Cover Page
Cover Page - shares | 3 Months Ended | |
Mar. 31, 2023 | May 03, 2023 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Mar. 31, 2023 | |
Document Transition Report | false | |
Entity File Number | 001-16753 | |
Entity Registrant Name | AMN HEALTHCARE SERVICES, INC. | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 06-1500476 | |
Entity Address, Address Line One | 8840 Cypress Waters Boulevard | |
Entity Address, Address Line Two | Suite 300 | |
Entity Address, City or Town | Dallas | |
Entity Address, State or Province | TX | |
Entity Address, Postal Zip Code | 75019 | |
City Area Code | 866 | |
Local Phone Number | 871-8519 | |
Title of 12(b) Security | Common Stock, $0.01 par value | |
Trading Symbol | AMN | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding (excluding treasury shares) | 39,645,292 | |
Entity Central Index Key | 0001142750 | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Year Focus | 2023 | |
Document Fiscal Period Focus | Q1 | |
Amendment Flag | false |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Current assets: | ||
Cash and cash equivalents | $ 28,516 | $ 64,524 |
Accounts receivable, net of allowances of $37,736 and $31,910 at March 31, 2023 and December 31, 2022, respectively | 687,645 | 675,650 |
Accounts receivable, subcontractor | 276,655 | 268,726 |
Prepaid expenses | 26,696 | 18,708 |
Other current assets | 51,552 | 66,037 |
Total current assets | 1,071,064 | 1,093,645 |
Restricted cash, cash equivalents and investments | 67,594 | 61,218 |
Fixed assets, net of accumulated depreciation of $233,942 and $227,617 at March 31, 2023 and December 31, 2022, respectively | 155,276 | 149,276 |
Other assets | 197,325 | 172,016 |
Goodwill | 935,319 | 935,364 |
Intangible assets, net of accumulated amortization of $379,172 and $361,327 at March 31, 2023 and December 31, 2022, respectively | 454,485 | 476,832 |
Total assets | 2,881,063 | 2,888,351 |
Current liabilities: | ||
Accounts payable and accrued expenses | 473,764 | 476,452 |
Accrued compensation and benefits | 269,237 | 333,244 |
Other current liabilities | 60,600 | 48,237 |
Total current liabilities | 803,601 | 857,933 |
Revolving credit facility | 140,000 | 0 |
Notes payable, net of unamortized fees and premium | 843,801 | 843,505 |
Deferred income taxes, net | 16,113 | 22,713 |
Other long-term liabilities | 121,774 | 120,566 |
Total liabilities | 1,925,289 | 1,844,717 |
Commitments and contingencies | ||
Stockholders’ equity: | ||
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at March 31, 2023 and December 31, 2022 | 0 | 0 |
Common stock, $0.01 par value; 200,000 shares authorized; 50,236 issued and 40,238 outstanding at March 31, 2023 and 50,109 issued and 41,879 outstanding at December 31, 2022 | 502 | 501 |
Additional paid-in capital | 505,857 | 501,674 |
Treasury stock, at cost; 9,998 and 8,230 shares at March 31, 2023 and December 31, 2022, respectively | (874,898) | (698,598) |
Retained earnings | 1,325,106 | 1,240,996 |
Accumulated other comprehensive loss | (793) | (939) |
Total stockholders’ equity | 955,774 | 1,043,634 |
Total liabilities and stockholders’ equity | $ 2,881,063 | $ 2,888,351 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Statement of Financial Position [Abstract] | ||
Accounts receivable, allowance | $ 37,736 | $ 31,910 |
Accumulated depreciation | 233,942 | 227,617 |
Accumulated amortization | $ 379,172 | $ 361,327 |
Preferred stock, par value (in dollars per share) | $ 0.01 | $ 0.01 |
Preferred stock, shares authorized (in shares) | 10,000,000 | 10,000,000 |
Preferred stock, shares issued (in shares) | 0 | 0 |
Preferred stock, shares outstanding (in shares) | 0 | 0 |
Common stock, par value (in dollars per share) | $ 0.01 | $ 0.01 |
Common stock, shares authorized (in shares) | 200,000,000 | 200,000,000 |
Common stock, shares issued (in shares) | 50,236,000 | 50,109,000 |
Common stock, shares outstanding (in shares) | 40,238,000 | 41,879,000 |
Treasury stock (in shares) | 9,998,000 | 8,230,000 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Comprehensive Income - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Statement of Comprehensive Income [Abstract] | ||
Revenue | $ 1,126,223 | $ 1,552,538 |
Cost of revenue | 757,377 | 1,056,370 |
Gross profit | 368,846 | 496,168 |
Operating expenses: | ||
Selling, general and administrative | 205,599 | 257,579 |
Depreciation and amortization (exclusive of depreciation included in cost of revenue) | 37,577 | 30,656 |
Total operating expenses | 243,176 | 288,235 |
Income from operations | 125,670 | 207,933 |
Interest expense, net, and other | 10,259 | 9,589 |
Income before income taxes | 115,411 | 198,344 |
Income tax expense | 31,301 | 52,336 |
Net income | 84,110 | 146,008 |
Other comprehensive income (loss): | ||
Unrealized gains (losses) on available-for-sale securities, net, and other | 146 | (907) |
Other comprehensive income (loss) | 146 | (907) |
Comprehensive income | $ 84,256 | $ 145,101 |
Net income per common share: | ||
Basic (in dollars per share) | $ 2.03 | $ 3.11 |
Diluted (in dollars per share) | $ 2.02 | $ 3.09 |
Weighted average common shares outstanding: | ||
Basic (in shares) | 41,378 | 46,913 |
Diluted (in shares) | 41,570 | 47,208 |
Condensed Consolidated Statem_2
Condensed Consolidated Statements of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands | Total | Common Stock | Additional Paid-in Capital | Treasury Stock | Retained Earnings | Accumulated Other Comprehensive Loss |
Beginning balance (in shares) at Dec. 31, 2021 | 49,849 | |||||
Beginning balance at Dec. 31, 2021 | $ 1,162,027 | $ 498 | $ 486,709 | $ (121,831) | $ 796,946 | $ (295) |
Beginning balance (in shares) at Dec. 31, 2021 | (2,586) | |||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Repurchase of common stock into treasury (in shares) | (2,298) | |||||
Repurchase of common stock into treasury | (228,024) | $ (228,024) | ||||
Equity awards vested, net of shares withheld for taxes (in shares) | 164 | |||||
Equity awards vested, net of shares withheld for taxes | (9,431) | $ 2 | (9,433) | |||
Share-based compensation | 11,259 | 11,259 | ||||
Comprehensive income (loss) | 145,101 | 146,008 | (907) | |||
Ending balance (in shares) at Mar. 31, 2022 | 50,013 | |||||
Ending balance at Mar. 31, 2022 | $ 1,080,932 | $ 500 | 488,535 | $ (349,855) | 942,954 | (1,202) |
Ending balance (in shares) at Mar. 31, 2022 | (4,884) | |||||
Beginning balance (in shares) at Dec. 31, 2022 | 41,879 | 50,109 | ||||
Beginning balance at Dec. 31, 2022 | $ 1,043,634 | $ 501 | 501,674 | $ (698,598) | 1,240,996 | (939) |
Beginning balance (in shares) at Dec. 31, 2022 | (8,230) | (8,230) | ||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Repurchase of common stock into treasury (in shares) | (1,768) | |||||
Repurchase of common stock into treasury | $ (176,300) | $ (176,300) | ||||
Equity awards vested, net of shares withheld for taxes (in shares) | 127 | |||||
Equity awards vested, net of shares withheld for taxes | (6,134) | $ 1 | (6,135) | |||
Share-based compensation | 10,318 | 10,318 | ||||
Comprehensive income (loss) | $ 84,256 | 84,110 | 146 | |||
Ending balance (in shares) at Mar. 31, 2023 | 40,238 | 50,236 | ||||
Ending balance at Mar. 31, 2023 | $ 955,774 | $ 502 | $ 505,857 | $ (874,898) | $ 1,325,106 | $ (793) |
Ending balance (in shares) at Mar. 31, 2023 | (9,998) | (9,998) |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2023 | Mar. 31, 2022 | ||
Cash flows from operating activities: | |||
Net income | $ 84,110 | $ 146,008 | |
Adjustments to reconcile net income to net cash provided by operating activities: | |||
Depreciation and amortization (inclusive of depreciation included in cost of revenue) | 38,834 | 31,510 | |
Non-cash interest expense and other | 505 | 479 | |
Change in fair value of contingent consideration liabilities | 80 | 0 | |
Increase in allowance for credit losses and sales credits | 25,447 | 3,432 | |
Provision for deferred income taxes | (6,639) | 18,526 | |
Share-based compensation | 10,318 | 11,259 | |
Loss on disposal or impairment of long-lived assets | 1,849 | 241 | |
Net loss on investments in available-for-sale securities | 81 | 174 | |
Net loss (gain) on deferred compensation balances | 41 | (570) | |
Non-cash lease expense | (228) | 2,880 | |
Changes in assets and liabilities, net of effects from acquisitions: | |||
Accounts receivable | (37,376) | (194,044) | |
Accounts receivable, subcontractor | (7,929) | (50,592) | |
Income taxes receivable | 8,875 | 0 | |
Prepaid expenses | (7,988) | 33,373 | |
Other current assets | (115) | 12,180 | |
Other assets | 221 | (342) | |
Accounts payable and accrued expenses | (9,557) | 70,988 | |
Accrued compensation and benefits | (71,038) | 96,486 | |
Other liabilities | 11,903 | 18,353 | |
Deferred revenue | 2,040 | (126) | |
Net cash provided by operating activities | 43,434 | 200,215 | |
Cash flows from investing activities: | |||
Purchase and development of fixed assets | (17,487) | (13,590) | |
Purchase of investments | 0 | (4,018) | |
Proceeds from sale and maturity of investments | 2,007 | 6,885 | |
Proceeds from sale of equity investment | 0 | 68 | |
Payments to fund deferred compensation plan | (16,951) | (12,584) | |
Net cash used in investing activities | (32,431) | (23,239) | |
Cash flows from financing activities: | |||
Payments on revolving credit facility | (70,000) | 0 | |
Proceeds from revolving credit facility | 210,000 | 0 | |
Repurchase of common stock | [1] | (174,744) | (228,024) |
Payment of financing costs | (3,579) | 0 | |
Cash paid for shares withheld for taxes | (6,134) | (9,431) | |
Net cash used in financing activities | (44,457) | (237,455) | |
Effect of exchange rate changes on cash | 0 | (183) | |
Net decrease in cash, cash equivalents and restricted cash | (33,454) | (60,662) | |
Cash, cash equivalents and restricted cash at beginning of period | 137,872 | 246,714 | |
Cash, cash equivalents and restricted cash at end of period | 104,418 | 186,052 | |
Supplemental disclosures of cash flow information: | |||
Cash paid for amounts included in the measurement of operating lease liabilities | 2,610 | 4,230 | |
Cash paid for interest (net of $288 and $121 capitalized for the three months ended March 31, 2023 and 2022, respectively) | 1,053 | 196 | |
Cash paid for income taxes | 5,404 | 9,824 | |
Supplemental disclosures of non-cash investing and financing activities: | |||
Purchase of fixed assets recorded in accounts payable and accrued expenses | 6,849 | 4,771 | |
Excise tax payable on share repurchases | $ 1,556 | $ 0 | |
[1]The difference between the amount reported for the three months ended March 31, 2023 and the corresponding amount presented in the condensed consolidated statements of stockholders’ equity is due to accrued excise tax payable on share repurchases recorded within treasury stock. |
Condensed Consolidated Statem_4
Condensed Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Statement of Cash Flows [Abstract] | ||
Interest capitalized | $ 288 | $ 121 |
Basis of Presentation
Basis of Presentation | 3 Months Ended |
Mar. 31, 2023 | |
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, stockholders’ equity 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 (“U.S. GAAP”). Please refer to the Company’s audited consolidated financial statements and the related notes for the fiscal year ended December 31, 2022, contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, filed with the Securities and Exchange Commission on February 22, 2023 (the “2022 Annual Report”). The preparation of financial statements in conformity with U.S. GAAP 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 intangible assets purchased in a business combination, asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation, contingent consideration liabilities associated with acquisitions, and income taxes. Actual results could differ from those estimates under different assumptions or conditions. Recently Adopted Accounting Pronouncements In October 2021, the Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) 2021-08, “Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers.” The new guidance requires companies to apply the definition of a performance obligation under Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers, to recognize and measure contract assets and contract liabilities, such as deferred revenue, relating to contracts with customers that are acquired in a business combination. Under prior guidance, an acquirer generally recognized assets acquired and liabilities assumed in a business combination, including contract assets and contract liabilities arising from revenue contracts with customers, at their acquisition-date fair values in accordance with ASC Subtopic 820-10, Fair Value Measurements—Overall. Generally, this new guidance will result in the acquirer recognizing acquired contract assets and liabilities on the same basis that would have been recorded by the acquiree prior to the acquisition under ASC Topic 606. The Company adopted this standard effective January 1, 2023 on a prospective basis, and the adoption did not have a material effect on the Company’s consolidated financial statements. Cash, Cash Equivalents and Restricted Cash 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, money market funds, commercial paper and other highly liquid investments. Restricted cash and cash equivalents primarily includes cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments. See Note (7), “Fair Value Measurement” for additional information. The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying condensed consolidated balance sheets and related notes to the amounts presented in the accompanying condensed consolidated statements of cash flows. March 31, 2023 December 31, 2022 Cash and cash equivalents $ 28,516 $ 64,524 Restricted cash and cash equivalents (included in other current assets) 31,500 37,225 Restricted cash, cash equivalents and investments 67,594 61,218 Total cash, cash equivalents and restricted cash and investments 127,610 162,967 Less restricted investments (23,192) (25,095) Total cash, cash equivalents and restricted cash $ 104,418 $ 137,872 The Company maintains its cash and restricted cash in bank deposit accounts primarily at large, national financial institutions, which typically exceed federally insured limits. The Company has not experienced any losses in such accounts. Accounts Receivable The Company records accounts receivable at the invoiced amount. Accounts receivable are non-interest bearing. The Company maintains an allowance for expected credit losses based on the Company’s historical write-off experience, an assessment of its customers’ financial conditions and available information that is relevant to assessing the collectability of cash flows, which includes current conditions and forecasts about future economic conditions. The following table provides a reconciliation of activity in the allowance for credit losses for accounts receivable: 2023 2022 Balance as of January 1, $ 31,910 $ 6,838 Provision for expected credit losses 6,938 1,166 Amounts written off charged against the allowance (1,112) (534) Balance as of March 31, $ 37,736 $ 7,470 The increase in the provision for expected credit losses for the three months ended March 31, 2023 was primarily the result of concern with a specific customer’s ability to meet its financial obligations, and uncertainty regarding the collectability of cash flows from customers due primarily to the current macroeconomic outlook. Reclassifications To conform to the current year presentation, certain reclassifications have been made to prior year balances in the condensed consolidated balance sheets and accompanying Note (10), “Balance Sheet Details.” |
Acquisitions
Acquisitions | 3 Months Ended |
Mar. 31, 2023 | |
Business Combination and Asset Acquisition [Abstract] | |
Acquisitions | ACQUISITIONS The Company accounted for the acquisition set forth below using the acquisition method of accounting. Accordingly, the Company recorded the tangible and intangible assets acquired and liabilities assumed at their estimated fair values as of the date of acquisition. Since the date of acquisition, the Company has revised the allocation of the purchase price to the tangible and intangible assets acquired and liabilities assumed based on analysis of information that has been made available through March 31, 2023. The allocation will continue to be updated through the measurement period, if necessary. The goodwill recognized for the acquisition is attributable to expected growth as the Company leverages its brand and diversifies its services offered to clients, including potential revenue growth and margin expansion. The Company did not incur any material acquisition-related costs. Connetics Acquisition On May 13, 2022, the Company completed its acquisition of Connetics Communications, LLC (“Connetics”), which specializes in the direct hire recruitment and permanent placement of international nurse and allied health professionals with healthcare facilities in the United States. The initial purchase price of $78,764 included (1) $70,764 cash consideration paid upon acquisition, funded through cash on hand, and (2) contingent consideration (earn-out payment) of up to $12,500 with an estimated fair value of $8,000 as of the acquisition date. The contingent earn-out payment is based on the operating results of Connetics for the twelve months ending May 31, 2023. The results of Connetics have been included in the Company’s nurse and allied solutions segment since the date of acquisition. During the fourth quarter of 2022, $231 was returned to the Company in respect of the final working capital settlement. The preliminary allocation of the $78,533 purchase price, which was reduced by the final working capital settlement during the fourth quarter of 2022, consisted of (1) $3,632 of fair value of tangible assets acquired, which included $963 cash received, (2) $8,244 of liabilities assumed, (3) $40,200 of identified intangible assets, and (4) $42,945 of goodwill, of which $34,944 is deductible for tax purposes. The intangible assets acquired have a weighted average useful life of approximately thirteen years. The following table summarizes the fair value and useful life of each intangible asset acquired as of the acquisition date: Fair Value Useful Life (in years) Identifiable intangible assets Customer relationships $ 32,800 15 Staffing database 4,200 5 Tradenames and trademarks 3,200 5 $ 40,200 |
Revenue Recognition
Revenue Recognition | 3 Months Ended |
Mar. 31, 2023 | |
Revenue from Contract with Customer [Abstract] | |
Revenue Recognition | REVENUE RECOGNITION Revenue primarily consists of fees earned from the temporary staffing and permanent placement of healthcare professionals, executives, and leaders (clinical and operational). The Company also generates revenue from technology-enabled services, including language interpretation and vendor management systems, and talent planning and acquisition services, including recruitment process outsourcing. The Company recognizes revenue when control of its services is transferred to its customers, in an amount that reflects the consideration the Company expects to be entitled to receive in exchange for those services. Revenue from temporary staffing services is recognized as the services are rendered by clinical and non-clinical healthcare professionals. Under the Company’s managed services program (“MSP”) arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own network of healthcare professionals along with those of third-party subcontractors. Revenue and the related direct costs under MSP arrangements are recorded in accordance with the accounting guidance on reporting revenue gross as a principal versus net as an agent. When the Company uses subcontractors and acts as an agent, revenue is recorded net of the related subcontractor’s expense. Revenue from permanent placement and recruitment process outsourcing services is recognized as the services are rendered. Depending on the arrangement, the Company’s technology-enabled service revenue is recognized either as the services are rendered or ratably over the applicable arrangement’s service period. The Company’s customers are primarily billed as services are rendered. Any fees billed in advance of being earned are recorded as deferred revenue. While payment terms vary by the type of customer and the services rendered, the term between invoicing and when payment is due is not significant. The Company has elected to apply the following practical expedients and optional exemptions related to contract costs and revenue recognition: • Recognize incremental costs of obtaining a contract with amortization periods of one year or less as expense when incurred. These costs are recorded within selling, general and administrative expenses. • Recognize revenue in the amount of consideration that the Company has a right to invoice the customer if that amount corresponds directly with the value to the customer of the Company’s services completed to date. • Exemptions from disclosing the value of unsatisfied performance obligations for (i) contracts with an original expected length of one year or less, (ii) contracts for which revenue is recognized in the amount of consideration that the Company has a right to invoice for services performed and (iii) contracts for which variable consideration is allocated entirely to a wholly unsatisfied performance obligation or to a wholly unsatisfied promise to transfer a distinct service that forms part of a single performance obligation. See Note (5), “Segment Information,” for additional information regarding the Company’s revenue disaggregated by service type. |
Net Income Per Common Share
Net Income Per Common Share | 3 Months Ended |
Mar. 31, 2023 | |
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: Three Months Ended March 31, 2023 2022 Net income $ 84,110 $ 146,008 Net income per common share - basic $ 2.03 $ 3.11 Net income per common share - diluted $ 2.02 $ 3.09 Weighted average common shares outstanding - basic 41,378 46,913 Plus dilutive effect of potential common shares 192 295 Weighted average common shares outstanding - diluted 41,570 47,208 Share-based awards to purchase 243 and 160 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, 2023 and 2022, respectively, because the effect of these instruments was anti-dilutive. Since March 31, 2023, and through May 5, 2023, the Company repurchased 594 shares of its common stock at an average price of $84.18 per share excluding broker’s fee, resulting in an aggregate purchase price of $50,000 excluding the effect of 1% of excise taxes on the repurchased amount. |
Segment Information
Segment Information | 3 Months Ended |
Mar. 31, 2023 | |
Segment Reporting [Abstract] | |
Segment Information | SEGMENT INFORMATION The Company’s operating segments are identified in the same manner as they are reported internally and used by the Company’s chief operating decision maker for the purpose of evaluating performance and allocating resources. The Company has three reportable segments: (1) nurse and allied solutions, (2) physician and leadership solutions, and (3) technology and workforce solutions. The nurse and allied solutions segment includes the Company’s travel nurse staffing (including international nurse staffing and rapid response nurse staffing), labor disruption staffing, local staffing, international nurse and allied permanent placement, allied staffing and revenue cycle solutions businesses. The physician and leadership solutions segment includes the Company’s locum tenens staffing, healthcare interim leadership staffing, executive search, and physician permanent placement businesses. The technology and workforce solutions segment includes the Company’s language services, vendor management systems, workforce optimization, virtual care, and outsourced solutions businesses. 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, 2023 2022 Revenue Nurse and allied solutions $ 824,480 $ 1,228,039 Physician and leadership solutions 165,757 179,506 Technology and workforce solutions 135,986 144,993 $ 1,126,223 $ 1,552,538 Segment operating income Nurse and allied solutions $ 113,445 $ 195,089 Physician and leadership solutions 25,100 20,381 Technology and workforce solutions 67,010 78,880 205,555 294,350 Unallocated corporate overhead 30,733 43,648 Depreciation and amortization 37,577 30,656 Depreciation (included in cost of revenue) 1,257 854 Share-based compensation 10,318 11,259 Interest expense, net, and other 10,259 9,589 Income before income taxes $ 115,411 $ 198,344 The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Balance, January 1, 2023 $ 382,005 $ 152,800 $ 400,559 $ 935,364 Goodwill adjustment for Connetics acquisition (45) — — (45) Balance, March 31, 2023 $ 381,960 $ 152,800 $ 400,559 $ 935,319 Accumulated impairment loss as of December 31, 2022 and March 31, 2023 $ 154,444 $ 60,495 $ — $ 214,939 Disaggregation of Revenue The following tables present the Company’s revenue disaggregated by service type: Three Months Ended March 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 592,677 $ — $ — $ 592,677 Labor disruption services 5,702 — — 5,702 Local staffing 25,272 — — 25,272 Allied staffing 196,125 — — 196,125 Locum tenens staffing — 106,703 — 106,703 Interim leadership staffing — 40,242 — 40,242 Temporary staffing 819,776 146,945 — 966,721 Permanent placement 4,704 18,812 — 23,516 Language services — — 61,676 61,676 Vendor management systems — — 54,173 54,173 Other technologies — — 7,347 7,347 Technology-enabled services — — 123,196 123,196 Talent planning and acquisition — — 12,790 12,790 Total revenue $ 824,480 $ 165,757 $ 135,986 $ 1,126,223 Three Months Ended March 31, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 970,109 $ — $ — $ 970,109 Local staffing 44,057 — — 44,057 Allied staffing 213,873 — — 213,873 Locum tenens staffing — 112,672 — 112,672 Interim leadership staffing — 44,354 — 44,354 Temporary staffing 1,228,039 157,026 — 1,385,065 Permanent placement — 22,480 — 22,480 Language services — — 49,238 49,238 Vendor management systems — — 75,022 75,022 Other technologies — — 7,658 7,658 Technology-enabled services — — 131,918 131,918 Talent planning and acquisition — — 13,075 13,075 Total revenue $ 1,228,039 $ 179,506 $ 144,993 $ 1,552,538 The Company did not generate material revenue from labor disruption services during the three months ended March 31, 2022. |
Notes Payable and Credit Agreem
Notes Payable and Credit Agreement | 3 Months Ended |
Mar. 31, 2023 | |
Debt Disclosure [Abstract] | |
Notes Payable and Credit Agreement | NOTES PAYABLE AND CREDIT AGREEMENTOn February 10, 2023, the Company entered into the third amendment to its credit agreement (the “Third Amendment”). The Third Amendment provides for, among other things, the following: (i) an extension of the maturity date of the secured revolving credit facility (the “Senior Credit Facility”) to February 10, 2028, (ii) an increase of the revolving commitments to $750,000, and (iii) a transition from LIBOR to a SOFR-based interest rate. The obligations of the Company under the amended credit agreement are secured by substantially all of the assets of the Company. Additional information regarding the credit agreement, Senior Credit Facility and Third Amendment is disclosed in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of the 2022 Annual Report. |
Fair Value Measurement
Fair Value Measurement | 3 Months Ended |
Mar. 31, 2023 | |
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 (3), Fair Value Measurement” of the 2022 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, 2023. Assets and Liabilities Measured on a Recurring Basis The Company invests a portion of its cash and cash equivalents in non-federally insured money market funds that are measured at fair value based on quoted prices, which are Level 1 inputs. The Company has a deferred compensation plan for certain executives and employees, which is composed of deferred compensation and all related income and losses attributable thereto. The Company’s obligation under its deferred compensation plan is measured at fair value based on quoted market prices of the participants’ elected investments, which are Level 1 inputs. The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company include commercial paper that is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. The Company’s cash equivalents also include commercial paper classified as Level 2 in the fair value hierarchy. Of the $37,600 commercial paper issued and outstanding as of March 31, 2023, none had original maturities greater than three months. Of the $31,536 commercial paper issued and outstanding as of December 31, 2022, none had original maturities greater than three months. The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company also include corporate bonds that are measured using readily available pricing sources that utilize observable market data, including the current interest rate for comparable instruments, which are Level 2 inputs. As of March 31, 2023, the Company had $23,192 corporate bonds issued and outstanding, all of which had original maturities greater than three months and were considered available-for-sale securities. As of December 31, 2022, the Company had $25,095 corporate bonds issued and outstanding, all of which had original maturities greater than three months and were considered available-for-sale securities. The Company’s contingent consideration liabilities associated with acquisitions are measured at fair value using a probability-weighted discounted cash flow analysis or a simulation-based methodology for the acquired companies, which are Level 3 inputs. The Company recognizes changes to the fair value of its contingent consideration liabilities in selling, general and administrative expenses in the condensed consolidated statements of comprehensive income. 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, 2023 Fair Value Measurements as of December 31, 2022 Assets (Liabilities) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Money market funds $ 641 $ — $ — $ 641 $ 36,895 $ — $ — $ 36,895 Deferred compensation (144,349) — — (144,349) (128,465) — — (128,465) Corporate bonds — 23,192 — 23,192 — 25,095 — 25,095 Commercial paper — 37,600 — 37,600 — 31,536 — 31,536 Acquisition contingent consideration liabilities — — (5,150) (5,150) — — (5,070) (5,070) 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, long-lived assets, and equity investments. The Company evaluates goodwill and indefinite-lived intangible assets annually for impairment and whenever events or changes in circumstances indicate that it is more likely than not that an impairment exists. 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. The Company’s equity investment represents an investment in a non-controlled corporation without a readily determinable market value. The Company has elected to measure the investment at cost minus impairment, if any, plus or minus changes resulting from observable price changes. The fair value is determined by using quoted prices for identical or similar investments of the same issuer, which are Level 2 inputs, and other information available to the Company such as the rights and obligations of the securities. The Company recognizes changes to the fair value of its equity investment in interest expense, net, and other in the condensed consolidated statements of comprehensive income. The balance of the equity investment was $19,204 as of both March 31, 2023 and December 31, 2022. There were no material impairment charges recorded during the three months ended March 31, 2023 and 2022. Fair Value of Financial Instruments The Company is required to disclose the fair value of financial instruments for which it is practicable to estimate the value, even though these instruments are not recognized at fair value in the consolidated balance sheets. The fair value of the Company’s 4.625% senior notes due 2027 (the “2027 Notes”) and 4.000% senior notes due 2029 (the “2029 Notes”) was estimated using quoted market prices in active markets for identical liabilities, which are Level 1 inputs. The carrying amounts and estimated fair value of the 2027 Notes and the 2029 Notes are presented in the following table. See additional information regarding the 2027 Notes and the 2029 Notes in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of the 2022 Annual Report. As of March 31, 2023 As of December 31, 2022 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 463,125 $ 500,000 $ 460,000 2029 Notes 350,000 308,875 350,000 300,125 |
Income Taxes
Income Taxes | 3 Months Ended |
Mar. 31, 2023 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | INCOME TAXESThe Company is subject to taxation in the U.S. and various states and foreign jurisdictions. With few exceptions, as of March 31, 2023, the Company is no longer subject to state, local or foreign examinations by tax authorities for tax years before 2011, and the Company is no longer subject to U.S. federal income or payroll tax examinations for tax years before 2019. The Company believes its liability 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 | 3 Months Ended |
Mar. 31, 2023 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | COMMITMENTS AND CONTINGENCIES Legal Proceedings 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, compensation, contract, competitor disputes and employee-related matters and include individual and class action lawsuits, as well as inquiries and investigations by governmental agencies regarding the Company’s employment and compensation 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 accrues for contingencies and 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 under California and Federal law. Specifically, among other claims in these lawsuits, it is alleged that certain expense reimbursements should be considered wages and included in the regular rate of pay for purposes of calculating overtime rates. On May 26, 2016, former travel nurse Verna Maxwell Clarke filed a complaint against AMN Services, LLC, in California Superior Court in Los Angeles County. The Company removed the case to the United States District Court for the Central District of California (Case No. 2:16-cv-04132-DSF-KS) (the “Clarke Matter”). The complaint asserts that, due to the Company’s per diem adjustment practices, traveling nurses’ per diem benefits should be included in their regular rate of pay for the purposes of calculating their overtime compensation. On June 26, 2018, the district court denied the plaintiffs’ Motion for Summary Judgment in its entirety, and granted the Company’s Motion for Summary Judgment with respect to the plaintiffs’ per diem and overtime claims. The plaintiffs filed an appeal of the judgment relating to the per diem claims with the Ninth Circuit Court of Appeals (the “Ninth Circuit”). On February 8, 2021, the Ninth Circuit issued an opinion that reversed the district court’s granting of the Company’s Motion for Summary Judgment and remanded the matter to the district court instructing the district to enter partial summary judgment in favor of the plaintiffs. On August 26, 2021, the Company filed a Petition for Writ of Certiorari in the United States Supreme Court seeking review of the Ninth Circuit’s decision, which was denied on December 13, 2021. This case is proceeding in the United States District Court. On May 2, 2019, former travel nurse Sara Woehrle filed a complaint against AMN Services, LLC, and Providence Health System – Southern California in California Superior Court in Los Angeles County. The Company removed the case to the United States District Court for the Central District of California (Case No. 2:19-cv-05282 DSF-KS). The complaint asserts that, due to the Company’s per diem adjustment practices, traveling nurses’ per diem benefits should be included in their regular rate of pay for the purposes of calculating their overtime compensation. The complaint also alleges that the putative class members were denied required meal periods, denied proper overtime compensation, were not compensated for all time worked, including reporting time and training time, and received non-compliant wage statements. The Company reached an agreement to settle this matter in its entirety and received court approval of the settlement. Payment is expected to be made in the second quarter of 2023. Because of the inherent uncertainty of litigation, the Company is not able to reasonably predict if any matter will be resolved in a manner that is materially adverse to the Company. The Company has recorded accruals in connection with the two matters described above amounting to $46,225. The Company is currently unable to estimate the possible loss or range of loss beyond amounts already accrued. Loss contingencies accrued as of both March 31, 2023 and December 31, 2022 are included in accounts payable and accrued expenses and other long-term liabilities in the consolidated balance sheets. Operating Leases In the first quarter of 2022, the Company entered into a lease agreement for an office building located in Dallas, Texas, with future undiscounted lease payments of approximately $29,514, excluding lease incentives. Because the Company does not control the underlying asset during the construction period, the Company is not considered the owner of the asset under construction for accounting purposes. The lease will commence upon completion of the construction of the office building which is expected be in the second quarter of 2023. The initial term of the lease is approximately eleven years with options to renew the lease during the lease term. A right-of-use asset and lease liability will be recognized in the consolidated balance sheet in the period the lease commences. |
Balance Sheet Details
Balance Sheet Details | 3 Months Ended |
Mar. 31, 2023 | |
Balance Sheet Related Disclosures [Abstract] | |
Balance Sheet Details | BALANCE SHEET DETAILS The consolidated balance sheets detail is as follows: March 31, 2023 December 31, 2022 Other current assets: Restricted cash and cash equivalents $ 31,500 $ 37,225 Income taxes receivable — 8,875 Other 20,052 19,937 Other current assets $ 51,552 $ 66,037 Fixed assets: Furniture and equipment $ 54,978 $ 51,408 Software 333,302 323,418 Leasehold improvements 938 2,067 389,218 376,893 Accumulated depreciation (233,942) (227,617) Fixed assets, net $ 155,276 $ 149,276 Other assets: Life insurance cash surrender value $ 140,731 $ 117,139 Operating lease right-of-use assets $ 14,484 16,266 Other 42,110 38,611 Other assets $ 197,325 $ 172,016 Accounts payable and accrued expenses: Trade accounts payable $ 81,447 $ 78,057 Subcontractor payable 278,432 295,259 Accrued expenses 82,337 73,885 Loss contingencies 15,874 14,638 Professional liability reserve 8,091 7,756 Other 7,583 6,857 Accounts payable and accrued expenses $ 473,764 $ 476,452 Accrued compensation and benefits: Accrued payroll $ 72,113 $ 63,857 Accrued bonuses and commissions 28,032 96,760 Workers compensation reserve 12,394 12,113 Deferred compensation 144,349 128,465 Other 12,349 32,049 Accrued compensation and benefits $ 269,237 $ 333,244 Other current liabilities: Acquisition related liabilities $ 5,150 $ 5,070 Income taxes payable 23,395 — Client deposits 7,463 21,466 Operating lease liabilities 7,789 8,090 Deferred revenue 13,876 11,825 Other 2,927 1,786 Other current liabilities $ 60,600 $ 48,237 Other long-term liabilities: Workers compensation reserve $ 22,756 $ 23,841 Professional liability reserve 38,153 36,214 Operating lease liabilities 7,652 9,360 Other 53,213 51,151 Other long-term liabilities $ 121,774 $ 120,566 |
Basis of Presentation (Policies
Basis of Presentation (Policies) | 3 Months Ended |
Mar. 31, 2023 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Use of Estimates | The preparation of financial statements in conformity with U.S. GAAP 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 intangible assets purchased in a business combination, asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation, contingent consideration liabilities associated with acquisitions, and income taxes. Actual results could differ from those estimates under different assumptions or conditions. |
Recently Adopted Accounting Pronouncements | Recently Adopted Accounting Pronouncements In October 2021, the Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) 2021-08, “Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers.” The new guidance requires companies to apply the definition of a performance obligation under Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers, to recognize and measure contract assets and contract liabilities, such as deferred revenue, relating to contracts with customers that are acquired in a business combination. Under prior guidance, an acquirer generally recognized assets acquired and liabilities assumed in a business combination, including contract assets and contract liabilities arising from revenue contracts with customers, at their acquisition-date fair values in accordance with ASC Subtopic 820-10, Fair Value Measurements—Overall. Generally, this new guidance will result in the acquirer recognizing acquired contract assets and liabilities on the same basis that would have been recorded by the acquiree prior to the acquisition under ASC Topic 606. The Company adopted this standard effective January 1, 2023 on a prospective basis, and the adoption did not have a material effect on the Company’s consolidated financial statements. |
Cash, Cash Equivalents and Restricted Cash | Cash, Cash Equivalents and Restricted Cash 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, money market funds, commercial paper and other highly liquid investments. Restricted cash and cash equivalents primarily includes cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments. See Note (7), “Fair Value Measurement” for additional information. |
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 expected credit losses based on the Company’s historical write-off experience, an assessment of its customers’ financial conditions and available information that is relevant to assessing the collectability of cash flows, which includes current conditions and forecasts about future economic conditions. |
Reclassification | Reclassifications To conform to the current year presentation, certain reclassifications have been made to prior year balances in the condensed consolidated balance sheets and accompanying Note (10), “Balance Sheet Details.” |
Revenue Recognition | Revenue primarily consists of fees earned from the temporary staffing and permanent placement of healthcare professionals, executives, and leaders (clinical and operational). The Company also generates revenue from technology-enabled services, including language interpretation and vendor management systems, and talent planning and acquisition services, including recruitment process outsourcing. The Company recognizes revenue when control of its services is transferred to its customers, in an amount that reflects the consideration the Company expects to be entitled to receive in exchange for those services. Revenue from temporary staffing services is recognized as the services are rendered by clinical and non-clinical healthcare professionals. Under the Company’s managed services program (“MSP”) arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own network of healthcare professionals along with those of third-party subcontractors. Revenue and the related direct costs under MSP arrangements are recorded in accordance with the accounting guidance on reporting revenue gross as a principal versus net as an agent. When the Company uses subcontractors and acts as an agent, revenue is recorded net of the related subcontractor’s expense. Revenue from permanent placement and recruitment process outsourcing services is recognized as the services are rendered. Depending on the arrangement, the Company’s technology-enabled service revenue is recognized either as the services are rendered or ratably over the applicable arrangement’s service period. The Company’s customers are primarily billed as services are rendered. Any fees billed in advance of being earned are recorded as deferred revenue. While payment terms vary by the type of customer and the services rendered, the term between invoicing and when payment is due is not significant. The Company has elected to apply the following practical expedients and optional exemptions related to contract costs and revenue recognition: • Recognize incremental costs of obtaining a contract with amortization periods of one year or less as expense when incurred. These costs are recorded within selling, general and administrative expenses. • Recognize revenue in the amount of consideration that the Company has a right to invoice the customer if that amount corresponds directly with the value to the customer of the Company’s services completed to date. • Exemptions from disclosing the value of unsatisfied performance obligations for (i) contracts with an original expected length of one year or less, (ii) contracts for which revenue is recognized in the amount of consideration that the Company has a right to invoice for services performed and (iii) contracts for which variable consideration is allocated entirely to a wholly unsatisfied performance obligation or to a wholly unsatisfied promise to transfer a distinct service that forms part of a single performance obligation. |
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 Assets and Liabilities | Assets and Liabilities Measured on a Recurring Basis The Company invests a portion of its cash and cash equivalents in non-federally insured money market funds that are measured at fair value based on quoted prices, which are Level 1 inputs. The Company has a deferred compensation plan for certain executives and employees, which is composed of deferred compensation and all related income and losses attributable thereto. The Company’s obligation under its deferred compensation plan is measured at fair value based on quoted market prices of the participants’ elected investments, which are Level 1 inputs. The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company include commercial paper that is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. The Company’s cash equivalents also include commercial paper classified as Level 2 in the fair value hierarchy. Of the $37,600 commercial paper issued and outstanding as of March 31, 2023, none had original maturities greater than three months. Of the $31,536 commercial paper issued and outstanding as of December 31, 2022, none had original maturities greater than three months. The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company also include corporate bonds that are measured using readily available pricing sources that utilize observable market data, including the current interest rate for comparable instruments, which are Level 2 inputs. As of March 31, 2023, the Company had $23,192 corporate bonds issued and outstanding, all of which had original maturities greater than three months and were considered available-for-sale securities. As of December 31, 2022, the Company had $25,095 corporate bonds issued and outstanding, all of which had original maturities greater than three months and were considered available-for-sale securities. The Company’s contingent consideration liabilities associated with acquisitions are measured at fair value using a probability-weighted discounted cash flow analysis or a simulation-based methodology for the acquired companies, which are Level 3 inputs. The Company recognizes changes to the fair value of its contingent consideration liabilities in selling, general and administrative expenses in the condensed consolidated statements of comprehensive income. 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, long-lived assets, and equity investments. The Company evaluates goodwill and indefinite-lived intangible assets annually for impairment and whenever events or changes in circumstances indicate that it is more likely than not that an impairment exists. 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. Fair Value of Financial Instruments The Company is required to disclose the fair value of financial instruments for which it is practicable to estimate the value, even though these instruments are not recognized at fair value in the consolidated balance sheets. The fair value of the Company’s 4.625% senior notes due 2027 (the “2027 Notes”) and 4.000% senior notes due 2029 (the “2029 Notes”) was estimated using quoted market prices in active markets for identical liabilities, which are Level 1 inputs. The carrying amounts and estimated fair value of the 2027 Notes and the 2029 Notes are presented in the following table. See additional information regarding the 2027 Notes and the 2029 Notes in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of the 2022 Annual Report. As of March 31, 2023 As of December 31, 2022 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 463,125 $ 500,000 $ 460,000 2029 Notes 350,000 308,875 350,000 300,125 |
Basis of Presentation (Tables)
Basis of Presentation (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Schedule of Reconciliation of Cash, Cash Equivalents and Restricted Cash | The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying condensed consolidated balance sheets and related notes to the amounts presented in the accompanying condensed consolidated statements of cash flows. March 31, 2023 December 31, 2022 Cash and cash equivalents $ 28,516 $ 64,524 Restricted cash and cash equivalents (included in other current assets) 31,500 37,225 Restricted cash, cash equivalents and investments 67,594 61,218 Total cash, cash equivalents and restricted cash and investments 127,610 162,967 Less restricted investments (23,192) (25,095) Total cash, cash equivalents and restricted cash $ 104,418 $ 137,872 |
Schedule of Reconciliation of Activity in Allowance for Credit Losses for Accounts Receivable | The following table provides a reconciliation of activity in the allowance for credit losses for accounts receivable: 2023 2022 Balance as of January 1, $ 31,910 $ 6,838 Provision for expected credit losses 6,938 1,166 Amounts written off charged against the allowance (1,112) (534) Balance as of March 31, $ 37,736 $ 7,470 |
Acquisitions (Tables)
Acquisitions (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Business Combination and Asset Acquisition [Abstract] | |
Schedule of Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination | The following table summarizes the fair value and useful life of each intangible asset acquired as of the acquisition date: Fair Value Useful Life (in years) Identifiable intangible assets Customer relationships $ 32,800 15 Staffing database 4,200 5 Tradenames and trademarks 3,200 5 $ 40,200 |
Net Income Per Common Share (Ta
Net Income Per Common Share (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Earnings Per Share [Abstract] | |
Schedule of 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: Three Months Ended March 31, 2023 2022 Net income $ 84,110 $ 146,008 Net income per common share - basic $ 2.03 $ 3.11 Net income per common share - diluted $ 2.02 $ 3.09 Weighted average common shares outstanding - basic 41,378 46,913 Plus dilutive effect of potential common shares 192 295 Weighted average common shares outstanding - diluted 41,570 47,208 |
Segment Information (Tables)
Segment Information (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Segment Reporting [Abstract] | |
Schedule of Reconciliation of Revenue and Segment Operating Income by Reportable Segment | 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, 2023 2022 Revenue Nurse and allied solutions $ 824,480 $ 1,228,039 Physician and leadership solutions 165,757 179,506 Technology and workforce solutions 135,986 144,993 $ 1,126,223 $ 1,552,538 Segment operating income Nurse and allied solutions $ 113,445 $ 195,089 Physician and leadership solutions 25,100 20,381 Technology and workforce solutions 67,010 78,880 205,555 294,350 Unallocated corporate overhead 30,733 43,648 Depreciation and amortization 37,577 30,656 Depreciation (included in cost of revenue) 1,257 854 Share-based compensation 10,318 11,259 Interest expense, net, and other 10,259 9,589 Income before income taxes $ 115,411 $ 198,344 |
Schedule of Goodwill by Reportable Segment | The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Balance, January 1, 2023 $ 382,005 $ 152,800 $ 400,559 $ 935,364 Goodwill adjustment for Connetics acquisition (45) — — (45) Balance, March 31, 2023 $ 381,960 $ 152,800 $ 400,559 $ 935,319 Accumulated impairment loss as of December 31, 2022 and March 31, 2023 $ 154,444 $ 60,495 $ — $ 214,939 |
Schedule of Disaggregation of Revenue | The following tables present the Company’s revenue disaggregated by service type: Three Months Ended March 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 592,677 $ — $ — $ 592,677 Labor disruption services 5,702 — — 5,702 Local staffing 25,272 — — 25,272 Allied staffing 196,125 — — 196,125 Locum tenens staffing — 106,703 — 106,703 Interim leadership staffing — 40,242 — 40,242 Temporary staffing 819,776 146,945 — 966,721 Permanent placement 4,704 18,812 — 23,516 Language services — — 61,676 61,676 Vendor management systems — — 54,173 54,173 Other technologies — — 7,347 7,347 Technology-enabled services — — 123,196 123,196 Talent planning and acquisition — — 12,790 12,790 Total revenue $ 824,480 $ 165,757 $ 135,986 $ 1,126,223 Three Months Ended March 31, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 970,109 $ — $ — $ 970,109 Local staffing 44,057 — — 44,057 Allied staffing 213,873 — — 213,873 Locum tenens staffing — 112,672 — 112,672 Interim leadership staffing — 44,354 — 44,354 Temporary staffing 1,228,039 157,026 — 1,385,065 Permanent placement — 22,480 — 22,480 Language services — — 49,238 49,238 Vendor management systems — — 75,022 75,022 Other technologies — — 7,658 7,658 Technology-enabled services — — 131,918 131,918 Talent planning and acquisition — — 13,075 13,075 Total revenue $ 1,228,039 $ 179,506 $ 144,993 $ 1,552,538 |
Fair Value Measurement (Tables)
Fair Value Measurement (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
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, 2023 Fair Value Measurements as of December 31, 2022 Assets (Liabilities) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Money market funds $ 641 $ — $ — $ 641 $ 36,895 $ — $ — $ 36,895 Deferred compensation (144,349) — — (144,349) (128,465) — — (128,465) Corporate bonds — 23,192 — 23,192 — 25,095 — 25,095 Commercial paper — 37,600 — 37,600 — 31,536 — 31,536 Acquisition contingent consideration liabilities — — (5,150) (5,150) — — (5,070) (5,070) |
Schedule of Fair Value of Financial Instruments | The carrying amounts and estimated fair value of the 2027 Notes and the 2029 Notes are presented in the following table. See additional information regarding the 2027 Notes and the 2029 Notes in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of the 2022 Annual Report. As of March 31, 2023 As of December 31, 2022 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 463,125 $ 500,000 $ 460,000 2029 Notes 350,000 308,875 350,000 300,125 |
Balance Sheet Details (Tables)
Balance Sheet Details (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Balance Sheet Related Disclosures [Abstract] | |
Schedule of Supplemental Balance Sheet Disclosures | The consolidated balance sheets detail is as follows: March 31, 2023 December 31, 2022 Other current assets: Restricted cash and cash equivalents $ 31,500 $ 37,225 Income taxes receivable — 8,875 Other 20,052 19,937 Other current assets $ 51,552 $ 66,037 Fixed assets: Furniture and equipment $ 54,978 $ 51,408 Software 333,302 323,418 Leasehold improvements 938 2,067 389,218 376,893 Accumulated depreciation (233,942) (227,617) Fixed assets, net $ 155,276 $ 149,276 Other assets: Life insurance cash surrender value $ 140,731 $ 117,139 Operating lease right-of-use assets $ 14,484 16,266 Other 42,110 38,611 Other assets $ 197,325 $ 172,016 Accounts payable and accrued expenses: Trade accounts payable $ 81,447 $ 78,057 Subcontractor payable 278,432 295,259 Accrued expenses 82,337 73,885 Loss contingencies 15,874 14,638 Professional liability reserve 8,091 7,756 Other 7,583 6,857 Accounts payable and accrued expenses $ 473,764 $ 476,452 Accrued compensation and benefits: Accrued payroll $ 72,113 $ 63,857 Accrued bonuses and commissions 28,032 96,760 Workers compensation reserve 12,394 12,113 Deferred compensation 144,349 128,465 Other 12,349 32,049 Accrued compensation and benefits $ 269,237 $ 333,244 Other current liabilities: Acquisition related liabilities $ 5,150 $ 5,070 Income taxes payable 23,395 — Client deposits 7,463 21,466 Operating lease liabilities 7,789 8,090 Deferred revenue 13,876 11,825 Other 2,927 1,786 Other current liabilities $ 60,600 $ 48,237 Other long-term liabilities: Workers compensation reserve $ 22,756 $ 23,841 Professional liability reserve 38,153 36,214 Operating lease liabilities 7,652 9,360 Other 53,213 51,151 Other long-term liabilities $ 121,774 $ 120,566 |
Basis of Presentation - Reconci
Basis of Presentation - Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 | Mar. 31, 2022 | Dec. 31, 2021 |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | ||||
Cash and cash equivalents | $ 28,516 | $ 64,524 | ||
Restricted cash and cash equivalents (included in other current assets) | 31,500 | 37,225 | ||
Restricted cash, cash equivalents and investments | 67,594 | 61,218 | ||
Total cash, cash equivalents and restricted cash and investments | 127,610 | 162,967 | ||
Less restricted investments | (23,192) | (25,095) | ||
Total cash, cash equivalents and restricted cash | $ 104,418 | $ 137,872 | $ 186,052 | $ 246,714 |
Basis of Presentation - Recon_2
Basis of Presentation - Reconciliation of Activity in Allowance for Credit Losses for Accounts Receivable (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Accounts Receivable, Allowance for Credit Loss [Roll Forward] | ||
Beginning balance | $ 31,910 | $ 6,838 |
Provision for expected credit losses | 6,938 | 1,166 |
Amounts written off charged against the allowance | (1,112) | (534) |
Ending balance | $ 37,736 | $ 7,470 |
Acquisitions - Connetics Acquis
Acquisitions - Connetics Acquisition (Details) - USD ($) $ in Thousands | 3 Months Ended | ||
May 13, 2022 | Mar. 31, 2023 | Dec. 31, 2022 | |
Business Acquisition [Line Items] | |||
Fair value of contingent earn-out | $ 5,150 | $ 5,070 | |
Goodwill | 935,319 | 935,364 | |
Connetics Communications, LLC | |||
Business Acquisition [Line Items] | |||
Initial purchase price | $ 78,764 | ||
Cash consideration | 70,764 | ||
Contingent earn-out based on future operating performance (up to) | 12,500 | ||
Fair value of contingent earn-out | 8,000 | ||
Cash returned to the Company for final working capital settlement | 231 | ||
Purchase price, net of working capital adjustment | $ 78,533 | ||
Fair value of tangible assets acquired | 3,632 | ||
Cash received | 963 | ||
Liabilities assumed | 8,244 | ||
Identifiable intangible assets | 40,200 | 40,200 | |
Goodwill | 42,945 | ||
Goodwill expected to be deductible for tax purposes | $ 34,944 | ||
Intangible assets acquired, weighted average useful life | 13 years | ||
Connetics Communications, LLC | Customer relationships | |||
Business Acquisition [Line Items] | |||
Identifiable intangible assets | $ 32,800 | ||
Useful Life | 15 years | ||
Connetics Communications, LLC | Staffing database | |||
Business Acquisition [Line Items] | |||
Identifiable intangible assets | $ 4,200 | ||
Useful Life | 5 years | ||
Connetics Communications, LLC | Tradenames and trademarks | |||
Business Acquisition [Line Items] | |||
Identifiable intangible assets | $ 3,200 | ||
Useful Life | 5 years |
Net Income Per Common Share (De
Net Income Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands | 1 Months Ended | 3 Months Ended | |
May 05, 2023 | Mar. 31, 2023 | Mar. 31, 2022 | |
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items] | |||
Net income | $ 84,110 | $ 146,008 | |
Net income per common share - basic (in dollars per share) | $ 2.03 | $ 3.11 | |
Net income per common share - diluted (in dollars per share) | $ 2.02 | $ 3.09 | |
Weighted average common shares outstanding - basic (in shares) | 41,378,000 | 46,913,000 | |
Plus dilutive effect of potential common shares (in shares) | 192,000 | 295,000 | |
Weighted average common shares outstanding - diluted (in shares) | 41,570,000 | 47,208,000 | |
Common stock excluded from calculation of EPS (in shares) | 243,000 | 160,000 | |
Aggregate purchase price of treasury stock | $ 176,300 | $ 228,024 | |
Subsequent Event | |||
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items] | |||
Treasury stock acquired (in shares) | 594,000 | ||
Treasury stock acquired (in dollars per share) | $ 84.18 | ||
Aggregate purchase price of treasury stock | $ 50,000 | ||
Treasury stock, excise tax effect on repurchase, percentage | 1% |
Segment Information - Narrative
Segment Information - Narrative (Details) | 3 Months Ended |
Mar. 31, 2023 segment | |
Segment Reporting [Abstract] | |
Number of reportable segments | 3 |
Segment Information - Reconcili
Segment Information - Reconciliation of Revenue and Segment Operating Income by Reportable Segment (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | $ 1,126,223 | $ 1,552,538 |
Segment operating income | 125,670 | 207,933 |
Depreciation and amortization | 37,577 | 30,656 |
Depreciation (included in cost of revenue) | 1,257 | 854 |
Share-based compensation | 10,318 | 11,259 |
Interest expense, net, and other | 10,259 | 9,589 |
Income before income taxes | 115,411 | 198,344 |
Nurse and allied solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 824,480 | 1,228,039 |
Physician and leadership solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 165,757 | 179,506 |
Technology and workforce solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 135,986 | 144,993 |
Operating segments | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 1,126,223 | 1,552,538 |
Segment operating income | 205,555 | 294,350 |
Operating segments | Nurse and allied solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 824,480 | 1,228,039 |
Segment operating income | 113,445 | 195,089 |
Operating segments | Physician and leadership solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 165,757 | 179,506 |
Segment operating income | 25,100 | 20,381 |
Operating segments | Technology and workforce solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 135,986 | 144,993 |
Segment operating income | 67,010 | 78,880 |
Unallocated corporate overhead | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Unallocated corporate overhead | $ 30,733 | $ 43,648 |
Segment Information - Summary o
Segment Information - Summary of Goodwill by Reportable Segment (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Dec. 31, 2022 | |
Goodwill [Roll Forward] | ||
Goodwill, beginning balance | $ 935,364 | |
Goodwill, ending balance | 935,319 | |
Accumulated impairment loss | 214,939 | $ 214,939 |
Connetics Communications, LLC | ||
Goodwill [Roll Forward] | ||
Goodwill adjustment | (45) | |
Goodwill, ending balance | 42,945 | |
Nurse and Allied Solutions | ||
Goodwill [Roll Forward] | ||
Goodwill, beginning balance | 382,005 | |
Goodwill, ending balance | 381,960 | |
Accumulated impairment loss | 154,444 | 154,444 |
Nurse and Allied Solutions | Connetics Communications, LLC | ||
Goodwill [Roll Forward] | ||
Goodwill adjustment | (45) | |
Physician and Leadership Solutions | ||
Goodwill [Roll Forward] | ||
Goodwill, beginning balance | 152,800 | |
Goodwill, ending balance | 152,800 | |
Accumulated impairment loss | 60,495 | 60,495 |
Physician and Leadership Solutions | Connetics Communications, LLC | ||
Goodwill [Roll Forward] | ||
Goodwill adjustment | 0 | |
Technology and Workforce Solutions | ||
Goodwill [Roll Forward] | ||
Goodwill, beginning balance | 400,559 | |
Goodwill, ending balance | 400,559 | |
Accumulated impairment loss | 0 | $ 0 |
Technology and Workforce Solutions | Connetics Communications, LLC | ||
Goodwill [Roll Forward] | ||
Goodwill adjustment | $ 0 |
Segment Information - Disaggreg
Segment Information - Disaggregation of Revenue (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Segment Reporting Information [Line Items] | ||
Revenue | $ 1,126,223 | $ 1,552,538 |
Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 824,480 | 1,228,039 |
Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 165,757 | 179,506 |
Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 135,986 | 144,993 |
Travel nurse staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 592,677 | 970,109 |
Travel nurse staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 592,677 | 970,109 |
Travel nurse staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Travel nurse staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Labor disruption services | ||
Segment Reporting Information [Line Items] | ||
Revenue | 5,702 | |
Labor disruption services | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 5,702 | |
Labor disruption services | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | |
Labor disruption services | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | |
Local staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 25,272 | 44,057 |
Local staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 25,272 | 44,057 |
Local staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Local staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Allied staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 196,125 | 213,873 |
Allied staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 196,125 | 213,873 |
Allied staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Allied staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Locum tenens staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 106,703 | 112,672 |
Locum tenens staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Locum tenens staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 106,703 | 112,672 |
Locum tenens staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Interim leadership staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 40,242 | 44,354 |
Interim leadership staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Interim leadership staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 40,242 | 44,354 |
Interim leadership staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Temporary staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 966,721 | 1,385,065 |
Temporary staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 819,776 | 1,228,039 |
Temporary staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 146,945 | 157,026 |
Temporary staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Permanent placement | ||
Segment Reporting Information [Line Items] | ||
Revenue | 23,516 | 22,480 |
Permanent placement | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 4,704 | 0 |
Permanent placement | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 18,812 | 22,480 |
Permanent placement | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Language services | ||
Segment Reporting Information [Line Items] | ||
Revenue | 61,676 | 49,238 |
Language services | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Language services | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Language services | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 61,676 | 49,238 |
Vendor management systems | ||
Segment Reporting Information [Line Items] | ||
Revenue | 54,173 | 75,022 |
Vendor management systems | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Vendor management systems | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Vendor management systems | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 54,173 | 75,022 |
Other technologies | ||
Segment Reporting Information [Line Items] | ||
Revenue | 7,347 | 7,658 |
Other technologies | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Other technologies | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Other technologies | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 7,347 | 7,658 |
Technology-enabled services | ||
Segment Reporting Information [Line Items] | ||
Revenue | 123,196 | 131,918 |
Technology-enabled services | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Technology-enabled services | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Technology-enabled services | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 123,196 | 131,918 |
Talent planning and acquisition | ||
Segment Reporting Information [Line Items] | ||
Revenue | 12,790 | 13,075 |
Talent planning and acquisition | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Talent planning and acquisition | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Talent planning and acquisition | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | $ 12,790 | $ 13,075 |
Notes Payable and Credit Agre_2
Notes Payable and Credit Agreement (Details) | Feb. 10, 2023 USD ($) |
Senior Credit Facility | Line of Credit | |
Debt Instrument [Line Items] | |
Maximum borrowing capacity | $ 750,000,000 |
Fair Value Measurement - Narrat
Fair Value Measurement - Narrative (Details) - USD ($) | 3 Months Ended | ||||
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | Oct. 20, 2020 | Aug. 13, 2020 | |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Asset impairment charges | $ 0 | $ 0 | |||
2027 Notes | Senior Notes | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Interest rate | 4.625% | ||||
2029 Notes | Senior Notes | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Interest rate | 4% | ||||
Fair Value, Measurements, Nonrecurring | Level 2 | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Equity investment balance | 19,204,000 | $ 19,204,000 | |||
Commercial paper | Fair Value, Measurements, Recurring | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Assets (liabilities) measured at fair value on a recurring basis | 37,600,000 | 31,536,000 | |||
Commercial paper | Fair Value, Measurements, Recurring | Level 2 | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Assets (liabilities) measured at fair value on a recurring basis | 37,600,000 | 31,536,000 | |||
Securities classified as available-for-sale | 0 | 0 | |||
Corporate bonds | Fair Value, Measurements, Recurring | Level 2 | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Assets (liabilities) measured at fair value on a recurring basis | 23,192,000 | 25,095,000 | |||
Securities classified as available-for-sale | $ 23,192,000 | $ 25,095,000 |
Fair Value Measurement - Financ
Fair Value Measurement - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Deferred compensation | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | $ (144,349) | $ (128,465) |
Deferred compensation | Level 1 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | (144,349) | (128,465) |
Deferred compensation | Level 2 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 0 | 0 |
Deferred compensation | Level 3 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 0 | 0 |
Acquisition contingent consideration liabilities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | (5,150) | (5,070) |
Acquisition contingent consideration liabilities | Level 1 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 0 | 0 |
Acquisition contingent consideration liabilities | Level 2 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 0 | 0 |
Acquisition contingent consideration liabilities | Level 3 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | (5,150) | (5,070) |
Money market funds | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 641 | 36,895 |
Money market funds | Level 1 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 641 | 36,895 |
Money market funds | Level 2 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 0 | 0 |
Money market funds | Level 3 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 0 | 0 |
Corporate bonds | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 23,192 | 25,095 |
Corporate bonds | Level 1 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 0 | 0 |
Corporate bonds | Level 2 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 23,192 | 25,095 |
Corporate bonds | Level 3 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 0 | 0 |
Commercial paper | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 37,600 | 31,536 |
Commercial paper | Level 1 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 0 | 0 |
Commercial paper | Level 2 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | 37,600 | 31,536 |
Commercial paper | Level 3 | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Assets (liabilities) measured at fair value on a recurring basis | $ 0 | $ 0 |
Fair Value Measurement - Fair V
Fair Value Measurement - Fair Value of Financial Instruments (Details) - Senior Notes - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
2027 Notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Carrying Amount | $ 500,000 | $ 500,000 |
Estimated Fair Value | 463,125 | 460,000 |
2029 Notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Carrying Amount | 350,000 | 350,000 |
Estimated Fair Value | $ 308,875 | $ 300,125 |
Commitments and Contingencies (
Commitments and Contingencies (Details) $ in Thousands | Mar. 31, 2023 USD ($) matter | Mar. 31, 2022 USD ($) |
Commitments and Contingencies [Line Items] | ||
Future undiscounted lease payments | $ 29,514 | |
Lease term | 11 years | |
Wage and Hour claims | Pending Litigation | ||
Commitments and Contingencies [Line Items] | ||
Litigation matters accrual | $ 46,225 | |
Number of legal matters | matter | 2 |
Balance Sheet Details (Details)
Balance Sheet Details (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Other current assets: | ||
Restricted cash and cash equivalents | $ 31,500 | $ 37,225 |
Income taxes receivable | 0 | 8,875 |
Other | 20,052 | 19,937 |
Other current assets | 51,552 | 66,037 |
Fixed assets: | ||
Furniture and equipment | 54,978 | 51,408 |
Software | 333,302 | 323,418 |
Leasehold improvements | 938 | 2,067 |
Fixed assets, gross | 389,218 | 376,893 |
Accumulated depreciation | (233,942) | (227,617) |
Fixed assets, net | 155,276 | 149,276 |
Other assets: | ||
Life insurance cash surrender value | 140,731 | 117,139 |
Operating lease right-of-use assets | 14,484 | 16,266 |
Other | 42,110 | 38,611 |
Other assets | 197,325 | 172,016 |
Accounts payable and accrued expenses: | ||
Trade accounts payable | 81,447 | 78,057 |
Subcontractor payable | 278,432 | 295,259 |
Accrued expenses | 82,337 | 73,885 |
Loss contingencies | 15,874 | 14,638 |
Professional liability reserve | 8,091 | 7,756 |
Other | 7,583 | 6,857 |
Accounts payable and accrued expenses | 473,764 | 476,452 |
Accrued compensation and benefits: | ||
Accrued payroll | 72,113 | 63,857 |
Accrued bonuses and commissions | 28,032 | 96,760 |
Workers compensation reserve | 12,394 | 12,113 |
Deferred compensation | 144,349 | 128,465 |
Other | 12,349 | 32,049 |
Accrued compensation and benefits | 269,237 | 333,244 |
Other current liabilities: | ||
Acquisition related liabilities | 5,150 | 5,070 |
Income taxes payable | 23,395 | 0 |
Client deposits | 7,463 | 21,466 |
Operating lease liabilities | 7,789 | 8,090 |
Deferred revenue | 13,876 | 11,825 |
Other | 2,927 | 1,786 |
Other current liabilities | 60,600 | 48,237 |
Other long-term liabilities: | ||
Workers compensation reserve | 22,756 | 23,841 |
Professional liability reserve | 38,153 | 36,214 |
Operating lease liabilities | 7,652 | 9,360 |
Other | 53,213 | 51,151 |
Other long-term liabilities | $ 121,774 | $ 120,566 |