AMN Healthcare Services (AMN) 10-Q 5 May 17 2017 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2017	May 03, 2017
Document and Entity Information [Abstract]
Entity Registrant Name	AMN HEALTHCARE SERVICES INC
Entity Central Index Key	1,142,750
Document Type	10-Q
Document Period End Date	Mar. 31, 2017
Amendment Flag	false
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding (excluding treasury shares)		47,901,973

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Current assets:
Cash and cash equivalents	$ 37,711	$ 10,622
Accounts receivable, net of allowances of $15,171 and $11,376 at March 31, 2017 and December 31, 2016, respectively	334,782	341,977
Accounts receivable, subcontractor	48,838	49,233
Prepaid expenses	19,498	14,189
Other current assets	31,395	34,607
Total current assets	472,224	450,628
Restricted cash, cash equivalents and investments	29,141	31,287
Fixed assets, net of accumulated depreciation of $87,843 and $84,865 at March 31, 2017 and December 31, 2016, respectively	62,620	59,954
Other assets	65,368	57,534
Goodwill	340,564	341,754
Intangible assets, net of accumulated amortization of $76,652 and $72,057 at March 31, 2017 and December 31, 2016, respectively	241,130	245,724
Total assets	1,211,047	1,186,881
Current liabilities:
Accounts payable and accrued expenses	136,028	137,512
Accrued compensation and benefits	99,642	107,993
Current portion of notes payable	3,750	3,750
Deferred revenue	8,840	8,924
Other current liabilities	29,428	16,611
Total current liabilities	277,688	274,790
Notes payable, less unamortized fees	358,512	359,192
Deferred income taxes, net	16,548	21,420
Other long-term liabilities	81,494	82,096
Total liabilities	734,242	737,498
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at March 31, 2017 and December 31, 2016	0	0
Common stock, $0.01 par value; 200,000 shares authorized; 48,326 issued and 47,883 shares issued and outstanding, respectively, at March 31, 2017 and 48,055 shares issued and 47,612 issued and outstanding, respectively, at December 31, 2016	483	481
Additional paid-in capital	447,857	452,491
Treasury stock, at cost (443 shares at March 31, 2017 and December 31, 2016)	(13,261)	(13,261)
Retained earnings	41,679	9,671
Accumulated other comprehensive income	47	1
Total stockholders’ equity	476,805	449,383
Total liabilities and stockholders’ equity	$ 1,211,047	$ 1,186,881

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 15,171	$ 11,376
Accumulated depreciation	87,843	84,865
Accumulated amortization	$ 76,652	$ 72,057
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	48,326,000	48,055,000
Common stock, shares outstanding	47,883,000	47,612,000
Treasury stock, shares	443,000	443,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Statement of Comprehensive Income [Abstract]
Revenue	$ 495,169	$ 468,002
Cost of revenue	333,393	316,104
Gross profit	161,776	151,898
Operating expenses:
Selling, general and administrative	102,073	97,823
Depreciation and amortization	7,668	6,765
Total operating expenses	109,741	104,588
Income from operations	52,035	47,310
Interest expense, net, and other	5,130	3,249
Income before income taxes	46,905	44,061
Income tax expense	14,897	18,192
Net income	32,008	25,869
Other comprehensive income (loss):
Foreign currency translation and other	3	39
Unrealized gain (loss) on cash flow hedge, net of income taxes	43	(463)
Other comprehensive income (loss)	46	(424)
Comprehensive income	$ 32,054	$ 25,445
Net income per common share:
Basic (in dollars per share)	$ 0.67	$ 0.54
Diluted (in dollars per share)	$ 0.65	$ 0.53
Weighted average common shares outstanding:
Basic (shares)	47,782	47,894
Diluted (shares)	49,520	49,103

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Cash flows from operating activities:
Net income	$ 32,008	$ 25,869
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	7,668	6,765
Non-cash interest expense and other	579	576
Change in fair value of contingent consideration	23	99
Increase in allowances for doubtful accounts and sales credits	5,408	2,687
Provision for deferred income taxes	(4,900)	(1,201)
Share-based compensation	2,681	3,381
Excess tax benefits from share-based compensation	0	(2,322)
Loss on disposal or sale of fixed assets	65	0
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable	1,787	(15,219)
Accounts receivable, subcontractor	395	916
Income taxes receivable	361	6,006
Prepaid expenses	(5,309)	(2,469)
Other current assets	2,945	(1,477)
Other assets	(3,139)	(2,471)
Accounts payable and accrued expenses	(1,599)	(10,229)
Accrued compensation and benefits	(8,351)	9,775
Other liabilities	16,825	14,079
Deferred revenue	(84)	286
Restricted cash, cash equivalents and investments balance	4,951	176
Net cash provided by operating activities	52,314	35,227
Cash flows from investing activities:
Purchase and development of fixed assets	(5,498)	(6,618)
Purchase of investments	(4,804)	0
Proceeds from maturity of investments	2,000	0
Change in restricted cash, cash equivalents and investments balance	(1)	0
Payments to fund deferred compensation plan	(4,998)	(2,855)
Cash paid for acquisitions, net of cash received	0	(165,230)
Net cash used in investing activities	(13,301)	(174,703)
Cash flows from financing activities:
Payments on term loans	(938)	(2,813)
Proceeds from term loans	0	75,000
Proceeds from revolving credit facility	0	85,000
Payment of financing costs	0	(448)
Earn-out payments for prior acquisitions	(3,677)	(900)
Cash paid for shares withheld for taxes	(7,313)	(5,194)
Excess tax benefits from equity awards vested and exercised	0	2,322
Net cash provided by (used in) financing activities	(11,928)	152,967
Effect of exchange rate changes on cash	4	39
Net increase in cash and cash equivalents	27,089	13,530
Cash and cash equivalents at beginning of period	10,622	9,576
Cash and cash equivalents at end of period	37,711	23,106
Supplemental disclosures of cash flow information:
Cash paid for interest (net of $22 and $264 capitalized for the three months ended March 31, 2017 and 2016, respectively)	545	2,295
Cash paid for income taxes	2,812	2,418
Acquisitions:
Fair value of tangible assets acquired in acquisitions, net of cash received	0	12,706
Goodwill	0	101,531
Intangible assets	0	69,844
Liabilities assumed	0	(13,139)
Holdback provision	0	(2,122)
Earn-out liabilities	0	(3,590)
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses	$ 2,440	$ 2,489

Condensed Consolidated Stateme6

Condensed Consolidated Statements of Cash Flows (Unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Statement of Cash Flows [Abstract]
Interest capitalized	$ 22	$ 264

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BASIS OF PRESENTATION	BASIS OF PRESENTATION The condensed consolidated balance sheets and related condensed consolidated statements of comprehensive income and cash flows contained in this Quarterly Report on Form 10-Q (this “Quarterly Report”), which are unaudited, include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries (collectively, the “Company”). All significant intercompany balances and transactions have been eliminated in consolidation. In the opinion of management, all entries necessary for a fair presentation of such unaudited condensed consolidated financial statements have been included. These entries consisted of all normal recurring items. The results of operations for the interim period are not necessarily indicative of the results to be expected for any other interim period or for the entire fiscal year or for any future period. The unaudited condensed consolidated financial statements do not include all information and notes necessary for a complete presentation of financial position, results of operations and cash flows in conformity with accounting principles generally accepted in the United States. Please refer to the Company’s audited consolidated financial statements and the related notes for the fiscal year ended December 31, 2016 , contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2016 , filed with the Securities and Exchange Commission on February 17, 2017 (“ 2016 Annual Report”). The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. On an ongoing basis, the Company evaluates its estimates, including those related to asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation, earn-out liabilities, and income taxes. Actual results could differ from those estimates under different assumptions or conditions. Recently Adopted Accounting Pronouncements In March 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2016-09, “Stock Compensation - Improvements to Employee Share-Based Payment Accounting.” The guidance attempts to simplify the accounting for share-based payment transactions in several areas, including the following: income tax consequences, classification of awards as either equity or liabilities, forfeitures, expected term, and statement of cash flows classification. The Company adopted this pronouncement prospectively beginning January 1, 2017. Accordingly, the prior period has not been adjusted and the primary effects of the adoption for the current period are as follows: • The Company recorded $4,297 of tax benefits within income tax expense for the three months ended March 31, 2017 related to the excess tax benefit on share-based compensation. Prior to adoption, this amount would have been recorded as additional paid-in capital; • The Company continued to estimate the number of awards expected to be forfeited in accordance with its existing accounting policy, which is to estimate forfeitures when recording share-based compensation expense; • The Company excluded the excess tax benefits from the assumed proceeds available to repurchase shares in the computation of its diluted earnings per share for the three months ended March 31, 2017 . The effect of this change on its diluted earnings per share was not significant; • For the three months ended March 31, 2017 , cash flows related to excess tax benefits were classified as an operating activity. There were no other material impacts to the Company's consolidated financial statements as a result of adopting this updated standard.

Business Combinations

Business Combinations	3 Months Ended
	Mar. 31, 2017
Business Combinations [Abstract]
BUSINESS COMBINATIONS	BUSINESS COMBINATIONS As set forth below, the Company completed three acquisitions since January 1, 2016 (all occurred during 2016). 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. Peak Provider Solutions Acquisition On June 3, 2016, the Company completed its acquisition of Peak Provider Solutions (“Peak”), which provides remote medical coding and consulting solutions to hospitals and physician medical groups nationwide. The addition of Peak has expanded the Company’s workforce solutions and enables the Company to offer services in coding diagnosis and procedure codes, which is critical to clinical quality reporting and the financial health of healthcare organizations. The initial purchase price of $52,125 included (1) $51,645 cash consideration paid upon acquisition, funded through cash-on-hand, net of cash received, and borrowings under the Company’s revolving credit facility, and (2) a contingent earn-out payment of up to $3,000 with an estimated fair value of $480 as of the acquisition date. The contingent earn-out payment was based on the operating results of Peak for the year ending December 31, 2016, which resulted in no earn-out payment. As the acquisition was not considered significant, pro forma information is not provided. The results of Peak have been included in the Company’s other workforce solutions segment since the date of acquisition. During the third quarter of 2016, an additional $275 of cash consideration was paid to the selling shareholders for the final working capital settlement. The preliminary allocation of the $52,400 purchase price, which included the additional cash consideration paid for the final working capital settlement, consisted of (1) $5,658 of fair value of tangible assets acquired, (2) $9,314 of liabilities assumed, (3) $19,220 of identified intangible assets, and (4) $36,836 of goodwill, none of which is deductible for tax purposes. The fair value of intangible assets primarily includes $7,600 of trademarks and $11,500 of customer relationships with a weighted average useful life of approximately thirteen years. HealthSource Global Staffing Acquisition On January 11, 2016, the Company completed its acquisition of HealthSource Global Staffing (“HSG”), which provides labor disruption and rapid response staffing. The acquisition helps the Company expand its service lines and provide clients with rapid response staffing services. The initial purchase price of $8,511 included (1) $2,799 cash consideration paid upon acquisition, funded through cash-on-hand, net of cash received, and settlement of the pre-existing relationship between AMN and HSG, (2) $2,122 cash holdback for potential indemnification claims, and (3) a tiered contingent earn-out payment of up to $4,000 with an estimated fair value of $3,590 as of the acquisition date. The contingent earn-out payment is comprised of (A) up to $2,000 based on the operating results of HSG for the year ending December 31, 2016, of which, $1,930 was paid in March 2017, and (B) up to $2,000 based on the operating results of HSG for the year ending December 31, 2017. As the acquisition was not considered significant, pro forma information is not provided. The results of HSG have been included in the Company’s nurse and allied solutions segment since the date of acquisition. During the third quarter of 2016, the final working capital settlement resulted in $292 due from the selling shareholders to the Company, which was settled through a reduction to a cash holdback. The allocation of the $8,219 purchase price, which was reduced by the final working capital settlement, consisted of (1) $1,025 of fair value of tangible assets acquired, (2) $3,698 of liabilities assumed, (3) $3,944 of identified intangible assets, and (4) $6,948 of goodwill, none of which is deductible for tax purposes. The intangible assets include the fair value of trademarks, customer relationships, staffing databases, and covenants not to compete with a weighted average useful life of approximately eight years. B.E. Smith Acquisition On January 4, 2016, the Company completed its acquisition of B.E. Smith (“BES”), a full-service healthcare interim leadership placement and executive search firm, for $162,232 in cash, net of cash received, and settlement of the pre-existing relationship between AMN and BES. BES 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 provides 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 to the Credit Agreement (the “First Amendment”), which provided $125,000 of additional available borrowings to the Company. The First Amendment was more fully described in “Item 8. Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of our 2016 Annual Report. The results of BES have been included in the Company’s other workforce solutions segment since the date of acquisition. During the second quarter of 2016, $524 was returned to the Company for the final working capital settlement. The allocation of the $161,708 purchase price, which was reduced by the final working capital settlement, consisted of (1) $11,953 of fair value of tangible assets acquired, (2) $7,272 of liabilities assumed, (3) $65,900 of identified intangible assets, and (4) $91,127 of goodwill, most of which is deductible for tax purposes. The intangible assets acquired have a weighted average useful life of approximately fifteen years. The following table summarizes the fair value and useful life of each intangible asset acquired: Fair Value Useful Life (in years) Identifiable intangible assets Tradenames and Trademarks $26,300 20 Customer Relationships 25,700 12 Staffing Database 13,000 10 Non-Compete Agreements 900 5 $65,900

Revenue Recognition

Revenue Recognition	3 Months Ended
	Mar. 31, 2017
Revenue Recognition [Abstract]
REVENUE RECOGNITION	REVENUE RECOGNITION Revenue consists of fees earned from the temporary and permanent placement of healthcare professionals and executives as well as from the Company’s SaaS-based technology, including its vendor management systems and its scheduling software. Revenue from temporary staffing services is recognized as the services are rendered by the healthcare professional or executive. 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. Payables to subcontractors of $49,915 and $51,973 were included in accounts payable and accrued expenses in the unaudited condensed consolidated balance sheet as of March 31, 2017 and the audited consolidated balance sheet as of December 31, 2016 , respectively. 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.

Net Income Per Common Share

Net Income Per Common Share	3 Months Ended
	Mar. 31, 2017
Earnings Per Share [Abstract]
NET INCOME PER COMMON SHARE	NET INCOME PER COMMON SHARE Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. The following table sets forth the computation of basic and diluted net income per common share for the three months ended March 31, 2017 and 2016 , respectively: Three Months Ended March 31, 2017 2016 Net income $ 32,008 $ 25,869 Net income per common share - basic $ 0.67 $ 0.54 Net income per common share - diluted $ 0.65 $ 0.53 Weighted average common shares outstanding - basic 47,782 47,894 Plus dilutive effect of potential common shares 1,738 1,209 Weighted average common shares outstanding - diluted 49,520 49,103 Share-based awards to purchase 43 shares of common stock were not included in the above calculation of diluted net income per common share for the three months ended March 31, 2016 , because the effect of these instruments was anti-dilutive.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2017
Segment Reporting [Abstract]
SEGMENT INFORMATION	SEGMENT INFORMATION The Company has three reportable segments: nurse and allied solutions, locum tenens solutions, and other workforce solutions. The Company’s chief operating decision maker relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation, interest expense, net, and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed. The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes: Three Months Ended March 31, 2017 2016 Revenue Nurse and allied solutions $ 313,523 $ 297,724 Locum tenens solutions 102,843 102,738 Other workforce solutions 78,803 67,540 $ 495,169 $ 468,002 Segment operating income Nurse and allied solutions $ 45,980 $ 41,618 Locum tenens solutions 12,219 13,291 Other workforce solutions 19,857 17,586 78,056 72,495 Unallocated corporate overhead 15,672 15,039 Depreciation and amortization 7,668 6,765 Share-based compensation 2,681 3,381 Interest expense, net, and other 5,130 3,249 Income before income taxes $ 46,905 $ 44,061 The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied Solutions Locum Tenens Solutions Other Workforce Solutions Total Balance, January 1, 2017 $ 104,306 $ 19,743 $ 217,705 $ 341,754 Goodwill adjustment for HSG acquisition (1,199 ) — — (1,199 ) Goodwill adjustment for Peak acquisition — — 9 9 Balance, March 31, 2017 $ 103,107 $ 19,743 $ 217,714 $ 340,564 Accumulated impairment loss as of December 31, 2016 and March 31, 2017 $ 154,444 $ 53,940 $ 6,555 $ 214,939

Fair Value Measurement

Fair Value Measurement	3 Months Ended
	Mar. 31, 2017
Fair Value Disclosures [Abstract]
FAIR VALUE MEASUREMENT	FAIR VALUE MEASUREMENT The Company’s valuation techniques and inputs used to measure fair value and the definition of the three levels (Level 1, Level 2, and Level 3) of the fair value hierarchy are disclosed in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note 4—Fair Value Measurement” of the 2016 Annual Report. The Company has not changed the valuation techniques or inputs it uses for its fair value measurement during the three months ended March 31, 2017 . 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 that are measured at fair value based on quoted prices, which are Level 1 inputs. The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company primarily consist of commercial paper that is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. Of the $23,450 commercial paper as of March 31, 2017 , $13,956 had original maturities greater than three months, which were considered available for sale securities. As of December 31, 2016 , the Company had $25,610 commercial paper, of which $11,152 had original maturities greater than three months and were considered available for sale securities. 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 March 31, 2017 , 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 the above-referenced assets and liabilities and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value: Fair Value Measurements as of March 31, 2017 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 $ 4,629 $ 4,629 $ — $ — Commercial paper 23,450 — 23,450 — Interest rate swap asset 94 — 94 — Acquisition contingent consideration earn-out liabilities (1,909 ) — — (1,909 ) Fair Value Measurements as of December 31, 2016 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 $ 4,627 $ 4,627 $ — $ — Commercial paper 25,610 — 25,610 — Interest rate swap asset 24 — 24 — Acquisition contingent consideration earn-out liabilities (6,816 ) — — (6,816 ) Level 3 Information The following table sets forth a reconciliation of changes in the fair value of contingent consideration liabilities classified as Level 3 in the fair value hierarchy: Three Months Ended March 31, 2017 2016 Balance as of January 1, $ (6,816 ) $ (3,770 ) Settlement of TFS earn-out for year ended December 31, 2015 — 1,000 Contingent consideration earn-out liability from HSG acquisition on January 11, 2016 — (3,590 ) Change in fair value of contingent consideration earn-out liability from Avantas acquisition — 660 Change in fair value of contingent consideration earn-out liability from TFS acquisition — (697 ) Change in fair value of contingent consideration earn-out liability from HSG acquisition (23 ) (62 ) Settlement of TFS earn-out for year ended December 31, 2016 3,000 — Settlement of HSG earn-out for year ended December 31, 2016 1,930 — Balance as of March 31, $ (1,909 ) $ (6,459 ) Assets Measured on a Non-Recurring Basis The Company applies fair value techniques on a non-recurring basis associated with valuing potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets, and equity method investment. The Company evaluates goodwill and indefinite-lived intangible assets annually for impairment and whenever circumstances occur indicating that goodwill might be impaired. The Company determines the fair value of its reporting units based on a combination of inputs, including the market capitalization of the Company, as well as Level 3 inputs such as discounted cash flows, which are not observable from the market, directly or indirectly. The Company determines the fair value of its indefinite-lived intangible assets using the income approach (relief-from-royalty method) based on Level 3 inputs. There were no triggering events identified and no indication of impairment of the Company’s goodwill, indefinite-lived intangible assets, long-lived assets, or equity method investment during the three months ended March 31, 2017 and 2016 . Fair Value of Financial Instruments The carrying amount of the Company’s senior notes and term loan approximate their fair values. As it relates to the term loan, the Company amended its credit facilities in January and September 2016 to increase the capacity of the revolver and to secure an additional term loan, and the variable interest rate under the revolver and the term loans (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) has remained unchanged since the amendment. As it relates to the senior notes issued in October 2016, they have a fixed rate of 5.125% and there have been no changes in available rates for similar debt since the date of issuance. See additional information in “Item 8. Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of our 2016 Annual Report. The fair value of the Company’s long-term self-insurance accruals cannot be estimated as the Company cannot reasonably determine the timing of future payments.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2017
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES The Company is subject to taxation in the U.S. and various states and foreign jurisdictions. With few exceptions, as of March 31, 2017 , the Company is no longer subject to state, local or foreign examinations by tax authorities for tax years before 2006, and the Company is no longer subject to U.S. federal income or payroll tax examinations for tax 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 for 2005 and 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 tax years 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 of the settlement, the Company recorded federal income tax benefits of approximately $12,200 during the quarter ended September 30, 2015, state income tax benefits (net of federal tax impact) of $568 for the year ended December 31, 2016, and expects to record state income tax benefits (net of federal tax impact) of approximately $1,200 by fiscal year 2019, when the various state statutes are projected to lapse. The IRS conducted and completed a separate audit of the Company’s 2011 and 2012 tax years that focused on income and employment tax issues similar to those raised in the 2007 through 2010 examination. The IRS completed its audit during the quarter ended March 31, 2015, 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 the matter is currently at IRS Appeals. The Company has met with the IRS Appeals office and will continue to meet with the IRS Appeals office during the next twelve months. The Company cannot predict with certainty the timing of a resolution of such matter. The IRS began an audit of the Company’s 2013 tax year during the quarter ended June 30, 2015. The Company believes its reserve for unrecognized tax benefits and contingent tax issues is adequate with respect to all open years. Notwithstanding the foregoing, the Company could adjust its provision for income taxes and contingent tax liability based on future developments.

Commitments and Contingencies_

Commitments and Contingencies: Legal	3 Months Ended
	Mar. 31, 2017
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES: LEGAL	COMMITMENTS AND CONTINGENCIES: LEGAL From time to time, the Company is involved in various lawsuits, claims, investigations, and proceedings that arise in the ordinary course of business. These matters typically relate to professional liability, tax, payroll, contract, competitor disputes and employee-related matters and include individual and collective lawsuits, as well as inquiries and investigations by governmental agencies regarding the Company’s employment practices. Additionally, some of the Company’s clients may also become subject to claims, governmental inquiries and investigations, and legal actions relating to services provided by the Company’s healthcare professionals. Depending upon the particular facts and circumstances, the Company may also be subject to indemnification obligations under its contracts with such clients relating to these matters. The Company records a liability when management believes an adverse outcome from a loss contingency is both probable and the amount, or a range, can be reasonably estimated. Significant judgment is required to determine both probability of loss and the estimated amount. The Company reviews its loss contingencies at least quarterly and adjusts its accruals and/or disclosures to reflect the impact of negotiations, settlements, rulings, advice of legal counsel, or other new information, as deemed necessary. The most significant matters for which the Company has established loss contingencies are class actions related to wage and hour claims. Management currently believes the probable loss related to these wage and hour claims is not material and the amount accrued by the Company for such claims is not material as of March 31, 2017 . However, losses ultimately incurred for such claims could materially differ from amounts already accrued by the Company. With regards to outstanding loss contingencies as of March 31, 2017 , which are included in accounts payable and accrued expenses in the consolidated balance sheet, the Company believes that such matters will not, either individually or in the aggregate, have a material adverse effect on its business, consolidated financial position, results of operations, or cash flows.

Balance Sheet Details

Balance Sheet Details	3 Months Ended
	Mar. 31, 2017
Balance Sheet Related Disclosures [Abstract]
BALANCE SHEET DETAILS	BALANCE SHEET DETAILS The consolidated balance sheets detail is as follows as of March 31, 2017 and December 31, 2016 : March 31, 2017 December 31, 2016 Other current assets: Restricted cash and cash equivalents $ 17,592 $ 20,271 Other 13,803 14,336 Other current assets $ 31,395 $ 34,607 Fixed assets: Furniture and equipment $ 26,487 $ 25,582 Software 116,194 112,405 Leasehold improvements 7,782 6,832 150,463 144,819 Accumulated depreciation (87,843 ) (84,865 ) Fixed assets, net $ 62,620 $ 59,954 Other assets: Life insurance cash surrender value $ 38,421 $ 32,190 Other 26,947 25,344 Other assets $ 65,368 $ 57,534 Accounts payable and accrued expenses: Trade accounts payable $ 33,158 $ 33,392 Subcontractor payable 49,915 51,973 Accrued expenses 42,174 37,251 Professional liability reserve 8,199 10,254 Other 2,582 4,642 Accounts payable and accrued expenses $ 136,028 $ 137,512 Accrued compensation and benefits: Accrued payroll $ 31,297 $ 30,917 Accrued bonuses 13,147 26,992 Accrued travel expense 3,120 2,972 Accrued health insurance reserve 3,501 3,189 Accrued workers compensation reserve 8,323 8,406 Deferred compensation 38,685 32,690 Other 1,569 2,827 Accrued compensation and benefits $ 99,642 $ 107,993 Other current liabilities: Acquisition related liabilities $ 5,016 $ 6,921 Income taxes payable 16,952 451 Other 7,460 9,239 Other current liabilities $ 29,428 $ 16,611 Other long-term liabilities: Workers’ compensation reserve $ 18,396 $ 18,708 Professional liability reserve 39,361 37,338 Deferred rent 13,761 13,274 Unrecognized tax benefits 8,586 8,464 Other 1,390 4,312 Other long-term liabilities $ 81,494 $ 82,096

Basis of Presentation (Policies

Basis of Presentation (Policies)	3 Months Ended
	Mar. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Use of Estimates	The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. On an ongoing basis, the Company evaluates its estimates, including those related to asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation, earn-out liabilities, and income taxes. Actual results could differ from those estimates under different assumptions or conditions.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In March 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2016-09, “Stock Compensation - Improvements to Employee Share-Based Payment Accounting.” The guidance attempts to simplify the accounting for share-based payment transactions in several areas, including the following: income tax consequences, classification of awards as either equity or liabilities, forfeitures, expected term, and statement of cash flows classification. The Company adopted this pronouncement prospectively beginning January 1, 2017. Accordingly, the prior period has not been adjusted and the primary effects of the adoption for the current period are as follows: • The Company recorded $4,297 of tax benefits within income tax expense for the three months ended March 31, 2017 related to the excess tax benefit on share-based compensation. Prior to adoption, this amount would have been recorded as additional paid-in capital; • The Company continued to estimate the number of awards expected to be forfeited in accordance with its existing accounting policy, which is to estimate forfeitures when recording share-based compensation expense; • The Company excluded the excess tax benefits from the assumed proceeds available to repurchase shares in the computation of its diluted earnings per share for the three months ended March 31, 2017 . The effect of this change on its diluted earnings per share was not significant; • For the three months ended March 31, 2017 , cash flows related to excess tax benefits were classified as an operating activity. There were no other material impacts to the Company's consolidated financial statements as a result of adopting this updated standard.
Revenue Recognition	Revenue consists of fees earned from the temporary and permanent placement of healthcare professionals and executives as well as from the Company’s SaaS-based technology, including its vendor management systems and its scheduling software. Revenue from temporary staffing services is recognized as the services are rendered by the healthcare professional or executive. 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.
Net Income per Common Share	Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period.
Segment Information	The Company’s chief operating decision maker relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation, interest expense, net, and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed.
Fair Value of Financial Instruments	Assets Measured on a Non-Recurring Basis The Company applies fair value techniques on a non-recurring basis associated with valuing potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets, and equity method investment. The Company evaluates goodwill and indefinite-lived intangible assets annually for impairment and whenever circumstances occur indicating that goodwill might be impaired. The Company determines the fair value of its reporting units based on a combination of inputs, including the market capitalization of the Company, as well as Level 3 inputs such as discounted cash flows, which are not observable from the market, directly or indirectly. The Company determines the fair value of its indefinite-lived intangible assets using the income approach (relief-from-royalty method) based on Level 3 inputs. 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 that are measured at fair value based on quoted prices, which are Level 1 inputs. The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company primarily consist of commercial paper that is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. Of the $23,450 commercial paper as of March 31, 2017 , $13,956 had original maturities greater than three months, which were considered available for sale securities. As of December 31, 2016 , the Company had $25,610 commercial paper, of which $11,152 had original maturities greater than three months and were considered available for sale securities. 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 Fair Value of Financial Instruments The carrying amount of the Company’s senior notes and term loan approximate their fair values. As it relates to the term loan, the Company amended its credit facilities in January and September 2016 to increase the capacity of the revolver and to secure an additional term loan, and the variable interest rate under the revolver and the term loans (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) has remained unchanged since the amendment. As it relates to the senior notes issued in October 2016, they have a fixed rate of 5.125% and there have been no changes in available rates for similar debt since the date of issuance. See additional information in “Item 8. Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of our 2016 Annual Report. The fair value of the Company’s long-term self-insurance accruals cannot be estimated as the Company cannot reasonably determine the timing of future payments.

Business Combinations (Tables)

Business Combinations (Tables)	3 Months Ended
	Mar. 31, 2017
Business Combinations [Abstract]
Summary of Fair Value and Useful Life of Each Intangible Asset Acquired	The following table summarizes the fair value and useful life of each intangible asset acquired: Fair Value Useful Life (in years) Identifiable intangible assets Tradenames and Trademarks $26,300 20 Customer Relationships 25,700 12 Staffing Database 13,000 10 Non-Compete Agreements 900 5 $65,900

Net Income Per Common Share (Ta

Net Income Per Common Share (Tables)	3 Months Ended
	Mar. 31, 2017
Earnings Per Share [Abstract]
Computation of basic and diluted net income per common share	The following table sets forth the computation of basic and diluted net income per common share for the three months ended March 31, 2017 and 2016 , respectively: Three Months Ended March 31, 2017 2016 Net income $ 32,008 $ 25,869 Net income per common share - basic $ 0.67 $ 0.54 Net income per common share - diluted $ 0.65 $ 0.53 Weighted average common shares outstanding - basic 47,782 47,894 Plus dilutive effect of potential common shares 1,738 1,209 Weighted average common shares outstanding - diluted 49,520 49,103

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2017
Segment Reporting [Abstract]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results	The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes: Three Months Ended March 31, 2017 2016 Revenue Nurse and allied solutions $ 313,523 $ 297,724 Locum tenens solutions 102,843 102,738 Other workforce solutions 78,803 67,540 $ 495,169 $ 468,002 Segment operating income Nurse and allied solutions $ 45,980 $ 41,618 Locum tenens solutions 12,219 13,291 Other workforce solutions 19,857 17,586 78,056 72,495 Unallocated corporate overhead 15,672 15,039 Depreciation and amortization 7,668 6,765 Share-based compensation 2,681 3,381 Interest expense, net, and other 5,130 3,249 Income before income taxes $ 46,905 $ 44,061
Schedule of goodwill	The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied Solutions Locum Tenens Solutions Other Workforce Solutions Total Balance, January 1, 2017 $ 104,306 $ 19,743 $ 217,705 $ 341,754 Goodwill adjustment for HSG acquisition (1,199 ) — — (1,199 ) Goodwill adjustment for Peak acquisition — — 9 9 Balance, March 31, 2017 $ 103,107 $ 19,743 $ 217,714 $ 340,564 Accumulated impairment loss as of December 31, 2016 and March 31, 2017 $ 154,444 $ 53,940 $ 6,555 $ 214,939

Fair Value Measurement (Tables)

Fair Value Measurement (Tables)	3 Months Ended
	Mar. 31, 2017
Fair Value Disclosures [Abstract]
Schedule of financial assets and liabilities measured at fair value on recurring basis	The following tables present information about the above-referenced assets and liabilities and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value: Fair Value Measurements as of March 31, 2017 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 $ 4,629 $ 4,629 $ — $ — Commercial paper 23,450 — 23,450 — Interest rate swap asset 94 — 94 — Acquisition contingent consideration earn-out liabilities (1,909 ) — — (1,909 ) Fair Value Measurements as of December 31, 2016 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 $ 4,627 $ 4,627 $ — $ — Commercial paper 25,610 — 25,610 — Interest rate swap asset 24 — 24 — Acquisition contingent consideration earn-out liabilities (6,816 ) — — (6,816 )
Reconciliations of changes in the fair value of contingent consideration liabilities	The following table sets forth a reconciliation of changes in the fair value of contingent consideration liabilities classified as Level 3 in the fair value hierarchy: Three Months Ended March 31, 2017 2016 Balance as of January 1, $ (6,816 ) $ (3,770 ) Settlement of TFS earn-out for year ended December 31, 2015 — 1,000 Contingent consideration earn-out liability from HSG acquisition on January 11, 2016 — (3,590 ) Change in fair value of contingent consideration earn-out liability from Avantas acquisition — 660 Change in fair value of contingent consideration earn-out liability from TFS acquisition — (697 ) Change in fair value of contingent consideration earn-out liability from HSG acquisition (23 ) (62 ) Settlement of TFS earn-out for year ended December 31, 2016 3,000 — Settlement of HSG earn-out for year ended December 31, 2016 1,930 — Balance as of March 31, $ (1,909 ) $ (6,459 )

Balance Sheet Details (Tables)

Balance Sheet Details (Tables)	3 Months Ended
	Mar. 31, 2017
Balance Sheet Related Disclosures [Abstract]
Schedule of Supplemental Balance Sheet Disclosures	The consolidated balance sheets detail is as follows as of March 31, 2017 and December 31, 2016 : March 31, 2017 December 31, 2016 Other current assets: Restricted cash and cash equivalents $ 17,592 $ 20,271 Other 13,803 14,336 Other current assets $ 31,395 $ 34,607 Fixed assets: Furniture and equipment $ 26,487 $ 25,582 Software 116,194 112,405 Leasehold improvements 7,782 6,832 150,463 144,819 Accumulated depreciation (87,843 ) (84,865 ) Fixed assets, net $ 62,620 $ 59,954 Other assets: Life insurance cash surrender value $ 38,421 $ 32,190 Other 26,947 25,344 Other assets $ 65,368 $ 57,534 Accounts payable and accrued expenses: Trade accounts payable $ 33,158 $ 33,392 Subcontractor payable 49,915 51,973 Accrued expenses 42,174 37,251 Professional liability reserve 8,199 10,254 Other 2,582 4,642 Accounts payable and accrued expenses $ 136,028 $ 137,512 Accrued compensation and benefits: Accrued payroll $ 31,297 $ 30,917 Accrued bonuses 13,147 26,992 Accrued travel expense 3,120 2,972 Accrued health insurance reserve 3,501 3,189 Accrued workers compensation reserve 8,323 8,406 Deferred compensation 38,685 32,690 Other 1,569 2,827 Accrued compensation and benefits $ 99,642 $ 107,993 Other current liabilities: Acquisition related liabilities $ 5,016 $ 6,921 Income taxes payable 16,952 451 Other 7,460 9,239 Other current liabilities $ 29,428 $ 16,611 Other long-term liabilities: Workers’ compensation reserve $ 18,396 $ 18,708 Professional liability reserve 39,361 37,338 Deferred rent 13,761 13,274 Unrecognized tax benefits 8,586 8,464 Other 1,390 4,312 Other long-term liabilities $ 81,494 $ 82,096

Basis of Presentation Basis of

Basis of Presentation Basis of Presentation - Additional Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Income tax benefit	$ 4,297

Business Combinations (Details)

Business Combinations (Details)	Jun. 03, 2016USD ($)	Jan. 11, 2016USD ($)	Jan. 04, 2016USD ($)	Mar. 31, 2017USD ($)	Mar. 31, 2017USD ($)	Sep. 30, 2016USD ($)	Jun. 30, 2016USD ($)	Mar. 31, 2016USD ($)	Mar. 31, 2017USD ($)aquisition	Dec. 31, 2016USD ($)
Business Acquisition [Line Items]
Number of acquisitions | aquisition									3
Business Combination, Description
Earn-out payments for prior acquisitions					$ 3,677,000			$ 900,000
Allocation of Purchase Price
Goodwill				$ 340,564,000	340,564,000				$ 340,564,000	$ 341,754,000
Nurse and Allied Solutions
Allocation of Purchase Price
Goodwill				103,107,000	103,107,000				103,107,000	104,306,000
Other Workforce Solutions
Allocation of Purchase Price
Goodwill				217,714,000	$ 217,714,000				$ 217,714,000	$ 217,705,000
Line of Credit
Business Combination, Description
Maximum borrowing capacity			$ 125,000,000
Peak
Business Combination, Description
Total purchase price of the acquisition	$ 52,400,000
Cash consideration	51,645,000
Contingent earn-out based on future operating performance	3,000,000
Fair value of contingent earn-out	480,000
Additional cash consideration paid						$ 275,000
Allocation of Purchase Price
Fair value of assets acquired	5,658,000
Liabilities assumed	9,314,000
Identified intangible assets	$ 19,220,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets	13 years
Peak | Other Workforce Solutions
Allocation of Purchase Price
Goodwill	$ 36,836,000
Peak | Trademarks
Allocation of Purchase Price
Identified intangible assets	7,600,000
Peak | Customer Relationships
Allocation of Purchase Price
Identified intangible assets	11,500,000
Peak | Scenario, Previously Reported
Business Combination, Description
Total purchase price of the acquisition	$ 52,125,000
HSG
Business Combination, Description
Total purchase price of the acquisition		$ 8,219,000
Cash consideration		2,799,000
Contingent earn-out based on future operating performance		4,000,000
Fair value of contingent earn-out		3,590,000
Indemnification assets, amount as of acquisition Date		2,122,000
Working capital settlement received						$ 292,000
Allocation of Purchase Price
Fair value of assets acquired		1,025,000
Liabilities assumed		3,698,000
Identified intangible assets		$ 3,944,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets		8 years
HSG | Nurse and Allied Solutions
Allocation of Purchase Price
Goodwill		$ 6,948,000
HSG | Scenario, Previously Reported
Business Combination, Description
Total purchase price of the acquisition		8,511,000
HSG | Earn-Out Payment, Based on Operating Results for 2016
Business Combination, Description
Contingent earn-out based on future operating performance		2,000,000
Earn-out payments for prior acquisitions				$ 1,930,000
HSG | Earn-Out Payment, Based on Operating Results for 2017
Business Combination, Description
Contingent earn-out based on future operating performance		$ 2,000,000
BES
Business Combination, Description
Cash consideration			161,708,000
Working capital settlement received							$ 524,000
Allocation of Purchase Price
Fair value of assets acquired			11,953,000
Liabilities assumed			7,272,000
Identified intangible assets			$ 65,900,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets			15 years
BES | Other Workforce Solutions
Allocation of Purchase Price
Goodwill			$ 91,127,000
BES | Tradenames and Trademarks
Allocation of Purchase Price
Identified intangible assets			$ 26,300,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			20 years
BES | Customer Relationships
Allocation of Purchase Price
Identified intangible assets			$ 25,700,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			12 years
BES | Staffing Database
Allocation of Purchase Price
Identified intangible assets			$ 13,000,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			10 years
BES | Non-Compete Agreements
Allocation of Purchase Price
Identified intangible assets			$ 900,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life			5 years
BES | Scenario, Previously Reported
Business Combination, Description
Cash consideration			$ 162,232,000

Revenue Recognition (Details)

Revenue Recognition (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Revenue Recognition [Abstract]
Payables to subcontractor	$ 49,915	$ 51,973

Net Income Per Common Share (De

Net Income Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Computation of basic and diluted net income per common share
Net income	$ 32,008	$ 25,869
Net income per common share - basic (in dollars per share)	$ 0.67	$ 0.54
Net income per common share - diluted (in dollars per share)	$ 0.65	$ 0.53
Weighted average common shares outstanding - basic (in shares)	47,782	47,894
Plus dilutive effect of potential common shares (in shares)	1,738	1,209
Weighted average common shares outstanding - diluted (in shares)	49,520	49,103
Common stock excluded from calculation of EPS (in shares)		43

Segment Information (Details)

Segment Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)segment	Mar. 31, 2016USD ($)
Segment Reporting, Revenue Reconciling Item [Line Items]
Number of reportable segments | segment	3
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	$ 495,169	$ 468,002
Segment operating income	52,035	47,310
Depreciation and amortization	7,668	6,765
Share-based compensation	2,681	3,381
Interest expense, net, and other	5,130	3,249
Income before income taxes	46,905	44,061
Operating segments
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	495,169	468,002
Segment operating income	78,056	72,495
Operating segments | Nurse and Allied Solutions
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	313,523	297,724
Segment operating income	45,980	41,618
Operating segments | Locum Tenens Solutions
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	102,843	102,738
Segment operating income	12,219	13,291
Operating segments | Other Workforce Solutions
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	78,803	67,540
Segment operating income	19,857	17,586
Unallocated corporate overhead
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Unallocated corporate overhead	$ 15,672	$ 15,039

Segment Information - Goodwill

Segment Information - Goodwill (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Dec. 31, 2016
Goodwill [Roll Forward]
Beginning balance	$ 341,754
Ending balance	340,564
Accumulated impairment loss	214,939	$ 214,939
HSG
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	(1,199)
Peak
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	9
Nurse and Allied Solutions
Goodwill [Roll Forward]
Beginning balance	104,306
Ending balance	103,107
Accumulated impairment loss	154,444	154,444
Nurse and Allied Solutions | HSG
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	(1,199)
Nurse and Allied Solutions | Peak
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	0
Locum Tenens Solutions
Goodwill [Roll Forward]
Beginning balance	19,743
Ending balance	19,743
Accumulated impairment loss	53,940	53,940
Locum Tenens Solutions | HSG
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	0
Locum Tenens Solutions | Peak
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	0
Other Workforce Solutions
Goodwill [Roll Forward]
Beginning balance	217,705
Ending balance	217,714
Accumulated impairment loss	6,555	$ 6,555
Other Workforce Solutions | HSG
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	0
Other Workforce Solutions | Peak
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	$ 9

Fair Value Measurement - Additi

Fair Value Measurement - Additional Information (Details) - USD ($) $ in Thousands	1 Months Ended
	Jan. 31, 2016	Mar. 31, 2017	Dec. 31, 2016	Oct. 31, 2016
Commercial paper | Fair Value, Measurements, Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Commercial paper		$ 23,450	$ 25,610
Commercial paper | Fair Value, Measurements, Recurring | Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Commercial paper		23,450	25,610
Available for sale securities		$ 13,956	$ 11,152
LIBOR | Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Basis spread on variable rate	1.50%
LIBOR | Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Basis spread on variable rate	2.25%
Base Rate | Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Basis spread on variable rate	0.50%
Base Rate | Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Basis spread on variable rate	1.25%
5.125% Senior Notes Due 2024 | Senior Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate				5.125%

Fair Value Measurement - Financ

Fair Value Measurement - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Money market funds
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	$ 4,629	$ 4,627
Money market funds | Quoted Prices in Active Markets for Identical Assets (Level 1)
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	4,629	4,627
Money market funds | Significant Other Observable Inputs (Level 2)
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Money market funds | Significant Unobservable Inputs (Level 3)
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Commercial paper
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	23,450	25,610
Commercial paper | Quoted Prices in Active Markets for Identical Assets (Level 1)
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Commercial paper | Significant Other Observable Inputs (Level 2)
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	23,450	25,610
Commercial paper | Significant Unobservable Inputs (Level 3)
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Interest rate swap asset | Interest Rate Swap
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	94	24
Interest rate swap asset | Quoted Prices in Active Markets for Identical Assets (Level 1) | Interest Rate Swap
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Interest rate swap asset | Significant Other Observable Inputs (Level 2) | Interest Rate Swap
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	94	24
Interest rate swap asset | Significant Unobservable Inputs (Level 3) | Interest Rate Swap
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Acquisition contingent consideration earn-out liabilities
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	(1,909)	(6,816)
Acquisition contingent consideration earn-out liabilities | Quoted Prices in Active Markets for Identical Assets (Level 1)
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Acquisition contingent consideration earn-out liabilities | Significant Other Observable Inputs (Level 2)
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Acquisition contingent consideration earn-out liabilities | Significant Unobservable Inputs (Level 3)
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	$ (1,909)	$ (6,816)

Fair Value Measurement - Reconc

Fair Value Measurement - Reconciliation of Changes in Contingent Consideration Liabilities (Details) - Significant Unobservable Inputs (Level 3) - Acquisition contingent consideration earn-out liabilities - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ (6,816)	$ (3,770)
Ending balance	(1,909)	(6,459)
TFS
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Settlement of earn-outs	3,000	1,000
Change in fair value of contingent consideration earn-out liability from acquisition	0	(697)
HSG
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Settlement of earn-outs	1,930
Contingent consideration earn-out liability from acquisition	0	(3,590)
Change in fair value of contingent consideration earn-out liability from acquisition	(23)	(62)
Avantas
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Change in fair value of contingent consideration earn-out liability from acquisition	$ 0	$ 660

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Sep. 30, 2015	Dec. 31, 2019	Dec. 31, 2016
Federal Tax Authority
Income Tax Examination [Line Items]
Income tax benefits to be recorded in connection with settlement	$ 12,200
Federal Tax Authority | Internal Revenue Service (IRS)
Income Tax Examination [Line Items]
Tax settlement amount	$ 7,200
State Jurisdiction
Income Tax Examination [Line Items]
Income tax benefits to be recorded in connection with settlement			$ 568
Scenario, Forecast | State Jurisdiction
Income Tax Examination [Line Items]
Income tax benefits to be recorded in connection with settlement		$ 1,200

Balance Sheet Details (Details)

Balance Sheet Details (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Other current assets:
Restricted cash and cash equivalents	$ 17,592	$ 20,271
Other	13,803	14,336
Other current assets	31,395	34,607
Fixed assets:
Furniture and equipment	26,487	25,582
Software	116,194	112,405
Leasehold improvements	7,782	6,832
Fixed assets, gross	150,463	144,819
Accumulated depreciation	(87,843)	(84,865)
Fixed assets, net	62,620	59,954
Other assets:
Life insurance cash surrender value	38,421	32,190
Other	26,947	25,344
Other assets	65,368	57,534
Accounts payable and accrued expenses:
Trade accounts payable	33,158	33,392
Subcontractor payable	49,915	51,973
Accrued expenses	42,174	37,251
Professional liability reserve	8,199	10,254
Other	2,582	4,642
Accounts payable and accrued expenses	136,028	137,512
Accrued compensation and benefits:
Accrued payroll	31,297	30,917
Accrued bonuses	13,147	26,992
Accrued travel expense	3,120	2,972
Accrued health insurance reserve	3,501	3,189
Accrued workers compensation reserve	8,323	8,406
Deferred compensation	38,685	32,690
Other	1,569	2,827
Accrued compensation and benefits	99,642	107,993
Other current liabilities:
Acquisition related liabilities	5,016	6,921
Income taxes payable	16,952	451
Other	7,460	9,239
Other current liabilities	29,428	16,611
Other long-term liabilities:
Workers’ compensation reserve	18,396	18,708
Professional liability reserve	39,361	37,338
Deferred rent	13,761	13,274
Unrecognized tax benefits	8,586	8,464
Other	1,390	4,312
Other long-term liabilities	$ 81,494	$ 82,096