AMN Healthcare Services (AMN) 10-K 24 Feb 16 2015 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2015	Feb. 19, 2016	Jun. 30, 2015
Document and Entity Information [Abstract]
Entity Registrant Name	AMN HEALTHCARE SERVICES INC
Entity Central Index Key	1,142,750
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Document Type	10-K
Document Period End Date	Dec. 31, 2015
Document Fiscal Year Focus	2,015
Document Fiscal Period Focus	FY
Amendment Flag	false
Entity Common Stock, Shares Outstanding		47,817,302
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Public Float			$ 1,479,930,594

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Current assets:
Cash and cash equivalents	$ 9,576	$ 13,073
Accounts receivable, net of allowances of $7,691 and $4,515 at December 31, 2015 and 2014, respectively	277,996	186,274
Accounts receivable, subcontractor	50,807	28,443
Deferred income taxes, net	0	27,330
Prepaid expenses	13,526	10,350
Other current assets	23,723	17,200
Total current assets	375,628	282,670
Restricted cash and cash equivalents	27,352	19,567
Fixed assets, net of accumulated depreciation of $76,680 and $68,814 at December 31, 2015 and 2014, respectively	50,134	32,880
Other assets	47,569	38,710
Goodwill	204,779	154,387
Intangible assets, net of accumulated amortization of $53,747 and $41,963 at December 31, 2015 and 2014, respectively	174,970	152,517
Total assets	880,432	680,731
Current liabilities:
Accounts payable and accrued expenses	118,822	78,993
Accrued compensation and benefits	83,701	67,995
Current portion of revolving credit facility	30,000	18,000
Current portion of notes payable	7,500	7,500
Deferred revenue	5,620	3,177
Other current liabilities	5,374	2,630
Total current liabilities	251,017	178,295
Revolving credit facility	52,500	0
Notes payable, less unamortized fees	128,490	135,690
Deferred income taxes, net	22,431	32,491
Other long-term liabilities	78,134	77,674
Total liabilities	$ 532,572	$ 424,150
Commitments and contingencies and subsequent events
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at December 31, 2015 and 2014	$ 0	$ 0
Common stock, $0.01 par value; 200,000 shares authorized; 47,709 and 46,639 shares issued and outstanding at December 31, 2015 and 2014, respectively	477	466
Additional paid-in capital	443,733	434,529
Accumulated deficit	(96,167)	(178,058)
Accumulated other comprehensive loss	(183)	(356)
Total stockholders’ equity	347,860	256,581
Total liabilities and stockholders’ equity	$ 880,432	$ 680,731

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 7,691	$ 4,515
Accumulated depreciation	76,680	68,814
Accumulated amortization	$ 53,747	$ 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	47,709,000	46,639,000
Common stock, shares outstanding	47,709,000	46,639,000

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Statement of Comprehensive Income [Abstract]
Revenue	$ 1,463,065	$ 1,036,027	$ 1,011,816
Cost of revenue	993,702	719,910	714,536
Gross profit	469,363	316,117	297,280
Operating expenses:
Selling, general and administrative	319,531	232,221	218,233
Depreciation and amortization	20,953	15,993	13,545
Total operating expenses	340,484	248,214	231,778
Income from operations	128,879	67,903	65,502
Interest expense, net (including loss on debt extinguishment of $3,113 and $434 for the years ended December 31, 2014 and 2013), and other	7,790	9,237	9,665
Income before income taxes	121,089	58,666	55,837
Income tax expense	39,198	25,449	22,904
Net income	81,891	33,217	32,933
Other comprehensive income (loss):
Foreign currency translation	75	142	(55)
Unrealized gain on cash flow hedge, net of income taxes	98	0	0
Other comprehensive income (loss)	173	142	(55)
Comprehensive income	$ 82,064	$ 33,359	$ 32,878
Net income per common share:
Basic (in dollars per share)	$ 1.72	$ 0.71	$ 0.72
Diluted (in dollars per share)	$ 1.68	$ 0.69	$ 0.69
Weighted average common shares outstanding:
Basic (shares)	47,525	46,504	45,963
Diluted (shares)	48,843	48,086	47,787

Consolidated Statements of Com5

Consolidated Statements of Comprehensive Income (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Statement of Comprehensive Income [Abstract]
Loss on debt extinguishment	$ 0	$ 3,113	$ 434

Consolidated Statement of Stock

Consolidated Statement of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Treasury Stock	Accumulated Deficit	Accumulated Other Comprehensive Gain (Loss)
Balance, shares at Dec. 31, 2012		45,691		0
Balance at Dec. 31, 2012	$ 182,111	$ 457	$ 424,292	$ 0	$ (242,195)	$ (443)
Statement of Stockholders' Equity [Roll Forward]
Settlement of acquisition share holdback	(3,046)			$ (3,046)
Treasury stock retirement, shares		(204)		0
Treasury stock retirement	0	$ (2)	(1,031)	$ 3,046	(2,013)
Equity awards vested and exercised, net of shares withheld for payroll taxes, shares		524
Equity awards vested and exercised, net of shares withheld for payroll taxes	(1,493)	$ 5	(1,498)
Excess income tax benefit from equity awards vested and exercised	1,167		1,167
Share-based compensation	6,125		6,125
Comprehensive income	32,878				32,933	(55)
Balance, shares at Dec. 31, 2013		46,011		0
Balance at Dec. 31, 2013	217,742	$ 460	429,055	$ 0	(211,275)	(498)
Statement of Stockholders' Equity [Roll Forward]
Equity awards vested and exercised, net of shares withheld for payroll taxes, shares		628
Equity awards vested and exercised, net of shares withheld for payroll taxes	(2,655)	$ 6	(2,661)
Excess income tax benefit from equity awards vested and exercised	978		978
Share-based compensation	7,157		7,157
Comprehensive income	33,359				33,217	142
Balance, shares at Dec. 31, 2014		46,639		0
Balance at Dec. 31, 2014	256,581	$ 466	434,529	$ 0	(178,058)	(356)
Statement of Stockholders' Equity [Roll Forward]
Equity awards vested and exercised, net of shares withheld for payroll taxes, shares		1,070
Equity awards vested and exercised, net of shares withheld for payroll taxes	(8,245)	$ 11	(8,256)
Excess income tax benefit from equity awards vested and exercised	7,176		7,176
Share-based compensation	10,284		10,284
Comprehensive income	82,064				81,891	173
Balance, shares at Dec. 31, 2015		47,709		0
Balance at Dec. 31, 2015	$ 347,860	$ 477	$ 443,733	$ 0	$ (96,167)	$ (183)

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Cash flows from operating activities:
Net income	$ 81,891	$ 33,217	$ 32,933
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	20,953	15,993	13,545
Non-cash interest expense and other	1,934	1,392	1,336
Change in fair value of contingent consideration	(330)	0	0
Increase in allowances for doubtful accounts and sales credits	6,684	4,393	4,628
Provision for deferred income taxes	12,677	11,779	3,031
Share-based compensation	10,284	7,157	6,125
Excess tax benefit from equity awards vested and exercised	(7,449)	(1,819)	(1,521)
Holdback settlement in equity from prior acquisition	0	0	(3,046)
Loss on disposal or sale of fixed assets	4	60	14
Loss on debt extinguishment	0	3,113	434
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable	(75,653)	(41,958)	(8,644)
Accounts receivable, subcontractor	(22,365)	(10,172)	196
Income taxes receivable	7,867	768	(1,572)
Prepaid expenses	(2,915)	(1,933)	(633)
Other current assets	(5,409)	1,920	3,859
Other assets	(4,785)	(268)	(11,865)
Accounts payable and accrued expenses	29,611	6,125	6,244
Accrued compensation and benefits	11,888	11,515	6,367
Other liabilities	(2,103)	(4,488)	13,129
Deferred revenue	1,313	(114)	(90)
Restricted cash and cash equivalents balance	(7,784)	(9,002)	(4,301)
Net cash provided by operating activities	56,313	27,678	60,169
Cash flows from investing activities:
Purchase and development of fixed assets	(27,010)	(19,134)	(9,047)
Change in restricted cash and cash equivalents balance	0	12,550	47
Equity method investment	(1,000)	(5,000)	0
Payments to fund deferred compensation plan	(3,004)	(2,174)	(1,298)
Cash paid for acquisitions, net of cash received	(84,081)	(14,470)	(39,500)
Cash paid for working capital adjustments and holdback liability for prior year acquisitions	(990)	0	0
Proceeds from sales of assets held for sale	0	0	600
Net cash used in investing activities	(116,085)	(28,228)	(49,198)
Cash flows from financing activities:
Capital lease repayments	(4)	(529)	(681)
Payments on term loan	(7,500)	(155,245)	(10,000)
Proceeds from term loan	0	150,000	0
Payments on revolving credit facility	(25,000)	(39,500)	(16,000)
Proceeds from revolving credit facility	89,500	47,500	26,000
Payment of financing costs	0	(3,488)	(364)
Proceeds from exercise of equity awards	3,663	1,792	1,177
Cash paid for shares withheld for taxes	(11,908)	(4,448)	(2,670)
Excess tax benefit from equity awards vested and exercised	7,449	1,819	1,521
Net cash provided by (used in) financing activities	56,200	(2,099)	(1,017)
Effect of exchange rate changes on cash	75	142	(55)
Net change in cash and cash equivalents	(3,497)	(2,507)	9,899
Cash and cash equivalents at beginning of year	13,073	15,580	5,681
Cash and cash equivalents at end of year	9,576	13,073	15,580
Supplemental disclosures of cash flow information:
Cash paid for interest (net of $264, $123 and $63 capitalized in 2015, 2014 and 2013, respectively)	5,806	4,599	7,405
Cash paid for income taxes	33,132	17,880	18,865
Acquisitions:
Fair value of tangible assets acquired in acquisitions, net of cash received	26,771	1,631	9,899
Goodwill	50,227	9,750	21,318
Intangible assets	34,237	9,960	19,790
Liabilities and deferred revenue assumed	(22,954)	(3,821)	(11,507)
Holdback provision	(1,500)	(1,650)	0
Earn-out liabilities	(2,700)	(1,400)	0
Net cash paid for acquisitions	84,081	14,470	39,500
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses	$ 3,337	$ 4,618	$ 3,727

Consolidated Statements of Cas8

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Statement of Cash Flows [Abstract]
Interest capitalized	$ 264	$ 123	$ 63

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2015
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies (a) General AMN Healthcare Services, Inc. was incorporated in Delaware on November 10, 1997. AMN Healthcare Services, Inc. and its subsidiaries (collectively, the “Company”) provide healthcare workforce solutions and staffing services at acute and sub-acute care hospitals and other healthcare facilities throughout the United States. (b) Principles of Consolidation The accompanying consolidated financial statements include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated in consolidation. (c) Use of Estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America 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 impairment, accruals for self-insurance and compensation and related benefits, contingencies and litigation, and income taxes. The Company bases these estimates on the information that is currently available and on various other assumptions that it believes are reasonable under the circumstances. Actual results could differ from those estimates under different assumptions or conditions. (d) Cash and Cash Equivalents The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. Cash and cash equivalents include currency on hand, deposits with financial institutions and highly liquid investments. (e) Restricted Cash and Cash Equivalents Restricted cash and cash equivalents primarily represent the cash and money market funds on deposit with financial institutions that serve as collateral for the Company’s outstanding letters of credit and captive insurance subsidiary claim payments. See Note (4), “Fair Value Measurement” and Note (8), “Notes Payable and Credit Agreement” for additional information. (f) Fixed Assets The Company records furniture, equipment, leasehold improvements and internal-use software at cost less accumulated amortization and depreciation. The Company records equipment acquired under capital leases at the present value of the future minimum lease payments. The Company capitalizes major additions and improvements, and it expenses maintenance and repairs when incurred. The Company calculates depreciation on furniture, equipment and technology and software using the straight-line method based on the estimated useful lives of the related assets ( three to seven years). The Company amortizes leasehold improvements and equipment obtained under capital leases over the shorter of the term of the lease or their estimated useful lives. The Company includes depreciation of equipment obtained under capital leases with depreciation expense in the accompanying consolidated financial statements. The Company capitalizes costs it incurs to develop internal-use software during the application development stage. Application development stage costs generally include costs associated with internal-use software configuration, coding, installation and testing. The Company also capitalizes costs of significant upgrades and enhancements that result in additional functionality, whereas it expenses as incurred costs for maintenance and minor upgrades and enhancements. The Company amortizes capitalized costs using the straight-line method over three to seven years once the software is ready for its intended use. The Company reviews long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset group to the future undiscounted net cash flows that are expected to be generated by the asset group. If such asset group is considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the asset group exceeds the fair value of the asset group. The Company reports assets to be disposed of at the lower of the carrying amount or fair value less costs to sell. (g) Goodwill The Company records as goodwill the portion of the purchase price that exceeds the fair value of net assets of entities acquired. The Company evaluates goodwill annually for impairment at the reporting unit level and whenever circumstances occur indicating that goodwill may be impaired. The Company may first assess qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount. If, after assessing the totality of events and circumstances, the Company determines that it is more likely than not that the fair value of the reporting unit is greater than its carrying amount, the quantitative impairment test is unnecessary. The performance of the quantitative impairment test involves a two-step process. The first step of the test involves comparing the fair value of the Company’s reporting units with the reporting unit’s carrying amount, including goodwill. The Company generally determines the fair value of its reporting units using a combination of the income approach (using discounted future cash flows) and the market valuation approach. If the carrying amount of a Company’s reporting unit exceeds its fair value, the Company performs the second step of the test to determine the amount of impairment loss. The second step of the test involves comparing the implied fair value of the Company’s reporting unit’s goodwill with the carrying amount of that goodwill. The amount by which the carrying value of the goodwill exceeds its implied fair value, if any, is recognized as an impairment loss. (h) Intangible Assets Intangible assets consist of identifiable intangible assets acquired through acquisitions. Identifiable intangible assets include tradenames and trademarks, customer relationships, non-compete agreements, staffing databases and acquired technology. The Company amortizes intangible assets, other than tradenames and trademarks with an indefinite life, using the straight-line method over their useful lives. The Company amortizes non-compete covenants using the straight-line method over the lives of the related agreements. The Company reviews for impairment intangible assets with estimable useful lives whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The Company does not amortize indefinite-lived tradenames and trademarks and instead reviews them for impairment annually . The Company may first perform a qualitative assessment to determine whether it is more likely than not that an indefinite-lived intangible asset is impaired. If, after assessing the totality of events and circumstances, the Company determines that it is more likely than not that the indefinite-lived intangible asset is not impaired, no quantitative fair value measurement is necessary. If a quantitative fair value measurement calculation is required for an indefinite-lived intangible asset, the Company compares its fair value with its carrying amount. If the carrying amount exceeds the fair value, the Company records the excess as an impairment loss. (i) Insurance Reserves The Company maintains an accrual for professional liability that is included in accounts payable and accrued expenses and other long-term liabilities in the consolidated balance sheets. The expense is included in the selling, general and administrative expenses in the consolidated statement of comprehensive income. The Company determines the adequacy of this accrual by evaluating its historical experience and trends, loss reserves established by the Company’s insurance carriers, management and third-party administrators, and independent actuarial studies. The Company obtains actuarial studies on a semi-annual basis that use the Company’s actual claims data and industry data to assist the Company in determining the adequacy of its reserves each year. For periods between the actuarial studies, the Company records its accruals based on loss rates provided in the most recent actuarial study and management’s review of loss history. In November 2012, the Company established a captive insurance subsidiary, which provides coverage, on an occurrence basis, for professional liability within its nurse and allied healthcare staffing segment. Liabilities include provisions for estimated losses incurred but not yet reported (“IBNR”), as well as provisions for known claims. IBNR reserve estimates involve the use of assumptions and are primarily based upon historical loss experience, industry data and other actuarial assumptions. The Company maintains excess insurance coverage through a commercial carrier for losses above the per occurrence retention. The Company maintains an accrual for workers compensation, which is included in accrued compensation and benefits and other long-term liabilities in the consolidated balance sheets. The expense relating to healthcare professionals is included in cost of revenue, while the expense relating to corporate employees is included in the selling, general and administrative expenses in the consolidated statement of comprehensive income. The Company determines the adequacy of this accrual by evaluating its historical experience and trends, loss reserves established by the Company’s insurance carriers and third-party administrators, and independent actuarial studies. The Company obtains actuarial studies on a semi-annual basis that use the Company’s payroll and historical claims data, as well as industry data, to determine the appropriate reserve for both reported claims and IBNR claims for each policy year. For periods between the actuarial studies, the Company records its accruals based on loss rates provided in the most recent actuarial study. (j) Revenue Recognition Revenue consists of fees earned from the temporary and permanent placement of healthcare professionals as well as from the Company’s software-as-a-service (SaaS)-based technology, including its vendor management systems (VMS) and its scheduling software. Revenue from temporary staffing services is recognized as the services are rendered by the healthcare professional. Under the Company’s managed services program arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own pool of healthcare professionals along with those of third-party subcontractors. When the Company uses subcontractors, revenue is recorded net of the related subcontractor’s expense. Revenue from recruitment and permanent placement services is recognized as the services are provided and upon successful placements. The Company’s SaaS-based revenue is recognized ratably over the applicable arrangement’s service period. Fees billed in advance of being earned are recorded as deferred revenue. (k) Accounts Receivable The Company records accounts receivable at the invoiced amount. Accounts receivable are non-interest bearing. The Company maintains an allowance for doubtful accounts based on the Company’s historical write-off experience and an assessment of its customers’ financial conditions. The Company also maintains a sales allowance to reserve for potential credits issued to customers, which is based on the Company’s historical experience. The Company has not experienced material bad debts or sales adjustments during the past three years. (l) Concentration of Credit Risk The majority of the Company’s business activity is with hospitals located throughout the United States. Credit is extended based on the evaluation of each entity’s financial condition. One customer within the Company’s nurse and allied healthcare staffing segment comprised approximately 11% and 10% of the consolidated revenue of the Company for the fiscal years ended December 31, 2015 and 2014, respectively, while no customer exceeded 10% of consolidated revenue for the year ended December 31, 2013 . The Company’s cash and cash equivalents and restricted cash and cash equivalents accounts are also financial instruments that are exposed to concentration of credit risk. The Company maintains its cash balances with high-credit quality and federally insured institutions. Cash balances may be invested in a non-federally insured money market account. As of December 31, 2015 and 2014 , there were $27,352 and $19,567 , respectively, of restricted cash and cash equivalents, a portion of which was invested in a non-federally insured money market fund. (m) Income Taxes The Company records income taxes using the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in the period the changes are enacted. In assessing the realizability of deferred tax assets, the Company considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. The Company considers the scheduled reversal of deferred tax liabilities (including the impact of available carryback and carryforward periods), projected future taxable income, and tax-planning strategies in making this assessment. The Company recognizes the effect of income tax positions only if it is more likely than not that such positions will be sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. The Company records interest and penalties related to unrecognized tax benefits in income tax expense. (n) Fair Value of Financial Instruments The carrying amounts of the Company’s cash equivalents and restricted cash equivalents approximate their respective fair values due to the short-term nature and liquidity of these financial instruments. The carrying amount of the Company’s term loan and revolver approximates their fair value as the Company amended its credit facilities in January 2016 to increase the capacity of the revolver and to secure a new term loan and the variable interest rates (LIBOR plus 1.50% to 2.25% or a base rate plus a spread of 0.50% to 1.25% , at the Company’s option) remain unchanged. See Note (8), “Notes Payable and Credit Agreement,” for additional information. The fair value of the long-term portion of the Company’s insurance accruals cannot be estimated because the Company cannot reasonably determine the timing of future payments. (o) Share-Based Compensation The Company accounts for its share-based employee compensation plans by expensing the estimated fair value of share-based awards on a straight-line basis over the requisite employee service period, which is the vesting period. Restricted stock units (“RSUs”) typically vest at the end of a three -year vesting period, however, 33% of the awards may vest on the 13 th month anniversary of the grant date and 34% on the second anniversary of the grant date if certain performance targets are met. Share-based compensation cost of RSUs is measured by the market value of the Company’s common stock on the date of grant, and the Company records share-based compensation expense only for those awards that are expected to vest. Performance restricted stock units (“PRSUs”) primarily consist of PRSUs that contain a performance condition dependent on the Company’s adjusted EBITDA margin during the third year of the three -year vesting period, with a range of 0% to 175% of the target amount granted to be issued under the award. Share-based compensation cost for these PRSUs is measured by the market value of the Company’s common stock on the date of grant, and the amount recognized is adjusted for estimated achievement of the performance conditions. A limited amount of PRSUs contain a market condition dependent upon the Company’s relative and absolute total shareholder return over a three -year period, with a range of 0% to 175% of the target amount granted to be issued under the award. Share-based compensation cost for these PRSUs is measured using the Monte-Carlo simulation valuation model and is not adjusted for the achievement, or lack thereof, of the performance conditions. (p) Net Income per Common Share Share-based awards to purchase 9 , 298 and 308 shares of common stock for the years ended December 31, 2015, 2014 and 2013, respectively, were not included in the calculation of diluted net income per common share 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 years ended December 31, 2015 , 2014 and 2013 , respectively: Years Ended December 31, 2015 2014 2013 Net income $ 81,891 $ 33,217 $ 32,933 Net income per common share - basic $ 1.72 $ 0.71 $ 0.72 Net income per common share - diluted 1.68 0.69 0.69 Weighted average common shares outstanding - basic 47,525 46,504 45,963 Plus dilutive effect of potential common shares 1,318 1,582 1,824 Weighted average common shares outstanding - diluted 48,843 48,086 47,787 (q) Segment Information The Company has three reportable segments: (1) nurse and allied healthcare staffing, (2) locum tenens staffing, and (3) physician permanent placement services. 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 segment operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes: Years Ended December 31, 2015 2014 2013 Revenue Nurse and allied healthcare staffing $ 1,023,936 $ 695,206 $ 681,979 Locum tenens staffing 385,091 296,166 287,484 Physician permanent placement services 54,038 44,655 42,353 $ 1,463,065 $ 1,036,027 $ 1,011,816 Segment operating income Nurse and allied healthcare staffing $ 149,258 $ 87,246 $ 82,458 Locum tenens staffing 48,011 30,985 24,712 Physician permanent placement services 15,101 9,818 8,929 212,370 128,049 116,099 Unallocated corporate overhead 52,254 36,996 30,927 Depreciation and amortization 20,953 15,993 13,545 Share-based compensation 10,284 7,157 6,125 Interest expense, net (including loss on debt extinguishment of $3,113 and $434 for the years ended December 31, 2014 and 2013, respectively), and other 7,790 9,237 9,665 Income from continuing operations before income taxes $ 121,089 $ 58,666 $ 55,837 (r) Reclassifications Certain reclassifications have been made to certain of the prior years’ consolidated financial statements to conform to the current year presentation. (s) Recently Adopted Accounting Pronouncements In April 2015, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”)2015-03, “Interest - Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs.” The update requires debt issuance costs related to a recognized debt liability to be presented in the balance sheet as a direct deduction from the carrying amount of the related debt liability instead of being presented as an asset. Debt disclosures will include the face amount of the debt liability and the effective interest rate. The update requires retrospective application and represents a change in accounting principle. The update is effective for fiscal years beginning after December 15, 2015 and the Company elected to early adopt this standard in fiscal year 2015. The adoption did not have a material effect on the Company’s consolidated financial statements as it only resulted in a reclassification of certain capitalized loan costs from other long-term assets to offset notes payable balance, including the reclassification of debt issuance costs from other assets to long-term notes payable of $1,185 as of December 31, 2014. In November 2015, the FASB issued ASU 2015-17, Income Taxes (Topic 740), “Balance Sheet Classification of Deferred Taxes,” which requires deferred tax liabilities and assets to be classified as noncurrent in a statement of financial position. This update is effective for financial statements issued for annual periods beginning after December 15, 2016, and interim periods within those annual periods. The Company has elected to early adopt this standard during the fourth quarter of 2015. The adoption of this new accounting resulted in a reclassification in the Company’s deferred income taxes, net, being presented within long-term liabilities on the Company’s consolidated balance sheet as of December 31, 2015. The Company did not retrospectively adjust the consolidated balance sheet as of December 31, 2014. The adoption did not have a material effect on the consolidated financial statements as it only resulted in a reclassification of current deferred income taxes, net (current assets) to long-term deferred income taxes, net (non-current liabilities). There was no impact to net income.

Business Combinations

Business Combinations	12 Months Ended
	Dec. 31, 2015
Business Combinations [Abstract]
Business Combinations	Business Combinations As set forth below, the Company completed five acquisitions from January 1, 2013 through December 31, 2015. The Company accounted for each acquisition using the acquisition method of accounting. Accordingly, it recorded the tangible and intangible assets acquired and liabilities assumed at their estimated fair values as of the applicable date of acquisition. For each acquisition, the Company did not incur any material acquisition-related costs. The acquisition of Onward Healthcare, Inc. (“Onward Healthcare”), including its two wholly-owned subsidiaries, Locum Leaders and Medefis (collectively with Onward Healthcare, “OH”), described below is the only acquisition considered significant. As a result, pro forma information for the other four acquisitions is not provided. MillicanSolutions Acquisition On October 5, 2015, the Company acquired MillicanSolutions, Inc. (“Millican”), a physician and executive leadership search firm. The total purchase price of $3,985 included (1) $2,985 cash consideration paid upon acquisition, funded by cash-on-hand, (2) $500 to be paid on December 31, 2016, and (3) $500 to be paid on December 31, 2017. The acquisition enhances the Company’s ability to respond to the specialized leadership needs within academic pediatrics and children’s medical centers and expands its expertise in serving academic medical centers and teaching hospitals in physician and leadership search. The results of operations of Millican have been included in the Company’s physician permanent placement segment since the date of acquisition. The preliminary allocation of the $3,985 purchase price consisted of (1) $636 of fair value of tangible assets acquired, (2) $662 of liabilities assumed, (3) $645 of identified intangible assets and (4) $3,366 of goodwill, a portion of which is deductible for tax purposes. The intangible assets include the fair value of tradenames and trademarks, staffing databases, customer relationships, and a covenant not to compete with a weighted average useful life of approximately five years . The First String Healthcare Acquisition On September 15, 2015, the Company completed its acquisition of The First String Healthcare, Inc. (“TFS”), a provider of interim staffing and permanent placement of nurse leaders and executives. The total purchase price of $7,653 included (1) $4,453 cash consideration paid upon acquisition, funded by cash-on-hand, net of cash received, (2) $500 to be paid on the first anniversary of the acquisition date, and (3) a tiered contingent earn-out payment of up to $4,000 with an estimated fair value of $2,700 as of the acquisition date. The contingent earn-out payment is comprised of (1) up to $1,000 based on the operating results of TFS for the year ended December 31, 2015, which was earned in its entirety, and (2) up to $3,000 based on the operating results of TFS for the year ending December 31, 2016. The acquisition agreement also provides for an additional $1,000 payment to be paid on the second anniversary of the acquisition date conditioned upon the continued employment of the selling shareholders. Accordingly, this amount is recorded as compensation expense over the two year service period. The acquisition enhances the Company’s capabilities to provide interim and permanent nursing leadership. The results of operations of TFS have been included in the Company’s nurse and allied healthcare staffing segment since the date of acquisition. The preliminary allocation of the $7,653 purchase price consisted of (1) $919 of fair value of tangible assets acquired, (2) $867 of liabilities assumed, (3) $3,373 of identified intangible assets and (4) $4,228 of goodwill, a portion of which is deductible for tax purposes. The intangible assets include the fair value of tradenames and trademarks, customer relationships, a staffing database and covenants not to compete with a weighted average useful life of approximately seven years . Onward Healthcare Acquisition On January 7, 2015, the Company completed its acquisition of OH for approximately $76,643 in cash paid upon acquisition, funded by cash-on-hand and borrowings under the Company’s revolving credit facility, net of cash received. 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 SaaS-based VMS 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 results of Onward Healthcare and Medefis have been included in the Company’s nurse and allied healthcare staffing segment and the results of Locum Leaders in the Company’s locum tenens staffing segment since the date of acquisition. The preliminary allocation of the $76,643 purchase price consisted of (1) $25,216 of fair value of tangible assets acquired (including $21,313 of accounts receivable), (2) $21,425 of liabilities assumed (including $11,113 of accounts payable and accrued expenses), (3) $30,219 of identified intangible assets and (4) $42,633 of goodwill, a portion of which is deductible for tax purposes. The intangible assets acquired and their weighted average useful life is as follows: Fair Value Useful Life (in years) Identifiable intangible assets Tradenames and Trademarks $ 8,100 3 - 15 Customer Relationships 17,600 10 - 15 Staffing Database 2,600 5 Acquired Technologies 1,700 8 Non-compete agreements 219 2 $ 30,219 Of the $42,633 allocated to goodwill, $37,392 and $5,241 were allocated to the Company’s nurse and allied healthcare staffing segment and locum tenens staffing segment, respectively. Approximately $145,178 of revenue and $16,229 of income before income taxes of the OH entities were included in the consolidated statement of comprehensive income for the year ended December 31, 2015. The following summary presents unaudited pro forma consolidated results of operations of the Company for the years ended December 31, 2015 and 2014 as if the OH acquisition had occurred on January 1, 2014, which 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 is it necessarily indicative of future operating results. Years Ended December 31, (Unaudited) 2015 2014 Revenue $ 1,465,350 $ 1,138,481 Net income $ 80,033 $ 34,230 Net income per common share: Basic $ 1.68 $ 0.74 Diluted $ 1.64 $ 0.71 Avantas Acquisition On December 22, 2014, the Company acquired Avantas, LLC (“Avantas”), a provider of clinical workforce management services, including its proprietary SaaS-based scheduling technology. The initial purchase price of $17,520 included (1) $14,470 cash consideration paid at acquisition, funded through cash-on-hand and borrowings under the Company’s revolving credit facility, (2) $1,650 cash holdback for potential indemnification claims and (3) a tiered contingent earn-out of up to $8,500 based on the operating performance of Avantas during the 12-month period ending June 30, 2016, with an estimated fair value at acquisition of $1,400 . During the year ended December 31, 2015, the Company paid an additional $165 to the selling equityholders for a working capital adjustment. The acquisition expanded the Company’s ability to provide workforce optimization services. The results of operations of Avantas have been included in the Company’s nurse and allied healthcare staffing segment since the date of acquisition. The allocation of the total $17,685 purchase price (which gives effect to the $165 working capital adjustment on the initial purchase price) consisted of (1) $1,631 of fair value of tangible assets acquired, (2) $3,821 of liabilities and deferred revenue assumed, (3) $9,960 of identified intangible assets, including tradenames and trademarks, customer relationships and acquired technologies with a weighted average useful life of approximately 14 years and (4) $9,915 of goodwill, a portion of which is deductible for tax purposes. ShiftWise Acquisition On November 20, 2013, the Company completed its acquisition of ShiftWise, a national provider of web-based healthcare workforce solutions, including its VMS technology utilized by hospitals and other healthcare systems. The purchase price of the acquisition totaled $39,500 , of which $6,000 was deposited in escrow to satisfy any potential indemnification claims by the Company and is scheduled to be released to the selling shareholders over three years following the closing date at $2,000 per annum minus any resolved or unresolved indemnification claims. As of December 31, 2015, a total of $3,970 has been released from the escrow, of which $3,614 has been released to the selling shareholders and the remaining has been returned to the Company for certain indemnification payments and payroll taxes the Company paid on behalf of the selling shareholders. The acquisition expanded the Company’s workforce solution offerings to include a standalone VMS technology. The results of operations of ShiftWise have been included in the Company’s nurse and allied healthcare staffing segment since the date of acquisition. The allocation of the $39,500 purchase price consisted of (1) $9,899 of fair value of tangible assets acquired, (2) $11,502 of liabilities assumed (including $2,701 of deferred tax liabilities), (3) $19,790 of identified intangible assets including tradenames and trademarks, customer relationships, non-compete agreements and acquired technologies with a weighted average useful life of approximately 8 years and (4) $21,313 of non-deductible goodwill.

Derivative Instruments

Derivative Instruments	12 Months Ended
	Dec. 31, 2015
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments	Derivative Instruments 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 term loan facility whereby the Company pays a fixed rate of 0.983% per annum and receives a variable rate equal to floating one-month LIBOR. The agreement expires on March 30, 2018. At December 31, 2015, the interest rate swap had a fair value of $165 , which is included in other assets in the accompanying consolidated balance sheet. The effectiveness of the interest rate swap was assessed at inception and on a quarterly basis thereafter. Because the interest rate swap is expected to be highly effective in hedging variable rate interest payments, the swap is accounted for as cash flow hedge, and changes in the fair value of the interest rate swap is reported as a component of accumulated other comprehensive (loss) income until earnings are affected by the hedged interest payment, at which time the hedged interest payment is recognized in interest expense. If at any time the assessment indicates that the derivative is no longer highly effective as a hedge, the Company will discontinue hedge accounting and recognize all subsequent derivative instrument gains and losses in the consolidated statement of comprehensive income.

Fair Value Measurement

Fair Value Measurement	12 Months Ended
	Dec. 31, 2015
Fair Value Disclosures [Abstract]
Fair Value Measurement	Fair Value Measurement Fair value represents the 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. When determining fair value, the Company considers the principal or most advantageous market in which the Company would conduct a transaction, in addition to the assumptions that market participants would use when pricing the related assets or liabilities, including non-performance risk. A three-level hierarchy prioritizes the inputs to valuation techniques used to measure fair value and requires an entity to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. The three levels of the fair value hierarchy are as follows: 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. Assets and Liabilities Measured on a Recurring Basis The Company’s restricted cash equivalents that serve as collateral for the Company’s outstanding letters of credit typically consist of money market funds or U.S. Treasury securities that are measured at fair value based on quoted prices, which are level 1 inputs. The Company’s interest rate swap is measured at fair value using a discounted cash flow analysis that includes the contractual terms, including the period to maturity, and level 2 observable market-based inputs, including interest rate curves. The fair value of the swap is determined by netting the discounted future fixed cash receipts payments and the discounted expected variable cash receipts. The variable cash receipts are based on an expectation of future interest rates (forward curves) derived from observable market interest rate yield curves. The valuation also considers credit risk adjustments that are necessary to reflect the probability of default by the counterparty or the Company, which are considered Level 3 inputs; however, as of December 31, 2015, the credit risk adjustments, including nonperformance risk, were considered insignificant to the total fair value of the interest rate swap. The Company’s contingent consideration liabilities are measured at fair value using probability-weighted discounted cash flow analysis for the acquired companies, which are level 3 inputs. The following tables present information about assets and liabilities measured at fair value on a recurring basis and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value: Fair Value Measurements as of December 31, 2015 Assets (Liabilities) Total Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Money market funds $ 5,627 $ 5,627 $ — $ — Interest rate swap asset 165 — 165 — Acquisition contingent consideration liabilities (3,770 ) — — (3,770 ) Fair Value Measurements as of December 31, 2014 Assets (Liabilities) Total Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Money market funds $ 335 $ 335 $ — $ — U.S. Treasury securities 5,291 5,291 — — Acquisition contingent consideration liabilities (1,400 ) — — (1,400 ) The following table sets forth reconciliations of changes in the fair value of contingent consideration liabilities classified as Level 3 in the fair value hierarchy: Years Ended December 31, 2015 2014 Balance as of January 1 $ (1,400 ) $ — Contingent consideration liabilities recorded at purchase (2,700 ) (1,400 ) Change in fair value of contingent consideration earn-out liabilities 330 — Balance as of December 31 $ (3,770 ) $ (1,400 ) 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 fair values of these assets are estimated primarily using Level 3 inputs such as discounted cash flows, which are not observable from the market, directly or indirectly. There were no impairment charges recorded during the three years ended December 31, 2015 requiring such measurements.

Goodwill and Identifiable Intan

Goodwill and Identifiable Intangible Assets	12 Months Ended
	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Identifiable Intangible Assets	Goodwill and Identifiable Intangible Assets As of December 31, 2015 and 2014 , the Company had the following acquired intangible assets: As of December 31, 2015 As of December 31, 2014 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Intangible assets subject to amortization: Staffing databases $ 6,333 $ (3,592 ) $ 2,741 $ 3,020 $ (2,618 ) $ 402 Customer relationships 96,829 (40,076 ) 56,753 77,300 (32,971 ) 44,329 Tradenames and trademarks 26,853 (7,718 ) 19,135 17,540 (5,436 ) 12,104 Non-compete agreements 572 (276 ) 296 190 (72 ) 118 Acquired technology 8,730 (2,085 ) 6,645 7,030 (866 ) 6,164 $ 139,317 $ (53,747 ) $ 85,570 $ 105,080 $ (41,963 ) $ 63,117 Intangible assets not subject to amortization: tradenames and trademarks $ 89,400 $ 89,400 $ 174,970 $ 152,517 Aggregate amortization expense for intangible assets was $11,784 and $7,639 for the years ended December 31, 2015 and 2014 , respectively. Based on the current amount of intangibles subject to amortization, the estimated amortization expense as of December 31, 2015 is as follows: Amount Year ending December 31, 2016 $ 11,948 Year ending December 31, 2017 11,613 Year ending December 31, 2018 10,540 Year ending December 31, 2019 9,835 Year ending December 31, 2020 6,917 Thereafter 34,717 $ 85,570 The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied Healthcare Staffing Locum Tenens Staffing Physician Permanent Placement Services Total Balance, January 1, 2014 $ 97,811 $ 14,502 $ 32,329 $ 144,642 Goodwill adjustment from prior acquisition (5 ) — — (5 ) Goodwill from Avantas acquisition 9,750 — — 9,750 Balance, December 31, 2014 107,556 14,502 32,329 154,387 Goodwill adjustment for Avantas acquisition 165 — — 165 Goodwill from OH acquisition 37,392 5,241 — 42,633 Goodwill from TFS acquisition 4,228 — — 4,228 Goodwill from Millican acquisition — — 3,366 3,366 Balance, December 31, 2015 $ 149,341 $ 19,743 $ 35,695 $ 204,779 Accumulated impairment loss as of December 31, 2014 and 2015 $ 154,444 $ 53,940 $ 6,555 $ 214,939

Balance Sheet Details

Balance Sheet Details	12 Months Ended
	Dec. 31, 2015
Balance Sheet Related Disclosures [Abstract]
Balance Sheet Details	Balance Sheet Details The consolidated balance sheets detail is as follows as of December 31, 2015 and 2014 : As of December 31, 2015 2014 Other current assets: Restricted cash 11,995 9,054 Income taxes receivable 3,687 3,503 Other 8,041 4,643 Other current assets $ 23,723 $ 17,200 Fixed assets: Furniture and equipment $ 23,380 $ 17,761 Technology and software 97,962 78,593 Leasehold improvements 5,472 5,340 126,814 101,694 Accumulated depreciation (76,680 ) (68,814 ) Fixed assets, net $ 50,134 $ 32,880 Accounts payable and accrued expenses: Trade accounts payable $ 53,261 $ 30,039 Subcontractor payable 56,177 33,474 Professional liability reserve 7,962 7,380 Overdraft 124 6,338 Other 1,298 1,762 Accounts payable and accrued expenses $ 118,822 $ 78,993 Accrued compensation and benefits: Accrued payroll $ 21,058 $ 21,857 Accrued bonuses and commissions 24,476 15,196 Accrued travel expense 2,740 2,413 Accrued health insurance reserve 3,225 1,871 Accrued workers compensation reserve 7,701 5,830 Deferred compensation 23,044 20,729 Other 1,457 99 Accrued compensation and benefits $ 83,701 $ 67,995 Other long-term liabilities: Workers compensation reserve $ 16,899 $ 13,855 Professional liability reserve 37,369 30,722 Deferred rent 11,826 8,122 Unrecognized tax benefits 8,081 21,706 Other 3,959 3,269 Other long-term liabilities $ 78,134 $ 77,674

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The provision for income taxes from operations for the years ended December 31, 2015 , 2014 and 2013 consists of the following: Years Ended December 31, 2015 2014 2013 Current income taxes: Federal $ 22,552 $ 10,787 $ 17,268 State 3,969 2,883 2,605 Total 26,521 13,670 19,873 Deferred income taxes: Federal 8,896 10,430 1,693 State 3,781 1,349 1,338 Total 12,677 11,779 3,031 Provision for income taxes from operations $ 39,198 $ 25,449 $ 22,904 Total income tax expense for the years ended December 31, 2015, 2014 and 2013 was allocated as follows: Years Ended December 31, 2015 2014 2013 Provision for income taxes from operations $ 39,198 $ 25,449 $ 22,904 Shareholders’ equity, for compensation expense for tax purposes in excess of amounts recognized for financial reporting purposes (7,176 ) (978 ) (1,167 ) $ 32,022 $ 24,471 $ 21,737 The Company’s income tax expense differs from the amount that would have resulted from applying the federal statutory rate of 35% to pretax income from operations because of the effect of the following items during the years ended December 31, 2015 , 2014 and 2013 : Years Ended December 31, 2015 2014 2013 Tax expense at federal statutory rate $ 42,381 $ 20,533 $ 19,543 State taxes, net of federal benefit 5,260 2,551 2,302 Non-deductible expenses 3,505 1,816 — Unrecognized tax benefit (11,464 ) 971 1,952 Other, net (484 ) (422 ) (893 ) Income tax expense from operations $ 39,198 $ 25,449 $ 22,904 The tax effects of temporary differences that give rise to significant portions of deferred tax assets and deferred tax liabilities are presented below as of the years ended December 31, 2015 and 2014 : Years Ended December 31, 2015 2014 Deferred tax assets: Stock compensation $ 10,170 $ 11,217 Deferred revenue 956 573 Allowance for doubtful accounts 1,971 1,467 Deferred compensation 9,153 8,142 Accrued expenses 24,932 20,475 Deferred rent 4,885 3,420 Net operating losses 8,809 14,354 State taxes 1,945 1,346 Other — 2,265 Total deferred tax assets $ 62,821 $ 63,259 Deferred tax liabilities: Intangibles $ (67,574 ) $ (57,316 ) Fixed assets (15,155 ) (8,453 ) Prepaid expenses (1,224 ) (1,427 ) Other (256 ) — Total deferred tax liabilities $ (84,209 ) $ (67,196 ) Valuation allowance $ (1,043 ) $ (1,224 ) Net deferred tax liabilities $ (22,431 ) $ (5,161 ) In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. Management believes it is more likely than not that the Company will realize the benefits of its deferred tax assets, net of the recorded valuation allowance. The deferred tax assets related to net operating losses (“NOLs”) include NOLs from the 2010 acquisition of NF Investors, Inc. (“NFI”) , the parent company of Medfinders and the 2013 acquisition of ShiftWise. The amount of NOL from acquired companies has been the subject of an evaluation under the NOL limitation rules of Internal Revenue Code (“IRC”) Section 382 and corresponding state authorities and the balances reflect these limitations. The amount of federal NOL carryforward that is available for use in years subsequent to December 31, 2015 is $20,164 , which is set to expire by 2029 . The amount of state NOL carryforward that is available for use in years subsequent to December 31, 2015 is $27,717 , which is set to expire at various dates between 2016 and 2032 . A summary of the changes in the amount of unrecognized tax benefits (excluding interest) for 2015 , 2014 and 2013 is as follows: 2015 2014 2013 Beginning balance of unrecognized tax benefits $ 22,890 $ 22,573 $ 21,415 Additions based on tax positions related to the current year — 317 809 Additions based on tax positions of prior years 395 — 349 Reductions due to lapse of applicable statute of limitation (214 ) — — Settlements (16,534 ) — — Ending balance of unrecognized tax benefits $ 6,537 $ 22,890 $ 22,573 At December 31, 2015 , if recognized, approximately $6,373 would affect the effective tax rate (including interest). The Company recognizes interest related to unrecognized tax benefits in income tax expense. The Company had approximately $1,544 , $5,815 and $4,605 of accrued interest related to unrecognized tax benefits at December 31, 2015 , 2014 and 2013 , respectively. The amount of interest expense (benefit) recognized in 2015 , 2014 and 2013 was $(4,272) , $1,211 and $1,427 , respectively. The Company is subject to taxation in the U.S. and various states and foreign jurisdictions. With few exceptions, as of December 31, 2015 , the Company is no longer subject to state, local or foreign examinations by tax authorities for years before 2006, and the Company is no longer subject to U.S. federal income or payroll tax examinations for years before 2011. The Company’s tax years 2007, 2008, 2009 and 2010 had 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 were mutually exclusive, and contained multiple tax positions, some of which were contrary to each other. The Company filed a Protest Letter for both the RAR and ETER positions in 2014 and the Company received a final determination from the IRS in July 2015 on both the RAR adjustments and ETER assessments, effectively settling these audits with the IRS for $7,200 (including interest) during the third quarter of 2015. As a result, the Company recorded federal income tax benefits of approximately $12,200 during the quarter ended September 30, 2015 and expects to record the state income tax benefits of approximately $1,500 by the quarter ending December 31, 2016, when the various state statutes are projected to lapse. The IRS has been conducting a separate audit of the Company’s 2011 and 2012 tax years that is focused on income and employment tax issues similar to those 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 with proposed adjustments to the Company’s taxable income for 2011 and 2012 and net operating loss carryforwards from 2010 and 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 filed a Protest Letter for both the RAR and ETER in April 2015 and expects the 2011 and 2012 years to be at IRS Appeals in 2016. The IRS began an audit of the Company’s 2013 tax year in the quarter ended June 30, 2015. The Company believes its reserves are adequate with respect to all open years.

Notes Payable and Credit Agreem

Notes Payable and Credit Agreement	12 Months Ended
	Dec. 31, 2015
Debt Disclosure [Abstract]
Notes Payable and Credit Agreement	Notes Payable and Credit Agreement On April 18, 2014, the Company entered into a Credit Agreement (the “Credit Agreement”) with several lenders to provide for two credit facilities (the “Credit Facilities”) to replace its prior credit facilities, including (A) a $225,000 secured revolving credit facility (the “Revolver”) that includes a $40,000 sublimit for the issuance of letters of credit and a $20,000 sublimit for swingline loans and (B) a $150,000 secured term loan credit facility (the “Term Loan”). In addition, the Credit Agreement provides that the Company may from time to time obtain an increase in the Revolver or the Term Loan or both in an aggregate principal amount not to exceed $125,000 subject to, among other conditions, the arrangement of additional commitments with financial institutions reasonably acceptable to the Company and the administrative agent. The Revolver carries an unused fee of 0.25% to 0.35% per annum and each standby letter of credit issued under the Revolver is subject to a letter of credit fee ranging from 1.50% to 2.25% per annum of the average daily maximum amount available to be drawn under the standby letter of credit, in each case, depending on the Company’s consolidated leverage ratio, as calculated quarterly in accordance with the Credit Agreement. The Term Loan is subject to amortization of principal of 5.00% per year of the original Term Loan amount, which is $7,500 per annum, and payable in equal quarterly installments. Borrowings under the Term Loan and Revolver bear interest at floating rates, at the Company’s option, based upon either LIBOR plus a spread of 1.50% to 2.25% or a base rate plus a spread of 0.50% to 1.25% . The applicable spread is determined quarterly based upon the Company’s consolidated leverage ratio. The interest rate for both the outstanding Term Loan and the Revolver was 2.2% on a LIBOR basis as of December 31, 2015. In connection with obtaining the Credit Facilities, the Company incurred $3,488 in fees paid to lenders and other third parties, which were capitalized and are amortized to interest expense over the term of the Credit Facilities. In addition, the Company wrote off $3,113 of unamortized financing fees and original issue discount, which was recorded as loss on debt extinguishment in the accompanying consolidated statement of comprehensive income for the year ended December 31, 2014. The Credit Facilities are available for working capital, capital expenditures, permitted acquisitions and general corporate purposes of the Company. The maturity date of the Credit Facilities is April 18, 2019. At December 31, 2015, the outstanding balance of the Term Loan was $136,875 , of which $7,500 is due in the next 12 months. Additionally, at December 31, 2015, unamortized fees relating to the Term Loan were $885 and $82,500 was outstanding under the Revolver. At December 31, 2015, with $10,161 of outstanding letters of credit collateralized by the Revolver, there was $132,339 of available credit under the Revolver. Annual principal maturities of the Term Loan as of December 31, 2015 are as follows: Year ending December 31, 2016 $ 7,500 Year ending December 31, 2017 7,500 Year ending December 31, 2018 7,500 Year ending December 31, 2019 114,375 Thereafter — $ 136,875 The Company’s outstanding debt instruments at December 31, 2015 and 2014 were secured by substantially all of the assets of the Company and the common stock or equity interests of its domestic subsidiaries. On January 4, 2016, the Company entered into the First Amendment to Credit Agreement (the “First Amendment” and together with the Credit Agreement, the “Amended Credit Agreement”) with several lenders to provide for, among other things, (A) a $50,000 increase to the Company’s Revolver to $275,000 and (B) an additional $75,000 secured term loan credit facility (the “Additional Term Loan”). Additionally, the Amended Credit Agreement no longer requires the Company to make mandatory prepayments under any of the credit facilities provided thereunder with the proceeds of extraordinary receipts and excess cash flow. The Amended Credit Agreement still provides that the Company may from time to time obtain an increase in the Revolver or the Term Loan or both in an aggregate principal amount not to exceed $125,000 subject to, among other conditions, the arrangement of additional commitments with financial institutions reasonably acceptable to the Company and the administrative agent. The obligations of the Company under the Amended Credit Agreement are secured by substantially all of the assets of the Company and the common stock or equity interests of its domestic subsidiaries. The payment obligations under the Amended Credit Agreement may be accelerated upon the occurrence of defined events of default. The Company used the proceeds from the Additional Term Loan, together with a drawdown of a portion of the Revolver, to complete its acquisition of B.E. Smith, as more fully described in Note (14), “Subsequent Events.” The Additional Term Loan is subject to amortization of principal of 5.00% per year of the original Additional Term Loan amount, payable in equal quarterly installments. The maturity date of the Additional Term Loan is January 4, 2021. The Amended Credit Agreement contains various customary affirmative and negative covenants, including restrictions on assumption of additional indebtedness, declaration and payment of dividends, dispositions of assets, consolidation into another entity and allowable investments. Additionally, there are financial covenants based on the Company’s consolidated leverage ratio and interest coverage ratio as calculated in accordance with the Amended Credit Agreement. Letters of Credit At December 31, 2015 , the Company maintained outstanding standby letters of credit totaling $15,788 as collateral in relation to its professional liability insurance agreements, workers compensation insurance agreements, and a corporate office lease agreement. Of the $15,788 outstanding letters of credit, the Company has collateralized $5,627 in cash and cash equivalents and the remaining amount has been collateralized by the Revolver. Outstanding standby letters of credit at December 31, 2014 totaled $15,006 .

Retirement Plans

Retirement Plans	12 Months Ended
	Dec. 31, 2015
Compensation and Retirement Disclosure [Abstract]
Retirement Plans	Retirement Plans The Company maintains the AMN Services 401(k) Retirement Savings Plan (the “AMN Plan”), which the Company believes complies with the IRC Section 401(k) provisions. The AMN Plan covers all employees that meet certain age and other eligibility requirements. An annual discretionary matching contribution is determined by the Compensation and Stock Plan Committee of the Board of Directors each year. Employer contributions under the AMN Plan were $1,225 , $553 and $165 for the years ended December 31, 2015 , 2014 and 2013 , respectively. The Company has a deferred compensation plan for certain executives and key employees (the “Plan”). The Plan is not intended to be tax qualified and is an unfunded plan. The Plan is composed of deferred compensation and all related income and losses attributable thereto. Discretionary matching contributions to the Plan are made that vest incrementally so that the employee is fully vested in the match following five years of employment with the Company. Under the Plan, participants can defer up to 80% of their base salary, 90% of their bonus and 100% of their vested RSUs or vested PRSUs. An annual discretionary matching contribution is determined by the Compensation and Stock Plan Committee of the Board of Directors each year. Employer contributions under the Plan were $974 , $595 and $384 for the years ended December 31, 2015 , 2014 and 2013 , respectively.

Capital Stock

Capital Stock	12 Months Ended
	Dec. 31, 2015
Equity [Abstract]
Capital Stock	Capital Stock (a) Preferred Stock The Company has 10,000 shares of preferred stock authorized for issuance in one or more series (including preferred stock designated as Series A Conditional Convertible Preferred Stock), at a par value of $0.01 per share. At December 31, 2015 and 2014 , no shares of preferred stock were outstanding. (b) Treasury Stock In connection with the 2010 acquisition of NFI, 457 shares of the Company’s common stock remained in escrow as of December 31, 2012 for potential Company indemnification claims. During the second quarter of 2013, the Company and former NFI selling shareholders agreed to release all 457 shares in escrow as follows: 1) 204 shares were returned to the Company for settlement of certain indemnification claims, which were recorded as treasury stock and a $3,046 reduction to selling, general and administrative expenses for the year ended December 31, 2013; and 2) the remaining 253 shares were released from escrow to the former NFI selling shareholders. During 2013, the Company cancelled and retired all 204 shares of treasury stock. Upon cancellation and retirement, these shares were returned to the status of authorized and unissued.

Share-Based Compensation

Share-Based Compensation	12 Months Ended
	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-Based Compensation	Share-Based Compensation (a) Equity Award Plans Stock Option Plan The Company established a stock option plan (the “Stock Option Plan”) to provide a means to attract and retain employees. 4,178 options were authorized for issuance to be granted under the Stock Option Plan. On April 12, 2006, 371 shares of common stock reserved for future issuance under The Stock Option Plan were rolled into the Equity Plan, which is discussed below. The Stock Option Plan has expired and no further equity awards have been granted from the Stock Option Plan since 2005. As of December 31, 2015, no equity awards were outstanding under it. Equity Plan The Company established the AMN Healthcare Equity Plan (as amended or amended and restated from time to time, the “Equity Plan”), which has been approved by the Company’s stockholders. At the time of the Equity Plan’s original adoption in 2006, equity awards, based on the Company’s common stock, could be issued for a maximum of 723 shares plus the number of shares of common stock underlying any grants under the Stock Option Plan (under which there are no longer any outstanding awards) that were forfeited, canceled or terminated (other than by exercise) from and after the effective date of the Equity Plan. Pursuant to the Equity Plan, stock options and stock appreciation rights (“SARs”) granted have a maximum contractual life of ten years and have exercise prices that will be determined at the time of grant, which will be no less than fair market value of the underlying common stock on the date of grant. Any shares to be issued under the Equity Plan will be issued by the Company from authorized but unissued common stock or shares of common stock reacquired by the Company. On April 18, 2007, April 9, 2009 and April 18, 2012, the Company amended the Equity Plan, with stockholder approval, to increase the number of shares authorized under the Equity Plan by 3,000 , 1,850 and 2,400 , respectively. At December 31, 2015 and 2014 , respectively, 2,128 and 2,421 shares of common stock were reserved for future grants under the Equity Plan. Other Plans From time to time, the Company grants, and has granted, key employees inducement awards outside of the Equity Plan (collectively, “Other Plans”), which have consisted of SARs, options or RSUs. Although these awards are not made under the Equity Plan, the key terms and conditions of the grant are typically the same as equity awards made under the Equity Plan. Additionally, in February 2014, the Company established the 2014 Employment Inducement Plan, which reserves for issuance 200 shares of common stock for prospective employees of the Company. As of December 31, 2015, 200 shares of common stock remained available for future grants under the 2014 Employment Inducement Plan. (b) Share-Based Compensation Restricted Stock Units RSUs and PRSUs (subject to a PRSU being earned) granted under the Equity Plan generally entitle the holder to receive, at the end of a vesting period, a specified number of shares of the Company’s common stock. The following table summarizes RSU and PRSU activity for non-vested awards for the years ended December 31, 2015 , 2014 and 2013 : Number of Shares Weighted Average Grant Date Fair Value per Share Unvested at January 1, 2013 1,659 $ 7.53 Granted—RSUs 285 $ 12.86 Granted—PRSUs 291 $ 13.86 Vested (588 ) $ 7.02 Canceled/forfeited/expired (10 ) $ 13.06 Unvested at December 31, 2013 1,637 $ 9.73 Granted—RSUs 361 $ 13.76 Granted—PRSUs 535 $ 14.97 Vested (838 ) $ 8.63 Canceled/forfeited/expired (120 ) $ 12.16 Unvested at December 31, 2014 1,575 $ 11.95 Granted—RSUs 203 $ 22.43 Granted—PRSUs 616 $ 13.58 Vested (1,081 ) $ 9.13 Canceled/forfeited/expired (76 ) $ 15.45 Unvested at December 31, 2015 1,237 $ 16.73 As of December 31, 2015 , there was $9,841 unrecognized compensation cost related to non-vested RSUs and PRSUs. The Company expects to recognize such cost over a period of 1.8 years. As of December 31, 2015 and 2014 , the aggregate intrinsic value of the RSUs and PRSUs outstanding was $38,400 and $30,876 , respectively. Stock Options and SARs Stock options entitle the holder to purchase, at the end of a vesting period, a specified number of shares of the Company’s common stock at a price per share set at the date of grant. SARs entitle the holder to receive, at the end of a vesting period, shares of the Company’s common stock equal in value to the difference between the exercise price of the SAR, which is set at the date of grant, and the fair market value of the Company’s common stock on the date of exercise. A summary of stock option and SAR activity under the Stock Option Plan and the Equity Plan and Other Plans are as follows: Stock Option Plan Equity Plan and Other Plans Number Outstanding Weighted- Average Exercise Price per Share Number Outstanding Weighted- Average Exercise Price per Share Outstanding at December 31, 2012 698 $ 14.34 1,241 $ 10.57 Granted — $ — — $ — Exercised (109 ) $ 11.23 (132 ) $ 8.31 Canceled/forfeited/expired — $ — (13 ) $ 15.19 Outstanding at December 31, 2013 589 $ 14.92 1,096 $ 10.78 Granted — $ — — $ — Exercised (117 ) $ 14.86 (142 ) $ 11.53 Canceled/forfeited/expired (227 ) $ 14.94 (6 ) $ 19.69 Outstanding at December 31, 2014 245 $ 14.93 948 $ 10.61 Granted — $ — — $ — Exercised (245 ) $ 14.93 (615 ) $ 10.79 Canceled/forfeited/expired — $ — (1 ) $ 24.95 Outstanding at December 31, 2015 — $ — 332 $ 10.26 Vested and expected to vest at December 31, 2015 — $ — 332 $ 10.26 Exercisable at December 31, 2015 — $ — 332 $ 10.26 As of December 31, 2015 , all SARs were fully vested, and there were no stock options outstanding. The total intrinsic value of stock options and SARs exercised was $10,505 , $770 and $980 for 2015 , 2014 and 2013 , respectively. At December 31, 2015 and 2014 , the total intrinsic value of stock options and SARs outstanding and exercisable was $7,013 and $10,142 , respectively. Share-Based Compensation Total share-based compensation expense for the years ended December 31, 2015 , 2014 and 2013 was as follows: Years Ended December 31, 2015 2014 2013 Share-based employee compensation, before tax $ 10,284 $ 7,157 $ 6,125 Related income tax benefits (3,990 ) (2,783 ) (2,383 ) Share-based employee compensation, net of tax $ 6,294 $ 4,374 $ 3,742

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 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. From time to time, and depending upon the particular facts and circumstances, the Company may be subject to indemnification obligations under its contracts with such clients relating to these matters. Certain of the above-referenced matters may include speculative claims for substantial or indeterminate amounts of damages. The Company records a liability when management believes that it is both probable that a loss has been incurred and the amount can be reasonably estimated. Significant judgment is required to determine both probability and the estimated amount. The Company reviews these provisions at least quarterly and adjusts them accordingly to reflect the impact of negotiations, settlements, rulings, advice of legal counsel and updated information. During the first quarter of 2014, the Company completed the settlement of a wage and hour class action (and a related action) for an immaterial amount. With regards to outstanding loss contingencies as of December 31, 2015, the Company believes that the amount or estimable range of reasonably possible loss, 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. However, the outcome of litigation is inherently uncertain, and therefore, if one or more of these legal matters were resolved against the Company for amounts in excess of management’s expectations, the Company’s results of operations and financial condition, including in a particular reporting period, could be materially adversely affected. (b) Leases The Company leases certain office facilities and equipment under various operating leases. The Company recognizes rent expense on a straight-line basis over the lease term. Future minimum lease payments under noncancelable operating leases (with initial or remaining lease terms in excess of one year) as of December 31, 2015 are as follows: Operating Leases Years ending December 31, 2016 $ 15,933 2017 14,619 2018 13,545 2019 12,469 2020 11,899 Thereafter 81,187 Total minimum lease payments $ 149,652 Rent expense under operating leases was $15,940 , $14,136 , and $14,205 for the years ended December 31, 2015 , 2014 and 2013 , respectively.

Quarterly Financial Data (Unaud

Quarterly Financial Data (Unaudited)	12 Months Ended
	Dec. 31, 2015
Quarterly Financial Information Disclosure [Abstract]
Quarterly Financial Data (Unaudited)	Quarterly Financial Data (Unaudited) Year Ended December 31, 2015 First Quarter Second Quarter Third Quarter Fourth Quarter Total Year (In thousands, except per share data) Revenue $ 327,510 $ 350,144 $ 382,859 $ 402,552 $ 1,463,065 Gross profit $ 101,432 $ 110,118 $ 126,009 $ 131,804 $ 469,363 Net income $ 12,209 $ 15,870 $ 33,647 $ 20,165 $ 81,891 Net income per share from: Basic $ 0.26 $ 0.33 $ 0.71 $ 0.42 $ 1.72 Diluted $ 0.25 $ 0.32 $ 0.69 $ 0.41 $ 1.68 Year Ended December 31, 2014 First Quarter Second Quarter Third Quarter Fourth Quarter Total Year (In thousands, except per share data) Revenue $ 240,881 $ 250,913 $ 264,584 $ 279,649 $ 1,036,027 Gross profit $ 73,956 $ 77,159 $ 80,306 $ 84,696 $ 316,117 Net income $ 7,630 $ 7,193 $ 8,499 $ 9,895 $ 33,217 Net income per share from: Basic $ 0.16 $ 0.15 $ 0.18 $ 0.21 $ 0.71 Diluted $ 0.16 $ 0.15 $ 0.18 $ 0.20 $ 0.69

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2015
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events B.E. Smith Acquisition On January 4, 2016, the Company completed its acquisition of B.E. Smith, a full-service healthcare interim leadership placement and executive search firm, for $163,750 in cash. B.E. Smith places interim leaders and executives across all healthcare settings, including acute care hospitals, academic medical and children’s hospitals, physician practices, and post-acute care providers. The acquisition will provide the Company additional access to healthcare executives and enhances its integrated services to hospitals, health systems and other healthcare facilities across the nation. To help finance the acquisition, the Company entered into the First Amendment, which provided $125,000 of additional available borrowings to the Company. The First Amendment is more fully described in Note (8), “Notes Payable and Credit Agreement.” HealthSource Global Staffing Acquisition On January 11, 2016, the Company completed its acquisition of HealthSource Global Staffing for $ 6,500 in cash and a tiered contingent earn-out payment of up to $4,000 . HealthSource Global is a crisis staffing company that also provides rapid response staffing under which it provides clients nurses who can begin assignments within one to two weeks in acute-care facilities in contrast to the three to five week lead time that may be required for travel and allied healthcare professionals.

Summary of Significant Accoun23

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2015
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation The accompanying consolidated financial statements include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America 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 impairment, accruals for self-insurance and compensation and related benefits, contingencies and litigation, and income taxes. The Company bases these estimates on the information that is currently available and on various other assumptions that it believes are reasonable under the circumstances. Actual results could differ from those estimates under different assumptions or conditions.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. Cash and cash equivalents include currency on hand, deposits with financial institutions and highly liquid investments.
Restricted Cash and Cash Equivalents	Restricted Cash and Cash Equivalents Restricted cash and cash equivalents primarily represent the cash and money market funds on deposit with financial institutions that serve as collateral for the Company’s outstanding letters of credit and captive insurance subsidiary claim payments.
Fixed Assets	Fixed Assets The Company records furniture, equipment, leasehold improvements and internal-use software at cost less accumulated amortization and depreciation. The Company records equipment acquired under capital leases at the present value of the future minimum lease payments. The Company capitalizes major additions and improvements, and it expenses maintenance and repairs when incurred. The Company calculates depreciation on furniture, equipment and technology and software using the straight-line method based on the estimated useful lives of the related assets ( three to seven years). The Company amortizes leasehold improvements and equipment obtained under capital leases over the shorter of the term of the lease or their estimated useful lives. The Company includes depreciation of equipment obtained under capital leases with depreciation expense in the accompanying consolidated financial statements. The Company capitalizes costs it incurs to develop internal-use software during the application development stage. Application development stage costs generally include costs associated with internal-use software configuration, coding, installation and testing. The Company also capitalizes costs of significant upgrades and enhancements that result in additional functionality, whereas it expenses as incurred costs for maintenance and minor upgrades and enhancements. The Company amortizes capitalized costs using the straight-line method over three to seven years once the software is ready for its intended use. The Company reviews long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset group to the future undiscounted net cash flows that are expected to be generated by the asset group. If such asset group is considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the asset group exceeds the fair value of the asset group. The Company reports assets to be disposed of at the lower of the carrying amount or fair value less costs to sell.
Goodwill	Goodwill The Company records as goodwill the portion of the purchase price that exceeds the fair value of net assets of entities acquired. The Company evaluates goodwill annually for impairment at the reporting unit level and whenever circumstances occur indicating that goodwill may be impaired. The Company may first assess qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount. If, after assessing the totality of events and circumstances, the Company determines that it is more likely than not that the fair value of the reporting unit is greater than its carrying amount, the quantitative impairment test is unnecessary. The performance of the quantitative impairment test involves a two-step process. The first step of the test involves comparing the fair value of the Company’s reporting units with the reporting unit’s carrying amount, including goodwill. The Company generally determines the fair value of its reporting units using a combination of the income approach (using discounted future cash flows) and the market valuation approach. If the carrying amount of a Company’s reporting unit exceeds its fair value, the Company performs the second step of the test to determine the amount of impairment loss. The second step of the test involves comparing the implied fair value of the Company’s reporting unit’s goodwill with the carrying amount of that goodwill. The amount by which the carrying value of the goodwill exceeds its implied fair value, if any, is recognized as an impairment loss.
Intangible Assets	Intangible Assets Intangible assets consist of identifiable intangible assets acquired through acquisitions. Identifiable intangible assets include tradenames and trademarks, customer relationships, non-compete agreements, staffing databases and acquired technology. The Company amortizes intangible assets, other than tradenames and trademarks with an indefinite life, using the straight-line method over their useful lives. The Company amortizes non-compete covenants using the straight-line method over the lives of the related agreements. The Company reviews for impairment intangible assets with estimable useful lives whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The Company does not amortize indefinite-lived tradenames and trademarks and instead reviews them for impairment annually . The Company may first perform a qualitative assessment to determine whether it is more likely than not that an indefinite-lived intangible asset is impaired. If, after assessing the totality of events and circumstances, the Company determines that it is more likely than not that the indefinite-lived intangible asset is not impaired, no quantitative fair value measurement is necessary. If a quantitative fair value measurement calculation is required for an indefinite-lived intangible asset, the Company compares its fair value with its carrying amount. If the carrying amount exceeds the fair value, the Company records the excess as an impairment loss.
Insurance Reserves	Insurance Reserves The Company maintains an accrual for professional liability that is included in accounts payable and accrued expenses and other long-term liabilities in the consolidated balance sheets. The expense is included in the selling, general and administrative expenses in the consolidated statement of comprehensive income. The Company determines the adequacy of this accrual by evaluating its historical experience and trends, loss reserves established by the Company’s insurance carriers, management and third-party administrators, and independent actuarial studies. The Company obtains actuarial studies on a semi-annual basis that use the Company’s actual claims data and industry data to assist the Company in determining the adequacy of its reserves each year. For periods between the actuarial studies, the Company records its accruals based on loss rates provided in the most recent actuarial study and management’s review of loss history. In November 2012, the Company established a captive insurance subsidiary, which provides coverage, on an occurrence basis, for professional liability within its nurse and allied healthcare staffing segment. Liabilities include provisions for estimated losses incurred but not yet reported (“IBNR”), as well as provisions for known claims. IBNR reserve estimates involve the use of assumptions and are primarily based upon historical loss experience, industry data and other actuarial assumptions. The Company maintains excess insurance coverage through a commercial carrier for losses above the per occurrence retention. The Company maintains an accrual for workers compensation, which is included in accrued compensation and benefits and other long-term liabilities in the consolidated balance sheets. The expense relating to healthcare professionals is included in cost of revenue, while the expense relating to corporate employees is included in the selling, general and administrative expenses in the consolidated statement of comprehensive income. The Company determines the adequacy of this accrual by evaluating its historical experience and trends, loss reserves established by the Company’s insurance carriers and third-party administrators, and independent actuarial studies. The Company obtains actuarial studies on a semi-annual basis that use the Company’s payroll and historical claims data, as well as industry data, to determine the appropriate reserve for both reported claims and IBNR claims for each policy year. For periods between the actuarial studies, the Company records its accruals based on loss rates provided in the most recent actuarial study.
Revenue Recognition	Revenue Recognition Revenue consists of fees earned from the temporary and permanent placement of healthcare professionals as well as from the Company’s software-as-a-service (SaaS)-based technology, including its vendor management systems (VMS) and its scheduling software. Revenue from temporary staffing services is recognized as the services are rendered by the healthcare professional. Under the Company’s managed services program arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own pool of healthcare professionals along with those of third-party subcontractors. When the Company uses subcontractors, revenue is recorded net of the related subcontractor’s expense. Revenue from recruitment and permanent placement services is recognized as the services are provided and upon successful placements.
Accounts Receivable	Accounts Receivable The Company records accounts receivable at the invoiced amount. Accounts receivable are non-interest bearing. The Company maintains an allowance for doubtful accounts based on the Company’s historical write-off experience and an assessment of its customers’ financial conditions. The Company also maintains a sales allowance to reserve for potential credits issued to customers, which is based on the Company’s historical experience. The Company has not experienced material bad debts or sales adjustments during the past three years.
Concentration of Credit Risk	The Company’s cash and cash equivalents and restricted cash and cash equivalents accounts are also financial instruments that are exposed to concentration of credit risk. The Company maintains its cash balances with high-credit quality and federally insured institutions. Cash balances may be invested in a non-federally insured money market account. Concentration of Credit Risk The majority of the Company’s business activity is with hospitals located throughout the United States. Credit is extended based on the evaluation of each entity’s financial condition.
Income Taxes	Income Taxes The Company records income taxes using the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in the period the changes are enacted. In assessing the realizability of deferred tax assets, the Company considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. The Company considers the scheduled reversal of deferred tax liabilities (including the impact of available carryback and carryforward periods), projected future taxable income, and tax-planning strategies in making this assessment. The Company recognizes the effect of income tax positions only if it is more likely than not that such positions will be sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. The Company records interest and penalties related to unrecognized tax benefits in income tax expense.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The carrying amounts of the Company’s cash equivalents and restricted cash equivalents approximate their respective fair values due to the short-term nature and liquidity of these financial instruments. The carrying amount of the Company’s term loan and revolver approximates their fair value as the Company amended its credit facilities in January 2016 to increase the capacity of the revolver and to secure a new term loan and the variable interest rates (LIBOR plus 1.50% to 2.25% or a base rate plus a spread of 0.50% to 1.25% , at the Company’s option) remain unchanged. See Note (8), “Notes Payable and Credit Agreement,” for additional information. The fair value of the long-term portion of the Company’s insurance accruals cannot be estimated because the Company cannot reasonably determine the timing of future payments.
Share-Based Compensation	Share-Based Compensation The Company accounts for its share-based employee compensation plans by expensing the estimated fair value of share-based awards on a straight-line basis over the requisite employee service period, which is the vesting period. Restricted stock units (“RSUs”) typically vest at the end of a three -year vesting period, however, 33% of the awards may vest on the 13 th month anniversary of the grant date and 34% on the second anniversary of the grant date if certain performance targets are met. Share-based compensation cost of RSUs is measured by the market value of the Company’s common stock on the date of grant, and the Company records share-based compensation expense only for those awards that are expected to vest. Performance restricted stock units (“PRSUs”) primarily consist of PRSUs that contain a performance condition dependent on the Company’s adjusted EBITDA margin during the third year of the three -year vesting period, with a range of 0% to 175% of the target amount granted to be issued under the award. Share-based compensation cost for these PRSUs is measured by the market value of the Company’s common stock on the date of grant, and the amount recognized is adjusted for estimated achievement of the performance conditions. A limited amount of PRSUs contain a market condition dependent upon the Company’s relative and absolute total shareholder return over a three -year period, with a range of 0% to 175% of the target amount granted to be issued under the award. Share-based compensation cost for these PRSUs is measured using the Monte-Carlo simulation valuation model and is not adjusted for the achievement, or lack thereof, of the performance conditions.
Segment Information	Segment Information The Company has three reportable segments: (1) nurse and allied healthcare staffing, (2) locum tenens staffing, and (3) physician permanent placement services. 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.
Reclassifications	Reclassifications Certain reclassifications have been made to certain of the prior years’ consolidated financial statements to conform to the current year presentation.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In April 2015, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”)2015-03, “Interest - Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs.” The update requires debt issuance costs related to a recognized debt liability to be presented in the balance sheet as a direct deduction from the carrying amount of the related debt liability instead of being presented as an asset. Debt disclosures will include the face amount of the debt liability and the effective interest rate. The update requires retrospective application and represents a change in accounting principle. The update is effective for fiscal years beginning after December 15, 2015 and the Company elected to early adopt this standard in fiscal year 2015. The adoption did not have a material effect on the Company’s consolidated financial statements as it only resulted in a reclassification of certain capitalized loan costs from other long-term assets to offset notes payable balance, including the reclassification of debt issuance costs from other assets to long-term notes payable of $1,185 as of December 31, 2014. In November 2015, the FASB issued ASU 2015-17, Income Taxes (Topic 740), “Balance Sheet Classification of Deferred Taxes,” which requires deferred tax liabilities and assets to be classified as noncurrent in a statement of financial position. This update is effective for financial statements issued for annual periods beginning after December 15, 2016, and interim periods within those annual periods. The Company has elected to early adopt this standard during the fourth quarter of 2015. The adoption of this new accounting resulted in a reclassification in the Company’s deferred income taxes, net, being presented within long-term liabilities on the Company’s consolidated balance sheet as of December 31, 2015. The Company did not retrospectively adjust the consolidated balance sheet as of December 31, 2014. The adoption did not have a material effect on the consolidated financial statements as it only resulted in a reclassification of current deferred income taxes, net (current assets) to long-term deferred income taxes, net (non-current liabilities). There was no impact to net income.

Summary of Significant Accoun24

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2015
Accounting Policies [Abstract]
Computation of basic and diluted net income (loss) per common share	The following table sets forth the computation of basic and diluted net income per common share for the years ended December 31, 2015 , 2014 and 2013 , respectively: Years Ended December 31, 2015 2014 2013 Net income $ 81,891 $ 33,217 $ 32,933 Net income per common share - basic $ 1.72 $ 0.71 $ 0.72 Net income per common share - diluted 1.68 0.69 0.69 Weighted average common shares outstanding - basic 47,525 46,504 45,963 Plus dilutive effect of potential common shares 1,318 1,582 1,824 Weighted average common shares outstanding - diluted 48,843 48,086 47,787
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results	The following table provides a reconciliation of revenue and segment operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes: Years Ended December 31, 2015 2014 2013 Revenue Nurse and allied healthcare staffing $ 1,023,936 $ 695,206 $ 681,979 Locum tenens staffing 385,091 296,166 287,484 Physician permanent placement services 54,038 44,655 42,353 $ 1,463,065 $ 1,036,027 $ 1,011,816 Segment operating income Nurse and allied healthcare staffing $ 149,258 $ 87,246 $ 82,458 Locum tenens staffing 48,011 30,985 24,712 Physician permanent placement services 15,101 9,818 8,929 212,370 128,049 116,099 Unallocated corporate overhead 52,254 36,996 30,927 Depreciation and amortization 20,953 15,993 13,545 Share-based compensation 10,284 7,157 6,125 Interest expense, net (including loss on debt extinguishment of $3,113 and $434 for the years ended December 31, 2014 and 2013, respectively), and other 7,790 9,237 9,665 Income from continuing operations before income taxes $ 121,089 $ 58,666 $ 55,837

Business Combinations (Tables)

Business Combinations (Tables)	12 Months Ended
	Dec. 31, 2015
Business Combinations [Abstract]
Summary of Fair Value and Useful Life of Each Intangible Asset Acquired	: Fair Value Useful Life (in years) Identifiable intangible assets Tradenames and Trademarks $ 8,100 3 - 15 Customer Relationships 17,600 10 - 15 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 years ended December 31, 2015 and 2014 as if the OH acquisition had occurred on January 1, 2014, which 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 is it necessarily indicative of future operating results. Years Ended December 31, (Unaudited) 2015 2014 Revenue $ 1,465,350 $ 1,138,481 Net income $ 80,033 $ 34,230 Net income per common share: Basic $ 1.68 $ 0.74 Diluted $ 1.64 $ 0.71

Fair Value Measurement (Tables)

Fair Value Measurement (Tables)	12 Months Ended
	Dec. 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 assets and liabilities measured at fair value on a recurring basis and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value: Fair Value Measurements as of December 31, 2015 Assets (Liabilities) Total Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Money market funds $ 5,627 $ 5,627 $ — $ — Interest rate swap asset 165 — 165 — Acquisition contingent consideration liabilities (3,770 ) — — (3,770 ) Fair Value Measurements as of December 31, 2014 Assets (Liabilities) Total Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Money market funds $ 335 $ 335 $ — $ — U.S. Treasury securities 5,291 5,291 — — Acquisition contingent consideration liabilities (1,400 ) — — (1,400 )
Fair value of contingent consideration liabilities	The following table sets forth reconciliations of changes in the fair value of contingent consideration liabilities classified as Level 3 in the fair value hierarchy: Years Ended December 31, 2015 2014 Balance as of January 1 $ (1,400 ) $ — Contingent consideration liabilities recorded at purchase (2,700 ) (1,400 ) Change in fair value of contingent consideration earn-out liabilities 330 — Balance as of December 31 $ (3,770 ) $ (1,400 )

Goodwill and Identifiable Int27

Goodwill and Identifiable Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Acquired Intangible Assets by Major Class	As of December 31, 2015 and 2014 , the Company had the following acquired intangible assets: As of December 31, 2015 As of December 31, 2014 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Intangible assets subject to amortization: Staffing databases $ 6,333 $ (3,592 ) $ 2,741 $ 3,020 $ (2,618 ) $ 402 Customer relationships 96,829 (40,076 ) 56,753 77,300 (32,971 ) 44,329 Tradenames and trademarks 26,853 (7,718 ) 19,135 17,540 (5,436 ) 12,104 Non-compete agreements 572 (276 ) 296 190 (72 ) 118 Acquired technology 8,730 (2,085 ) 6,645 7,030 (866 ) 6,164 $ 139,317 $ (53,747 ) $ 85,570 $ 105,080 $ (41,963 ) $ 63,117 Intangible assets not subject to amortization: tradenames and trademarks $ 89,400 $ 89,400 $ 174,970 $ 152,517
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	Based on the current amount of intangibles subject to amortization, the estimated amortization expense as of December 31, 2015 is as follows: Amount Year ending December 31, 2016 $ 11,948 Year ending December 31, 2017 11,613 Year ending December 31, 2018 10,540 Year ending December 31, 2019 9,835 Year ending December 31, 2020 6,917 Thereafter 34,717 $ 85,570
Schedule of Goodwill	The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied Healthcare Staffing Locum Tenens Staffing Physician Permanent Placement Services Total Balance, January 1, 2014 $ 97,811 $ 14,502 $ 32,329 $ 144,642 Goodwill adjustment from prior acquisition (5 ) — — (5 ) Goodwill from Avantas acquisition 9,750 — — 9,750 Balance, December 31, 2014 107,556 14,502 32,329 154,387 Goodwill adjustment for Avantas acquisition 165 — — 165 Goodwill from OH acquisition 37,392 5,241 — 42,633 Goodwill from TFS acquisition 4,228 — — 4,228 Goodwill from Millican acquisition — — 3,366 3,366 Balance, December 31, 2015 $ 149,341 $ 19,743 $ 35,695 $ 204,779 Accumulated impairment loss as of December 31, 2014 and 2015 $ 154,444 $ 53,940 $ 6,555 $ 214,939

Balance Sheet Details (Tables)

Balance Sheet Details (Tables)	12 Months Ended
	Dec. 31, 2015
Balance Sheet Related Disclosures [Abstract]
Consolidated balance sheets detail	The consolidated balance sheets detail is as follows as of December 31, 2015 and 2014 : As of December 31, 2015 2014 Other current assets: Restricted cash 11,995 9,054 Income taxes receivable 3,687 3,503 Other 8,041 4,643 Other current assets $ 23,723 $ 17,200 Fixed assets: Furniture and equipment $ 23,380 $ 17,761 Technology and software 97,962 78,593 Leasehold improvements 5,472 5,340 126,814 101,694 Accumulated depreciation (76,680 ) (68,814 ) Fixed assets, net $ 50,134 $ 32,880 Accounts payable and accrued expenses: Trade accounts payable $ 53,261 $ 30,039 Subcontractor payable 56,177 33,474 Professional liability reserve 7,962 7,380 Overdraft 124 6,338 Other 1,298 1,762 Accounts payable and accrued expenses $ 118,822 $ 78,993 Accrued compensation and benefits: Accrued payroll $ 21,058 $ 21,857 Accrued bonuses and commissions 24,476 15,196 Accrued travel expense 2,740 2,413 Accrued health insurance reserve 3,225 1,871 Accrued workers compensation reserve 7,701 5,830 Deferred compensation 23,044 20,729 Other 1,457 99 Accrued compensation and benefits $ 83,701 $ 67,995 Other long-term liabilities: Workers compensation reserve $ 16,899 $ 13,855 Professional liability reserve 37,369 30,722 Deferred rent 11,826 8,122 Unrecognized tax benefits 8,081 21,706 Other 3,959 3,269 Other long-term liabilities $ 78,134 $ 77,674

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Schedule of provision for income taxes from continuing operations	The provision for income taxes from operations for the years ended December 31, 2015 , 2014 and 2013 consists of the following: Years Ended December 31, 2015 2014 2013 Current income taxes: Federal $ 22,552 $ 10,787 $ 17,268 State 3,969 2,883 2,605 Total 26,521 13,670 19,873 Deferred income taxes: Federal 8,896 10,430 1,693 State 3,781 1,349 1,338 Total 12,677 11,779 3,031 Provision for income taxes from operations $ 39,198 $ 25,449 $ 22,904 Total income tax expense for the years ended December 31, 2015, 2014 and 2013 was allocated as follows: Years Ended December 31, 2015 2014 2013 Provision for income taxes from operations $ 39,198 $ 25,449 $ 22,904 Shareholders’ equity, for compensation expense for tax purposes in excess of amounts recognized for financial reporting purposes (7,176 ) (978 ) (1,167 ) $ 32,022 $ 24,471 $ 21,737
Schedule of income tax reconciliation	The Company’s income tax expense differs from the amount that would have resulted from applying the federal statutory rate of 35% to pretax income from operations because of the effect of the following items during the years ended December 31, 2015 , 2014 and 2013 : Years Ended December 31, 2015 2014 2013 Tax expense at federal statutory rate $ 42,381 $ 20,533 $ 19,543 State taxes, net of federal benefit 5,260 2,551 2,302 Non-deductible expenses 3,505 1,816 — Unrecognized tax benefit (11,464 ) 971 1,952 Other, net (484 ) (422 ) (893 ) Income tax expense from operations $ 39,198 $ 25,449 $ 22,904
Schedule of deferred tax assets and liabilities	The tax effects of temporary differences that give rise to significant portions of deferred tax assets and deferred tax liabilities are presented below as of the years ended December 31, 2015 and 2014 : Years Ended December 31, 2015 2014 Deferred tax assets: Stock compensation $ 10,170 $ 11,217 Deferred revenue 956 573 Allowance for doubtful accounts 1,971 1,467 Deferred compensation 9,153 8,142 Accrued expenses 24,932 20,475 Deferred rent 4,885 3,420 Net operating losses 8,809 14,354 State taxes 1,945 1,346 Other — 2,265 Total deferred tax assets $ 62,821 $ 63,259 Deferred tax liabilities: Intangibles $ (67,574 ) $ (57,316 ) Fixed assets (15,155 ) (8,453 ) Prepaid expenses (1,224 ) (1,427 ) Other (256 ) — Total deferred tax liabilities $ (84,209 ) $ (67,196 ) Valuation allowance $ (1,043 ) $ (1,224 ) Net deferred tax liabilities $ (22,431 ) $ (5,161 )
Schedule of unrecognized tax benefits	A summary of the changes in the amount of unrecognized tax benefits (excluding interest) for 2015 , 2014 and 2013 is as follows: 2015 2014 2013 Beginning balance of unrecognized tax benefits $ 22,890 $ 22,573 $ 21,415 Additions based on tax positions related to the current year — 317 809 Additions based on tax positions of prior years 395 — 349 Reductions due to lapse of applicable statute of limitation (214 ) — — Settlements (16,534 ) — — Ending balance of unrecognized tax benefits $ 6,537 $ 22,890 $ 22,573

Notes Payable and Credit Agre30

Notes Payable and Credit Agreement (Tables)	12 Months Ended
	Dec. 31, 2015
Debt Disclosure [Abstract]
Schedule of annual principal maturities	Annual principal maturities of the Term Loan as of December 31, 2015 are as follows: Year ending December 31, 2016 $ 7,500 Year ending December 31, 2017 7,500 Year ending December 31, 2018 7,500 Year ending December 31, 2019 114,375 Thereafter — $ 136,875

Share-Based Compensation (Table

Share-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of RSU and PRSU activity for non-vested awards	The following table summarizes RSU and PRSU activity for non-vested awards for the years ended December 31, 2015 , 2014 and 2013 : Number of Shares Weighted Average Grant Date Fair Value per Share Unvested at January 1, 2013 1,659 $ 7.53 Granted—RSUs 285 $ 12.86 Granted—PRSUs 291 $ 13.86 Vested (588 ) $ 7.02 Canceled/forfeited/expired (10 ) $ 13.06 Unvested at December 31, 2013 1,637 $ 9.73 Granted—RSUs 361 $ 13.76 Granted—PRSUs 535 $ 14.97 Vested (838 ) $ 8.63 Canceled/forfeited/expired (120 ) $ 12.16 Unvested at December 31, 2014 1,575 $ 11.95 Granted—RSUs 203 $ 22.43 Granted—PRSUs 616 $ 13.58 Vested (1,081 ) $ 9.13 Canceled/forfeited/expired (76 ) $ 15.45 Unvested at December 31, 2015 1,237 $ 16.73
Schedule of stock option and SAR activity	A summary of stock option and SAR activity under the Stock Option Plan and the Equity Plan and Other Plans are as follows: Stock Option Plan Equity Plan and Other Plans Number Outstanding Weighted- Average Exercise Price per Share Number Outstanding Weighted- Average Exercise Price per Share Outstanding at December 31, 2012 698 $ 14.34 1,241 $ 10.57 Granted — $ — — $ — Exercised (109 ) $ 11.23 (132 ) $ 8.31 Canceled/forfeited/expired — $ — (13 ) $ 15.19 Outstanding at December 31, 2013 589 $ 14.92 1,096 $ 10.78 Granted — $ — — $ — Exercised (117 ) $ 14.86 (142 ) $ 11.53 Canceled/forfeited/expired (227 ) $ 14.94 (6 ) $ 19.69 Outstanding at December 31, 2014 245 $ 14.93 948 $ 10.61 Granted — $ — — $ — Exercised (245 ) $ 14.93 (615 ) $ 10.79 Canceled/forfeited/expired — $ — (1 ) $ 24.95 Outstanding at December 31, 2015 — $ — 332 $ 10.26 Vested and expected to vest at December 31, 2015 — $ — 332 $ 10.26 Exercisable at December 31, 2015 — $ — 332 $ 10.26
Schedule of share-based compensation expense	Total share-based compensation expense for the years ended December 31, 2015 , 2014 and 2013 was as follows: Years Ended December 31, 2015 2014 2013 Share-based employee compensation, before tax $ 10,284 $ 7,157 $ 6,125 Related income tax benefits (3,990 ) (2,783 ) (2,383 ) Share-based employee compensation, net of tax $ 6,294 $ 4,374 $ 3,742

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2015
Commitments and Contingencies Disclosure [Abstract]
Schedule of Future Minimum Lease Payments	Future minimum lease payments under noncancelable operating leases (with initial or remaining lease terms in excess of one year) as of December 31, 2015 are as follows: Operating Leases Years ending December 31, 2016 $ 15,933 2017 14,619 2018 13,545 2019 12,469 2020 11,899 Thereafter 81,187 Total minimum lease payments $ 149,652

Quarterly Financial Data (Una33

Quarterly Financial Data (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2015
Quarterly Financial Information Disclosure [Abstract]
Schedule of Quarterly Financial Information	Year Ended December 31, 2015 First Quarter Second Quarter Third Quarter Fourth Quarter Total Year (In thousands, except per share data) Revenue $ 327,510 $ 350,144 $ 382,859 $ 402,552 $ 1,463,065 Gross profit $ 101,432 $ 110,118 $ 126,009 $ 131,804 $ 469,363 Net income $ 12,209 $ 15,870 $ 33,647 $ 20,165 $ 81,891 Net income per share from: Basic $ 0.26 $ 0.33 $ 0.71 $ 0.42 $ 1.72 Diluted $ 0.25 $ 0.32 $ 0.69 $ 0.41 $ 1.68 Year Ended December 31, 2014 First Quarter Second Quarter Third Quarter Fourth Quarter Total Year (In thousands, except per share data) Revenue $ 240,881 $ 250,913 $ 264,584 $ 279,649 $ 1,036,027 Gross profit $ 73,956 $ 77,159 $ 80,306 $ 84,696 $ 316,117 Net income $ 7,630 $ 7,193 $ 8,499 $ 9,895 $ 33,217 Net income per share from: Basic $ 0.16 $ 0.15 $ 0.18 $ 0.21 $ 0.71 Diluted $ 0.16 $ 0.15 $ 0.18 $ 0.20 $ 0.69

Summary of Significant Accoun34

Summary of Significant Accounting Policies - Fixed Assets (Details)	12 Months Ended
	Dec. 31, 2015
Furniture, Equipment and Software | Minimum
Property, Plant and Equipment [Line Items]
Fixed assets, useful life	3 years
Furniture, Equipment and Software | Maximum
Property, Plant and Equipment [Line Items]
Fixed assets, useful life	7 years
Software Development | Minimum
Property, Plant and Equipment [Line Items]
Fixed assets, useful life	3 years
Software Development | Maximum
Property, Plant and Equipment [Line Items]
Fixed assets, useful life	7 years

Summary of Significant Accoun35

Summary of Significant Accounting Policies - Concentration of Credit Risk (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2015USD ($)customer	Dec. 31, 2014USD ($)customer	Dec. 31, 2013customer
Concentration Risk [Line Items]
Restricted cash and cash equivalents | $	$ 27,352	$ 19,567
Healthcare System | Consolidated Revenue | Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk, number of customers | customer	1	1	0
Concentration risk percentage	11.00%	10.00%

Summary of Significant Accoun36

Summary of Significant Accounting Policies - Share-Based Compensation (Details)	12 Months Ended
	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period for relative and absolute shareholder return	3 years
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years
Performance Shares, EBITDA-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period for relative and absolute shareholder return	3 years
Minimum | Performance Shares, EBITDA-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	0.00%
Minimum | Performance Shares, Shareholder Return-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	0.00%
Maximum | Performance Shares, EBITDA-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	175.00%
Maximum | Performance Shares, Shareholder Return-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	175.00%
Vesting Period, Thirteen Month Aniversary of Grant Date | Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-Based Compensation Arrangement By Share-Based Payment Award, Grant Date Anniversary Term	13 months
Vesting percentage	33.00%
Vesting Period, Second Anniversary of Grant Date | Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-Based Compensation Arrangement By Share-Based Payment Award, Grant Date Anniversary Term	2 years
Vesting percentage	34.00%

Summary of Significant Accoun37

Summary of Significant Accounting Policies - Net income per common share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Computation of Basic and Diluted Net Income Per Common Share [Abstract]
Net income	$ 20,165	$ 33,647	$ 15,870	$ 12,209	$ 9,895	$ 8,499	$ 7,193	$ 7,630	$ 81,891	$ 33,217	$ 32,933
Net income per common share - basic (in dollars per share)	$ 0.42	$ 0.71	$ 0.33	$ 0.26	$ 0.21	$ 0.18	$ 0.15	$ 0.16	$ 1.72	$ 0.71	$ 0.72
Net income per common share - diluted (in dollars per share)	$ 0.41	$ 0.69	$ 0.32	$ 0.25	$ 0.20	$ 0.18	$ 0.15	$ 0.16	$ 1.68	$ 0.69	$ 0.69
Weighted average common shares outstanding - basic									47,525	46,504	45,963
Plus dilutive effect of potential common shares									1,318	1,582	1,824
Weighted average common shares outstanding - diluted									48,843	48,086	47,787
Stock Compensation Plan
Class of Stock [Line Items]
Common stock excluded from calculation of EPS (shares)									9	298	308

Summary of Significant Accoun38

Summary of Significant Accounting Policies - Segment (Details) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015USD ($)	Sep. 30, 2015USD ($)	Jun. 30, 2015USD ($)	Mar. 31, 2015USD ($)	Dec. 31, 2014USD ($)	Sep. 30, 2014USD ($)	Jun. 30, 2014USD ($)	Mar. 31, 2014USD ($)	Dec. 31, 2015USD ($)segment	Dec. 31, 2014USD ($)	Dec. 31, 2013USD ($)
Accounting Policies [Abstract]
Reportable business segments | segment									3
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue	$ 402,552	$ 382,859	$ 350,144	$ 327,510	$ 279,649	$ 264,584	$ 250,913	$ 240,881	$ 1,463,065	$ 1,036,027	$ 1,011,816
Segment operating income									128,879	67,903	65,502
Depreciation and amortization									20,953	15,993	13,545
Share-based compensation									10,284	7,157	6,125
Interest expense, net (including loss on debt extinguishment of $3,113 and $434 for the years ended December 31, 2014 and 2013, respectively), and other									7,790	9,237	9,665
Income from continuing operations before income taxes									121,089	58,666	55,837
Loss on debt extinguishment									0	3,113	434
Operating Segments
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue									1,463,065	1,036,027	1,011,816
Segment operating income									212,370	128,049	116,099
Operating Segments | Nurse and Allied Healthcare Staffing
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue									1,023,936	695,206	681,979
Segment operating income									149,258	87,246	82,458
Operating Segments | Locum Tenens Staffing
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue									385,091	296,166	287,484
Segment operating income									48,011	30,985	24,712
Operating Segments | Physician Permanent Placement Services
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue									54,038	44,655	42,353
Segment operating income									15,101	9,818	8,929
Corporate, Non-Segment
Segment Reporting Information, Profit (Loss) [Abstract]
Unallocated corporate overhead									$ 52,254	$ 36,996	$ 30,927

Summary of Significant Accoun39

Summary of Significant Accounting Policies - Fair Value of Financial Assets (Details) - Line of Credit	Apr. 18, 2014
Minimum | Revolving Credit Facility | LIBOR
Debt Instrument [Line Items]
Interest rates spread over LIBOR and Base rate	1.50%
Minimum | Revolving Credit Facility | Base Rate
Debt Instrument [Line Items]
Interest rates spread over LIBOR and Base rate	0.50%
Minimum | Term Loan | LIBOR
Debt Instrument [Line Items]
Interest rates spread over LIBOR and Base rate	1.50%
Minimum | Term Loan | Base Rate
Debt Instrument [Line Items]
Interest rates spread over LIBOR and Base rate	0.50%
Maximum | Revolving Credit Facility | LIBOR
Debt Instrument [Line Items]
Interest rates spread over LIBOR and Base rate	2.25%
Maximum | Revolving Credit Facility | Base Rate
Debt Instrument [Line Items]
Interest rates spread over LIBOR and Base rate	1.25%
Maximum | Term Loan | LIBOR
Debt Instrument [Line Items]
Interest rates spread over LIBOR and Base rate	2.25%
Maximum | Term Loan | Base Rate
Debt Instrument [Line Items]
Interest rates spread over LIBOR and Base rate	1.25%

Summary of Significant Accoun40

Summary of Significant Accounting Policies - Recently Adopted Accounting Pronouncements (Details) - New Accounting Pronouncement, Early Adoption, Effect $ in Thousands	Dec. 31, 2014USD ($)
Other Assets
New Accounting Pronouncement, Early Adoption [Line Items]
Deferred finance costs, net	$ (1,185)
Long-term Notes Payable
New Accounting Pronouncement, Early Adoption [Line Items]
Deferred finance costs, net	$ 1,185

Derivative Instruments (Details

Derivative Instruments (Details) - Interest Rate Swap - Designated as Hedging Instrument - USD ($)	Dec. 31, 2015	Apr. 30, 2015
Derivative [Line Items]
Interest rate swap, face amount		$ 100,000,000
Fixed rate on interest rate swap, percent		0.983%
Other Assets
Derivative [Line Items]
Fair value of interest rate swap	$ 165,000

Business Combinations (Details)

Business Combinations (Details)

Dec. 31, 2017USD ($)

Sep. 15, 2017USD ($)

Dec. 31, 2016USD ($)

Sep. 15, 2016USD ($)

Oct. 06, 2015USD ($)

Sep. 15, 2015USD ($)

Jan. 07, 2015USD ($)subsidiary

Dec. 22, 2014USD ($)

Nov. 20, 2013USD ($)

Nov. 20, 2013USD ($)

Dec. 31, 2015USD ($)$ / shares

Dec. 31, 2014USD ($)$ / shares

Dec. 31, 2013USD ($)

Dec. 31, 2015USD ($)aquisition

Business Combination, Description

Number of acquisitions | aquisition

5

Number of acquisitions without pro forma information | aquisition

4

Additional cash paid for working capital adjustment settlement

$ 990,000

$ 0

$ 0

Allocation of Purchase Price:

Goodwill

204,779,000

154,387,000

144,642,000

$ 204,779,000

Liabilities assumed

(22,954,000)

(3,821,000)

(11,507,000)

Nurse and Allied Healthcare Staffing

Allocation of Purchase Price:

Goodwill

149,341,000

107,556,000

97,811,000

149,341,000

Locum Tenens Staffing

Allocation of Purchase Price:

Goodwill

19,743,000

14,502,000

$ 14,502,000

$ 19,743,000

MillicanSolutions Acquisition

Business Combination, Description

Purchase price of the acquisition

$ 3,985,000

Cash consideration

2,985,000

Allocation of Purchase Price:

Fair value of tangible assets acquired

636,000

Liabilities assumed

(662,000)

Identified intangible assets

645,000

Goodwill

$ 3,366,000

Intangible Assets, Net (Including Goodwill) [Abstract]

Weighted average useful life of intangible assets

5 years

MillicanSolutions Acquisition | Scenario, Forecast

Business Combination, Description

Cash consideration

$ 500,000

$ 500,000

The First String Healthcare Acquisition

Business Combination, Description

Purchase price of the acquisition

$ 7,653,000

Cash consideration

4,453,000

Contingent earn-out

$ 2,700,000

Service period

2 years

Contingent earn-out based on future operating performance (up to)

$ 4,000,000

Allocation of Purchase Price:

Fair value of tangible assets acquired

919,000

Liabilities assumed

(867,000)

Identified intangible assets

3,373,000

Goodwill

$ 4,228,000

Intangible Assets, Net (Including Goodwill) [Abstract]

Weighted average useful life of intangible assets

7 years

The First String Healthcare Acquisition | Scenario, Forecast

Business Combination, Description

Cash consideration

$ 1,000,000

$ 500,000

The First String Healthcare Acquisition | Scenario, Forecast | Earn-Out Payment, Payable in 2016 Based on TFS Results in 2015

Business Combination, Description

Contingent earn-out based on future operating performance (up to)

$ 1,000,000

The First String Healthcare Acquisition | Scenario, Forecast | Earn-Out Payment, Payable in 2017 Based on TFS Results in 2016

Business Combination, Description

Contingent earn-out based on future operating performance (up to)

$ 3,000,000

Onward Healthcare Acquisition

Business Combination, Description

Number of subsidiaries acquired | subsidiary

2

Cash consideration

$ 76,643,000

Allocation of Purchase Price:

Fair value of tangible assets acquired

25,216,000

Liabilities assumed

(21,425,000)

Identified intangible assets

30,219,000

Goodwill

42,633,000

Accounts receivable

21,313,000

Accounts payable and accrued expenses

11,113,000

Business Acquisition, Pro Forma Information [Abstract]

Revenue of acquiree

145,178,000

Income before income taxes of acquiree

16,229,000

Pro forma revenue

1,465,350,000

1,138,481,000

Pro forma net income

$ 80,033,000

$ 34,230,000

Pro forma net income per common share, basic (in dollars per share) | $ / shares

$ 1.68

$ 0.74

Pro forma net income per common share, diluted (in dollars per share) | $ / shares

$ 1.64

$ 0.71

Onward Healthcare Acquisition | Nurse and Allied Healthcare Staffing

Allocation of Purchase Price:

Goodwill

37,392,000

Onward Healthcare Acquisition | Locum Tenens Staffing

Allocation of Purchase Price:

Goodwill

5,241,000

Onward Healthcare Acquisition | Tradenames and Trademarks

Allocation of Purchase Price:

Identified intangible assets

$ 8,100,000

Onward Healthcare Acquisition | Tradenames and Trademarks | Minimum

Intangible Assets, Net (Including Goodwill) [Abstract]

Useful life

3 years

Onward Healthcare Acquisition | Tradenames and Trademarks | Maximum

Intangible Assets, Net (Including Goodwill) [Abstract]

Useful life

15 years

Onward Healthcare Acquisition | Customer Relationships

Allocation of Purchase Price:

Identified intangible assets

$ 17,600,000

Onward Healthcare Acquisition | Customer Relationships | Minimum

Intangible Assets, Net (Including Goodwill) [Abstract]

Useful life

10 years

Onward Healthcare Acquisition | Customer Relationships | Maximum

Intangible Assets, Net (Including Goodwill) [Abstract]

Useful life

15 years

Onward Healthcare Acquisition | Staffing Databases

Allocation of Purchase Price:

Identified intangible assets

$ 2,600,000

Intangible Assets, Net (Including Goodwill) [Abstract]

Useful life

5 years

Onward Healthcare Acquisition | Acquired Technologies

Allocation of Purchase Price:

Identified intangible assets

$ 1,700,000

Intangible Assets, Net (Including Goodwill) [Abstract]

Useful life

8 years

Onward Healthcare Acquisition | Non-compete Agreements

Allocation of Purchase Price:

Identified intangible assets

$ 219,000

Intangible Assets, Net (Including Goodwill) [Abstract]

Useful life

2 years

Avantas Acquisition

Business Combination, Description

Purchase price of the acquisition

$ 17,520,000

Cash consideration

14,470,000

Contingent earn-out

1,400,000

Cash holdback for potential claims

1,650,000

Contingent earn-out based on future operating performance (up to)

8,500,000

Additional cash paid for working capital adjustment settlement

165,000

Total purchase price

17,685,000

Allocation of Purchase Price:

Fair value of tangible assets acquired

1,631,000

Liabilities assumed

(3,821,000)

Identified intangible assets

9,960,000

Goodwill

$ 9,915,000

Intangible Assets, Net (Including Goodwill) [Abstract]

Weighted average useful life of intangible assets

14 years

Shiftwise Acquisition

Business Combination, Description

Purchase price of the acquisition

$ 39,500,000

Amount deposited into escrow

6,000,000

Escrow release period

3 years

Escrow deposit disbursements

$ 2,000,000

Cash released from escrow to Company

$ 3,970,000

Cash released from escrow to former Shiftwise shareholders

$ 3,614,000

Allocation of Purchase Price:

Fair value of tangible assets acquired

9,899,000

9,899,000

Identified intangible assets

19,790,000

19,790,000

Goodwill

21,313,000

$ 21,313,000

Liabilities assumed

(11,502,000)

Deferred tax liability

$ 2,701,000

Intangible Assets, Net (Including Goodwill) [Abstract]

Weighted average useful life of intangible assets

8 years

Fair Value Measurement - Textua

Fair Value Measurement - Textual (Details) - USD ($)	Oct. 31, 2015	Oct. 31, 2014	Oct. 31, 2013
Fair Value Disclosures [Abstract]
Goodwill impairment loss	$ 0	$ 0	$ 0
Indefinite-lived intangible asset impairment	$ 0	$ 0	$ 0

Fair Value Measurement - Financ

Fair Value Measurement - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Money Market Funds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	$ 5,627	$ 335
Interest Rate Swap Asset | Interest Rate Swap
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	165
US Treasury Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value		5,291
Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	(3,770)	(1,400)
Quoted Prices in Active Markets for Identical Assets (Level 1) | Money Market Funds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value		335
Quoted Prices in Active Markets for Identical Assets (Level 1) | Interest Rate Swap Asset | Interest Rate Swap
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	0
Quoted Prices in Active Markets for Identical Assets (Level 1) | US Treasury Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value		5,291
Quoted Prices in Active Markets for Identical Assets (Level 1) | Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	0	0
Significant Other Observable Inputs (Level 2) | Money Market Funds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	0	0
Significant Other Observable Inputs (Level 2) | Interest Rate Swap Asset | Interest Rate Swap
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	165
Significant Other Observable Inputs (Level 2) | Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	0	0
Significant Unobservable Inputs (Level 3) | Money Market Funds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	0	0
Significant Unobservable Inputs (Level 3) | Interest Rate Swap Asset | Interest Rate Swap
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	0
Significant Unobservable Inputs (Level 3) | Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets measured at fair value	$ (3,770)	$ (1,400)

Fair Value Measurement - Reconc

Fair Value Measurement - Reconciliation of Changes in Contingent Consideration Liabilities (Details) - Significant Unobservable Inputs (Level 3) - Contingent Consideration - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ (1,400)	$ 0
Additional contingent consideration earn-out liability from acquisition	(2,700)	(1,400)
Change in fair value of contingent consideration earn-out liability from acquisition	330	0
Ending balance	$ (3,770)	$ (1,400)

Goodwill and Identifiable Int46

Goodwill and Identifiable Intangible Assets - Acquired Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Schedule of Acquired Intangible Assets By Major Class [Line Items]
Gross Carrying Amount	$ 139,317	$ 105,080
Accumulated Amortization	(53,747)	(41,963)
Net Carrying Amount	85,570	63,117
Intangible assets excluding goodwill	174,970	152,517
Trade Names and Trademarks
Schedule of Acquired Intangible Assets By Major Class [Line Items]
Intangible assets not subject to amortization: tradenames and trademarks	89,400	89,400
Staffing Databases
Schedule of Acquired Intangible Assets By Major Class [Line Items]
Gross Carrying Amount	6,333	3,020
Accumulated Amortization	(3,592)	(2,618)
Net Carrying Amount	2,741	402
Customer Relationships
Schedule of Acquired Intangible Assets By Major Class [Line Items]
Gross Carrying Amount	96,829	77,300
Accumulated Amortization	(40,076)	(32,971)
Net Carrying Amount	56,753	44,329
Trade Names and Trademarks
Schedule of Acquired Intangible Assets By Major Class [Line Items]
Gross Carrying Amount	26,853	17,540
Accumulated Amortization	(7,718)	(5,436)
Net Carrying Amount	19,135	12,104
Non-compete Agreements
Schedule of Acquired Intangible Assets By Major Class [Line Items]
Gross Carrying Amount	572	190
Accumulated Amortization	(276)	(72)
Net Carrying Amount	296	118
Acquired Technology
Schedule of Acquired Intangible Assets By Major Class [Line Items]
Gross Carrying Amount	8,730	7,030
Accumulated Amortization	(2,085)	(866)
Net Carrying Amount	$ 6,645	$ 6,164

Goodwill and Identifiable Int47

Goodwill and Identifiable Intangible Assets - Estimated Amortization Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Goodwill and Intangible Assets Disclosure [Abstract]
Aggregate amortization expense, intangible assets	$ 11,784	$ 7,639
Year ending December 31, 2016	11,948
Year ending December 31, 2017	11,613
Year ending December 31, 2018	10,540
Year ending December 31, 2019	9,835
Year ending December 31, 2020	6,917
Thereafter	34,717
Net Carrying Amount	$ 85,570	$ 63,117

Goodwill and Identifiable Int48

Goodwill and Identifiable Intangible Assets - Changes in the Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Goodwill [Roll Forward]
Beginning Balance	$ 154,387	$ 144,642
Ending Balance	204,779	154,387
Accumulated impairment loss	214,939	214,939
Nurse and Allied Healthcare Staffing
Goodwill [Roll Forward]
Beginning Balance	107,556	97,811
Ending Balance	149,341	107,556
Accumulated impairment loss	154,444	154,444
Locum Tenens Staffing
Goodwill [Roll Forward]
Beginning Balance	14,502	14,502
Ending Balance	19,743	14,502
Accumulated impairment loss	53,940	53,940
Physician Permanent Placement Services
Goodwill [Roll Forward]
Beginning Balance	32,329	32,329
Ending Balance	35,695	32,329
Accumulated impairment loss	6,555	6,555
Shiftwise Acquisition
Goodwill [Roll Forward]
Goodwill adjustment for acquisition		(5)
Shiftwise Acquisition | Nurse and Allied Healthcare Staffing
Goodwill [Roll Forward]
Goodwill adjustment for acquisition		(5)
Shiftwise Acquisition | Locum Tenens Staffing
Goodwill [Roll Forward]
Goodwill adjustment for acquisition		0
Shiftwise Acquisition | Physician Permanent Placement Services
Goodwill [Roll Forward]
Goodwill adjustment for acquisition		0
Avantas Acquisition
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	165
Goodwill from acquisition		9,750
Avantas Acquisition | Nurse and Allied Healthcare Staffing
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	165
Goodwill from acquisition		9,750
Avantas Acquisition | Locum Tenens Staffing
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	0
Goodwill from acquisition		0
Avantas Acquisition | Physician Permanent Placement Services
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	0
Goodwill from acquisition		$ 0
Onward Healthcare Acquisition
Goodwill [Roll Forward]
Goodwill from acquisition	42,633
Onward Healthcare Acquisition | Nurse and Allied Healthcare Staffing
Goodwill [Roll Forward]
Goodwill from acquisition	37,392
Onward Healthcare Acquisition | Locum Tenens Staffing
Goodwill [Roll Forward]
Goodwill from acquisition	5,241
Onward Healthcare Acquisition | Physician Permanent Placement Services
Goodwill [Roll Forward]
Goodwill from acquisition	0
The First String Healthcare Acquisition
Goodwill [Roll Forward]
Goodwill from acquisition	4,228
The First String Healthcare Acquisition | Nurse and Allied Healthcare Staffing
Goodwill [Roll Forward]
Goodwill from acquisition	4,228
The First String Healthcare Acquisition | Locum Tenens Staffing
Goodwill [Roll Forward]
Goodwill from acquisition	0
The First String Healthcare Acquisition | Physician Permanent Placement Services
Goodwill [Roll Forward]
Goodwill from acquisition	0
MillicanSolutions Acquisition
Goodwill [Roll Forward]
Goodwill from acquisition	3,366
MillicanSolutions Acquisition | Nurse and Allied Healthcare Staffing
Goodwill [Roll Forward]
Goodwill from acquisition	0
MillicanSolutions Acquisition | Locum Tenens Staffing
Goodwill [Roll Forward]
Goodwill from acquisition	0
MillicanSolutions Acquisition | Physician Permanent Placement Services
Goodwill [Roll Forward]
Goodwill from acquisition	$ 3,366

Balance Sheet Details (Details)

Balance Sheet Details (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Other current assets:
Restricted cash	$ 11,995	$ 9,054
Income taxes receivable	3,687	3,503
Other	8,041	4,643
Other current assets	23,723	17,200
Fixed assets:
Furniture and equipment	23,380	17,761
Technology and software	97,962	78,593
Leasehold improvements	5,472	5,340
Fixed Assets, Gross	126,814	101,694
Accumulated depreciation	(76,680)	(68,814)
Fixed assets, net	50,134	32,880
Accounts payable and accrued expenses:
Trade accounts payable	53,261	30,039
Subcontractor payable	56,177	33,474
Professional liability reserve	7,962	7,380
Overdraft	124	6,338
Other	1,298	1,762
Accounts payable and accrued expenses	118,822	78,993
Accrued compensation and benefits:
Accrued payroll	21,058	21,857
Accrued bonuses and commissions	24,476	15,196
Accrued travel expense	2,740	2,413
Accrued health insurance reserve	3,225	1,871
Accrued workers compensation reserve	7,701	5,830
Deferred compensation	23,044	20,729
Other	1,457	99
Accrued compensation and benefits	83,701	67,995
Other long-term liabilities:
Workers compensation reserve	16,899	13,855
Professional liability reserve	37,369	30,722
Deferred rent	11,826	8,122
Unrecognized tax benefits	8,081	21,706
Other	3,959	3,269
Other long-term liabilities	$ 78,134	$ 77,674

Income Taxes - Provision (Detai

Income Taxes - Provision (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Current income taxes:
Federal	$ 22,552	$ 10,787	$ 17,268
State	3,969	2,883	2,605
Total	26,521	13,670	19,873
Deferred income taxes:
Federal	8,896	10,430	1,693
State	3,781	1,349	1,338
Total	12,677	11,779	3,031
Income tax expense from operations	$ 39,198	$ 25,449	$ 22,904

Income Taxes - Income Tax Expen

Income Taxes - Income Tax Expense Allocation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Provision for income taxes from operations	$ 39,198	$ 25,449	$ 22,904
Shareholders' equity, for compensation expense for tax purposes in excess of amounts recognized for financial reporting purposes	(7,176)	(978)	(1,167)
Income tax from operations including excess tax windfall from stock compensation	$ 32,022	$ 24,471	$ 21,737

Income Taxes - Reconciliation (

Income Taxes - Reconciliation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Federal statutory tax rate	35.00%	35.00%	35.00%
Income tax reconciliation
Tax expense at federal statutory rate	$ 42,381	$ 20,533	$ 19,543
State taxes, net of federal benefit	5,260	2,551	2,302
Non-deductible expenses	3,505	1,816	0
Unrecognized tax benefit	(11,464)	971	1,952
Other, net	(484)	(422)	(893)
Income tax expense from operations	$ 39,198	$ 25,449	$ 22,904

Income Taxes - Deferred Tax Ass

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Deferred Tax Assets, Net [Abstract]
Stock compensation	$ 10,170	$ 11,217
Deferred revenue	956	573
Allowance for doubtful accounts	1,971	1,467
Deferred compensation	9,153	8,142
Accrued expenses	24,932	20,475
Deferred rent	4,885	3,420
Net operating losses	8,809	14,354
State taxes	1,945	1,346
Other	0	2,265
Total deferred tax assets	62,821	63,259
Deferred tax liabilities:
Intangibles	(67,574)	(57,316)
Fixed assets	(15,155)	(8,453)
Prepaid expenses	(1,224)	(1,427)
Other	(256)	0
Total deferred tax liabilities	(84,209)	(67,196)
Valuation allowance	(1,043)	(1,224)
Net deferred tax liabilities	$ (22,431)	$ (5,161)

Income Taxes - Operating Loss C

Income Taxes - Operating Loss Carryforwards (Details) $ in Thousands	Dec. 31, 2015USD ($)
Federal
Operating Loss Carryforwards
Operating loss carryforwards	$ 20,164
State
Operating Loss Carryforwards
Operating loss carryforwards	$ 27,717

Income Taxes - Unrecognized Tax

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Jul. 31, 2015	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2016	Sep. 30, 2015
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Beginning balance of unrecognized tax benefits		$ 22,890	$ 22,573	$ 21,415
Additions based on tax positions related to the current year		0	317	809
Additions based on tax positions of prior years		395	0	349
Reductions due to lapse of applicable statute of limitation		(214)	0	0
Settlements		(16,534)	0	0
Ending balance of unrecognized tax benefits		6,537	22,890	22,573
Unrecognized tax benefits that would affect the effective tax rate		6,373
Accrued interest and penalties related to uncertain tax positions		1,544	5,815	4,605
Interest and penalties recognized		$ (4,272)	$ 1,211	$ 1,427
Domestic Tax Authority
Income Tax Contingency [Line Items]
Federal income tax benefit						$ 12,200
State | Scenario, Forecast
Income Tax Contingency [Line Items]
Federal income tax benefit					$ 1,500
Federal | Domestic Tax Authority
Income Tax Contingency [Line Items]
IRS settlement amount	$ 7,200

Notes Payable and Credit Agre56

Notes Payable and Credit Agreement (Details)	Jan. 04, 2016USD ($)	Apr. 18, 2014USD ($)credit_facility	Dec. 31, 2014USD ($)	Dec. 31, 2015USD ($)
Line of Credit Facility [Line Items]
Fees paid to lenders and other third parties			$ 3,488,000
Write off of unamortized financing fees and original issue discount			3,113,000
Long-term debt due in next 12 months				$ 7,500,000
Standby Letters of Credit
Line of Credit Facility [Line Items]
Letters of credit, amount outstanding			$ 15,006,000	15,788,000
Debt collateral				$ 5,627,000
Line of Credit
Line of Credit Facility [Line Items]
Number of credit facilities | credit_facility		2
Credit facility, available		$ 125,000,000
Line of Credit | Subsequent Event
Line of Credit Facility [Line Items]
Credit facility, available	$ 125,000,000
Line of Credit | Revolving Credit Facility, Swing Line Loan
Line of Credit Facility [Line Items]
Credit facility, available		20,000,000
Line of Credit | Revolving Credit Facility
Line of Credit Facility [Line Items]
Credit facility, available		$ 225,000,000
Line of Credit | Revolving Credit Facility | Subsequent Event
Line of Credit Facility [Line Items]
Credit facility, available	275,000,000
Line of Credit | Revolving Credit Facility | Minimum
Line of Credit Facility [Line Items]
Unused fee, percent		0.25%
Letter of credit fee		1.50%
Line of Credit | Revolving Credit Facility | Maximum
Line of Credit Facility [Line Items]
Unused fee, percent		0.35%
Letter of credit fee		2.25%
Line of Credit | Term Loan
Line of Credit Facility [Line Items]
Credit facility, available		$ 150,000,000
Amortization rate		5.00%
Annual principal payment		$ 7,500,000
Interest rate				2.20%
Long-term debt due in next 12 months				$ 7,500,000
Additional borrowing capacity		50,000,000
Line of Credit | Term Loan | Subsequent Event
Line of Credit Facility [Line Items]
Credit facility, available	$ 75,000,000
Amortization rate	5.00%
Line of Credit | Letter of Credit
Line of Credit Facility [Line Items]
Credit facility, available		$ 40,000,000
Available credit				132,339,000
Debt collateral				10,161,000
Line of Credit | LIBOR | Revolving Credit Facility | Minimum
Line of Credit Facility [Line Items]
Interest rates spread over LIBOR and Base rate		1.50%
Line of Credit | LIBOR | Revolving Credit Facility | Maximum
Line of Credit Facility [Line Items]
Interest rates spread over LIBOR and Base rate		2.25%
Line of Credit | LIBOR | Term Loan | Minimum
Line of Credit Facility [Line Items]
Interest rates spread over LIBOR and Base rate		1.50%
Line of Credit | LIBOR | Term Loan | Maximum
Line of Credit Facility [Line Items]
Interest rates spread over LIBOR and Base rate		2.25%
Line of Credit | Base Rate | Revolving Credit Facility | Minimum
Line of Credit Facility [Line Items]
Interest rates spread over LIBOR and Base rate		0.50%
Line of Credit | Base Rate | Revolving Credit Facility | Maximum
Line of Credit Facility [Line Items]
Interest rates spread over LIBOR and Base rate		1.25%
Line of Credit | Base Rate | Term Loan | Minimum
Line of Credit Facility [Line Items]
Interest rates spread over LIBOR and Base rate		0.50%
Line of Credit | Base Rate | Term Loan | Maximum
Line of Credit Facility [Line Items]
Interest rates spread over LIBOR and Base rate		1.25%
Revolver | Line of Credit | Revolving Credit Facility
Line of Credit Facility [Line Items]
Outstanding balance				82,500,000
Unamortized Debt Issuance Expense				885,000
Term Loan | Line of Credit | Term Loan
Line of Credit Facility [Line Items]
Outstanding balance				$ 136,875,000

Notes Payable and Credit Agre57

Notes Payable and Credit Agreement - Maturities (Details) $ in Thousands	Dec. 31, 2015USD ($)
Maturities of Long-term Debt [Abstract]
Year ending December 31, 2016	$ 7,500
Year ending December 31, 2017	7,500
Year ending December 31, 2018	7,500
Year ending December 31, 2019	114,375
Thereafter	0
Total credit agreement debt	$ 136,875

Retirement Plans - 401(k) Retir

Retirement Plans - 401(k) Retirement Savings Plan (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Compensation and Retirement Disclosure [Abstract]
Employer contributions, net of forfeitures	$ 1,225	$ 553	$ 165

Retirement Plans - Deferred Com

Retirement Plans - Deferred Compensation Plan(Details) - Key Executives and Key Employees - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items]
Service vesting period	5 years
Maximum percent of base salary deferrable	80.00%
Maximum percent of bonus deferrable	90.00%
Maximum percent of vested RSUs and PRSUs deferrable	100.00%
Employer contributions	$ 974	$ 595	$ 384

Capital Stock (Details)

Capital Stock (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013	Jun. 30, 2013	Dec. 31, 2012
Preferred Stock, Number of Shares, Par Value and Other Disclosures [Abstract]
Preferred stock total shares including Series A	10,000,000	10,000,000
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares outstanding	0	0
Treasury Stock, Number of Shares and Restriction Disclosures [Abstract]
Common stock remaining in escrow (shares)					457,000
Common Stock Released From Escrow				457,000
Number of shares returned to the Company			204,000	204,000
Holdback settlement in equity from prior acquisition	$ 0	$ 0	$ 3,046
Number of shares released from escrow				253,000

Share-Based Compensation - Text

Share-Based Compensation - Textual (Details) - USD ($) $ in Thousands	Apr. 18, 2012	Apr. 09, 2009	Apr. 18, 2007	Apr. 12, 2006	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013	Feb. 28, 2014	Dec. 31, 2006
Stock Options and Stock Appreciation Rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total intrinsic value of share-based payment award exercised					$ 10,505	$ 770	$ 980
Total intrinsic value of share-based payment award outstanding and exercisable					$ 7,013	10,142
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period					3 years
Total unrecognized compensation cost					$ 9,841
Unrecognized compensation cost, weighted average remaining period					1 year 9 months 18 days
Aggregate intrinsic value					$ 38,400	$ 30,876
Stock Option Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of common stock transferred between plans				371,000
Stock Option Plan | Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized for issuance					4,178,000
Stock Option Plan | Stock Options and Stock Appreciation Rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of equity awards reserved for future issuance					0
Number of equity awards outstanding					0
Equity Plan | Stock Options and Stock Appreciation Rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized for issuance									723,000
Number of equity awards reserved for future issuance					2,128,000	2,421,000
Contractual life of stock options and SARs					10 years
Additional number of shares authorized	2,400,000	1,850,000	3,000,000
2014 Employee Inducement Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized for issuance								200,000
Shares of common stock available for future grants					200,000

Share-Based Compensation - Rest

Share-Based Compensation - Restricted Stock Units (Details) - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Number of Shares
Unvested Shares, Beginning Balance	1,575	1,637	1,659
Vested shares	(1,081)	(838)	(588)
Canceled/forfeited/expired shares	(76)	(120)	(10)
Unvested Shares, Ending Balance	1,237	1,575	1,637
Weighted Average Grant Date Fair Value (in dollars per share) per Share
Unvested weighted average fair value per share, Beginning Balance	$ 11.95	$ 9.73	$ 7.53
Vested weighted average fair value per share	9.13	8.63	7.02
Canceled/forfeited/expired weighted average fair value per share	15.45	12.16	13.06
Unvested weighted average fair value per share, Ending Balance	$ 16.73	$ 11.95	$ 9.73
Restricted Stock Units (RSUs)
Number of Shares
Granted shares	203	361	285
Weighted Average Grant Date Fair Value (in dollars per share) per Share
Granted weighted average fair value per share	$ 22.43	$ 13.76	$ 12.86
Performance Restricted Stock Units (PRSUs)
Number of Shares
Granted shares	616	535	291
Weighted Average Grant Date Fair Value (in dollars per share) per Share
Granted weighted average fair value per share	$ 13.58	$ 14.97	$ 13.86

Share-Based Compensation - Summ

Share-Based Compensation - Summary of Stock Option and SAR Activity (Details) - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Stock Option Plan | Stock Options
Stock Option Plan, Number Outstanding (shares)
Number outstanding, Beginning balance	245	589	698
Number outstanding, granted	0	0	0
Number outstanding, exercised	(245)	(117)	(109)
Number outstanding, canceled/forfeited/expired	0	(227)	0
Number outstanding, Ending balance	0	245	589
Vested and expected to vest (shares)	0
Exercisable (shares)	0
Stock Option Plan, Weighted-Average Exercise Price per Share (in dollars per share)
Weighted-average exercise price per share, Beginning balance	$ 14.93	$ 14.92	$ 14.34
Weighted-average exercise price per share, granted	0	0	0
Weighted-average exercise price per share, exercised	14.93	14.86	11.23
Weighted-average exercise price per share, canceled/forfeited/expired	0	14.94	0
Weighted-average exercise price per share, Ending balance	0	$ 14.93	$ 14.92
Vested and expected to vest (usd per share)	0
Exercisable (usd per share)	$ 0
Equity Plan and Other Plans | Stock Appreciation Rights (SARs)
Equity Plan and Other Plans, Number Outstanding (shares)
Number outstanding, Beginning balance	948	1,096	1,241
Number outstanding, granted	0	0	0
Number outstanding, exercised	(615)	(142)	(132)
Number outstanding, canceled/forfeited/expired	(1)	(6)	(13)
Number outstanding, Ending balance	332	948	1,096
Vested and expected to vest (shares)	332
Exercisable (shares)	332
Equity Plan and Other Plans, Weighted-Average Exercise Price per Share (in dollars per share)
Weighted-average exercise price per share, Beginning balance	$ 10.61	$ 10.78	$ 10.57
Weighted-average exercise price per share, granted	0	0	0
Weighted-average exercise price per share, exercised	10.79	11.53	8.31
Weighted-average exercise price per share, canceled/forfeited/expired	24.95	19.69	15.19
Weighted-average exercise price per share, Ending balance	10.26	$ 10.61	$ 10.78
Vested and expected to vest (usd per share)	10.26
Exercisable (usd per share)	$ 10.26

Share-Based Compensation - Shar

Share-Based Compensation - Share Based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-based employee compensation, before tax	$ 10,284	$ 7,157	$ 6,125
Related income tax benefits	(3,990)	(2,783)	(2,383)
Share-based employee compensation, net of tax	$ 6,294	$ 4,374	$ 3,742

Commitments and Contingencies -

Commitments and Contingencies - Capital and Operating Leases (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Operating Leases
2,016	$ 15,933
2,017	14,619
2,018	13,545
2,019	12,469
2,020	11,899
Thereafter	81,187
Total minimum lease payments	149,652
Rent expense under operating leases for continuing operations	$ 15,940	$ 14,136	$ 14,205

Quarterly Financial Data (Una66

Quarterly Financial Data (Unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Selected Quarterly Financial Information [Abstract]
Revenue	$ 402,552	$ 382,859	$ 350,144	$ 327,510	$ 279,649	$ 264,584	$ 250,913	$ 240,881	$ 1,463,065	$ 1,036,027	$ 1,011,816
Gross profit	131,804	126,009	110,118	101,432	84,696	80,306	77,159	73,956	469,363	316,117	297,280
Net income	$ 20,165	$ 33,647	$ 15,870	$ 12,209	$ 9,895	$ 8,499	$ 7,193	$ 7,630	$ 81,891	$ 33,217	$ 32,933
Basic (in dollars per share)	$ 0.42	$ 0.71	$ 0.33	$ 0.26	$ 0.21	$ 0.18	$ 0.15	$ 0.16	$ 1.72	$ 0.71	$ 0.72
Diluted (in dollars per share)	$ 0.41	$ 0.69	$ 0.32	$ 0.25	$ 0.20	$ 0.18	$ 0.15	$ 0.16	$ 1.68	$ 0.69	$ 0.69

Subsequent Events (Details)

Subsequent Events (Details) - USD ($)	Jan. 11, 2016	Jan. 04, 2016	Apr. 18, 2014
Line of Credit
Subsequent Event [Line Items]
Credit facility, available			$ 125,000,000
Subsequent Event | B.E. Smith Acquisition
Subsequent Event [Line Items]
Cash consideration		$ 163,750,000
Subsequent Event | HealthSource Global Staffing Acquisition
Subsequent Event [Line Items]
Cash consideration	$ 6,500,000
Contingent earn-out based on future operating performance (up to)	$ 4,000,000
Subsequent Event | HealthSource Global Staffing Acquisition | Minimum
Subsequent Event [Line Items]
Rapid response period, Acute-care facilities	7 days
Rapid response period, traveling and allied healthcare	21 days
Subsequent Event | HealthSource Global Staffing Acquisition | Maximum
Subsequent Event [Line Items]
Rapid response period, Acute-care facilities	14 days
Rapid response period, traveling and allied healthcare	35 days
Subsequent Event | Line of Credit
Subsequent Event [Line Items]
Credit facility, available		$ 125,000,000