Carrying Fair Carrying Fair (amounts in thousands) Financial Liabilities: (Level 2) Term Loan, net $ 99,134 $ 100,500 $ 39,137 $ 41,500 Convertible Notes, net $ — $ — $ 20,331 $ 27,250 Concentration of Risk The Company has invested its excess cash in highly-rated overnight funds and other highly-rated liquid accounts. The Company has been exposed to credit risk associated with these investments. The Company minimizes its credit risk relating to these positions by monitoring the financial condition of the financial institutions involved and by primarily conducting business with large, well established financial institutions and diversifying its counterparties. The Company generally does not require collateral and mitigates its credit risk by performing credit evaluations and monitoring at-risk accounts. The allowance for doubtful accounts represents the Company’s estimate of uncollectible receivables based on a review of specific accounts and the Company’s historical collection experience. The Company writes off specific accounts based on an ongoing review of collectability as well as past experience with the customer. The Company’s contract terms typically require payment between 15 to 60 days from the date services are provided and are considered past due based on the particular negotiated contract terms. Overall, based on the large number of customers in differing geographic areas, primarily throughout the United States and its territories, the Company believes the concentration of credit risk is limited. |
Employee Benefit Plans
Employee Benefit Plans | 12 Months Ended |
Dec. 31, 2017 | |
Retirement Benefits [Abstract] | |
Employee Benefit Plans | Employee Benefit Plans The Company maintains a voluntary defined contribution 401(k) profit-sharing plan covering all eligible employees as defined in the plan documents. The plan provides for a discretionary matching contribution, which is equal to a percentage of each eligible contributing participant’s elective deferral, which the Company, at its sole discretion, determines from year to year. Contributions by the Company, net of forfeitures, under this plan amounted to $0.7 million , $0.8 million , and $0.7 million for the years ended December 31, 2017 , 2016 , and 2015 , respectively. Eligible employees who elect to participate in the plan are generally vested in any existing matching contribution after three years of service with the Company. The Company offers a non-qualified deferred compensation program to certain key employees whereby they may defer a portion of annual compensation for payment upon retirement. The program is unfunded for tax purposes and for purposes of Title I of the Employee Retirement Income Security Act of 1974. The liability for the deferred compensation is included in other long-term liabilities on the consolidated balance sheets and amounted to $1.5 million at December 31, 2017 and 2016 . |
Commitments and Contingencies
Commitments and Contingencies | 12 Months Ended |
Dec. 31, 2017 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | Commitments Operating Leases The Company has entered into non-cancelable operating lease agreements for the rental of office space and equipment. Certain of these leases include options to renew as well as rent escalation clauses and in certain cases, incentives from the landlord for rent-free months and premises reductions, and allowances for tenant improvements. The rent escalations and incentives have been reflected in the table below. Future minimum lease payments, as of December 31, 2017 , associated with these agreements with terms of one year or more are as follows: Years Ending December 31: (amounts in thousands) 2018 $ 6,700 2019 5,180 2020 4,438 2021 3,993 2022 3,698 Thereafter 8,732 $ 32,741 Total operating lease expense included in selling, general, and administrative expenses was approximately $9.4 million , $8.4 million, and $8.1 million for the years ending December 31, 2017 , 2016 , and 2015 , respectively. Contingencies Sales and Other State Non-income Tax Liabilities The Company's sales and other state non-income tax filings are subject to routine audits by authorities in the jurisdictions where it conducts business in the United States which may result in assessments of additional taxes. The Company accrues sales and other non-income tax liabilities based on the Company's best estimate of its probable liability utilizing currently available information and interpretation of relevant tax regulations. Given the nature of the Company's business, significant subjectivity exists as to both whether sales and other state non-income taxes can be assessed on its activity and how the sales tax will ultimately be measured by the relevant jurisdictions. The Company makes a determination for each reporting period whether the estimates for sales and other non-income taxes in certain states should be revised. Non-income tax expense is included in selling, general and administrative expenses on its consolidated statements of operations and the liability is reflected in sales tax payable within other current liabilities as of December 31, 2017 and 2016 , on its consolidated balance sheets. Legal Proceedings The Company is subject to legal proceedings and claims that arise in the ordinary course of its business. The Company does not believe the outcome of these other matters will have a material adverse effect on the Company’s business, financial condition, results of operations or cash flows. |
Income Taxes
Income Taxes | 12 Months Ended |
Dec. 31, 2017 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | he components of the Company's income before income taxes are as follows: Year Ended December 31, 2017 2016 2015 (amounts in thousands) United States $ 3,826 $ 3,309 $ 3,565 Foreign 475 1,236 595 Income before income taxes $ 4,301 $ 4,545 $ 4,160 The components of the Company’s income tax benefit are as follows: Year Ended December 31, 2017 2016 2015 (amounts in thousands) Current: Federal $ (555 ) $ 227 $ 551 State (273 ) 587 (21 ) Foreign 139 322 220 Total (689 ) 1,136 750 Deferred: Federal (23,245 ) (4,114 ) (1,819 ) State (10,684 ) (866 ) 8 Foreign 117 (342 ) 267 Total (33,812 ) (5,322 ) (1,544 ) Total income tax benefit $ (34,501 ) $ (4,186 ) $ (794 ) Deferred income taxes reflect the net tax effect of temporary differences between the carrying amount of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of the Company’s deferred tax assets and liabilities are as follows: December 31, 2017 2016 (amounts in thousands) Deferred Tax Assets: Accrued other and prepaid expenses $ 2,955 $ 3,494 Allowance for doubtful accounts 624 704 Intangible Assets 7,776 10,725 Net operating loss carryforwards 14,718 17,228 Derivative interest — 7,940 Accrued professional liability claims 1,709 2,632 Accrued workers’ compensation claims 2,512 3,439 Share-based compensation 734 — Credit carryforwards 189 1,055 Other 444 584 Gross deferred tax assets 31,661 47,801 Valuation allowance (1,076 ) (46,454 ) 30,585 1,347 Deferred Tax Liabilities: Depreciation (41 ) (70 ) Indefinite intangibles (9,964 ) (13,971 ) Tax on unrepatriated earnings (466 ) (263 ) Share-based compensation — (197 ) (10,471 ) (14,501 ) Net deferred taxes $ 20,114 $ (13,154 ) As of December 31, 2016 the Company had a valuation allowance on its deferred tax assets, exclusive of indefinite-lived intangible deferred tax liabilities, of $46.5 million resulting from a prior history of losses from its operations. As of December 31, 2016, the Company determined that it could not sustain a conclusion that it was more likely than not that it would realize any of its deferred tax assets resulting from recent losses, the difficulty of forecasting future taxable income, and other factors. For the year ended December 31, 2017, predominantly on the basis of a reassessment of the amount of its deferred tax assets that are more likely than not to be realized, the Company reduced its valuation allowance by $45.4 million (comprised of $15.7 million related to U.S. net operating losses, $4.4 million related to state net operating losses, and $25.3 million related to other net deferred tax assets). In the reassessment, positive and negative factors were considered to arrive at a conclusion to release the valuation allowance. The primary focus of the analysis emphasized the positive evidence of the Company’s three-year cumulative pre-tax income position and projections of future taxable income which outweighed any negative evidence available. For the twelve quarters ended December 31, 2017, the Company had cumulative pre-tax income adjusted for permanent items of $27.7 million . It also has a history of utilizing net operating losses prior to expiration. Further, the five-year forecast of pre-tax book income is expected to exceed future tax deductions. Growing demand for healthcare solutions for the Company’s customers, including a growing aging U.S. population, and its customers’ pressure to keep costs down by using temporary staffing solutions were also positive factors in the analysis. With regard to negative evidence, there are no material taxable temporary differences to offset deductible temporary differences and no net operating losses available for carryback. Additionally, no tax planning strategies that would impact the valuation allowance analysis have been considered. The valuation allowance on a portion of state net operating losses not more likely than not realizable was not released after analysis of respective expiration periods and specific state taxable income projections. As of December 31, 2017, a valuation allowance of $1.1 million remained. On December 22, 2017, the 2017 Tax Act was signed into legislation which, among other changes, reduced the corporate federal income tax rate from 35% to 21% effective for the Company's year ended December 31, 2018. Because a change in tax law is accounted for in the period of enactment, the Company recorded income tax expense of $8.0 million , primarily due to a re-measurement of deferred tax assets and liabilities. The impact of the Global Intangible Low-Taxed Income provision, the transition tax on the deemed repatriation of deferred foreign income, and any future tax impact associated with basis differences on foreign subsidiaries is expected to be immaterial. The 2017 Tax Act is a comprehensive bill containing other provisions, such as limitations on the deductibility of interest expense and certain executive compensation, that are not expected to materially affect the Company. The Securities and Exchange Commission (SEC) staff issued Staff Accounting Bulletin No. 118 (SAB 118), which provides guidance on accounting for the tax effects of the 2017 Tax Act. SAB 118 provides a measurement period that should not extend beyond one year from the enactment date for companies to complete the accounting required under the Income Taxes Topic of the FASB ASC. In accordance with SAB 118, a company must reflect the income tax effects of those aspects of the 2017 Tax Act for which the accounting under the Income Taxes Topic of the FASB ASC is complete. To the extent that a company's accounting for certain income tax effects is incomplete but it is able to determine a reasonable estimate, it must record a provisional estimate in its financial statements. If a company cannot determine a provisional estimate to be included in its financial statements, it should continue to apply the Income Taxes Topic of the FASB ASC on the basis of the provisions of the tax laws that were in effect immediately before the enactment. The ultimate impact of the 2017 Tax Act in the Company's financial statements is provisional with regard to certain foreign tax provisions and may differ from its estimates due to changes in the interpretations and assumptions made by the Company as well as additional regulatory guidance that may be issued. As of December 31, 2017 and 2016 , respectively, the Company had approximately $166.1 million and $161.1 million of federal, state, and foreign net operating loss carryforwards. The carryforwards will expire as follows: federal between 2032 and 2037 , state between 2018 and 2037 , and foreign between 2019 and 2022 . The reconciliation of income tax computed at the U. S. federal statutory rate to income tax benefit is as follows: Year Ended December 31, 2017 2016 2015 (amounts in thousands) Tax at U.S. statutory rate $ 1,506 $ 1,591 $ 1,456 State taxes, net of federal benefit (1,374 ) 344 (13 ) Noncontrolling interest (455 ) (260 ) — Non-deductible meals and entertainment 2,676 1,546 1,510 Foreign tax expense 175 (5 ) (6 ) Valuation allowances (45,354 ) (8,379 ) (5,078 ) Uncertain tax positions 1,145 1,090 917 Federal rate change 8,011 — — Other (831 ) (113 ) 420 Total income tax benefit $ (34,501 ) $ (4,186 ) $ (794 ) The tax years of 2008 and 2010 through 2016 remain open to examination by certain taxing jurisdictions to which the Company is subject to tax. During 2017, the Company accrued $0.1 million of India tax on earnings of approximately $0.5 million . India withholding taxes on a dividend of India earnings are not affected by the calculation of U.S. taxes due and continue to be accrued. A reconciliation of the beginning and ending amounts of unrecognized tax benefits is approximately as follows: 2017 2016 2015 (amounts in thousands) Balance at January 1 $ 5,180 $ 4,071 $ 3,777 Additions based on tax positions related to the current year 1,145 1,054 861 Additions based on tax positions related to prior years — 55 62 Reductions based on settlements of tax positions related to prior years (439 ) — (624 ) 2017 Tax Act federal tax rate change (1,859 ) — — Other (220 ) — (5 ) Balance at December 31 $ 3,807 $ 5,180 $ 4,071 Short-term unrecognized tax benefits are included in other current liabilities on the consolidated balance sheets and were $0.1 million as of December 31, 2017 , 2016 , and 2015. Long-term unrecognized tax benefits are included in other long-term liabilities on the consolidated balance sheets and were $0.5 million , $0.9 million , and $0.8 million as of December 31, 2017 , 2016 , and 2015, respectively. See Note 7 - Balance Sheet Details. As of December 31, 2017 , 2016 , and 2015, the Company had unrecognized tax benefits, which would affect the effective tax rate if recognized, of $4.0 million , $4.9 million, and $3.8 million , respectively. During 2017 , the Company had gross increases of $1.1 million to its current year unrecognized tax benefits, related to federal and state tax positions as well as $0.2 million in gross decreases related to statute expirations. The Company recognizes interest and penalties related to unrecognized tax benefits in the provision for income taxes. During the years ended December 31, 2017 and 2015, the Company recognized a net decrease in interest and penalties of $0.2 million related to statute expirations. During the year ended December 31, 2016 , the Company recognized an increase in interest and penalties of $0.1 million. The Company has accrued $0.2 million, $0.5 million, and $0.4 million for the payment of interest and penalties at December 31, 2017 , 2016 , and 2015, respectively. |
Stockholders' Equity
Stockholders' Equity | 12 Months Ended |
Dec. 31, 2017 | |
Equity [Abstract] | |
Stockholders' Equity | Stockholders’ Equity Stock Repurchase Programs In February 2008, the Company’s Board of Directors authorized its most recent stock repurchase program whereby the Company may purchase up to 1,500,000 shares of its common stock, subject to terms of the Company’s credit agreement. The shares may be repurchased from time-to-time in the open market and the repurchase program may be discontinued at any time at the Company’s discretion. During the years ended December 31, 2017 , 2016 , and 2015 , the Company did not repurchase any shares of its Common Stock under its February 2008 Board authorization. As of December 31, 2017 , the Company may purchase up to an additional 942,443 shares of Common Stock under the February 2008 Board authorization, subject to certain conditions in the Company's Amended and Restated Credit Agreement. The Company may repurchase up to an aggregate amount not to exceed $5.0 million in any fiscal year, or an unlimited amount if the Company meets certain conditions as described in its Amended and Restated Credit Agreement. Shares Issued The Company issued 3,175,584 shares to its prior Convertible Notes noteholders. See Note 8 - Debt. Share-Based Payments 2014 Omnibus Incentive Plan The Company's 2014 Omnibus Incentive Plan (2014 Plan) provides for the issuance of stock options, stock appreciation rights, restricted stock, performance shares, and performance-based cash awards that may be granted with the intent to comply with the “performance-based compensation” exception under Section 162(m) of the Internal Revenue Code, and other stock-based awards, all as defined by the 2014 Plan, to eligible employees, consultants and non-employee Directors. On May 23, 2017, the Company's shareholders approved an amendment and restatement of its 2014 Plan which, among others, included the following modifications: (i) a 2,000,000 share increase of the aggregate share reserve to 6,100,000 shares, (2) extension of the 2014 Plan until May 23, 2027, and (3) re-approval of the Section 162(m) performance goals so that certain incentive awards granted to certain executive officers of the Company may qualify as exempt performance-based compensation. Under the 2014 Plan, the Compensation Committee of the Company’s Board of Directors (the Committee), has the discretion to determine the terms of the awards at the time of the grant provided, however, that in the case of stock options and stock appreciation rights (share options): 1) the exercise price per share of the award is not less than 100% (or, in the case of 10% or more stockholders, the exercise price of the incentive stock options (ISOs) granted may not be less than 110% ) of the fair market value of the common stock at the time of the grant; and 2) the term of the award will be no more than 10 years after the date the option is granted (or, shall not exceed five years, in the case of a 10% or more stockholder). In the case of restricted stock, the purchase price may be zero to the extent permitted by applicable law. Restricted stock awards granted under the Company’s 2014 Plan entitle the holder to receive, at the end of a vesting period, a specified number of shares of the Company’s common stock. Share-based compensation expense is measured by the market value of the Company’s stock on the date of grant. The shares vest ratably over a three year period ending on the anniversary date of the grant, and vesting is subject to the employee's continuing employment. There is no partial vesting and any unvested portion is forfeited. Pursuant to the 2014 Plan, the number of target shares that are issued for performance-based stock awards are determined based on the level of attainment of the targets. The following table summarizes restricted stock awards and performance stock awards activity issued under the 2014 Plan for the year ended December 31, 2017 : Restricted Stock Awards Performance Stock Awards Number of Weighted Number of Target Weighted Unvested restricted stock awards, January 1, 2017 532,294 $ 9.98 332,092 $ 11.73 Granted 323,503 $ 13.70 181,067 $ 14.36 Vested (292,615 ) $ 8.64 (124,568 ) $ 11.86 Forfeited (47,581 ) $ 10.41 (131,016 ) $ 11.78 Unvested restricted stock awards, December 31, 2017 515,601 $ 13.03 257,575 $ 13.49 If the minimum level of performance is attained for the 2017 awards, restricted stock will be issued with a vesting date of March 31, 2020, subject to the employee’s continuing employment. During the first quarter of 2017 , the Company's Compensation Committee of the Board of Directors approved a 48% level of attainment for the 2016 performance-based share awards, resulting in the issuance of 86,784 performance shares that will vest on December 31, 2018. As of December 31, 2017 , the Company had approximately $4.6 million pre-tax of total unrecognized compensation cost related to non-vested restricted stock awards which may be adjusted for future changes in forfeitures. The Company expects to recognize such cost over a weighted average period of 1.97 years . The fair value of shares vested was approximately $3.7 million, $4.3 million , and $3.9 million for the years ended December 31, 2017 , 2016 , and 2015 , respectively. As of December 31, 2017 , the Company had approximately $2.2 million pre-tax of total unrecognized compensation cost related to performance stock awards which may be adjusted for future changes in forfeitures. The Company expects to recognize such cost over a weighted average period of 2.05 years , the remaining service period. The fair value of shares vested was approximately $1.6 million for the year ended December 31, 2017 and $1.2 million for the year ended December 31, 2016 , the first year these awards began to vest. During the years ended December 31, 2017 , 2016 , and 2015 , the Company did not issue stock options or stock appreciation rights. The following table represents information about stock options and stock appreciation rights exercised in each year. Year Ended December 31, 2017 2016 2015 (amounts in thousands) Total intrinsic value of options exercised $ 516 $ 1,323 $ 1,610 The stock appreciation rights can only be settled with stock or cash, at the discretion of the Committee. The stock appreciation rights vest 25% per year over a 4 year period and expire after 7 years. The Company’s policy is to issue new shares from its authorized but unissued balance of common stock outstanding or shares of common stock reacquired by the Company if stock appreciation rights are settled with stock. The Company recorded compensation expense for stock options based on the estimated fair value of the options on the date of grant using the Black-Scholes option-pricing model. Due to the adoption of the 2014 Plan (previously titled the 2007 Stock Incentive Plan), no further grants have been issued under the Company’s 1999 Plans referred to below. 1999 Stock Option Plan and Equity Participation Plan On December 16, 1999, the Company’s Board of Directors approved the 1999 Stock Option Plan and Equity Participation Plan (collectively, the 1999 Plans), which was amended and restated on October 25, 2001 and provided for the issuance of ISOs and non-qualified stock options to eligible employees and non-employee directors for the purchase of up to 4,398,001 shares of common stock. The following table summarizes the Company’s activities with respect to all of its share option plans (issued under the 2014 Plan and the 1999 Plan) for the year ended December 31, 2017 : Number of Shares Option Price Weighted Weighted- Aggregate Share options outstanding, January 1, 2017 188,213 $4.16-$22.50 $5.72 Granted — — — Exercised (74,625 ) $4.35-$8.09 $5.71 Forfeited/expired (19,088 ) $5.21-$22.50 $8.43 Share options outstanding and exercisable, December 31, 2017 94,500 $4.16-$7.44 $5.19 1.85 $ 716 As of December 31, 2017 , the Company had 94,500 share options outstanding, all of which were vested at a weighted average exercise price of $5.19 , intrinsic value of $0.7 million, and a weighted average contractual life of 1.85 years. |
Earnings Per Share
Earnings Per Share | 12 Months Ended |
Dec. 31, 2017 | |
Earnings Per Share [Abstract] | |
Earnings Per Share | he following table sets forth the components of the numerator and denominator for the computation of the basic and diluted earnings per share: Year Ended December 31, 2017 2016 2015 (amounts in thousands, except per share data) Numerator: Net income attributable to common shareholders - Basic $ 37,513 $ 7,967 $ 4,418 Interest on Convertible Notes 694 3,383 * Gain on derivative liability (1,581 ) (5,805 ) * Net income attributable to common shareholders - Diluted $ 36,626 $ 5,545 $ 4,418 Denominator: Weighted average common shares - Basic 35,018 32,132 31,514 Effective of diluted shares: Share-based awards 425 593 648 Convertible Notes 723 3,521 — Weighted average common shares - Diluted 36,166 36,246 32,162 Net income per share attributable to common shareholders - Basic $ 1.07 $ 0.25 $ 0.14 Net income per share attributable to common shareholders - Diluted $ 1.01 $ 0.15 $ 0.14 * For the year 2015 , the Convertible Notes would have been anti-dilutive if converted at the beginning of the period and therefore, amounts are not applicable. For the years 2017, 2016, and 2015, no tax benefits were assumed in the weighted average share calculation due to the Company's net operating loss position. The following table represents the securities that could potentially dilute net income per share attributable to common shareholders in the future that were not included in the computation of diluted net income per share attributable to common shareholders because to do so would have been anti-dilutive for the periods presented. Year Ended December 31, 2017 2016 2015 (amounts in thousands) Convertible notes and share-based awards 118 — 3,521 |
Related Party Transactions
Related Party Transactions | 12 Months Ended |
Dec. 31, 2017 | |
Related Party Transactions [Abstract] | |
Related Party Transactions | Related Party Transactions The Company provides services to hospitals which are affiliated with certain members of the Company’s Board of Directors. Management believes services with related parties were conducted on terms equivalent to those prevailing in an arm's-length transaction. Revenue related to these transactions was $4.9 million , $5.0 million , and $11.8 million in 2017 , 2016 , and 2015 , respectively. Accounts receivable due from these hospitals at December 31, 2017 and 2016 were approximately $0.4 million and $1.0 million , respectively. In connection with the acquisition of MSN, the Company acquired a 68% ownership interest in Cross Country Talent Acquisition Group, LLC (formerly InteliStaf of Oklahoma, LLC), a joint venture between the Company and a hospital system. The Company generated revenue providing staffing services to the hospital system of $17.9 million , $12.6 million , and $10.0 million in 2017, 2016, and 2015, respectively. At December 31, 2017 and 2016, the Company had a receivable balance of $0.8 million and $1.5 million , respectively, and a payable balance of $0.3 million and $0.2 million , respectively. Subsequent to the Company's acquisition of Mediscan on October 30, 2015, Mediscan continued to operate at premises owned, in part, by the founding members of Mediscan. The Company paid $0.4 million for rent for these premises in 2017 and 2016 and $0.1 million for the two months ended December 31, 2015. |
Segment Data
Segment Data | 12 Months Ended |
Dec. 31, 2017 | |
Segment Reporting [Abstract] | |
Segment Data | Segment Data In accordance with the Segment Reporting Topic of the FASB ASC, the Company reports three business segments – Nurse and Allied Staffing, Physician Staffing, and Other Human Capital Management Services. The Company manages and segments its business based on the services it offers to its customers as described below: • Nurse and Allied Staffing - Nurse and Allied Staffing provides traditional staffing, recruiting, and value-added workforce solutions including: temporary and permanent placement of travel and local branch-based nurse and allied professionals, MSP services, education healthcare services, and outsourcing services. Its clients include: public and private acute care and non-acute care hospitals, government facilities, public schools and charter schools, outpatient clinics, ambulatory care facilities, physician practice groups, retailers, and many other healthcare providers throughout the U.S. Substantially all of the results of the Advantage acquisition have been aggregated with the Company's Nurse and Allied Staffing business segment. See Note 3 - Acquisitions. • Physician Staffing - Physician Staffing provides physicians in many specialties, certified registered nurse anesthetists (CRNAs), nurse practitioners (NPs), and physician assistants (PAs) as independent contractors on temporary assignments throughout the U.S. at various healthcare facilities, such as acute and non-acute care facilities, medical group practices, government facilities, and managed care organizations. Less than 2% of the business related to the Advantage acquisition is managed by, and included in, the Physician Staffing business segment. • Other Human Capital Management Services - Other Human Capital Management Services includes retained and contingent search services for physicians, healthcare executives, and other healthcare professionals within the U.S. The Company’s management evaluates performance of each segment primarily based on revenue and contribution income. The Company defines contribution income as income or loss from operations before depreciation and amortization, loss on sale of business, acquisition and integration costs, acquisition-related contingent consideration, restructuring costs, impairment charges, and corporate expenses not specifically identified to a reporting segment. Contribution income is a financial measure used by management when assessing segment performance and is provided in accordance with the Segment Reporting Topic of the FASB ASC. The Company’s management does not evaluate, manage, or measure performance of segments using asset information; accordingly, total asset information by segment is not prepared or disclosed. The information in the following table is derived from the segments’ internal financial information as used for corporate management purposes. Certain corporate expenses are not allocated to and/or among the operating segments. Information on operating segments and a reconciliation to income from operations for the periods indicated are as follows: Year Ended December 31, 2017 2016 2015 (amounts in thousands) Revenues: Nurse and Allied Staffing $ 758,267 $ 721,486 $ 621,258 Physician Staffing 93,610 98,283 115,336 Other Human Capital Management Services 13,171 13,768 30,827 $ 865,048 $ 833,537 $ 767,421 Contribution income: Nurse and Allied Staffing $ 73,614 $ 71,992 $ 55,718 Physician Staffing 5,256 8,265 10,213 Other Human Capital Management Services (357 ) (535 ) 1,863 78,513 79,722 67,794 Unallocated corporate overhead (a) 39,190 38,400 32,703 Depreciation and amortization 10,174 9,182 8,066 Loss on sale of business (b) — — 2,184 Acquisition and integration costs 1,975 78 902 Acquisition-related contingent consideration 44 814 — Restructuring costs 1,026 753 1,274 Impairment charges (c) 14,356 24,311 2,100 Income from operations $ 11,748 $ 6,184 $ 20,565 _______________ (a) The Company has been centralizing administrative functions to gain efficiencies, which have been recorded in unallocated corporate overhead. (b) On August 31, 2015, the Company completed the sale of CCE, and recognized a pre-tax loss of $2.2 million related to the divestiture of the business. See Note 4 - Disposal. (c) During the years ended December 31, 2017, 2016, and 2015, the Company recorded non-cash impairment charges of $14.4 million , $24.3 million , and $2.1 million , respectively. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets. |
Quarterly Financial Data (Unaud
Quarterly Financial Data (Unaudited) | 12 Months Ended |
Dec. 31, 2017 | |
Quarterly Financial Information Disclosure [Abstract] | |
Quarterly Financial Data (Unaudited) | First Second Third Fourth 2017 (amounts in thousands, except per share data) Revenue from services $ 207,573 $ 209,313 $ 228,488 $ 219,674 Gross profit (a) 53,275 56,528 60,480 58,303 Consolidated net (loss) income (1,718 ) 5,220 7,044 28,256 Net (loss) income attributable to common shareholders (2,010 ) 4,850 6,723 27,950 Net (loss) income per share attributable to common shareholders - Basic $ (0.06 ) $ 0.14 $ 0.19 $ 0.78 Net (loss) income per share attributable to common shareholders - Diluted $ (0.08 ) $ 0.13 $ 0.19 $ 0.77 First Second Third Fourth 2016 (amounts in thousands, except per share data) Revenue from services $ 196,583 $ 199,443 $ 214,988 $ 222,523 Gross profit (a) 51,046 54,846 58,210 57,633 Consolidated net income (loss) 19,186 (17,095 ) 14,289 (7,649 ) Net income (loss) attributable to common shareholders 19,022 (17,237 ) 14,066 (7,884 ) Net income (loss) per share attributable to common shareholders - Basic $ 0.60 $ (0.54 ) $ 0.44 $ (0.24 ) Net income (loss) per share attributable to common shareholders - Diluted $ 0.09 $ (0.54 ) $ 0.22 $ (0.24 ) ________________ (a) Excludes depreciation and amortization. The following items impact the comparability and presentation of our consolidated data: • The Company recorded changes in the fair value of Convertible Notes derivative liability, recording a gain in the first quarter of 2017 of $1.6 million , a gain in the first and third quarters of 2016 of $16.4 million and $7.1 million , respectively, and a loss in the second and fourth quarters of 2016 of $3.6 million and $14.2 million , respectively. See Note 9 - Convertible Notes Derivative Liability. • During the fourth quarter of 2017 and the second quarter of 2016, the Company recorded non-cash impairment charges of $14.4 million and $24.3 million , respectively. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets. • During the first quarter of 2017, the Company settled its Convertible Notes and recognized a loss on extinguishment of debt of $5.0 million . During the second quarter of 2016, the Company repaid its Second Lien Term Loan and recognized a loss on extinguishment of debt of $1.6 million . See Note 8 - Debt. • On July 1, 2017, the Company acquired all of the assets of Advantage. The acquisition has been accounted for in accordance with the Business Combinations Topic of the FASB ASC , using the acquisition method. The results of the acquisition's operations have been included in the consolidated statements of operations from its date of acquisition. See Note 3 - Acquisitions. • In 2017 and 2016, the Company recorded acquisition-related contingent consideration expense primarily related to the Mediscan and USR acquisitions, recording expense of $0.3 million in the first and second quarters of 2017, a credit of $0.6 million in the third quarter of 2017, and expense of $0.1 million in the fourth quarter of 2017, and expense of $0.3 million in the first quarter of 2016, $0.2 million in the second and third quarters of 2016, and $0.1 million in the fourth quarter of 2016. See Note 3 - Acquisitions and Note 10 - Fair Value Measurements. • In the third and fourth quarters of 2017, the Company recorded restructuring costs of $0.7 million and $0.3 million , respectively, primarily related to a cost saving initiative, and in the third and fourth quarters of 2016, $0.6 million and $0.2 million , respectively, primarily related to the centralization of corporate functions. See Note 2 - Summary of Significant Accounting Policies. • In the fourth quarter of 2017, the Company benefited from a $43.3 million reversal of valuation allowance on its net deferred tax assets, offset by additional income tax expense of $8.0 million related to the remeasurement of its deferred tax assets as a result of the 2017 Tax Act. See Note 13 - Income Taxes. |
Schedule II - Valuation and Qua
Schedule II - Valuation and Qualifying Accounts | 12 Months Ended |
Dec. 31, 2017 | |
Valuation and Qualifying Accounts [Abstract] | |
Schedule II - Valuation and Qualifying Accounts | Schedule II CROSS COUNTRY HEALTHCARE, INC. VALUATION AND QUALIFYING ACCOUNTS FOR THE YEARS ENDED DECEMBER 31, 2017, 2016, AND 2015 Balance at Charged to Operations Write-Offs Recoveries Other Balance at (amounts in thousands) Allowances for Accounts Receivable Year Ended December 31, 2017 $ 3,245 $ 4,705 $ (4,804 ) $ 542 $ — $ 3,688 Year Ended December 31, 2016 $ 4,045 $ 4,034 $ (5,149 ) $ 315 $ — $ 3,245 Year Ended December 31, 2015 $ 1,425 $ 2,414 $ (923 ) $ 1,129 $ — $ 4,045 Valuation Allowance for Deferred Tax Assets Year Ended December 31, 2017 $ 46,454 $ (3,007 ) $ (43,333 ) (a) $ — $ 962 (c) $ 1,076 Year Ended December 31, 2016 $ 55,336 $ (8,894 ) $ — $ — $ 12 $ 46,454 Year Ended December 31, 2015 $ 63,616 $ (7,518 ) (b) $ — $ — $ (762 ) (c) $ 55,336 ________________ (a) Release of valuation allowances on the Company’s deferred tax assets. (b) Includes a reversal of valuation allowance related to CCE. (c) Valuation allowance on deferred tax asset related to share-based compensation. |
Summary of Significant Accoun27
Summary of Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2017 | |
Accounting Policies [Abstract] | |
Use of Estimates | Use of Estimates The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (U.S. GAAP), requires management to make estimates and assumptions that affect the reported amounts in the consolidated financial statements and accompanying notes. Significant estimates and assumptions are used for, but not limited to: (1) the valuation of accounts receivable; (2) goodwill, trade names, and other intangible assets; (3) other long-lived assets; (4) share-based compensation; (5) accruals for health, workers’ compensation, and professional liability claims; (6) valuation of deferred tax assets; (7) purchase price allocation; (8) derivative liability; (9) legal contingencies; (10) contingent considerations; (11) income taxes; and, (12) sales and other non-income tax liabilities. Accrued insurance claims and reserves include estimated settlements from known claims and actuarial estimates for claims incurred but not reported. Actual results could differ from those estimates. |
Cash and Cash Equivalents | Cash and Cash Equivalents The Company considers all investments with original maturities of three months or less to be cash and cash equivalents. The Company invests its excess cash in highly rated overnight funds and other highly rated liquid accounts. The Company is exposed to credit risk associated with these investments. The Company minimizes its credit risk relating to these positions by monitoring the financial condition of the financial institutions involved and by primarily conducting business with large, well established financial institutions, and diversifying its counterparties. The Company does not currently anticipate nonperformance by any of its significant counterparties. Interest income on cash and cash equivalents is included in other income, net, on the Company’s consolidated statements of operations. |
Accounts Receivable, Allowance for Doubtful Accounts, and Concentration of Credit Risk | Accounts Receivable, Allowance for Doubtful Accounts, and Concentration of Credit Risk Accounts receivable potentially subject the Company to concentrations of credit risk. The Company’s customers are primarily healthcare providers, and accounts receivable represent amounts due from them. The Company generally does not require collateral and mitigates its credit risk by performing credit evaluations and monitoring at-risk accounts. The allowance for doubtful accounts represents the Company’s estimate of uncollectible receivables based on a review of specific accounts and the Company’s historical collection experience. The Company writes off specific accounts based on an ongoing review of collectability as well as past experience with the customer. In addition, the Company maintains a sales allowance for customer disputes which may arise in the ordinary course, which is recorded as contra-revenue. The Company’s contract terms typically require payment between 15 to 60 days from the date services are provided and are considered past due based on the particular negotiated contract terms. The majority of the Company's business activity is with hospitals located throughout the United States. |
Prepaid Rent and Deposits | Prepaid Rent and Deposits The Company leases apartments for eligible field employees under short-term agreements (typically three to six months), which generally coincide with each employee’s staffing contract. Costs relating to these leases are included in direct operating expenses on the accompanying consolidated statements of operations. As a condition of these agreements, the Company may place security deposits on the leased apartments. Deposits on field employees’ apartments related to these short-term agreements are included in other current assets on the accompanying consolidated balance sheets. |
Property and Equipment | Property and Equipment Property and equipment are stated at cost, less accumulated depreciation. Depreciation is determined on a straight-line basis over the estimated useful lives of the assets, which generally range from three to seven years. Leasehold improvements are depreciated over the shorter of their estimated useful life or the term of the individual lease. On an annual basis, the Company reviews its property and equipment listings and disposes of assets that are no longer in use. Certain software development costs have been capitalized in accordance with the provisions of the Intangibles-Goodwill and Other/Internal-Use Software Topic of the Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC). Such costs include charges for consulting services and costs for Company personnel associated with programming, coding, and testing such software. Amortization of capitalized software costs begins when the software is ready for use and is included in depreciation expense in the accompanying consolidated statements of operations. Software development costs are being amortized using the straight-line method over three to five years. |
Business Combinations | Business Combinations The Company applies accounting in accordance with the Business Combinations Topic of the FASB ASC when it acquires control over a business. Business combinations are accounted for at fair value. The associated acquisition costs are expensed as incurred and recorded as acquisition and integration costs; noncontrolling interests, if any, are reflected at fair value at the acquisition date; restructuring costs associated with a business combination are expensed; contingent consideration is measured at fair value at the acquisition date, with changes in the fair value after the acquisition date affecting earnings; and goodwill is determined as the excess of the fair value of the consideration conveyed in the acquisition over the fair value of the net assets acquired. The accounting for business combinations requires estimates and judgments as to expectations for future cash flows of the acquired business, and the allocation of those cash flows to identifiable intangible assets, in determining the estimated fair value for assets and liabilities acquired. The fair values assigned to tangible and intangible assets acquired and liabilities assumed are based on management's estimates and assumptions, including valuations that utilize customary valuation procedures and techniques. If the actual results differ from the estimates and judgments used in these estimates, the amounts recorded in the financial statements could result in a possible impairment of the intangible assets and goodwill, or require acceleration of the amortization expense of finite-lived intangible assets. The results of the acquired businesses' operations are included in the consolidated statements of operations of the combined entity beginning on the date of acquisition. See Note 3 - Acquisitions. |
Goodwill, Trade Names, and Other Intangible Assets | Goodwill, Trade Names, and Other Intangible Assets Goodwill represents the excess of purchase price and related costs over the fair value assigned to the net tangible and identifiable intangible assets of businesses acquired. Other identifiable intangible assets with definite lives are being amortized using the straight-line method over their estimated useful lives which range from 1 to 16 years. Goodwill and certain intangible assets with indefinite lives are not amortized. Instead, in accordance with the Intangibles-Goodwill and Other Topic of the FASB ASC, these assets are reviewed for impairment annually at the beginning of the fourth quarter, and whenever circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. When reviewed, the Company has the option to first assess qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount, as a basis for determining whether it is necessary to perform the quantitative testing. If it is determined that a quantitative test is necessary or more efficient than a qualitative approach, the Company generally measures the fair value of its reporting units using a combination of income and market approaches. For the periods prior to the fourth quarter of 2017, the performance of the quantitative impairment test involved a two-step process. The first step required the Company to determine the fair value of each of its reporting units and compare it to the reporting unit’s carrying amount. If the reporting unit's fair value was less than its carrying amount, the Company was required to perform a second step to calculate the implied value of goodwill. The implied value was then compared to its carrying amount to calculate the impairment charge, if any. Beginning in the fourth quarter of 2017, for its annual review on October, 1, 2017, the Company early adopted the provisions of Accounting Standards Update (ASU) 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment. Under ASU 2017-04, the second step of the quantitative assessment is eliminated, and, if the reporting unit’s carrying value exceeds its fair value, an impairment charge is recognized for the amount by which the carrying amount exceeds the reporting unit’s fair value not to exceed the total amount of goodwill allocated to that reporting unit. Additionally, income tax effects from any tax deductible goodwill on the carrying amount of the reporting unit when measuring the goodwill impairment loss is considered, if applicable. See Recently Adopted Accounting Pronouncements. The Company determines its reporting units by identifying its operating segments and any component businesses and aggregates the components businesses if they have similar economic characteristics. The Company had the following reporting units that it reviewed for impairment: 1) Nurse and Allied Staffing; 2) Physician Staffing; and 3) Search. Management considers historical experience and all available information at the time the fair values of its reporting units are estimated. However, fair values that could be realized in an actual transaction may have differed from those used to evaluate the potential impairment of goodwill. Long-lived assets and identifiable intangible assets with definite lives are evaluated for impairment in accordance with the Property, Plant, and Equipment Topic of the FASB ASC. In accordance with this Topic, long-lived assets and definite-lived intangible assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount may not be recoverable. Recoverability of long-lived assets is measured by a comparison of the carrying amount of the asset group to the future undiscounted net cash flow that is expected to be generated by those assets. If such assets are considered to be impaired, the impairment charge recognized is the amount by which the carrying amount of the assets exceeds the fair value of the assets. Any related impairment losses are recognized in earnings and included in the caption impairment charges on the consolidated statements of operations. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets. |
Debt Discount and Debt Issuance Costs | Debt Discount and Debt Issuance Costs Stated discounts on proceeds, and other fees reimbursed to lender, as well as the initial value of any embedded derivative features of the Convertible Notes and Term Loans, as defined in Note 8 - Debt, are treated as a discount associated with the respective debt instrument and presented in the balance sheet as an offset to the carrying amount of the debt. Discounts are amortized to interest expense using the effective interest rate method, or a method that approximates the effective interest rate method, over the expected life of the debt. Deferred costs related to the issuance of the Convertible Notes and the Term Loans were capitalized and are presented in the balance sheet as a direct deduction from the carrying amount of the debt liability. Deferred costs are amortized using the effective interest method. Deferred costs related to the Convertible Notes were written off in connection with the repayment of such Convertible Notes. See Note 8 - Debt. Deferred costs related to the issuance of the Company’s Revolving Credit Facilities and Senior Secured Asset-Based Loan, as defined in Note 8 - Debt, have been capitalized and included in other assets on the consolidated balance sheets, and amortized using the straight line method over the term of the related credit agreement. |
Derivative Financial Instruments | Derivative Financial Instruments The Company evaluates embedded conversion features within its convertible debt in accordance with the Derivatives and Hedging Topic of the FASB ASC to determine whether the embedded conversion feature should be bifurcated from the host instrument and accounted for as a derivative at fair value. The Company used a trinomial lattice model to estimate the fair value of embedded conversion and redemption features in its convertible debt at the end of each applicable reporting period. Changes in the fair value of these derivatives during each reporting period were reported in other expenses (income) on the consolidated statements of operations. The fair value at inception had been recorded as debt discount and was being amortized to interest expense over the term of the note using the effective interest method. On March 17, 2017, the Company paid in full its Convertible Notes and, as a result, derecognized the derivative liability. See Note 8 - Debt. |
Sales and Other State Non-income Tax Liabilities | Sales and Other State Non-income Tax Liabilities The Company accrues sales and other state non-income tax liabilities based on the Company’s best estimate of its probable liability utilizing currently available information and interpretation of relevant tax regulations. Given the nature of the Company’s business, significant subjectivity exists as to both whether sales and other state non-income taxes can be assessed on its activity and how the sales tax will ultimately be measured by the relevant jurisdictions. The Company makes a determination for each reporting period whether the estimates for sales and other non-income taxes in certain states should be revised. |
Insurance Claims | Insurance Claims The Company provides workers’ compensation insurance coverage, professional liability coverage, and healthcare benefits for eligible employees. The Company records its estimate of the ultimate cost of, and reserves for, workers' compensation and professional liability benefits based on actuarial models prepared or reviewed by an independent actuary using the Company’s loss history as well as industry statistics. The healthcare insurance accrual is for estimated claims that have occurred but have not been reported and is based on the Company’s historical claim submission patterns. Furthermore, in determining its reserves, the Company includes reserves for estimated claims incurred but not reported as well as unfavorable claims development. The Other Expenses/Insurance Costs Topic of the FASB ASC previously issued authoritative accounting guidance in the area of insurance contracts and related activity thereto. This topic concluded that, under circumstances such as in the Company’s insured professional liability and workers' compensation policies, since a right of legal offset does not exist due to the fact that there are three parties to an incurred claim, the insured, the insurer, and the claimant, the related liability to the claimant should be classified separately on a gross basis with a separate related receivable from the insurer recognized as being due from insurance carriers. Accordingly, the Company’s consolidated balance sheets as of December 31, 2017 and 2016 reflect the related short-term liabilities in accrued compensation and benefits and the related long-term liabilities as long-term accrued claims, and the short-term receivable portion as insurance recovery receivable and the long-term portion as non-current insurance recovery receivable. See Note 7 - Balance Sheet Details. The ultimate cost of workers’ compensation, professional liability, and health insurance claims will depend on actual amounts incurred to settle those claims and may differ from the amounts reserved by the Company for those claims. Workers’ compensation benefits are provided under a partially self-insured plan. The Company has letters of credit to guarantee payments of claims. At December 31, 2017 and 2016 , the Company had outstanding approximately $19.6 million and $20.2 million , respectively, of standby letters of credit as collateral to secure the self-insured portion of this plan. The Company has occurrence-based primary professional liability policies that provide the Company and each working professional in its nurse and allied healthcare business with coverage. Effective January 1, 2016, the Company has a claims-made professional liability policy for its physicians and advanced practitioners, with a $0.5 million self-insured retention per claim. Prior to January 1, 2016, the Company had an occurrence-based professional liability policy for its independent contractor physicians and advanced practitioners which was insured by a wholly-owned subsidiary, Jamestown Indemnity, Ltd., a wholly-owned Cayman Island captive company (the Captive), until its voluntary liquidation in the third quarter of 2015. Beginning in March 2015, the Company's Physician subsidiary self-insured $0.5 million for each of its professional liability claims. Under the terms of the Captive’s reinsurance policy there was a requirement to guarantee the payment of claims to its insured party’s primary medical malpractice insurance carrier via a letter of credit. As a result of the Captive's liquidation, the letter of credit was reduced. As of both December 31, 2017 and 2016 , the value of the letter of credit was $2.0 million. Subject to certain limitations, the Company also has umbrella liability coverage for its working nurses and allied healthcare professionals. While this umbrella coverage does not extend to professional liability claims against its independent contractor physicians and advanced practitioners, it does cover claims brought against all of the Company’s subsidiaries for non-patient general liability. |
Revenue Recognition | Revenue Recognition The Company recognizes revenue when it is earned and when all of the following criteria are met: persuasive evidence of the arrangement exists; delivery has occurred or the service has been provided and the Company has no remaining obligations; the fee is fixed or determinable; and, collectability is reasonably assured. The Company includes reimbursable expenses in revenues, and the associated amounts of reimbursable expenses in cost of services. Temporary Staffing Revenue Revenue from services consists primarily of temporary staffing revenue. Revenues from temporary staffing, net of sales adjustments and discounts, are recognized when earned, based on hours worked by the Company’s healthcare professionals. Billings to customers are based on specific contract provisions which may include approval of submitted time by our customers. Accordingly, accounts receivable includes estimated revenue for employees’ and independent contractors’ time worked but not yet invoiced. At December 31, 2017 and 2016 , the Company's estimate of amounts that had not been billed totaled $41.8 million and $41.2 million, respectively, and are included in accounts receivable on the consolidated balance sheets. Permanent Placement Revenue on permanent placements is recognized when services provided are substantially completed. The Company does not, in the ordinary course of business, provide refunds. If a candidate leaves a permanent placement within a relatively short period of time, it is customary for the Company to provide a replacement at no additional cost. Gross Versus Net Policies The Company records revenue on a gross basis as a principal or on a net basis as an agent depending on the arrangement, as follows: Managed Service Programs Arrangements The Company has entered into certain contracts with acute care facilities to provide comprehensive managed service programs (MSP). Under these contract arrangements, the Company uses its healthcare professionals along with those of third-party subcontractors to fulfill customer orders. If its healthcare professional is used, revenue is recorded on a gross basis. If a subcontractor is used, the customer is invoiced for their services and a subcontractor liability is recorded in accrued expenses, but only the resulting administrative fee is recognized as revenue. The subcontractor is paid after the Company has received payment from the acute care facility. The Company determined that it acts as an agent in these arrangements. Physician Staffing The Physician Staffing business enters into contracts with its healthcare customers to provide temporary staffing services. The Company uses independent contractors for these services. The Company determined that it acts as a principal in this arrangement and, therefore, revenue is reported on a gross basis in the consolidated statements of operations. Education Seminars During the third quarter of 2015, the Company completed the sale of its education seminars business, Cross Country Education, LLC (CCE). See Note 4 - Disposal. Prior to the sale of CCE, revenue from the Company’s Education Seminars services was recognized as the independent contractor-led seminars were performed. In the Company’s Education Seminars business, revenue was recorded in the consolidated statements of operations on a gross basis as a principal. |
Share-Based Compensation | Share-Based Compensation The Company has, from time to time, granted stock options, stock appreciation rights, performance-based stock awards, and restricted stock for a fixed number of common shares to employees. In accordance with the Compensation-Stock-Compensation Topic of the FASB ASC, companies may choose from alternative valuation models. The Company used the Black-Scholes method of valuing its options and stock appreciation rights. The Company has elected to recognize compensation expense on a straight-line basis over the requisite service period of the entire award. The Company values its restricted stock awards and the fair value of its performance-based stock awards by reference to its stock price on the date of grant. The Company granted performance-based stock awards to certain key personnel pursuant to its 2014 Omnibus Incentive Plan as described in Note 14 - Stockholders' Equity. Pursuant to the plan, the number of target shares that vest are determined based on the level of attainment of the targets. If a minimum level of performance is attained for the awards, restricted stock is issued with a vesting date in the future, subject to the employee's continuing employment. The Company recognizes performance-based restricted stock as compensation expense based on the most likely probability of attaining the prescribed performance and over the requisite service period beginning at its grant date and through the date the restricted stock vests. The Company used historical data of options with similar characteristics to estimate pre-vesting option forfeitures, as it believed that historical behavior patterns are the best indicators of future behavior patterns. Compensation expense related to share-based payments is included in selling, general, and administrative expenses in the consolidated statements of operations, and totaled $4.1 million, $3.4 million, and $2.5 million, during the years ended December 31, 2017 , 2016 , and 2015 , respectively. See Note 14 - Stockholders’ Equity. |
Advertising | Advertising The Company’s advertising expense consists primarily of online advertising, internet direct marketing, print media, promotional material and, prior to the sale of CCE, direct mail marketing. Advertising costs that were expensed as incurred totaled $7.6 million , $10.2 million, and $4.9 million, for the years ended December 31, 2017 , 2016 , and 2015 , respectively. Prior to the sale of CCE, direct mail marketing costs associated with the Company’s education seminars services were capitalized when the Company determined that there was a reasonable expectation that the cost of the incurred advertising would be recovered from the gross profit generated by the advertised event and expensed when the related event took place. |
Restructuring Costs | Restructuring Costs The Company considers restructuring activities to be programs whereby it fundamentally changes its operations, such as closing and consolidating facilities, reducing headcount and realigning operations in response to changing market conditions. As a result, restructuring costs on the consolidated statements of operations include on-going benefit costs for its employees and exit costs. |
Deferred Rent | Deferred Rent Deferred rent consists of free rent, rent escalation, tenant improvement allowances, and other incentives received from landlords related to the operating leases for our facilities. Rent escalation represents the difference between actual operating lease payments due and straight-line rent expense, which we record over the term of the lease. The excess is recorded as a deferred credit in the early periods of the lease, when cash payments are generally lower than straight-line rent expense, and is reduced in the later periods of the lease when payments begin to exceed the straight-line expense. Tenant allowances from landlords for tenant improvements are generally comprised of cash received from the landlord or paid on our behalf as part of the negotiated terms of the lease. These tenant improvement allowances and other leasehold incentives are recorded when realizable as deferred rent and are amortized as a reduction of periodic rent expense, over the term of the applicable lease. See Note 12 - Commitments and Contingencies. |
Income Taxes | Income Taxes The Company accounts for income taxes under the Income Taxes Topic of the FASB ASC. Deferred income tax assets and liabilities are determined based upon differences between the financial reporting and tax basis of assets and liabilities, and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to reverse. The Company recognizes in its financial statements the impact of a tax position if that position is more likely than not of being sustained on audit, based on the technical merits of the position. The Company recognizes interest and penalties related to unrecognized tax benefits in the provision for income taxes. The Company determines the need for a valuation allowance by assessing the probability of realizing deferred tax assets, taking into consideration all available positive and negative evidence, including historical operating results, expectations of future taxable income, carryforward periods available to the Company for tax reporting purposes, the evaluation of various income tax planning strategies, and other relevant factors. The Company maintains a valuation allowance when it is more likely than not that all or a portion of a deferred tax asset will not be realized based on consideration of all available evidence. Adjustments to the deferred tax valuation allowances are made to earnings in the period when such assessments are made. Significant judgment is required in making this assessment and to the extent future expectations change, the Company would have to assess the recoverability of its deferred tax assets at that time. See Note 13 - Income Taxes. |
Comprehensive Income (Loss) | Comprehensive Income (Loss) Total comprehensive income (loss) includes net income or loss and foreign currency translation adjustments, net of any related deferred taxes. Certain of the Company’s foreign subsidiaries use their respective local currency as their functional currency. In accordance with the Foreign Currency Matters Topic of the FASB ASC, assets and liabilities of these operations are translated at the exchange rates in effect on the balance sheet date. Income statement items are translated at the average exchange rates for the period. |
Fair Value Measurements | Fair Value Measurements The Company complies with the provisions of the Fair Value Measurements and Disclosures Topic of the FASB ASC, which defines fair value, establishes a framework for measuring fair value under U.S. GAAP, and expands disclosures about fair value measurements. As of December 31, 2017 and 2016 , the Company’s financial assets and liabilities required to be measured on a recurring basis were its deferred compensation liability, its Convertible Notes derivative liability, and its contingent consideration liabilities. See Note 10 - Fair Value Measurements. |
Earnings Per Share | Earnings Per Share In accordance with the requirements of the Earnings Per Share Topic of the FASB ASC, basic earnings per share is computed by dividing net income available to common shareholders (numerator) by the weighted average number of vested unrestricted common shares outstanding during the period (denominator). Diluted earnings per share gives effect to all dilutive potential common shares outstanding during the period including stock appreciation rights and options and unvested restricted stock, as calculated utilizing the treasury stock method, and Convertible Notes using the if-converted method prior to their payment in full in the first quarter of 2017. |
Recent Accounting Pronouncements | Recently Adopted Accounting Pronouncements In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment, to simplify how an entity is required to test goodwill for impairment by eliminating Step 2 from the goodwill impairment test. Under this guidance, an entity would perform its annual, or interim goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount. An impairment charge would be recognized for the amount by which the carrying amount exceeds the reporting unit’s fair value; however, the loss recognized should not exceed the total amount of goodwill allocated to that reporting unit. Additionally, an entity would consider income tax effects from any tax deductible goodwill on the carrying amount of the reporting unit when measuring the goodwill impairment loss. An entity still has the option to perform the qualitative assessment for a reporting unit to determine if the quantitative impairment test is necessary. ASU 2017-04 is effective for annual or any interim goodwill impairment tests in fiscal years beginning after December 15, 2019 and is to be applied prospectively. Early adoption was permitted for interim or annual goodwill impairment tests performed on testing dates after January 1, 2017. The Company elected to early adopt this standard in its fourth quarter of 2017, which was the first quarter in which an impairment test was performed. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets. In August 2016, the Financial Accounting Standards Board (FASB) issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments , which amends the guidance in ASC 230 on the classification of certain cash receipts and payments in the statement of cash flows. This update intended to reduce the diversity that has resulted from the lack of consistent principles on this topic by adding or clarifying guidance on eight cash flow issues, including: debt prepayment or debt extinguishment costs, contingent consideration payments made after a business combination, and separately identifiable cash flows and application of the predominance principle. ASU 2016-15 is effective for annual periods beginning after December 15, 2017, and interim periods within those annual periods. Early adoption was permitted. The Company elected to early adopt this standard in its first quarter of 2017, applying the guidance retrospectively with no material impact on its consolidated financial statements. In March 2016, the FASB issued ASU No. 2016-09, Compensation-Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting. The Company adopted this guidance in the first quarter of 2017. ASU 2016-09 eliminates the requirement to delay the recognition of excess tax benefits until they reduce current taxes payable. The required method of adoption is modified retrospective transition method. Upon adoption, previously unrecognized excess tax benefits of $1.3 million had no impact on the Company's accumulated deficit balance as the related deferred tax assets were fully offset by a valuation allowance. ASU 2016-09 also requires excess tax benefits and deficiencies to be recognized prospectively in the provision for income taxes rather than additional paid-in capital. As a result of the adoption and the reversal of the valuation allowance on deferred tax assets, the Company recognized $0.6 million for these excess tax benefits relating to share-based awards vested and exercised for the year ended December 31, 2017. Additionally, as permitted by the ASU, the Company elected to account for forfeitures as they occur rather than estimate expected forfeitures using a modified retrospective transition method. As a result, the Company recorded a cumulative-effect adjustment of $0.5 million to accumulated deficit and greater share-based compensation expense of $0.2 million compared to the amount of expense that would have been recorded for 2017. Under ASU 2016-09, the threshold for awards to qualify for equity treatment permits withholding up to the maximum statutory tax rates in the applicable jurisdictions. Prior to the adoption of ASU 2016-09, the Company did not allow an award to be partially settled in cash in excess of the minimum statutory withholding requirements. Subsequent to the adoption of the standard, the Company will allow awards to be partially settled at the maximum applicable statutory rates. Finally, ASU 2016-09 requires excess tax benefits to be presented as a component of operating cash flows rather than financing cash flows. The Company elected to adopt this requirement prospectively and accordingly, prior periods have not been adjusted. Excess tax benefits were not material for all periods presented. In March 2016, the FASB issued ASU No. 2016-06, Derivatives and Hedging (Topic 815): Contingent Put and Call Options in Debt Instruments , to clarify the steps required to assess whether a call or put option meets the criteria for bifurcation as an embedded derivative. ASU 2016-06 is effective for interim and annual periods beginning after December 15, 2016, and requires a modified retrospective approach to adoption. The Company adopted this guidance in the first quarter of 2017. The adoption of this guidance had no impact on the Company's results of operations. Recent Accounting Pronouncements In February 2018, the FASB issued ASU No. 2018-02, Income Statement - Reporting Comprehensive Income (Topic 220): Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income. The amendments in this Update allow a reclassification from accumulated other comprehensive income to retained earnings for stranded tax effects resulting from the Tax Cuts and Jobs Act (2017 Tax Act), and require certain disclosures about stranded tax effects. The guidance that requires that the effect of a change in tax laws or rates be included in income from continuing operations is not affected. The amendments in this Update are effective for all entities for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, and should be applied either in the period of adoption or retrospectively to each period in which the effect of the change in the U.S. federal corporate tax rate in the 2017 Tax Act is recognized. For public business entities, for reporting periods for which financial statements have not yet been issued, early adoption is permitted, including adoption in any interim period. The Company expects to adopt this standard in its first quarter of 2018, and does not expect this guidance to have a material impact on its consolidated financial statements. In July 2017, the FASB issued ASU No. 2017-11, Earnings Per Share (Topic 260); Distinguishing Liabilities from Equity (Topic 480); and Derivatives and Hedging (Topic 815): I. Accounting for Certain Financial Instruments with Down Round Features, and II. Replacement of the Indefinite Deferral for Mandatorily Redeemable Financial Instruments of Certain Nonpublic Entities and Certain Mandatorily Redeemable Noncontrolling Interests with a Scope Exception . The amendments in Part I of this Update change the classification analysis of certain equity-linked financial instruments (or embedded features) with down round features. When determining whether certain financial instruments should be classified as liabilities or equity instruments, a down round feature no longer precludes equity classification when assessing whether the instrument is indexed to an entity’s own stock. The amendments in Part II of this Update recharacterize the indefinite deferral of certain provisions of Topic 480 that now are presented as pending content in the Codification, to a scope exception. Those amendments do not have an accounting effect. For public business entities, the amendments in Part I of this Update are effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2018, and should be applied retrospectively to outstanding financial instruments with a down round feature by means of either a cumulative-effect adjustment or for each prior reporting period presented. Early adoption is permitted for all entities, including adoption in an interim period. The Company expects to adopt this standard in its first quarter of 2019, and does not expect this guidance to have a material impact on its consolidated financial statements. In May 2017, the FASB issued ASU No. 2017-09, Compensation-Stock Compensation (Topic 718): Scope of Modification Accounting, to provide guidance about which changes to the terms or conditions of a share-based payment award require an entity to apply modification accounting in Topic 718. Under this guidance, an entity should account for the effects of a modification unless all of the following are met: (1) the fair value of the modified award is the same as the fair value of the original award immediately before the original award is modified, (2) the vesting conditions of the modified award are the same as the vesting conditions of the original award immediately before the original award is modified, and (3) the classification of the modified award as an equity instrument or a liability instrument is the same as the classification of the original award immediately before the original award is modified. ASU 2017-09 is effective for all entities for annual periods, and interim periods within those annual periods, beginning after December 15, 2017 and is to be applied prospectively to an award modified on or after the adoption date. Early adoption is permitted. The Company expects to adopt this standard in its first quarter of 2018, and does not expect this guidance to have a material impact on its consolidated financial statements. In January 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business , which clarifies the definition of a business, with the objective of adding guidance to assist entities with evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. This update provides a framework to assist entities in evaluating whether both an input and a substantive process are present, and narrows the definition of the term output so that the term is consistent with how outputs are described in the new revenue recognition standard. ASU 2017-01 is effective for annual periods beginning after December 15, 2017, and interim periods within those annual periods. Early adoption is permitted depending upon the date of the transaction. Entities should apply the guidance prospectively on or after the effective date. No disclosures are required at transition. The Company expects to adopt this standard in its first quarter of 2018, and does not expect this guidance to have a material impact on its consolidated financial statements. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) , which will require, among other items, lessees to recognize most leases as assets and liabilities on the balance sheet. Qualitative and quantitative disclosures will be enhanced to better understand the amount, timing and uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. Full retrospective application is prohibited. The Company expects the valuation of right of use assets and lease liabilities, previously described as operating leases, to be the present value of our forecasted future lease commitments. The Company is continuing to assess the overall impacts of the new standard, including the discount rate to be applied in these valuations. See Note 12 - Commitments and Contingencies. In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606) . Topic 606 introduced a new five-step revenue recognition model in which an entity should recognize revenue when its customer obtains control of promised goods or services, in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Topic 606 also requires additional disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments. The FASB has issued several other subsequent updates including the following: 1) further clarification of the guidance on principal versus agent considerations; 2) expanded guidance on identifying performance obligations; and 3) additional guidance and practical expedients in response to identified implementation issues. Collectively, Topic 606, Subtopic 340-40, and all subsequent ASUs that modified Topic 606, are referred to as the “new revenue standard.” The new revenue standard is effective for annual reporting periods beginning after December 15, 2017, including interim periods within such reporting period. The new revenue standard is effective for the Company in the first quarter of 2018 and the Company expects to adopt using a modified retrospective method, which will only impact contracts not completed as of December 31, 2017. The Company employed a cross-functional implementation team which consisted of representatives from across all of its business segments to analyze and identify material revenue streams and its largest customers within those streams. The implementation team completed a thorough review of its existing contracts and business practices for those customers to assess the impact of the new revenue standard. In the fourth quarter of 2017, the Company finalized its assessment of the new revenue standard and began implementing changes to its accounting policies, processes, and internal controls. The Company has determined that the adoption of the new revenue standard will not have a material impact on its consolidated financial statements, other than expanded disclosures. The Company has concluded that transfer of control of its staffing services, which represent the majority of its revenues, occurs as the services are provided, which is consistent with recognition under the prior guidance. |
Summary of Significant Accoun28
Summary of Significant Accounting Policies (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Accounting Policies [Abstract] | |
Schedule of restructuring costs | Reconciliations of the beginning and ending total restructuring liability balances are presented below: Year Ended December 31, 2017 2016 2015 (amounts in thousands) On-Going Benefit Costs Exit Costs On-Going Benefit Costs Exit Costs On-Going Benefit Costs Exit Costs Balance at beginning of period $ 325 $ 273 $ 44 $ 338 $ — $ — Charged to restructuring costs 522 504 563 190 633 641 Payments (760 ) (336 ) (282 ) (255 ) (589 ) (303 ) Balance at end of period $ 87 $ 441 $ 325 $ 273 $ 44 $ 338 |
Acquisitions (Tables)
Acquisitions (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Business Combinations [Abstract] | |
Schedule of business acquisitions | The following is the estimated fair value of the purchase price for Mediscan on October 30, 2015: (amounts in thousands) Cash purchase price paid at closing $ 28,000 Fair value of shares 4,723 Fair value of contingent consideration 3,686 Net working capital adjustment, including receivable 503 Total consideration $ 36,912 The following is the estimated fair value of the purchase price for Advantage on July 1, 2017: (amounts in thousands) Purchase price $ 88,000 Net working capital adjustments (1,438 ) Cash consideration 86,562 Cash acquired 2,833 Total consideration $ 89,395 |
Schedule of assets acquired and liabilities assumed | The following table is an estimate of the fair value of the assets acquired and liabilities assumed on July 1, 2017. (amounts in thousands) Cash and cash equivalents $ 2,833 Accounts receivable 14,396 Other current assets 392 Property and equipment 333 Goodwill 43,596 Other intangible assets 29,900 Total assets acquired 91,450 Accounts payable and accrued expenses 368 Accrued employee compensation and benefits 1,685 Other current liabilities 2 Total liabilities assumed 2,055 Net assets acquired $ 89,395 The following table summarizes the fair value of the assets acquired and liabilities assumed. The Company used a third-party appraiser to assist with the determination of the fair value and estimated useful lives of acquired assets and liabilities assumed as of October 30, 2015: (amounts in thousands) Cash and cash equivalents $ 79 Accounts receivable 6,851 Other current assets 140 Property and equipment 20 Goodwill 14,338 Other intangible assets 17,200 Total assets acquired 38,628 Accounts payable and accrued expenses 306 Accrued employee compensation and benefits 1,410 Total liabilities assumed 1,716 Net assets acquired $ 36,912 |
Pro forma information | The following unaudited pro forma financial information approximates the consolidated results of operations of the Company as if the Advantage acquisition had occurred as of January 1, 2016, after giving effect to certain adjustments, including additional interest expense on the amount the Company borrowed on the date of the transaction, the amortization of acquired intangible assets, and the elimination of certain expenses that will not be recurring in post-acquisition periods, net of an estimated income tax impact. These adjustments include removing transaction-related expenses of approximately $2.0 million for the year ended December 31, 2017. These results are not necessarily indicative of future results as they do not include incremental investments in support functions, elimination of costs for integration or operating synergies, or an estimate of any impact on interest expense resulting from the operating cash flow of the acquired businesses, among other adjustments that could be made in the future but are not factually supportable on the date of the transaction. Year Ended December 31, 2017 2016 (unaudited, amounts in thousands except per share data) Revenue from services $ 916,149 $ 934,904 Net income attributable to common shareholders $ 40,255 $ 11,391 Net income per common share attributable to common shareholders - basic $ 1.16 $ 0.35 Net income per common share attributable to common shareholders - diluted $ 1.09 $ 0.25 |
Goodwill, Trade Names, and Ot30
Goodwill, Trade Names, and Other Intangible Assets (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Acquired Intangible Assets | The Company had the following acquired intangible assets: December 31, 2017 December 31, 2016 Gross Accumulated Net Gross Accumulated Net (amounts in thousands) Intangible assets subject to amortization: Databases $ 42,909 $ 18,702 $ 24,207 $ 31,609 $ 16,147 $ 15,462 Customer relationships 55,524 25,912 29,612 41,724 23,316 18,408 Non-compete agreements 3,919 3,600 319 3,619 3,527 92 Trade names 7,716 878 6,838 3,216 343 2,873 Other intangible assets, net $ 110,068 $ 49,092 $ 60,976 $ 80,168 $ 43,333 $ 36,835 Intangible assets not subject to amortization: Trade names 26,702 35,402 $ 87,678 $ 72,237 |
Estimated Annual Amortization Expense | As of December 31, 2017 , estimated annual amortization expense is as follows: Years Ending December 31: (amounts in thousands) 2018 $ 7,167 2019 7,131 2020 7,027 2021 6,819 2022 6,743 Thereafter 26,089 $ 60,976 |
Changes in Carrying Amount of Goodwill by Segment | The changes in the carrying amount of goodwill by segment are as follows: Nurse and Allied Staffing Segment Physician Staffing Segment Other Human Capital Management Services Segment Total (amounts in thousands) Balances as of December 31, 2016 Aggregate goodwill acquired $ 304,277 $ 43,405 $ 19,307 $ 366,989 Sale of CCE — — (9,889 ) (9,889 ) Accumulated impairment loss (259,732 ) (17,720 ) — (277,452 ) Goodwill, net of impairment loss 44,545 25,685 9,418 79,648 Changes to aggregate goodwill in 2017 Goodwill acquired (a) 43,596 — — 43,596 Impairment charges — (5,655 ) — (5,655 ) Balances as of December 31, 2017 Aggregate goodwill acquired 347,873 43,405 19,307 410,585 Sale of CCE — — (9,889 ) (9,889 ) Accumulated impairment loss (259,732 ) (23,375 ) — (283,107 ) Goodwill, net of impairment loss $ 88,141 $ 20,030 $ 9,418 $ 117,589 _______________ (a) Goodwill acquired from the acquisition of Advantage. See Note 3 - Acquisitions. |
Property and Equipment (Tables)
Property and Equipment (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Property, Plant and Equipment [Abstract] | |
Property and Equipment | The Company's property and equipment consists of the following: December 31, Useful Lives 2017 2016 (amounts in thousands) Computer equipment 3-5 years $ 6,432 $ 13,584 Computer software 3-5 years 24,933 28,752 Office equipment 5-7 years 1,379 2,397 Furniture and fixtures 5-7 years 4,680 3,969 Leasehold improvements (a) 7,340 7,257 44,764 55,959 Less accumulated depreciation and amortization (30,678 ) (43,141 ) $ 14,086 $ 12,818 _______________ (a) See Note 2 – Summary of Significant Accounting Policies. |
Balance Sheet Details (Tables)
Balance Sheet Details (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Balance Sheet Related Disclosures [Abstract] | |
Balance Sheet Details | December 31, 2017 2016 (amounts in thousands) Insurance recovery receivable: Insurance recovery for health $ — $ 279 Insurance recovery for workers’ compensation 1,623 1,271 Insurance recovery for professional liability 1,874 1,487 $ 3,497 $ 3,037 Other non-current assets: Insurance recovery for workers’ compensation claims $ 6,093 $ 5,857 Insurance recovery for professional liability claims 10,011 10,353 Non-current security deposits 1,095 925 Non-current income tax receivable 1,044 — Net debt issuance costs 985 929 $ 19,228 $ 18,064 Accrued compensation and benefits: Salaries and payroll taxes $ 16,342 $ 15,480 Bonuses 2,067 3,915 Accrual for workers’ compensation claims 5,957 5,266 Accrual for professional liability claims 2,683 2,433 Accrual for healthcare benefits 5,105 4,053 Accrual for vacation 2,117 2,096 $ 34,271 $ 33,243 Long-term accrued claims: Accrual for workers’ compensation claims $ 13,160 $ 12,817 Accrual for professional liability claims 15,597 16,053 $ 28,757 $ 28,870 Other long-term liabilities: Deferred compensation $ 1,467 $ 1,472 Deferred rent 6,875 5,011 Long-term unrecognized tax benefits 485 874 Other 344 52 $ 9,171 $ 7,409 |
Debt (Tables)
Debt (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Debt Disclosure [Abstract] | |
Long-term Debt | Subject to the Amended and Restated Credit Agreement, the Company pays interest on (i) each Base Rate Loan at the Base Rate (as defined therein) plus the Applicable Margin in effect from time to time, (ii) each LIBOR Index Rate Loan at the One Month LIBOR Index Rate (as defined therein) plus the Applicable Margin in effect from time to time and (iii) each Eurodollar Loan at the Adjusted LIBOR for the applicable Interest Period (as defined therein) in effect for such Loan plus the Applicable Margin in effect from time to time. The Applicable Margin, as of any date, is a percentage per annum determined by reference to the applicable Consolidated Net Leverage Ratio (as defined by the agreement) in effect on such date as set forth in the table below. Level Consolidated Net Leverage Ratio Eurodollar Loans, LIBOR Index Rate Loans and Letter of Credit Fee Base Rate Loans Commitment Fee I Less than 1.50:1.00 1.75% 0.75% 0.25% II Greater than or equal to 1.50:1.00 but less than 2.00:1.00 2.00% 1.00% 0.30% III Greater than or equal to 2.00:1.00 but less than 2.50:1.00 2.25% 1.25% 0.30% IV Greater than or equal to 2.50:1.00 but less than 3.00:1.00 2.50% 1.50% 0.35% V Greater than or equal to 3.00:1.00 2.75% 1.75% 0.40% he Company's long-term debt consists of the following: December 31, 2017 December 31, 2016 Principal Unamortized Discount and Debt Issuance Costs Principal Unamortized Discount and Debt Issuance Costs (amounts in thousands) Term Loan, interest of 3.61% and 2.62% at December 31, 2017 and 2016, respectively $ 100,000 $ (866 ) $ 39,500 $ (363 ) Convertible Notes, fixed rate interest of 8.00% — — 25,000 (4,669 ) Convertible Notes derivative liability — — 27,532 — Total debt 100,000 (866 ) 92,032 (5,032 ) Less current portion (6,875 ) — (2,250 ) — Long-term debt $ 93,125 $ (866 ) $ 89,782 $ (5,032 ) |
Aggregate scheduled maturities of debt | As of December 31, 2017 , the aggregate scheduled maturities of debt are as follows: Term Loan (amounts in thousands) Through Years Ending December 31: 2018 $ 6,875 2019 7,500 2020 8,125 2021 10,000 2022 67,500 Total $ 100,000 |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Fair Value Disclosures [Abstract] | |
Summary of Estimated Fair Values of Financial Assets and Liabilities Measured on a Recurring Basis | The table which follows summarizes the estimated fair value of the Company’s financial assets and liabilities measured on a recurring basis: Fair Value Measurements December 31, 2017 December 31, 2016 Financial Liabilities: (amounts in thousands) (Level 1) Deferred compensation $ 1,467 $ 1,472 (Level 3) Convertible Notes derivative liability $ — $ 27,532 Contingent purchase price liabilities $ 5,368 $ 5,603 |
Fair Value, Liabilities Measured on recurring Basis, Unobservable Input Reconciliation | The table which follows reconciles the opening balances to the closing balances for fair value measurements categorized within Level 3 of the fair value hierarchy: Contingent Purchase Convertible Notes Price Liabilities (a) Derivative Liability (amounts in thousands) December 31, 2015 $ 3,686 $ 33,337 Additions 1,300 — Payments (152 ) — Accretion expense 887 — Valuation gain for the period (118 ) (5,805 ) December 31, 2016 5,603 27,532 Payments/Settlements (280 ) (25,951 ) Accretion expense 967 — Valuation gain for the period (922 ) (1,581 ) December 31, 2017 $ 5,368 $ — _______________ (a) Related to the Mediscan acquisition on October 30, 2015 and the USR acquisition on December 1, 2016. See Note 3 - Acquisitions. Valuation gain and accretion expense is included as acquisition-related contingent consideration on the consolidated statements of operations. |
Carrying Amounts and Estimated Fair Values of Significant Financial Instrument that were not Measured at Fair Value | The following table represents the carrying amounts and estimated fair value of the Company’s significant financial instruments that were not measured at fair value: December 31, 2017 December 31, 2016 Carrying Fair Carrying Fair (amounts in thousands) Financial Liabilities: (Level 2) Term Loan, net $ 99,134 $ 100,500 $ 39,137 $ 41,500 Convertible Notes, net $ — $ — $ 20,331 $ 27,250 |
Commitments and Contingencies (
Commitments and Contingencies (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Commitments and Contingencies Disclosure [Abstract] | |
Future Minimum Lease Payments | Future minimum lease payments, as of December 31, 2017 , associated with these agreements with terms of one year or more are as follows: Years Ending December 31: (amounts in thousands) 2018 $ 6,700 2019 5,180 2020 4,438 2021 3,993 2022 3,698 Thereafter 8,732 $ 32,741 |
Income Taxes (Tables)
Income Taxes (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Income Tax Disclosure [Abstract] | |
Components of Income (Loss) Before Income Taxes | The components of the Company's income before income taxes are as follows: Year Ended December 31, 2017 2016 2015 (amounts in thousands) United States $ 3,826 $ 3,309 $ 3,565 Foreign 475 1,236 595 Income before income taxes $ 4,301 $ 4,545 $ 4,160 |
Components of Income Tax Expense (Benefit) | The components of the Company’s income tax benefit are as follows: Year Ended December 31, 2017 2016 2015 (amounts in thousands) Current: Federal $ (555 ) $ 227 $ 551 State (273 ) 587 (21 ) Foreign 139 322 220 Total (689 ) 1,136 750 Deferred: Federal (23,245 ) (4,114 ) (1,819 ) State (10,684 ) (866 ) 8 Foreign 117 (342 ) 267 Total (33,812 ) (5,322 ) (1,544 ) Total income tax benefit $ (34,501 ) $ (4,186 ) $ (794 ) |
Significant Components of Deferred Tax Assets and Liabilities | Significant components of the Company’s deferred tax assets and liabilities are as follows: December 31, 2017 2016 (amounts in thousands) Deferred Tax Assets: Accrued other and prepaid expenses $ 2,955 $ 3,494 Allowance for doubtful accounts 624 704 Intangible Assets 7,776 10,725 Net operating loss carryforwards 14,718 17,228 Derivative interest — 7,940 Accrued professional liability claims 1,709 2,632 Accrued workers’ compensation claims 2,512 3,439 Share-based compensation 734 — Credit carryforwards 189 1,055 Other 444 584 Gross deferred tax assets 31,661 47,801 Valuation allowance (1,076 ) (46,454 ) 30,585 1,347 Deferred Tax Liabilities: Depreciation (41 ) (70 ) Indefinite intangibles (9,964 ) (13,971 ) Tax on unrepatriated earnings (466 ) (263 ) Share-based compensation — (197 ) (10,471 ) (14,501 ) Net deferred taxes $ 20,114 $ (13,154 ) |
Reconciliation of Income Tax Computed At U. S. Federal Statutory Rate to Income Tax (Benefit) Expense | The reconciliation of income tax computed at the U. S. federal statutory rate to income tax benefit is as follows: Year Ended December 31, 2017 2016 2015 (amounts in thousands) Tax at U.S. statutory rate $ 1,506 $ 1,591 $ 1,456 State taxes, net of federal benefit (1,374 ) 344 (13 ) Noncontrolling interest (455 ) (260 ) — Non-deductible meals and entertainment 2,676 1,546 1,510 Foreign tax expense 175 (5 ) (6 ) Valuation allowances (45,354 ) (8,379 ) (5,078 ) Uncertain tax positions 1,145 1,090 917 Federal rate change 8,011 — — Other (831 ) (113 ) 420 Total income tax benefit $ (34,501 ) $ (4,186 ) $ (794 ) |
Reconciliation of Beginning and Ending Amounts of Unrecognized Tax Benefits | A reconciliation of the beginning and ending amounts of unrecognized tax benefits is approximately as follows: 2017 2016 2015 (amounts in thousands) Balance at January 1 $ 5,180 $ 4,071 $ 3,777 Additions based on tax positions related to the current year 1,145 1,054 861 Additions based on tax positions related to prior years — 55 62 Reductions based on settlements of tax positions related to prior years (439 ) — (624 ) 2017 Tax Act federal tax rate change (1,859 ) — — Other (220 ) — (5 ) Balance at December 31 $ 3,807 $ 5,180 $ 4,071 |
Stockholders' Equity (Tables)
Stockholders' Equity (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Equity [Abstract] | |
Summary of Restricted Stock Award Activity | The following table summarizes restricted stock awards and performance stock awards activity issued under the 2014 Plan for the year ended December 31, 2017 : Restricted Stock Awards Performance Stock Awards Number of Weighted Number of Target Weighted Unvested restricted stock awards, January 1, 2017 532,294 $ 9.98 332,092 $ 11.73 Granted 323,503 $ 13.70 181,067 $ 14.36 Vested (292,615 ) $ 8.64 (124,568 ) $ 11.86 Forfeited (47,581 ) $ 10.41 (131,016 ) $ 11.78 Unvested restricted stock awards, December 31, 2017 515,601 $ 13.03 257,575 $ 13.49 |
Stock Options and Stock Appreciation Rights Granted and Exercised | The following table represents information about stock options and stock appreciation rights exercised in each year. Year Ended December 31, 2017 2016 2015 (amounts in thousands) Total intrinsic value of options exercised $ 516 $ 1,323 $ 1,610 |
Summary of Share Option Plans Activities | The following table summarizes the Company’s activities with respect to all of its share option plans (issued under the 2014 Plan and the 1999 Plan) for the year ended December 31, 2017 : Number of Shares Option Price Weighted Weighted- Aggregate Share options outstanding, January 1, 2017 188,213 $4.16-$22.50 $5.72 Granted — — — Exercised (74,625 ) $4.35-$8.09 $5.71 Forfeited/expired (19,088 ) $5.21-$22.50 $8.43 Share options outstanding and exercisable, December 31, 2017 94,500 $4.16-$7.44 $5.19 1.85 $ 716 |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Earnings Per Share [Abstract] | |
Components of Numerator and Denominator for Computation of Basic and Diluted Earnings per Share | The following table sets forth the components of the numerator and denominator for the computation of the basic and diluted earnings per share: Year Ended December 31, 2017 2016 2015 (amounts in thousands, except per share data) Numerator: Net income attributable to common shareholders - Basic $ 37,513 $ 7,967 $ 4,418 Interest on Convertible Notes 694 3,383 * Gain on derivative liability (1,581 ) (5,805 ) * Net income attributable to common shareholders - Diluted $ 36,626 $ 5,545 $ 4,418 Denominator: Weighted average common shares - Basic 35,018 32,132 31,514 Effective of diluted shares: Share-based awards 425 593 648 Convertible Notes 723 3,521 — Weighted average common shares - Diluted 36,166 36,246 32,162 Net income per share attributable to common shareholders - Basic $ 1.07 $ 0.25 $ 0.14 Net income per share attributable to common shareholders - Diluted $ 1.01 $ 0.15 $ 0.14 * For the year 2015 , the Convertible Notes would have been anti-dilutive if converted at the beginning of the period and therefore, amounts are not applicable. |
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share | The following table represents the securities that could potentially dilute net income per share attributable to common shareholders in the future that were not included in the computation of diluted net income per share attributable to common shareholders because to do so would have been anti-dilutive for the periods presented. Year Ended December 31, 2017 2016 2015 (amounts in thousands) Convertible notes and share-based awards 118 — 3,521 |
Segment Data (Tables)
Segment Data (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Segment Reporting [Abstract] | |
Information on Operating Segments and Reconciliation to Income From Operations | Information on operating segments and a reconciliation to income from operations for the periods indicated are as follows: Year Ended December 31, 2017 2016 2015 (amounts in thousands) Revenues: Nurse and Allied Staffing $ 758,267 $ 721,486 $ 621,258 Physician Staffing 93,610 98,283 115,336 Other Human Capital Management Services 13,171 13,768 30,827 $ 865,048 $ 833,537 $ 767,421 Contribution income: Nurse and Allied Staffing $ 73,614 $ 71,992 $ 55,718 Physician Staffing 5,256 8,265 10,213 Other Human Capital Management Services (357 ) (535 ) 1,863 78,513 79,722 67,794 Unallocated corporate overhead (a) 39,190 38,400 32,703 Depreciation and amortization 10,174 9,182 8,066 Loss on sale of business (b) — — 2,184 Acquisition and integration costs 1,975 78 902 Acquisition-related contingent consideration 44 814 — Restructuring costs 1,026 753 1,274 Impairment charges (c) 14,356 24,311 2,100 Income from operations $ 11,748 $ 6,184 $ 20,565 _______________ (a) The Company has been centralizing administrative functions to gain efficiencies, which have been recorded in unallocated corporate overhead. (b) On August 31, 2015, the Company completed the sale of CCE, and recognized a pre-tax loss of $2.2 million related to the divestiture of the business. See Note 4 - Disposal. (c) During the years ended December 31, 2017, 2016, and 2015, the Company recorded non-cash impairment charges of $14.4 million , $24.3 million , and $2.1 million , respectively. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets. |
Quarterly Financial Data (Una40
Quarterly Financial Data (Unaudited) (Tables) | 12 Months Ended |
Dec. 31, 2017 | |
Quarterly Financial Information Disclosure [Abstract] | |
Quarterly Financial Data | First Second Third Fourth 2017 (amounts in thousands, except per share data) Revenue from services $ 207,573 $ 209,313 $ 228,488 $ 219,674 Gross profit (a) 53,275 56,528 60,480 58,303 Consolidated net (loss) income (1,718 ) 5,220 7,044 28,256 Net (loss) income attributable to common shareholders (2,010 ) 4,850 6,723 27,950 Net (loss) income per share attributable to common shareholders - Basic $ (0.06 ) $ 0.14 $ 0.19 $ 0.78 Net (loss) income per share attributable to common shareholders - Diluted $ (0.08 ) $ 0.13 $ 0.19 $ 0.77 First Second Third Fourth 2016 (amounts in thousands, except per share data) Revenue from services $ 196,583 $ 199,443 $ 214,988 $ 222,523 Gross profit (a) 51,046 54,846 58,210 57,633 Consolidated net income (loss) 19,186 (17,095 ) 14,289 (7,649 ) Net income (loss) attributable to common shareholders 19,022 (17,237 ) 14,066 (7,884 ) Net income (loss) per share attributable to common shareholders - Basic $ 0.60 $ (0.54 ) $ 0.44 $ (0.24 ) Net income (loss) per share attributable to common shareholders - Diluted $ 0.09 $ (0.54 ) $ 0.22 $ (0.24 ) ________________ (a) Excludes depreciation and amortization. The following items impact the comparability and presentation of our consolidated data: • The Company recorded changes in the fair value of Convertible Notes derivative liability, recording a gain in the first quarter of 2017 of $1.6 million , a gain in the first and third quarters of 2016 of $16.4 million and $7.1 million , respectively, and a loss in the second and fourth quarters of 2016 of $3.6 million and $14.2 million , respectively. See Note 9 - Convertible Notes Derivative Liability. • During the fourth quarter of 2017 and the second quarter of 2016, the Company recorded non-cash impairment charges of $14.4 million and $24.3 million , respectively. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets. • During the first quarter of 2017, the Company settled its Convertible Notes and recognized a loss on extinguishment of debt of $5.0 million . During the second quarter of 2016, the Company repaid its Second Lien Term Loan and recognized a loss on extinguishment of debt of $1.6 million . See Note 8 - Debt. • On July 1, 2017, the Company acquired all of the assets of Advantage. The acquisition has been accounted for in accordance with the Business Combinations Topic of the FASB ASC , using the acquisition method. The results of the acquisition's operations have been included in the consolidated statements of operations from its date of acquisition. See Note 3 - Acquisitions. • In 2017 and 2016, the Company recorded acquisition-related contingent consideration expense primarily related to the Mediscan and USR acquisitions, recording expense of $0.3 million in the first and second quarters of 2017, a credit of $0.6 million in the third quarter of 2017, and expense of $0.1 million in the fourth quarter of 2017, and expense of $0.3 million in the first quarter of 2016, $0.2 million in the second and third quarters of 2016, and $0.1 million in the fourth quarter of 2016. See Note 3 - Acquisitions and Note 10 - Fair Value Measurements. • In the third and fourth quarters of 2017, the Company recorded restructuring costs of $0.7 million and $0.3 million , respectively, primarily related to a cost saving initiative, and in the third and fourth quarters of 2016, $0.6 million and $0.2 million , respectively, primarily related to the centralization of corporate functions. See Note 2 - Summary of Significant Accounting Policies. • In the fourth quarter of 2017, the Company benefited from a $43.3 million reversal of valuation allowance on its net deferred tax assets, offset by additional income tax expense of $8.0 million related to the remeasurement of its deferred tax assets as a result of the 2017 Tax Act. See Note 13 - Income Taxes. |
Summary of Significant Accoun41
Summary of Significant Accounting Policies - Narrative (Details) - USD ($) | 1 Months Ended | 3 Months Ended | 12 Months Ended | |||
Mar. 31, 2015 | Dec. 31, 2017 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | Jan. 01, 2016 | |
Significant Accounting Policies [Line Items] | ||||||
Outstanding standby letters of credit as collateral | $ 19,600,000 | $ 19,600,000 | $ 20,200,000 | |||
Accrued revenue | 41,800,000 | 41,800,000 | 41,200,000 | |||
Equity compensation | 4,100,000 | 3,400,000 | $ 2,500,000 | |||
Advertising costs | 7,600,000 | 10,200,000 | 4,900,000 | |||
Prepaid expenses, advertising | 0 | 0 | 0 | |||
Cumulative impact of currency fluctuations | 1,200,000 | 1,200,000 | 1,200,000 | |||
Income tax expense related to deferred tax asset | 8,000,000 | 200,000 | ||||
Income tax expense (benefit) related to items of other comprehensive (loss) income | 0 | $ 200,000 | ||||
Occurrence-Based Professional Liability Insurance | MDA Holdings Inc | ||||||
Significant Accounting Policies [Line Items] | ||||||
Coverage for professional liability claims | $ 500,000 | |||||
Claims-Based Liability Insurance | ||||||
Significant Accounting Policies [Line Items] | ||||||
Self insured retention claim per policy | $ 500,000 | |||||
Claims-Based Liability Insurance | MDA Holdings Inc | ||||||
Significant Accounting Policies [Line Items] | ||||||
Letter of credit for malpractice claims | $ 2,000,000 | $ 2,000,000 | $ 2,000,000 | |||
Minimum | ||||||
Significant Accounting Policies [Line Items] | ||||||
Contract terms | 15 days | |||||
Short term leases period | 3 months | |||||
Estimated useful life of assets | 3 years | |||||
Intangible assets- useful life | 1 year | |||||
Minimum | Computer software | ||||||
Significant Accounting Policies [Line Items] | ||||||
Estimated useful life of assets | 3 years | |||||
Maximum | ||||||
Significant Accounting Policies [Line Items] | ||||||
Contract terms | 60 days | |||||
Short term leases period | 6 months | |||||
Estimated useful life of assets | 7 years | |||||
Intangible assets- useful life | 16 years | |||||
Maximum | Computer software | ||||||
Significant Accounting Policies [Line Items] | ||||||
Estimated useful life of assets | 5 years |
Summary of Significant Accoun42
Summary of Significant Accounting Policies - Reconciliation of Restructuring Liabilities (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Restructuring Reserve [Roll Forward] | |||
Charged to restructuring costs | $ 1,026 | $ 753 | $ 1,274 |
Cost Optimization Project | On-Going Benefit Costs | |||
Restructuring Reserve [Roll Forward] | |||
Balance at beginning of period | 325 | 44 | 0 |
Charged to restructuring costs | 522 | 563 | 633 |
Payments | (760) | (282) | (589) |
Balance at end of period | 87 | 325 | 44 |
Cost Optimization Project | Exit Costs | |||
Restructuring Reserve [Roll Forward] | |||
Balance at beginning of period | 273 | 338 | 0 |
Charged to restructuring costs | 504 | 190 | 641 |
Payments | (336) | (255) | (303) |
Balance at end of period | $ 441 | $ 273 | $ 338 |
Summary of Significant Accoun43
Summary of Significant Accounting Policies - Recently Adopted Accounting Pronouncements (Details) - USD ($) $ in Thousands | 12 Months Ended | |||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | Jan. 01, 2017 | |
New Accounting Pronouncements or Change in Accounting Principle [Line Items] | ||||
Deferred tax assets | $ 31,661 | $ 47,801 | ||
Excess tax benefit | 600 | |||
Valuation allowance | 1,076 | 46,454 | ||
Share-based compensation | (4,100) | $ (3,400) | $ (2,500) | |
ASU 2016-09 | ||||
New Accounting Pronouncements or Change in Accounting Principle [Line Items] | ||||
Deferred tax assets | $ 1,300 | |||
Valuation allowance | 1,300 | |||
Share-based compensation | $ 200 | |||
Retained Earnings | ASU 2016-09, Forfeiture Rate Component | ||||
New Accounting Pronouncements or Change in Accounting Principle [Line Items] | ||||
Cumulative effect adjustment | $ 500 |
Acquisitions - Advantage RN (De
Acquisitions - Advantage RN (Details) - USD ($) $ in Thousands | Jul. 28, 2017 | Jul. 01, 2017 | Sep. 30, 2017 | Dec. 31, 2017 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 |
Business Acquisition [Line Items] | |||||||
Cash consideration | $ 85,977 | $ 1,900 | $ 28,721 | ||||
Release of remaining contingent liability | (44) | (769) | 0 | ||||
Proceeds from Term Loans | 62,000 | 40,000 | 0 | ||||
Acquisition related costs | 1,975 | $ 78 | $ 902 | ||||
Advantage RN, LLC | |||||||
Business Acquisition [Line Items] | |||||||
Cash consideration | $ 86,562 | ||||||
Net working capital adjustment | 600 | ||||||
Reimbursement from working capital adjustment settled | $ 800 | ||||||
Contingent liability | $ 300 | 300 | |||||
Release of remaining contingent liability | 300 | ||||||
Escrow payment related to tax liabilities | 14,500 | ||||||
Escrow payment related to post-close liabilities | 7,500 | ||||||
Release of escrow to seller | $ 7,300 | ||||||
Escrow deposit related to tax liabilities | $ 7,200 | ||||||
Consideration transferred, available cash | 19,900 | ||||||
Revenue since acquisition | 47,000 | ||||||
Net income since acquisition | $ 3,800 | ||||||
Assets acquired | $ 29,900 | ||||||
Weighted average useful life of assets acquired | 10 years | ||||||
Goodwill expected to be deductible | $ 43,600 | ||||||
Acquisition related costs | $ 2,000 | ||||||
Trade names | Advantage RN, LLC | |||||||
Business Acquisition [Line Items] | |||||||
Assets acquired | $ 4,500 | ||||||
Weighted average useful life of assets acquired | 10 years | ||||||
Customer relationships | Advantage RN, LLC | |||||||
Business Acquisition [Line Items] | |||||||
Assets acquired | $ 13,800 | ||||||
Weighted average useful life of assets acquired | 10 years | ||||||
Databases | Advantage RN, LLC | |||||||
Business Acquisition [Line Items] | |||||||
Assets acquired | $ 11,300 | ||||||
Weighted average useful life of assets acquired | 10 years | ||||||
Non-compete agreements | Advantage RN, LLC | |||||||
Business Acquisition [Line Items] | |||||||
Assets acquired | $ 300 | ||||||
Weighted average useful life of assets acquired | 5 years | ||||||
Deferred Consideration Transferred | Advantage RN, LLC | |||||||
Business Acquisition [Line Items] | |||||||
Contingent liability | $ 600 | ||||||
Period of deferred consideration | 20 months | ||||||
Credit Agreement | |||||||
Business Acquisition [Line Items] | |||||||
Proceeds from Term Loans | $ 66,900 | ||||||
Term Loan, net | Incremental Term Loan | |||||||
Business Acquisition [Line Items] | |||||||
Proceeds from Term Loans | 40,000 | ||||||
Physician Staffing Segment | Advantage RN, LLC | |||||||
Business Acquisition [Line Items] | |||||||
Percent of business included in segment, less than | 2.00% | ||||||
Purchase Price | Advantage RN, LLC | |||||||
Business Acquisition [Line Items] | |||||||
Purchase price | $ 88,000 |
Acquisitions - Fair Value of Pu
Acquisitions - Fair Value of Purchase Price (Details) - USD ($) $ in Thousands | Jul. 01, 2017 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 |
Business Acquisition [Line Items] | ||||
Cash consideration | $ 85,977 | $ 1,900 | $ 28,721 | |
Advantage RN, LLC | ||||
Business Acquisition [Line Items] | ||||
Cash consideration | $ 86,562 | |||
Cash acquired | 2,833 | |||
Total consideration | 89,395 | |||
Purchase Price | Advantage RN, LLC | ||||
Business Acquisition [Line Items] | ||||
Purchase price | 88,000 | |||
Net Working Capital Adjustments | Advantage RN, LLC | ||||
Business Acquisition [Line Items] | ||||
Purchase price | $ (1,438) |
Acquisitions - Assets Acquired
Acquisitions - Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands | Dec. 31, 2017 | Jul. 01, 2017 | Dec. 31, 2016 | Oct. 30, 2015 |
Business Acquisition [Line Items] | ||||
Goodwill | $ 117,589 | $ 79,648 | ||
Advantage RN, LLC | ||||
Business Acquisition [Line Items] | ||||
Cash and cash equivalents | $ 2,833 | |||
Accounts receivable | 14,396 | |||
Other current assets | 392 | |||
Property and equipment | 333 | |||
Goodwill | 43,596 | |||
Other intangible assets | 29,900 | |||
Total assets acquired | 91,450 | |||
Accounts payable and accrued expenses | 368 | |||
Accrued employee compensation and benefits | 1,685 | |||
Other current liabilities | 2 | |||
Total liabilities assumed | 2,055 | |||
Net assets acquired | $ 89,395 | |||
Mediscan | ||||
Business Acquisition [Line Items] | ||||
Cash and cash equivalents | $ 79 | |||
Accounts receivable | 6,851 | |||
Other current assets | 140 | |||
Property and equipment | 20 | |||
Goodwill | 14,338 | |||
Other intangible assets | 17,200 | |||
Total assets acquired | 38,628 | |||
Accounts payable and accrued expenses | 306 | |||
Accrued employee compensation and benefits | 1,410 | |||
Total liabilities assumed | 1,716 | |||
Net assets acquired | $ 36,912 |
Acquisitions - Pro Forma (Detai
Acquisitions - Pro Forma (Details) - USD ($) $ / shares in Units, $ in Thousands | 12 Months Ended | |
Dec. 31, 2017 | Dec. 31, 2016 | |
Business Combinations [Abstract] | ||
Revenue from services | $ 916,149 | $ 934,904 |
Net income attributable to common shareholders | $ 40,255 | $ 11,391 |
Net income per share attributable to common shareholders - Basic (in dollars per share) | $ 1.16 | $ 0.35 |
Net income per share attributable to common shareholders - Diluted (in dollars per share) | $ 1.09 | $ 0.25 |
Acquisitions - Narrative (Detai
Acquisitions - Narrative (Details) $ in Thousands | May 03, 2017USD ($) | Oct. 30, 2015USD ($)shares | Jun. 30, 2014USD ($) | Dec. 31, 2015USD ($) | Dec. 31, 2017USD ($)stateclientspecialty | Sep. 30, 2017USD ($) | Jun. 30, 2017USD ($) | Mar. 31, 2017USD ($) | Dec. 31, 2016USD ($) | Sep. 30, 2016USD ($) | Jun. 30, 2016USD ($) | Mar. 31, 2016USD ($) | Dec. 31, 2017USD ($)stateclientspecialty | Dec. 31, 2016USD ($) | Dec. 31, 2015USD ($) | Mar. 31, 2016USD ($) | Dec. 31, 2018USD ($) | Dec. 01, 2016USD ($) | Apr. 01, 2016USD ($) |
Business Acquisition [Line Items] | |||||||||||||||||||
Consolidated net income | $ 28,256 | $ 7,044 | $ 5,220 | $ (1,718) | $ (7,649) | $ 14,289 | $ (17,095) | $ 19,186 | $ 38,802 | $ 8,731 | $ 4,954 | ||||||||
Release of remaining contingent liability | (44) | (769) | 0 | ||||||||||||||||
Goodwill | $ 117,589 | 79,648 | 117,589 | 79,648 | |||||||||||||||
Acquisition related costs | $ 1,975 | 78 | $ 902 | ||||||||||||||||
US Resources Healthcare, LLC | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration, range of outcomes, high | $ 4,500 | ||||||||||||||||||
Mediscan | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration, range of outcomes, high | $ 7,000 | ||||||||||||||||||
Cash purchase price paid at closing | 29,900 | ||||||||||||||||||
Cash consideration plus working capital estimate | 28,000 | ||||||||||||||||||
Fair value of shares | $ 4,723 | ||||||||||||||||||
Fair value of shares (in shares) | shares | 349,871 | ||||||||||||||||||
Net working capital adjustment | $ 503 | $ 0 | |||||||||||||||||
Release of escrow to seller | $ 5,000 | ||||||||||||||||||
Number of states | state | 11 | 11 | |||||||||||||||||
Number of clients (more than) | client | 300 | 300 | |||||||||||||||||
Number of specialties (more than) | specialty | 70 | 70 | |||||||||||||||||
Revenue since acquisition | $ 6,700 | ||||||||||||||||||
Net income since acquisition | 300 | ||||||||||||||||||
Assets acquired | $ 17,200 | ||||||||||||||||||
Weighted average useful life of assets acquired | 10 years | ||||||||||||||||||
Goodwill | $ 14,338 | ||||||||||||||||||
Acquisition related costs | $ 700 | ||||||||||||||||||
Medical Staffing Network | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Release of remaining contingent liability | $ 400 | ||||||||||||||||||
Contingent consideration liabilities | $ 2,100 | ||||||||||||||||||
Potential Earnout, Attainment of Specific Performance Criteria in 2017 | US Resources Healthcare, LLC | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration, range of outcomes, high | 1,000 | ||||||||||||||||||
Potential Earnout, Attainment of Specific Performance Criteria in 2017 | Mediscan | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration, range of outcomes, high | 3,500 | ||||||||||||||||||
Potential Earnout, Attainment of Specific Performance Criteria in 2018 | US Resources Healthcare, LLC | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration, range of outcomes, high | 2,000 | ||||||||||||||||||
Potential Earnout, Attainment of Specific Performance Criteria in 2019 | US Resources Healthcare, LLC | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration, range of outcomes, high | $ 1,500 | ||||||||||||||||||
Acquisition-Related Contingent Consideration | US Resources Healthcare, LLC | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Release of remaining contingent liability | $ 1,300 | ||||||||||||||||||
Assumed Additional Contingent Purchase Price Liabilities | US Resources Healthcare, LLC | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration liabilities | 200 | $ 200 | |||||||||||||||||
Assumed Additional Contingent Purchase Price Liabilities | Mediscan | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration, range of outcomes, high | 300 | $ 300 | 300 | $ 300 | |||||||||||||||
Contingent consideration liabilities | $ 5,200 | 5,200 | |||||||||||||||||
Potential Earnout, Attainment of Specific Performance Criteria in 2016 | Mediscan | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration, range of outcomes, high | 3,500 | ||||||||||||||||||
Deferred Consideration Transferred | Medical Staffing Network | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration liabilities | $ 2,500 | ||||||||||||||||||
Period of deferred consideration | 21 months | ||||||||||||||||||
Forecast | Assumed Additional Contingent Purchase Price Liabilities | Mediscan | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Contingent consideration, range of outcomes, high | $ 300 | ||||||||||||||||||
Acquisition-related Costs | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Consolidated net income | $ 2,000 | ||||||||||||||||||
Trade names | Mediscan | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Assets acquired | $ 3,200 | ||||||||||||||||||
Weighted average useful life of assets acquired | 11 years | ||||||||||||||||||
Customer relationships | Mediscan | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Assets acquired | $ 5,200 | ||||||||||||||||||
Weighted average useful life of assets acquired | 10 years | ||||||||||||||||||
Databases | Mediscan | |||||||||||||||||||
Business Acquisition [Line Items] | |||||||||||||||||||
Assets acquired | $ 8,800 | ||||||||||||||||||
Weighted average useful life of assets acquired | 10 years |
Acquisitions - Mediscan Estimat
Acquisitions - Mediscan Estimated Fair Value of Purchase Price (Details) - Mediscan - USD ($) $ in Thousands | Oct. 30, 2015 | Mar. 31, 2016 |
Business Acquisition [Line Items] | ||
Cash purchase price paid at closing | $ 28,000 | |
Fair value of shares | 4,723 | |
Fair value of contingent consideration | 3,686 | |
Net working capital adjustment, including receivable | 503 | $ 0 |
Total consideration | $ 36,912 |
Disposal - Narrative (Details)
Disposal - Narrative (Details) - USD ($) $ in Thousands | Aug. 31, 2015 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||
Loss on sale of business | $ 0 | $ 0 | $ 2,184 | |
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Cross Country Education, LLC | ||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||
Aggregate amount of selling prices | $ 8,000 | |||
Escrow deposit | $ 500 | |||
Earn-out held in escrow, term (in months) | 12 months | |||
Earnout (up to) | $ 500 | |||
Loss on sale of business | $ 2,200 | 2,200 | ||
Recorded tax benefit related to sale of business | 3,500 | |||
Gain on sale of discontinued operations, net of tax | $ 1,300 |
Goodwill, Trade Names, and Ot51
Goodwill, Trade Names, and Other Intangible Assets - Acquired Intangible Assets (Details) - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016 |
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items] | ||
Gross Carrying Amount | $ 110,068 | $ 80,168 |
Accumulated Amortization | 49,092 | 43,333 |
Net Carrying Amount | 60,976 | 36,835 |
Trade names | 26,702 | 35,402 |
Intangible assets not subject to amortization, net | 87,678 | 72,237 |
Databases | ||
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items] | ||
Gross Carrying Amount | 42,909 | 31,609 |
Accumulated Amortization | 18,702 | 16,147 |
Net Carrying Amount | 24,207 | 15,462 |
Customer relationships | ||
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items] | ||
Gross Carrying Amount | 55,524 | 41,724 |
Accumulated Amortization | 25,912 | 23,316 |
Net Carrying Amount | 29,612 | 18,408 |
Non-compete agreements | ||
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items] | ||
Gross Carrying Amount | 3,919 | 3,619 |
Accumulated Amortization | 3,600 | 3,527 |
Net Carrying Amount | 319 | 92 |
Trade names | ||
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items] | ||
Gross Carrying Amount | 7,716 | 3,216 |
Accumulated Amortization | 878 | 343 |
Net Carrying Amount | $ 6,838 | $ 2,873 |
Goodwill, Trade Names, and Ot52
Goodwill, Trade Names, and Other Intangible Assets - Estimated Annual Amortization Expense (Details) - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016 |
Goodwill and Intangible Assets Disclosure [Abstract] | ||
2,018 | $ 7,167 | |
2,019 | 7,131 | |
2,020 | 7,027 | |
2,021 | 6,819 | |
2,022 | 6,743 | |
Thereafter | 26,089 | |
Net Carrying Amount | $ 60,976 | $ 36,835 |
Goodwill, Trade Names, and Ot53
Goodwill, Trade Names, and Other Intangible Assets - Changes in Carrying Amount of Goodwill by Segment (Details) - USD ($) $ in Thousands | Jun. 30, 2016 | Dec. 31, 2017 | Dec. 31, 2017 | Dec. 31, 2016 |
Goodwill balances | ||||
Goodwill, net of impairment loss, beginning of period | $ 79,648 | |||
Goodwill, Translation and Purchase Accounting Adjustments [Abstract] | ||||
Goodwill, net of impairment loss, end of period | $ 117,589 | 117,589 | $ 79,648 | |
Physician Staffing Segment | ||||
Goodwill, Translation and Purchase Accounting Adjustments [Abstract] | ||||
Impairment charges | $ (17,700) | (5,700) | ||
Operating Segments | ||||
Goodwill balances | ||||
Goodwill, net of impairment loss, beginning of period | 79,648 | |||
Sale of CCE | (9,889) | (9,889) | ||
Accumulated impairment loss, beginning of period | (277,452) | |||
Aggregate goodwill acquired, beginning of period | 366,989 | |||
Goodwill, Translation and Purchase Accounting Adjustments [Abstract] | ||||
Goodwill acquired | 43,596 | |||
Impairment charges | (5,655) | |||
Aggregate goodwill acquired, end of period | 410,585 | 410,585 | 366,989 | |
Accumulated impairment loss, end of period | 283,107 | 283,107 | 277,452 | |
Goodwill, net of impairment loss, end of period | 117,589 | 117,589 | 79,648 | |
Operating Segments | Nurse and Allied Staffing Segment | ||||
Goodwill balances | ||||
Goodwill, net of impairment loss, beginning of period | 44,545 | |||
Sale of CCE | 0 | 0 | ||
Accumulated impairment loss, beginning of period | (259,732) | |||
Aggregate goodwill acquired, beginning of period | 304,277 | |||
Goodwill, Translation and Purchase Accounting Adjustments [Abstract] | ||||
Goodwill acquired | 43,596 | |||
Impairment charges | 0 | |||
Aggregate goodwill acquired, end of period | 347,873 | 347,873 | 304,277 | |
Accumulated impairment loss, end of period | 259,732 | 259,732 | 259,732 | |
Goodwill, net of impairment loss, end of period | 88,141 | 88,141 | 44,545 | |
Operating Segments | Physician Staffing Segment | ||||
Goodwill balances | ||||
Goodwill, net of impairment loss, beginning of period | 25,685 | |||
Sale of CCE | 0 | 0 | ||
Accumulated impairment loss, beginning of period | (17,720) | |||
Aggregate goodwill acquired, beginning of period | 43,405 | |||
Goodwill, Translation and Purchase Accounting Adjustments [Abstract] | ||||
Goodwill acquired | 0 | |||
Impairment charges | (5,655) | |||
Aggregate goodwill acquired, end of period | 43,405 | 43,405 | 43,405 | |
Accumulated impairment loss, end of period | 23,375 | 23,375 | 17,720 | |
Goodwill, net of impairment loss, end of period | 20,030 | 20,030 | 25,685 | |
Operating Segments | Other Human Capital Management Services Segment | ||||
Goodwill balances | ||||
Goodwill, net of impairment loss, beginning of period | 9,418 | |||
Sale of CCE | (9,889) | (9,889) | ||
Accumulated impairment loss, beginning of period | 0 | |||
Aggregate goodwill acquired, beginning of period | 19,307 | |||
Goodwill, Translation and Purchase Accounting Adjustments [Abstract] | ||||
Goodwill acquired | 0 | |||
Impairment charges | 0 | |||
Aggregate goodwill acquired, end of period | 19,307 | 19,307 | 19,307 | |
Accumulated impairment loss, end of period | 0 | 0 | 0 | |
Goodwill, net of impairment loss, end of period | $ 9,418 | $ 9,418 | $ 9,418 |
Goodwill, Trade Names, and Ot54
Goodwill, Trade Names, and Other Intangible Assets - Narrative (Details) $ in Thousands | Oct. 01, 2017 | Jun. 30, 2016USD ($) | Dec. 31, 2017USD ($) | Jun. 30, 2016USD ($) | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($) | Dec. 31, 2015USD ($) |
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Impairment charges | $ 14,400 | $ 24,300 | $ 14,356 | $ 24,311 | $ 2,100 | ||
Physician Staffing Segment | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Goodwill impairment charge | $ 17,700 | 5,700 | |||||
Impairment charges | 24,300 | ||||||
Customer relationships | Physician Staffing Segment | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Impairment of intangibles finite lived | $ 6,000 | ||||||
Income Approach Valuation Technique | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Terminal value growth rate percentage | 3.00% | ||||||
Income Approach Valuation Technique | Physician Staffing Segment | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Weighted applied percentage | 75.00% | ||||||
Income Approach Valuation Technique | Search Reporting Unit [Member] | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Weighted applied percentage | 75.00% | ||||||
Income Approach Valuation Technique | Nurse and Allied Staffing Segment | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Weighted applied percentage | 50.00% | ||||||
Income Approach Valuation Technique | Customer relationships | Physician Staffing Segment | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Discount rate percentage | 13.50% | ||||||
Income and Market Approach Valuation Technique | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Forecast period | 10 years | ||||||
Market Approach Valuation Technique | Physician Staffing Segment | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Weighted applied percentage | 25.00% | ||||||
Market Approach Valuation Technique | Search Reporting Unit [Member] | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Weighted applied percentage | 25.00% | ||||||
Market Approach Valuation Technique | Nurse and Allied Staffing Segment | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Weighted applied percentage | 50.00% | ||||||
Minimum | Income Approach Valuation Technique | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Discount rate percentage | 11.00% | ||||||
Minimum | Market Approach Valuation Technique | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Ratio of total enterprise value by EBITDA | 5.75 | ||||||
Maximum | Income Approach Valuation Technique | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Discount rate percentage | 15.00% | ||||||
Maximum | Market Approach Valuation Technique | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Ratio of total enterprise value by EBITDA | 15 | ||||||
Trade Names | Physician Staffing Segment | |||||||
Goodwill and Intangible Assets Disclosure [Line Items] | |||||||
Impairment of intangibles indefinite lived | $ 600 | $ 8,700 | $ 2,100 |
Property and Equipment (Details
Property and Equipment (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2017 | Dec. 31, 2016 | |
Property, Plant and Equipment [Line Items] | ||
Property and equipment | $ 44,764 | $ 55,959 |
Less accumulated depreciation and amortization | (30,678) | (43,141) |
Property and equipment, net of accumulated depreciation and amortization | 14,086 | 12,818 |
Computer equipment | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment | 6,432 | 13,584 |
Computer software | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment | 24,933 | 28,752 |
Office equipment | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment | 1,379 | 2,397 |
Furniture and fixtures | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment | 4,680 | 3,969 |
Leasehold improvements | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment | $ 7,340 | $ 7,257 |
Minimum | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 3 years | |
Minimum | Computer equipment | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 3 years | |
Minimum | Computer software | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 3 years | |
Minimum | Office equipment | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 5 years | |
Minimum | Furniture and fixtures | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 5 years | |
Maximum | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 7 years | |
Maximum | Computer equipment | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 5 years | |
Maximum | Computer software | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 5 years | |
Maximum | Office equipment | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 7 years | |
Maximum | Furniture and fixtures | ||
Property, Plant and Equipment [Line Items] | ||
Estimated useful life | 7 years |
Balance Sheet Details (Details)
Balance Sheet Details (Details) - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016 |
Balance Sheet Related Disclosures [Abstract] | ||
Insurance recovery for health | $ 0 | $ 279 |
Insurance recovery for workers’ compensation | 1,623 | 1,271 |
Insurance recovery for professional liability | 1,874 | 1,487 |
Insurance recovery receivable | 3,497 | 3,037 |
Insurance recovery for workers’ compensation claims | 6,093 | 5,857 |
Insurance recovery for professional liability claims | 10,011 | 10,353 |
Non-current security deposits | 1,095 | 925 |
Non-current income tax receivable | 1,044 | 0 |
Net debt issuance costs | 985 | 929 |
Other non-current assets | 19,228 | 18,064 |
Salaries and payroll taxes | 16,342 | 15,480 |
Bonuses | 2,067 | 3,915 |
Accrual for workers’ compensation claims | 5,957 | 5,266 |
Accrual for professional liability claims | 2,683 | 2,433 |
Accrual for healthcare benefits | 5,105 | 4,053 |
Accrual for vacation | 2,117 | 2,096 |
Accrued compensation and benefits | 34,271 | 33,243 |
Accrual for workers’ compensation claims | 13,160 | 12,817 |
Accrual for professional liability claims | 15,597 | 16,053 |
Long-term accrued claims | 28,757 | 28,870 |
Deferred compensation | 1,467 | 1,472 |
Deferred rent | 6,875 | 5,011 |
Long-term unrecognized tax benefits | 485 | 874 |
Other | 344 | 52 |
Other long-term liabilities | $ 9,171 | $ 7,409 |
Debt - Long- Term Debt (Details
Debt - Long- Term Debt (Details) - USD ($) $ in Thousands | Dec. 31, 2017 | Mar. 17, 2017 | Dec. 31, 2016 |
Debt Instrument [Line Items] | |||
Total debt | $ 100,000 | $ 92,032 | |
Less current portion | (6,875) | (2,250) | |
Long-term Debt and Capital Lease Obligations | 93,125 | 89,782 | |
Unamortized Discount and Debt Issuance Costs | (866) | (5,032) | |
Senior Debt | Term Loan, net | |||
Debt Instrument [Line Items] | |||
Debt | 100,000 | 39,500 | |
Unamortized Discount and Debt Issuance Costs | $ (866) | $ (363) | |
Interest Rate | 3.61% | 2.62% | |
Convertible Notes | |||
Debt Instrument [Line Items] | |||
Interest Rate | 8.00% | ||
Convertible Notes | 8% Convertible Notes | |||
Debt Instrument [Line Items] | |||
Debt | $ 0 | $ 25,000 | |
Unamortized Discount and Debt Issuance Costs | 0 | $ (4,669) | |
Interest Rate | 8.00% | ||
Convertible Notes | Convertible Note Derivative Liability | |||
Debt Instrument [Line Items] | |||
Debt | 0 | $ 27,532 | |
Unamortized Discount and Debt Issuance Costs | $ 0 | $ 0 |
Debt - Debt Maturities (Details
Debt - Debt Maturities (Details) - Term Loan $ in Thousands | Dec. 31, 2017USD ($) |
Long-term Debt, Fiscal Year Maturity [Abstract] | |
2,018 | $ 6,875 |
2,019 | 7,500 |
2,020 | 8,125 |
2,021 | 10,000 |
2,022 | 67,500 |
Total | $ 100,000 |
Debt - Amendment And Restatemen
Debt - Amendment And Restatement Of Senior Credit Facility (Details) | Aug. 01, 2017USD ($) | Dec. 31, 2017USD ($)financial_covenant | Dec. 31, 2016USD ($) | Dec. 31, 2015USD ($) |
Debt Instrument [Line Items] | ||||
Proceeds from Term Loans | $ 62,000,000 | $ 40,000,000 | $ 0 | |
Amended And Restated Credit Agreement | ||||
Debt Instrument [Line Items] | ||||
Face amount | $ 215,000,000 | |||
Sub facility for swingline loans | 15,000,000 | |||
Line of credit, subfacility for standby letters of credit | 35,000,000 | |||
Proceeds from Term Loans | 106,500,000 | |||
Interest rate increase (decrease) (percent) | 2.00% | |||
Quarterly commitment fee on the average daily unused portion (percent) | 0.30% | |||
Number of financial covenants | financial_covenant | 2 | |||
Amended And Restated Credit Agreement | Minimum | ||||
Debt Instrument [Line Items] | ||||
Consolidated Fixed Charge Coverage Ratio | 1.50 | |||
Amended And Restated Credit Agreement | Fiscal Quarters Ending September 30, 2017 through June 30, 2018 | Maximum | ||||
Debt Instrument [Line Items] | ||||
Consolidated Total Leverage Ratio | 3.50 | |||
Amended And Restated Credit Agreement | Fiscal Quarters Ending September 30, 2018 through June 30, 2019 | Maximum | ||||
Debt Instrument [Line Items] | ||||
Consolidated Total Leverage Ratio | 3.25 | |||
Amended And Restated Credit Agreement | Each Fiscal Quarter Ending Thereafter | Maximum | ||||
Debt Instrument [Line Items] | ||||
Consolidated Total Leverage Ratio | 3 | |||
Term Loan, net | Amended And Restated Credit Agreement | ||||
Debt Instrument [Line Items] | ||||
Face amount | 100,000,000 | |||
Additional capacity | $ 50,000,000 | |||
Term Loan, net | Amended And Restated Credit Agreement | First Four Installments | ||||
Debt Instrument [Line Items] | ||||
Periodic payment, percentage of principal | 5.00% | |||
Term Loan, net | Amended And Restated Credit Agreement | Next Eight Installments | ||||
Debt Instrument [Line Items] | ||||
Periodic payment, percentage of principal | 7.50% | |||
Term Loan, net | Amended And Restated Credit Agreement | Remaining Installments | ||||
Debt Instrument [Line Items] | ||||
Periodic payment, percentage of principal | 10.00% | |||
Revolving Credit Facility | Amended And Restated Credit Agreement | ||||
Debt Instrument [Line Items] | ||||
Letters of credit outstanding | $ 21,600,000 | |||
Line of credit outstanding | $ 93,400,000 | |||
Revolving Credit Facility | Amended And Restated Credit Agreement | LIBOR | ||||
Debt Instrument [Line Items] | ||||
Interest margin | 2.25% | |||
Revolving Credit Facility | Line of Credit | Amended And Restated Credit Agreement | ||||
Debt Instrument [Line Items] | ||||
Maximum borrowing capacity | $ 115,000,000 | |||
Proceeds from Term Loans | $ 6,500,000 |
Debt - Consolidated Net Leverag
Debt - Consolidated Net Leverage Ratio (Details) - Credit Agreement | Jul. 05, 2017 | Dec. 31, 2017 |
Covenant Term 1 | ||
Line of Credit Facility [Line Items] | ||
Commitment fee percentage | 0.25% | |
Covenant Term 1 | Eurodollar Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 1.75% | |
Covenant Term 1 | LIBOR Index Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 1.75% | |
Covenant Term 1 | Letter of Credit Fee | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 1.75% | |
Covenant Term 1 | Base Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 0.75% | |
Covenant Term 1 | Maximum | ||
Line of Credit Facility [Line Items] | ||
Consolidated Net Leverage Ratio | 1.50 | |
Covenant Term 2 | ||
Line of Credit Facility [Line Items] | ||
Commitment fee percentage | 0.30% | |
Covenant Term 2 | Eurodollar Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.00% | |
Covenant Term 2 | LIBOR Index Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.00% | |
Covenant Term 2 | Letter of Credit Fee | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.00% | |
Covenant Term 2 | Base Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 1.00% | |
Covenant Term 2 | Minimum | ||
Line of Credit Facility [Line Items] | ||
Consolidated Net Leverage Ratio | 1.50 | |
Covenant Term 2 | Maximum | ||
Line of Credit Facility [Line Items] | ||
Consolidated Net Leverage Ratio | 2 | |
Covenant Term 3 | ||
Line of Credit Facility [Line Items] | ||
Commitment fee percentage | 0.30% | 0.30% |
Covenant Term 3 | Eurodollar Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.25% | 2.25% |
Covenant Term 3 | LIBOR Index Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.25% | |
Covenant Term 3 | Letter of Credit Fee | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.25% | |
Covenant Term 3 | Base Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 1.25% | 1.25% |
Covenant Term 3 | Minimum | ||
Line of Credit Facility [Line Items] | ||
Consolidated Net Leverage Ratio | 2 | |
Covenant Term 3 | Maximum | ||
Line of Credit Facility [Line Items] | ||
Consolidated Net Leverage Ratio | 2.50 | |
Covenant Term 4 | ||
Line of Credit Facility [Line Items] | ||
Commitment fee percentage | 0.35% | |
Covenant Term 4 | Eurodollar Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.50% | |
Covenant Term 4 | LIBOR Index Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.50% | |
Covenant Term 4 | Letter of Credit Fee | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.50% | |
Covenant Term 4 | Base Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 1.50% | |
Covenant Term 4 | Minimum | ||
Line of Credit Facility [Line Items] | ||
Consolidated Net Leverage Ratio | 2.50 | |
Covenant Term 4 | Maximum | ||
Line of Credit Facility [Line Items] | ||
Consolidated Net Leverage Ratio | 3 | |
Covenant Term 5 | ||
Line of Credit Facility [Line Items] | ||
Commitment fee percentage | 0.40% | |
Covenant Term 5 | Eurodollar Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.75% | |
Covenant Term 5 | LIBOR Index Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.75% | |
Covenant Term 5 | Letter of Credit Fee | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 2.75% | |
Covenant Term 5 | Base Rate Loans | ||
Line of Credit Facility [Line Items] | ||
Interest margin | 1.75% | |
Covenant Term 5 | Minimum | ||
Line of Credit Facility [Line Items] | ||
Consolidated Net Leverage Ratio | 3 |
Debt - 2016 Senior Credit Facil
Debt - 2016 Senior Credit Facilities (Details) - USD ($) | Jul. 05, 2017 | Jun. 22, 2016 | Jun. 30, 2016 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 |
Debt Instrument [Line Items] | ||||||
Prepayment penalty | $ 600,000 | |||||
Loss on early extinguishment of debt | $ 4,969,000 | $ 1,568,000 | $ 0 | |||
Second Lien Term Loan, net | ||||||
Debt Instrument [Line Items] | ||||||
Loss on early extinguishment of debt | $ 1,600,000 | |||||
Senior Debt | Credit Agreement | ||||||
Debt Instrument [Line Items] | ||||||
Maximum borrowing capacity | 40,000,000 | |||||
Subordinated Debt | Second Lien Term Loan, net | ||||||
Debt Instrument [Line Items] | ||||||
Loss on early extinguishment of debt | $ 1,600,000 | |||||
Term Loan, net | Incremental Term Loan | ||||||
Debt Instrument [Line Items] | ||||||
Face amount | $ 40,000,000 | |||||
Term Loan, net | Incremental Term Loan | First Eight Installments | ||||||
Debt Instrument [Line Items] | ||||||
Periodic payment, percentage of principal | 1.875% | |||||
Term Loan, net | Incremental Term Loan | Remaining Installments | ||||||
Debt Instrument [Line Items] | ||||||
Periodic payment, percentage of principal | 2.50% | |||||
Term Loan, net | Incremental Term Loan | Eurodollar | ||||||
Debt Instrument [Line Items] | ||||||
Interest margin | 2.25% | |||||
Term Loan, net | Incremental Term Loan | Base Rate Loans | ||||||
Debt Instrument [Line Items] | ||||||
Interest margin | 1.25% | |||||
Revolving Credit Facility | Credit Agreement | ||||||
Debt Instrument [Line Items] | ||||||
Maximum borrowing capacity | 100,000,000 | |||||
Sub facility for swingline loans | 15,000,000 | |||||
Line of credit, subfacility for standby letters of credit | 35,000,000 | |||||
Revolving Credit Facility | Subordinated Debt | Second Lien Term Loan, net | ||||||
Debt Instrument [Line Items] | ||||||
Maximum borrowing capacity | $ 30,000,000 | |||||
Covenant Term 3 | Credit Agreement | ||||||
Debt Instrument [Line Items] | ||||||
Commitment fee percentage | 0.30% | 0.30% | ||||
Covenant Term 3 | Credit Agreement | Eurodollar | ||||||
Debt Instrument [Line Items] | ||||||
Interest margin | 2.25% | 2.25% | ||||
Covenant Term 3 | Credit Agreement | Base Rate Loans | ||||||
Debt Instrument [Line Items] | ||||||
Interest margin | 1.25% | 1.25% |
Debt - Private Placement of Con
Debt - Private Placement of Convertible Notes Narrative (Details) | Mar. 17, 2017USD ($)dayinstrumentd$ / sharesshares | Mar. 31, 2017USD ($) | Dec. 31, 2017USD ($)$ / shares | Dec. 31, 2016USD ($)$ / shares | Dec. 31, 2015USD ($) | Jun. 30, 2014USD ($) |
Debt Instrument [Line Items] | ||||||
Common stock, par value (usd per share) | $ / shares | $ 0.0001 | $ 0.0001 | ||||
Repayments of debt | $ 1,500,000 | $ 30,500,000 | $ 0 | |||
Extinguishment fees | 578,000 | 641,000 | 0 | |||
Loss on early extinguishment of debt | $ 4,969,000 | $ 1,568,000 | $ 0 | |||
Convertible Notes | ||||||
Debt Instrument [Line Items] | ||||||
Face amount | $ 25,000,000 | |||||
Common stock, par value (usd per share) | $ / shares | $ 0.0001 | |||||
Payment of debt and extinguishment fees | $ 5,600,000 | |||||
Repayments of debt | 5,000,000 | |||||
Extinguishment fees | 600,000 | |||||
Loss on early extinguishment of debt | 5,000,000 | $ 5,000,000 | ||||
Non-cash write off related to settlement of convertible notes | $ 46,000,000 | |||||
Debt conversion price (in usd per share) | $ / shares | $ 7.10 | |||||
Debt instrument, convertible, number of equity instruments | instrument | 3,521,126 | |||||
Debt Instrument, convertible, threshold period following issuance date (in years) | 3 years | |||||
Debt instrument, convertible, threshold percentage of stock price trigger | 125.00% | |||||
Debt instrument, convertible, threshold trading days | day | 20 | |||||
Debt instrument, convertible, threshold consecutive trading days | d | 30 | |||||
Interest rate (percent) | 8.00% | |||||
Common Stock | ||||||
Debt Instrument [Line Items] | ||||||
Shares issued (in shares) | shares | 3,175,584 | |||||
8% Convertible Notes | Convertible Notes | ||||||
Debt Instrument [Line Items] | ||||||
Original debt amount in debt conversion | $ 20,000,000 | |||||
Interest rate (percent) | 8.00% | |||||
Convertible Note Derivative Liability | Convertible Notes | ||||||
Debt Instrument [Line Items] | ||||||
Original debt amount in debt conversion | $ 26,000,000 |
Fair Value Measurements - Estim
Fair Value Measurements - Estimated Fair values Assets and Liabilities Measured on Recurring Basis (Details) - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016 |
Level 3 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Contingent purchase price liabilities | $ 5,368 | $ 5,603 |
Convertible Notes derivative liability | Level 3 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Convertible Notes derivative liability | 0 | 27,532 |
Deferred compensation | Level 1 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Deferred compensation | $ 1,467 | $ 1,472 |
Fair Value Measurements - Sched
Fair Value Measurements - Schedule of reconciliation of opening and closing balances for fair value measurements categorized within Level 3 (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2017 | Dec. 31, 2016 | |
Contingent Purchase Price Liabilities | ||
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward] | ||
Beginning balance | $ 5,603 | $ 3,686 |
Additions | 1,300 | |
Payments/Settlements | (280) | (152) |
Accretion expense | 967 | 887 |
Valuation gain for the period | (922) | (118) |
Ending balance | 5,368 | 5,603 |
Convertible Notes Derivative Liability | ||
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward] | ||
Beginning balance | 27,532 | 33,337 |
Additions | 0 | |
Payments/Settlements | (25,951) | 0 |
Accretion expense | 0 | 0 |
Valuation gain for the period | (1,581) | (5,805) |
Ending balance | $ 0 | $ 27,532 |
Fair Value Measurements - Finan
Fair Value Measurements - Financial Instruments that were not Measured at Fair Value (Details) - Level 2 - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016 |
Term Loan, net | Carrying Amount | ||
Fair Value, Option, Quantitative Disclosures [Line Items] | ||
Carrying Amount | $ 99,134 | $ 39,137 |
Term Loan, net | Fair Value | ||
Fair Value, Option, Quantitative Disclosures [Line Items] | ||
Fair Value | 100,500 | 41,500 |
Convertible Notes, net | Carrying Amount | ||
Fair Value, Option, Quantitative Disclosures [Line Items] | ||
Carrying Amount | 0 | 20,331 |
Convertible Notes, net | Fair Value | ||
Fair Value, Option, Quantitative Disclosures [Line Items] | ||
Fair Value | $ 0 | $ 27,250 |
Fair Value Measurements - Narra
Fair Value Measurements - Narrative (Details) | 12 Months Ended |
Dec. 31, 2017 | |
Minimum | |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
Threshold period, past due for payment of services provided | 15 days |
Maximum | |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
Threshold period, past due for payment of services provided | 60 days |
Employee Benefit Plans - Narrat
Employee Benefit Plans - Narrative (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Retirement Benefits [Abstract] | |||
Company contribution net of forfeitures | $ 700 | $ 800 | $ 700 |
Deferred compensation liabilities | $ 1,467 | $ 1,472 |
Commitments and Contingencies -
Commitments and Contingencies - Future Minimum Lease Payments (Details) $ in Thousands | Dec. 31, 2017USD ($) |
Commitments and Contingencies Disclosure [Abstract] | |
2,018 | $ 6,700 |
2,019 | 5,180 |
2,020 | 4,438 |
2,021 | 3,993 |
2,022 | 3,698 |
Thereafter | 8,732 |
Total | $ 32,741 |
Commitments and Contingencies69
Commitments and Contingencies - Narrative (Details) - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Commitments and Contingencies Disclosure [Abstract] | |||
Operating lease expense | $ 9.4 | $ 8.4 | $ 8.1 |
Income Taxes - Components of In
Income Taxes - Components of Income (Loss) Before Income Taxes (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Income Tax Disclosure [Abstract] | |||
United States | $ 3,826 | $ 3,309 | $ 3,565 |
Foreign | 475 | 1,236 | 595 |
Income before income taxes | $ 4,301 | $ 4,545 | $ 4,160 |
Income Taxes - Components of 71
Income Taxes - Components of Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Current: | |||
Federal | $ (555) | $ 227 | $ 551 |
State | (273) | 587 | (21) |
Foreign | 139 | 322 | 220 |
Total | (689) | 1,136 | 750 |
Deferred: | |||
Federal | (23,245) | (4,114) | (1,819) |
State | (10,684) | (866) | 8 |
Foreign | 117 | (342) | 267 |
Total | (33,812) | (5,322) | (1,544) |
Total income tax benefit | $ (34,501) | $ (4,186) | $ (794) |
Income Taxes - Significant Comp
Income Taxes - Significant Components of Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016 |
Deferred Tax Assets: | ||
Accrued other and prepaid expenses | $ 2,955 | $ 3,494 |
Allowance for doubtful accounts | 624 | 704 |
Intangible Assets | 7,776 | 10,725 |
Net operating loss carryforwards | 14,718 | 17,228 |
Derivative interest | 0 | 7,940 |
Accrued professional liability claims | 1,709 | 2,632 |
Accrued workers’ compensation claims | 2,512 | 3,439 |
Share-based compensation | 734 | 0 |
Credit carryforwards | 189 | 1,055 |
Other | 444 | 584 |
Gross deferred tax assets | 31,661 | 47,801 |
Valuation allowance | (1,076) | (46,454) |
Deferred tax assets | 30,585 | 1,347 |
Deferred Tax Liabilities: | ||
Depreciation | (41) | (70) |
Indefinite intangibles | (9,964) | (13,971) |
Tax on unrepatriated earnings | (466) | (263) |
Share-based compensation | 0 | (197) |
Deferred tax liabilities | (10,471) | (14,501) |
Net deferred taxes | $ 20,114 | $ (13,154) |
Income Taxes - Narrative (Detai
Income Taxes - Narrative (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | 36 Months Ended | |||
Dec. 31, 2017 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2017 | Dec. 31, 2014 | |
Income Tax Contingency [Line Items] | ||||||
Valuation allowance | $ 1,076 | $ 1,076 | $ 46,454 | $ 1,076 | ||
Reduction in valuation allowance | 45,400 | |||||
Cumulative pre-tax income adjusted for permanent items | 27,700 | |||||
Income tax expense related to deferred tax asset | 8,000 | 200 | ||||
Federal, state and foreign net operating loss carryforwards | 166,100 | 166,100 | 161,100 | 166,100 | ||
Deferred liabilities on undistributed foreign earnings | 466 | 466 | 263 | 466 | ||
Unrecognized tax benefits | 3,807 | 3,807 | 5,180 | $ 4,071 | 3,807 | $ 3,777 |
Unrecognized tax benefits, which would affect the effective tax rate | 4,000 | 4,000 | 4,900 | 3,800 | 4,000 | |
Gross increases in current year unrecognized tax | 1,100 | |||||
Gross decreases related to statute expirations | 200 | |||||
Increase (decrease) in recognized interest and penalties | (200) | 100 | (200) | |||
Unrecognized tax benefit accrued interest and penalties | 200 | 200 | 500 | 400 | 200 | |
India | ||||||
Income Tax Contingency [Line Items] | ||||||
Deferred liabilities on undistributed foreign earnings | 100 | 100 | 100 | |||
Repatriated amount of foreign earnings | 500 | |||||
Other Current Liabilities | ||||||
Income Tax Contingency [Line Items] | ||||||
Unrecognized tax benefits | 100 | 100 | 100 | 100 | 100 | |
Other Noncurrent Liabilities | ||||||
Income Tax Contingency [Line Items] | ||||||
Unrecognized tax benefits | $ 500 | 500 | $ 900 | $ 800 | $ 500 | |
Net Operating Losses | U.S. | ||||||
Income Tax Contingency [Line Items] | ||||||
Reduction in valuation allowance | 15,700 | |||||
Net Operating Losses | State | ||||||
Income Tax Contingency [Line Items] | ||||||
Reduction in valuation allowance | 4,400 | |||||
Other Net Deferred Tax Assets | ||||||
Income Tax Contingency [Line Items] | ||||||
Reduction in valuation allowance | $ 25,300 |
Income Taxes - Reconciliation o
Income Taxes - Reconciliation of Income Tax Computed At U. S. Federal Statutory Rate to Income Tax (Benefit) Expense (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Income Tax Disclosure [Abstract] | |||
Tax at U.S. statutory rate | $ 1,506 | $ 1,591 | $ 1,456 |
State taxes, net of federal benefit | (1,374) | 344 | (13) |
Noncontrolling interest | (455) | (260) | 0 |
Non-deductible meals and entertainment | 2,676 | 1,546 | 1,510 |
Foreign tax expense | 175 | (5) | (6) |
Valuation allowances | (45,354) | (8,379) | (5,078) |
Uncertain tax positions | 1,145 | 1,090 | 917 |
Federal rate change | 8,011 | 0 | 0 |
Other | (831) | (113) | 420 |
Total income tax benefit | $ (34,501) | $ (4,186) | $ (794) |
Income Taxes - Reconciliation75
Income Taxes - Reconciliation of Beginning and Ending Balance of Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward] | |||
Balance at January 1 | $ 5,180 | $ 4,071 | $ 3,777 |
Additions based on tax positions related to the current year | 1,145 | 1,054 | 861 |
Additions based on tax positions related to prior years | 0 | 55 | 62 |
Reductions based on settlements of tax positions related to prior years | (439) | 0 | (624) |
2017 Tax Act federal tax rate change | (1,859) | 0 | 0 |
Other | (220) | 0 | (5) |
Balance at December 31 | $ 3,807 | $ 5,180 | $ 4,071 |
Stockholders' Equity - Narrativ
Stockholders' Equity - Narrative (Details) - USD ($) | Mar. 17, 2017 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | Feb. 28, 2008 |
February 2008 Board Authorization | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Common stock authorized for stock repurchase program (in shares) | 1,500,000 | ||||
Shares repurchased (in shares) | 0 | 0 | 0 | ||
Common stock left remaining to repurchase under the plan (in shares) | 942,443 | ||||
Aggregate stock repurchase amount | $ 5,000,000 | ||||
Common Stock | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Shares converted (in shares) | 3,175,584 |
Stockholders' Equity - 2014 Omn
Stockholders' Equity - 2014 Omnibus Incentive Plan (Details) - USD ($) $ in Millions | May 23, 2017 | Mar. 31, 2017 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 |
Omnibus Plan [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Additional shares authorized (in shares) | 2,000,000 | ||||
Shares reserved for future issuance (in shares) | 6,100,000 | ||||
Minimum | 2014 Plan | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Exercise price percentage of the fair market value of common stock | 100.00% | ||||
Maximum | 2014 Plan | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Stock expiration period | 10 years | ||||
Ten Percent Or More Stockholders | Minimum | 2014 Plan | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Exercise price percentage of the fair market value of common stock | 110.00% | ||||
Ten Percent Or More Stockholders | Maximum | 2014 Plan | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Stock expiration period | 5 years | ||||
Restricted Stock Awards | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Pretax of total unrecognized compensation cost related to non-vested restricted stock awards | $ 4.6 | ||||
Pretax total unrecognized compensation cost related to share options- period | 1 year 11 months 20 days | ||||
Fair value of shares vested | $ 0 | $ 4.3 | $ 3.9 | ||
Restricted Stock Awards | 2014 Plan | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Stock vesting period | 3 years | ||||
Performance Stock Awards | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Pretax of total unrecognized compensation cost related to non-vested restricted stock awards | $ 2.2 | ||||
Pretax total unrecognized compensation cost related to share options- period | 2 years 18 days | ||||
Fair value of shares vested | $ 1.6 | $ 1.2 | |||
Performance Stock Awards | Omnibus Plan [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Percentage of performance attained | 48.00% | ||||
Shares issued (in shares) | 86,784 | ||||
Stock Appreciation Rights | 2007 Stock Incentive Plan | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Stock expiration period | 7 years | ||||
Stock vesting period | 4 years | ||||
Stock vesting percentage per year | 25.00% |
Stockholders' Equity - Summary
Stockholders' Equity - Summary of Restricted Stock Award Activity and Performance Stock Awards (Details) | 12 Months Ended |
Dec. 31, 2017$ / sharesshares | |
Restricted Stock Awards | |
Number of Shares | |
Unvested restricted stock awards, beginning balance (in shares) | shares | 532,294 |
Granted (in shares) | shares | 323,503 |
Vested (in shares) | shares | (292,615) |
Forfeited (in shares) | shares | (47,581) |
Unvested restricted stock awards, ending balance (in shares) | shares | 515,601 |
Weighted average grant date fair value | |
Unvested restricted stock awards, beginning balance (usd per share) | $ / shares | $ 9.98 |
Granted (usd per share) | $ / shares | 13.70 |
Vested (usd per share) | $ / shares | 8.64 |
Forfeited (usd per share) | $ / shares | 10.41 |
Unvested restricted stock awards, ending balance (usd per share) | $ / shares | $ 13.03 |
Performance Stock Awards | |
Number of Shares | |
Unvested restricted stock awards, beginning balance (in shares) | shares | 332,092 |
Granted (in shares) | shares | 181,067 |
Vested (in shares) | shares | (124,568) |
Forfeited (in shares) | shares | (131,016) |
Unvested restricted stock awards, ending balance (in shares) | shares | 257,575 |
Weighted average grant date fair value | |
Unvested restricted stock awards, beginning balance (usd per share) | $ / shares | $ 11.73 |
Granted (usd per share) | $ / shares | 14.36 |
Vested (usd per share) | $ / shares | 11.86 |
Forfeited (usd per share) | $ / shares | 11.78 |
Unvested restricted stock awards, ending balance (usd per share) | $ / shares | $ 13.49 |
Stockholders' Equity - Stock Op
Stockholders' Equity - Stock Options and Stock Appreciation Rights Granted and Exercised (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Equity [Abstract] | |||
Total intrinsic value of options exercised | $ 516 | $ 1,323 | $ 1,610 |
Stockholders' Equity - 1999 Sto
Stockholders' Equity - 1999 Stock Option Plan and Equity Participation Plan (Details) - USD ($) $ / shares in Units, $ in Millions | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Oct. 25, 2001 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share options outstanding (in shares) | 94,500 | 188,213 | |
Shares options outstanding vested or expected to vest -weighted average exercise price (usd per share) | $ 5.19 | ||
Shares options outstanding vested or expected to vest ,intrinsic value | $ 0.7 | ||
Shares options outstanding vested or expected to vest -weighted average contractual life | 1 year 10 months 6 days | ||
The 1999 Plan | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Aggregate number of common stock shares authorized for issuance (in shares) | 4,398,001 |
Stockholders' Equity - Summar81
Stockholders' Equity - Summary of Company's Share Option Plans Activities (Details) $ / shares in Units, $ in Thousands | 12 Months Ended |
Dec. 31, 2017USD ($)$ / sharesshares | |
Number of Shares | |
Share options outstanding at beginning of year (in shares) | shares | 188,213 |
Granted (in shares) | shares | 0 |
Exercised (in shares) | shares | (74,625) |
Forfeited/expired (in shares) | shares | (19,088) |
Share options outstanding at end of year (in shares) | shares | 94,500 |
Weighted Average Exercise Price | |
Share options outstanding at beginning of year, weighted average exercise price (usd per share) | $ 5.72 |
Granted, weighted average exercise price (usd per share) | 0 |
Exercised, weighted average exercise price (usd per share) | 5.71 |
Forfeited/expired, weighted average exercise price (usd per share) | 8.43 |
Share options outstanding at end of year, weighted average exercise price (usd per share) | $ 5.19 |
Share options outstanding at end of year, weighted-average remaining contractual life | 1 year 10 months 6 days |
Share options outstanding at end of year | $ | $ 716 |
Exercise Price Range One | |
Number of Shares | |
Exercise Price, Lower Limit (usd per share) | $ 4.16 |
Exercise Price, Upper Limit (usd pre share) | 22.50 |
Exercise Price Range Two | |
Number of Shares | |
Exercise Price, Lower Limit (usd per share) | 4.35 |
Exercise Price, Upper Limit (usd pre share) | 8.09 |
Exercise Price Range Three | |
Number of Shares | |
Exercise Price, Lower Limit (usd per share) | 5.21 |
Exercise Price, Upper Limit (usd pre share) | 22.50 |
Exercise Price Range Four | |
Number of Shares | |
Exercise Price, Lower Limit (usd per share) | 4.16 |
Exercise Price, Upper Limit (usd pre share) | 7.44 |
Exercise Price Range Five | |
Number of Shares | |
Exercise Price, Lower Limit (usd per share) | 4.16 |
Exercise Price, Upper Limit (usd pre share) | $ 7.44 |
Earnings Per Share - Components
Earnings Per Share - Components of Numerator and Denominator for Computation of Basic and Diluted Earnings per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Mar. 31, 2016 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Numerator: | |||||||||||
Net income attributable to common shareholders - Basic | $ 37,513 | $ 7,967 | $ 4,418 | ||||||||
Interest on Convertible Notes | 694 | 3,383 | |||||||||
Gain on derivative liability | $ (1,600) | $ 14,200 | $ (7,100) | $ 3,600 | $ (16,400) | (1,581) | (5,805) | 9,901 | |||
Net income attributable to common shareholders - Diluted | $ 36,626 | $ 5,545 | $ 4,418 | ||||||||
Denominator: | |||||||||||
Weighted average common shares - Basic (shares) | 35,018 | 32,132 | 31,514 | ||||||||
Effective of diluted shares: | |||||||||||
Share-based awards (shares) | 425 | 593 | 648 | ||||||||
Convertible Notes (shares) | 723 | 3,521 | 0 | ||||||||
Weighted average common shares - Diluted (shares) | 36,166 | 36,246 | 32,162 | ||||||||
Net income per share attributable to common shareholders - Basic (usd per share) | $ 0.78 | $ 0.19 | $ 0.14 | $ (0.06) | $ (0.24) | $ 0.44 | $ (0.54) | $ 0.60 | $ 1.07 | $ 0.25 | $ 0.14 |
Net income per share attributable to common shareholders - Diluted (usd per share) | $ 0.77 | $ 0.19 | $ 0.13 | $ (0.08) | $ (0.24) | $ 0.22 | $ (0.54) | $ 0.09 | $ 1.01 | $ 0.15 | $ 0.14 |
Earnings Per Share - Antidiluti
Earnings Per Share - Antidilutive Securities (Details) - shares shares in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Convertible notes and share-based awards | |||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | |||
Antidilutive securities | 118 | 0 | 3,521 |
Related Party Transactions (Det
Related Party Transactions (Details) - USD ($) $ in Millions | 2 Months Ended | 12 Months Ended | ||
Dec. 31, 2015 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Related Party Transaction [Line Items] | ||||
Revenue from related parties | $ 4.9 | $ 5 | $ 11.8 | |
Account receivable due from related parties | 0.4 | 1 | ||
Corporate Joint Venture | ||||
Related Party Transaction [Line Items] | ||||
Revenue from related parties | $ 17.9 | 12.6 | $ 10 | |
Percent ownership in joint venture | 68.00% | |||
Receivable balance with joint venture | $ 0.8 | 1.5 | ||
Due to joint venture | 0.3 | 0.2 | ||
Affiliated Entity | ||||
Related Party Transaction [Line Items] | ||||
Rent expense | $ 0.1 | $ 0.4 | $ 0.4 |
Segment Data - Operating Segmen
Segment Data - Operating Segments (Details) - USD ($) $ in Thousands | Jun. 30, 2016 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Mar. 31, 2016 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 |
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] | ||||||||||||
Revenues | $ 219,674 | $ 228,488 | $ 209,313 | $ 207,573 | $ 222,523 | $ 214,988 | $ 199,443 | $ 196,583 | $ 865,048 | $ 833,537 | $ 767,421 | |
Contribution income | 78,513 | 79,722 | 67,794 | |||||||||
Unallocated corporate overhead | 39,190 | 38,400 | 32,703 | |||||||||
Depreciation and amortization | 10,174 | 9,182 | 8,066 | |||||||||
Loss on sale of business | 0 | 0 | 2,184 | |||||||||
Acquisition and integration costs | 1,975 | 78 | 902 | |||||||||
Acquisition-related contingent consideration | 44 | 814 | 0 | |||||||||
Restructuring costs | 1,026 | 753 | 1,274 | |||||||||
Impairment charges | $ 14,400 | $ 24,300 | 14,356 | 24,311 | 2,100 | |||||||
Income from operations | 11,748 | 6,184 | 20,565 | |||||||||
Physician Staffing Segment | ||||||||||||
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] | ||||||||||||
Impairment charges | $ 24,300 | |||||||||||
Operating Segments | Nurse and Allied Staffing Segment | ||||||||||||
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] | ||||||||||||
Revenues | 758,267 | 721,486 | 621,258 | |||||||||
Contribution income | 73,614 | 71,992 | 55,718 | |||||||||
Operating Segments | Physician Staffing Segment | ||||||||||||
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] | ||||||||||||
Revenues | 93,610 | 98,283 | 115,336 | |||||||||
Contribution income | 5,256 | 8,265 | 10,213 | |||||||||
Operating Segments | Other Human Capital Management Services Segment | ||||||||||||
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] | ||||||||||||
Revenues | 13,171 | 13,768 | 30,827 | |||||||||
Contribution income | $ (357) | $ (535) | $ 1,863 |
Segment Data - Additional Infor
Segment Data - Additional Information (Details) $ in Thousands | Jun. 30, 2016USD ($) | Aug. 31, 2015USD ($) | Dec. 31, 2017USD ($) | Jun. 30, 2016USD ($) | Dec. 31, 2017 | Dec. 31, 2017USD ($)segment | Dec. 31, 2016USD ($) | Dec. 31, 2015USD ($) |
Segment Reporting Information [Line Items] | ||||||||
Number of operating segments | segment | 3 | |||||||
Loss on sale of business | $ 0 | $ 0 | $ 2,184 | |||||
Impairment charges | $ 14,400 | $ 24,300 | $ 14,356 | $ 24,311 | 2,100 | |||
Cross Country Education, LLC | Disposal Group, Disposed of by Sale, Not Discontinued Operations | ||||||||
Segment Reporting Information [Line Items] | ||||||||
Loss on sale of business | $ 2,200 | $ 2,200 | ||||||
Physician Staffing Segment | ||||||||
Segment Reporting Information [Line Items] | ||||||||
Impairment charges | $ 24,300 | |||||||
Advantage RN, LLC | Physician Staffing Segment | ||||||||
Segment Reporting Information [Line Items] | ||||||||
Percent of business included in segment, less than | 2.00% |
Quarterly Financial Data (Una87
Quarterly Financial Data (Unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands | Mar. 17, 2017 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Mar. 31, 2016 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 |
Quarterly Financial Information Disclosure [Abstract] | ||||||||||||
Revenue from services | $ 219,674 | $ 228,488 | $ 209,313 | $ 207,573 | $ 222,523 | $ 214,988 | $ 199,443 | $ 196,583 | $ 865,048 | $ 833,537 | $ 767,421 | |
Gross profit (a) | 58,303 | 60,480 | 56,528 | 53,275 | 57,633 | 58,210 | 54,846 | 51,046 | ||||
Consolidated net (loss) income | 28,256 | 7,044 | 5,220 | (1,718) | (7,649) | 14,289 | (17,095) | 19,186 | 38,802 | 8,731 | 4,954 | |
Net (loss) income attributable to common shareholders | $ 27,950 | $ 6,723 | $ 4,850 | $ (2,010) | $ (7,884) | $ 14,066 | $ (17,237) | $ 19,022 | $ 37,513 | $ 7,967 | $ 4,418 | |
Net income (loss) per share attributable to common shareholders - Basic (usd per share) | $ 0.78 | $ 0.19 | $ 0.14 | $ (0.06) | $ (0.24) | $ 0.44 | $ (0.54) | $ 0.60 | $ 1.07 | $ 0.25 | $ 0.14 | |
Net income (loss) per share attributable to common shareholders - Diluted (usd per share) | $ 0.77 | $ 0.19 | $ 0.13 | $ (0.08) | $ (0.24) | $ 0.22 | $ (0.54) | $ 0.09 | $ 1.01 | $ 0.15 | $ 0.14 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||||||
(Gain) loss on derivative liability | $ (1,600) | $ 14,200 | $ (7,100) | $ 3,600 | $ (16,400) | $ (1,581) | $ (5,805) | $ 9,901 | ||||
Impairment charges | $ 14,400 | 24,300 | 14,356 | 24,311 | 2,100 | |||||||
Loss on extinguishment of debt | 4,969 | 1,568 | 0 | |||||||||
Acquisition-related contingent consideration expense (benefit) | 44 | 814 | 0 | |||||||||
Restructuring costs | 1,026 | $ 753 | $ 1,274 | |||||||||
Reduction in valuation allowance | 45,400 | |||||||||||
Income tax expense related to deferred tax asset | 8,000 | $ 200 | ||||||||||
Convertible Notes | ||||||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||||||
Loss on extinguishment of debt | $ 5,000 | 5,000 | ||||||||||
Second Lien Term Loan, net | ||||||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||||||
Loss on extinguishment of debt | 1,600 | |||||||||||
Second Lien Term Loan, net | Subordinated Debt | ||||||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||||||
Loss on extinguishment of debt | 1,600 | |||||||||||
Mediscan and USR | ||||||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||||||
Acquisition-related contingent consideration expense (benefit) | 100 | $ (600) | $ 300 | $ 300 | 100 | 200 | $ 200 | $ 300 | ||||
Centralization of Corporate Functions | ||||||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||||||
Restructuring costs | 300 | $ 700 | $ 200 | $ 600 | ||||||||
Remeasurement of deferred tax assets | ||||||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||||||
Reduction in valuation allowance | $ 43,300 |
Schedule II - Valuation and Q88
Schedule II - Valuation and Qualifying Accounts (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Allowances for Accounts Receivable | |||
Movement in Valuation Allowances and Reserves [Roll Forward] | |||
Balance at Beginning of Period | $ 3,245 | $ 4,045 | $ 1,425 |
Charged to Operations | 4,705 | 4,034 | 2,414 |
Write-Offs | (4,804) | (5,149) | (923) |
Recoveries | 542 | 315 | 1,129 |
Other Changes | 0 | 0 | 0 |
Balance at End of Period | 3,688 | 3,245 | 4,045 |
Valuation Allowance for Deferred Tax Assets | |||
Movement in Valuation Allowances and Reserves [Roll Forward] | |||
Balance at Beginning of Period | 46,454 | 55,336 | 63,616 |
Charged to Operations | (3,007) | (8,894) | (7,518) |
Write-Offs | (43,333) | 0 | 0 |
Recoveries | 0 | 0 | 0 |
Other Changes | 962 | 12 | (762) |
Balance at End of Period | $ 1,076 | $ 46,454 | $ 55,336 |