AMN Healthcare Services (AMN) 10-Q 8 May 15 2015 Q1 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	3 Months Ended
	Mar. 31, 2015	6-May-15
Document and Entity Information [Abstract]
Entity Registrant Name	AMN HEALTHCARE SERVICES INC
Entity Central Index Key	1142750
Document Type	10-Q
Document Period End Date	31-Mar-15
Amendment Flag	FALSE
Document Fiscal Year Focus	2015
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	-19
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		47,555,758

Condensed_Consolidated_Balance

Condensed Consolidated Balance Sheets (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Current assets:
Cash and cash equivalents	$11,633	$13,073
Accounts receivable, net of allowances of $6,019 and $4,515 at March 31, 2015 and December 31, 2014, respectively	221,001	186,274
Accounts receivable, subcontractor	34,191	28,443
Deferred income taxes, net	26,466	27,330
Prepaid and other current assets	29,065	27,550
Total current assets	322,356	282,670
Restricted cash, cash equivalents and investments	19,772	19,567
Fixed assets, net of accumulated depreciation of $71,019 and $68,814 at March 31, 2015 and December 31, 2014, respectively	36,674	32,880
Other assets	44,117	39,895
Goodwill	197,254	154,387
Intangible assets, net of accumulated amortization of $44,822 and $41,963 at March 31, 2015 and December 31, 2014, respectively	179,877	152,517
Total assets	800,050	681,916
Current liabilities:
Accounts payable and accrued expenses	92,081	78,993
Accrued compensation and benefits	72,237	67,995
Current portion of revolving credit facility	30,000	18,000
Current portion of notes payable	7,500	7,500
Deferred revenue	3,137	3,177
Other current liabilities	2,662	2,630
Total current liabilities	207,617	178,295
Revolving credit facility	65,500	0
Notes payable	135,000	136,875
Deferred income taxes, net	37,198	32,491
Other long-term liabilities	83,972	77,674
Total liabilities	529,287	425,335
Commitments and contingencies and subsequent events
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at March 31, 2015 and December 31, 2014	0	0
Common stock, $0.01 par value; 200,000 shares authorized; 47,455 and 46,639 shares issued and outstanding at March 31, 2015 and December 31, 2014, respectively	475	466
Additional paid-in capital	436,425	434,529
Accumulated deficit	-165,849	-178,058
Accumulated other comprehensive loss	-288	-356
Total stockholders’ equity	270,763	256,581
Total liabilities and stockholders’ equity	$800,050	$681,916

Condensed_Consolidated_Balance1

Condensed Consolidated Balance Sheets (Parenthetical) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, except Share data, unless otherwise specified
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$6,019	$4,515
Accumulated depreciation	71,019	68,814
Accumulated amortization	$44,822	$41,963
Preferred stock, par value (in dollars per share)	$0.01	$0.01
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value (in dollars per share)	$0.01	$0.01
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares issued	47,455,000	46,639,000
Common stock, shares outstanding	47,455,000	46,639,000

Condensed_Consolidated_Stateme

Condensed Consolidated Statements of Comprehensive Income (USD $)	3 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
Statement of Comprehensive Income [Abstract]
Revenue	$327,510	$240,881
Cost of revenue	226,078	166,925
Gross profit	101,432	73,956
Operating expenses:
Selling, general and administrative	71,552	54,667
Depreciation and amortization	5,095	3,820
Total operating expenses	76,647	58,487
Income from operations	24,785	15,469
Interest expense, net, and other	1,807	1,846
Income before income taxes	22,978	13,623
Income tax expense	10,769	5,993
Net income	12,209	7,630
Other comprehensive income (loss) - foreign currency translation	68	-9
Comprehensive income	$12,277	$7,621
Net income per common share:
Basic (in dollars per share)	$0.26	$0.16
Diluted (in dollars per share)	$0.25	$0.16
Weighted average common shares outstanding:
Basic (shares)	47,146	46,354
Diluted (shares)	48,364	47,917

Condensed_Consolidated_Stateme1

Condensed Consolidated Statements of Cash Flows (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
Cash flows from operating activities:
Net income	$12,209	$7,630
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	5,095	3,820
Non-cash interest expense and other	457	295
Increase in allowances for doubtful accounts and sales credits	2,192	443
Provision for deferred income taxes	5,359	1,885
Share-based compensation	2,377	1,819
Excess tax benefits from share-based compensation	-5,029	-1,546
(Gain) loss on disposal or sale of fixed assets	-2	1
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable	-16,443	-3,806
Accounts receivable, subcontractor	-5,748	-409
Income taxes receivable	5,171	3,114
Prepaid expenses and other current assets	-3,063	-4,068
Other assets	-2,150	-606
Accounts payable and accrued expenses	3,621	-6,190
Accrued compensation and benefits	996	1,008
Other liabilities	4,382	369
Deferred revenue	-532	-20
Restricted cash, cash equivalents and investments balance	-205	-2,875
Net cash provided by operating activities	8,687	864
Cash flows from investing activities:
Purchase and development of fixed assets	-6,370	-5,843
Loan to Pipeline Health Holdings LLC	-667	0
Equity method investment	0	-2,000
Payments to fund deferred compensation plan	-1,203	-1,215
Cash paid for acquisition, net of cash received	-76,945	0
Change in restricted cash, cash equivalents and investments balance	0	4,349
Cash paid for working capital adjustments for prior acquisition	-165	0
Net cash used in investing activities	-85,350	-4,709
Cash flows from financing activities:
Capital lease repayments	-4	-156
Payments on term loan	-1,875	0
Payments on revolving credit facility	-7,000	-1,000
Proceeds from revolving credit facility	84,500	1,000
Proceeds from exercise of equity awards	3,199	58
Cash paid for shares withheld for taxes	-8,694	-3,905
Excess tax benefits from share-based compensation	5,029	1,546
Net cash provided by (used in) financing activities	75,155	-2,457
Effect of exchange rate changes on cash	68	-9
Net decrease in cash and cash equivalents	-1,440	-6,311
Cash and cash equivalents at beginning of period	13,073	15,580
Cash and cash equivalents at end of period	11,633	9,269
Supplemental disclosures of cash flow information:
Cash paid for interest (net of $43 and $123 capitalized for the three months ended March 31, 2015 and 2014, respectively)	1,330	1,588
Cash paid for income taxes	473	223
Acquisitions:
Fair value of tangible assets acquired in acquisition, net of cash received	25,627	0
Goodwill	42,702	0
Intangible assets	30,219	0
Liabilities assumed	-21,603	0
Net cash paid for acquisitions	-76,945	0
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses	$3,607	$3,067

Condensed_Consolidated_Stateme2

Condensed Consolidated Statements of Cash Flows (Parenthetical) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
Statement of Cash Flows [Abstract]
Interest capitalized	$43	$123

Basis_of_Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BASIS OF PRESENTATION	BASIS OF PRESENTATION
	The condensed consolidated balance sheets and related condensed consolidated statements of comprehensive income and cash flows contained in this Quarterly Report on Form 10-Q (this “Quarterly Report”), which are unaudited, include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries (collectively, the “Company”). All significant intercompany balances and transactions 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 results of operations for the interim period are not necessarily indicative of the results to be expected for any other interim period or for the entire fiscal year or for any future period.
	The unaudited condensed consolidated financial statements do not include all information and notes necessary for a complete presentation of financial position, results of operations and cash flows in conformity with accounting principles generally accepted in the United States. Please refer to the Company’s audited consolidated financial statements and the related notes for the fiscal year ended December 31, 2014, contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2014, filed with the Securities and Exchange Commission on February 25, 2015 (“2014 Annual Report”).
	The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. On an ongoing basis, the Company evaluates its estimates, including those related to asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation and income taxes. Actual results could differ from those estimates under different assumptions or conditions.
	Reclassification
	Certain reclassifications that are not material have been made to the prior year’s consolidated financial statements to conform to the current year presentation.

Business_Combinations

Business Combinations	3 Months Ended
	Mar. 31, 2015
Business Combinations [Abstract]
BUSINESS COMBINATIONS	BUSINESS COMBINATIONS
	Onward Healthcare Acquisition
	On January 7, 2015, the Company completed its acquisition of Onward Healthcare, including its two wholly-owned subsidiaries, Locum Leaders and Medefis (collectively, “OH”), for approximately $76,945 in cash, funded by cash-on-hand and borrowings under the Company’s revolving credit facility. Onward Healthcare is a national nurse and allied healthcare staffing firm, Locum Leaders is a national locum tenens provider, and Medefis is a provider of a software as a service, or “SaaS,” based vendor management system for healthcare facilities. The acquisition helps the Company to expand its service lines and its supply and placement capabilities of healthcare professionals to its clients.
	The Company accounted for the acquisition using the acquisition method of accounting and, accordingly, it recorded the tangible and intangible assets acquired and liabilities assumed at their estimated fair values as of the date of the acquisition. As of the filing date of this Form 10-Q, the Company is still finalizing the allocation of the purchase price, primarily related to tax matters and valuation of intangibles.
	The preliminary allocation of the $76,945 purchase price consisted of $25,627 of fair value of tangible assets acquired (including $20,476 of accounts receivable), $21,603 of liabilities assumed (including $10,478 of accounts payable and accrued expenses), $30,219 of identified intangible assets, and $42,702 of goodwill, none of which is deductible for tax purposes. The intangible assets include the fair value of tradenames and trademarks, customer relationships, staffing database, acquired technologies and non-compete agreements. The weighted average useful life of the acquired intangible assets is approximately 11 years. The following table summarizes the fair value and useful life of each intangible asset acquired:
				Fair Value				Useful Life
								(in years)
	Identifiable intangible assets
		Tradenames and Trademarks		$	8,100			15-Mar
		Customer Relationships		17,600				15-Oct
		Staffing Database		2,600				5
		Acquired Technologies		1,700				8
		Non-compete agreements		219				2
				$	30,219
	Of the $42,702 allocated to goodwill, $37,233 and $5,469 were allocated to the Company’s nurse and allied healthcare staffing segment and locum tenens staffing segment, respectively.
	The results of Onward Healthcare and Medefis are included in the Company’s nurse and allied healthcare staffing segment and the results of Locum Leaders are included in the Company’s locum tenens staffing segment. For the three months ended March 31, 2015, approximately $31,236 of revenue and $2,821 of income before income taxes of the Onward Healthcare entities were included in the unaudited condensed consolidated statement of operations since the date of acquisition.
	The following summary presents unaudited pro forma consolidated results of operations of the Company for the three months ended March 31, 2015 and 2014 as if the OH acquisition described above had occurred on January 1, 2014. The following unaudited pro forma financial information gives effect to certain adjustments, including the reduction in compensation expense related to non-recurring executive salary expense, acquisition-related costs and the amortization of acquired intangible assets. The pro forma financial information is not necessarily indicative of the operating results that would have occurred had the acquisition been consummated as of the date indicated, nor are they necessarily indicative of future operating results.
		Three Months Ended
		March 31,
		2015				2014
	Revenue	$	329,795			$	266,899
	Net income	$	12,883			$	7,660
	Avantas Acquisition
	On December 22, 2014, the Company completed its acquisition of Avantas, a leading provider of clinical labor management services, including workforce consulting, data analytics, predictive modeling and SaaS-based scheduling technology, for $17,520, which the Company funded through cash-on-hand and borrowings under its revolving credit facility. The total purchase price of $17,520 included $14,470 cash consideration paid, $1,650 cash holdback for potential claims, and contingent earn-out with a fair value of $1,400. During the three months ended March 31, 2015, the Company paid an additional $165 to the selling equityholders for a working capital adjustment. The acquisition is intended to help enable the Company to provide a level of workforce predictability to clients that can be integrated with its workforce and staffing solutions. The acquisition is not considered a material business combination and, accordingly, pro forma information is not provided. The Company did not incur any material acquisition-related costs.
	The Company accounted for the acquisition using the acquisition method of accounting and, accordingly, it recorded the tangible and intangible assets acquired and liabilities assumed at their estimated fair values as of the date of the acquisition. The acquisition agreement provides for a tiered contingent earn-out payment of up to $8,500 to be paid in 2016 based on the operating results of Avantas for the 12 month period ending June 30, 2016. As of the filing date of this Form 10-Q, the Company is still finalizing the allocation of the purchase price, primarily related to tax matters.
	The preliminary allocation of the purchase price consisted of $1,631 of fair value of tangible assets acquired, $3,821 of liabilities and deferred revenue assumed, $9,960 of identified intangible assets and $9,916 of goodwill, which goodwill is deductible for tax purposes. The intangible assets include the fair value of tradenames and trademarks, customer relationships and acquired technologies. The weighted average useful life of the acquired intangible assets subject to amortization is approximately 14 years.
	The results of operations of Avantas are included in the nurse and allied healthcare staffing segment in the Company’s consolidated financial statements.

Revenue_Recognition

Revenue Recognition	3 Months Ended
	Mar. 31, 2015
Revenue Recognition [Abstract]
REVENUE RECOGNITION	REVENUE RECOGNITION
	Revenue consists of fees earned from the permanent and temporary placement of healthcare professionals. Revenue is recognized when earned and realizable. The Company has entered into certain contracts with healthcare organizations to provide managed services programs. Under these contract arrangements, the Company uses its healthcare professionals along with those of third party subcontractors to fulfill client orders. If the Company uses subcontractors, it records revenue net of related subcontractors expense. The resulting net revenue represents the administrative fee the Company charges for its vendor management services. The Company records subcontractor accounts receivable from the client in the consolidated balance sheets. The Company generally pays the subcontractor after it has received payment from the client. Payables to subcontractors of $41,671 and $33,474, respectively, were included in accounts payable and accrued expenses in the unaudited condensed consolidated balance sheet as of March 31, 2015 and the audited consolidated balance sheet as of December 31, 2014.

Net_Income_Per_Common_Share

Net Income Per Common Share	3 Months Ended
	Mar. 31, 2015
Earnings Per Share [Abstract]
NET INCOME PER COMMON SHARE	NET INCOME PER COMMON SHARE
	Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. Diluted net income per common share reflects the effects of potentially dilutive share-based equity instruments.
	Share-based awards to purchase 33 and 361 shares of common stock were not included in the calculation of diluted net income per common share for the three months ended March 31, 2015 and 2014, respectively, because the effect of these instruments was anti-dilutive.
	The following table sets forth the computation of basic and diluted net income per common share for the three months ended March 31, 2015 and 2014, respectively:
		Three Months Ended March 31,
		2015		2014
	Net income	$	12,209	$	7,630
	Net income per common share - basic	$	0.26	$	0.16
	Net income per common share - diluted	$	0.25	$	0.16
	Weighted average common shares outstanding - basic	47,146		46,354
	Plus dilutive effect of potential common shares	1,218		1,563
	Weighted average common shares outstanding - diluted	48,364		47,917

Segment_Information

Segment Information	3 Months Ended
	Mar. 31, 2015
Segment Reporting [Abstract]
SEGMENT INFORMATION	SEGMENT INFORMATION
	The Company has three reportable segments: nurse and allied healthcare staffing, locum tenens staffing and physician permanent placement services.
	The Company’s management relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation expense, interest expense (net) and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed.
	The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes:
		Three Months Ended March 31,
		2015		2014
	Revenue
	Nurse and allied healthcare staffing	$	229,046	$	163,450
	Locum tenens staffing	86,692		66,871
	Physician permanent placement services	11,772		10,560
		$	327,510	$	240,881
	Segment Operating Income
	Nurse and allied healthcare staffing	$	31,901	$	19,972
	Locum tenens staffing	9,110		6,873
	Physician permanent placement services	3,271		2,131
		44,282		28,976
	Unallocated corporate overhead	12,025		7,868
	Depreciation and amortization	5,095		3,820
	Share-based compensation	2,377		1,819
	Interest expense, net, and other	1,807		1,846
	Income before income taxes	$	22,978	$	13,623

Fair_Value_Measurement

Fair Value Measurement	3 Months Ended
	Mar. 31, 2015
Fair Value Disclosures [Abstract]
FAIR VALUE MEASUREMENT	FAIR VALUE MEASUREMENTS
	The Company’s valuation techniques and inputs used to measure fair value and the definition of the three levels (Level 1, Level 2 and Level 3) of the fair value hierarchy are disclosed in Part II, Item 8, “Financial Statements and Supplementary Data - Notes to Consolidated Financial Statements - Note 4 - Fair Value Measurement” of the Company’s 2014 Annual Report. The Company has not changed the valuation techniques or inputs it uses to measure fair value during the three months ended March 31, 2015.
	Assets and Liabilities Measured on a Recurring Basis
	The Company’s assets that are measured at fair value on a recurring basis include restricted cash equivalents and investments.
	In addition, with the recent acquisition of Avantas, the Company may have an obligation to pay earn-out consideration of up to $8,500 to the selling equity holders if Avantas meets certain future financial metrics for the 12 month period ending June 30, 2016. The earn-out liability was estimated based on estimated cash flows determined using the probability-weighted average of possible outcomes that would occur should certain financial metrics be reached. As there is no market data available to use in valuing the contingent consideration, the Company developed its own assumptions related to the future financial performance of Avantas to estimate the fair value of this liability. As such, the contingent consideration liability is classified within Level 3.
	In connection with estimating the fair value of the contingent consideration, the Company estimates the weighted probability of Avantas earning each of the five specified tiered earn-out amounts of $0, $1,500, $3,500, $5,500 and $8,500, which are each tied to the financial performance of Avantas for the 12 month period ending June 30, 2016. An increase or decrease in the probability of achievement will result in an increase or decrease to the estimated fair value of the contingent consideration. The Company reassesses the fair value each reporting period and adjusts the liability to its then fair value. There was no change in the fair value of the liability during the three months ended March 31, 2015.
	The following tables present information about these assets and liabilities and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value:
		Fair Value Measurements as of March 31, 2015
		Total		Quoted Prices in		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
				Active Markets
				for Identical
				Assets
				(Level 1)
	U.S. Treasury securities	$	5,291	$	5,291	$	—	$	—
	Money market funds	335		335		—		—
	Acquisition contingent consideration earn-out liability	1,400		—		—		1,400
	Total financial assets and liabilities measured at fair value	$	7,026	$	5,626	$	—	$	1,400
		Fair Value Measurements as of December 31, 2014
		Total		Quoted Prices in		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
				Active Markets
				for Identical
				Assets
				(Level 1)
	U.S. Treasury securities	$	5,291	$	5,291	$	—	$	—
	Money market funds	335		335		—		—
	Acquisition contingent consideration earn-out liability	1,400		—		—		1,400
	Total financial assets and liabilities measured at fair value	$	7,026	$	5,626	$	—	$	1,400
	The Company’s restricted cash equivalents and investments typically consist of U.S. Treasury securities and money market funds on deposit with financial institutions that serve as collateral for the Company’s outstanding letters of credit.
	Assets Measured on a Non-Recurring Basis
	The Company applies fair value techniques on a non-recurring basis associated with valuing potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets and equity method investment.
	The Company evaluates goodwill and indefinite-lived intangible assets annually for impairment and whenever circumstances occur indicating that goodwill might be impaired. The Company determines the fair value of its reporting units based on a combination of inputs including the market capitalization of the Company as well as Level 3 inputs such as discounted cash flows, which are not observable from the market, directly or indirectly. The Company determines the fair value of its indefinite-lived intangible assets using the income approach (relief-from-royalty method) based on Level 3 inputs.
	There were no triggering events identified and no indication of impairment of the Company’s goodwill, indefinite-lived intangible assets, long-lived assets or equity method investment during the three months ended March 31, 2015 and 2014.
	Fair Value of Financial Instruments
	The carrying amount of notes payable and revolving credit facility approximate their fair value as the instruments’ interest rates are variable and comparable to rates currently offered for similar debt instruments of comparable maturity. The fair value of the Company’s long-term self-insurance accruals cannot be estimated as the Company cannot reasonably determine the timing of future payments.

Income_Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2015
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES
	The Company is subject to income taxation in the U.S. and various states and foreign jurisdictions. With few exceptions, as of March 31, 2015, the Company is no longer subject to U.S. federal, state, local or foreign income tax examinations by tax authorities for years before 2005. The Company’s tax years 2007, 2008, 2009 and 2010 have been under audit by the Internal Revenue Service (“IRS”) for several years and in 2014, the IRS issued the Company its Revenue Agent Report (“RAR”) and an Employment Tax Examination Report (“ETER”). The RAR proposed adjustments to the Company’s taxable income for 2007-2010 and net operating loss carryforwards from 2005-2006, resulting from the proposed disallowance of certain per diems paid to the Company’s healthcare professionals, and the ETER proposed assessments for additional payroll tax liabilities and penalties for 2009 and 2010 related to the Company’s treatment of certain non-taxable per diem allowances and travel benefits. The positions in the RAR and ETER are mutually exclusive, and contain multiple tax positions, some of which are contrary to each other. The Company filed a Protest Letter for both the RAR and ETER positions in 2014. The Company anticipates that the final settlement of the audits will occur in the next twelve months and believes its reserves are adequate to cover any final settlement.
	The IRS has also been conducting a separate audit of the Company’s 2011 and 2012 tax years. The income and employment tax issues addressed in the 2011 and 2012 examination are consistent with the issues raised in the 2007 through 2010 examination. During the quarter ended March 31, 2015, the IRS completed its 2011 and 2012 examination and issued its RAR and ETER to the Company. The proposed adjustments to the Company’s taxable income for 2011 and 2012 and net operating loss carryforwards from 2010, and the ETER proposed assessments for additional payroll tax liabilities and penalties for 2011 and 2012 related to the Company’s treatment of certain non-taxable per diem allowances and travel benefits. The positions in the RAR and ETER for the 2011 and 2012 years are mutually exclusive and contain multiple tax positions, some of which are contrary to each other. The Company has filed a Protest Letter for both the RAR and ETER and intends to defend its position. The Company believes its reserves are adequate with respect to these open years.
	The Company was notified during the quarter ended March 31, 2015 that the IRS will also audit the Company’s 2013 tax year.

Commitments_and_Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2015
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES
	(a) Legal
	From time to time, the Company is involved in various lawsuits, claims, investigations, and proceedings that arise in the ordinary course of business. Additionally, some of its clients may also become subject to claims, governmental inquiries and investigations and legal actions relating to services provided by the Company’s healthcare professionals. Depending upon the particular facts and circumstances, the Company may also be subject to indemnification obligations under its contracts with such clients relating to these matters. The Company records a liability when management believes an adverse outcome from a loss contingency is both probable and the amount, or a range, can be reasonably estimated. Significant judgment is required to determine both probability of loss and the estimated amount. The Company reviews its loss contingencies at least quarterly and adjusts its accruals and/or disclosures to reflect the impact of negotiations, settlements, rulings, advice of legal counsel, or other new information, as deemed necessary. With regards to outstanding loss contingencies as of March 31, 2015, the Company believes that such matters will not, either individually or in the aggregate, have a material adverse effect on its business, consolidated financial position, results of operations or cash flows.
	(b) Leases
	On January 26, 2015, the Company entered into a 10-year operating lease agreement for office space in Dallas, Texas that will replace its current operating lease agreement for its Irving, Texas offices, which expires in August 2015. Base rent payments under the new lease agreement will begin in September 2015 and the total estimated base rent payments will be approximately $23,956 over the life of the lease, which is ten years. The rent payments have been included in the total minimum lease payment table set forth in Part II, Item 8, “Financial Statements and Supplementary Data - Notes to Consolidated Financial Statements - Note 12(b) - Commitments and Contingencies - Leases” of the Company’s 2014 Annual Report on Form 10-K.

Subsequent_Events

Subsequent Events	3 Months Ended
	Mar. 31, 2015
Subsequent Events [Abstract]
SUBSEQUENT EVENTS	SUBSEQUENT EVENTS
	In April 2015, the Company entered into an interest rate swap agreement to minimize its exposure to interest rate fluctuations on $100,000 of its outstanding variable rate debt under its existing credit facility whereby the Company pays a fixed rate of 0.983% and receives a variable rate equal to floating one-month LIBOR. This agreement expires on March 30, 2018, and no initial investment was made to enter into this agreement.

Basis_of_Presentation_Policies

Basis of Presentation (Policies)	3 Months Ended
	Mar. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Use of Estimates	The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. On an ongoing basis, the Company evaluates its estimates, including those related to asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation and income taxes. Actual results could differ from those estimates under different assumptions or conditions.
Revenue Recognition	Revenue consists of fees earned from the permanent and temporary placement of healthcare professionals. Revenue is recognized when earned and realizable. The Company has entered into certain contracts with healthcare organizations to provide managed services programs. Under these contract arrangements, the Company uses its healthcare professionals along with those of third party subcontractors to fulfill client orders. If the Company uses subcontractors, it records revenue net of related subcontractors expense. The resulting net revenue represents the administrative fee the Company charges for its vendor management services. The Company records subcontractor accounts receivable from the client in the consolidated balance sheets. The Company generally pays the subcontractor after it has received payment from the client.
Net Income per Common Share	Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. Diluted net income per common share reflects the effects of potentially dilutive share-based equity instruments.
Segment Information	The Company’s management relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation expense, interest expense (net) and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed.
Fair Value of Financial Instruments	Assets and Liabilities Measured on a Recurring Basis
	The Company’s assets that are measured at fair value on a recurring basis include restricted cash equivalents and investments.
	Assets Measured on a Non-Recurring Basis
	The Company applies fair value techniques on a non-recurring basis associated with valuing potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets and equity method investment.
	Fair Value of Financial Instruments
	The carrying amount of notes payable and revolving credit facility approximate their fair value as the instruments’ interest rates are variable and comparable to rates currently offered for similar debt instruments of comparable maturity. The fair value of the Company’s long-term self-insurance accruals cannot be estimated as the Company cannot reasonably determine the timing of future payments.

Business_Combinations_Tables

Business Combinations (Tables)	3 Months Ended
	Mar. 31, 2015
Business Combinations [Abstract]
Summary of Fair Value and Useful Life of Each Intangible Asset Acquired	The following table summarizes the fair value and useful life of each intangible asset acquired:
				Fair Value				Useful Life
								(in years)
	Identifiable intangible assets
		Tradenames and Trademarks		$	8,100			15-Mar
		Customer Relationships		17,600				15-Oct
		Staffing Database		2,600				5
		Acquired Technologies		1,700				8
		Non-compete agreements		219				2
				$	30,219
Business Acquisition, Pro Forma Information	The following summary presents unaudited pro forma consolidated results of operations of the Company for the three months ended March 31, 2015 and 2014 as if the OH acquisition described above had occurred on January 1, 2014. The following unaudited pro forma financial information gives effect to certain adjustments, including the reduction in compensation expense related to non-recurring executive salary expense, acquisition-related costs and the amortization of acquired intangible assets. The pro forma financial information is not necessarily indicative of the operating results that would have occurred had the acquisition been consummated as of the date indicated, nor are they necessarily indicative of future operating results.
		Three Months Ended
		March 31,
		2015				2014
	Revenue	$	329,795			$	266,899
	Net income	$	12,883			$	7,660

Net_Income_Per_Common_Share_Ta

Net Income Per Common Share (Tables)	3 Months Ended
	Mar. 31, 2015
Earnings Per Share [Abstract]
Computation of basic and diluted net income per common share	The following table sets forth the computation of basic and diluted net income per common share for the three months ended March 31, 2015 and 2014, respectively:
		Three Months Ended March 31,
		2015		2014
	Net income	$	12,209	$	7,630
	Net income per common share - basic	$	0.26	$	0.16
	Net income per common share - diluted	$	0.25	$	0.16
	Weighted average common shares outstanding - basic	47,146		46,354
	Plus dilutive effect of potential common shares	1,218		1,563
	Weighted average common shares outstanding - diluted	48,364		47,917

Segment_Information_Tables

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2015
Segment Reporting [Abstract]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results	The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes:
		Three Months Ended March 31,
		2015		2014
	Revenue
	Nurse and allied healthcare staffing	$	229,046	$	163,450
	Locum tenens staffing	86,692		66,871
	Physician permanent placement services	11,772		10,560
		$	327,510	$	240,881
	Segment Operating Income
	Nurse and allied healthcare staffing	$	31,901	$	19,972
	Locum tenens staffing	9,110		6,873
	Physician permanent placement services	3,271		2,131
		44,282		28,976
	Unallocated corporate overhead	12,025		7,868
	Depreciation and amortization	5,095		3,820
	Share-based compensation	2,377		1,819
	Interest expense, net, and other	1,807		1,846
	Income before income taxes	$	22,978	$	13,623

Fair_Value_Measurement_Tables

Fair Value Measurement (Tables)	3 Months Ended
	Mar. 31, 2015
Fair Value Disclosures [Abstract]
Schedule of financial assets and liabilities measured at fair value on recurring basis	The following tables present information about these assets and liabilities and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value:
		Fair Value Measurements as of March 31, 2015
		Total		Quoted Prices in		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
				Active Markets
				for Identical
				Assets
				(Level 1)
	U.S. Treasury securities	$	5,291	$	5,291	$	—	$	—
	Money market funds	335		335		—		—
	Acquisition contingent consideration earn-out liability	1,400		—		—		1,400
	Total financial assets and liabilities measured at fair value	$	7,026	$	5,626	$	—	$	1,400
		Fair Value Measurements as of December 31, 2014
		Total		Quoted Prices in		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
				Active Markets
				for Identical
				Assets
				(Level 1)
	U.S. Treasury securities	$	5,291	$	5,291	$	—	$	—
	Money market funds	335		335		—		—
	Acquisition contingent consideration earn-out liability	1,400		—		—		1,400
	Total financial assets and liabilities measured at fair value	$	7,026	$	5,626	$	—	$	1,400

Business_Combinations_Details

Business Combinations (Details) (USD $)	3 Months Ended		0 Months Ended
	Mar. 31, 2015	Mar. 31, 2014	Jan. 07, 2015	Dec. 22, 2014	Dec. 31, 2014
			subsidiary
Business Combination, Description
Additional cash paid for working capital adjustment settlement	$165,000	$0
Allocation of Purchase Price
Goodwill	197,254,000				154,387,000
Onward Healthcare Acquisition [Member]
Business Combination, Description
Number of subsidiaries acquired with parent			2
Cash consideration			76,945,000
Allocation of Purchase Price
Fair value of assets acquired			25,627,000
Accounts receivable acquired			20,476,000
Liabilities assumed			21,603,000
Accounts payable assumed			10,478,000
Identified intangible assets			30,219,000
Goodwill			42,702,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets			11 years
Business Acquisition, Pro Forma Information [Abstract]
Actual acquiree revenue since date of acquisition	31,236,000
Actual acquiree income before income taxes since date of acquisition	2,821,000
Pro forma revenue	329,795,000	266,899,000
Pro forma net income	12,883,000	7,660,000
Avantas Acquisition [Member]
Business Combination, Description
Cash consideration				14,470,000
Total purchase price of the acquisition				17,520,000
Cash holdback for potential claims				1,650,000
Contingent earn-out				1,400,000
Additional cash paid for working capital adjustment settlement				165,000
Contingent earn-out based on future operating performance				8,500,000
Allocation of Purchase Price
Fair value of assets acquired				1,631,000
Liabilities assumed				3,821,000
Identified intangible assets				9,960,000
Goodwill				9,916,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets				14 years
Nurse and allied healthcare staffing [Member] | Onward Healthcare Acquisition [Member]
Allocation of Purchase Price
Goodwill			37,233,000
Locum tenens staffing [Member] | Onward Healthcare Acquisition [Member]
Allocation of Purchase Price
Goodwill			5,469,000
Tradenames and trademarks [Member] | Onward Healthcare Acquisition [Member]
Allocation of Purchase Price
Identified intangible assets			8,100,000
Customer relationships [Member] | Onward Healthcare Acquisition [Member]
Allocation of Purchase Price
Identified intangible assets			17,600,000
Staffing database [Member] | Onward Healthcare Acquisition [Member]
Allocation of Purchase Price
Identified intangible assets			2,600,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			5 years
Technologies [Member] | Onward Healthcare Acquisition [Member]
Allocation of Purchase Price
Identified intangible assets			1,700,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			8 years
Noncompete agreements [Member] | Onward Healthcare Acquisition [Member]
Allocation of Purchase Price
Identified intangible assets			$219,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			2 years
Minimum [Member] | Tradenames and trademarks [Member] | Onward Healthcare Acquisition [Member]
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			3 years
Minimum [Member] | Customer relationships [Member] | Onward Healthcare Acquisition [Member]
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			10 years
Maximum [Member] | Tradenames and trademarks [Member] | Onward Healthcare Acquisition [Member]
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			15 years
Maximum [Member] | Customer relationships [Member] | Onward Healthcare Acquisition [Member]
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			15 years

Revenue_Recognition_Details

Revenue Recognition (Details) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Revenue Recognition [Abstract]
Payables to subcontractor	$41,671	$33,474

Net_Income_Per_Common_Share_De

Net Income Per Common Share (Details) (USD $)	3 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
Earnings Per Share [Abstract]
Common stock excluded from calculation of EPS	33	361
Computation of basic and diluted net income per common share
Net income	$12,209	$7,630
Net income per common share - basic (in dollars per share)	$0.26	$0.16
Net income per common share - diluted (in dollars per share)	$0.25	$0.16
Weighted average common shares outstanding - basic	47,146	46,354
Plus dilutive effect of potential common shares	1,218	1,563
Weighted average common shares outstanding - diluted	48,364	47,917

Segment_Information_Details

Segment Information (Details) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
	segment
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	$327,510	$240,881
Operating Income	24,785	15,469
Depreciation and amortization	5,095	3,820
Share-based compensation	2,377	1,819
Interest expense, net, and other	1,807	1,846
Income before income taxes	22,978	13,623
Segment Information (Textual) [Abstract]
Reportable business segments	3
Operating segments [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	327,510	240,881
Operating Income	44,282	28,976
Operating segments [Member] | Nurse and allied healthcare staffing [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	229,046	163,450
Operating Income	31,901	19,972
Operating segments [Member] | Locum tenens staffing [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	86,692	66,871
Operating Income	9,110	6,873
Operating segments [Member] | Physician permanent placement services [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	11,772	10,560
Operating Income	3,271	2,131
Corporate, non-segment [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Unallocated corporate overhead	$12,025	$7,868

Fair_Value_Measurement_Financi

Fair Value Measurement - Financial Assets and Liabilities (Details) (Fair Value, Measurements, Recurring [Member], USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	$7,026	$7,026
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	5,626	5,626
Significant Other Observable Inputs (Level 2) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Significant Unobservable Inputs (Level 3) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	1,400	1,400
Securities (Assets) [Member] | US Treasury securities [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	5,291	5,291
Securities (Assets) [Member] | Money Market Funds [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	335	335
Securities (Assets) [Member] | Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] | US Treasury securities [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	5,291	5,291
Securities (Assets) [Member] | Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] | Money Market Funds [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	335	335
Securities (Assets) [Member] | Significant Other Observable Inputs (Level 2) [Member] | US Treasury securities [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Securities (Assets) [Member] | Significant Other Observable Inputs (Level 2) [Member] | Money Market Funds [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Securities (Assets) [Member] | Significant Unobservable Inputs (Level 3) [Member] | US Treasury securities [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Securities (Assets) [Member] | Significant Unobservable Inputs (Level 3) [Member] | Money Market Funds [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Contingent Consideration [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	1,400	1,400
Contingent Consideration [Member] | Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Contingent Consideration [Member] | Significant Other Observable Inputs (Level 2) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Contingent Consideration [Member] | Significant Unobservable Inputs (Level 3) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	$1,400	$1,400

Fair_Value_Measurement_Textual

Fair Value Measurement - Textual (Details) (Avantas Acquisition [Member], USD $)	3 Months Ended
	Mar. 31, 2015	Dec. 22, 2014
	tier
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent earn-out based on future operating performance		$8,500,000
Contingent Consideration [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Number of earn-out tiers	5
Earn-out Tier 1 [Member] | Contingent Consideration [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent earn-out based on future operating performance	0
Earn-out Tier 2 [Member] | Contingent Consideration [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent earn-out based on future operating performance	1,500,000
Earn-out Tier 3 [Member] | Contingent Consideration [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent earn-out based on future operating performance	3,500,000
Earn-out Tier 4 [Member] | Contingent Consideration [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent earn-out based on future operating performance	5,500,000
Earn-out Tier 5 [Member] | Contingent Consideration [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent earn-out based on future operating performance	8,500,000

Commitments_and_Contingencies_

Commitments and Contingencies - Leases (Details) (USD $)	0 Months Ended
In Thousands, unless otherwise specified	Jan. 26, 2015	Jan. 26, 2015
Commitments and Contingencies Disclosure [Abstract]
Operating lease agreement term	10 years
Total minimum lease payments		$23,956

Subsequent_Events_Details

Subsequent Events (Details) (Interest Rate Swap [Member], Subsequent Event [Member], USD $)	Apr. 30, 2015
Interest Rate Swap [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Amount subject to interest rate swap agreement	$100,000,000
Fixed interest rate on swap agreement	0.98%