Cross Country Healthcare (CCRN) 10-Q 2 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	Apr. 26, 2019
Document and Entity Information [Abstract]
Trading Symbol	CCRN
Entity Registrant Name	CROSS COUNTRY HEALTHCARE INC
Entity Central Index Key	0001141103
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Emerging Growth Company	false
Entity Small Business	false
Document Type	10-Q
Document Period End Date	Mar. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Amendment Flag	false
Entity Common Stock, Shares Outstanding		36,826,003

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 18,286	$ 16,019
Accounts receivable, net of allowances of $3,811 in 2019 and $3,705 in 2018	154,758	166,128
Prepaid expenses	4,844	6,208
Insurance recovery receivable	7,003	4,186
Other current assets	1,593	2,364
Total current assets	186,484	194,905
Property and equipment, net of accumulated depreciation of $34,582 in 2019 and $33,476 in 2018	13,641	13,628
Operating lease right-of-use assets	20,965	0
Goodwill	101,081	101,060
Trade names	20,402	20,402
Other intangible assets, net	53,298	55,182
Non-current deferred tax assets	26,944	23,750
Other non-current assets	18,620	18,076
Total assets	441,435	427,003
Current liabilities:
Accounts payable and accrued expenses	48,143	43,744
Accrued compensation and benefits	31,690	33,332
Current portion of long-term debt	0	5,235
Operating lease liabilities - current	5,063	0
Other current liabilities	4,892	3,075
Total current liabilities	89,788	85,386
Long-term debt, less current portion	75,489	77,944
Operating lease liabilities - non-current	22,426	0
Long-term accrued claims	29,887	29,299
Contingent consideration	4,812	7,409
Other long-term liabilities	3,023	8,767
Total liabilities	225,425	208,805
Commitments and contingencies
Stockholders' equity:
Common stock	4	4
Additional paid-in capital	302,802	303,048
Accumulated other comprehensive loss	(1,661)	(1,462)
Accumulated deficit	(85,829)	(84,062)
Total Cross Country Healthcare, Inc. stockholders' equity	215,316	217,528
Noncontrolling interest in subsidiary	694	670
Total stockholders' equity	216,010	218,198
Total liabilities and stockholders' equity	$ 441,435	$ 427,003

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts	$ 3,811	$ 3,705
Property and equipment, accumulated depreciation	$ 34,582	$ 33,476

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Statement [Abstract]
Revenue from services	$ 195,171	$ 210,288
Operating expenses:
Direct operating expenses	146,917	156,535
Selling, general and administrative expenses	46,036	45,634
Bad debt expense	270	199
Depreciation and amortization	2,984	2,909
Acquisition-related contingent consideration	247	213
Acquisition and integration costs	265	115
Restructuring costs	1,140	435
Total operating expenses	197,859	206,040
(Loss) income from operations	(2,688)	4,248
Other expenses (income):
Interest expense	1,422	1,266
Loss on early extinguishment of debt	360	0
Other income, net	(82)	(101)
(Loss) income before income taxes	(4,388)	3,083
Income tax (benefit) expense	(3,012)	1,163
Consolidated net (loss) income	(1,376)	1,920
Less: Net income attributable to noncontrolling interest in subsidiary	391	278
Net (loss) income attributable to common shareholders	$ (1,767)	$ 1,642
Net (loss) income per share attributable to common shareholders - Basic (in dollars per share)	$ (0.05)	$ 0.05
Net (loss) income per share attributable to common shareholders - Diluted (in dollars per share)	$ (0.05)	$ 0.05
Weighted average common shares outstanding:
Basic (shares)	35,700	35,803
Diluted (shares)	35,700	36,087

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Statement of Comprehensive Income [Abstract]
Consolidated net (loss) income	$ (1,376)	$ 1,920
Other comprehensive loss, before income tax:
Unrealized foreign currency translation gain (loss)	72	(27)
Unrealized loss on interest rate contracts	(350)	(228)
Reclassification adjustment to interest expense	12	0
Other comprehensive loss, before income tax	(266)	(255)
Taxes on other comprehensive loss:
Income tax expense (benefit) related to foreign currency translation adjustments	18	(4)
Income tax benefit related to unrealized gain on interest rate contracts	(88)	(57)
Income tax expense related to reclassification adjustment to interest expense	3	0
Taxes on other comprehensive loss	(67)	(61)
Other comprehensive loss, net of tax	(199)	(194)
Comprehensive (loss) income	(1,575)	1,726
Less: Net income attributable to noncontrolling interest in subsidiary	391	278
Comprehensive (loss) income attributable to common shareholders	$ (1,966)	$ 1,448

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-In Capital [Member]	Accumulated Other Total Comprehensive Loss, net [Member]	(Accumulated Deficit) Retained Earnings [Member]	Noncontrolling Interest in Subsidiary [Member]
Beginning Balance (in shares) at Dec. 31, 2017		35,838,000
Beginning Balance at Dec. 31, 2017	$ 237,719	$ 4	$ 305,362	$ (1,166)	$ (67,111)	$ 630
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of share options (in shares)		8,000
Vesting of restricted stock and performance stock awards (in shares)		102,000
Vesting of restricted stock and performance stock awards	(621)		(621)
Equity compensation	469		469
Stock repurchase and retirement (in shares)		(242,400)
Stock repurchase and retirement	(2,885)		(2,885)
Foreign currency translation adjustment, net of taxes	(23)			(23)
Net change in hedging transaction, net of taxes	(171)			(171)
Distribution to noncontrolling shareholder	(308)					(308)
Net (loss) income	1,921				1,642	279
Ending Balance (in shares) at Mar. 31, 2018		35,706,000
Ending Balance at Mar. 31, 2018	236,101	$ 4	302,325	(1,360)	(65,469)	601
Beginning Balance (in shares) at Dec. 31, 2018		35,626,000
Beginning Balance at Dec. 31, 2018	218,198	$ 4	303,048	(1,462)	(84,062)	670
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of share options (in shares)		4,000
Vesting of restricted stock and performance stock awards (in shares)		176,000
Vesting of restricted stock and performance stock awards	(777)		(777)
Equity compensation	531		531
Stock repurchase and retirement (in shares)		0
Foreign currency translation adjustment, net of taxes	53			53
Net change in hedging transaction, net of taxes	(252)			(252)
Distribution to noncontrolling shareholder	(367)					(367)
Net (loss) income	(1,376)				(1,767)	391
Ending Balance (in shares) at Mar. 31, 2019		35,806,000
Ending Balance at Mar. 31, 2019	$ 216,010	$ 4	$ 302,802	$ (1,661)	$ (85,829)	$ 694

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities
Consolidated net (loss) income	$ (1,376)	$ 1,920
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	2,984	2,909
Provision for allowances	970	671
Deferred income tax (benefit) expense	(3,146)	825
Non-cash lease expense	1,254	0
Loss on early extinguishment of debt	360	0
Equity compensation	531	469
Other non-cash costs	365	322
Changes in operating assets and liabilities:
Accounts receivable	10,400	12,598
Prepaid expenses and other assets	(1,477)	(477)
Accounts payable and accrued expenses	2,841	(5,786)
Operating lease liabilities	(1,399)	0
Other liabilities	480	(178)
Net cash provided by operating activities	12,787	13,273
Cash flows from investing activities
Acquisition-related settlements	(136)	(24)
Purchases of property and equipment	(1,109)	(1,003)
Net cash used in investing activities	(1,245)	(1,027)
Cash flows from financing activities
Principal payments on Term Loans	(7,500)	(1,250)
Debt issuance costs	(568)	0
Stock repurchase and retirement	0	(2,885)
Other	(1,227)	(1,014)
Net cash used in financing activities	(9,295)	(5,149)
Effect of exchange rate changes on cash	20	(13)
Change in cash and cash equivalents	2,267	7,084
Cash and cash equivalents at beginning of period	16,019	25,537
Cash and cash equivalents at end of period	$ 18,286	$ 32,621

ORGANIZATION AND BASIS OF PRESE

ORGANIZATION AND BASIS OF PRESENTATION	3 Months Ended
	Mar. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
ORGANIZATION AND BASIS OF PRESENTATION	ORGANIZATION AND BASIS OF PRESENTATION Nature of Business The accompanying condensed consolidated financial statements include the accounts of Cross Country Healthcare, Inc. and its direct and indirect wholly-owned subsidiaries (collectively, the Company). The condensed consolidated financial statements include all assets, liabilities, revenue, and expenses of Cross Country Talent Acquisition Group, 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. In the opinion of management, all entries necessary for a fair presentation of such unaudited condensed consolidated financial statements have been included. These entries consisted of all normal recurring items. The accompanying condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by United States generally accepted accounting principles (U.S. GAAP) for complete financial statements. These operating results are not necessarily indicative of the results that may be expected for the year ending December 31, 2019 . These unaudited interim condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto for the year ended December 31, 2018 included in the Company’s Annual Report on Form 10-K as filed with the Securities and Exchange Commission. The December 31, 2018 condensed consolidated balance sheet included herein was derived from the December 31, 2018 audited consolidated balance sheet included in the Company’s Annual Report on Form 10-K. Liquidity and Operations On March 29, 2019, the Company amended the terms of its senior credit facility and subsequently made an optional prepayment of $7.5 million on its outstanding debt. As of March 31, 2019, the Company was in compliance with its financial covenants under its amended senior credit facility. See Note 8 - Debt.

SUMMARY OF SIGNIFICANT ACCOUNTI

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	3 Months Ended
	Mar. 31, 2019
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. GAAP requires management to make estimates and assumptions that affect the reported amounts in the condensed 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) fair value of interest rate swap agreement; (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. 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, exit costs, and other costs including write-offs related to abandoned locations. Effective January 1, 2019, in conjunction with the adoption of ASC 842, certain office locations that the Company vacated in connection with restructuring activities were included in the measurement of its beginning operating lease liabilities. Previous accruals related to these locations of $0.3 million have been presented as a reduction to the operating lease right-of-use assets on the condensed consolidated balance sheets. Reconciliation of the on-going benefit costs beginning and ending liability balance is presented below: On-Going Benefit Costs (amounts in thousands) Balance at January 1, 2019 $ 556 Charged to restructuring costs 1,104 Payments (373 ) Balance at March 31, 2019 $ 1,287 Recently Adopted Accounting Pronouncements Effective January 1, 2019, the Company adopted ASU No. 2016-02, Leases (Topic 842) , which requires that, as lessee, leases, as defined by the standard, are to be recognized on the balance sheet as right-of-use assets and as lease liabilities. The Company elected not to apply the recognition requirements to short-term leases, and to apply the transition method, which is applied prospectively, measuring and recognizing the initial right-of-use asset and liability at January 1, 2019, without revising comparative period information or disclosure. In addition, the Company elected the package of transition provisions available for expired or existing contracts, which allowed the Company to forego assessment of: (1) whether contracts are or contain leases, (2) lease classification, and (3) initial direct costs. Consistent with current accounting, all of the Company's existing leases identified under ASC 840 will be treated as operating leases. The Company has also elected the practical expedient to not separate non-lease components from the lease components to which they relate, and instead account for each as a single lease component, for all of its underlying asset classes. Accordingly, all expenses associated with a lease contract are accounted for as lease expenses. As of the later of January 1, 2019 or each lease’s respective commencement date, the Company recorded lease liabilities equal to the present value of its remaining minimum lease payments and right-of-use assets equal to the corresponding lease liability adjusted for any prepaid or accrued lease payments and the remaining balance of lease incentives received. At the transition date, the right of use asset and total lease liabilities were $22.0 million and $28.6 million , respectively. The difference between the right-of use-asset and lease liabilities is due to the derecognition of accrued lease payments of $7.2 million , previously included in other current and non-current liabilities, and prepaid rent of $0.6 million , previously included in prepaid expenses. See Note 10 - Leases.

REVENUE RECOGNITION

REVENUE RECOGNITION	3 Months Ended
	Mar. 31, 2019
Revenue from Contract with Customer [Abstract]
REVENUE RECOGNITION	REVENUE RECOGNITION The Company's revenues, generated from temporary staffing services and other services, are disaggregated in the following table. Sales and usage-based taxes are excluded from revenue. Three Months ended March 31, 2019 Nurse Physician Search Total (amounts in thousands) Temporary Staffing Services $ 172,653 $ 15,154 $ — $ 187,807 Other Services 3,420 1,005 2,939 7,364 Total $ 176,073 $ 16,159 $ 2,939 $ 195,171 Accounts receivable includes estimated revenue for the Company's employees', subcontracted employees', and independent contractors’ time worked but not yet invoiced. At March 31, 2019 and December 31, 2018, the Company's estimate of amounts that had been worked but had not been billed totaled $43.0 million and $44.1 million , respectively, and are included in accounts receivable on the Company's condensed consolidated balance sheets.

ACQUISITIONS

ACQUISITIONS	3 Months Ended
	Mar. 31, 2019
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 was due to the seller within 20 months, less any Cobra and healthcare payments incurred by the Company on behalf of the seller. The Company incurred approximately $0.5 million in COBRA expenses since the Advantage acquisition and, in February 2019, released to the seller the remaining liability of $0.1 million . 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 . On April 3, 2019, $4.3 million related to the tax liabilities was disbursed to pay taxes and the remaining $2.9 million was released from escrow to the seller. In the first quarter of 2019, $7.0 million related to the post-close liabilities was released from escrow, leaving a balance of $0.5 million to cover pending post-close liabilities. 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). In connection with the Mediscan acquisition, the Company assumed 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 years 2016 through 2018 were limited to $0.3 million and 2019 is uncapped. During the three months ended March 31, 2019 and 2018, the Company paid $0.1 million each period related to the years 2018 and 2017, respectively. As of March 31, 2019, the fair value of the remaining obligations was estimated at $7.8 million and is included in other current liabilities and contingent consideration on the condensed consolidated balance sheets. See Note 11 - Fair Value Measurements.

COMPREHENSIVE INCOME

COMPREHENSIVE INCOME	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
COMPREHENSIVE INCOME (LOSS)	COMPREHENSIVE INCOME Total comprehensive income (loss) includes net income or loss, foreign currency translation adjustments, and net change in derivative transactions, 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 condensed consolidated balance sheets and was an unrealized loss of $1.2 million at March 31, 2019 and $1.3 million at December 31, 2018 . The cumulative impact of net changes in derivative instruments included in other comprehensive loss in the condensed consolidated balance sheets was an unrealized loss of $0.4 million at March 31, 2019 and $0.2 million at December 31, 2018. See Note 9 - Derivative. The income tax impact related to components of other comprehensive income (loss) for the three months ended March 31, 2019 and 2018 is reflected on the condensed consolidated statements of comprehensive income.

EARNINGS PER SHARE

EARNINGS PER SHARE	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
EARNINGS PER SHARE	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: Three Months Ended March 31, 2019 2018 (amounts in thousands, except per share data) Numerator: Net (loss) income attributable to common shareholders - Basic and Diluted $ (1,767 ) $ 1,642 Denominator: Weighted average common shares - Basic 35,700 35,803 Effective of diluted shares: Share-based awards — 284 Weighted average common shares - Diluted 35,700 36,087 Net (loss) income per share attributable to common shareholders - Basic $ (0.05 ) $ 0.05 Net (loss) income per share attributable to common shareholders - Diluted $ (0.05 ) $ 0.05 For the three months ended March 31, 2019 and 2018, no tax benefits were assumed in the weighted average share calculation due to the Company's net operating loss position. Due to the net loss for the three months ended March 31, 2019, 97,184 shares were excluded from diluted weighted average shares.

GOODWILL, TRADE NAMES, AND OTHE

GOODWILL, TRADE NAMES, AND OTHER INTANGIBLE ASSETS	3 Months Ended
	Mar. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
GOODWILL, TRADE NAMES, AND OTHER INTANGIBLE ASSETS	GOODWILL, TRADE NAMES, AND OTHER INTANGIBLE ASSETS The Company had the following acquired intangible assets: March 31, 2019 December 31, 2018 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount (amounts in thousands) Intangible assets subject to amortization: Databases $ 30,530 $ 9,979 $ 20,551 $ 30,530 $ 9,216 $ 21,314 Customer relationships 49,758 24,121 25,637 49,758 23,296 26,462 Non-compete agreements 320 113 207 320 97 223 Trade names 8,879 1,976 6,903 8,879 1,696 7,183 Other intangible assets, net $ 89,487 $ 36,189 $ 53,298 $ 89,487 $ 34,305 $ 55,182 Intangible assets not subject to amortization: Trade names 20,402 20,402 $ 73,700 $ 75,584 As of March 31, 2019 , estimated annual amortization expense is as follows: Years Ending December 31: (amounts in thousands) 2019 $ 5,651 2020 7,431 2021 7,131 2022 6,780 2023 6,677 Thereafter 19,628 $ 53,298 As of March 31, 2019, the Company performed a qualitative assessment of each of its reporting units and determined it was not more likely than not that the fair value of its reporting units dropped below their carrying value. As a result, management concluded that no impairment testing was warranted as of March 31, 2019. 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. As of March 31, 2019, goodwill by reporting segment was: $88.9 million for Nurse and Allied Staffing, $2.8 million for Physician Staffing, and $9.4 million for Search Services, totaling $101.1 million .

DEBT

DEBT	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
DEBT	DEBT The Company's long-term debt consists of the following: March 31, 2019 December 31, 2018 Principal Debt Issuance Costs Principal Debt Issuance Costs (amounts in thousands) Term Loan, interest 5.5% and 4.8% at March 31, 2019 and December 31, 2018, respectively $ 76,377 $ (888 ) $ 83,876 $ (697 ) Less current portion — — (5,235 ) — Long-term debt $ 76,377 $ (888 ) $ 78,641 $ (697 ) Amended and Restated Senior Credit Facility On March 29, 2019, the Company entered into a Second Amendment (Second Amendment) to its Amended and Restated Credit Agreement that, among other administrative changes, modifies the following: (1) changes the financial leverage ratio from Consolidated Total Leverage to Consolidated Net Leverage and permits a maximum Consolidated Net Leverage Ratio of 4.60 :1.00 for the periods of December 31, 2018 through June 30, 2019, 4.25 :1:00 for the period ended September 30, 2019, to 4.00 :1.00 for the period ended December 31, 2019, 3.75 :1.00 for the period ended March 31, 2020, 3.50 :1.00 for the period ending June 30, 2020, 3.25 :1.00 for the period ending September 30, 2020, and maintains 3.00 :1:00 for the periods thereafter and as adjusted pursuant to a Specified and Qualified Permitted Acquisition (as defined therein); (2) the Applicable Margin definition has been revised to: modify Level V to be greater than or equal to 3.00 :1.00 but less than 3.50 :1.00; adds an additional Level VI if the Consolidated Net Leverage is greater than or equal to 3.50 :1.00 but less than 4.00 :1.00; and adds an additional Level VII if Consolidated Net Leverage Ratio is greater than 4.00 :1.00. The added Levels VI and VII result in an increase in the Applicable Margin for borrowing from their respective prior Levels by 25 basis points for each and an increase of 5 basis points to the Commitment Fee for each; (3) adds an additional financial covenant for the quarters ending March 31, 2019 through and including the quarter ending December 31, 2019, that requires the Consolidated Asset Coverage Ratio to be no less than 1.10 :1.00; and (4) the exercise of a $40.0 million Optional Reduction of the Aggregate Revolving Commitments from $115 million to $75 million . The Second Amendment has been treated as a modification and accordingly, the fees of $0.6 million paid to its lenders in connection with the amendment are included as $0.3 million of debt issuance costs associated with the revolving credit agreement, and $0.3 million as a reduction to the carrying amount of the term loan. The fees will be amortized to interest expense over the term of the arrangement. In addition, in the three months ended March 31, 2019, $0.3 million of debt issuance costs was written off due to the reduction in borrowing capacity under the revolving credit facility, which is included in loss on early extinguishment on the consolidated statement of operations. On March 29, 2019, the Company also made an optional prepayment of $7.5 million on its Term Loan, which has been allocated to the next five scheduled quarterly payments and a portion of the sixth payment. 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 written notice (or telephonic notice promptly confirmed in writing). 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. As of March 31, 2019 , the aggregate scheduled maturities of the term loan are as follows: Term Loan (amounts in thousands) Through Years Ending December 31: 2019 $ — 2020 3,407 2021 6,980 2022 65,990 2023 — Thereafter — Total $ 76,377 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 of March 31, 2019 , the Amended Term Loan and Amended Revolving Credit Facility bore interest at a rate equal to One Month LIBOR plus 3.00% . 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 is 0.45% as of March 31, 2019 . During the three months ended March 31, 2018, the Company entered into an interest rate swap to reduce its exposure to fluctuations in the interest rates associated with its debt, which was effective April 2, 2018. See Note 9 - Derivative. 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. In addition to the Consolidated Total Leverage ratio and the Consolidated Asset Coverage ratio mentioned previously, the Amended and Restated Credit Agreement also includes a financial covenant of 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 March 31, 2019, the Company was in compliance with all of the financial covenants and other covenants contained in the Amended and Restated 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 March 31, 2019 , the Company had $20.6 million letters of credit outstanding, which relate to the Company’s workers’ compensation and professional liability insurance policies.

DERIVATIVE

DERIVATIVE	3 Months Ended
	Mar. 31, 2019
Derivative Instruments and Hedging Activities Disclosure [Abstract]
DERIVATIVE	DERIVATIVE The Company has an interest rate swap agreement that, at initiation, effectively fixed the interest rate on 50% of the amortizing balance of the Company’s term debt, exclusive of the credit spread on the debt. The interest rate swap agreement requires the Company to pay a fixed rate to the respective counterparty of 2.627% per annum on an amortizing notional amount corresponding with the initial term loan payment schedule, and to receive from the respective counterparty, interest payments based on the applicable notional amounts and 1 month USD LIBOR, with no exchanges of notional amounts. As of March 31, 2019 and December 31, 2018, the interest rate swap is treated as a cash flow hedge and its fair value of a $0.6 million liability and a $0.2 million liability, respectively, is included in current and non-current liabilities on the consolidated balance sheets. See Note 11 - Fair Value Measurements

LEASES

LEASES	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
LEASES	LEASES The Company has lease contracts related to the rental of office space, housing for its healthcare professionals on assignments, and other equipment rentals. The Company's lease population included in the recognition of its beginning right-of-use asset and lease liabilities under the new standard is substantially related to its office locations. The Company enters into lease agreements as lessee for the rental of office space for both its corporate and branch locations that may include options to extend or terminate early. Many of these real estate leases require variable payments of property taxes, insurance, and common area maintenance, in addition to base rent. The variable portion of these lease payments is not included in the right-of-use assets or lease liabilities. Rather, variable payments, other than those dependent upon an index or rate, are expensed when the obligation for those payments is incurred and are included in lease expense in selling, general and administrative expense on the condensed consolidated statement of operations. These leases do not include residual value guarantees, covenants, or other restrictions. Certain of the leases have provisions for free rent months during the lease term and/or escalating rent payments. In addition, particularly for the Company’s longer-term leases for its corporate offices, it has received incentives to enter into the leases such as receiving up to a specified dollar amount to construct tenant improvements. Pursuant to ASC 840, these lease incentives resulted in deferred rent credits. Upon adoption of the ASC 842, these deferred rent credits reduced the beginning operating right-of-use asset recognized and, consistent with the prior guidance will be recognized as a reduction to future rent expense over the expected remaining term of the respective leases. The Company determines whether an arrangement constitutes a lease and records lease liabilities and right-of-use assets on its consolidated balance sheets at lease commencement. Lease liabilities are measured based on the present value of the total lease payments not yet paid discounted based on its incremental borrowing rate, as the rate implicit in the lease is not determinable. Its incremental borrowing rate is estimated based on what it would be required to pay for a collateralized borrowing equal to the total lease payments over the term of the lease. As such, the Company estimates its incremental borrowing rate based on an analysis of publicly traded debt securities of companies with credit and financial profiles similar to its own. Right-of-use assets are measured based on the corresponding lease liability adjusted for: (i) payments made to the lessor at or before the commencement date, (ii) initial direct costs, and (iii) tenant incentives under the lease. Rent expense commences when the lessor makes the underlying asset available to us. The Company does not assume renewals or early terminations unless it is reasonably certain to exercise these options at commencement. For short-term leases, rent expense is recognized in the condensed consolidated statements of operations on a straight-line basis over the lease term. The table below presents the lease-related assets and liabilities included on the condensed consolidated balance sheets: Classification on Condensed Consolidated Balance Sheets: March 31, 2019 (amounts in thousands) Operating lease right-of-use assets $ 20,965 Operating lease liabilities - current $ 5,063 Operating lease liabilities - non-current $ 22,426 Weighted-average remaining lease term 5.3 years Weighted average discount rate (a) 6.24 % ________________ (a) Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019. The table below reconciles the undiscounted cash flows for each of the first five years and total of the remaining years to the operating lease liabilities (which do not include short-term leases) recorded on the condensed consolidated balance sheets: Years Ending December 31: (amounts in thousands) 2019 $ 4,914 2020 6,572 2021 5,702 2022 4,929 2023 4,702 Thereafter 5,869 Total minimum lease payments 32,688 Less: amount of lease payments representing interest (5,199 ) Present value of future minimum lease payments 27,489 Less: current lease obligations (5,063 ) Non-current lease obligations $ 22,426 Future minimum lease payments, as of December 31, 2018, associated with non-cancelable operating lease agreements with terms of one year or more are as follows: Years Ending December 31: (amounts in thousands) 2019 $ 7,451 2020 6,287 2021 5,407 2022 4,857 2023 4,700 Thereafter 5,893 Total minimum lease payments $ 34,595 Other Information The table below provides information regarding supplemental cash flows: March 31, 2019 (amounts in thousands) Supplemental Cash Flow Information: Cash paid for amounts included in the measurement of operating lease liabilities $ 1,845 ROU assets obtained in exchange for new operating lease liabilities $ 300 The components of lease expense are as follows: March 31, 2019 (amounts in thousands) Amounts Included in Condensed Consolidated Statements of Operations: Operating lease expense $ 1,694 Short-term lease expense $ 2,159 Variable and other lease costs $ 718 Operating lease expense, short-term lease expense, and variable and other lease costs are included in selling, general and administrative expenses and direct operating expenses on the Company's condensed consolidated statements of operations, depending on the nature of the leased asset. As of March 31, 2019, the Company does not have any material operating leases which have not yet commenced.

FAIR VALUE MEASUREMENTS

FAIR VALUE MEASUREMENTS	3 Months Ended
	Mar. 31, 2019
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, interest rate swap agreement included in other current and non-current liabilities, and contingent consideration liabilities. Deferred compensation —The Company utilizes Level 1 inputs to value its deferred compensation liabilities. The Company’s deferred compensation liabilities are measured using publicly available indices that define the liability amounts, as per the plan documents. Interest rate swap agreement —The Company utilized Level 2 inputs to value its interest rate swap agreement. See Note 8 - Debt and Note 9 - Derivative. Contingent consideration liabilities —Potential earnout payments related to the acquisition of Mediscan are contingent upon meeting certain performance requirements through 2019. The long-term portion of these liabilities has been included in contingent consideration, and the short-term portion is included in other current liabilities on the condensed 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. The Mediscan contingent consideration liability has 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. See Note 4 - 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 condensed 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 March 31, 2019 December 31, 2018 Financial Liabilities: (amounts in thousands) (Level 1) Deferred compensation $ 1,782 $ 1,725 (Level 2) Interest rate swaps $ 572 $ 234 (Level 3) Contingent consideration liabilities $ 7,836 $ 7,689 The opening balances of contingent consideration liabilities are reconciled to the closing balances for fair value measurements of these liabilities categorized within Level 3 of the fair value hierarchy are as follows: Contingent Consideration Liabilities (amounts in thousands) December 31, 2018 $ 7,689 Payments (100 ) Accretion expense 247 March 31, 2019 $ 7,836 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 fourth quarter of 2018, the carrying value of goodwill and trade names in the Physician Staffing reporting unit exceeded their fair values. As a result, the Company recorded impairment charges that incorporated fair value measurements based on Level 3 inputs. For the three months ended March 31, 2019, no impairment charges were recognized. Other Fair Value Disclosures: Financial instruments not measured or recorded at fair value in the accompanying condensed 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 carrying amounts and estimated fair value of the Company’s significant financial instruments that were not measured at fair value are as follows: March 31, 2019 December 31, 2018 Carrying Fair Carrying Fair Financial Liabilities: (amounts in thousands) (Level 2) Term Loan, net $ 75,489 $ 75,300 $ 83,179 $ 81,800 Concentration of Credit Risk: The Company has invested 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, as the cash balances typically exceed the current Federal Deposit Insurance Corporation (FDIC) limit of $250,000 . 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 of invoice 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.

STOCKHOLDERS' EQUITY

STOCKHOLDERS' EQUITY	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
STOCKHOLDERS' EQUITY	STOCKHOLDERS’ EQUITY Stock Repurchase Program During the three months ended March 31, 2019, the Company did not repurchase any shares of its Common Stock. During the three months ended March 31, 2018, the Company repurchased and retired 242,400 shares of its Common Stock for $2.9 million , at an average market price of $11.88 per share, under an authorized share repurchase program. As of March 31, 2019 , the Company has 510,004 shares of Common Stock under the current share repurchase program available to repurchase, subject to certain conditions in the Company's Amended and Restated Credit Agreement. Share-Based Payments The following table summarizes restricted stock awards and performance stock awards activity issued under the 2017 Plan for the three months ended March 31, 2019 : Restricted Stock Awards Performance Stock Awards Number of Weighted Number of Target Weighted Unvested restricted stock awards, January 1, 2019 589,120 $ 12.00 365,149 $ 12.35 Granted 696,545 $ 7.03 182,189 $ 7.03 Vested (273,716 ) $ 11.48 — $ — Forfeited (19,349 ) $ 11.81 (161,653 ) $ 12.48 Unvested restricted stock awards, March 31, 2019 992,600 $ 8.88 385,685 $ 9.79 Restricted stock awards granted under the Company’s 2017 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 2017 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. During the three months ended March 31, 2019, $0.5 million was included in selling, general and administrative expenses related to share-based payments, and a net of 176,436 shares of Common Stock were issued upon the vesting of restricted stock. During the three months ended March 31, 2018, $0.5 million was included in selling, general and administrative expenses related to share-based payments, and a net of 101,834 shares of Common Stock were issued upon the vesting of restricted stock.

SEGMENT DATA

SEGMENT DATA	3 Months Ended
	Mar. 31, 2019
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 Search 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 United States. ● Physician Staffing – Physician Staffing provides physicians in many specialties, as well as certified registered nurse anesthetists, nurse practitioners, and physician assistants as independent contractors on temporary assignments throughout the United States at various healthcare facilities, such as acute and non-acute care facilities, medical group practices, government facilities, and managed care organizations. ● Search Services – Search Services includes retained and contingent search services for physicians, healthcare executives, and other healthcare professionals, as well as recruitment process outsourcing. 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, acquisition and integration costs, acquisition-related contingent consideration, restructuring costs, impairment charges, and corporate overhead. 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: Three Months Ended March 31, 2019 2018 (amounts in thousands) Revenue from services: Nurse and Allied Staffing $ 176,073 $ 185,105 Physician Staffing 16,159 21,560 Search Services 2,939 3,623 $ 195,171 $ 210,288 Contribution income: Nurse and Allied Staffing $ 14,156 $ 16,760 Physician Staffing 405 1,500 Search Services (283 ) 312 14,278 18,572 Corporate overhead 12,330 10,652 Depreciation and amortization 2,984 2,909 Acquisition-related contingent consideration 247 213 Acquisition and integration costs 265 115 Restructuring costs 1,140 435 (Loss) income from operations $ (2,688 ) $ 4,248

CONTINGENCIES

CONTINGENCIES	3 Months Ended
	Mar. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
CONTINGENCIES	CONTINGENCIES Legal Proceedings From time to time, the Company is involved in various litigation, claims, investigations, and other proceedings that arise in the ordinary course of its business. These matters primarily relate to employee-related matters that include individual and collective claims, professional liability, tax, and payroll practices. The Company establishes reserves when available information indicates that a loss is probable and an amount, or range of loss can be reasonably estimated. These assessments are performed at least quarterly and are based on the information available to management at the time and involve a significant management judgment to determine the probability and estimated amount of potential losses, if any. Based on the available information considered in its reviews, the Company adjusts its loss contingency accruals and its disclosures as may be required. Actual outcomes or losses may differ materially from those estimated by the Company's current assessments including available insurance recoveries, which would impact its profitability. Adverse developments in existing litigation claims or legal proceedings involving the Company or new claims could require it to establish or increase litigation reserves or enter into unfavorable settlements or satisfy judgments for monetary damages for amounts in excess of current reserves, which could adversely affect its financial results. With regard to the outstanding contingencies as of March 31, 2019, the Company believes the outcome of these matters will not have a material adverse effect on its business, financial condition, results of operations or cash flows. 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. Non-income tax expense is included in selling, general and administrative expenses on its condensed consolidated statements of operations and the liability is reflected in sales tax payable within other current liabilities as of March 31, 2019 and December 31, 2018 , on its condensed consolidated balance sheets.

INCOME TAXES

INCOME TAXES	3 Months Ended
	Mar. 31, 2019
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES For the three months ended March 31, 2019 and 2018, the Company calculated its income tax expense or benefit using an estimated annual effective tax rate which is applied to the Company’s pretax income or loss as of the interim period. The Company’s effective tax rate for the three months ended March 31, 2019 and 2018 was 68.6% and 37.7% , respectively, including the impact of discrete items. Excluding discrete items, the Company’s effective tax rate for the three months ended March 31, 2019 and 2018 was 73.8% and 35.3% , respectively. The effective tax rates for the first quarter of 2019 and 2018 were primarily impacted by the nondeductibility of certain per diem expenses, the officers' compensation limitation, and state taxes. The Company will continue to assess the realizability of its deferred tax assets and, as of March 31, 2019 , has maintained a $1.2 million valuation allowance against certain state net operating losses. The Company's current year assumptions are consistent with estimates and plans used to manage its business. In the event that actual results differ from these estimates, or the Company adjusts these estimates in future periods for current trends or changes in its estimating assumptions, the Company may modify the level of the valuation allowance. As of March 31, 2019 , the Company had approximately $0.7 million of unrecognized tax benefits included in other long-term liabilities ( $5.9 million , net of deferred taxes, which would affect the effective tax rate if recognized). During the three months ended March 31, 2019 , the Company had gross increases of $0.4 million to its current year unrecognized tax benefits related to federal and state tax provisions. The tax years of 2008 and 2010 through 2018 remain open to examination by certain taxing jurisdictions to which the Company is subject to tax.

RELATED PARTY TRANSACTIONS

RELATED PARTY TRANSACTIONS	3 Months Ended
	Mar. 31, 2019
Related Party Transactions [Abstract]
RELATED PARTY TRANSACTIONS	RELATED PARTY TRANSACTIONS The Company provides services to entities 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 and accounts receivable related to these transactions were less than $0.1 million for the three months ended March 31, 2019 and March 31, 2018. The Company has a 68% ownership interest in Cross Country Talent Acquisition Group, LLC, a joint venture between the Company and a hospital system. The Company generated revenue providing staffing services to the hospital system of $5.6 million and $4.4 million for the three months ended March 31, 2019 and March 31, 2018, respectively. At March 31, 2019 and December 31, 2018 , the Company had a receivable balance of $3.1 million and $2.8 million , respectively, and a payable balance of $0.4 million and $0.3 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 $0.1 million in rent expense for these premises for the three months ended March 31, 2018. In the fourth quarter of 2018, the Company vacated the premises.

RECENT ACCOUNTING PRONOUNCEMENT

RECENT ACCOUNTING PRONOUNCEMENTS	3 Months Ended
	Mar. 31, 2019
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
RECENT ACCOUNTING PRONOUNCEMENTS	RECENT ACCOUNTING PRONOUNCEMENTS In August 2018, the FASB issued ASU No. 2018-15, Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40), Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That is a Service Contract. The amendments in this update align the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software (and hosting arrangements that include an internal use software license). The amendments in this update are effective for public business entities for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years, and should be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. Early adoption is permitted for all entities, including adoption in an interim period. The Company expects to early adopt this standard, on a prospective basis, in its second quarter of 2019. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820), Disclosure Framework - Changes to the Disclosure Requirements for Fair Value Measurement. The amendments in this update modify the disclosure requirements on fair value measurements in Topic 820, Fair Value Measurement , based on the concepts in the Concepts Statement, including the consideration of costs and benefits. The amendments in this update are effective for all entities for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, and should be applied either prospectively or retrospectively depending on the nature of the disclosure. An entity is permitted to early adopt any removed or modified disclosures upon issuance of this update and delay adoption of the additional disclosures until their effective date. The Company is currently in the process of evaluating this standard and expects to adopt the full provisions in its first quarter of 2020. In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326), Measurement of Credit Losses on Financial Instruments. The amendments in this update require a financial asset (or a group of financial assets) measured at amortized cost basis to be presented at the net amount expected to be collected based on historical experience, current conditions, and reasonable supportable forecasts. The amendments in this update are effective for public business entities for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, with early adoption permitted no sooner than the first quarter of 2019. A modified retrospective approach is required for all investments, except debt securities for which an other-than-temporary impairment had been recognized prior to the effective date, which will require a prospective transition approach and should be applied either prospectively or retrospectively depending on the nature of the disclosure. The Company is currently in the process of evaluating this standard and expects to adopt the full provisions in its first quarter of 2020.

SUMMARY OF SIGNIFICANT ACCOUN_2

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Consolidation	The accompanying condensed consolidated financial statements include the accounts of Cross Country Healthcare, Inc. and its direct and indirect wholly-owned subsidiaries (collectively, the Company). The condensed consolidated financial statements include all assets, liabilities, revenue, and expenses of Cross Country Talent Acquisition Group, 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. In the opinion of management, all entries necessary for a fair presentation of such unaudited condensed consolidated financial statements have been included. These entries consisted of all normal recurring items.
Basis of Accounting	The accompanying condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by United States generally accepted accounting principles (U.S. GAAP) for complete financial statements. These operating results are not necessarily indicative of the results that may be expected for the year ending December 31, 2019 . These unaudited interim condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto for the year ended December 31, 2018 included in the Company’s Annual Report on Form 10-K as filed with the Securities and Exchange Commission. The December 31, 2018 condensed consolidated balance sheet included herein was derived from the December 31, 2018 audited consolidated balance sheet included in the Company’s Annual Report on Form 10-K.
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts in the condensed 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) fair value of interest rate swap agreement; (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.
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, exit costs, and other costs including write-offs related to abandoned locations.
Recently Adopted Accounting Pronouncement	Recently Adopted Accounting Pronouncements Effective January 1, 2019, the Company adopted ASU No. 2016-02, Leases (Topic 842) , which requires that, as lessee, leases, as defined by the standard, are to be recognized on the balance sheet as right-of-use assets and as lease liabilities. The Company elected not to apply the recognition requirements to short-term leases, and to apply the transition method, which is applied prospectively, measuring and recognizing the initial right-of-use asset and liability at January 1, 2019, without revising comparative period information or disclosure. In addition, the Company elected the package of transition provisions available for expired or existing contracts, which allowed the Company to forego assessment of: (1) whether contracts are or contain leases, (2) lease classification, and (3) initial direct costs. Consistent with current accounting, all of the Company's existing leases identified under ASC 840 will be treated as operating leases. The Company has also elected the practical expedient to not separate non-lease components from the lease components to which they relate, and instead account for each as a single lease component, for all of its underlying asset classes. Accordingly, all expenses associated with a lease contract are accounted for as lease expenses. As of the later of January 1, 2019 or each lease’s respective commencement date, the Company recorded lease liabilities equal to the present value of its remaining minimum lease payments and right-of-use assets equal to the corresponding lease liability adjusted for any prepaid or accrued lease payments and the remaining balance of lease incentives received. At the transition date, the right of use asset and total lease liabilities were $22.0 million and $28.6 million , respectively. The difference between the right-of use-asset and lease liabilities is due to the derecognition of accrued lease payments of $7.2 million , previously included in other current and non-current liabilities, and prepaid rent of $0.6 million , previously included in prepaid expenses. See Note 10 - Leases. RECENT ACCOUNTING PRONOUNCEMENTS In August 2018, the FASB issued ASU No. 2018-15, Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40), Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That is a Service Contract. The amendments in this update align the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software (and hosting arrangements that include an internal use software license). The amendments in this update are effective for public business entities for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years, and should be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. Early adoption is permitted for all entities, including adoption in an interim period. The Company expects to early adopt this standard, on a prospective basis, in its second quarter of 2019. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820), Disclosure Framework - Changes to the Disclosure Requirements for Fair Value Measurement. The amendments in this update modify the disclosure requirements on fair value measurements in Topic 820, Fair Value Measurement , based on the concepts in the Concepts Statement, including the consideration of costs and benefits. The amendments in this update are effective for all entities for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, and should be applied either prospectively or retrospectively depending on the nature of the disclosure. An entity is permitted to early adopt any removed or modified disclosures upon issuance of this update and delay adoption of the additional disclosures until their effective date. The Company is currently in the process of evaluating this standard and expects to adopt the full provisions in its first quarter of 2020. In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326), Measurement of Credit Losses on Financial Instruments. The amendments in this update require a financial asset (or a group of financial assets) measured at amortized cost basis to be presented at the net amount expected to be collected based on historical experience, current conditions, and reasonable supportable forecasts. The amendments in this update are effective for public business entities for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, with early adoption permitted no sooner than the first quarter of 2019. A modified retrospective approach is required for all investments, except debt securities for which an other-than-temporary impairment had been recognized prior to the effective date, which will require a prospective transition approach and should be applied either prospectively or retrospectively depending on the nature of the disclosure. The Company is currently in the process of evaluating this standard and expects to adopt the full provisions in its first quarter of 2020.

SUMMARY OF SIGNIFICANT ACCOUN_3

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Restructuring and Related Costs	Reconciliation of the on-going benefit costs beginning and ending liability balance is presented below: On-Going Benefit Costs (amounts in thousands) Balance at January 1, 2019 $ 556 Charged to restructuring costs 1,104 Payments (373 ) Balance at March 31, 2019 $ 1,287

REVENUE RECOGNITION (Tables)

REVENUE RECOGNITION (Tables)	3 Months Ended
	Mar. 31, 2019
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	The Company's revenues, generated from temporary staffing services and other services, are disaggregated in the following table. Sales and usage-based taxes are excluded from revenue. Three Months ended March 31, 2019 Nurse Physician Search Total (amounts in thousands) Temporary Staffing Services $ 172,653 $ 15,154 $ — $ 187,807 Other Services 3,420 1,005 2,939 7,364 Total $ 176,073 $ 16,159 $ 2,939 $ 195,171

EARNINGS PER SHARE (Tables)

EARNINGS PER SHARE (Tables)	3 Months Ended
	Mar. 31, 2019
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: Three Months Ended March 31, 2019 2018 (amounts in thousands, except per share data) Numerator: Net (loss) income attributable to common shareholders - Basic and Diluted $ (1,767 ) $ 1,642 Denominator: Weighted average common shares - Basic 35,700 35,803 Effective of diluted shares: Share-based awards — 284 Weighted average common shares - Diluted 35,700 36,087 Net (loss) income per share attributable to common shareholders - Basic $ (0.05 ) $ 0.05 Net (loss) income per share attributable to common shareholders - Diluted $ (0.05 ) $ 0.05

GOODWILL, TRADE NAMES, AND OT_2

GOODWILL, TRADE NAMES, AND OTHER INTANGIBLE ASSETS (Tables)	3 Months Ended
	Mar. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Acquired Intangible Assets	The Company had the following acquired intangible assets: March 31, 2019 December 31, 2018 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount (amounts in thousands) Intangible assets subject to amortization: Databases $ 30,530 $ 9,979 $ 20,551 $ 30,530 $ 9,216 $ 21,314 Customer relationships 49,758 24,121 25,637 49,758 23,296 26,462 Non-compete agreements 320 113 207 320 97 223 Trade names 8,879 1,976 6,903 8,879 1,696 7,183 Other intangible assets, net $ 89,487 $ 36,189 $ 53,298 $ 89,487 $ 34,305 $ 55,182 Intangible assets not subject to amortization: Trade names 20,402 20,402 $ 73,700 $ 75,584
Estimated Annual Amortization Expense	As of March 31, 2019 , estimated annual amortization expense is as follows: Years Ending December 31: (amounts in thousands) 2019 $ 5,651 2020 7,431 2021 7,131 2022 6,780 2023 6,677 Thereafter 19,628 $ 53,298

DEBT (Tables)

DEBT (Tables)	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Long-term Debt	The Company's long-term debt consists of the following: March 31, 2019 December 31, 2018 Principal Debt Issuance Costs Principal Debt Issuance Costs (amounts in thousands) Term Loan, interest 5.5% and 4.8% at March 31, 2019 and December 31, 2018, respectively $ 76,377 $ (888 ) $ 83,876 $ (697 ) Less current portion — — (5,235 ) — Long-term debt $ 76,377 $ (888 ) $ 78,641 $ (697 )
Aggregate scheduled maturities of debt	As of March 31, 2019 , the aggregate scheduled maturities of the term loan are as follows: Term Loan (amounts in thousands) Through Years Ending December 31: 2019 $ — 2020 3,407 2021 6,980 2022 65,990 2023 — Thereafter — Total $ 76,377

LEASES (Tables)

LEASES (Tables)	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Supplemental Balance Sheet Information	The table below presents the lease-related assets and liabilities included on the condensed consolidated balance sheets: Classification on Condensed Consolidated Balance Sheets: March 31, 2019 (amounts in thousands) Operating lease right-of-use assets $ 20,965 Operating lease liabilities - current $ 5,063 Operating lease liabilities - non-current $ 22,426 Weighted-average remaining lease term 5.3 years Weighted average discount rate (a) 6.24 % ________________ (a) Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019.
Operating Lease Maturity	The table below reconciles the undiscounted cash flows for each of the first five years and total of the remaining years to the operating lease liabilities (which do not include short-term leases) recorded on the condensed consolidated balance sheets: Years Ending December 31: (amounts in thousands) 2019 $ 4,914 2020 6,572 2021 5,702 2022 4,929 2023 4,702 Thereafter 5,869 Total minimum lease payments 32,688 Less: amount of lease payments representing interest (5,199 ) Present value of future minimum lease payments 27,489 Less: current lease obligations (5,063 ) Non-current lease obligations $ 22,426
Future Minimum Lease Payments under Topic 840	Future minimum lease payments, as of December 31, 2018, associated with non-cancelable operating lease agreements with terms of one year or more are as follows: Years Ending December 31: (amounts in thousands) 2019 $ 7,451 2020 6,287 2021 5,407 2022 4,857 2023 4,700 Thereafter 5,893 Total minimum lease payments $ 34,595
Lease Costs	The table below provides information regarding supplemental cash flows: March 31, 2019 (amounts in thousands) Supplemental Cash Flow Information: Cash paid for amounts included in the measurement of operating lease liabilities $ 1,845 ROU assets obtained in exchange for new operating lease liabilities $ 300 The components of lease expense are as follows: March 31, 2019 (amounts in thousands) Amounts Included in Condensed Consolidated Statements of Operations: Operating lease expense $ 1,694 Short-term lease expense $ 2,159 Variable and other lease costs $ 718

FAIR VALUE MEASUREMENTS (Tables

FAIR VALUE MEASUREMENTS (Tables)	3 Months Ended
	Mar. 31, 2019
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 March 31, 2019 December 31, 2018 Financial Liabilities: (amounts in thousands) (Level 1) Deferred compensation $ 1,782 $ 1,725 (Level 2) Interest rate swaps $ 572 $ 234 (Level 3) Contingent consideration liabilities $ 7,836 $ 7,689
Schedule of reconciliation of opening and closing balances for fair value measurements categorized within Level 3	The opening balances of contingent consideration liabilities are reconciled to the closing balances for fair value measurements of these liabilities categorized within Level 3 of the fair value hierarchy are as follows: Contingent Consideration Liabilities (amounts in thousands) December 31, 2018 $ 7,689 Payments (100 ) Accretion expense 247 March 31, 2019 $ 7,836
Carrying Amounts and Estimated Fair Values of Significant Financial Instrument that were not Measured at Fair Value	The carrying amounts and estimated fair value of the Company’s significant financial instruments that were not measured at fair value are as follows: March 31, 2019 December 31, 2018 Carrying Fair Carrying Fair Financial Liabilities: (amounts in thousands) (Level 2) Term Loan, net $ 75,489 $ 75,300 $ 83,179 $ 81,800

STOCKHOLDERS' EQUITY (Tables)

STOCKHOLDERS' EQUITY (Tables)	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
Summary of Restricted Stock Activity	The following table summarizes restricted stock awards and performance stock awards activity issued under the 2017 Plan for the three months ended March 31, 2019 : Restricted Stock Awards Performance Stock Awards Number of Weighted Number of Target Weighted Unvested restricted stock awards, January 1, 2019 589,120 $ 12.00 365,149 $ 12.35 Granted 696,545 $ 7.03 182,189 $ 7.03 Vested (273,716 ) $ 11.48 — $ — Forfeited (19,349 ) $ 11.81 (161,653 ) $ 12.48 Unvested restricted stock awards, March 31, 2019 992,600 $ 8.88 385,685 $ 9.79

SEGMENT DATA (Tables)

SEGMENT DATA (Tables)	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Information on Operating Segments and Reconciliation to Loss From Operations	Information on operating segments and a reconciliation to income from operations for the periods indicated are as follows: Three Months Ended March 31, 2019 2018 (amounts in thousands) Revenue from services: Nurse and Allied Staffing $ 176,073 $ 185,105 Physician Staffing 16,159 21,560 Search Services 2,939 3,623 $ 195,171 $ 210,288 Contribution income: Nurse and Allied Staffing $ 14,156 $ 16,760 Physician Staffing 405 1,500 Search Services (283 ) 312 14,278 18,572 Corporate overhead 12,330 10,652 Depreciation and amortization 2,984 2,909 Acquisition-related contingent consideration 247 213 Acquisition and integration costs 265 115 Restructuring costs 1,140 435 (Loss) income from operations $ (2,688 ) $ 4,248

ORGANIZATION AND BASIS OF PRE_2

ORGANIZATION AND BASIS OF PRESENTATION - Additional Information (Details) $ in Millions	Mar. 29, 2019USD ($)
Second Amendment, Amended And Restated Credit Agreement [Member] | Term Loan [Member]
Debt Instrument [Line Items]
Payment for debt prepayment	$ 7.5

SUMMARY OF SIGNIFICANT ACCOUN_4

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Restructuring Costs (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Restructuring Reserve [Roll Forward]
Charged to restructuring costs	$ 1,140	$ 435
Cost Optimization Project [Member] | On-Going Benefit Costs [Member]
Restructuring Reserve [Roll Forward]
Balance at January 1, 2019	556
Charged to restructuring costs	1,104
Payments	(373)
Balance at March 31, 2019	1,287
Cost Optimization Project [Member] | Exit Costs [Member]
Restructuring Cost and Reserve [Line Items]
ASC 842 lease reclassification	$ (300)

SUMMARY OF SIGNIFICANT ACCOUN_5

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Recently Adopted Accounting Pronouncements (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Jan. 01, 2019	Dec. 31, 2018
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating lease right-of-use assets	$ 20,965	$ 22,000	$ 0
Operating lease liabilities	$ 27,489	28,600
Adjustment for ASU 2016-02
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Accrued lease payments		7,200
Prepaid rent		$ 600

REVENUE RECOGNITION - Disaggreg

REVENUE RECOGNITION - Disaggregation of Revenue (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Disaggregation of Revenue [Line Items]
Revenue	$ 195,171
Temporary Staffing Services [Member]
Disaggregation of Revenue [Line Items]
Revenue	187,807
Other Services [Member]
Disaggregation of Revenue [Line Items]
Revenue	7,364
Nurse And Allied Staffing Segment [Member]
Disaggregation of Revenue [Line Items]
Revenue	176,073
Nurse And Allied Staffing Segment [Member] | Temporary Staffing Services [Member]
Disaggregation of Revenue [Line Items]
Revenue	172,653
Nurse And Allied Staffing Segment [Member] | Other Services [Member]
Disaggregation of Revenue [Line Items]
Revenue	3,420
Physician Staffing Segment [Member]
Disaggregation of Revenue [Line Items]
Revenue	16,159
Physician Staffing Segment [Member] | Temporary Staffing Services [Member]
Disaggregation of Revenue [Line Items]
Revenue	15,154
Physician Staffing Segment [Member] | Other Services [Member]
Disaggregation of Revenue [Line Items]
Revenue	1,005
Search Services Segment [Member]
Disaggregation of Revenue [Line Items]
Revenue	2,939
Search Services Segment [Member] | Temporary Staffing Services [Member]
Disaggregation of Revenue [Line Items]
Revenue	0
Search Services Segment [Member] | Other Services [Member]
Disaggregation of Revenue [Line Items]
Revenue	$ 2,939

REVENUE RECOGNITION - Additiona

REVENUE RECOGNITION - Additional Information (Details) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018
Revenue from Contract with Customer [Abstract]
Unbilled contracts receivable	$ 43	$ 44.1

ACQUISITIONS - Advantage RN (De

ACQUISITIONS - Advantage RN (Details) - Advantage RN, LLC [Member] $ in Millions	Apr. 03, 2019USD ($)	Jul. 28, 2017USD ($)	Jul. 01, 2017USD ($)escrow_account	Feb. 28, 2019USD ($)	Mar. 31, 2019USD ($)	Sep. 30, 2017USD ($)	Feb. 28, 2019USD ($)
Business Acquisition [Line Items]
Cash consideration			$ 86.6
Net working capital adjustment			$ 0.6
Reimbursement from working capital adjustment settled						$ 0.8
Number of escrow accounts | escrow_account			2
Release of remaining contingent liability							$ 0.5
Remaining liability released to seller				$ 0.1
Escrow deposit related to tax liabilities		$ 7.2	$ 14.5
Escrow deposit related to post close liabilities			7.5		$ 0.5
Release of escrow to seller		$ 7.3			$ 7
Deferred Consideration Transferred [Member]
Business Acquisition [Line Items]
Contingent liability			$ 0.6
Period of deferred consideration			20 months
Purchase Price [Member]
Business Acquisition [Line Items]
Purchase price			$ 88
Subsequent Event [Member]
Business Acquisition [Line Items]
Release of escrow to seller	$ 2.9
Escrow disbursement related to tax liabilities	$ 4.3

ACQUISITIONS - Narrative (Detai

ACQUISITIONS - Narrative (Details) - Assumed Additional Contingent Purchase Price Liabilities [Member] - Mediscan [Member] $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Business Acquisition [Line Items]
Contingent consideration, range of outcomes, high	$ 0.3
Contingent liability paid	0.1
Contingent consideration liabilities	$ 7.8

COMPREHENSIVE INCOME (Details)

COMPREHENSIVE INCOME (Details) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018
Equity [Abstract]
Loss on currency fluctuations	$ 1.2	$ 1.3
Unrealized loss on derivatives	$ 0.4	$ 0.2

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
	Mar. 31, 2019	Mar. 31, 2018
Numerator:
Net (loss) income attributable to common shareholders - Basic and Diluted	$ (1,767)	$ 1,642
Denominator:
Weighted average common shares - Basic (shares)	35,700	35,803
Effective of diluted shares:
Share-based awards (shares)	0	284
Weighted average common shares - Diluted (shares)	35,700	36,087
Net (loss) income per share attributable to common shareholders - Basic (in dollars per share)	$ (0.05)	$ 0.05
Net (loss) income per share attributable to common shareholders - Diluted (in dollars per share)	$ (0.05)	$ 0.05

EARNINGS PER SHARE - Additional

EARNINGS PER SHARE - Additional Information (Details)	3 Months Ended
	Mar. 31, 2019shares
Earnings Per Share [Abstract]
Shares excluded from diluted weighted average shares (shares)	97,184

GOODWILL, TRADE NAMES, AND OT_3

GOODWILL, TRADE NAMES, AND OTHER INTANGIBLE ASSETS - Acquired Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 89,487	$ 89,487
Accumulated Amortization	36,189	34,305
Intangible assets subject to amortization, net carrying amount	53,298	55,182
Trade names	20,402	20,402
Total intangible assets, net	73,700	75,584
Databases [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	30,530	30,530
Accumulated Amortization	9,979	9,216
Intangible assets subject to amortization, net carrying amount	20,551	21,314
Customer relationships [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	49,758	49,758
Accumulated Amortization	24,121	23,296
Intangible assets subject to amortization, net carrying amount	25,637	26,462
Non-compete agreements [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	320	320
Accumulated Amortization	113	97
Intangible assets subject to amortization, net carrying amount	207	223
Trade names [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	8,879	8,879
Accumulated Amortization	1,976	1,696
Intangible assets subject to amortization, net carrying amount	$ 6,903	$ 7,183

GOODWILL, TRADE NAMES, AND OT_4

GOODWILL, TRADE NAMES, AND OTHER INTANGIBLE ASSETS - Annual Amortization Expense (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
2019	$ 5,651
2020	7,431
2021	7,131
2022	6,780
2023	6,677
Thereafter	19,628
Intangible assets subject to amortization, net carrying amount	$ 53,298	$ 55,182

GOODWILL, TRADE NAMES, AND OT_5

GOODWILL, TRADE NAMES, AND OTHER INTANGIBLE ASSETS - Goodwill (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Goodwill [Line Items]
Goodwill	$ 101,081	$ 101,060
Nurse And Allied Staffing [Member]
Goodwill [Line Items]
Goodwill	88,900
Physician Staffing [Member]
Goodwill [Line Items]
Goodwill	2,800
Search Services [Member]
Goodwill [Line Items]
Goodwill	$ 9,400

DEBT - Long- Term Debt (Details

DEBT - Long- Term Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Less current portion	$ 0	$ (5,235)
Long-term debt	75,489	77,944
Senior Debt [Member]
Debt Instrument [Line Items]
Long term debt	76,377
Senior Debt [Member] | Term Loan [Member]
Debt Instrument [Line Items]
Long term debt	76,377	83,876
Less current portion	0	(5,235)
Long-term debt	76,377	78,641
Debt Issuance Costs	$ (888)	$ (697)
Interest Rate	5.50%	4.80%

DEBT - Amendment And Restated S

DEBT - Amendment And Restated Senior Credit Facility (Details) $ in Thousands	Mar. 29, 2019USD ($)	Mar. 31, 2019USD ($)	Mar. 31, 2018USD ($)	Aug. 01, 2017USD ($)
Debt Instrument [Line Items]
Payment of debt issuance costs		$ 568	$ 0
Second Amendment, Amended And Restated Credit Agreement [Member]
Debt Instrument [Line Items]
Reduction in revolving commitments	$ 40,000
Maximum borrowing capacity	75,000
Payment of debt issuance costs	$ 600
Second Amendment, Amended And Restated Credit Agreement [Member] | Minimum [Member]
Debt Instrument [Line Items]
Consolidated Asset Coverage Ratio	1.10
Second Amendment, Amended And Restated Credit Agreement [Member] | Fiscal Quarters Ending December 31, 2018 Through June 30, 2019 [Member] | Maximum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	4.60
Second Amendment, Amended And Restated Credit Agreement [Member] | Fiscal Quarter Ending September 30, 2019 [Member] | Maximum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	4.25
Second Amendment, Amended And Restated Credit Agreement [Member] | Fiscal Quarter Ending December 31, 2019 [Member] | Maximum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	4
Second Amendment, Amended And Restated Credit Agreement [Member] | Fiscal Quarter Ending March 31, 2020 [Member] | Maximum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	3.75
Second Amendment, Amended And Restated Credit Agreement [Member] | Fiscal Quarter Ending June 30, 2020 [Member] | Maximum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	3.50
Second Amendment, Amended And Restated Credit Agreement [Member] | Fiscal Quarter Ending September 30, 2020 [Member] | Maximum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	3.25
Second Amendment, Amended And Restated Credit Agreement [Member] | Each Fiscal Quarter Ending Thereafter [Member] | Maximum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	3
First Amendment, Amended And Restated Credit Agreement [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity				$ 115,000
Amended And Restated Credit Agreement [Member]
Debt Instrument [Line Items]
Interest rate increase (decrease) (percent)		2.00%
Quarterly commitment fee on the average daily unused portion (percent)		0.45%
Amended And Restated Credit Agreement [Member] | Minimum [Member]
Debt Instrument [Line Items]
Consolidated fixed charge coverage ratio		1.50
Term Loan [Member] | Second Amendment, Amended And Restated Credit Agreement [Member]
Debt Instrument [Line Items]
Reduction in carrying amount of debt	$ 300
Payment for debt prepayment	7,500
Revolving Credit Facility [Member] | Amended And Restated Credit Agreement [Member]
Debt Instrument [Line Items]
Letters of credit outstanding		$ 20,600
Revolving Credit Facility [Member] | Amended And Restated Credit Agreement [Member] | LIBOR [Member]
Debt Instrument [Line Items]
Interest margin		3.00%
Revolving Credit Facility [Member] | Line of Credit [Member] | Second Amendment, Amended And Restated Credit Agreement [Member]
Debt Instrument [Line Items]
Payment of debt issuance costs	$ 300
Write off of debt issuance costs		$ 300
Covenant Term 5 [Member] | Second Amendment, Amended And Restated Credit Agreement [Member] | Maximum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	3.50
Covenant Term 5 [Member] | Second Amendment, Amended And Restated Credit Agreement [Member] | Minimum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	3
Covenant Term 6 [Member] | Second Amendment, Amended And Restated Credit Agreement [Member]
Debt Instrument [Line Items]
Increase in Consolidated Net Leverage Ratio	0.25%
Increase in Commitment Fee Percentage	0.05%
Covenant Term 6 [Member] | Second Amendment, Amended And Restated Credit Agreement [Member] | Maximum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	4
Covenant Term 6 [Member] | Second Amendment, Amended And Restated Credit Agreement [Member] | Minimum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	3.50
Covenant Term 7 [Member] | Second Amendment, Amended And Restated Credit Agreement [Member]
Debt Instrument [Line Items]
Increase in Consolidated Net Leverage Ratio	0.25%
Increase in Commitment Fee Percentage	0.05%
Covenant Term 7 [Member] | Second Amendment, Amended And Restated Credit Agreement [Member] | Minimum [Member]
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio	4

DEBT - Debt Maturities (Details

DEBT - Debt Maturities (Details) - Term Loan [Member] $ in Thousands	Mar. 31, 2019USD ($)
Long-term Debt, Fiscal Year Maturity [Abstract]
2019	$ 0
2020	3,407
2021	6,980
2022	65,990
2023	0
Thereafter	0
Long term debt	$ 76,377

DERIVATIVE - Additional Informa

DERIVATIVE - Additional Information (Details) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018
Interest Rate Swap [Member]
Derivative [Line Items]
Interest rate swap fixed rate percentage			2.627%
Term Loan [Member] | Senior Debt [Member]
Derivative [Line Items]
Percentage of debt balance with fixed interest rate			50.00%
Cash flow hedging [Member] | Interest Rate Swap [Member]
Derivative [Line Items]
Interest rate swaps	$ 0.6	$ 0.2

LEASES - Balance Sheet Informat

LEASES - Balance Sheet Information (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Jan. 01, 2019	Dec. 31, 2018
Leases [Abstract]
Operating lease right-of-use assets	$ 20,965	$ 22,000	$ 0
Operating lease liabilities - current	5,063		0
Operating lease liabilities - non-current	$ 22,426		$ 0
Weighted-average remaining lease term	5 years 4 months
Weighted average discount rate	6.24%

LEASES - Undiscounted Cash Flow

LEASES - Undiscounted Cash Flows (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Jan. 01, 2019	Dec. 31, 2018
Leases [Abstract]
2019	$ 4,914
2020	6,572
2021	5,702
2022	4,929
2023	4,702
Thereafter	5,869
Total minimum lease payments	32,688
Less: amount of lease payments representing interest	(5,199)
Present value of future minimum lease payments	27,489	$ 28,600
Less: current lease obligations	(5,063)		$ 0
Non-current lease obligations	$ 22,426		$ 0

LEASES - Future Minimum Lease P

LEASES - Future Minimum Lease Payments Under Topic 840 (Details) $ in Thousands	Dec. 31, 2018USD ($)
Leases [Abstract]
2019	$ 7,451
2020	6,287
2021	5,407
2022	4,857
2023	4,700
Thereafter	5,893
Total minimum lease payments	$ 34,595

LEASES - Other Information (Det

LEASES - Other Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Leases [Abstract]
Cash paid for amounts included in the measurement of operating lease liabilities	$ 1,845
ROU assets obtained in exchange for new operating lease liabilities	300
Operating lease expense	1,694
Short-term lease expense	2,159
Variable and other lease costs	$ 718

FAIR VALUE MEASUREMENTS - Estim

FAIR VALUE MEASUREMENTS - Estimated Fair values Assets and Liabilities Measured on Recurring Basis (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Fair Value, Inputs, Level 1 [Member] | Deferred compensation [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Deferred compensation	$ 1,782	$ 1,725
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liabilities	7,836	7,689
Interest Rate Swap [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate swaps	$ 572	$ 234

FAIR VALUE MEASUREMENTS - Sched

FAIR VALUE MEASUREMENTS - Schedule of reconciliation of opening and closing balances for fair value measurements categorized within Level 3 (Details) - Contingent Consideration Liabilities [Member] $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Convertible Note Derivative Liability
Beginning balance	$ 7,689
Payments	(100)
Accretion expense	247
Ending balance	$ 7,836

FAIR VALUE MEASUREMENTS - Narra

FAIR VALUE MEASUREMENTS - Narrative (Details)	3 Months Ended
	Mar. 31, 2019USD ($)
Fair Value Measurement [Line Items]
Impairment charges	$ 0
Minimum [Member]
Fair Value Measurement [Line Items]
Threshold period, past due for payment of services provided	15 days
Maximum [Member]
Fair Value Measurement [Line Items]
Threshold period, past due for payment of services provided	60 days

FAIR VALUE MEASUREMENTS - Finan

FAIR VALUE MEASUREMENTS - Financial Instrument that were not Measured at Fair Value (Details) - Term Loan, Net [Member] - Fair Value, Inputs, Level 2 [Member] - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Reported Value Measurement [Member]
Fair Value, Option, Quantitative Disclosures [Line Items]
Financial Liabilities, Carrying Amount	$ 75,489	$ 83,179
Estimate of Fair Value Measurement [Member]
Fair Value, Option, Quantitative Disclosures [Line Items]
Financial Liabilities, Fair Value	$ 75,300	$ 81,800

STOCKHOLDERS' EQUITY - Narrativ

STOCKHOLDERS' EQUITY - Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Value of shares repurchased and retired		$ 2,885
Common shares left remaining to repurchase under the plan (up to) (in shares)	510,004
Selling, General and Administrative Expenses [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation	$ 500	$ 500
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years
Vested in period, net (in shares)	176,436	101,834
Common Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares repurchased and retired (in shares)	0	242,400
Shares repurchased (in dollars per share)		$ 11.88

STOCKHOLDERS' EQUITY - Summary

STOCKHOLDERS' EQUITY - Summary of Restricted Stock and Performance Shares (Details)	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Restricted Stock [Member]
Number of Shares
Unvested restricted stock awards, Beginning balance (in shares) | shares	589,120
Granted (in shares) | shares	696,545
Vested (in shares) | shares	(273,716)
Forfeited (in shares) | shares	(19,349)
Unvested restricted stock awards, Ending balance (in shares) | shares	992,600
Weighted Average Grant Date Fair Value (in usd per share)
Unvested restricted stock awards, Beginning balance (in dollars per share) | $ / shares	$ 12
Granted (in dollars per share) | $ / shares	7.03
Vested (in dollars per share) | $ / shares	11.48
Forfeited (in dollars per share) | $ / shares	11.81
Unvested restricted stock awards, Ending balance (in dollars per share) | $ / shares	$ 8.88
Performance Stock [Member]
Number of Shares
Unvested restricted stock awards, Beginning balance (in shares) | shares	365,149
Granted (in shares) | shares	182,189
Vested (in shares) | shares	0
Forfeited (in shares) | shares	(161,653)
Unvested restricted stock awards, Ending balance (in shares) | shares	385,685
Weighted Average Grant Date Fair Value (in usd per share)
Unvested restricted stock awards, Beginning balance (in dollars per share) | $ / shares	$ 12.35
Granted (in dollars per share) | $ / shares	7.03
Vested (in dollars per share) | $ / shares	0
Forfeited (in dollars per share) | $ / shares	12.48
Unvested restricted stock awards, Ending balance (in dollars per share) | $ / shares	$ 9.79

SEGMENT DATA - Narrative (Detai

SEGMENT DATA - Narrative (Details)	3 Months Ended
	Mar. 31, 2019segment
Segment Reporting [Abstract]
Number of operating segments	3

SEGMENT DATA - Information on O

SEGMENT DATA - Information on Operating Segments and Reconciliation to Loss From Operations (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from services	$ 195,171	$ 210,288
Contribution income	14,278	18,572
Corporate overhead	12,330	10,652
Depreciation and amortization	2,984	2,909
Acquisition-related contingent consideration	247	213
Acquisition and integration costs	265	115
Restructuring costs	1,140	435
(Loss) income from operations	(2,688)	4,248
Nurse And Allied Staffing [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from services	176,073	185,105
Contribution income	14,156	16,760
Physician Staffing [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from services	16,159	21,560
Contribution income	405	1,500
Search Services [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from services	2,939	3,623
Contribution income	$ (283)	$ 312

INCOME TAXES (Details)

INCOME TAXES (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Valuation Allowance [Line Items]
Effective tax rate	68.60%	37.70%
Effective tax rate, excluding discrete items	73.80%	35.30%
Unrecognized tax benefits	$ 0.7
Unrecognized tax benefits that would impact effective tax rate	5.9
Gross increase to current year unrecognized tax benefits related to federal and state tax issues	0.4
State and Local Jurisdiction [Member]
Valuation Allowance [Line Items]
Valuation allowance	$ 1.2

RELATED PARTY TRANSACTIONS (Det

RELATED PARTY TRANSACTIONS (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Related Party Transaction [Line Items]
Revenue from related parties	$ 0.1	$ 0.1
Accounts receivable from related parties	0.1	0.1
InteliStaf [Member]
Related Party Transaction [Line Items]
Revenue from related parties	$ 5.6	4.4
Joint venture, percent ownership	68.00%
Receivable balance with joint venture	$ 3.1		$ 2.8
Payable balance with joint venture	$ 0.4		$ 0.3
Affiliated Entity [Member]
Related Party Transaction [Line Items]
Rent expense		$ 0.1